The WHO Global Code of Practice on International Healthcare Recruitment Explained: What the 2026 Amendment Means for International Recruitment
Executive Summary
International healthcare recruitment has become an increasingly important part of workforce planning. Hospitals and health systems across high-income countries face persistent shortages of nurses, doctors, allied health professionals and other healthcare workers, while many healthcare professionals seek opportunities abroad for better working conditions, career development and remuneration.International mobility can therefore provide significant benefits. It can help hospitals fill vacancies, give healthcare professionals access to new opportunities and generate financial and professional benefits for countries of origin.However, international recruitment can also create problems when poorly managed. If large numbers of healthcare workers are actively recruited from countries already experiencing critical workforce shortages, migration can weaken the health systems those workers leave behind.The World Health Organization (WHO) created the Global Code of Practice on the International Recruitment of Health Personnel in 2010 to address this challenge. The Code established a framework for ethical international recruitment, balancing the interests of migrant healthcare workers, destination countries and source countries. It is voluntary rather than legally binding, but it has become an important international reference point for governments, employers and recruitment organisations.In May 2026, the 79th World Health Assembly adopted WHA79.12, amending the Code and strengthening its implementation. The changes are significant for international healthcare recruitment. They expand the Code's relevance to internationally recruited care workers, clarify its application during emergencies and place greater emphasis on co-investment in health systems and health workforces, so that international recruitment produces benefits for both destination and source countries.The 2026 amendment does not mean that international recruitment has been banned or that healthcare employers can no longer recruit internationally. Instead, it represents a move toward a more structured model of ethical, sustainable and mutually beneficial healthcare workforce mobility.For recruitment agencies, hospitals and healthcare professionals, understanding this change is increasingly important.
Introduction: Why International Healthcare Recruitment Needs Global Rules
Healthcare workers have always moved between countries. Nurses, doctors and other professionals may migrate to access better salaries, improved working conditions, specialist training or greater career opportunities.For destination countries, international recruitment can be an effective way of addressing workforce shortages. For individual healthcare professionals, migration can provide substantial benefits.The challenge is that the global healthcare workforce is unevenly distributed.Countries with comparatively strong economies and established healthcare systems may be able to offer significantly higher salaries and better employment conditions than lower-income countries. As a result, healthcare workers may naturally move toward countries offering greater opportunities.From an individual perspective, this can be entirely rational.At the health-system level, however, the consequences can be more complicated.If a country that already has a serious shortage of nurses loses a significant proportion of its trained workforce through international recruitment, the resulting shortage can make healthcare access more difficult for its population.The WHO has therefore sought to distinguish between health worker migration itself, which can provide significant benefits, and poorly managed recruitment, which can contribute to workforce instability and inequality.The Global Code of Practice was created against this background.
What Is the WHO Global Code of Practice?
The WHO Global Code of Practice on the International Recruitment of Health Personnel was adopted by the World Health Assembly in 2010 through Resolution WHA63.16.It was designed as a global framework for the ethical international recruitment of healthcare workers.The Code's objectives include promoting ethical recruitment practices, protecting the rights and interests of migrant healthcare workers, supporting stronger health systems and encouraging cooperation between source and destination countries.Importantly, the Code is voluntary.It is not an international treaty and does not function like a national immigration law or professional licensing regulation. Countries are not automatically subject to criminal or financial penalties simply because an individual recruitment activity does not comply with every recommendation in the Code.Nevertheless, the Code is influential.The WHO describes it as a key global governance instrument for health worker migration. Member States are encouraged to implement its recommendations, collect information about health worker migration and report on implementation. Relevant stakeholders—including recruiters, employers, professional organisations and healthcare workers—are also included within its scope.This distinction is important for recruitment companies."Voluntary" does not mean "irrelevant."The Code provides governments and healthcare organisations with an internationally recognised framework against which recruitment policies and practices can be assessed.It can also influence bilateral agreements, national recruitment policies, procurement requirements and the reputational expectations placed on recruitment organisations.
