WHO’s latest workforce findings show a wide Europe–Africa staffing gap. Older doctor workforces and uneven local coverage add different challenges for health services.
The world’s health workforce has grown, but its distribution remains sharply uneven. In findings publicised on 18 September, the World Health Organization reported doctor density in its European Region at 13 times the level in its African Region. For nurses and midwives, the ratio was six to one.1
The underlying National health workforce accounts: health workforce levels and trends 2026 draws on countries’ official reporting in the 2025 data release. WHO’s publication page is dated 22 June; September is the date of the accompanying news update. Those dates describe publication and reporting, not a simultaneous census of every country’s workforce.2
These ratios compare workers with population. They do not measure appointment availability, staff hours or whether care is affordable. Nor can a regional average describe the position of every country inside it. A well-staffed capital and an understaffed district can disappear into the same aggregate.
Analysis: the two questions to keep separate are how much clinical capacity exists now, and how much will need replacing. A comparatively young workforce can still be too small for its population. An older workforce can sit inside a system with relatively high staffing. One measure cannot substitute for the other.
WHO says nearly one in four doctors, on average across the latest available data from 122 countries, is older than 55. The share is nearly one in three in high-income countries.1 This is an age profile, not an observed retirement count.
Separate OECD analysis puts the share over 55 at 32% across its members in 2023. Latvia, Estonia, Italy and Hungary each had at least 44% in that age group. Italy also had more than one doctor in five aged 65 or above.3
That supports the broad concern about replacing experienced staff, without independently reproducing WHO’s global estimate. The populations, dates and reporting coverage differ, so the two averages should not be read as a trend.
OECD also reports that some doctors have extended their careers, helping limit shortages. Flexible transitions towards retirement can retain willing, able practitioners. The age figures therefore identify a planning exposure; they do not establish that everyone crossing a particular birthday will stop work within ten years.3
Unequal coverage also appears within relatively wealthy countries. Across 18 OECD countries, metropolitan areas averaged 5.0 doctors per 1,000 residents against 3.2 in remote areas, using the organisation’s 2023 comparison and nearest available observations.4
OECD highlights Lithuania, where metropolitan density was 6.6 doctors per 1,000 people, compared with 2.0 in remote areas. It finds more even distributions in Belgium, Japan and Korea. These local comparisons are different from WHO’s continent-scale regional groupings.4
Some urban concentration reflects specialist services serving wider catchment areas, OECD explains. It also cautions that rising headcounts need not produce an equivalent increase in working capacity: average doctor hours have fallen in most countries it examines.5
Analysis: neither equal headcounts everywhere nor a rising national total proves that needs are being met. Assessing a local service also requires its patient catchment, available specialties, opening hours and referral arrangements. The comparisons above flag uneven distribution; they cannot specify the right staffing level for an individual hospital.
OECD identifies several ways to influence where doctors practise: financial incentives, recruiting medical students from rural backgrounds, changing training locations and improving working conditions in underserved areas.5 WHO’s rural-workforce guidance likewise recommends combining interventions suited to local circumstances, protecting existing staff alongside developing and recruiting multidisciplinary teams.7
International recruitment links national workforce decisions. OECD’s migration review shows that countries can be both destinations and sources of health professionals; Germany and the UK illustrate that overlap. It warns that destination-country records alone provide an incomplete account of movements, including migration outside the OECD.6
Analysis: replacing a retiring doctor, increasing total capacity and improving rural coverage are separate objectives. A staffing plan needs to say which it is addressing, and track whether additional workers actually reach the services with gaps.
For readers assessing a recruitment announcement, that means asking what its headline number counts. Is it new training places, qualified people hired, or additional clinical hours? Does it allow for departures? Is it a national total or a commitment to a specific underserved area? Those are different tests of whether capacity is increasing where it is needed. An age profile can help frame those questions, but it cannot answer them on its own.
The material verified for this article does not provide a comparable doctor-age breakdown for every WHO region, matched to the same year’s staffing density. We therefore cannot rank regions by their combined exposure to ageing and low staffing. The full WHO report download was inaccessible during preparation; its new headline figures are taken from WHO’s update and publication overview.
OECD also notes that some countries count doctors licensed to practise rather than only those providing care. Different definitions and reference years limit precise comparisons.3 No retirement forecast is plotted here.