先日、「世界手洗いの日」に関する記事で、アフリカのギニアビサウで大規模なコレラが発生している事を記しましたが、ケニア、ナイジェリア、モザンビーク、ジンバブエなどでも広がりを見せているようです。

コレラ対策のグローバルな取り組みについては、WHOの「The Global Task Force on Cholera Control」を参照してください。

ロンドンのインペリアル・カレッジの研究によると、改善された新しく導入されたワクチンは、1型ポリオに対して有効でこれまでの4倍の効果があるそうです。New England Journal of Medicineに報告されています。

1型ポリオはナイジェリアで一般的なポリオなので、ワクチンの数が十分確保されて、効果的な戦略がとることによって大きな効果が期待されます。

参考までにWHOによる日本のポリオ根絶宣言は2000年です。

アンゴラでは、毎年、少なくとも140万から200万の下痢が報告され、その３分の１は５歳未満の子供です。（アンゴラの全人口は約1000万人）

世界手洗いの日にあわせて発表されたUNICEFの報告によると幼児死亡の47％は劣悪な衛生環境が原因であるとされています。

ドバイを本拠地とする不動産会社 RUWAAD が南アフリカ共和国東部の都市ダーバンにアフリカ最大にして世界最高級のテーマパークの建設を予定しています。

2010年のサッカーワールドカップ南アフリカ大会を見越してのことですが、建設は今後25年間のフェーズが通して行われます。

パーク内には教育と保健関連施設（ビレッジ）予定されているとのこと。

進むアフリカの海外直接投資。

今年初めには、Googleが本格的にアフリカ大陸に進出。先日は、アフリカの中小企業向けのサービスとしてGoogle Appsも始めました。

アフリカが本格的に「開発の場」となっていきます。 もう援助の対象とばかり考えているのは誤った認識です。当然のことですが、アフリカにも「光と影」の両側面があります。

経済成長にわく国・地域、一方、貧富の差を生みやすい社会構造を温存したまま、また植民地時代の土地問題を抱えたままの国も多々あります。今後、経済開発と社会開発を如何にバランスよく両立していくか、その中で日本人が果たせる役割は何なのか、自分はどう関わっていくのか。

今後のアフリカの動向からますます目が離せません。

今年から10月15日（水）は「世界手洗いの日（Global Handwashing Day）」と決められました。

今年2008年は、国連衛生年（UN International Year of Sanitation）でもあり、衛生環境の改善に最も重要な方法のひとつとされている手洗いを奨励していこう、というもので、ユニセフ, CDC、UNAID、世界銀行などの国際機関、そしてユニリーバやP&Gといった民間企業がスポンサーとなっています。

ちょうどこの時期、西アフリカのギニアビサウではコレラが大規模に発生していて（現地は雨期にあたります）、その原因のひとつに、住民の間に手洗いをすることによって水を介して伝染病がうつると信じられているからではないかと言われています。

これは、水道や下水設備が整っている場所ではない地域で、手洗いはたらいに入った水を複数人で共有せざるをえず、考えられていることだと思います。

自分も現地駐在の時、友人宅に招かれたり外食をする時に、そこの家族と同じ水で手を洗って食事をした経験が何度もありますし、学校建設の支援プロジェクトでトイレを使った後の手荒い指導を活動内容に入れて取り組んできましたので、その背景はよく理解できます。

食事をする時、たらいに注がれた水と石鹸が回ってきて、その限られて水で手をぬらし、石鹸をつけ、石鹸の泡を取ります。当然、たらいの中には石鹸で濁った水が残ります。その同じ水をそこにいる人たちが順番に使っていくのです。

自分の場合は男性であり（ジェンダー的要素がまだまだ強い地域もあります）、友人宅に招かれている立場であったりするので、たらいに注がれた水を最初に使うように促されますが、その同じ水を使って最後の方に手洗いをするのは女性であったり、子どもであったりと社会的弱者になってしまうのです。

