Transnational physician migration has concerned states' health and migration policies for many years. Recent developments have increased attention to the outcomes of these flows in the global south, where physician emigration is undermining public health policies. Cuba's exporting of medical professionals presents an alternative dynamic, based upon both an ideology of humanitarian solidarity and a need to secure hard currency earnings. The benefits and challenges arising from a bilateral agreement between Cuba and South Africa to supply Cuban doctors to South Africa and training at the Latin American Medical School (ELAM) for South African medical students are addressed. The benefits of skills enhancement and professional development are noted, as well as the economic benefits for both the Cuban government and individual doctors, while concerns with the appropriateness of the medical training provided at ELAM for the South African health context and the sustainability of the current policy are discussed.
- Strategic bi-lateral agreements offer a productive route towards more sustainable management of skilled migration.
- When migration agreements include skills training, attention is needed to ensure the training provided is appropriate to the destination context: attention needs to be paid to the appropriateness of the medical training afforded to South African medical students in Cuba for health requirements in South Africa.
- International migration agreements can form part of a broader policy suite aimed at realizing public health and other development priorities. However, attention must be paid to the suitability and sustainability of the outcomes of these practices.