The World Medical Association (WMA) has criticized a Brazilian decision to import about 4,000 Cuban physicians to work in underserviced parts of the country.
"The government claims it is filling places where no Brazilian physician would go," says the WMA, which represents the CMA and 100 other national medical associations on the international stage. "First reports, however, indicate that Brazilian physicians are now being laid off to be replaced by cheaper Cuban health workers."
Under Brazil's Mais Medicos (More Physicians) plan, the imported physicians are supposed to be sent to remote parts of the country. The World Health Organization says Brazil has 1.8 physicians per 1,000 people, while Cuba has 6.7/1,000. (Canada's ratio is 2.4/1,000, and the OECD average is 3.1/1,000.)
The WMA says the Cuban visitors do not receive a salary for their services, "but merely get pocket money, contrary to Brazilian labour rights and laws. In the case of Cuban health workers, the Brazilian government is paying the Cuban government [directly] for their services, and a small part will then be paid by the Cuban government to the workers....
"In the international press, this is already being quoted as 'modern slavery.'"
Dr. Mukesh Haikerwal, who chairs the WMA Council, says that if Brazil's government wants to help improve health care, "it should have increased its investment in the health system, which is low compared to other countries with universal public health systems." He also said the competencies of some of the imported workers "remain questionable."
Haikerwal says the importation issue is already on the agenda for the WMA's next General Assembly, which will be held in Brazil in October.
Dr. Jeff Blackmer, the CMA's director of ethics, said many WMA member associations are tracking the situation in Brazil.
"The WMA's argument is that the Brazilian approach may save money, but it does not ensure access to high quality care," said Blackmer. "This means the debate at the WMA's October General Assembly - which is really a sounding board for physicians from around the world - should be quite interesting."
See: WMA condemns way of importing physicians by Brazil government.