手洗いのように日常生活に根ざした習慣のようなものほど、行動変容を妨げる様々な社会文化的要因があります。

このように運動化して、国や地域の政治・政策の意思決定者や保健関係者に手洗い活動に取り組みやすい環境を作るのは大切なことだと思います。

アフリカのブレイン・ドレイン（頭脳流出）問題（３）その処方箋

■ ブレイン・ドレイン問題への対応策

・先進国が途上国から人材を奪わないように国際取り決めを行う。

Another strategy is the adoption of international agreements by industrial and developing nations under which wealthy countries pledge not to recruit skilled people from developing states. However, the two most popular strategies involve transferring skills through networks of professionals and intellectuals and the time-tested approach of repatriation.

Mutume G. (2003) Reversing Africa's 'brain drain' New initiatives tap skills of African expatriates Africa Recovery, Vol.17 No. 2 (July 2003)

■ 取り組み事例

・海外に住んでいるアフリカ人は政治経済的に不安定な母国に帰ってきたくない。そこで、海外にいながら彼らの知識をネットワークで結んで活用しようという動きがある。南アの例：South African Network of Skills Abroad (SANSA)

Because many people are reluctant to return to politically or economically unstable countries, some countries are now trying to find other ways to tap the knowledge and skills of their professionals based overseas. This approach is popular because it does not require participants to relocate to their home countries.

The South African Network of Skills Abroad (SANSA) is an example. Through its website, it invites professional South Africans to sign up. It reports that at least 22,000 graduates from five major South African universities resident abroad remain in touch with the universities. SANSA estimates that about 60 per cent of the country's expatriate graduates are located in six countries, with Australia, the UK and the US accounting for more than half of them. Looking at the nature of their skills, the group estimates that about 30 per cent of the University of Cape Town's contactable doctoral graduates are living overseas. They comprise significant proportions of the university's graduates in medicine, commerce, education and engineering, all areas in which South Africa has an acute shortage of skills.

・もう一つのプログラムとしては、海外にいるアフリカ人を母国に再派遣するというプログラム。しかし、彼らは家族全員本国への送還を望んだり、多額の金額を給与として望む場合がある。それに対するケニアの例：Kenya-based Research and Development Forum for Science-Led Development in Africa (RANDFORUM)

Other programmes to counter the brain drain involve the physical relocation of expatriate Africans either to their home countries or elsewhere on the continent. A major limitation, however, is that such operations require large sums of money. Some expatriates may wish to be repatriated with their entire families. Others may request salaries comparable to what they earn in their host countries, along with up-to-date technological resources. Another limitation is that repatriation only allows for the return of the individual expatriate and not the knowledge networks to which he or she may belong.

Despite such challenges, the Kenya-based Research and Development Forum for Science-Led Development in Africa (RANDFORUM) has been exploring ways to repatriate African professionals and intellectuals, as requested in 1999 by the Presidential Forum on the Management of Science and Technology in Africa, a grouping of African heads of state. That year, a taskforce led by a former Zambian president, Mr. Kenneth Kaunda, recommended that RANDFORUM and its sister organization, the African Foundation for Research and Development, identify overseas-based Africans interested in returning home to offer their skills. Another RANDFORUM project aims to relocate professionals from "distressed countries" -- those that are faltering economically or politically, such as Liberia or Somalia -- to where they can be productive. Rather than confine professionals and intellectuals from such countries to refugee camps, they are utilized elsewhere and returned once the situation in their countries normalizes.

Mutume G. (2003) Reversing Africa's 'brain drain' New initiatives tap skills of African expatriates Africa Recovery, Vol.17 No. 2 (July 2003)

■ 今後の取り組み・イニシアティブ

・ナイジェリアのオブサンジェ大統領はこの問題を活発に指導してきた。NEPADでブレイン・ドレインについて触れ、「ブレインドレインを防ぐためのインセンティブづくりのために政治社会、経済的な状況を整えないといけない」と述べている。

Nigerian President Olusegun Obasanjo is one of the leaders actively attempting to address the challenges of the brain drain. On his trips abroad, President Obasanjo often meets professionals and intellectuals who have left Nigeria to ask them how they can contribute to their country's development. President Obasanjo also is one of the architects of the continent's new development framework, the New Partnership for Africa's Development (NEPAD).

