A pressing public health and human rights crisis is unfolding across the Americas, where persistent violence against health care workers is eroding clinician well-being and undermining the functionality of regional health systems, the Pan American Health Organization (PAHO) has warned. The warning came during a landmark regional seminar that gathered nearly 400 stakeholders from 34 nations, including senior health officials, leading specialists, and professional association representatives, who collectively confirmed that the crisis remains drastically underreported and widely normalized across many workplaces.
In a major push to boost awareness and drive coordinated, systemic solutions to the issue, PAHO debuted a new evidence-based fact sheet titled *Preventing violence against health workers in the Region of the Americas*, designed to guide policymakers, health system leaders, clinical professionals, and other key actors in addressing the crisis. Citing an international systematic review featured in the new publication, PAHO notes that roughly 62 percent of health workers globally have endured at least one form of workplace violence. Verbal abuse, reported by 58 percent of survey respondents, is the most prevalent form of non-physical aggression, followed by threats at 33 percent and sexual harassment at 12 percent.
A separate multinational study, which surveyed participants across 22 countries including 20 Latin American nations, painted an even grimmer picture for the region: 66.7 percent of responding health workers reported experiencing some form of aggression in the 12 months prior to the survey, with physical violence accounting for approximately one in every 10 recorded incidents.
“Violence against health workers should not be considered an inevitable part of the job. It is a public health issue, a human rights issue, and a challenge for the effective functioning of health systems,” stated Silvana Luciani, Chief of PAHO’s Noncommunicable Diseases and Violence Prevention Unit.
Seminar participants emphasized that violence against health workers manifests across a wide spectrum of harm. It ranges from verbal abuse, threats, and physical assaults perpetrated by patients or their family members, to internal workplace harassment, discrimination, sexual violence, and threats tied to generalized community insecurity and organized criminal activity.
Beyond the immediate harm inflicted on individual workers, violence creates cascading damage that extends across entire health systems. It inflicts lasting physical and mental harm on clinicians, contributes to professional burnout, elevated absenteeism rates, high staff turnover, and persistent challenges in retaining trained, experienced health personnel. Multiple risk factors amplify the likelihood of violence, including excessive workloads, long patient wait times, widespread staff and resource shortages, communication breakdowns between clinical teams and patients, and generally substandard working conditions. The regional study also identified care delays and gaps in critical medical resources as two of the most common triggers for patient and family aggression against staff.
Broader societal factors, including widespread community insecurity, armed conflict, organized criminal activity, and emergency or crisis settings, further exacerbate risks. Violence can also occur between colleagues, including workplace bullying, discrimination, and sexual violence, behaviors that are often enabled by rigid institutional hierarchies and cultural norms that tolerate or normalize such abuse.
Frontline clinical staff, particularly nurses, face the highest exposure to violence due to their constant, direct contact with patients and communities. In the Caribbean, for example, seminar experts highlighted that verbal abuse is the most common form of aggression targeting nursing staff, while also noting the disproportionate impact of sexual harassment and the critical unmet need for safe, confidential reporting channels for workers.
“When a nurse is affected, the health system is affected,” explained Javon Gray, President of the Omega Kappa Chapter of Sigma Theta Tau International Honor Society of Nursing, representing The University of the West Indies (UWI) School of Nursing, Mona. “Violence against nurses and health workers must not be normalized.”
Women, who make up nearly 70 percent of the global health workforce, face disproportionate risk of gender-based violence, particularly sexual harassment. PAHO emphasized that effective prevention and response strategies must explicitly integrate a gender perspective to address these unequal risks.
“Violence can be prevented, and preventing it requires comprehensive and sustained action,” said Britta Monika Baer, PAHO Regional Advisor on Violence Prevention and Response, during the seminar.
Despite the overwhelming scale of the crisis, a large share of violent incidents never get reported, making it impossible to capture the true scope of the problem and design evidence-based interventions. Key barriers to reporting include workers’ fear of employer retaliation, lack of trust in institutional reporting mechanisms, and the widespread normalization of violence as “just part of the job.”
For these reasons, participants unanimously highlighted the urgent need to strengthen national reporting and monitoring systems, build safe, confidential, and accessible reporting channels, and develop clear, standardized protocols for prevention, response, and investigation of incidents.
“What is not reported remains invisible,” noted Leidy Villanueva, from the Office of Territorial Management, Emergencies and Disasters of Colombia’s Ministry of Health and Social Protection. “Protection begins before the incident occurs.”
Colombia’s national experience offers a model for proactive action, demonstrating the value of anticipating risks through targeted staff training, systematic risk analysis, cross-territorial coordination, and the adoption of specialized protection mechanisms for health workers, facilities, and services.
Seminar attendees also stressed that sustainable prevention requires systemic improvements to working conditions and workplace organization, training for staff in violence prevention, crisis management, and de-escalation techniques, guaranteed medical and psychosocial support for workers who experience violence, and consistent follow-up for all reported incidents.
Meaningful progress in preventing violence requires coordinated, cross-sector collaboration between national governments, health care institutions, professional associations, worker organizations, academic bodies, local communities, and other key stakeholders. PAHO emphasized that the primary legal and ethical responsibility for preventing and responding to violence rests with national states, health care employers, and health institutions. Individual safety actions taken by workers are complementary and do not replace the core obligation of institutions to provide safe working environments.
PAHO’s new fact sheet consolidates existing evidence on the different forms of violence against health workers, their far-reaching consequences, and the underlying factors that increase risk. It also outlines actionable measures that authorities and health institutions can implement, including establishing clear legal and policy frameworks and standardized prevention and response protocols; building safe, confidential, and accessible reporting systems; upgrading facility security; providing targeted staff training; guaranteeing medical and psychosocial support for affected workers; and systematic data collection on incidents and follow-up actions.
At the national public policy level, PAHO also underscores the importance of cross-sector coordination between health, security, justice, education, and labor agencies, as well as the need to allocate sufficient funding and human resources, monitor long-term violence trends, and partner with local communities to reduce risks—especially in settings affected by humanitarian crisis and health misinformation.
“Violence against those who work in the health sector is not an isolated issue. It is a direct obstacle to the well-being of health workers and to the ability of health systems to fulfill their mission,” said Yoana Díaz, PAHO Regional Advisor on Professional Training in Human Resources for Health. “Caring for those who care for us is not just a slogan, it is a commitment to action.”
The fact sheet also highlights a stark global gap in protection: only 26 of the 195 Member States of the World Health Organization (WHO) currently have national occupational health and safety policies or programs specifically designed to protect health workers, underscoring the urgent need to scale up protection measures worldwide.
The seminar closed with a unified, clear message: violence against health workers is not inevitable, and it can be prevented through sustained, coordinated action. Protecting the workers who provide life-saving care is not only a core obligation to the health workforce, but also essential to guaranteeing high-quality care for all populations and enabling health systems to meet community needs.
