The government has been accused of cutting crucial health spending aid to countries with severe nursing shortages, while ‘heavily’ recruiting from those same countries.
New analysis from the Royal College of Nursing (RCN) suggests that between 2020 and 2023, direct UK aid for health projects in ‘red list’ countries fell by almost 63%, from £484m to £181m.
Spending on projects meant to grow the healthcare workforce in these countries also fell by 83% from £24m to £4m.
Countries on the World Health Organization’s (WHO) ‘red list’ cannot be actively recruited from by UK health and social care organisations and includes countries struggling with their own health workforce challenges, including lack of universal health coverage.
However, analysis shows that between September 2020 and September 2024, the number of UK registered nurses trained in red list countries, including Nigeria and Ghana, had almost tripled – from 11,386 to 32,543.
In 2020, 749 nurses joined the register from ‘red list’ countries and in 2024, that figure was 5,703.
In the economic context of the Covid-19 pandemic in 2020, the then government, announced a ‘temporary’ reduction in Official Development Assistance (ODA), from the United Nations (UN) target of 0.7% gross national income (GNI), to 0.5% of GNI.
The reduction was applied as part of a £4 bn cut to the foreign aid budget, introduced by former Prime Minister Boris Johnston.
Labour has since kept government spending at this reduced figure and the RCN has this week urged ministers to restore aid spending to 0.7% of GNI urgently.
The RCN calculated that an additional £12.4bn would have been available to ‘much needed development projects’ overseas had the ODA target remained at 0.7%.
And the college said the Labour government now has a ‘duty to fix’ aid cuts imposed by the previous government, as well as the UK’s dwindling supply of domestic nurses.
RCN general secretary and chief executive, Professor Nicola Ranger, said: ‘Cutting crucial health aid spending to countries with the most chronic nursing workforce shortages, while recruiting heavily from those same countries, is damaging some of the most fragile health systems across the globe.
‘It is a damning indictment of our development policy and the failure to grow our own domestic nursing profession.’
She added: ‘This situation cannot be allowed to continue. The UK Government must restore aid spending to 0.7% and aid health care spending.
‘It is our responsibility to ensure healthcare across the globe don’t suffer additional workforce shortages because of our own failure to recruit and retain nursing staff within the UK.’
According to the RCN, the 0.2% reduction has caused £1.3bn worth of cuts to the UK’s ODA health spending between 2021 and 2024.
Only seven countries on the 2023 ‘red list’ received bilateral ODA for projects focused on ‘health personnel development in 2023’.
Last month, mid-year registration data from the Nursing and Midwifery Council (NMC) found that the pace of international recruitment had slowed, while the number of numbers and midwives leaving the UK register had also increased.
For the first time there was over 200,000 international professionals on the NMC register, up 5.3 percentage points from April 2024.
However, the number of internationally educated professionals who joined the NMC register in the six months to September 2025 fell by 16.6% on the same period in 2023.
The 55 countries on the World Health Organisation’s (WHO) ‘red-list’ include Ghana, Nigeria and Pakistan.
A government spokesperson said: ‘The UK remains one of the most generous donors among the G7 and we are committed to restoring development spending to 0.7% of gross national income (GNI) as soon as fiscal circumstances allow.’
They added that the government is ‘working to address’ the global shortage of health workers through work including work with the WHO and World Bank.
