Health systems around the world are facing continuing pressure from workforce shortages, constrained public finances and uneven investment, according to recent World Health Organization assessments.
The pressures are emerging as countries simultaneously try to maintain routine healthcare, prepare for future pandemics and respond to growing challenges linked to ageing populations, infectious diseases, climate-related threats and other emergencies.
WHO said more than 120 countries have identified strengthening institutional capacity to deliver essential public-health functions as a medium-to-high priority for support. The organisation also warned that tighter public budgets and reliance on external financing are making some public-health systems harder to sustain.
Health workforce remains a central challenge
The availability of trained health workers is one of the most important constraints facing health systems.
WHO’s 2026 National Health Workforce Accounts report estimates that the global health and care workforce now exceeds 70 million people.
Despite that growth, WHO says major differences remain between countries and regions in the availability and distribution of health workers. The organisation has revised its projected global workforce shortage for 2030 to 11 million workers.
The projected shortage does not mean that every country will experience the same deficit.
Health-worker availability varies considerably according to national income, population needs, training capacity, migration patterns and the distribution of workers between urban and rural areas.
Global workforce numbers have increased
WHO’s latest workforce data also show that progress has been made.
Health-worker density, measured using doctors, nursing and midwifery personnel, dentists and pharmacists, increased by 52% globally between 2006 and 2025.
WHO estimates that there were 67.9 such health workers per 10,000 people in 2025, compared with 44.8 per 10,000 in 2006.
The increase demonstrates that the global workforce has expanded.
However, WHO cautions that global averages can conceal substantial differences between countries and regions.
A country can therefore experience severe shortages even while the worldwide number of health workers is increasing.
The projected 2030 gap remains significant
WHO’s revised projection of an 11 million health-worker shortage in 2030 highlights the scale of the remaining challenge.
The organisation says the pace of progress has slowed and that workforce shortages remain unevenly distributed.
The projection also represents an update from the previous 2022 estimate of a 10 million shortage by 2030.
The change does not mean that 11 million workers are currently missing.
It is a projection of the workforce gap expected in 2030 under the assumptions used by WHO.
Africa faces particularly large workforce pressures
The WHO African Region faces a significant share of the global health workforce challenge.
WHO’s 2026 assessment of Africa projects a needs-based shortage of about 5.85 million health workers by 2030 under its current scenario.
The report projects that the shortage could reach about 6.28 million by 2035 if workforce growth does not keep pace with population needs.
Nursing personnel account for a particularly large portion of the projected African workforce deficit.
WHO projects that the nursing shortage in the region could increase from 3.65 million in 2024 to 4.43 million by 2035 under the scenario examined.
These figures illustrate why workforce planning is especially important for countries where population growth is increasing demand for healthcare.
Funding pressures affect public-health capacity
Workforce shortages are occurring alongside financial pressures.
WHO said in September that public budgets are tightening while countries face increasingly complex health challenges.
The organisation reported that funding for essential public-health functions is often fragmented, donor-driven and focused on individual programmes rather than broader institutional capacity.
This can make it more difficult for governments to maintain laboratories, surveillance systems, emergency preparedness structures and other public-health infrastructure.
Long-term capacity requires predictable financing rather than resources that appear only during individual outbreaks or emergencies.
External financing remains important in many countries
International assistance continues to play an important role in financing health programmes, particularly in low- and middle-income countries.
However, WHO has warned that reliance on external financing can create sustainability problems when funding is tied to individual programmes or changes according to donor priorities.
The organisation has called for stronger domestic financing and more coordinated international support.
WHO also says multilateral development banks could play a greater role in financing public-health capacity where appropriate.
Health workers are a major part of health spending
Increasing the number of health workers requires substantial investment.
WHO notes that health workers form the backbone of health systems and that workforce spending can represent a large share of recurrent health expenditure.
A WHO webinar on sustainable health-workforce financing noted that health and care workers can account for approximately 50% to 70% of recurrent health expenditure.
That creates a difficult policy challenge.
Governments need enough workers to deliver healthcare, but expanding the workforce requires sustained spending on education, salaries, training, working conditions and retention.
Distribution can matter as much as overall numbers
A country can increase its total number of health workers without eliminating shortages in areas where healthcare needs are greatest.
WHO’s workforce assessment highlights persistent inequalities in the distribution of health workers.
Urban centres can attract larger numbers of doctors, nurses and other professionals, while rural and remote communities can face difficulty attracting and retaining workers.
This creates gaps in access even when national workforce totals improve.
Policies addressing recruitment, retention, working conditions and training therefore need to consider where workers are located as well as how many are employed.
An ageing workforce adds another challenge
WHO’s 2026 workforce report also examines the ageing of health workers.
An ageing workforce can increase retirement-related pressures and create additional demand for training and recruitment.
