The 74th WHO Regional Committee for Europe (RC74) drew to a close on 31 October 2024 following a 3-day agenda covering a wide range of discussions and decisions on health and governance topics.
Dr Hans Henri P. Kluge, WHO’s Regional Director for Europe since 2020, was nominated for a second term by Member States and committed to moving forward on the next stage of the European Programme of Work (EPW).
Speaking after the election, Dr Kluge said, “Serving as WHO Regional Director for Europe has been the honour of my life, and I am truly so thankful – and humbled – by the overwhelming support demonstrated for my nomination. Looking ahead to my second term next year, my first task will be to consult all 53 Member States across Europe and Central Asia, as well as all our health partners, to develop our next 5-year plan together, also known as the European Programme of Work’s second edition.”
High-level speeches and Member State debate kick off day 1
Ms Zhyparisa Rysbekova, speaking on behalf of His Excellency Sadyr Zhaparov, President of the Kyrgyz Republic, addressed delegates at the opening of this year’s session. Referring to the Central Asia International Health Investment Forum, which was held under the auspices of His Excellency the President of the Kyrgyz Republic this June, Ms Rysbekova underlined the strategic importance of health as a generator of economic prosperity. “Health is the best investment in our common future; economic growth and health go hand in hand,” she said.
The European Commissioner for Health and Food Safety, Ms Stella Kyriakides, reflected on 5 challenging years in the WHO European Region and globally, which have changed the face of health and health security. Yet Commissioner Kyriakides outlined that the strong collaboration between WHO and the European Union (EU) in difficult times has led to new ways of working on antimicrobial resistance, the health workforce crisis, vaccination, mental health and health digitalization. She acknowledged the importance of the Preparedness 2.0 strategy and action plan on this year’s Regional Committee agenda (see more details in the sections on Preparedness 2.0 and Emergency Medical Teams below).
Youth engagement
Young people formed a crucial part of this year’s Regional Committee. As highlighted by Ms Katja Čič, Youth4Health representative, there was almost no youth engagement at WHO/Europe 5 years ago. In this short timeframe, young people have been involved through the Youth4Health network, the Tirana Health and Well-being Forum, and the 7th Ministerial Conference on Environment and Health, to mention just a few examples.
Closing her address, Katja Čič made a direct appeal to the Regional Committee. “Being a youth advocate technically has an expiration date, but being a champion of youth does not.”
In addition to this address, delegates were treated to a performance by House of Swag, a group of young dancers from Ireland. Focusing on the message, “It’s okay not to be okay”, the dance routine expressed how mental health issues affect young people.
Election of officers
Following a short address by Dr Azhar Giniyat, the former Minister of Healthcare of Kazakhstan and outgoing Executive President of RC73, on the outcomes of last year’s Regional Committee session in Astana, Kazakhstan, the following individuals were elected as officers of RC74:
- Professor Alexandru Rafila, Minister of Health of Romania, RC74 President;
- Professor Adriana Pistol of Romania, Executive President;
- Dr Thomas Dentzer of Luxembourg, Deputy Executive President; and
- Dr Rano Rahimova, Ministry of Health and Social Protection of Population of Tajikistan, RC74 Rapporteur.
Director-General address
Addressing delegates, WHO’s Director-General, Dr Tedros Adhanom Ghebreyesus, congratulated Member States in the Region for recent successes, including increasing human papillomavirus (HPV) vaccine uptake, stronger tobacco control measures, and improving TB treatment success rates.
However, Dr Tedros also highlighted some challenges facing the Region, including population ageing, high mortality from noncommunicable diseases (NCDs), high rates of multidrug resistant tuberculosis (MDR-TB), a shortage of health workers, the mounting impacts of climate change, conflict and health inequalities.
Speaking from a global perspective, the Director-General pointed out that, while Member States have made some progress on the “Pandemic prevention, preparedness and response accord”, some of the most crucial issues remain unresolved. “I urge all Member States to continue listening to each other – within the Region and beyond – to continue to seek common ground, and to conclude a strong agreement by the end of this year if possible,” he said.
Dr Tedros also called for renewed efforts to end ongoing conflicts in the Region, reiterating the importance of peace for health.