The Core Principle: International Recruitment Should Be Ethical
The Code does not argue that wealthy countries should simply stop recruiting healthcare professionals internationally.Instead, it seeks to make international recruitment more sustainable.A central principle is that healthcare workers should be treated fairly and that international recruitment should respect their rights.Healthcare professionals who migrate should not be treated simply as commodities within an international labour market.They are professionals with qualifications, rights, families and long-term careers.Ethical recruitment therefore involves issues such as:transparent employment conditions;fair treatment;accurate information about jobs;appropriate recognition of qualifications;protection from exploitation;respect for professional rights;appropriate support during migration and integration;and freedom from discriminatory recruitment practices.For employers and recruiters, this creates an important principle:The objective should not simply be to fill a vacancy. It should be to create a sustainable employment relationship.That distinction is becoming increasingly important as healthcare recruitment becomes more international.
Source Countries Matter
One of the most important ideas behind the WHO Code is that recruitment should take account of the health systems from which workers are being recruited.Imagine two countries.Country A has a large healthcare workforce and produces more nurses than its domestic health system can employ.Country B has one of the world's most severe nursing shortages and is already struggling to provide basic healthcare services.Recruiting nurses from Country A may have very different consequences from aggressively recruiting nurses from Country B.The Code therefore encourages countries and organisations to consider the circumstances of source countries.The WHO has developed a Health Workforce Support and Safeguards List to identify countries facing significant health workforce challenges. The purpose is to encourage safeguards around active international recruitment from particularly vulnerable health systems.This does not mean that healthcare professionals from countries on such lists cannot migrate.That distinction is crucial.The WHO framework is principally concerned with how recruitment occurs, particularly active international recruitment and its impact on vulnerable health systems.Individual healthcare workers retain their own aspirations and rights.Ethical recruitment should therefore avoid turning a safeguard mechanism into a restriction on individual mobility.
What Changed in 2026?
In May 2026, WHO Member States adopted Resolution WHA79.12, amending the Global Code of Practice and strengthening its implementation.The changes followed three reviews of the Code's relevance and effectiveness and extensive consultations involving Member States and an Expert Advisory Group.The WHO identified three particularly important additions:1. Internationally recruited care workers are now explicitly covered.2. The Code's recommendations are clarified for emergency situations.3. Greater emphasis is placed on co-investment in health systems and health workforces.These changes reflect the reality that healthcare workforce mobility has evolved considerably since the original Code was adopted in 2010.
1. Care Workers Are Now Explicitly Included
One of the most significant changes is the incorporation of provisions concerning healthcare personnel recruited internationally for employment as care workers.This matters because international care work has expanded considerably.Healthcare workforce discussions have historically focused heavily on doctors and nurses. Yet health and social care systems also depend on large numbers of people working in care roles, including workers supporting older people, people with disabilities and individuals requiring assistance with daily living.International mobility in this workforce can therefore have substantial consequences.By explicitly addressing care workers, the amended Code recognises that ethical recruitment principles should not stop at traditional regulated clinical professions.For recruitment companies, this creates an important practical implication.A company cannot assume that ethical recruitment principles apply only when recruiting a registered nurse or physician.The broader international care workforce increasingly falls within the conversation.That means recruitment organisations working across nursing, social care and related healthcare occupations should consider whether their recruitment practices reflect the same principles of transparency, worker protection and responsible international recruitment.
2. The Code Now Explicitly Addresses Emergencies
The second major change concerns emergencies.Healthcare workforce crises do not occur only under normal circumstances.Pandemics, natural disasters, armed conflicts and other emergencies can create sudden and extraordinary demand for healthcare professionals.The COVID-19 pandemic demonstrated how quickly healthcare workforce requirements can change.During an emergency, a country may suddenly need thousands of additional nurses, doctors or other professionals.At the same time, source countries may themselves be experiencing extraordinary healthcare pressures.The 2026 amendment therefore clarifies the applicability of the Code's recommendations during emergencies.This is important because emergencies can create an environment in which normal recruitment safeguards become easier to overlook.For example, a destination country facing an urgent shortage may be tempted to accelerate international recruitment without adequately considering the effect on vulnerable source countries.The updated framework encourages countries to maintain ethical principles even when workforce pressures are intense.For recruiters, this means that urgency should not automatically become an excuse for poor recruitment practices.A hospital can have a genuine emergency staffing requirement while still respecting international recruitment principles.
