ICN’s calls on G20 leaders to address international health worker migration crisis reflected in recent G20 Health Ministers’ Declaration

Ahead of the G20 Leaders Summit in Rio de Janeiro next week, the International Council of Nurses (ICN) welcomes the Declarations recently adopted by the G20 Health Working Group and health ministers. The Declarations unite health leaders from the world’s largest economies behind shared commitments to health equity, sustainable and resilient health systems, digital transformation, and pandemic and climate change prevention, preparedness and response.

The Rio de Janeiro Declaration of G20 Health Ministers directly addresses inequitable international nurse recruitment patterns, an issue consistently raised by ICN and the subject of an open letter sent by ICN’s President, Dr Pamela Cipriano, to the G20 leaders earlier this year. In the letter, Dr Cipriano called for urgent action to protect nursing workforces in fragile nations facing severe shortages and warned that aggressive recruitment of these nurses by high-income nations is widening global health gaps. Such recruitment threatens access to essential health services in under-resourced regions and undermines shared global commitments to health equity and universal health coverage.

Dr Cipriano remarked:

“Strong health workforces are the foundation of global health equity and ICN commends the G20 health ministers' acknowledgement that we must better manage health workforce migration and welcomes their commitment to implementing the WHO Global Code of Practice on the International Recruitment of Health Personnel.

The world’s most fragile health systems cannot afford to lose the nurses they have invested in training and who provide vital health care to their communities. We know there can be no health for all without nurses for all. We now need to see these statements translated into decisive actions to build self-sufficient nursing workforces worldwide and to end the unsustainable and unethical practice of wealthy nations addressing their own shortages by depleting the nursing workforces of vulnerable countries.”

The Declaration emphasizes the need to strengthen and support the health workforce in the face of our global shortage of nurses and other health professionals, with a focus on improving working conditions, renumeration, education, and gender equity.

This Declaration also includes commitments to support an equitable and ethical digital health transformation, establish a new global coalition to promote access to vaccines and health products, and strengthen pandemic preparedness and response, recognizing, for the first time, that social inequalities are a driver of pandemics.

In addition, the G20 health leaders issued a separate Health Ministerial Declaration on Climate Change, Health and Equity, and One Health, which recognizes the urgent need to address the escalating impacts of climate change and tackle antimicrobial resistance (AMR) and disease prevention through a One Health approach. ICN has long advocated for the need to put health at the centre of climate change action and has made strong calls for climate action and an integrated global response to the growing threat of AMR.

The G20 Joint Finance and Health Ministerial Meeting's Chair's Statement further addresses urgently-needed sustainable funding and health financing mechanisms.

These Declarations lay important groundwork for the upcoming G20 Leaders’ Summit, which will be held 18-19 November in Rio de Janeiro and attended by the leaders of the 19 member countries as well as the African Union and the European Union. At the end of the Summit, the G20 Presidency will transfer from Brazil to South Africa.

Dr Cipriano added: “We know that health is not a cost, it is an investment — and investing in universal health coverage and the health professionals who deliver that care and coverage is a key pathway to reducing inequalities and catalysing economic and societal growth. As we look towards the G20 Leaders’ Summit, COP29, and South Africa's forthcoming G20 presidency, ICN calls on the world’s leaders to make urgent and transformative investments in health that match the scale of our global challenges.”