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esearch has focused on what is termed “brain drain.” It emphasizes how the
globalization of the world economy is shaping the patterns of global health, and has
generated an uneven distribution of the costs and benefits depending on the direction of
the migration flux. The host countries benefit from (i) a short term relief of labor
shortages, (ii) an added value in terms of R&D, (iii) more tax and social security
revenues and (iv) an increased competitiveness. The sending country on the other,
registers (i) a loss in its medical staff, (ii) a loss on the return to investment in education,
(iii) a loss in tax and social security revenues, (iv) higher salaries in the medical sector
and overall, a deeper poverty. The other strand of research has been shaped by a more
active view on immigration. Under the umbrella of the World health system, this strand
builds on the cooperative framework and coalition to advocate that immigration can
benefit both the sending and the receiving countries. This is mainly based on the
theoretical contributions from the new economics of skilled labor migration.
III.1.1 Globalization and Health: A diverse web of linkages
The pathways from globalization to health have been assessed in conceptual frameworks
by a multitude of authors and frameworks. One strand of this research focuses on the
impact of globalization of population health, for example, Woodward et al., (2001),
Labonte and Togerson (2003), Labonte et al., (2007) and Huynen et al. (2005). For a
selective critique of some of the most cited frameworks, see Labonte and Torgerson
(2003). Another strand, centers on establishing the impact of globalization on the social
determinants of health (for example, Lee et al. (2007).
Woodward et al. (2001) identify five factors that map the links from globalization to
population health. Three of these factors are direct and the two others operate in an
indirect way as illustrated in figure III.1.1. The direct effects comprise effects of
international organization such as the WTO and the General Agreement on Trade in
Services (GATS), for example, on national health systems and policies, especially
through price setting. Another direct effect resides in the cross border transmission of
disease threats and the marketing of a life style such as smoking, for example. The two
indirect effects are vehicled mainly through economic channels (Labonte and Torgerson,
2003). Lee (2004) links globalization to health via three channels. First, globalization has
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