Brasília, 25 July 2025 (PAHO) — Representatives from Ministries of Health across the Americas reached consensus on key elements for a future roadmap to ethical and sustainable management of migration of health professionals, in response to the growing shortage of health workers in the region. These discussions took place during the International Forum on Human Resources for Health (HRH) in the Americas, held from 23 to 25 July in Brasília, Brazil, and co-organized by Brazil’s Ministry of Health and the Pan American Health Organization (PAHO).
The migration of physicians, nurses, and other health professionals is severely impacting low- and middle-income countries, particularly in Central America and the Caribbean. The COVID-19 pandemic exacerbated this situation, exposing critical gaps in staffing, especially in rural and underserved areas. It is estimated that by 2030, Latin America and the Caribbean will face a shortage of between 600,000 and 2 million health professionals.
“The increasing migration of health professionals places additional pressure on health systems, worsening structural gaps and difficult working conditions,” said Dr. Jarbas Barbosa, PAHO Director, during the forum’s opening session. “It is crucial to strengthen human resources for health policies and seek joint solutions between countries of origin and destination,” he emphasized.
A growing challenge
Low wages, limited opportunities for professional development, and difficult working conditions are among the main reasons why health care personnel leave their countries. In some cases, insecurity and political instability also drive migration. The prospect of improving living conditions and accessing new opportunities remains a strong incentive, particularly among younger professionals. Nurses—most of whom are women—face a 20% gender pay gap and have less access to leadership positions.
In response to this reality, countries agreed to work toward a joint roadmap that builds on guidance established in 2024. It includes promoting commitments between countries for ethical recruitment and fair treatment of migrant health workers, in line with the WHO Global Code of Practice. The roadmap also aims to enhance health workforce planning, strengthen health systems through primary health care and talent retention, and promote data collection on mobility and migration, with support from PAHO and WHO.
According to Brazil’s Minister of Health, Dr. Alexandre Padilha, the Forum is taking place at a strategic moment, when rethinking labor, education, and health policies is becoming increasingly urgent.
“The shortage and uneven distribution of health professionals remain concrete challenges in many of our countries, and international migration—when not managed ethically and in a coordinated manner—can exacerbate inequalities,” emphasized the Minister.
“Brazil has sought to address these issues through policies that train, support, and value workers within the Unified Health System (SUS),” he added, reaffirming the country’s commitment to the principles of the WHO Code.
Toward resilient health systems
The Forum also included a regional consultation on the third review of the WHO Global Code of Practice on the International Recruitment of Health Personnel, adopted in 2010. Countries supported the recommendations and shared experiences to improve international cooperation.
PAHO reaffirmed its commitment to supporting countries in the planning, training, and retention of health personnel, with a focus on equity.
The Forum in Brasília brought together official delegations from the Ministries of Health of eighteen countries of the Americas, representatives from European countries, international organizations, United Nations agencies, academic institutions, and health professional organizations. Participants reaffirmed their support for coordinated action and regional and international cooperation to address the challenges facing the health workforce in the region.
While the roadmap is still under development, countries expressed a shared commitment to protect workers’ rights, improve working conditions, and promote growth opportunities to retain talent, while ensuring ethical and sustainable migration.
