The crisis of health workforce lies at the core of the crisis of health care systems, as a global shortage of health workers is becoming critical in most countries. The nexus between the crises in health care systems and in health in general has become a vicious cycle. The importance of strengthening health systems has been neglected for a long time as the societies tend more to invest in technologies and drugs and not in social protection, health systems or people. Corollary, often the pressure from health budget constraints has been aggravated by the misallocation of resources within health systems, where money is being spent on the purchase of high-tech medical equipment rather than on human resources (PSI, 2004).

The global health workers shortage is an obvious threat to health systems. Three decades of "reforms" have treated health workers as a burden rather than as an asset. Health workers is many parts of the poor world were harder hit as they were at the same time under pressure due to three main factors: lack of investment, the HIV/AIDS pandemic, and migration, the latter being accelerated as a result of the first two factors. Health workers in many countries of the developed world have also seen a continues deterioration of their working life characterised by job satisfaction problems such as inadequate staffing, heavy work-loads, the increased use of overtime, a lack of sufficient support staff, inadequacy of wages and by too few workers training as nurses.

Indeed, the crisis of the health workforce as expressed by the flow of health workers across national boundaries is one of the strong indicators of the crises of health systems.