Regional Director address
Building on this year’s comprehensive Regional Director’s report, Dr Kluge’s address began with a video outlining some of the successes of the past 4 years.
The Regional Director thanked Member States and partners for their close collaboration and identified the 5 working methods – close contact with each country, participatory governance, unity across WHO and the UN system, zero tolerance of any form of harassment, and rigorous financial management – that have guided his approach.
Looking ahead to a second EPW, Dr Kluge underlined that this will be developed through an innovative participatory process involving Member States and partners, providing 70% continuity from the first EPW with around 30% innovation. The second EPW will also align with WHO’s 14th General Programme of Work (GPW14).
Priorities that the Regional Director has identified as key themes going forward include: 1) national health security; 2) NCDs and mental health; 3) tackling the climate crisis; and 4) ageing in good health. This is in response to some of the more recent challenges posed by the COVID-19 pandemic, but also in taking a frank look at some of the issues facing health systems in a Region with an ageing population.
Underpinning all this, Dr Kluge highlighted primary health care, which connects various health agendas while also building on the current work ongoing within WHO/Europe, including on financial protection, addressing health worker shortages, expanding the use of digital health, and building sustainable health systems.
Crucially, the Regional Director also singled out the health consequences of sexual and gender-based violence – particularly against women and girls – which continue to blight societies across the Region.
During the general discussion that followed these addresses, 46 Member States, together with partners and non-State actors (NSAs), took the floor. A full recording of this session is available for viewing on WHO/Europe’s YouTube page.
Report of the 31st Standing Committee of the Regional Committee (SCRC)
Professor Dr Adriana Pistol, Chair of the 31st SCRC, outlined the SCRC’s work over the past year, including preparations for this Regional Committee session and scrutiny of the technical and governance items. The SCRC also took forward its work through 2 subgroups – on WHO/Europe’s governance and WHO’s work at the country level. The governance subgroup discussed measures to enhance transparency and predictability in nominations and elections and increase the SCRC’s visibility as well as key performance indicators on governance. The subgroup on work at the country level oversaw the continued implementation of the country strategy “Delivering United Action for Better Health – a strategy for collaboration between the WHO Regional Office for Europe and Member States of the European Region” adopted at RC72, as well as the compendium of country stories showcasing collaboration, which was presented to RC74 in the Country Impact Report.
Private meeting on nominations and elections
During the private meeting on nominations and elections, the Regional Committee requested the Director-General to propose to the Executive Board the appointment of Dr Hans Henri P. Kluge as Regional Director for Europe for a period of 5 years from 4 February 2025.
The Regional Committee also decided that Spain and Serbia would put forward their candidatures to the World Health Assembly in May 2025 for subsequent election to the Executive Board.
Turning to the members of the SCRC, the Regional Committee elected Croatia, Ireland, Portugal and Türkiye for membership for a 3-year term from October 2024 to October 2027.
The Regional Committee also selected Romania for membership of Category 2 of the Policy and Coordination Committee of the Special Programme of Research, Development and Research Training in Human Reproduction from 1 January 2025 to 31 December 2027.
Governance and leadership of the WHO European Region
This agenda item was opened by the Regional Director, who introduced the second Accountability report, which gives a snapshot of how WHO/Europe is managed, led and governed.
The speakers described the sustainable measures that have been put in place to meet the increased demand for enabling services and shift towards enhanced country operations, including through the enabling hub in Istanbul, Türkiye. Two thirds of WHO/Europe’s staff are now located outside Copenhagen, 58% are women, and 90 nationalities are represented. Expenditure during the 2022–2023 biennium totaled US$ 745 million, with a large proportion focused on goods procurement.
Over the past 4 years, WHO/Europe has taken stock of how it works with Member States, strengthened its existing efforts and introduced new collaborative approaches, outlined in “Delivering United Action for Better Health” – a strategy for collaboration between WHO/Europe and Member States in the Region. Since its adoption 2 years ago, there has been a more strategic approach to how WHO/Europe and a Member State agree on priorities and approaches; more responsive engagement using country support teams; and a new model for collaboration, using designated WHO counterparts, with countries where WHO does not have a physical presence.