The New Partnership calls for the establishment of a reliable, continental database to determine the magnitude of the problem and promote collaboration between Africans abroad and those at home. An important NEPAD priority is to develop Africa's human resources and reverse the brain drain. Under NEPAD, African leaders explicitly call for the creation of the "necessary political, social and economic conditions that would serve as incentives to curb the brain drain...." (NEPAD P.30:122.Actions)

・海外からの先進国政府に途上国からの人材移入に対する政策を見直すように働きかけないといけない。しかし、このグローバリゼーションの流れの中で人の動きを制限する事が国の政策でどこまで可能なのか非常に難しくなってきている。

It says that the international community needs to put pressure on developed nations to modify existing policies on the immigration of professionals from developing countries. However, it may become even tougher to stem the outward flow of skilled professionals from developing countries in future. With falling birth rates and aging populations, demand for labour in Northern countries is forecast to grow, as younger people are needed to maintain productivity. In poorer countries, millions will continue to seek opportunities in richer countries to find better paying jobs and raise their standards of living. And in a globalizing world, where the dominant economic paradigm promotes the free movement of capital, it will become increasingly difficult to restrict the free movement of skilled labour.

Mutume G. (2003) Reversing Africa's 'brain drain' New initiatives tap skills of African expatriates Africa Recovery, Vol.17 No. 2 (July 2003)

・ペーパーの総括としては、アフリカは政治的抑圧を止め、個人の機会拡大に努める事が必要であるということ。

Our broad conclusion is that, ultimately, Africans will only stop leaving when political repression ends and personal opportunities improve on the continent.

・ダイアスポラの問題とその解決策について再定義しなければならない。歴史的にアフリカの指導者は、このブレイン・ドレイン問題を単に賃金格差が引き起こすものとし、市場の力の前では解決は不可能と考えていた。

Redefining the problems and the solutions

Historically, African leaders have tended to frame the brain-drain problem as a simple consequence of higher wages abroad. That conception led many states to conclude that solutions were impossible, given the power of market forces.

・しかし、このペシミズムを捨て去りより建設的な解決策を探ろうとする動きがある。なぜなら、アジアでも同様の問題を何とか解決したのだから。

But a growing number of African leaders and organisations are shrugging off the pessimism and seeking creative solutions to harness the intellectual and financial strength of the diaspora –something the Asians have already discovered.

・中国の例：

・1970年代に欧米に学生を留学させる門戸を開いてからブレイン・ドレインの問題は深刻であった。232,000人が1997年までに留学し、その32％しか自国に帰国しなかった。

・しかし、学生が時刻に戻るためのインセンティブづくりと経済の自由化が、彼らの海外での経験や富、そして新しいノウハウを社会にもたらした。特に科学技術のレベルを底上げした。

Since it began opening to the West and sending college students abroad in the 1970s, China has had its own brain-drain problem. Of the 232,000 students who went to universities overseas until the end of 1997, only 32% returned, according to David Zweig, of the Hong Kong University of Science and Technology and Stan Rosen of the University of Southern California, who are collaborating on a study of the return of the Chinese diaspora.

However, incentives to returning scholars and economic liberalisation have brought back a wealth of experience and know-how. Zweig and Rosen wrote recently in Sci-Dev.net that out of ’65 returners interviewed in high-tech zones n Hangzhou, Guangzhou and Wuhan, early half had imported technology of which 71% was state-of-the-art while another 23% was new for China. Also, 23% had imported foreign capital, while 28% maintained overseas contacts on a daily basis. In-depth interviews reveal that these returners are raising the technological level of China’s domestic economy.’

