Health workers in low- and middle-income countries face impossible choices: remain in under-resourced systems where their expertise cannot fully develop and their salary is 10-20x lower than in wealthy countries, or emigrate for professional and financial advancement. 5 million nurses work in countries other than where they trained.

Sub-Saharan Africa has 6% of the world's nurses but faces 25% of the global disease burden. The result is a vicious cycle: weak health systems cannot retain talent → brain drain accelerates → systems weaken further → crisis response capacity collapses.