As the UK economy enters a recession and the NHS faces funding uncertainties, spare a thought for fellow nurses, health care workers and patients in the developing world. Fragile health economies for the poorest people are endangered by any collateral retrenchment of international aid and development spending. This,after decades of struggles to keep health services going against a backdrop of massive debt to western banks. Despite much rhetoric from the G8 and impressive community and global campaigning, the practices of the World Bank and International Monetary Fund have resulted in aid and debt-relief often being tied to retraction and privatisation of public services such as health and education. A global shortage of skilled nurses has also led to richer nations raiding developing countries for staff. The UK has been guilty of this but has latterly introduced tighter regulations under pressure from trade unions.