International nursing bodies: ICN, EFN, WHO and French representation

Definition of the profession, training standards, global shortage, mobility of healthcare workers: many decisions affecting French nurses are shaped at European and international level. Three organisations play a central role: the International Council of Nurses (ICN), the European Federation of Nurses Associations (EFN) and the World Health Organization (WHO). This guide presents their role, how they work and France's place within them.

Why do international bodies matter to French nurses?

Because they directly influence practice in France:

• minimum requirements for nursing training and recognition of qualifications across Europe are set by a European directive, on which the profession exerts influence through the EFN;
• the definition of nursing care and the profession's ethical framework are promoted globally by the ICN;
• data on workforce numbers, shortages and strategic directions for nursing care are produced by the WHO and inform national policies.

What is the International Council of Nurses (ICN)?

The International Council of Nurses (ICN) was founded in 1899. Based in Geneva, it is a federation of more than 140 national associations of nurses, representing more than 30 million nurses worldwide. It describes itself as 'the global voice of nursing'.

What is its mission?

The ICN's mission is to represent nursing worldwide, advance the profession, promote the wellbeing of nurses and advocate for health in all policies. It aims for quality nursing care for all, strong health policies, advancement of nursing knowledge and a respected profession everywhere in the world.

How does one become a member?

There is no individual membership of the ICN. Its members are national associations: nurses who join the national association that is a member in their country automatically become part of the ICN.

What does it produce?

• A definition of nursing care and the nurse, revised following work concluded in 2025. According to this definition, a nurse is a professional trained in scientific knowledge, skills and the philosophy of nursing care, and regulated to practise according to established practice standards and ethical codes.
• The ICN Code of Ethics for Nurses, an ethical framework of reference at international level.
• Position statements on major health and professional issues.
• International Nurses Day, celebrated every year on 12 May, the anniversary of Florence Nightingale's birth. The ICN chooses the theme each year and distributes resources to help prepare for it.

What is the European Federation of Nurses Associations (EFN)?

The European Federation of Nurses Associations (EFN) was established in 1971. Based in Brussels, it brings together 38 national nursing associations and represents approximately 3 million nurses. It was created to represent the nursing profession and its interests to European institutions, particularly on directives concerning training and nurse mobility.

Who are its members?

Its members are national nursing associations from the 27 EU Member States, as well as from the United Kingdom, Norway, Iceland, Switzerland, North Macedonia, Montenegro, Serbia, Albania and Moldova. The ICN, the WHO, the European Nursing Students Association (ENSA) and the Nursing Chamber of Kosovo have observer status.

What subjects does it work on?

• nursing workforce numbers and working conditions;
• training, with a European competency framework;
• quality and safety of care;
• digital health;
• care for older people;
• climate and planetary health.

Good to know:automatic recognition of nursing qualifications throughout the European Union stems from Directive 2005/36/EC, as amended by Directive 2013/55/EU. Its practical effects are explained in our guide practising abroad with a French nursing qualification.

What is the WHO's role in nursing care?

The World Health Organization notes that nurses and midwives represent nearly half of the health workforce worldwide. It tracks workforce numbers, publishes data and helps countries plan their human resources for health.

What do WHO figures show?

According to the report The State of the World's Nursing 2025, there were approximately 29.8 million nurses worldwide in 2023, compared with 27.9 million in 2018. The global shortage fell from 6.2 million in 2020 to 5.8 million in 2023, and the WHO projects it at 4.1 million in 2030. The WHO calls on countries to use this data to strengthen training, create sustainable jobs and regulate international recruitment.

What is the WHO Chief Nursing Officer?

The World Health Organization has a Chief Nursing Officer office, whose mission is to carry and amplify the voice of nurses and midwives worldwide. The position is held by Dr Amelia Latu Afuhaamango Tuipulotu, from Tonga, appointed in December 2022. The office notably facilitates an online global community of practice for nurses and midwives.

What is the global nursing care strategy?

The WHO has adopted Global strategic directions for nursing and midwifery. In May 2025, it extended them until 2030.

How do these three organisations work together?

The ICN has maintained official relations with the WHO for over 75 years. Both the ICN and the WHO are observers at the EFN. In practice, national associations bring their country's positions to the EFN and ICN, which then relay them to European institutions and the WHO, where member states' governments are represented.

How is France represented?

Les infirmiers français sont représentés auprès de ces instances par l'Association nationale française des infirmières et infirmiers diplômés et des étudiants (ANFIIDE) :

• At the ICN, ANFIIDE is the national member association for France: it is through ANFIIDE that French nurses are linked to the global federation.
• At the EFN, ANFIIDE carries the voice of French nurses to European institutions.
• At the EFNNMA, the European Forum of National Associations of Nurses and Midwives, which brings together these associations in the WHO European region, ANFIIDE also represents French nurses.
• At the WHO, it is member states that decide, notably within the World Health Assembly: France is represented there by its government.

To follow these commitments, consult the page ANFIIDE internationally.

How can I get involved as an individual?

1. Join a national nursing association: this is the gateway to European and international work.
2. Take part in International Nurses Day on 12 May, using resources distributed by the ICN.
3. Join the WHO community of practice for nurses and midwives, open online.
4. Draw on the position statements from the ICN and EFN for your projects, research work or exchanges with decision-makers.

These resources are valuable for historical or research work: see our guide nursing research.

What resources should I consult?

• the ICN website, for its position statements, its definition of nursing care and resources for International Nurses Day;
• the EFN website, for its European position statements and the list of its members;
• the WHO pages dedicated to nursing care and the Chief Nursing Officer office.

Point to note: documents from the ICN, EFN and WHO are often published first in English. Always cite the original version and its date when referring to them in work or presentations.

For recognition in France of foreign qualifications, consult our guide practising in France with a foreign nursing qualification.

Official sources

• International Council of Nurses: about us, our members, current definitions of nursing care, International Nurses Day, mission, vision and constitution
• European Federation of Nurses Associations: EFN presentation, members, list of members
• World Health Organization: nursing and midwifery care information sheet, chief nursing officer, nursing care