Acute global shortages in the health workforce today represent a crisis that looks certain to worsen in the years ahead. There is a chronic worldwide need for some 2.4 million more physicians, nurses and midwives, and for almost two million more pharmacists and other paramedical workers.
Currently there are almost 60 million health workers globally, but they are unevenly distributed across countries and regions. Typically, they are scarcest where they are most needed, especially in the poorest countries. In any case, the total number is incapable of  meeting the demands of many populations for access to the health care they require. Both developed and developing countries are struggling to cope with the huge challenges posed by the imbalance between increasing demand and faltering supply.
The crisis has long been painfully familiar to health policy-makers and public health analysts internationally. The migration of health personnel – especially doctors and nurses – around the world is also a long-standing phenomenon, as they seek better salaries and conditions in other countries. In many cases they are actively recruited by the wealthy nations of Europe, North America, Australasia and elsewhere. As a consequence, the health infrastructure in migrants’ own countries is liable to be seriously weakened.
The crisis, and the impact on it on migration, is aggravated by new complexities. The global economic downturn in recent years has resulted in austerity measures in some countries, including severe cuts in health and social services budgets. Inevitably, the health of many millions of citizens, rich and poor, is under new and growing threats.
Foreign-trained doctors and nurses make up a significant share of the health workforce in the major English-speaking destinations; these flows do not seem to have been strongly affected so far by the global economic crisis and are expected to remain strong in coming decades as aging populations further increase the demand for health services. While some governments – notably in the United Kingdom – have actively recruited foreign health professionals in the past, they can receive large inflows even without actively or deliberately recruiting them.