State should pay to replace health workers it recruits – Robinson

Former president says ‘you can’t build health system if you don’t have health workers’

Ireland has one of the heaviest dependencies internationally on overseas staff in its health service, and recruits directly from developing countries in Asia and Africa. Photograph: Reuters

Ireland and other western countries which recruit health workers from the developing world should have to pay the cost of replacement staff in poor countries, according to former President Mary Robinson.

“You can’t build a health system if you don’t have health workers and the trouble is health workers are still migrating from countries with under-provision,” she told a conference in Dublin.

“There is still a tendency in the countries to which they go to think of individual health workers as gaining in income and not to think of depriving under-resourced countries of their health workers.”

Ireland has one of the heaviest dependencies internationally on overseas staff in its health service, and recruits directly from developing countries in Asia and Africa.

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Mrs Robinson said wealthy countries should pay for the education and training of at least one person for every health worker they recruited from poorer countries.

Speaking at the Princeton-Fung global forum on lessons learned from the Ebola crisis in west Africa, she criticised the lack of respect for human rights in Sierra Leone, Liberia and Guinea, the three countries worst affected by the outbreak.

Ebola shock

The protection of health workers was inadequate, there was a lack of understanding of the gender dimension of the issue and an overuse of quarantine measures, she said.

While the three states had weak health systems and were unable to withstand the shock caused by Ebola, their problems were compounded by fear and a lack of respect for human rights.

Aids pioneer and leading Ebola researcher Peter Piot called for the establishment of a global fund to incentivise the development of new vaccines against emerging infectious diseases.

Dr Piot said the key lessons learned from the west African Ebola epidemic since 2014 was the importance of acting promptly, the crucial role of leadership and the enormous difference that politics can make, positively and negatively.

The response to epidemics needs to be driven by the principles of science and human rights and needs to listen to the people affected. “We cannot accept a world where those who can’t afford to pay will die,” he told the conference.

He described the west African epidemic as a “perfect storm” that was completely different from previous outbreaks of the disease. This was the first time Ebola crossed borders, the first time it spread in a city and, positively, the first time research into vaccines took place during an epidemic.

Dr Piot said it was clear now that the virus can be sexually transmitted, and lives in male semen for up to nine months. The extent to which the 7,000 male survivors of the disease in west Africa were retransmitting the disease was unknown.

Paul Cullen

Paul Cullen

Paul Cullen is a former heath editor of The Irish Times.