Acting Early on Non-Communicable Diseases 2026
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Health system workforce challenges extend beyond
numbers to fundamental mismatches in composition,
distribution and training. The declining attractiveness
of primary care and prevention specialties creates
structural obstacles to NCD management even in
countries expanding overall workforce capacity. Medical education continues to emphasize acute care
despite the reality that most graduates will spend their
careers managing chronic conditions. Geographical
concentration in urban centres operates even within
publicly funded systems, driven by market forces that
payment reforms have failed to counteract.3.3 Workforce capacity and development
Current landscape
Practising generalist doctors, specialist doctors and nurses per 1,000 population,
2015 and 202260FIGURE 5
3.55
5.28
4.32
2.83
3.18
4.77
2.98
d
2.43
d
2.45
Specialist doctors
10.18
12.08
3.84
d
6.81
12.18
5.82
6.08
d,e
9.91
8.47
10.72
3.21
d
5.49
e
11.33
5.20
5.29
d,e
Nurses
1.26
1.41
0.96
0.41
0.89
d
0.38
0.75
d
Canada
France
Germany
Greece
Italy
Japan
Poland
Spain
Generalist doctors
1.48
1.82
2.65
d
2.70
1.41
1.70
1.94
1.33
1.37
1.03
0.46
1.05
0.87
0.95
d
No formal system for general
practitioners, most patients
go straight to specialist
doctors for treatment
2015 2022 Notes: d = deviation from the definition;
e = estimated value
Source: Adapted from: OECD (2023), Health at a
glance 2023: OECD indicators. OECD Publishing, Paris
Acting Early on Non-Communicable Diseases: A Framework for Health System Transformation 18
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