Disease outbreaks may cost the world 17,500 health workers each year
Epidemics are deepening health worker shortages in the countries that can least afford them.
- 23 September 2026
- 4 min read
- by Linda Geddes
At a glance
- A new study drawing on 30 years of data from 194 countries and territories estimates that infectious disease outbreaks may account for the loss of around 17,500 health workers from the global workforce each year.
- Niger experienced the greatest losses relative to the size of its health workforce, followed by Somalia and Ethiopia, while India has the greatest estimated losses overall.
- The researchers called for specific measures to protect and retain health workers, particularly in lower-income countries where staffing is already stretched.
Infectious disease outbreaks may account for the loss of about 17,500 health workers from the global workforce each year, with the greatest losses occurring in countries that can least afford to lose them, a new study suggests.
Health workers are unevenly distributed around the world, with some countries having far fewer per head of population than others. Many of the countries with the greatest shortages are also disproportionately affected by epidemics.
During such outbreaks, health workers may not only lose their lives or suffer from disability and other long-term effects of disease, but also become disillusioned and leave their jobs. The resulting economic disruption can leave health systems less able to retain staff.
Measures to reduce the burden of epidemics, including improved disease surveillance and greater vaccination coverage, could help to reduce pressure on health workers.
Yet, while short-term links between epidemics and strain on the health workforce had previously been reported, “no study had quantified how many health workers are lost to epidemics at the global, regional, and national levels, or whether these losses are unequal among countries,” the researchers said.
“Understanding this burden could help direct support toward the health workforce protection and epidemic preparedness, particularly in countries that can least afford further losses.”
How do epidemics affect health worker numbers?
To investigate, Manman Chen at the Chinese Academy of Medical Sciences and Peking Union Medical College in Beijing and colleagues combined 30 years of data on epidemic disasters with health worker density data from 194 countries and territories, calculating the number of epidemic events recorded in each country each year between 1990 and 2019.
These were defined as outbreaks that met at least one of four criteria: affecting at least 100 individuals, involving 10 or more deaths, prompting a country to declare a state of emergency, or triggering a formal request for international assistance.
After accounting for differences in countries’ income levels, socio-demographic development, urbanisation and population density, the researchers found that each additional epidemic recorded in a country was followed by a fall in health worker density the next year.
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Assuming these associations were causal, they estimated that the loss of 17,549 health workers globally each year – equivalent to around 2.6 for every 10,000 health workers – could be attributed to epidemics, with low- and lower-middle-income countries experiencing disproportionately greater losses.
Relative to the size of its health workforce Niger was hardest hit, with an estimated 57 health worker losses per 10,000, followed by Somalia (44 per 10,000) and Ethiopia (37 per 10,000). In terms of overall numbers, India topped the list, with epidemics accounting for an estimated 7,900 health worker losses each year.
Nurses and midwives accounted for the greatest share of the global total, with an estimated 6,125 of losses each year, followed by aides and emergency medical workers (3,162) and doctors (1,478). However, it wasn't only health workers directly involved in treating people with infectious diseases who were apparently affected.
“Beyond cadres with direct clinical exposure to infectious disease, we also observed reduced density among cadres less directly involved in outbreak response, including dieticians and nutritionists, environmental health officers, optometrists and radiographers,” the researchers said.
“A plausible explanation is the reallocation of these workers toward epidemic response and case management during outbreaks, particularly in countries with limited human resources for health capacity where staff are commonly redeployed across cadres out of necessity.
“Disruption to routine, non-emergency health services during epidemics may also reduce demand for these cadres specifically.”
The study was published in PLOS Medicine.
How could countries plan for future epidemics?
The researchers argue that protecting health workers should become a more explicit part of planning for future epidemics, particularly in lower-income countries where staffing is already stretched. This could include specific measures to protect and retain staff, especially nurses, midwives and doctors.
They also suggested that measures to reduce the burden of epidemics, including improved disease surveillance and greater vaccination coverage, could help to reduce pressure on health workers.
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