Nardi stresses that the Caribbean countries are not an isolated example. “In Malawi, there are only 17 nurses for every 100 000 people,” she says. In India, nurse shortages occur at every level of the health-care system. According to Dileep Kumar, chief nursing officer at the Ministry of Health and director of the Indian Nursing Council, 2.4 million nurses will be needed by 2012 to provide a nurse-patient ratio of one nurse per 500 patients.