According to a study published in the British Medical Journal in November 2011, nine sub-Saharan countries (Ethiopia, Kenya, Malawi, Nigeria, South Africa, Tanzania, Uganda, Zambia and Zimbabwe) invested some $2 billion in costs of educating doctors who subsequently emigrated to the United States, United Kingdom, Australia, or Canada.

The receiving countries gained an estimated $4.55 billion from these investments, in savings from medical education that they did not have to finance. The familiar phenomenon of "brain drain," it is clear, should also be seen as a subsidy from developing to developed countries.

This AfricaFocus Bulletin contains excerpts from this new study published in the British Medical Journal, providing quantitative estimates of the losses to nine sub-Saharan African countries (and associated gains to recipient countries) from the emigration of doctors to the United States, United Kingdom, Canada, and Australia, reaching a cumulative total of at least $2 billion. This raises the question of how to compensate the countries who provided these doctors for their de facto subsidies to the countries receiving these skilled workers.