・ダイアスポラのポジティブな側面：

１）進んだ知識の流入。途上国にとっては、自国の人材が出て行くという事実と同時に、様々な形態で外国から人材が進んだ知識を持って流入してきており、失うより得るほうが多い場合もあるので、「ブレイン・ドレイン」という概念自体やめたほうがいい。

‘The West does not pay for the contribution of Aryabhatta (the great Indian mathematician) either. But let us concede that the overwhelming flow of free knowledge is from the rich to poor countries. Yes, we export free brainpower in the form of engineers. And yes, we enjoy a huge import of free brain power in a multitude of forms. On balance, we get far more than we supply. So, I think we need to abandon the concept of a brain drain.

２）人、物、金がグローバルに流動している中で、ダイアスポラを人的交流ネットワークとして活用していこうという動き。エジプトではダイアスポラを海外に留めておいて、知識の交換や民間外交間としての役目も期待している。

But we can indeed talk of flows of brainpower, of global flows of innovations, ideas and creativity.’ Similarly, African policymakers have begun to look upon the diaspora as a human network through which new ideas, capital and technology flow back to the continent. Damtew Teferra, a lecturer and researcher on the diaspora at the Centre for International Higher Education in Boston, United States, notes: ‘Egypt … considers its diaspora as its treasures kept abroad. It is vital to affirm that these unclaimed treasures can potentially serve as another window to the industrialised world, as another bridge in knowledge transmission and exchange, and as another catalyst in fostering knowledge creation and utilisation. It is apt to remark, therefore, that the diaspora is a vital and influential community of “undercover” ambassadors – of their home countries and regions – without formally designated portfolio.’

・アフリカの「ブレイン・ドレイン問題」の話では、医者や教授、エンジニア等の流出問題として語られる事が多いが、未熟技術者も海外に移住する問題がある。自国に明確なキャリアパスがないからである。しかし、彼らも海外でマネジメント経験などの技術を身につけて、アフリカのビジネスに貢献をすると考えられる。

While Africa’s ‘brain drain’ debate has focused heavily on the loss of doctors and other top professionals, scores of students and unskilled Africans have also emigrated and – because they had no preconceived career paths – have gained management experience and other skills in a wide variety of industries. Many of these people have returned with valuable new ideas and practices that improve the effectiveness of African business.

South African Institute of International Affaires (SAIA) (2003) The African Diaspora, e-Africa (Electric Journal of Governance and Innovation, September 2003)

■ HIV/AIDSの影響

Al-Samarrai S. and Bennell P. (2003) Where has all the education gone in Africa? Employment outcomes among secondary school and university leavers, Institute of Development Studies

・DIFDの資金援助による調査。マラウイ、タンザニア、ウガンダそしてジンバブエにおける5,000人を超える中高等学校、大学の卒業生を対象とした調査。

A large DFID-funded research project has used tracer survey methodology to generate time-series information on the working lives of over 5000 secondary school-leavers and university graduates in Malawi, Tanzania, Uganda, and Zimbabwe. The synthesis report entitled ‘Where has all the education gone in Africa?’ summarises the employment and training outcomes among these two groups. It highlights the enormous investments that individuals make in their education and the how the labour market opportunities for these individuals have been changing. The research findings dispel the common assertions that graduate unemployment in Africa is rising, that graduates are under-employed and not using acquired skills that female graduates are particularly disadvantaged, and that huge numbers of graduates emigrate.

・HIV/AIDSがマラウイ,ウガンダの卒業生に壊滅的な影響を与えている。1980年に卒業した4分の1（マラウイ）、3分の1（ウガンダ）は既に死亡。

They also show that: •The HIV/AIDS epidemic is having a devastating impact on the educated – a quarter of Malawians and a third of Ugandans who graduated from university in 1980 have died. Mortality is higher among secondary school-leavers although mortality appears to be on the decline.

•Nearly all of the university graduates interviewed are in training-related wage employment – the incidence of unemployment is very low.

