Message from Acting WHO Regional Director for Africa, Dr Chikwe Ihekweazu
Today, on International Nurses Day, we honour the commitment, compassion, and courage of nurses across Africa and the world. Representing nearly 70% of the health workforce, nurses are the foundation of our health systems – essential every day, and indispensable in times of crisis.
This year’s theme, Our Nurses. Our Future. Caring for Nurses Strengthens Health Systems and Economies reminds us that supporting nurses is key to building resilient, equitable, and thriving health systems.
The State of the World’s Nursing Report 2025 offers a clear and urgent call to action. While the global nursing workforce has grown to 29.8 million, up from about 28 million in 2018, this progress conceals dangerous inequities. Nearly 80% of nurses serve only 49% of the world’s population.
In the African Region, recent investments in nursing education and training are yielding results. The number of nurses has nearly doubled, from 900,000 in 2018 to 1.7 million in 2023, increasing the nurse-to-population ratio from 8.7 to 14.1 per 1000 000 people. Yet this remains one of the lowest ratios globally, and more than tenfold lower than in high-income countries.
Nurses account for 66% of the region’s projected shortfall of 6.1 million health workers by 2030. This shortage limits access to essential services, from maternal and child health to chronic disease care, and slows progress towards universal health coverage.
At the same time, while 43% of our nursing workforce is under the age of 35, many lack access to mentorship or clear career pathways. High-income countries continue to recruit nurses from lower-income settings, with foreign-born nurses comprising nearly a quarter of their nursing workforce. In our region, 42% of nurses also report an intention to emigrate, an alarming trend that risks draining critical talent and undermining our most fragile systems.
Constrained budgets add a further layer of complexity. On average, African countries face a 43% shortfall in health workforce financing. As a result, nearly one in three health workers, mostly nurses and midwives, is unemployed or underemployed.
Yet, there is cause for hope.
In May 2024, African leaders endorsed the Africa Health Workforce Investment Charter, setting the stage for long-term progress. Several countries are now generating data, building consensus through national dialogues, and developing Investment Compacts that align with their specific needs. Zimbabwe’s new Investment Compact, for example, is expected to mobilize an additional US$166 million annually over the next three years to strengthen its health workforce.
Still, more is needed.
The 2025 report outlines a clear path forward:
• Expand nursing education, including digital and clinical training.
• Strengthen regulation and introduce advanced practice roles.
• Improve working conditions, including mental health support and fair pay.
• Close the gender pay gap: still at 7%, despite women comprising 85% of nurses.
• Invest in nursing leadership, including empowered Government Chief Nursing Officers.
Nurses are more than caregivers. They are educators, innovators, and frontline responders, often working in the most remote, under-resourced, or crisis-affected areas.
As we mark this day, let us move beyond words to action.
Let us commit to building a future in which nurses are trained, protected, respected, and empowered to lead!
Happy International Nurses Day.
Learn more:
• Global strategic directions for nursing and midwifery 2021-2025
• The Nursing and Midwifery Workforce in the African Region: Optimizing and Accelerating Investments for Resilient Health Systems
• Africa health workforce investment charter: enabling sustainable health workforce investments for universal health coverage and health security for the Africa we want
• Needs-based health workforce requirements to address Africa’s disease burden and demographic evolution: implications for investing in the education and employment of health workers, 2022–2030
• Kenya: Strengthening the health workforce
• Sister Marie Blanche Kambire: serving the most vulnerable
• International Day of the Midwife 2025
