Will This Be the Moment We Truly Invest in Health Workers?
Reflections Ahead of the High-Level Meeting on Non-Communicable Diseases (NCDs)
Health Workers are at the heart of health, and they are in crisis
The global health workforce is in crisis. Forecasts show that by 2030, the world could face a shortfall of 11 million health workers, with the most severe gaps in low- and middle-income countries. As the global supply of health workers dwindles, demand for health services continues to rise due to emerging and converging health challenges and emergencies, including NCDs.
But it’s not just a numbers game. Health workers are chronically underpaid, undervalued, and overstretched. Many work without job security, adequate training, fair pay, or essential supplies. Women, who make up 70% of the health and social care workforce, are especially affected by low wages or unpaid work, unsafe working conditions, gender-based violence, and limited leadership opportunities. And across it all, the global mental health toll is rising, placing enormous emotional and psychological strain on health workers themselves.
It is also not just a workforce issue. Health workers are a cornerstone of sustainable development, and their impact extends far beyond clinical care. They contribute directly to economic growth, social development and national and global security. When health workers are supported, countries thrive. When they are neglected, everyone pays the price.
Global Commitments to Health Workers: Still Not Enough
Political declarations from the 2019 and 2023 UN High-Level Meetings on Universal Health Coverage, TB, and Pandemic Preparedness as well as the recently adopted Pandemic Agreement have all highlighted the urgent need to invest in health workers. They call for better pay, training, protection, and recognition of health workers, including for women and cadres of workers whose rights, needs and contributions are often overlooked, like community health workers and midwives. However, many of these promises remain unfulfilled because of insufficient and fragmented funding and domestic policies that fall short of translating commitments into concrete reforms of the health workforce.
And Now, Another Missed Opportunity? Health Workers and NCDs
As we look ahead to the upcoming UN High-Level Meeting on Non-Communicable Diseases (NCDs) in September, health workers must be front and center. NCDs — including heart disease, diabetes, mental health conditions, upper respiratory disease and cancer — are now responsible for over 43 million deaths per year, with mortality projected to rise to 52 million by 2030. Over 85% of premature NCD deaths occur in low-and middle-income countries. Approximately 48% of NCD-related deaths occur in people under age 70, weakening national economies and undermining human capital development. The urgency is compounded by today’s converging polycrises, including violent conflict, climate change, pandemics, and economic decline.
Primary health care workers, nurses, community health workers, and midwives are vital for NCD prevention, early detection, treatment, and palliative care. Over 80% of NCDs are preventable, but these interventions are impossible without a resilient and adequately supported health workforce. Yet, in the Zero Draft Political Declaration on NCDs, the health workforce is scarcely mentioned. The Coalition is extremely concerned about the Declaration’s weak language regarding the broader health and care workforce and has drafted a statement and proposed revisions in response. Without bold commitment to and sustained investment in health workers, there can be no effective response to the global burden of NCDs. This truth must be at the forefront of global dialogue.
Recommendations and Member Successes
Increase investments in the health workforce, bolstering the accessibility of primary care and specialist services by means of well-supported and fairly compensated health workers who are trained in NCD competencies and social determinants of health.
Since January 2024, Last Mile Health has collaborated with Ethiopia’s Ministry of Health to implement the country’s first in-service training program on non-communicable diseases for community health workers. The initiative has demonstrated marked success in skill and knowledge assessments, and improved community access to NCD education, screening, counseling, and treatment services. This national program aims to expand NCD competencies to all 40,000 of Ethiopia’s health extension workers.
Utilize data collection and analysis tools, alongside health worker expertise, to shape national NCD response frameworks and health workforce planning, thus maximizing the effectiveness and sustainability of interventions.
CMMB’s NCDI Initiative in Kenya, spanning 50 health facilities, plans to introduce an additional training in May 2025 to enhance the skill sets of 200 nurses and clinical officers in addressing cardiometabolic diseases. Along with building more resilient supply chain processes and improving data management in alignment with Kenya’s national health system, the Initiative improves access to NCD-specialized training.
Foster innovative and sustainable national health financing schemes that incorporate country NCD priorities and support all cadres of health workers to optimize management, performance, and retention.
In February 2025, Partners in Health launched Sierra Leone’s first dedicated NCD clinic in partnership with the Ministry of Health and NCDI Poverty Network. The clinic is part of a larger NCD treatment strategy to address infrastructural limitations in treating NCDs in Sierra Leone’s rural populations. The clinic empowers low- to mid-level health workers to provide accessible care through education, access to innovative technology, and opportunities for upskilling and career advancement. This approach centers cost-effective interventions facilitated through local recruitment and expertise.
Provide health workers with fair pay, well-regulated and safe working environments, and the necessary psychosocial support mechanisms to protect their physical and mental health.
Project HOPE has long been a pioneer in NCD care, having trained more than 234,000 health workers across the world in NCD competencies over the last 30 years. In addition to upskilling health workers, Project HOPE’s domestic programs offer mental health and resilience training and support to frontline providers while strengthening local capacities and catering resources to marginalized communities and youth.
Prioritize equity-based development strategies, providing women and marginalized groups with opportunities for career advancement and high-level representation.
CARE’s LOVE Project in Marawi City, Philippines provided NCD prevention, screening, and management services to humanitarian refugees from 2019 to 2021. The Project operated through a women-led, community-based model to address chronic illness, empower local women, and combat the prevalence of gender-based violence in refugee settings.