1. Mason, Diana J. PhD, RN, FAAN, editor-in-chief

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Three prominent themes emerged from the 1,500 presentations at the 23rd Quadrennial Congress of the International Council of Nurses (ICN), May 21-27, in Taipei, Taiwan. More than 4,000 nurses from at least 130 countries attended, and the Council of Nursing Representatives (CNR), the governing body of ICN, included a record 104 National Nurses Associations (NNAs).


The three themes were:



Stephen Lewis, United Nations envoy for HIV-AIDS in Africa, provided a moving keynote address describing the global impact of the pandemic and challenging the nursing community to be a leading voice for free drug treatment. And outgoing ICN president Christine Hancock announced a new initiative to raise money to educate girls who are orphans of nurses from developing nations who have died of AIDS (see Editorial, page 11).


The global nursing shortage is attributed to the impact of HIV-AIDS, poor working conditions, the limited ability to educate enough nurses, and the recruitment of nurses by Western nations, which further depletes developing countries. ICN chief executive officer Judith Oulton noted that discussions of the role of the World Bank and World Trade Organization in migration, human resources, and health promotion in developing countries were more prevalent at this congress than at previous ones. The ICN announced it's partnering with the Commission on Graduates of Foreign Nursing Schools to form the International Centre on Nurse Migration "for the development, promotion, and dissemination of research, policy, and information" to address workforce issues related to nurse migration (

FIGURE. Stephen Lewi... - Click to enlarge in new windowFIGURE. Stephen Lewis, United Nations envoy for HIV-AIDS in Africa, left, and Christine Hancock, outgoing president of the International Council of Nurses (ICN), at the ICN's 23rd Quadrennial Congress in Taipei, Taiwan, in May.

Acknowledging that nurses worldwide are struggling to cope with the demands of daily work, Oulton said that even the United States has a "depressed and demoralized" nursing work-force, despite having much higher staffing levels than some countries. Many speakers emphasized the shortage's impact on quality of care, with some observing that nurses must make this connection to policymakers when seeking a policy solution.


Nursing's role in global health.

At a time when there is an incredible need for nurses' involvement in international health and workforce matters, the World Health Organization (WHO) is poised to eliminate its nursing and midwifery advisory group and replace it with a "human resources" advisory group. Oulton urged the NNAs to lobby their own countries' ministers of health to advise the WHO director general to retain the nursing-specific advisory group and to ensure that nursing positions within WHO aren't eliminated. Oulton warned that if the WHO doesn't have nurses in its central offices (such as its world headquarters in Geneva, Switzerland), the regional and national offices of the organization will follow suit, further quelling nurses' voices and undermining nurses' contributions to international health care at a time when they're desperately needed. Oulton said that the ICN and the International Council of Midwifery recently wrote a strong letter to the WHO, stating, "If you want to reach your Millennium [Development] Goals, you won't do so without nurses." The Millennium Development Goals are the WHO's goals for promoting health worldwide (


Other highlights:


* Hiroko Minami was elected as the 25th president of the ICN. Minami is the president of the Japanese Nursing Association (the largest NNA in the world, with 470,000 members) and director of the Japanese Academy of Nursing Science.


* The United Arab Emirates' Nurses Association was seated as the newest member of ICN.


* William Holzemer, president of the American Nurses Foundation and professor of nursing at the University of California at San Francisco, was elected to the ICN board of directors.


* The ICN is meeting with the NNAs in Sri Lanka, Indonesia, and other Asian countries affected by the December 26, 2004, tsunami to consider establishing a group to address the need for more disaster pre-paredness and nursing education worldwide.


* ICN's first vice president and AJN international advisory board member Eleanor Ross of Canada announced the launch of a "globally accessible" database of nursing innovations, serving as "an important source of progress for health care systems around the world." Nurses are encouraged to post their innovations that improve outcomes and reduce costs at


* The 2009 Quadrennial ICN Congress will be held in Durban, South Africa, hosted by the Democratic Nursing Organisation of South Africa (DENOSA).