The State of the World’s Nursing 2025 report, published by the World Health Organization (WHO) in partnership with the International Council of Nurses and other global stakeholders, paints a nuanced picture of the global nursing sector, marked by steady progress yet shadowed by enduring disparities.

Between 2018 and 2023, the global nursing workforce expanded from 27.9 million to 29.8 million. While this upward trend is a welcome sign of progress, the report warns that the uneven distribution of nurses across regions and income groups threatens efforts to achieve universal health coverage, strengthen health security, and meet broader development goals.

Published on International Nurses Day, the report draws on data from all 194 WHO Member States, offering a detailed snapshot of workforce dynamics and policy trends. It reveals a gradual decline in the global nursing shortage from 6.2 million in 2020 to 5.8 million in 2023 with projections suggesting a further drop to 4.1 million by 2030. Yet this overall progress conceals deep imbalances: nearly 78 per cent of nurses are employed in countries that represent less than half of the global population. A 33 per cent rise in national data reporting since 2020 has significantly improved the accuracy and depth of this year’s findings.

In his remarks, the WHO Director-General acknowledged the positive signals but also emphasised the gaps that remain. He called on governments to use the report as a roadmap measuring past achievements, addressing present shortcomings, and setting priorities for future workforce development. The President of the International Council of Nurses echoed this, stressing that unless structural inequalities are addressed, nursing will continue to fall short of its transformative potential in health system reform.

The report highlights clear differences in the challenges faced by countries at different income levels. Low- and middle-income nations are contending with chronic underinvestment in training, employment, and retention of nurses largely due to constrained resources. These countries are urged to increase investment in job creation and better integration of nurses into national health systems.

In contrast, high-income countries face an ageing nursing workforce and looming waves of retirement. These systems are being pushed to reduce dependence on foreign-trained nurses by strengthening domestic capacity and revisiting international recruitment practices. Developing bilateral agreements and enhancing local training pipelines are presented as critical next steps.

The report also delves into gender and migration patterns. Women comprise 85 per cent of the global nursing workforce, yet leadership and policy influence remain inconsistent. Meanwhile, richer countries are heavily reliant on internationally trained nurses: globally, one in seven nurses is foreign-born, and in high-income settings, that figure rises to nearly one in four. This stands in sharp contrast to lower-income regions, where education systems are expanding, but job creation and retention lag behind.

Rapid population growth in many low-income countries is outpacing gains in nurse training. Without adequate employment opportunities and improved working conditions, these countries risk losing talent and undermining the sustainability of their health systems.

Globally, the nursing workforce remains relatively young, one-third are under 35. However, in about 20 countries, mostly high-income, retirements are projected to exceed the number of new entrants, sparking concern over the loss of experienced mentors and knowledge transfer in the profession.

Encouragingly, advanced practice nursing is gaining traction, with 62 per cent of countries reporting implementation, up from 53 per cent in 2020. These roles are known to improve access and quality of care. Leadership representation has also improved, with over 80 per cent of countries appointing a senior government nurse. Nonetheless, leadership development remains inconsistent: only one in four low-income countries report having formal leadership training initiatives in place.

Mental health support for nurses continues to be a neglected area. Despite the enduring strain from the COVID-19 pandemic, just 42 per cent of countries have instituted mental health support measures for nursing staff. The report underscores the need to prioritise mental well-being to ensure workforce retention and maintain care quality.

Looking ahead, the report outlines a policy agenda for 2026–2030 focused on building stronger, more equitable nursing systems. Recommendations include expanding employment opportunities, ensuring fair distribution of the workforce, improving education and aligning qualifications with system needs, and promoting pay equity and decent working conditions.

It also calls for accelerating the regulation and development of advanced nursing roles, addressing gender inequity, protecting nurses in conflict zones, integrating digital technologies, and preparing the workforce for climate-resilient healthcare delivery. Strengthening leadership and ensuring equitable access to development opportunities are positioned as foundational to long-term success.