The WHO Global Code of Practice Has Just Been Amended — Here's What It Actually Means for Our Candidates and Clients
An in-depth briefing on the May 2026 World Health Assembly resolution and its practical implications for ethical medical recruitment
Introduction: A Rulebook 16 Years in the Making Just Got Rewritten
On 29 May 2026, WHO Member States adopted a resolution amending the WHO Global Code of Practice on the International Recruitment of Health Personnel — the foundational ethical framework that has governed how countries, employers, and recruitment agencies are expected to approach international health worker mobility since it was first adopted by the World Health Assembly in 2010. This is only the fourth major moment in the Code's history to meaningfully shift its substance, following three earlier rounds of relevance-and-effectiveness review, and it lands at a moment when international health worker migration is accelerating, not slowing, against a backdrop of aging populations in destination countries, chronic underfunding in source-country health systems, and increasing reliance on international recruitment to plug emergency gaps.
For an organization built around medical recruitment with a genuine humanitarian commitment, this amendment isn't background policy news — it's a direct signal about how the rules of our own industry are shifting, who's affected, and what's coming next. This briefing works through exactly what changed, why it changed, what it means concretely for candidates on our books and clients we place them with, and what to watch for as WHO finalizes the updated Health Workforce Support and Safeguards List later this year.
What the Code Actually Is, Briefly
For readers newer to this framework: the Code is WHO's voluntary — though increasingly nationally codified — set of ethical principles governing international health worker recruitment. Its core mechanism is the Health Workforce Support and Safeguards List (often shortened to "the Safeguards List" or, in UK recruitment circles, "the red list"), a dynamic roster of countries facing the most severe domestic health workforce shortages, currently standing at 55 countries, the large majority of them in the WHO African region. The Code doesn't ban health workers from these countries from taking jobs abroad — individual health workers retain full freedom to apply for and accept international roles of their own initiative. What it discourages is active, systematic recruitment by employers, agencies, or governments specifically targeting these vulnerable health systems — advertising campaigns, agency outreach, or organized recruitment drives aimed at pulling large numbers of workers out of a system that can't easily absorb the loss. Passive recruitment — responding to a candidate who applies independently — and recruitment structured under a formal bilateral government-to-government agreement remain permitted even for Safeguards List countries. This distinction between active and passive recruitment is the single most important operational concept in the entire framework, and it's the one this amendment leaves untouched while restructuring almost everything around it.
What Actually Changed: Three Substantive Additions
The May 2026 resolution, developed following Member State-led consultations ahead of the Seventy-ninth World Health Assembly and building on recommendations from a WHO Director-General-appointed Expert Advisory Group, adds three substantive elements to the Code that weren't previously addressed with this level of specificity.
1. Care workers are now explicitly covered. Until this amendment, the Code's provisions were focused on the recruitment of clinically licensed health personnel — doctors, nurses, allied health professionals. The updated Code now includes specific provisions covering health personnel recruited internationally for employment as care workers — a category encompassing roles like aged-care and social-care staff that sit adjacent to, but distinct from, clinically regulated professions, and that have grown enormously as a share of international healthcare-adjacent recruitment, particularly into aging destination markets like the UK, much of Continental Europe, and parts of East Asia. This closes a real gap: care worker recruitment has, in practice, often operated with less ethical scrutiny than nursing or medical recruitment, despite drawing from many of the same vulnerable source countries and often involving workers with less bargaining power and fewer protections than their clinically licensed counterparts.
2. The Code now explicitly applies during emergencies. This is a direct response to a pattern WHO and Member States observed repeatedly over the past several years: ethical recruitment principles tend to get quietly set aside during acute crises — pandemics, conflicts, natural disasters — precisely the moments when the temptation to recruit rapidly and aggressively from any available source is strongest, and precisely the moments when a source country's own health system is least able to absorb additional workforce loss. The amendment makes clear that emergency conditions do not suspend the Code's recommendations; if anything, the updated provisions emphasize that ethical principles matter more, not less, when recruitment pressure spikes during a crisis.
3. Co-investment is now an explicit, named expectation. This is arguably the amendment's most structurally significant change. The updated Code actively encourages destination countries — and by extension, the employers and health systems within them who benefit from internationally recruited talent — to co-invest in the health systems and workforce development of source countries, so that international recruitment produces genuinely proportional benefit on both ends of the relationship, rather than flowing one direction only. WHO's Assistant Director-General for Health Systems, Access and Data, Dr Yukiko Nakatani, framed this explicitly as a shift toward viewing co-investment as a mutually beneficial arrangement rather than a one-sided obligation or charitable add-on — language that signals WHO wants this understood as good workforce-planning practice, not merely an ethical nicety layered on top of ordinary recruitment.
