Opportunities and Challenges of the 2025 United Nations Political Declaration on Noncommunicable Diseases for Nephrology Nursing Governance and Workforce Roles
Katherinne Anyela Sáez-Pulgar, Paula Andrea Betancourt-Henríquez, Astrid Valeria Munzenmayer-GutiérrezBackground
Chronic kidney disease (CKD) affects more than 674 million people worldwide and remains insufficiently prioritized in the global noncommunicable disease (NCD) agenda. Although nurses comprise a substantial share of the global health workforce, their roles in implementing global kidney health commitments remain unclear.
Purpose
Drawing on the Walt and Gilson policy analysis framework, this study critically examines the opportunities and challenges posed by the 2025 United Nations Political Declaration on NCDs (A/80/L.34) for nephrology nursing governance, workforce roles, and integration into primary and community-based kidney care.
Methods
A qualitative policy analysis examined the declaration through four interrelated dimensions (policy context, content, actors, and process), anchored in the official text adopted by the United Nations General Assembly on December 15, 2025.
Findings
The declaration explicitly recognizes CKD in the global NCD agenda and reinforces primary healthcare and community-based services as central strategies. However, it provides limited operational guidance on workforce role delineation, particularly regarding nursing leadership. Governance and accountability mechanisms for implementing kidney health commitments are underdeveloped. Although nephrology nursing is implicitly positioned as a strategic workforce, its formal integration into health system planning has not been articulated explicitly.
Conclusions
Translating the declaration into effective and equitable kidney care requires explicit recognition of nephrology nursing in governance arrangements, workforce planning, and policy implementation. Without such integration, global commitments risk being merely aspirational. Strengthening nursing leadership, advanced education, and expanded scopes of practice are critical policy levers for advancing equitable and sustainable kidney care across diverse health-system contexts.