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population (recipients of the remittances) and, hence, public health. The benefits for the exporting country’s health system are indirect only. Temporary movement abroad provides local health care providers with a number of opportunities, including access to training, new technologies, acquisition of additional skills and specialization, and so on. Upon their return to their origin countries, these service providers will help the local population (and their local colleagues) benefit from the skills acquired abroad. Given the rapid evolution in medicine, these movements across borders are particularly important to the sector. The potential risks associated with health service exports and the measures to mitigate them The risks associated with exports in health services largely mirror those described above for imports. They can therefore be quickly reviewed. For Modes 1 and 2, the main risk is the diversion of scarce human and financial resources to health care services entirely dedicated to the treatment of foreign patients. The case of Thailand reveals that an additional 100,000 foreign patients seeking medical treatment in the country could lead to an internal human resource drain of 240–700 doctors (box 4.7). Exports of health services therefore represent a challenge to the objectives of universal access and equity of access to quality health services. The internal human resource drain also represents a loss of public investment in medical education and training. Potentially, the richest local clientele are also diverted to these high-end health care service providers to the detriment of the profitability and sustainability of the public health sector. As suggested in the case of Thailand, however, a number of accompanying policies could help minimize these diversion risks, including through the cross-fertilization of public and private health initiatives. The risks associated with exports under Mode 4 primarily depend on the intentions of the migrants. While the flow of expertise should be encouraged (Mode 4, as a regulated scheme for the temporary movement of personnel, is a factor in the flow of expertise), the human resource drain could have dramatic effects on local public health. Opportunities for individuals can translate into losses for a society. This is particularly true in the health sector, where medical density dramatically varies across countries and across regions within countries. Well-regulated trade under Mode 4 should contribute to preventing the human resource drain because nothing can prevent people from leaving a country. (Agreements on Mode 4 can include a scheme to foster the return of migrant workers.) Some countries, such as the Philippines, have introduced special curricula and created private schools to train nurses desiring to move abroad. The benefit of such schemes is to limit the losses (in terms of education) and avoid diverting the local supply of health care