THE shortage of Australian-trained doctors and nurses is well documented. More than 10% of our medical workforce is made up of foreign-trained doctors, mostly from Asia. At a time when the Government has committed to further strengthen health services for Aborigines, many of whom live in remote corners of the Northern Territory, this raises significant ethical issues. Where will these health professionals come from? Can we continue, with a clear conscience, to recruit trained doctors, nurses and midwives from the countries that need them more than we do?

At this week's G8 meeting in Japan, leaders of the most powerful nations of the world were joined by leaders from poorer African and Asian countries, including the Prime Minister of India. These countries have all been affected by migration of doctors and nurses who have helped prop up the Western world's health systems.

As well as meeting Australia's shortfall, India continues to supply much of the foreign-trained medical workforce recruited by Britain and the United States, where 30% and 20% respectively of that workforce is recruited from Asia and Africa.

The World Health Organisation estimates that the global shortfall of health workers is a staggering 4.3 million. It is no wonder that without enough doctors and nurses the poorest countries remain the sickest. This crisis is most apparent in the countries of sub-Saharan Africa and South Asia. Our continued failure to find local solutions to the health workforce needs of Australia sadly contributes to sustained poverty and illness in Africa and Asia, where the situation is far worse than that experienced in our rural and remote settings.

Recognising that the poorest countries are home to 4% of the global health workforce but experience 25% of the global burden of disease, WHO two years ago called on all nations to marshal resources to deal with this shortfall. India, for example, has recently responded and is setting up new public health institutes that will increase the meagre annual output of 400 public health graduates a year to 10,000 a year within the next 10 years. Continued...