Five years after COVID, UNI report exposes deepening global care crisis

A staggering new global survey of care workers reveals a deepening staffing crisis in the health and care sectors, with nearly 70% of workers frequently understaffed and over a third (36.4%) saying they are always working short-handed. Released on the fifth anniversary of the W.H.O.’s COVID-19 pandemic declaration, the UNI Global Union report—based on responses from 11,233 workers across 63 countries—exposes a care system still in freefall. Despite being hailed as heroes, care workers face chronic understaffing, poverty wages, and surging workplace violence, driving many out of the profession and leaving patients at risk. Workers without union protections are affected by this trend even more intensely. The same failures that cost tens of thousands of lives during the pandemic remain dangerously ignored.

UNI warns that these conditions are driving workers away from the sector, exacerbating a crisis that governments and employers have failed to address. The survey shows that union membership and collective bargaining significantly improve worker retention and satisfaction.

Safe staffing levels are essential for high-quality care and safer work environments, but chronic shortages in hospitals and care homes undermine patient health – even causing preventable deaths. For care workers, understaffing leads to poor morale, increased workplace violence and injury rates, and high turnover.

“Five years after the pandemic, care workers are still being overworked, underpaid and exposed to dangerous conditions,” said Christy Hoffman, General Secretary of UNI Global Union. “This report is a wake-up call. Without immediate action to raise wages, improve staffing levels, and combat workplace violence, care systems will collapse.”

Increased public funding for the care sector to ensure quality services, fair pay and a workforce that can meet growing demands.

“There is no shortage of care workers—there is a shortage of care workers willing to endure low pay, chronic understaffing and unsafe conditions,” said Alan Sable, Head of Care for UNI Global Union. “The care staffing crisis cannot be solved simply by training new workers or recruiting migrant care workers. Unless we address the core issues driving people out of the sector—low wages, understaffing and widespread violence and harassment—the cycle of worker shortages and declining care quality will continue.”

UNI Global Union demands immediate action

UNI Global Union is calling on governments and employers to act now with the following urgent reforms:

✔ Higher wages and better benefits to make care jobs sustainable and retain workers.
✔ Mandatory safe staffing levels to prevent burnout and protect patient care.
✔ Stronger protections against workplace violence and harassment, including ratification and enforcement of ILO Convention 190.
✔ Fair treatment and legal protections for migrant workers, who face disproportionate discrimination and unsafe conditions.
✔ Support for union representation and collective bargaining, which improve working conditions and job sustainability.

✔ Increased public funding for the care sector to ensure quality services, fair pay and a workforce that can meet growing demands.

Worker testimonies: “We’re failing—And no one cares”

Real-life accounts from frontline workers expose the human toll of this crisis:

➡ United Kingdom ( Hospital worker) “People being bullied and people being racist in our department, and it’s always brushed under the carpet, and I believe this is done because we are so short-staffed.”

➡ New Zeland (Caregiver, Aged Care Facility) – “I was sexually assaulted twice by a resident because I wasn’t listened to or protected by my manager or my work colleagues. That occurred because of being short staffed and I ended up having to provide care to the person who sexually assaulted me a year prior.”

➡ Kenya (Hospital Nurse) – “It should not be like this. Working with so little equipment, resources, drugs and with such high expectations in the populace. We’re failing, badly. And the government doesn’t care.”

➡ Canada (Aged Care Worker) – “Every government has promised to make Healthcare a priority, that definitely has not happened. I had hoped that after the horrible living conditions shown during covid in long term care that things would improve. They have not other than the extra paperwork and political bullshit. I want to see us just take care of these people. We need the staff and support to do that!”

➡ Austria (Nurse, Aged Care Facility) – “I was really looking forward to this job. But reality caught up with me very quickly. I’m shocked at what the government/country has done with the healthcare system. Everyone has said that a massive wave of pensions is coming, but fewer and fewer people have been trained. I now know 8 colleagues who have given up the nursing profession (these colleagues had too much heart and passion for this profession, and that was their downfall).”

➡ United Kingdom ( Health care assistant) “I get paid £1 more than minimum wage to be assaulted daily. The level of staff turnover is so high they struggle to replace them.”

A system on the brink

The COVID-19 pandemic exposed deep, structural failures in healthcare—failures that led to tens of thousands of preventable deaths. Five years later, those failures remain dangerously ignored. UNI Global Union’s report makes one thing clear: without urgent action, care systems – already strained by an aging population and still under threat from another pandemic – will crumble, and lives will be lost.

This research was supported by the CARE Fund and Ford Foundation.