As a medical student in the US, originally from Nigeria, I am acutely aware of tremendous disparities that exist between people living in different halves of the world. I remember my days in Nigeria; friends, family and casual acquaintances routinely dying in their first and second decades from malaria, diarrhea, typhoid, and sickle cell disease, to name a few. Over the past few years, from formal education and personal learning, I am beginning to fully grasp the magnitude of the health problems that face billions of fellow humans and the intricate intertwinement of poor health with global sociopolitical inequity and injustice.

One area of very prominent maldistribution of international resources is in the health workforce. It is now common knowledge, even to any off‐ the‐street lay person, that developing countries especially those in sub‐Saharan Africa (SSA) carry a disproportionate share of the global disease burden. Many also know that these same areas have a very low proportionate share of the global health workforce. However, fewer make the connection that these two above facts contribute to the perfect storm that perpetuates the persistence of the abysmal morbidity and mortality rates in these parts of the world. I cannot deny that there has been success on multiple fronts, examples include the widespread availability of antiretroviral drugs in some countries, the uptake of mosquito net programs in other areas and the establishment of direct observed therapy for tuberculosis treatments even in low resource settings. These successes are encouraging.

Moreover, a prominent problem that frequently arises is that these successes are rarely sustained. One of the root causes of this problem goes back to the lack of skilled individuals to carry‐on. The international scholarly community and the World Health Organization acknowledge that the lack of skilled health workers in the global south is critical and some efforts to address the shortage have begun, under the auspices of the Global Health Workforce Alliance. The inaugural global Human Resource for Health convention in Kampala in 2008 was a positive sign as it affirmed and officially recognized the importance of capacity building.

However, it does not appear that US global health policy gives the necessary and deserved focus to international capacity building, specifically pertaining to increasing the numbers of skilled health workers. No real and critical analysis of the global health workforce can be undertaken without the acknowledgement of the central role of the US. In raw numbers, the US comprises the largest market for all types of skilled health professionals; and per capita levels of health workers in the US are also amongst the highest in the world. It is also no secret that a significant proportion of the US healthcare workforce is comprised of skilled worker immigrants. For example, some estimates of international nursing and medical graduates (people who complete professional education outside the US) are as high as 25% of the practicing population. In other words, the US does not produce sufficient healthcare workers to meet its demands.

In today’s globalized world, with international market forces and liberalization of migration, a discussion of health worker capacity building in developing countries is inseparable from discourse on issues surrounding the global stock of skilled healthcare workers. A frank acknowledgement and assessment by US policy makers and the medical establishment of the local (US) problem of shortage of health workers is paramount. The US ought to take the onus to ensure that it is, at the very least, producing sufficient health workers to avoid implicit free‐riding and unwittingly taxing other much poorer countries to supplement its inadequacies. Building and licensing more medical schools and expanding current medical school class sizes not only solves local shortage of doctors in the US but also will dampen the gradient that encourages out‐migration from poor countries. The UK has taken similar measures over the past 10 years. Since the training of skilled health workers has a high latency period, the benefits of increasing the pipeline have a slower onset but will sustained overall.

In addition, a similar undertaking in developing countries is necessary. For example, a handful of countries in SSA have no medical schools; and many others have severely inadequate capacities. Multi‐pronged interventions at several tiers of the society will be necessary. Funding specifically earmarked to build medical schools, nursing schools, and public health and health management institutions will produce sustained longer‐term benefits. Building the health workforce capacity can also be incorporated into every project; continued funding for any project should require clear and direct objectives and goals for training and improving capacity of local workers. Some may contend that the mere increase in numbers of health workers may be an inappropriate outcome to measure. Nonetheless, most scholars would gree that there is a positive correlation between the number of health care workers nd survival in infants, children and mothers.