3. The Biggest Strategic Change: Co-Investment
Perhaps the most important long-term development is the greater emphasis on co-investment.The amended Code encourages investment in health systems and health workforces so that international recruitment can generate proportional benefits for both source and destination countries.This represents an important evolution in thinking.The traditional model of international recruitment can be described simply:Country A has a shortage → Country A recruits workers from Country B → workers move to Country A.The new approach asks a broader question:Can international healthcare mobility benefit both countries?This could involve investment in areas such as healthcare education, workforce development, training infrastructure, professional development or health-system strengthening.The objective is not necessarily to create a direct financial transaction every time a healthcare worker migrates.Rather, the broader principle is that countries benefiting from international healthcare recruitment should consider how their workforce strategies can contribute to sustainable global health systems.The WHO specifically describes co-investment as an opportunity to create a "win-win" relationship between source and destination countries.
What Does the 2026 Amendment Mean for Recruitment Agencies?
For recruitment organisations, the amendment represents a shift in expectations.The future of international healthcare recruitment is unlikely to be defined simply by the ability to identify qualified candidates quickly.Recruitment companies will increasingly need to demonstrate that they understand:where candidates are coming from;the workforce situation in source countries;destination-country workforce requirements;applicable national recruitment policies;professional registration requirements;immigration requirements;employment conditions;candidate welfare;and ethical recruitment principles.This creates an opportunity for professional recruitment firms.An ethical recruiter can become more than an intermediary.It can become a workforce partner.For example, a recruitment organisation could maintain country-level intelligence covering workforce shortages, recruitment restrictions, professional registration pathways and relevant safeguards.This would allow employers to make better-informed decisions before launching international recruitment campaigns.
What Does This Mean for Healthcare Employers?
Hospitals and healthcare providers should also pay attention.The 2026 amendment reinforces the idea that international recruitment should form part of a broader workforce strategy.International recruitment should not necessarily be viewed as a replacement for domestic workforce development.Instead, it can form one component of a diversified strategy involving:Education + retention + workforce planning + domestic recruitment + international recruitment.Hospitals should also consider whether the recruitment partners they use understand ethical recruitment.A recruitment company that can supply candidates cheaply and quickly is not necessarily the same as a company capable of delivering sustainable international workforce solutions.Employers increasingly have an interest in asking recruitment partners questions such as:Where are candidates being recruited from?How are candidates approached?What fees are candidates required to pay?How are contracts explained?What support is provided after arrival?How are professional registration and credentialing handled?What happens if the candidate's employment circumstances change?How does the recruitment strategy account for source-country workforce conditions?These questions are increasingly relevant in an environment where healthcare workforce migration is receiving greater international scrutiny.
What Does It Mean for International Healthcare Workers?
For nurses, doctors, carers and other healthcare professionals considering migration, the amended Code should not be interpreted as a warning that international recruitment is disappearing.Quite the opposite.International mobility remains an important component of global healthcare workforce planning.The key change is that migration should increasingly take place within a framework that protects healthcare workers as well as health systems.Healthcare professionals should therefore be cautious of recruiters who:make unrealistic salary promises;conceal employment conditions;charge inappropriate recruitment fees;misrepresent immigration or registration requirements;pressure candidates into accepting unsuitable jobs;or provide inadequate information about the destination country.A reputable international recruiter should provide clear information rather than simply attempting to secure a placement.The goal should be an informed decision by the healthcare professional.
The 2026 Update to the WHO Safeguards List
Another development worth watching is the planned update to the WHO Health Workforce Support and Safeguards List.The WHO announced in May 2026 that an updated version would be published later in the year.Importantly, the updated approach is expected to introduce greater flexibility.Countries will have more ability to indicate that they are willing to allow active international recruitment, while countries not included on the list may be able to request tailored support and safeguards.This is significant because it suggests a move away from a simplistic model in which countries are divided into "allowed" and "not allowed" recruitment markets.Instead, the future framework is likely to become more country-led and nuanced.That matters to recruiters.The ethical question is increasingly unlikely to be simply:"Is recruitment from this country permitted?"It is more likely to become:"What is the workforce situation in this country, what does the country want, and what safeguards should apply?"That is a much more sophisticated model of international recruitment.
