WMA president highlights inequality of global healthcare

The total inequality of healthcare delivery around the world has been highlighted by the President of the World Medical Association, Dr. Cecil Wilson.

Speaking at the All Nepal Medical Conference in Kathmandu, Dr. Wilson said that globally there is no uniformity. Some countries have systems of care for the population, others do not.

Of the approximately 200 countries in the world, only the 40 economically developed countries have organized healthcare systems. Because of this the majority of people worldwide never see a doctor in their whole life.

Dr. Wilson said that the rich countries in the world meet some of their need for health professionals by recruiting them from poorer countries. In large areas of Africa, Asia and parts of rural South America the availability of healthcare workers does not match the size of the population.

Judged by the global burden of disease in different continental regions, Africa with a large amount of the disease burden, 25 per cent, has less than five per cent of the global workforce and healthcare expenditures are miniscule. At the other end, the Americas with only 10 per cent of the disease burden have 38 per cent of the global workforce and spend a lot on healthcare.

When it comes to the percentage of physicians in economically developed countries who are trained abroad, 34 per cent of New Zealand physicians, 32 per cent of physicians in Great Britain and 28 per cent of physicians practicing in the US were trained abroad. But South Africa has 38 per cent of its physicians working abroad, Ghana 29 per cent, Angola 19 per cent and Nigeria 12 per cent.

'All of these are countries in which the disease burden is high and healthcare workforce inadequate', said Dr. Wilson. 'In short, countries least able to afford this brain drain.'

He said the major focus worldwide now is in trying to control escalating costs, a problem regardless of the type system in place. Countries without organized healthcare systems are looking at how to achieve universal care for all their citizens. Whether one model works for a particular country depends on its goals and values. In other words there is no evidence that one model is better than another.