Asia’s nursing leaders sound the alarm on workforce shortages and advance strategies for 2025 and beyond

As the world marks the start of a defining period for nursing and global health policy, nursing leaders from across Asia have called for immediate action to address severe workforce challenges threatening healthcare systems. The coming year will see the release of WHO's second State of the World's Nursing Report, the finalization of the new Global Strategic Directions for Nursing and Midwifery, and the beginning of the final five-year countdown to achieve the UN Sustainable Development Goals (SDGs) and Universal Health Coverage (UHC) targets by 2030.

The 22nd Asia Workforce Forum (AWFF), co-hosted by the International Council of Nurses (ICN) and Malaysian Nurses Association in Kuala Lumpur, brought together nursing leaders representing 11 National Nurses Associations and almost 11 million nurses. During the two-day meeting, the NNAs (see full list below) engaged in critical discussions about the future of nursing in the region. The Forum concluded with the release of a communiqué outlining the challenges facing the region’s healthcare systems and mapping the actions needed to strengthen nursing workforce capacity across Asia.

The Forum highlighted the critical need to invest in the nursing workforce to achieve Universal Health Coverage and the SDGs and emphasized the essential role of primary health care and nurse-led models of care in meeting evolving health care needs and improving community and global health. WHO has identified primary health care (PHC) as the critical success factor in achieving UHC and the Forum recognized that nurses are at the heart of primary health care delivery and must be enabled and supported.

However, participants reported that many countries in Asia are strongly affected by the world’s grave shortage of nurses, which ICN has designated a global health emergency. Nurse leaders brought evidence of escalating difficulties in several regions caused by chronic nurse understaffing and exacerbated by burnout and resignations in the profession stemming from inadequate compensation and unsustainable working conditions; underinvestment in the education pipeline; and migration of nurses from lower- to higher-income countries.

Whilst supporting the right of individual nurses to move abroad, Forum participants noted concerning growth in migration of nurses from the region and recognized that unethical recruitment of nurses from low- and middle-income countries by a small number of high-income nations can exacerbate workforce shortages in source countries, depriving underserved populations of access to health care and deepening regional and global health inequities.

ICN Chief Executive Officer, Howard Catton participated in the AWFF and remarked: “The insights we’ve heard at this Forum show the scale of our global nursing workforce crisis and the urgent need for decisive action, not only within the Asia region but throughout the world. The analysis provided by the region’s nursing leaders speaks to severe staffing shortages, underfunding of health systems, and accelerating migration patterns that are only widening gaps between countries, with vulnerable health systems losing nurses they desperately need.

Even under these circumstances, we are seeing strong leadership and dedication from nurses throughout Asia, including in advanced roles and community and primary care. However, chronic underinvestment is holding back the potential of the world’s nursing workforce at a time when we need nurses more than ever to address our growing health challenges, from aging populations and chronic diseases to climate-related emergencies. We will be unable to achieve Universal Health Coverage and meet our increasingly complex global health needs unless we urgently commit to funding, supporting, and enabling nurses in all regions.”

Participants highlighted the complex health challenges facing the region, with rising non-communicable diseases and shifts towards aging or “super-aging” populations identified as concerns in many Asian countries. Nurses from across the region also reported the demands placed on nurses by intensifying natural disasters, public health emergencies, and impacts of climate change, and shared information about emergency preparedness.

The Forum participants proposed comprehensive solutions and called for Asia’s governments to work with health and nursing organizations to advance the policy actions outlined in ICN’s Charter for Change and Bucharest Declaration as well as the Global Strategic Directions for Nursing and Midwifery 2021-2025.

Specific recommendations included:

• Strategic workforce planning with comprehensive retention strategies that ensure equitable distribution of the nursing workforce
• Funding and support for nursing education systems, including Continuous Professional Development, that equip nurses with the skills to meet evolving population health needs, including preventive and primary health care
• Enabling nurses to work to their full scope of practice and perform advanced practice roles to improve health care access and outcomes
• Investment in safe, supportive work environments that protect nurses' physical and mental wellbeing

Participants brought evidence of progress with initial policies designed to improve recruitment and retention of nurses, including support for new career development and advanced roles, increased compensation and working conditions, and digital transformation support. They highlighted the importance of advancing “bundles” of coordinated policy interventions rather than isolated or disconnected policies. Looking ahead to 2025, Forum representatives committed to working closely with their countries’ governments and health organizations to ensure that the second State of the World's Nursing Report and new Global Strategic Directions for Nursing and Midwifery accurately reflect both current nursing workforce realities and increasing population health needs.

Mr Catton added:

“The evidence gathered at this Forum shows that urgent investment in nursing is essential to achieve our regional and global health goals. As we approach the critical 2025-2030 period, we must make sure that our new SOWN Report and Strategic Directions for Nursing and Midwifery pave the way for a truly strengthened and supported nursing workforce. Data tells us that spending on nursing is not only a cost — it is an investment, which generates multiple returns through improved population health, better education and career opportunities, and economic growth. We now need bold action to build a global nursing workforce that can meet changing population health needs and make Universal Health Coverage a reality.”

Here is the list of the NNAs represented at this year’s AWFF:

Chinese Nursing Association

College of Nursing Hong Kong

Indonesian National Nurses Association

Indian Nursing Council

Japanese Nursing Association

Malaysian Nurses Association

Nurses Association of Macau

Nurses Association of Thailand

Philippine Nurses Association

Singapore Nurses Association

Taiwan Nurses Association