WHO Member States Strengthen Ethical Recruitment Rules for Health Workers Worldwide

The World Health Organization (WHO) Member States have approved important amendments to the WHO Global Code of Practice on the International Recruitment of Health Personnel, reinforcing global efforts to ensure ethical recruitment, sustainable workforce mobility, and stronger health systems worldwide. The decision was adopted during the Seventy-ninth World Health Assembly and represents a significant milestone in addressing growing challenges related to the international movement of health and care workers.

The updated resolution reflects the evolving realities of the global health workforce and aims to ensure that all countries can maintain access to competent, motivated, and adequately supported health personnel. Health workers remain the foundation of effective healthcare systems, universal health coverage, and global health security. As demand for healthcare services continues to increase worldwide, countries are facing mounting pressures to recruit and retain skilled workers while ensuring equitable access to healthcare for their populations.

Originally adopted in 2010 by the Sixty-third World Health Assembly, the WHO Global Code of Practice established voluntary principles and standards to guide the international recruitment of health personnel. It was designed to promote ethical recruitment practices while minimizing negative impacts on countries facing shortages of doctors, nurses, midwives, and other healthcare professionals.

Over the past decade and a half, international migration among health workers has increased significantly. Many countries experiencing workforce shortages have relied heavily on foreign-trained professionals to fill critical gaps in their healthcare systems. While international recruitment can create opportunities for workers and help address staffing shortages, it can also contribute to workforce depletion in countries already struggling with limited healthcare resources.

Recognizing these challenges, WHO Member States undertook extensive consultations to review and strengthen the Code. The latest amendments seek to balance the benefits of workforce mobility with the need to protect healthcare systems in vulnerable countries.

Expanding Protection to Care Workers

One of the most important additions to the updated Code is the inclusion of provisions covering internationally recruited care workers. Until now, much of the focus has been on traditional healthcare professions such as doctors and nurses. However, the global demand for caregivers has grown rapidly, driven by ageing populations, rising healthcare needs, and expanding long-term care services.

Care workers play a crucial role in supporting older adults, persons with disabilities, and individuals requiring long-term assistance. The revised Code recognizes their contribution to health and social care systems and extends ethical recruitment principles to this important segment of the workforce.

By addressing recruitment practices in the care sector, WHO aims to improve worker protections, promote fair employment conditions, and support sustainable workforce planning across countries.

Guidance for Emergencies and Health Crises

Another major enhancement is the clarification of how the Code should apply during emergencies. Recent global events, including the COVID-19 pandemic and other public health crises, highlighted the importance of maintaining sufficient health workforce capacity during periods of exceptional demand.

During emergencies, countries often intensify recruitment efforts to address urgent staffing shortages. While such measures may be necessary, they can also place additional strain on countries with already fragile health systems.

The updated provisions emphasize the continued importance of ethical recruitment principles even during crises. By promoting responsible workforce mobility, the amendments aim to prevent emergency recruitment practices from undermining healthcare delivery in vulnerable countries.

Encouraging Co-Investment in Health Systems

A central theme of the revised Code is the promotion of co-investment in health systems and workforce development. The amendments encourage destination countries that benefit from internationally recruited health personnel to contribute to strengthening healthcare systems in source countries.

This approach seeks to create more balanced outcomes from international recruitment by ensuring that workforce mobility generates mutual benefits rather than exacerbating inequalities.

Co-investment may include support for health workforce training, education, infrastructure development, professional capacity building, and broader health system improvements. WHO officials view this strategy as a practical way to strengthen global healthcare capacity while maintaining opportunities for international career mobility.

WHO Assistant Director-General for Health Systems, Access and Data, Dr Yukiko Nakatani, welcomed the amendments and emphasized the importance of sustainable and ethical workforce mobility. She noted that the updated framework encourages countries to view co-investment as a mutually beneficial approach that supports both recruitment needs and health system development.

Progress and Remaining Challenges

The amendments were informed by recommendations from an Expert Advisory Group appointed by the WHO Director-General. The group conducted a comprehensive review of the Code’s implementation and effectiveness, examining progress achieved since its adoption in 2010.

According to the group’s findings, important advances have been made in several areas. Countries have improved the collection and availability of health workforce data, strengthened protections for migrant health workers, and increasingly incorporated ethical recruitment principles into national policies and regulations.

At the same time, the review identified areas where further progress is needed. Many source countries continue to face significant healthcare workforce shortages, and additional support is required to strengthen workforce planning, education systems, and healthcare infrastructure.

The Expert Advisory Group also highlighted the importance of ensuring that international recruitment practices contribute positively to long-term health system development rather than creating unintended negative consequences.

Updating Global Recruitment Safeguards

WHO is already taking steps to implement key elements of the new resolution. One major initiative involves updating the WHO Health Workforce Support and Safeguards List, which guides ethical international recruitment by identifying countries experiencing the most severe health workforce challenges.

The revised list, expected to be published later in 2026, will introduce greater flexibility and country-led decision-making. Countries facing workforce shortages will have more options to indicate whether they wish to permit active international recruitment under specific circumstances.

In addition, countries not currently included on the list will be able to request tailored support and safeguards based on their individual workforce situations. This approach reflects WHO’s commitment to balancing workforce mobility with the need to protect vulnerable health systems.

The updated framework is designed to recognize the diverse realities faced by countries while ensuring that ethical recruitment remains a central principle of international health workforce management.

Supporting Universal Health Coverage and Global Health Security

The adoption of the amended Code comes at a time when health systems worldwide are grappling with workforce shortages, funding pressures, demographic changes, and increasing demand for healthcare services.

Experts estimate that millions of additional health and care workers will be needed globally in the coming decades to achieve universal health coverage and meet growing healthcare needs. Ensuring that these workers are trained, supported, and fairly recruited is considered essential for building resilient health systems.

The revised Code reinforces WHO’s broader objective of ensuring that everyone, everywhere has access to qualified health personnel. Strong health workforces are not only critical for routine healthcare delivery but also serve as the first line of defense against public health emergencies and emerging global health threats.

Dr Nakatani expressed appreciation for the contributions of Member States and the Expert Advisory Group throughout the review process. She called on governments and stakeholders to maintain the collaborative spirit that guided the amendments and to work together in implementing the new measures.

As international migration of health professionals continues to grow, the strengthened Code provides a renewed framework for managing workforce mobility in a way that promotes fairness, sustainability, and shared responsibility. By encouraging ethical recruitment, supporting workforce investment, and protecting vulnerable health systems, the updated resolution aims to help build a stronger and more equitable global healthcare workforce for the future.