Why the 2026 Amendment Matters for the Future of Global Healthcare
The global healthcare workforce is becoming increasingly interconnected.A nurse trained in one country may work in another. A doctor may complete postgraduate training abroad before returning home. A care worker may migrate permanently or temporarily. Governments may establish bilateral workforce agreements. Hospitals may use international recruitment to address shortages that cannot be solved domestically.These movements cannot be understood purely as immigration.They are also a component of global health workforce planning.The WHO's 2026 amendment recognises this changing reality.It does not attempt to stop healthcare worker migration.Instead, it seeks to make migration more sustainable.That is arguably the most important message of the amendment.International healthcare recruitment is not inherently unethical. Poorly managed international recruitment can be.Well-managed mobility can provide benefits to healthcare professionals, employers, destination countries and source countries.The challenge is designing systems that maximise those benefits while reducing the risks.
Implications for Huz Health
For organisations such as Huz Health, the 2026 amendment provides an important framework for thinking about international recruitment.A modern healthcare recruitment organisation should not simply ask:"Can we find a nurse?"It should ask:"Can we create a successful and ethical international placement?"That means considering the entire recruitment journey—from the initial sourcing of candidates through employment, professional registration, relocation and integration.It also means understanding that international recruitment operates within a wider global workforce system.Huz Health's approach to ethical recruitment can therefore be built around several principles:Transparency: Candidates should understand the role, employer, salary, conditions and recruitment process.Candidate protection: Healthcare professionals should be treated as skilled professionals rather than commodities.Responsible sourcing: Recruitment strategies should consider the workforce situation in source countries.Employer accountability: Healthcare providers should receive candidates whose qualifications and circumstances are properly understood.Long-term workforce planning: International recruitment should complement, rather than simply replace, domestic workforce development.Global responsibility: Recruitment should seek outcomes that are sustainable for both source and destination countries.These principles are increasingly aligned with the direction of international healthcare workforce policy.
Conclusion
The WHO Global Code of Practice has been an important reference point for international healthcare recruitment since its adoption in 2010.Sixteen years later, the global healthcare workforce environment looks very different.Healthcare worker migration has increased. International recruitment has become an essential component of workforce strategies in many countries. Health systems continue to face shortages, while healthcare professionals increasingly move across borders in search of opportunity.The 2026 amendment to the WHO Global Code of Practice responds to this changing environment.It expands the framework to explicitly address internationally recruited care workers, clarifies its application during emergencies and places greater emphasis on co-investment in health systems and health workforces.Most importantly, it reinforces a broader principle:International healthcare recruitment should create sustainable value rather than simply transfer healthcare workers from one country to another.For destination countries, international recruitment can help address critical shortages.For healthcare professionals, it can provide career opportunities and improved living standards.For source countries, migration can generate remittances, professional networks and opportunities for skills development—but unmanaged recruitment can also worsen existing shortages.The future therefore lies not in stopping international healthcare mobility, but in managing it responsibly.For healthcare employers and recruitment organisations, this means that ethical recruitment is increasingly becoming part of professional workforce management rather than simply a matter of corporate responsibility.For international healthcare professionals, it means that understanding how recruitment works—and choosing reputable employers and recruitment partners—is increasingly important.And for the global healthcare system, the 2026 amendment represents another step toward a model in which healthcare worker mobility can support, rather than undermine, the goal of stronger health systems worldwide.
Sources and Further Reading
World Health Organization — WHO Global Code of Practice on the International Recruitment of Health Personnel
The original Code, adopted by the World Health Assembly in 2010 through Resolution WHA63.16.
WHO Global Code of Practice on the International Recruitment of Health PersonnelWorld Health Organization — WHO Global Code of Practice on the International Recruitment of Health Personnel Amended, 29 May 2026
The WHO's announcement explaining the 2026 amendments, including care workers, emergencies and co-investment.
WHO: Global Code of Practice amended in 2026World Health Assembly — Resolution WHA79.12, 23 May 2026
The formal resolution adopted at the 79th World Health Assembly.
WHA79.12 — WHO Global Code of PracticeWorld Health Organization — Health Workforce Migration
WHO's broader explanation of health worker migration, the Code and the Health Workforce Support and Safeguards List.
WHO Health Workforce MigrationWorld Health Organization — Managing Health Workforce Migration: The Global Code of Practice
Background on implementation, reporting and the role of Member States and stakeholders.
Managing Health Workforce Migration — WHOWorld Health Organization — User's Guide to the Global Code of Practice
Detailed guidance on the purpose and implementation of the Code.
WHO User's Guide to the Global Code of Practice