Keypoints:
- Africa targets three million additional health workers
- Up to 943,000 trained professionals may be unemployed
- Governments face major funding and retention tests
HEALTH ministers from across the WHO African Region have committed to educate, employ and retain at least three million additional health workers by 2035, as the region confronts the paradox of severe staffing shortages alongside hundreds of thousands of trained professionals who may be unemployed.
The Africa Health Workforce Agenda 2026–2035, endorsed by health ministers from the WHO African Region, shifts the emphasis beyond producing more doctors, nurses and midwives towards creating funded jobs, improving working conditions and retaining skilled professionals within African health systems.
Training alone will not meet target
The distinction is critical because WHO estimates that as many as 943,000 trained health workers may be unemployed across the region even as hospitals and clinics struggle with shortages.
Responding to questions from Africa Briefing, Dr James Avoka Asamani, Health Workforce Team Lead at the WHO Regional Office for Africa, said the three-million target should not be interpreted as a pledge simply to train another three million people.
‘The Africa Health Workforce Agenda 2026–2035 sets a target to educate, employ and retain at least three million additional health workers by 2035,’ Asamani said.
He stressed that a trained professional who remains unemployed ‘does not count towards the target’.
The Agenda identifies health labour-market failures, including an average 35 percent shortfall in health workforce budgets, as a major reason countries can simultaneously experience worker shortages and unemployment.
WHO wants governments to absorb appropriately qualified unemployed professionals through funded annual recruitment plans, while reducing health worker unemployment from around 27 percent to 13 percent or less by 2035.
Additional training, Asamani said, should be directed towards occupations, competencies and underserved areas where evidence shows genuine shortages.
Africa had an estimated 5.72 million health workers in 2024 but only about 46 percent of the workforce it requires. Without decisive intervention, WHO warns the region could face a shortage of more than six million workers by 2035.
Governments must find the money
Financing is likely to be the biggest test of the pledge.
WHO estimates that closing Africa’s health workforce gap would require additional spending of roughly $4 to $6 per person each year.
Asamani said governments would have to carry much of that burden themselves.
‘Because health workers provide essential public services and salaries are recurrent, financing must come principally from domestic public budgets,’ he said.
Many countries may need to increase health workforce compensation allocations by around 15 percent annually.
Governments are expected to undertake labour-market and fiscal-space assessments before developing costed investment plans that feed into medium-term expenditure frameworks and national budgets.
Asamani argued that spending priorities will also need to change.
‘There is room to better prioritise health workforce within existing budgets,’ he said.
WHO estimates that technical inefficiencies can absorb around one-fifth of health spending in parts of the region, suggesting that better use of existing resources could create additional fiscal space for recruitment.
The Agenda also proposes private-sector measures adapted to national conditions to help absorb trained health professionals.
Brain drain remains a threat
Keeping workers once they are employed presents another challenge.
African doctors, nurses and specialists continue to leave for wealthier countries offering better salaries, safer workplaces and clearer career prospects.
‘Health worker emigration and retention challenges are driven by multiple factors, including inadequate remuneration, limited employment and career opportunities, unsafe working environments, and active international recruitment by wealthier countries,’ Asamani said.
The Agenda calls for progressively better pay and conditions, career development, continuing professional development, stronger worker protection and targeted incentives for professionals serving in underserved areas.
It also promotes migration monitoring, return and reintegration programmes, diaspora engagement and bilateral agreements requiring recruiting countries to make proportionate investments in the health systems from which they draw workers.
WHO wants at least 80 percent of countries in the region to have regularly updated collective agreements with health worker unions by 2035, compared with around 20 percent in 2024.
Governments face accountability test
The three-million regional target will not be divided into identical national quotas.
‘Each country has committed to establish evidence-based targets reflecting its population needs, workforce shortages, labour market and fiscal capacity,’ Asamani said.
Member States held implementation discussions in Johannesburg from August 10 to 21 and have been given three months to submit national roadmaps.
Regional milestones envisage 1.5 million additional health workers by 2030, 1.7 million by 2032 and three million by 2035.
Progress will be tracked annually through national workforce and expenditure data, National Health Workforce Accounts and the Health Workforce Investment Charter scorecard.
Formal progress reports are expected to go before the WHO Regional Committee in 2028, 2030, 2032 and 2035.
The three-million pledge will therefore be judged not by how many workers Africa trains, but by how many governments can afford to hire — and keep.