What's Coming Next: A More Flexible, Country-Led Safeguards List
Alongside the resolution itself, WHO confirmed that an updated version of the Health Workforce Support and Safeguards List will be published later in 2026 — the first scheduled update since the current 55-country 2023 list, which was itself an escalation from 47 countries in 2021 and the original 57-country iteration dating back to 2006. Two structural changes to the list mechanism are worth understanding well before the update lands:
Countries can now opt to signal openness to active recruitment. As recommended by the Expert Advisory Group, the updated list framework will build in additional flexibility allowing countries facing workforce challenges to indicate their own willingness to permit active international recruitment, rather than the current largely binary red-list structure. This is a meaningful shift toward country agency: a nation on the Safeguards List due to genuine workforce density and coverage shortfalls may nonetheless judge that structured, managed active recruitment — paired with appropriate safeguards or co-investment commitments — serves its own interests better than a blanket discouragement does.
Countries not on the list can request tailored support. The updated framework also allows Member States who fall outside the Safeguards List but still face specific, more localized workforce vulnerabilities to request customized support and safeguards, rather than facing an all-or-nothing designation. This reflects a genuinely more nuanced, country-led approach than the previous list's relatively blunt inclusion/exclusion logic — and it means the clean "is this country on the list or not" question that recruiters have relied on may, going forward, require a somewhat more careful reading of each country's specific, self-indicated position.
What This Means for Our Candidates
For clinicians and care workers we're currently working with, or hope to work with, from countries anywhere near this framework, a few things follow directly.
If you're from a Safeguards List country, nothing about your personal right to apply for international roles has changed. The amendment doesn't touch the fundamental active-versus-passive distinction — individual applications remain entirely unrestricted regardless of a country's list status, and this amendment reinforces rather than weakens that protection. What may change, for some source countries, is how actively agencies and employers can now legitimately engage with candidates from that country, depending on how that specific nation chooses to position itself under the new opt-in flexibility once the updated list publishes.
Care worker candidates now have a clearer ethical framework protecting them. For candidates pursuing aged-care, social-care, or other non-clinically-licensed international roles — a growing share of our own placement pipeline — the explicit inclusion of care workers in the Code closes a real protections gap. Practically, this should translate into more consistent expectations around fair contract terms, transparent recruitment practices, and protection from exploitative fee structures for this category of worker, mirroring what nursing and medical candidates have generally been entitled to since 2010.
Candidates should expect more visibility into what's happening on their behalf. As co-investment becomes an explicit, named expectation rather than an implicit ethical aspiration, candidates placed from source countries facing workforce vulnerabilities have a stronger basis to ask a prospective employer or recruiting agency directly what, if anything, the destination institution is doing to support the health system they're leaving — a question that's now squarely within the spirit of the framework rather than an awkward one to raise.
Watch for country-specific changes once the updated Safeguards List publishes later in 2026. A candidate's home country's position on the list — or its self-indicated openness to active recruitment — may shift meaningfully from the 2023 version, and that shift could change how visible and how proactively agencies are permitted to engage with candidates from that specific country going forward.
What This Means for Our Clients
For the hospitals, health systems, and care providers we place candidates with, the implications are more structural, and worth taking seriously well ahead of the updated list's publication.
Care worker recruitment programs now need the same ethical scrutiny as clinical recruitment. Any client currently sourcing aged-care or social-care staff internationally — a category that has, in many markets, operated with meaningfully less formal oversight than nursing or physician recruitment — should expect this gap to close. Institutions that haven't already extended ethical-recruitment compliance processes to their care-worker pipelines specifically will want to do so proactively rather than waiting for it to become a compliance requirement imposed from outside.
Crisis-driven recruitment surges are no longer an implicit exception. Clients who have historically treated emergency staffing gaps — a sudden surge, a regional health crisis, a pandemic-style event — as situations where ordinary ethical recruitment caution could reasonably be relaxed should recalibrate that assumption. The amendment specifically closes that door, and institutions building emergency staffing contingency plans should build ethical-sourcing safeguards into those plans directly, rather than treating them as a normal-times-only consideration.
