WHO Global Code of Practice on the International Recruitment of Health Personnel

WHO Global Code of Practice on the International Recruitment of Health Personnel
Name	WHO Global Code of Practice on the International Recruitment of Health Personnel
Adopted	2010
Adopters	World Health Organization
Subject	International recruitment of health personnel

Contents

WHO Global Code of Practice on the International Recruitment of Health Personnel

The WHO Global Code of Practice on the International Recruitment of Health Personnel is a non-binding instrument adopted in 2010 by the World Health Assembly, the decision-making body of the World Health Organization. It aims to guide ethical international recruitment between countries such as United Kingdom, United States, India, Philippines, and South Africa and to address health workforce challenges highlighted by entities like the United Nations, World Bank, International Labour Organization, Organisation for Economic Co-operation and Development, and the European Union.

Background and Adoption

The Code was developed amid concerns raised by reports from World Health Organization technocrats, analyses by the Global Health Workforce Alliance, and policy debates in forums including the World Health Assembly and the United Nations General Assembly. Pressure for a global instrument followed regional studies conducted by institutions such as Pan American Health Organization, African Union, and Association of Southeast Asian Nations and advocacy by groups like Médecins Sans Frontières, International Council of Nurses, and the Commonwealth Secretariat. The adoption in May 2010 occurred against a backdrop of migration patterns involving source countries such as Jamaica, Nigeria, Kenya, and Ghana and destination countries like Australia, Canada, New Zealand, and Germany.

The Code addresses recruitment of cadres including physician, nurse, midwife, pharmacist, and other health professionals across transnational corridors involving states such as Bangladesh, Pakistan, Sri Lanka, Nepal, and Zimbabwe. Its objectives include promoting ethical recruitment practices endorsed by stakeholders such as World Health Organization, United Nations Population Fund, United Nations Office on Drugs and Crime, and regional bodies including the European Commission and the African Development Bank. It seeks to balance rights of individuals exemplified in instruments like the Universal Declaration of Human Rights with health system needs discussed in publications from Institute for Health Metrics and Evaluation and Lancet commissions.

Core principles draw on precedents from instruments such as the International Labour Organization conventions and guidance from the World Health Organization and incorporate obligations for Member States, employers like National Health Service trusts, recruitment agencies illustrated by the International Organization for Migration, and professional bodies including the Royal College of Physicians, American Medical Association, Canadian Nurses Association, and International Council of Nurses. Provisions cover information exchange mechanisms similar to systems promoted by the Organisation for Economic Co-operation and Development, bilateral agreements modeled after accords between Philippines and Saudi Arabia, and measures to strengthen health systems in source countries like Mozambique and Malawi. The Code encourages ethical recruitment practices referenced by World Health Organization guidelines, compensation or support strategies akin to programs in Cuba and China, and safeguards for workforce planning consistent with analyses by World Bank and Commonwealth Secretariat.

Implementation relies on national policies adopted by ministries such as Ministry of Health (United Kingdom), U.S. Department of Health and Human Services, Ministry of Health and Family Welfare (India), and counterparts in Philippines and South Africa. National action has included bilateral memoranda with countries like United Kingdom–India agreements, regulatory changes influenced by professional regulators such as the General Medical Council, Medical Board of Australia, and College of Physicians and Surgeons of Ontario, and employer codes adopted by institutions like NHS Foundation Trusts and major hospitals including Mayo Clinic and Cleveland Clinic. Civil society actors such as Oxfam, Amnesty International, and Global Health Watch have campaigned to align domestic policy with Code recommendations.

Monitoring uses reporting mechanisms coordinated by the World Health Organization secretariat, drawing data from sources including the Organisation for Economic Co-operation and Development health workforce statistics, migration data from the International Organization for Migration, and health labor market analyses by the World Bank and Institute for Health Metrics and Evaluation. Evaluation efforts reference frameworks employed by United Nations Development Programme and outcomes measured in studies published in journals such as Lancet, BMJ, and Health Policy and Planning. Periodic reports to the World Health Assembly and reviews involving stakeholders like the Global Health Workforce Alliance and regional offices such as WHO Regional Office for Africa inform adjustments and technical support to Member States including Kenya, Pakistan, and Bangladesh.

The Code's impact has been evident in bilateral agreements, changes in recruitment practice by agencies operating across corridors involving Philippines–United States and Nigeria–United Kingdom, and policy shifts in destination states such as Canada and Australia. Critics including academics from Harvard University, London School of Hygiene and Tropical Medicine, and University of Cape Town and NGOs like Médecins Sans Frontières argue the Code is limited by its voluntary nature, enforcement gaps highlighted in analyses by the World Bank and OECD, and challenges in addressing push factors linked to fiscal policies by institutions such as the International Monetary Fund. Debates continue within forums like the World Health Assembly, United Nations, and regional bodies such as the African Union over stronger measures, compensation mechanisms, and integration with global initiatives like the Sustainable Development Goals and the Global Health Security Agenda.