Fifth high-level meeting of small countries: working together for better health and well-being for all


Iceland's Prime Minister, Katrín Jakobsdóttir

Held in Reykjavik, Iceland, on 26-27 June 2018, the meeting provided members of the Small Countries Initiative of the WHO European Region – Andorra, Cyprus, Iceland, Luxemburg, Malta, Monaco, Montenegro and San Marino – with a high-level forum for discussions on their health agendas and ways of progressing towards achievement of the United Nations Sustainable Development Goals (SDGs). It underlined the importance of intercountry partnerships in this endeavour, as well as direct involvement at the ministerial level, not only of the health sector, but of other sectors as well. The eight Member States, with populations of less than one million, were represented by ministers and general directors in sectors, such as health, welfare and environment.

The meeting aimed to:

  • provide examples from the small countries of good practice in implementing the United Nations 2030 Agenda for Sustainable Development, using whole-of-government and whole-of-society approaches;
  • strengthen the commitments of the small countries to the promotion of safe and climate-resilient water and sanitation and the protection of health from environmental risks;
  • examine policy options for small countries in addressing inequalities in financial protection and the design of coverage policy;
  • review effective practice in tackling issues related to nutrition, physical activity and obesity with a view to achieving the SDGs;
  • provide state-of-the-art knowledge on the various aspects of resilience and how it relates to health and well-being at the individual, community and system levels;
  • review progress in the work of the Small Countries Health Information Network (SCHIN) (a subnetwork of the Initiative) and its relevance for the small countries;
  • consider ways of engaging the media in the small countries as a partner in health and development by building the capacity of a critical mass of communications professionals in these countries.

In her opening speech, Dr Zsuzsanna Jakab, WHO Regional Director for Europe, emphasized the importance of the Small Countries Initiative. Its creation has provided a knowledge-sharing platform, allowing the countries to share their experiences and develop innovative practice, and thus bringing about impactful change toward the implementation of Health 2020, the European policy for health and well-being, and the 2030 Agenda. In connection with the promotion of safe and climate-resilient water, Dr Jakab strongly highlighted the importance of safeguarding water resources, an area common to multiple priorities of the 2030 Agenda.

The meeting underlined the importance of speeding up implementation in the field of financial protection and universal health coverage, which are essential to health equality by protecting the most vulnerable in society. This can be done through a strong overarching structure of governance, which fosters and balances three “I”s – include; invest; innovate – the themes of the WHO high-level meeting, “Health systems for prosperity and solidarity: leaving no one behind”, held in Tallinn, Estonia, on 13–14 June 2018 . In this scenario, the Small Countries Initiative can be considered a rich laboratory. Since their size makes it easier for small countries to introduce innovation and create a virtuous cycle, they are ideal catalysts for change in bigger countries. The work carried out in the countries participating in the Small Countries Initiative is already inspiring small countries in other WHO regions, such as the Regions of the Americas and South-East Asia, where an interest in the process has been expressed.

The outcome of the meeting was the Iceland Statement, “Ensuring safe and climate-resilient water and sanitation”, which was endorsed by all members of the Small Countries Initiative. The Statement commits the signatory countries to taking concrete action towards achieving the objectives of the 2030 Agenda, promoting safe and climate-resilient water and sanitation resources and protecting health from environmental risks and climate change.

About the Small Countries Initiative

In 2013, the WHO Regional Office for Europe launched the Small Countries Initiative, which serves as a platform for sharing knowledge and experience on implementing Health 2020 and the 2030 Agenda in Member States with populations of less than one million. The eight members of the Initiative are Andorra, Cyprus, Iceland, Luxembourg, Malta, Monaco, Montenegro and San Marino. The members host annual high-level meetings on a rotational basis.

The Initiative encompasses two subnetworks: SCHIN, which addresses specific challenges related to health-information systems and reporting; and the network of communication professionals/journalists, which focuses on communicating progress in the implementation of the 2030 Agenda and media reporting on health.