Without greater national self-sufficiency, migration will be encouraged in one form or another. The ministers of health from PICs agreed in 2005 to develop a Pacific Code to provide a mechanism to facilitate recruitment of health workers between and from PICs within a framework based on ‘mutuality of benefits’ for all, a form of managed migration (see section 6.10). This so-called Samoa Commitment recognised that the loss of skilled health workers through migration, where there was already a shortage, had serious implications for the health of Pacific people.