INSIGHT 3: Expanding Pet Care Access: Making Care Available for Every Pet

A Global “Pawprint”

Today, over 4 billion animals share their lives with humans, driving an increasing demand for veterinary care[1] In key regions like the U.S., EU, Brazil, and China, more than 500 million dogs and cats are part of multi-species families.[2] Meanwhile, in rapidly growing markets like India, the number of pet dogs alone is expected to surge from 33 million in 2023 to over 51 million by 2028.[3]

This demographic transformation is mirrored by a deeper integration of pets into human social structures. Nearly 95% of pet guardians worldwide consider their animals family, and 98% report experiencing health benefits from their companionship.[4] As this bond deepens, veterinary care takes on an even greater role in addressing the needs of an increasingly interconnected multi-species community.

A Paradox of Care

With pets becoming ever more integrated into families, expectations for their medical care have also evolved. One notable trend is the rising demand for advanced veterinary care (AVC), reflecting a desire to provide pets with medical interventions comparable to those available to humans. A 2024 study[5] by Corr et al. found that roughly half of pet owners believe their animals should have access to the same diagnostic tests as humans, and nearly 60% want the same treatment options, including advanced imaging like MRI and CT scans, complex surgeries, and chemotherapy.

While some pursue advanced medical interventions for their pets, many are unable to afford even basic veterinary care. In the United States, approximately 20 million pets live in poverty alongside their families, with 70% having never seen a veterinarian.6 Furthermore, 43% of pet guardians report being unable to afford their pets' needs due to financial constraints.[6]

In Europe, a 2020 survey encompassing France, Germany, Italy, Spain, and the UK, found that approximately 17% of pet owners cited cost as a factor in not regularly visiting the veterinarian, with France standing out at over 23%.7 Furthermore, 23% of people having cats and 11% of people having dogs across these European countries visit the veterinarian less than once a year, with some pets never receiving veterinary care.[7]

A Multifaceted Challenge

The affordability of veterinary care is often the main focus in discussions about access, but it's just one piece of a much broader and more complex issue. The framework of the "5 A's"—developed by Penchansky and Thomas in 1981—provides a comprehensive way to understand access to care.[8] These dimensions—Availability, Accessibility, Accommodation, Acceptability, and Affordability—illustrate that access to veterinary care for companion animals is multifaceted.

While financial factors are undeniably important, a complete picture of access requires addressing several interconnected elements. Here, we will focus specifically on some aspects related to Availability, a dimension that holds particular relevance as it underscores both the quantity and distribution of veterinary resources.

The Role of Veterinarians

Veterinarians are highly skilled professionals whose expertise is essential not only for the care of companion animals but also for broader public health initiatives, including zoonotic disease control and food safety. The educational journey of a veterinarian is extensive, encompassing a wide range of disciplines such as systems biology, pathobiology, clinical and comparative medicine, surgery, epidemiology, and public health.[9]The rapid pace of advancements in veterinary medicine and technology underscores the need for lifelong learning to ensure that professionals remain at the forefront of their field.[10]

Despite the prominent role of veterinary professionals, the acquisition of accurate global data on the veterinary workforce presents significant challenges. A confluence of factors may explain the reasons. For example, nations may lack centralized registries or standardized licensing systems, hindering precise tracking of practicing veterinarians.

Moreover, possible variations in data collection methodologies across countries may lead to inconsistencies and discrepancies. Additionally, the cross-border mobility of veterinarians and the difficulties associated with updating databases to reflect retirees or deceased practitioners may further compound the data collection process.

A Veterinary Workforce Gap

Aside significant challenges in obtaining reliable global data on the veterinary workforce, reports from various regions consistently indicate widespread strain on veterinary capacity. In the United States, the sufficiency of the veterinary workforce remains a topic of considerable debate.[11–13] In Europe, the Federation of Veterinarians of Europe (FVE) reports growing shortages, particularly in rural areas, driving increased workloads, professional burnout, and exacerbating challenges related to an aging workforce and difficulties in recruiting new graduates to rural practices.[14]

In emerging economies, significant workforce deficits are reported. Data from India (1 veterinarian per approximately 5,000 pets)[15], China (1 veterinarian per approximately 3,577 pets),[16] and South Africa (~60-70 veterinarians per million citizens)[17] underscore this challenge. A 2023 survey[18] conducted in preparation for a World Organisation for Animal Health (WOAH) workshop in Central Asia and the Caucasus revealed that 86% of respondents cited a general shortage of veterinary personnel, although the specific areas of deficiency were less clearly defined. In some regions, the workforce shortage is especially acute. Tonga, for instance, is a striking example of an entire country lacking any resident veterinarians.[19,20]

Inequities in Education

While global veterinary workforce shortages have been well-documented, workforce availability is not solely determined by the number of practitioners. A comprehensive review[21] published in the Scientific and Technical Review, sheds light on significant disparities in veterinary medical education, which have direct implications for the quality and consistency of veterinary services, particularly for companion animals. The analysis, based on data from 194 countries, uncovered 597 veterinary medical academic institutions across more than 100 nations using 15 distinct nomenclatures and conferring 54 different veterinary degree titles, reflecting a lack of standardization in both institutional naming conventions and academic qualifications.[21]

In addition to discrepancies in terminology, the review identified significant inter- and intranational variation in the structure of veterinary degree programs and training facilities, underscoring the absence of a universally recognized standard in veterinary medical education and raising concerns about the preparedness of veterinary graduates. [21]Such disparities may impair veterinarians' ability to meet the diverse needs of companion animals and hinder their proficiency in diagnosing, treating, and preventing diseases effectively.

