One in seven nurses practices outside their country of birth. Since the pandemic, international recruitment has increased significantly due to the global shortage of 5.8 million nurses. High-income countries’ reliance on foreign-born nurses shifts
educational investment from low-income source countries with little evidence of proportional or reciprocal benefit. This weakens health systems and deepens global health inequities.

The 2025 State of the World's Nursing (SOWN) reveals how shortages, unequal distribution, low pay and poor working conditions fuel increased recruitment and migration risking even greater inequality. The WHO Global Code of Practice must be urgently strengthened to ensure that ethical and proportionate benefits are not just words but deeds. ICN urges governments to leverage the SOWN data, implement its policy recommendations and investment boldly in nursing to address workforce shortages, strengthen health systems and demonstrate through practical actions that if they take they also give back.