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BMJ 2008; 336 doi: 10.1136/bmj.39500.453206.80 (Published 28 February 2008)
Cite this as: BMJ 2008;336:472

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Poaching health workers from Africa is an international crime

Lancet 2008;371:685-8
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Developed countries that actively recruit health workers from Africa are violating the human rights of African people by leaving them with pitiful numbers of doctors, nurses, and pharmacists to administer desperately needed health care, says a team of experts. The situation is now so serious that systematic recruitment contributing to the brain drain should be viewed as an international crime. Sub-Saharan Africa has only one doctor for every 8000 people. In the worst affected areas, such as Malawi, that ratio is down to 1:50 000. If migration continues unchecked, the number of doctors available to treat HIV will have halved by 2012, they write.

Nigeria already loses a third of its medical graduates to developed countries such as the UK, US, and Canada. Many countries lose more nurses and pharmacists each year than they train, as profit making recruitment agencies offer legal assistance, moving expenses, and jobs with guaranteed income abroad. International declarations agree that this kind of recruitment is wrong, but developed countries continue to profit from the skills of health workers trained at great expense by the poorest countries. The consequences for the people of sub-Saharan Africa are dire, say the experts. Active recruitment must stop now and rich countries must be forced to pay poor countries for the health workers they have lost.

Aprotinin linked to excess deaths again

N Engl J Med2008;358:771-83
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N Engl J Med2008;358:784-93
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Aprotinin is an antifibrinolytic agent used to limit bleeding during cardiac surgery. The manufacturers temporarily suspended marketing late last year, when researchers reported excess deaths associated with this popular drug. Two further studies have now been published, and both showed increased mortality associated with the use of aprotinin during coronary artery bypass surgery⇑.

Together, these observational studies included data from nearly 90 000 US adults who had either aprotinin, aminocaproic acid, or no antifibrinolytic …

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