The legacy of Fadwa Affara, RGN, MA, MSc, MEd

The International Council of Nurses (ICN) was greatly saddened to learn of the recent passing of Fadwa Ahmed Affara, who died peacefully in Edinburgh last week.

An internationally respected nurse consultant and educator, who dedicated her life to advancing the nursing profession and strengthening health systems worldwide, Fadwa will be remembered as a pioneering nurse leader whose work at ICN helped shape global standards in nursing regulation, education, and policy.

ICN CEO, Howard Catton, paid his respects, saying:

“ICN and nurses around the world have lost a great leader! Fadwa’s legacy is one of dedication, vision, and unwavering commitment to the nursing profession. She leaves behind a global community of nurses and health leaders who continue to benefit from her work and inspiration. In honouring Fadwa Affara, we celebrate a life devoted to strengthening nursing worldwide, ensuring that the profession remains at the heart of resilient and equitable health systems.”

Born in Yemen, she pursued her education in Edinburgh before embarking on a career that spanned more than three decades across the Middle East, Europe, and international organizations. She joined ICN as a consultant in health policy and nursing in 1987.

Fadwa was head of ICN’s Nursing Regulation Project where she was instrumental in developing frameworks that guided countries in building strong nursing regulation systems, ensuring that nurses everywhere could practice safely, effectively, and to the full scope of their training. Her work emphasized the importance of aligning nursing education with evolving health needs and of creating policies that empowered nurses as leaders in health care delivery.

Her contributions were particularly impactful in low- and middle-income countries, where she worked tirelessly to support governments and nursing organizations in strengthening their workforce capacity. She believed that universal health coverage could only be achieved if nurses and midwives were properly supported, regulated, and valued. Her efforts at ICN helped establish international standards that continue to influence nursing practice today.

Thanks to her work, the ICN regulatory framework has served as a guideline for many countries as they reviewed and/or developed their regulatory system. The regional offices of the World Health Organization (WHO) also drew heavily on ICN’s work as they developed guidelines for countries in the process of developing or reforming professional regulatory systems.

During her time at ICN, Fadwa also worked on credentialing, including the creation of the ICN Credentialing Forum. Through its credentialing programme, ICN helped to assure that providers and consumers can be confident of the competency of nurses and other health care professionals, and the quality of educational and health care services.

As globalization led to acceleration in the provision of international services and education, ICN moved more firmly as an international leader in professional standard setting and quality assurance. For example, ICN established service standards for telenursing, and developed international competencies for the generalist nurse.

She was one of the pivotal figures in the establishment of the ICN NP/APN Network, which is still active today and will be holding its 14th NP/APN Network Conference in Nashville, Tennessee in 2026. In 2006, Fadwa Affara and Madrean Schober wrote Advanced Nursing Practice, which tracked the evolution of new advanced practice nursing roles and innovative practice models, and examined the need for international guidelines.

For numerous years, Fadwa led ICN’s efforts to develop the International Classification for Nursing Practice or ICNP®. This groundbreaking project, still active today, provides a structured and defined vocabulary and unifying framework for nurses around the world.

Fadwa retired from ICN in 2002, but continued to act as the ICN liaison person with the NP/APN Network for many years, and completed work for ICN on the international competencies for the generalist nurse, family nurse, and distance learning.

In addition to her work with ICN, Fadwa collaborated with WHO to push forward nursing policies and help national nursing associations to be able to implement important outcomes of the World Health Assembly meetings and transform them into policies, strategies, and plans of action at the national level. She also served as a consultant to national governments, advocating for equitable access to health care and the professional recognition of nurses. Her leadership was recognized globally when she was awarded the 2020 Princess Srinagarindra Award for her outstanding achievements in nursing regulation and policy.

Fadwa was held in particularly high esteem by nurses in the Eastern Mediterranean region. She carried out a WHO assignment in Yemen to assist with the development of a regulatory system for nurses and midwives, and served as a consultant to the first meeting of the Nursing Advisory Committee of the Arab League where they agreed to a regulatory framework. She also worked with the Jordan Nursing Council, and the Oman Nursing and Midwifery Council.

Despite retirement, Fadwa’s work continued. During the COVID pandemic, she assisted three international colleagues to establish 'The Covid-19 Africa Action Network for Nurses & Nurse-Midwives' and the 'Protect Nurses. Save Lives' campaign, which aimed to protect African nurses and save lives by providing them with locally made personal protective equipment.

Fadwa Affara’s legacy lives on in the hearts and minds of the nurses around the world whose lives she improved.