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Code of Practice on international recruitment of health personnel adopted by World Health Assembly

Code of Practice on international recruitment of health personnel adopted by World Health Assembly

Geneva, 20 May 2010. In only the second time in its history, the United Nations’ World Health Assembly voted tonight in Geneva at 8 pm to adopt a voluntary code directing nations to employ more ethical practices in relation to a major international health problem.  The Code of Practice on the International Recruitment of Health Personnel sets forth ten articles advising both source and destination countries on how to regulate the recruitment of health personnel in a way that mitigates damage to low-income countries struggling to meet the basic health needs of their populations in a setting of serious workforce deficits.

The Code recognizes “the severe shortage of health personnel…[which] constitutes a threat to the performance of health systems and undermines the ability … to achieve the Millennium Development Goals.” The Code takes into account both the right of health personnel to migrate, as well as the right of populations to the highest attainable standard of health.  

The 63rd World Health Assembly, on its opening day on May 17, 2010, appointed a "drafting committee" to revise a draft of the Code that had previously been approved by the World Health Organization’s executive board in January, 2010.  The drafting committee, attended by delegates from dozens of countries, and chaired by Thailand’s Ministry of Health delegate Dr. Viroj Tangcharoensathien, worked through the night until 4:30 in the morning today to arrive at a compromise that balances the interests of countries that lose and countries that gain health workers through migration.

The Code was championed by an international civil society body, the Health Workforce Advocacy Initiative, which has member organizations from countries on both sides of the sending and receiving equation who care about improving the health of people in low-income countries.  It is affiliated with the World Health Organization’s Global Health Workforce Alliance, which held the first global forum on human resources for health in Kampala, Uganda, in March of 2008—the event that launched international enthusiasm for a Code of Practice on this issue.

The Honorable Mary Robinson, President of Realizing Rights and the former UN High Commissioner for Human Rights and former President of Ireland, led a spirited “pep rally” for the Code of Practice Tuesday night (May 18) in the Palais des Nations (UN Headquarters). 

WHA side event: WHO Code of Practice on the International Recruitment of Health Personnel: If adopted, ensuring impact?

One of the speakers at the rally for the Code was Annelies Allain, of the UK's International Baby Food Action Network, who spoke about the 1981 World Health Assembly, which voted to adopt the World Health Organization’s first and, until now, only previous voluntary code of ethical practice, The Code of Marketing of Breast-milk Substitutes. The vote on that infant formula marketing code was 118 yes votes against only one “no” vote, that of the U.S.  By contrast, tonight’s vote was unanimous.

The United States delegation played a significant part in the negotiations in the drafting committee, however.  As a major “receiving country,” with 25 percent of its physicians imported from abroad (and two-thirds of them from lower income countries), the U.S. argued for a weaker Code than was preferred by delegates from African countries, which lose a large proportion of their trained doctors to European and American practices.  Norway’s delegation, headed by Dr Bjørn-Inge Larsen, Director-General, Norwegian Directorate of Health, was an important advocate for the interests of low-income countries.  Norway developed a 2007 “framework on global solidarity” pledging to refrain from recruiting health workers from developing countries.

Dr. Francis Omaswa, now director the African Centre for Global Health and Social Transformation in Uganda, and formerly director of the Global Health Workforce Alliance, said after the vote that he most pleased with the results.  “The world’s nations have come together to do the right thing by the millions of health workers who need our help.”  Further, he said, civil society “played an important and critical role in moving the process towards a positive result.”

Sandra Kiapi, Executive Director of Action Group for Health, Human Rights and HIV/AIDS (AGHA), an NGO in Uganda, said, “The Code is a great victory. However, this is just the beginning of a journey. It is now time to disseminate the Code widely among governments, recruiters, intergovernmental organizations, health professionals and other civil society organizations and all stakeholders with a view to promoting its implementation."

Anke Tijtsma of the Dutch organization Wemos, said “We are very encouraged by the Assembly’s vote tonight.” She pledged “Civil society organizations will remain involved in monitoring and implementing the code, as we can play a role in holding all sectors accountable.”


The Medicus Mundi International Network, a member of the Health Workforce Advocacy Initiative (HWAI) and of the Global Health Workforce Alliance (GHWA), congratulates the WHO members on having adopted the code. We are proud of having been part of the civil society alliance advocating for the adoption of the code – and we will part of the team involved in monitoring and implementing the code.

Congratulations to our member Wemos and the Wemos team involved in lobbying for the code in Geneva throughout this week! And congratulations to WHO, GHWA, HWAI and all the others contributing to the development and fighting for the adoption of the Code.

Source: HWAI media release: PDF

More information: see list of organizations and contacts on

MMI Network and the implementation of the Code:
MMI News, June 2010, editorial by Remco van de Pas

Final version of the Code: WHO website

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