In a small African country, a young woman who recently graduated in nursing from a European university hesitates. The diploma is in the suitcase, the European visa too. In his hometown, the central hospital has one doctor for every five thousand inhabitants and would give him a salary of around 250 euros per month, irregular in payment, with an employment relationship dependent on the political and personal sympathies of its director. In a European capital, they offer you a work contract, a decent salary, the possibility of paying rent and starting a family. Choose Europe. And who can blame her?
The dilemma of Education in developing countries is rarely discussed with the necessary frontality. We train, locally or abroad, qualified young people who, once equipped with skills and diplomas, find emigration the only way to professional and personal fulfillment. And they have the absolute right to both. Each engineer, each doctor, each nurse who leaves represents simultaneously an individual success and a collective failure.
The World Health Organization estimates that Sub-Saharan Africa will have a shortage of 5.3 million healthcare professionals in 2030. From Ghana alone, 500 nurses leave each month for the West. The United Kingdom currently employs more Ghanaian nurses than Ghana itself. In Nigeria, there is one doctor for every five thousand inhabitants – eight times worse than the World Health Organization recommendation – while thousands of Nigerian doctors work in the British National Health Service (NHS): 25% of NHS workers are Nigerians. A recent study by UNCTAD estimates that brain drain costs the African continent around four billion dollars annually.
The causes are known and repeated ad nauseam: chronic political instability, fragile or non-existent economies, impossible salaries, lack of healthcare, social protection and education that allow for a family to be raised with some security. The average salary of a doctor can be seven to nine thousand dollars per month in North America; in many West African countries, the same professional will be paid $400 to $600.
The paradox is evident to international donors and countries engaged in development cooperation. Investing in training is fundamental and no one seriously argues otherwise. But investing massively in Education, without there being minimum conditions for retention, could be equivalent to simply financing the flight of staff that perpetuates dependence. As an African academic recently wrote, the continent has become the world’s most generous donor: it exports what is scarce and imports what is expensive.
Some tracks have been rehearsed. Gabon announced that it will no longer grant scholarships for studies in France, the United States or Canada from 2026. Nigeria has suspended academic exchange programs. Other countries experiment with conditional scholarships, with contracts that require people to return and work in the public sector for a set period. The diaspora is mobilized through knowledge transfer programs, allowing remote contributions without requiring permanent return.
Honesty also forces us to recognize another dimension, which does not allow the incentives in question to be changed. Europe is aging and needs qualified labor. Germany will need almost 300,000 new foreign workers per year until 2040 just to maintain its current workforce. There is a latent hypocrisy in lamenting African emigration while benefiting from it, in financing the training of cadres who are then actively recruited.
There are no simple solutions, but international cooperation cannot continue to artificially separate Education, governance, Health and Economy, into endless vicious circles. Training staff to appease consciences without simultaneously contributing, in a real way, to institutional stability and local economic growth is only feeding this dysfunction.
Without fear of neocolonial accusations. Sustainable development requires that receiving countries assume greater responsibilities, financing not only training, but also the conditions that make return a viable option and not a sacrifice. Respecting that, in between, there are always people’s lives, based on their circumstances, who dream and decide today and not in an ideal future. And they must do so with freedom – even knowing that lack of hope and short-term pressure are the greatest enemies of development.
Professor at the Faculty of Law of the University of Lisbon
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