WHO’s Western Pacific office reported in September that one in four doctors globally is approaching retirement age.
The retirement issue does not mean that all of those doctors will leave the workforce simultaneously.
It does, however, highlight the importance of succession planning and ensuring that enough younger professionals enter and remain in healthcare careers.
Training capacity needs to expand
Increasing the workforce requires more than recruiting existing professionals.
Countries need sufficient educational institutions, clinical training facilities, qualified educators and financing to produce new health workers.
WHO’s workforce strategy therefore includes measures aimed at expanding education and employment in the health and care sector, addressing critical skills gaps and improving retention.
The organisation also highlights the importance of safe working conditions and lifelong learning.
Without investment in training capacity, recruitment efforts can simply shift workers between countries rather than increasing the overall global supply.
International migration is another factor
Health-worker migration can help individual professionals find better employment opportunities but can also create shortages in countries that lose trained staff.
WHO has continued work on the ethical management of international health-worker recruitment.
Its 2026 resolutions include an updated Global Code of Practice on the International Recruitment of Health Personnel.
The issue is particularly sensitive where countries with limited training capacity lose experienced professionals to countries offering higher salaries or better working conditions.
International recruitment policies therefore form part of the wider workforce-planning challenge.
Public-health institutions face pressures beyond hospitals
The current debate is not limited to hospitals and clinical care.
WHO defines essential public-health functions broadly, including activities such as disease surveillance, health promotion, prevention, emergency preparedness and other functions needed to protect populations.
The organisation said more than 120 countries have identified strengthening institutional capacity for these functions as a medium-to-high priority.
These systems are particularly important during outbreaks because governments need reliable surveillance and response mechanisms before an emergency begins.
Pandemic preparedness adds another demand
The workforce and financing challenges have become more important as governments seek to strengthen pandemic preparedness.
At the UN General Assembly’s September 25 high-level meeting on pandemic prevention, preparedness and response, world leaders renewed commitments to stronger health systems and increased investment.
The meeting also highlighted persistent financing gaps and the need for equitable access to vaccines, diagnostics and treatments.
Pandemic preparedness therefore depends partly on the same health-system infrastructure required for routine healthcare.
Weaknesses in laboratories, workforce capacity and primary healthcare can affect both everyday services and emergency response.
Climate and other risks increase pressure
WHO has identified climate-related threats and other emerging risks as additional pressures on health systems.
Extreme weather, changing disease patterns and other environmental pressures can increase demand for healthcare and public-health interventions.
At the same time, health systems must continue treating existing diseases and providing routine services.
This creates competing demands for limited financial and human resources.
Countries are looking for different solutions
Governments are responding to the pressures through different approaches.
These include increasing domestic health budgets, expanding medical and nursing education, strengthening primary healthcare, improving worker retention and using technology to support training and service delivery.
WHO has also highlighted opportunities for South-South cooperation and institutional partnerships among developing countries.
The appropriate combination of measures varies according to each country’s workforce structure, fiscal position and healthcare needs.
Technology can help, but does not replace workers
Digital health tools, telemedicine and artificial intelligence are increasingly being considered as ways to improve healthcare delivery and training.
However, technology does not remove the need for qualified health professionals.
WHO’s workforce strategy continues to emphasise the need for trained, competent and adequately supported health workers.
Digital tools can potentially improve efficiency and access, but their effectiveness depends on infrastructure, regulation, skills and reliable financing.
The challenge is long term
Health workforce shortages cannot generally be resolved through short-term recruitment campaigns.
Doctors, nurses and other health professionals require years of education and clinical training.
Governments therefore need workforce plans that anticipate population growth, ageing, disease patterns, retirement and migration.
WHO’s workforce data are intended to help countries improve this type of long-term planning.
What happens next
WHO is encouraging governments to treat health-system capacity as a continuing investment rather than an emergency response mechanism.
That includes strengthening health-worker education, improving retention, developing reliable workforce data and directing financing toward essential public-health functions.
International organisations and development banks also have a role in supporting countries where domestic resources are insufficient.
The challenge is to ensure that external assistance strengthens national systems rather than creating parallel programmes that are difficult to maintain.
Global health systems remain under pressure
As of September 27, 2026, global health systems have more health workers than two decades ago, but WHO data show that major workforce and distribution gaps remain.
The organisation now projects an 11 million health-worker shortage by 2030, while its recent public-health assessment highlights tighter budgets, uneven investment and dependence on external financing as continuing constraints.
The pressures are interconnected.
A shortage of trained workers can reduce access to healthcare, while inadequate financing can make it harder to recruit and retain staff. Weak public-health institutions can then make it more difficult to detect and respond to disease outbreaks.
The latest international health discussions therefore increasingly focus on building systems that can provide routine healthcare while remaining capable of responding to future emergencies.
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