African leaders have launched a detailed investment blueprint to close the continent’s massive health workforce shortage, warning that Africa will need an additional 6.1 million health professionals by 2030 to achieve universal health coverage (UHC).
The report, “An Analysis of Africa’s Health Workforce Compact Investment,” was released last week by the African Union and Africa CDC in response to a resolution from the 35th Ordinary Session of the AU in Addis Ababa. It provides a first‑ever continental investment baseline for the African Health Workforce Compact, mapping out how much African countries must spend to train and retain the doctors, nurses, midwives, and community health workers required to serve their populations.
The report makes a stark economic argument: while the cost of building a strong local health workforce is high, the cost of inaction is far greater. Africa is already losing an estimated $2.4 trillion through medical tourism, as people travel abroad seeking care that should be available at home.
By investing in its own health workers, the continent can keep this money within its economies, strengthen local health systems, and save lives. The model outlines three pathways: a “status quo” scenario, a “moderate” path to reach 70% health coverage, and an “ambitious” plan aiming at 100% coverage.
Under the most ambitious scenario, the continent’s return on investment is projected to reach 19.4 by 2063 – roughly $19 in economic and social benefits for every $1 spent on the health workforce.
Currently, only two African countries meet the historic Abuja Declaration target of allocating 15% of their national budgets to health. Many others still rely heavily on foreign aid, which the report warns is becoming less predictable.
“With the changing landscape of international financial support, African countries must look inward,” the report urges. It calls on countries like Ethiopia, Ghana, Liberia, and Zimbabwe to prioritize domestic resource mobilization – using tax revenues, innovative financing, and health sector reforms – to pay for the training, deployment, and salaries of the continent’s future doctors and nurses.
As host of the African Union and central to this initiative, Ethiopia is at the heart of the continental strategy. Yet the country faces the same dual challenge as many neighbors: a critical shortage of health workers and a persistent “brain drain.”
The report notes that the annual migration of doctors and nurses from Africa is relatively low (0.5% and 0.4% respectively), but the desire to emigrate among health professionals is alarmingly high, averaging about 42.2%.
To stop this exodus, the report recommends improving working conditions, scaling up diaspora repatriation programs, and negotiating bilateral service agreements so that trained professionals choose to stay or return.
The compact proposes clear targets: for every 10,000 people, Africa needs 11.1 doctors (including specialists and general practitioners), 83.77 nurses and midwives, 36.2 community health workers, and 20 laboratory scientists.
Since not all students who start medical or nursing school complete it – the report cites completion rates of about 74.7% for doctors and 82.6% for nurses – governments must significantly increase enrolment to compensate and reach the overall goal.
Each additional doctor, the report estimates, saves an average of 1.72 mothers and children under five per year. Reaching ambitious workforce targets could prevent millions of deaths and illnesses, with total benefits in the highest scenario reaching about $410 trillion by 2063, including saved lives and avoided illness.
