Ultimately, return migration has not solved labour shortage problems and, like the Cook Islands, Fiji, Palau and other Pacific island states, Samoa and Tonga have turned towards Asian labour markets for replacements, although not without tensions and social conflicts. The most obvious means of preventing international migration of skilled health workers (SHWs) is simply to ban migration, and refuse to recognise or issue passports. This has never been discussed in Samoa or Tonga for obvious reasons, and outright bans on the emigration of SHWs, and others, are implausible for ethical, political and, above all, economic reasons.