Co-investment is moving from goodwill to expectation — and, in some jurisdictions, may move further still. While the Code itself remains voluntary at the international level, its provisions become legally binding wherever individual countries adopt them into national policy — exactly the mechanism through which the UK's own Code of Practice red-and-amber list system operates today. Clients operating in, or recruiting into, countries that have historically been quick to codify WHO Code provisions domestically should treat co-investment as a genuine strategic planning item, not a future hypothetical: expect the conversation to shift, over the coming few years, from "should we consider contributing to source-country workforce development" to "what does our co-investment commitment look like," particularly for large-volume institutional recruiters.
The more flexible Safeguards List creates genuine new opportunity — and genuine new complexity. Clients who have avoided recruiting from certain source countries purely because of blanket list inclusion may find, once the updated list publishes, that some of those countries have opted to signal openness to structured active recruitment. This is a real opportunity to responsibly expand sourcing into markets that were previously off-limits to active outreach — but it also means the simple "check the list, recruit or don't" compliance model many institutions have relied on will need to become a more nuanced, country-by-country reading exercise, and clients relying on outdated 2023-list guidance after the update publishes will be operating on stale information.
What This Means for How We Operate
A few practical implications for how we should be positioning and preparing internally, ahead of the updated Safeguards List landing later this year:
Extend our existing ethical-sourcing framework to care worker placements explicitly, rather than treating it as a clinical-recruitment-only discipline, ahead of this becoming a formal expectation rather than a best practice.
Build emergency/crisis staffing protocols that assume Code compliance continues, not pauses — this is directly relevant to our humanitarian arm's deployment work, where the pressure to move quickly during a crisis is exactly the scenario this amendment is designed to hold a line against.
Start developing a co-investment narrative now, rather than reactively later. Being able to point concretely to how placements we facilitate contribute something back to source-country systems — whether through diaspora engagement models, training partnerships, or transparent fee structures that don't extract value from already-strained systems — is likely to become a genuine competitive differentiator with institutional clients over the next several years, not just an ethical talking point.
Prepare to re-brief both candidates and clients the moment the updated Safeguards List publishes. Because the new framework introduces country-level opt-in flexibility rather than a simple binary list, our own guidance to both sides of a placement will need a genuine update, not just a re-read, once the details land — and the organizations that communicate that shift clearly and early will look considerably more credible to institutional clients than those still operating off 2023-list assumptions well into 2027.
Treat this as validation, not disruption, of positioning built around ethical recruitment. Every substantive addition in this amendment — care worker inclusion, emergency-context applicability, named co-investment expectations — pushes the entire industry toward practices that a recruitment organization with a genuine humanitarian arm should already be closer to than a purely commercial, volume-driven competitor. That gap is worth making visible to clients directly over the coming months.
Conclusion
This amendment doesn't overhaul the Code's core logic — the fundamental distinction between active and passive recruitment, the one mechanism candidates rely on most directly, remains intact. What it does is close real gaps that had been left open since 2010: care workers were unprotected by the same framework covering clinical staff, emergency contexts had become a de facto exception to ethical recruitment discipline, and co-investment sat as an implied aspiration rather than a named expectation. The genuinely consequential piece is still ahead of us — the updated Safeguards List, due later in 2026, with its new country-opt-in flexibility, will be the moment this amendment translates from principle into practice for specific source countries our candidates come from and our clients recruit into. Getting ahead of that update, for both the candidates we represent and the clients we place them with, is the most concrete thing we can do with this news right now.
Sources
World Health Organization, "WHO Global Code of Practice on the International Recruitment of Health Personnel amended," Departmental update, 29 May 2026
World Health Assembly resolution A79/R12, Seventy-ninth World Health Assembly (2026)
WHO Expert Advisory Group final report to the 158th Executive Board (document EB158/17)
Pieterse, P., "Health Workers in Sub-Saharan Africa: Concurrent Skilled Health Worker Shortages and Under-Employment," International Journal of Health Planning and Management (2025)
"Understanding the WHO health workforce support and safeguards list 2023," PMC / Bulletin of the World Health Organization
WHO, "WHO health workforce support and safeguards list," Questions and Answers
NHS Employers, "Code of Practice red and amber list of countries" and "Code of Practice frequently asked questions" (2025–2026)
NHS Employers, "Quick guide: Code of Practice for International Recruitment"
DevDiscourse, "WHO Member States Strengthen Ethical Recruitment Rules for Health Workers Worldwide" (2026)