ILC110/III/(B) – Securing decent work for nursing personnel and domestic workers, key actors in the care economy Introduction X II. The instruments 4. This is the first occasion on which the instruments on nursing personnel (Convention No. 149 and Recommendation No. 157) and decent work for domestic workers (Convention No. 189 and Recommendation No. 201) have been the subject of a General Survey. Nursing personnel 5. The Committee observes that the examination of the instruments on nursing personnel is particularly timely. The World Health Organization (WHO) designated 2020 as International Year of the Nurse and the Midwife, not only to commemorate the 200th anniversary of the birth of Florence Nightingale,3 but also to highlight the vital role played by nurses and midwives in providing health services to their communities, and the urgent need to address persistent shortages in the global nursing workforce. Shortly thereafter, the outbreak of the COVID-19 pandemic in early 2020 further increased global attention on the vital role played by nursing personnel and other health workers. 6. On 7 April 2020, the WHO, in collaboration with the International Council of Nurses (ICN) and the global Nursing Now campaign, launched the first State of the world’s nursing report entitled State of the world’s nursing 2020: Investing in education, jobs and leadership,4 which highlights the strong political commitment to universal health coverage (UHC) globally and the central role of nurses in its achievement, at a time when the emergency preparedness and resilience of national health systems is being tested by the pandemic. 7. Subsequently, in November 2020, the WHO designated 2021 as International Year of Health and Care Workers in recognition of the millions of health and care workers at the frontlines of the COVID-19 pandemic. In particular, the WHO recognized the difficult conditions in which health and care workers, including nursing personnel, provide their services. The pandemic, which has stretched health systems to breaking point in many countries, has exacerbated the difficult working conditions and decent work challenges already faced by these workers. Within this framework, the WHO launched the campaign “Protect. Invest. Together”, which highlights the urgent need to invest in the health workforce.5 8. The need to ensure an adequate number of qualified nursing personnel is greater than ever, particularly in light of the pandemic. At present, the global nursing workforce totals 27.9 million, of whom 19.3 million (69 per cent) are professional nurses, 6 million (22 per cent) are associate professional nurses and 2.6 million (9 per cent) are not classified. Nursing personnel make up the largest occupational group in the health sector, accounting for some 59 per cent of the health workforce.6 Nursing is also highly feminized, with women representing 89 per cent of the nursing workforce globally.7 9. The demand for health workers is expected to almost double by 2030, significantly exacerbating existing shortages of qualified nursing personnel.8 The ICN estimates a global shortfall of 13 million nurses by 2030, compounded by an ageing workforce and the impact of COVID.9 Disparities in the number of nursing personnel between regions are also significant, largely 3 Florence Nightingale (12 May 1820–13 August 1910) is generally considered to be the founder of modern nursing. In recognition of her work, the Nightingale Pledge is taken by new nurses, and the Florence Nightingale Medal was named in her honour. International Nurses Day is celebrated annually on her birthday. 4 WHO, ICN and Nursing Now (2020). State of the world’s nursing 2020: Investing in education, jobs and leadership , Geneva. 5 WHO. “Year of Health and Care Workers 2021 ”. 6 WHO, ICN and Nursing Now (2020). State of the world’s nursing 2020, op. cit., p. xiii. 7 ibid., p. 41. 8 ILO, OECD and WHO (2018). Five-year Action Plan for Health Employment and Inclusive Grow th (2017–2021) , Geneva, para. 3. 9 ICN (2021). “The Global Nursing shortage and Nurse Retention ”, p. 1. 17