Addressing the global health workforce crisis: from numerical shortages to skills quality

Healthcare systems can only function with competent workers providing a care of high quality. Currently the world faces a growing health workforce crisis. The World Health Organisation (WHO) has projected a shortfall of 10 million health care workers by 2030. This is a significant challenge for nations worldwide regardless of their developmental status. In response, many nations have become increasingly dependent on migrant health workers to address staffing shortages. To promote fairer and more sustainable workforce mobility, the WHO has introduced Bilateral Framework Agreements aimed at ensuring equitable benefits for both source and destination countries involved in the mobility of healthcare workers. Most international responses aimed at meeting the number gap largely focus on migration pathways and qualification recognition frameworks. However, it is important to note that the recognition of qualifications does not automatically guarantee equivalency in professional competence across countries, particularly within allied health professions where internationally accepted competency benchmarks remain poorly defined. This commentary argues that existing migration frameworks and qualification recognition processes may not do enough in the absence of structured competency benchmarking and measurable skills standards. Although WHO initiatives such as the Global Code of Practice, Bilateral Framework Agreements, and the Global Competency Framework for Universal Health Coverage provide important policy foundations, significant implementation gaps remain in the assessment and comparison of competencies across borders. Competency-based education offers a potential pathway toward more measurable, transparent, and outcome-focused workforce development. The discussion also draws attention to the comparatively limited focus on allied health professions within competency-based education research and global workforce policy, despite the increasingly central role these professions play in multidisciplinary care for ageing populations. Structured global benchmarking and standardization of education and skills are needed so tertiary institutions graduate a competent workforce for multidisciplinary care. Integrating competency benchmarking more effectively into bilateral agreements, educational systems, and international workforce mobility frameworks may support equitable health worker migration, strengthen health systems, and advance progress toward Universal Health Coverage and the Sustainable Development Goals.