ICN President raises concerns with Spain’s Minister of Health and WHO Representative: global nurse shortages, unethical recruitment, and attacks on health care

The President of the International Council of Nurses (ICN), Dr. José Luis Cobos Serrano, met in Madrid with Spain’s Minister of Health and European representative on the Executive Board of the World Health Organization (WHO), Mónica García. During the meeting, they addressed the major challenges threatening the sector: the severe shortage of nurses, inequalities in international recruitment processes, and the rise in attacks against health services, especially in conflict zones.

Dr. Cobos shared with the Minister his deep concerns around the violence nurses face, “in conflict zones as well as in smaller‑scale situations, including the assaults nurses face within health systems”, noting ICN's recent letter to the United Nations Secretary-General, António Guterres, calling for immediate measures to stop attacks on health care. The ICN President also highlighted the impact of ICN's #NursesforPeace campaign and Humanitarian Fund, which support frontline nurses in crisis areas such as Gaza, Ukraine, Sudan, and many other regions, and was recognized by the UN Special Rapporteur on the Right to Health.

Dr. Cobos and the Minister also discussed ICN’s Nursing Leadership for Crisis Response and Recovery (NLCRR) programme, which supports nurses in strengthening their leadership in situations of conflict or disaster.

He underscored the importance of the 2025 State of the World’s Nursing report (SOWN 2) that ICN co-chaired with WHO, which shows a persistent grave shortage of almost 6 million nurses globally. ICN’s President also praised Spain’s support for the extension until 2030 of the Global Strategic Directions for Nursing and Midwifery, approved by the World Health Assembly.

Discussing health inequities worldwide, Dr. Cobos warned that unequal and unfair international recruitment practices are a serious problem that can leave the most vulnerable countries without sufficient nursing staff and without any return on their investment in training them. He pointed to a clear lack of reciprocity in compensating these countries for the loss of their professionals.

The ICN President also expressed concerns that the vital importance of health professionals is being overlooked in multilateral forums, saying: “Not enough emphasis has been placed on health workers, especially on nurses, including the most recent UN General Assembly. For example, the UN Political Declaration on noncommunicable diseases (NCDs) does not sufficiently recognize the importance of health professionals in tackling these conditions, and the WHO NCD ‘best buys’ report fails to recognize nurses and health workers as one of these priority investments — even though they are the ones on the front lines delivering the treatment.

The conversation with the Minister also focused on the internal reorganization under way at the WHO, which is marked by budget cuts and the merging of the nursing, health workforce, and WHO Academy departments. Dr. Cobos raised the alarm that these changes could reduce the visibility, leadership, and strategic impact of nursing within WHO, stating “We simply cannot afford to lose the progress we have achieved in recent years”.

Finally, the ICN President reiterated his willingness to continue working closely with the Minister with the aim of strengthening nursing leadership, promoting an ethical and sustainable health workforce, and advancing resilient health systems.