Why Brain Drain Isn't Something We Should Worry About
What becomes of a country where all the educated people leave?
The majority of young people in sub-Saharan Africa want to leave their home countries. They have pretty understandable concerns about the places they live - and they want to go where there are good jobs, the government functions well, and where they can walk the streets without fear.
And the more educated they are, the more likely they are to be able to achieve their ambitions of leaving - and leave their home country for greener pastures. This is particularly true in the medical sector, where people have skills valued in almost every country.
In the seven years between 2011 and 2018, some 10% of doctors in Bhutan left the country for good. By 2017, 88% of Nigerian doctors were considering moving abroad. In the last decade, the number of doctors seeking to leave Turkey has increased a terrifying 70-fold (with no end in sight). What does the medical sector in these countries even look like in ten years?
Policymakers are certainly concerned about this; in 2010, the speaker of Parliament in Lebanon said brain drain was “the biggest problem we face”. In 2020, the WHO launched a program to stop rich countries from recruiting medical personnel from countries that desperately needed their doctors and nurses to stay at home. In 2023, Nigeria considered passing a law that would force all graduates from medical school to stay in the country for at least five years.
All of this policy concern is completely misplaced. Countries should encourage their skilled people to seek the best opportunities possible, even if it means leaving the country altogether.
Why? There are lots of ways that migrants contribute to their home country
Most obviously, many migrants send home money - perhaps 10-15% of what they earn. Since migrants can make 5-10x what they would at home, they can end up sending home as much as they would have earned if they hadn’t left - leaving both them and their families better off. Remittances pay for new homes, pay for more school for their kids, and let people get much needed medical care.1
In some cases, remittances power entire economies. About one in ten Hondurans and Kyrgyz people live abroad, but about a third of both economies is entirely remittances. It is hard to believe that Honduras or Kyrgyzstan would be better off if all those people returned home to far lower wages.
But policymakers don’t think remittances are good enough for migration to be worth it. If all the doctors in a country leave, the country will struggle no matter how much money those doctors send back; money is only good as far as you can purchase goods and services with it. And once all your doctors and nurses - and teachers and engineers and scientists - have gone, from whom will you purchase those services?
If the supply of doctors and nurses is fixed, this is a valid concern. In the real world, the supply of doctors isn’t fixed. When people have the option to earn qualifications in order to go abroad and earn more, they are much more likely to pursue those qualifications. When doctors can go abroad (and earn more), more people want to become doctors. Some of these additional doctors will end up leaving, but some will end up deciding not to.2
This is exactly what happened in the Philippines when US visa rules changed to make it easier to move there as a nurse. Many more Filipinos decided to train as nurses; new nursing colleges opened to accommodate the demand. Many of the newly trained nurses did end up moving, but not (even close to) the majority. Even after some left for the US, the Philippines ended up with considerably more nurses than they’d had before.
The same happened in the IT sector in India. Many people in India went to school and learned IT because they hoped to migrate to the US. But not all ended up getting visas to the US - and those that stayed behind helped start the Indian software boom. India did not end up worse off because people tried to migrate; instead, they ended up with more skilled people than ever before.
The logic makes sense. You’re probably more likely to enroll in a costly, time-consuming university course if you think you might move to another country and make more money than you’ve ever seen. But life happens; people get married, start families, and change their plans. Not everyone who thinks that they might want to go abroad will end up doing so.
Furthermore, many of those that do go abroad - almost 40% - eventually come home. In the interim, they’ve gained even more skills. Return migrants drive increases in productivity and are much more likely to start businesses and employ others upon return.
So policies to deter doctors from moving away from Nigeria are doing exactly the opposite thing that they’re intended to do. You might keep a few doctors from moving away, but far fewer Nigerians will want to become doctors. You might avoid brain drain - but you also avoid creating highly educated brains in the first place.
Instead, policymakers should accept that migration is a part of a globalized world. Developing countries do not lose out when highly educated people pursue opportunities around the world. Contra the Lebanese (and Nigerian and Turkish and Bhutanese…) government, brain drain isn’t a huge problem; indeed, it is… not actually a problem at all. International migration is a feature for developing countries; it’s not a bug.
The only people who don’t benefit from remittances may be autocrats - remittances may make the population less dependent on the current regime and more likely to push for electoral accountability.
That is, policy makers are considering this issue in partial equilibrium, but they should be thinking about the general equilibrium effects.
Really excited to see where this substack goes, but I have to start off with some disagreements! The remittances point is fine, as is return migration. But the literature on brain gain has always seemed pretty uncompelling.
The most obvious problem is that increasing the supply of skilled workers requires both increasing demand for education (which emigration possibilities do) and increasing the supply of education. The latter is _not_ a given in any country. Expanding college enrolment is _hard._ New colleges need staff, instructors, and administrators, all of which are scarce. Government colleges need to be established by a bureaucracy, private colleges need to be regulated and quality-controlled, both of which require a lot of governance capacity by the country. We can't just handwave the claim that if more people want to become doctors, more people can become doctors.
So I'm concerned that there's a site selection bias in the countries studied in this literature. People are writing papers about the countries that did manage to successfully pull off a large educational expansion, so they find that emigration boosted human capital. But for countries that can't pull it off, emigration really might be a brain drain.