•The incidence of wage employment is considerably lower among secondary school-leavers: of those who quit school in 1990 without reaching upper secondary, only around half are in wage employment in Tanzania, Uganda and Zimbabwe.

・調査は、UPEへの過重な負担が中等教育以上の人材育成において深刻な府の影響を与えていることを指摘。

The research team warns that the attainment of universal primary education at the expense of secondary and higher education would have serious consequences for human resource development. They recommend that policy-makers:

•pay more attention to ensuring that secondary and tertiary graduates are better prepared for productive self-employment: provision of basic pre-vocational demand-driven training in business and management and information technology is vital

Al-Samarrai S. and Bennell P. (2003) Where has all the education gone in Africa? Employment outcomes among secondary school and university leavers, Institute of Development Studies

■ これまでの取り組み・政策方針・批判

・近年までアフリカ政府はこのブレイン・ドレインの問題に大きな関心を払っていなかった。海外からの専門家と国を捨てる人間に対する非愛国主義者というレッテル。

Until recently, African governments had expressed little concern about the loss of skilled people, while development lending agencies often compounded the problem by obliging recipient countries to hire foreign expatriates, as part of the conditions attached to those loans. Moreover, politicians often portrayed countrymen who opted to work and live abroad as unpatriotic. But the sharp rise in skilled emigration and the serious human resource constraints facing the continent have forced many to rethink their views.

Mutume G. (2003) Reversing Africa's 'brain drain' New initiatives tap skills of African expatriates Africa Recovery, Vol.17 No.2 (July 2003)

・海外にいるアフリカ人は、本国の援助依存心を強めることになるという考えから、ドナーの介入政策を快く思っていない。

Sometimes, trained professionals are frustrated by donor policies that have the unintended effect of over-emphasizing reliance on foreign technical experts at the expense of trained nationals. In a 1993 report on the effectiveness of technical cooperation, UNDP noted growing concern among African development experts about the persistent reliance on expatriate technical personnel decades after independence and despite major efforts to train nationals. In Burkina Faso, UNDP noted, 800 foreigners with university degrees were employed in the country in 1990, while an equivalent number of Burkinabè nationals with university degrees were jobless. African governments and donors are at times "too quick to bring outside expertise without exploring the capabilities available at home or that could be attracted to return," UNDP reported.

・アフリカがダイアスポラに財政的に大きく依存している。彼らによる海外送金。それが、自国の通貨の暴落を抑えている。

One of the most startling facts about the diaspora is just how much Africa depends on it financially. Although the continent spends much time courting foreign investment by multinational companies, remittances from the diaspora represent a far larger source of funds for many African countries and have played a major role in stabilising collapsing currencies.

NEPAD (2001) The Newpartnership for Africa's Development (NEPAD)

■ ブレイン・ドレインの規模

・IOMの統計：1960年から75年の間は、27,000人、75－84年は40,000人、90年以降は少なくとも20,000人のアフリカ人が毎年アフリカ大陸から工業国（先進国）に移住している。

The UN Economic Commission for Africa and the International Organization for Migration (IOM) estimate that 27,000 Africans left the continent for industrialized countries between 1960 and 1975. During the period 1975 to 1984, the figure rose to 40,000. It is estimated that since 1990 at least 20,000 people leave the continent annually.

Mutume G. (2003)　Reversing Africa's 'brain drain' New initiatives tap skills of African expatriates, Africa Recovery, Vol.17 No.2 (July 2003)

・このギャップを埋めるために毎年40億ドルの非アフリカ人専門家（約10万人）を雇うための資金が必要。

・アフリカ全体にいるエンジニアの数よりもアメリカにいるアフリカ人エンジニアの方が多い。最も被害を受けているのは保健分野。ザンビアで教育を受けた医者の75％は海外に移住している。

The phenomenon "is putting a huge strain on the continent," notes IOM Deputy Director-General Ndioro Ndiaye. To fill the gap created by the skills shortage, African countries spend an estimated $4 bn annually to employ about 100,000 non-African expatriates. "It is high time programmes and policies are put in place to reverse the devastating effects of the brain drain," she says.

