Growing international mobility of health professionals needs to be better monitored. Intra-OECD movements of health professionals account for an important share of health worker immigration to OECD countries, inducing cross-OECD interdependency in the management of health human resources. Ultimately there is a risk of exporting shortages within or beyond the OECD area, including to the poorest nations. Migration from countries which train to supply the world market cannot be a complete solution if all receiving countries turn to a limited number of origin countries which also have to respond to an increasing domestic demand in the near future. The global health workforce shortage, which goes far beyond the migration issue, calls for a shared responsibility between sending and destination countries. Origin countries must strength their health systems, improve domestic working conditions and encourage better management of their workforce. Host countries, on the other hand, must be aware of the impact of their policies on the health systems of impoverished nations. However, good practice for an ethical management of international recruitment raise several implementation and conceptual challenges, making the concept of shared responsibility difficult to operationalise. There is a need for greater international sharing of knowledge about useful examples with a view to their assessment and if appropriate, replication.