As we celebrated International Nurses Day on 12 May, the World Health Organization (WHO) hosted the global launch of its latest State of the World's Nursing 2025 report, which builds on the fascinating 2020 WHO report published after the COVID-19 pandemic (WHO, 2020; 2025).
The 2025 update provides a comprehensive summary of the state of the nursing workforce across the WHO's 194 member countries, in the context of a changing global environment, increasingly complex health and disease profiles and greater demands on health systems. It also highlights the urgency of focusing on the global policy priorities of the UN 2030 Agenda for Sustainable Development over its remaining 5 years (UN, 2015).
There has been progress and widespread uptake of the Global Strategic Directions for Nursing and Midwifery (2021–2025) (WHO, 2021). However, the figures show that the shortage of nurses and midwives has persisted globally. In 2023, the nurse shortage was estimated at 5.8 million, primarily concentrated in the African, Eastern Mediterranean and South-East Asia regions. By 2030, WHO (2025) estimates that the global health and care worker shortage will be 11 million, with a nursing shortfall of 4.1 million.
The report also shows that, while supply has been improved in the countries affected compared with a previous baseline, acceleration to increase nurse numbers is clearly needed, particularly in low income and lower middle income countries. Upper middle and high income countries have also faced threats to supply, due their older workforce and reliance on international recruitment.
Presenting the most contemporary evidence on the global nursing workforce, the report provides us with critical insights into the global picture in a range of areas, including education, employment, migration, regulation, working conditions and leadership.
It includes updated indicators, robust estimates on global and regional-level supplies, shortages and projections of nurse numbers to 2030. Country profiles with national-level data are available online for download.
The data, analyses and policy options outlined in the report will enable policymakers to make investment decisions at country level to support nurse education, employment, leadership and service delivery, and promote the profession as part of an integrated health and care workforce.
Slow progress
Produced by the WHO in partnership with the International Council of Nurses and the global Nursing Now campaign, the 2020 report highlighted nursing as the largest occupational group in the health sector, accounting for about 59% of health professions, and set out to inform national, regional and global actions towards achieving the UN's Sustainable Development Goals (https://sdgs.un.org/goals). It revealed significant findings regarding the status of the nursing workforce leading up to 2020.
In the 2020 report, WHO member states reported high levels of uptake and adaptation of the Global Strategic Directions (WHO, 2021), with many of these national plans extending beyond the end date of 2025.
In view of the data and evidence contained in both reports, what progress has been made? Reading them has provoked the following thoughts and questions.
Given that nursing is the largest occupational group in the health sector and critical for strengthening primary health care to attain universal health coverage, why do significant shortages persist globally, especially in regions with the greatest need? What tangible measures are needed to ensure adequate investment in and support for these regions?
Despite the widespread uptake of the Global Strategic Directions (WHO, 2021) at national levels, major challenges such as unsafe working conditions, gender pay gaps and lack of lifelong learning opportunities remain. Therefore, what are the systemic barriers hindering effective implementation of the Directions? How can accountability be strengthened to ensure nurses benefit from the stated policy priorities?
Global health faces increasingly complex challenges, including climate change impacts, digital transformation and mental health crises. With support for extending the nursing and midwifery strategic directions to 2030, how can global and national strategies effectively integrate these priorities into nursing education and practice, while simultaneously addressing the foundational issues of recruitment and retention, for the existing workforce?
The evidence consistently points to the need for sustained investment in nursing. Beyond government budgets, what innovative, multisectoral approaches involving academia, civil society and the private sector are necessary to secure the required resources and build the institutional capacity needed for effective nursing leadership and governance globally?
The State of the World's Nursing 2025 report is well worth a read as it provides an up-to-date global picture of nursing, and outlines priorities for investment in education, employment, leadership and services. And it provides food for thought for UK nurse leaders.