The global nursing workforce has grown from 27.9 million in 2018 to 29.8 million in 2023, yet stark disparities persist in nurse distribution across regions and income levels, according to the newly released State of the World’s Nursing 2025 report by the World Health Organization (WHO) and the International Council of Nurses (ICN).
Published on International Nurses Day, the report presents the most comprehensive and current analysis of the global nursing workforce, drawing on data from all 194 WHO Member States.
While the findings highlight progress—particularly a reduction in the global nurse shortage from 6.2 million in 2020 to 5.8 million in 2023—experts caution that this overall improvement conceals deep structural and regional inequalities.
The shortage is projected to decline further to 4.1 million by 2030, but that goal remains uncertain unless urgent, coordinated action is taken.
Inequities in Workforce Distribution
According to the report, a staggering 78% of the world’s nurses are employed in countries that account for just 49% of the global population.
This lopsided distribution leaves low- and middle-income countries (LMICs) struggling to graduate, employ, and retain enough nurses to meet healthcare needs.
“This report contains encouraging news, for which we congratulate the countries making progress,” said WHO Director-General Dr. Tedros Adhanom Ghebreyesus. “However, we cannot ignore the inequalities that mark the global nursing landscape.
On International Nurses Day, I urge countries and partners to use this report as a signpost—showing us where we’ve come from, where we are now, and where we need to go—urgently.”
High-Income Countries Face Retirements, Overreliance on Migrant Nurses
The report underscores that 23% of nurses in high-income countries are foreign-born, compared to just 8% in upper-middle-income countries, 3% in low-income countries, and 1% in lower-middle-income countries.
This highlights a growing reliance on international migration to staff health systems, especially in wealthier nations.
WHO and ICN call for greater domestic investment in health workforce training and employment, and for high-income countries to strengthen ethical recruitment practices and bilateral agreements with countries they draw nurses from.
Compounding this issue, some 19% of nurses globally are expected to retire within the next decade, with retirements expected to outpace new entrants in 20 mostly high-income countries.
This trend could leave significant experience gaps, jeopardizing mentorship for younger nurses and undermining care quality.
Graduation Gains Not Translating into Workforce Growth
While low-income countries are increasing the number of nurse graduates faster than high-income countries, these gains are not always translating into increased workforce density.
Rapid population growth, coupled with limited job opportunities, means many graduates remain unemployed or underemployed.
The report urges countries to create more nursing jobs, ensure proper integration of graduates into health systems, and improve working conditions to reduce attrition.
Gender, Equity, and Leadership
Women continue to represent the vast majority—85%—of the global nursing workforce. Despite this, gender equity in leadership and decision-making remains a concern.
Positively, 82% of countries now report having a senior government nursing official, up from previous years.
However, structured leadership development programs are present in only 25% of low-income countries, compared to 66% globally.
“This new data exposes the inequalities holding back the nursing profession and hindering progress toward universal health coverage,” said Pam Cipriano, President of the International Council of Nurses. “Delivering UHC depends on recognizing the value of nurses and empowering them to drive positive change in our health systems.”
Advanced Practice Roles and Future Directions
Encouragingly, 62% of countries now report having advanced practice nursing (APN) roles, up from 53% in 2020. APNs are key to expanding access and quality of care, especially in underserved areas.
Looking ahead, the report recommends that from 2026 to 2030, countries focus on:
- Expanding and equitably distributing nursing jobs, especially in rural and underserved regions.
- Improving working conditions, including pay equity and mental health support.
- Investing in leadership training, particularly for women in the profession.
- Enhancing workforce data systems to better inform policy and planning.
As the world continues to grapple with health system pressures—from aging populations to the aftermath of global pandemics—strengthening the nursing workforce remains critical to global health resilience.
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