Veterinarian Wellness Crisis

Veterinary medicine is integral to global public health and the well-being of companion animals. However, mounting evidence reveals a growing crisis within this essential workforce: occupational burnout.

Recent studies[22,23] indicate that over half of veterinarians report moderate to high levels of burnout, a prevalence rate that rivals that of human physicians, a profession long acknowledged for its stressors. The pressures of modern veterinary practice, including long hours, emotional tolls, ethical dilemmas, economic strain from practice ownership, and substantial student debt, contribute significantly to these challenges.[24–27]

The economic repercussions of burnout extend beyond the individual. A 2022 study[28] estimated that burnout costs the U.S. veterinary services industry $1 to $2 billion annually. These losses stem largely from turnover and reduced working hours, leading to costly recruitment and retraining, while remaining veterinarians face diminished productivity and disengagement, further compounding revenue losses.[28] As burnout drives turnover, it reduces the active workforce and limits the profession’s capacity to meet rising animal healthcare demands, while reduced working hours among affected practitioners further restrict care availability.[28,29]

Access to Therapeutics

Veterinary care is not only essential for the welfare of animals but also for the well-being of families and communities. Access to veterinary medications is essential, allowing veterinarians to address a wide range of health issues in companion animals. Yet, the shortage of these critical pharmaceuticals poses a serious barrier to care, threatening both the health of pets and the strength of the human-animal bond.

Global veterinary organizations report a widespread shortage of essential medications—such as antibiotics, analgesics, and vaccines—essential for both routine and emergency care. A 2016 survey of WSAVA members, primarily from countries with developing companion animal practices, found that 75% faced significant obstacles in accessing even basic medicines, with 20% stating that this severely impacted their ability to provide optimal care.[30] A more recent 2022 study at the WSAVA World Congress revealed significant variation in the availability of core medicines for cats and dogs, further threatening animal welfare and undermining veterinarians' ability to meet minimum care standards.[31]

The implications of these shortages extend far beyond the limitations of available medications. The rise of substandard and falsified veterinary medicines exacerbates the situation, undermining efforts to secure access to safe and effective treatments. The illicit market for counterfeit veterinary drugs, worth billions annually, introduces further risks by flooding the supply chain with unsafe and ineffective products.[32,33] This is particularly concerning for pet guardians who may struggle to distinguish between legitimate and counterfeit medications.[34] The proliferation of falsified drugs not only erodes trust in the veterinary pharmaceutical system but also compromises the quality of care available to companion animals.[35]

Unmet Diagnostic Needs

Veterinary diagnostic capacity is a cornerstone of effective care for companion animals, ensuring that accurate diagnoses are made to guide appropriate treatment. However, as with many aspects of veterinary care, access to diagnostic tools and equipment is limited by substantial barriers, particularly in low-resource settings.[36,37] Despite significant investments in sophisticated diagnostic equipment, challenges persist that compromise the availability and functionality of these tools, directly impacting the quality of care veterinarians can provide.

The results of the World Organisation for Animal Health's (WOAH) Equipment Management and Sustainability Survey (EMSS) highlight these concerns within veterinary diagnostic laboratories. The 2019 survey, which assessed equipment across 227 laboratories in 136 countries, revealed that 22% of equipment was improperly maintained and 46% was improperly calibrated.[38]

This lack of operational readiness, particularly in the context of advanced diagnostics like imaging technologies, poses a direct threat to veterinarians’ ability to deliver timely and accurate care to companion animals. These deficits exacerbate existing challenges in ensuring that all animals, regardless of geography or economic status, have access to the diagnostic services necessary for optimal healthcare.

Addressing Pet Care

Veterinary care for companion animals is at a crossroads. While advancements in diagnostics, therapeutics, and medical technologies continue to expand the boundaries of care, access to these innovations remains uneven. Gaps in diagnostic capacity, shortages of essential pharmaceuticals, and an overstretched workforce highlight structural challenges that, if left unaddressed, could hinder the profession’s ability to meet growing demand.

These challenges point to a need for strengthening veterinary resources. With increased focus on diagnostics, workforce development, and technology, clinical capacity can be improved. The allocation of resources and the integration of companion animal care into global health discussions are becoming more urgent.

At the same time, global cooperation and resource mobilization are increasingly important, especially in an environment where multilateral efforts and investment in global health are under pressure. Addressing the vulnerability of global companion animal care requires new, collaborative approaches and fresh ideas to meet the evolving needs.

Insight's contributors

Stefano Gnes Vera Gualdi

President & Co-founder Vice-President & Co-founder

Noble Alliance Association Noble Alliance Association

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