How large could this site selection bias be? I pulled some data on college enrolment rates and emigration (net, not for any skill group) and compared India and the Philippines to the rest of them. (There was no data on Cabo Verde, the other country you cited.) Among the top 20 emigrant-sending developing countries, India had one of the highest increases in college enrolment (21 pp) between 1990 and 2015, while the Philippines was a bit above average (13 pp). As a specific contrasting example, Nigeria had only a 7 pp increase in college enrollment during this period. (data: https://github.com/karthiktadepalli1/emigration/blob/main/output/top20_emigrant_senders.csv, graph: https://github.com/karthiktadepalli1/emigration/blob/main/output/enrolment_growth_emigrators.png)
A similar picture emerges when comparing India and the Philippines to developing countries as a whole. India has close to the highest enrolment growth over this period, and the Philippines is still above average, while Nigeria is still below average. (https://github.com/karthiktadepalli1/emigration/blob/main/output/enrolment_distribution.png) So we should not expect Nigeria's brain gain to be anywhere close to that of India or the Philippines.
You could argue that India and the Philippines had higher growth _because_ emigration incentives increased the supply of education. But:
1. The emigration incentives studied by Khanna/Morales and Abarcar/Theoharides are not India-specific or Philippines-specific - this fact is necessary for their estimates to be causal! - so we shouldn't expect these countries to have larger increases in enrolment just from emigration incentives.
2. Even if emigration incentives have a causal effect on the supply of colleges that was for some reason higher in India and the Philippines, I would expect that effect to be small relative to other factors that make governments want to supply more colleges (domestic political projects, trying to attract foreign companies, trying to spur industrial growth). So heterogeneous effects of emigration incentives can't explain much of the difference between these two countries and other developing countries.
In general, I wish there was more nuance around the brain gain hypothesis. I would speculate it has such immediate acceptance because it resolves our conflicting commitments as cosmopolitans: we want people to be able to pursue a better life, we want high-income countries to have more open immigration policy, and we want low-income countries to grow faster. The brain gain hypothesis is alluring because it promises that we can have all of the above. But I think that relies on other things going right that absolutely don't have to go right. And I wish there was more acceptance of that nuance.
Although I agree with your headline points, the argument doesn't consider counter arguments - the potential negatives of immigration aren't properly explored. The only one dealt with is the staff replacement issue. These are 2 potential negatives that I think deserve consideration in this debate.
1. The best people leave, people that could be innovating, inspiring, leading and starting the best businesses that could grow the country. When you skim off the top 1%, you can "replace" them by training others, but you can't replace their natural brilliant traits that could have led them to transform their countries.
2. "Japa" Syndrome and social destabilisation. The "Japa" syndrome in Nigeria and other countries can destabilise the social milleu, slow institution building and potentially reduce individual wellbeing. When everyone is wanting o leave who then is committed building the country and its institutions? Who among young people is committed to improving their own country? Also all those left behind and wanting to leave will probably feel just alittle worse about their own life. This phenomenon has already been fairly well researched by social scientists, and its effect on both institutional growth and individual wellbeing and could be a significant negative to high emigration.
Anecdotally as well talking with Nigerians its a real negative vibe, and I'm happy this phenomenon hasn't yet reached Northern Uganda here!
I think its very fair to argue that remittances and other benefits might well overcome these negatives, but these should be deeply considered and thought through rather than either being quickly dismissed or ignored like they are here, and seem to be in most pro-immigration arguments. These are easier to ignore though because of measurability bias - they are harder to measure than people and money movement. The effect of immigration are more complicated than the common simplistic framings of people-out/people-in and money-in.
Also although I generally agree with much of the replacability argument, I disagree with the Nigerian doctor example. "You might keep a few doctors from moving away, but far fewer Nigerians will want to become doctors."
In Nigeria far more people want to be doctors than can be doctors. The limiting factor isn't aspiration, its training opportunities and your grades. Every year in most countries, thousands of people want to be doctors but can't. Even if the number of doctor places increase by 5x (which would be amazing) I don't think "Aspiration" would be a limiting factor. You could make the argument (like happened in the Phillipines) that training places will increase as a result of demand, but the aspiration argument doen't make sense to me.
Also the data doesn't (as far as I can see) doesn't seem to support this conclusion that we don't need to worry about doctors leaving. The WorldBank dataset (which I don't overly trust), the doctor per person ratio in Nigeria steadily increased from 1870 until 2008 and since then has plateued. There's a high chance that immigration is a core reason for that plateau, and even if there are other causes based on this data its hard to make the argument that immigration is helping Nigeria's doctor situation. Based on this, the reactionary policy of countries like Nigeria trying to keep more of their doctors at home may or may not be bad policy, but I wouldn't call it "completely misplaced."
https://data.worldbank.org/indicator/SH.MED.PHYS.ZS?end=2021&locations=NG&start=1960&view=chart
Also have signed up to your substack, looking forward to more :). I copy pasted this across from the EA forum because engagement seems to be here. Don't feel the need to reply to stuff you've already discussed on other threads!