Experts on the continent are increasingly engaged in strategies and programmes to reverse the brain drain or retain skilled professionals at home. They include restrictive policies aimed at delaying emigration, such as adding extra years to medical students' training. Various tax proposals have been put forward as governments realize that the large numbers of citizens living outside their borders are a potential economic resource. Proposals range from one-time exit taxes to bilateral tax arrangements, which would require the receiving nation to tax citizens of another and remunerate the home country.

More African scientists and engineers are now working in the US than in all of Africa. At the same time, more non-African professionals are working in Africa than in the 1960s. The most damaging emigration affects health care; 75% of the doctors trained in Zambia have emigrated, for example.

South African Institute of International Affaires (2003) The African Diaspora, e-Africa (Electric Journal of Governance and Innovation, September 2003

■ ブレイン・ドレインの問題点

Emeagwali P. (2002) Brain Drain, Education in Africa interview of Emeagwali

Emeagwali P. (2002) Can Africa Leapfrog into the super-information age?, A Keynote Speech at the African Week, Bowling Green State University, OH, Friday April 12, 2002

・ブレイン・ドレインは社会における中間層（医者、エンジニア、その他の専門職）を形成する障害となっている。

・アフリカには二つの大きな層がある。職がなく貧困にあえぐ大多数と少数の豊裕層。それは、軍と政府の役人によって腐敗されている。

Brain drain makes it difficult to create a middle class consisting of doctors, engineers and other professionals. We have a two class African society: a massive underclass that is largely unemployed and very poor people and a few very rich people that are mostly corrupt military and government officials.

・ブレイン・ドレインは貧弱なリーダーシップと腐敗を助長してしまう。

Brain drain gives rise to poor leadership and corruption. A large educated middle class will ensure that political power is transferred by ballots instead of by bullets. When the medical doctors emigrate to the United States, the poor are forced to seek medical treatment from traditional healers while the elite fly to London for their routine medical checkups.

It is the best and brightest that can emigrate, leaving behind the weak and less imaginative. It means a slow death for Africa.

We cannot achieve long-term economic growth by exporting our natural resources. In the new world order, economic growth is driven by people with knowledge. We talk a lot of poverty alleviation in Africa. But who is going to alleviate the poverty? It is most talented that should lead the people, create wealth and eradicate poverty and corruption.

・中間層の絶対的は不足が疫病的な政府の腐敗と軍によるクーデターを助長している。または防ぎきれない要因となっている。

The professionals that are emigrating out of Africa include those with technical expertise, entrepreneurial and managerial skills. Their absence increases the endemic corruption and makes it easier for the military to overthrow a democratically elected government.

今月３日からウガンダの首都カンパラで、WHOによる保健分野における人材に関するグローバル・フォーラム（Global Forum on Humna Resource for Health）が開催されています。

そこでの主要課題の一つが、医療従事者の人材不足。

Uganda: Over 500 Doctors Work Abroad

New Vision (Kampala)　3 March 2008　Posted to the web 4 March 2008

Africa: Continent Worst Affected By Shortage of Health Workers

UN Integrated Regional Information Networks 4 March 2008 Posted to the web 4 March 2008

アジアのどこかの国も同じで、全く他人ごとではありません。

もちろん、アフリカの人材不足はその規模と深刻さがぜんぜん違います。

医療従事者を含む理工系の人材流出問題（ブレイン・ドレイン）は、アフリカ各国の健全な国家開発を阻害している大きな要因の一つと言われています。

先のフォーラムの記事を読み、ブレイン・ドレインについて３年ほど前に記事をまとめたことを思い出したので、簡単に箇条書きの形で整理してみます。今の研究テーマ、「キャパシティ・ディベロップメント」とも関連しているのです。

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