The first-ever Country Impact Report produced for this Regional Committee session showcases real-life examples of collaboration in each of the 53 Member States. An exhibition at RC74 showcased 12 examples of collaboration from the Country Impact Report from Armenia, Denmark, Estonia, France, Georgia, Germany, Kyrgyzstan, Latvia, Montenegro, North Macedonia, Portugal and Turkmenistan.
Programme budget matters
The speakers also provided an overview of WHO/Europe programme budgets for 2022–2023 and 2024–2025 as well as the development of the programme budget for 2026–2027. The current WHO Investment Round, underway to fund the 14th General Programme of Work, has a funding target of US$ 7 billion, and Member States of the WHO European Region are playing a significant role with US$ 814 million pledged from countries within the Region so far.
Framework for resilient and sustainable health systems
The “Framework for resilient and sustainable health systems”, adopted by the Regional Committee, is the culmination of 4 years of work at the regional and country level, during which time WHO/Europe has shone a spotlight on key issues needing action in health systems. This includes, for example, the health workforce, through the adoption of the Bucharest Declaration; primary health care, through the Astana Conference on the 45th anniversary of the Alma-Ata Declaration; and the launch of new regional reports on financial protection, data and digital health, and other health systems pillars – these activities led up to the adoption of the Tallinn Outcome Statement at the 15th anniversary of the Tallinn Health Systems conference in 2023. The Tallinn Outcome Statement was the blueprint on which the new health systems framework was built, with trust and transformation as its key calls to action.
The “Framework for resilient and sustainable health systems” was developed in close consultation with Member States and civil society and outlines a new vision where every person has access to the right care, at the right time, in the right place, from the right person, without experiencing financial hardship. It emphasizes the need for relationships of trust in health systems, quality care delivered by motivated and supported health-care professionals, and the importance of health systems adapting to future challenges.
Preparedness 2.0
It is difficult to overstate the impact that health emergencies have had globally over the past 5 years. In response, at this Regional Committee session, a new strategy and action plan on preparedness, response and resilience was endorsed by Member States.
Known as Preparedness 2.0, the strategy seeks to create a coordinated Region-wide approach to all hazards while incorporating the One Health perspective – recognizing the links between human, animal and environmental health. The strategy highlights collaborative surveillance, community resilience and protection, emergency coordination, access to countermeasures and safe and scalable care as crucial components for success.
Emergency Medical Teams
Following the session on preparedness, the Regional Committee turned its attention to Emergency Medical Teams (EMTs), adopting the “Emergency Medical Teams regional action plan 2024–2030”, which is based on the Emergency Medical Teams 2030 Strategy.
During the session, it was highlighted that 85 EMTs in the Region provide lifesaving, quality care and critical health services while responding to a range of health emergencies, from natural disasters to disease outbreaks.
The EMT regional action plan was co-created with the community of EMTs and outlines important elements, such as commitment, partnerships and coordination as well as quality and capacity. It also sets out WHO/Europe’s expertise and capacity to support governments throughout the implementation process.
Harnessing innovation for public health
As part of the consultation process to develop a strategy to harness innovation for public health in the Region, WHO/Europe invited feedback from Member States on their perspectives regarding the institutionalization of innovation for public health within their national priorities and asked them to reflect on how they envision the role of WHO in championing innovation for public health in the Region.
The final draft strategy on harnessing innovation for public health will be submitted for consideration to RC75.
Dates of RC75 and closure of the session
The Regional Committee agreed that the 75th session will be held from 28–30 October 2025 in Copenhagen, Denmark.
Closing the session, the Regional Director once again thanked delegates for nominating him for a second term, calling it an “immense privilege”. Determining that the second EPW, to be developed in close consultation with Member States and partners, “will be ambitious and bold”, Dr Kluge concluded, “Let me underscore – investing in health is not a luxury. It is an imperative – economic, social, human.”
Other Regional Committee-related activities
Non-State actors (NSAs)
On the eve of RC74, representatives from over 100 NSAs and WHO/Europe launched an engagement plan that sets out actions to strengthen collaboration. It has been developed in close consultation with NSAs to enhance engagement through 3 key areas: dialogue that better informs engagement; institutionalization that enables more systematic engagement; and collaboration that integrates NSAs into WHO/Europe’s ways of working both at the regional and country level. The plan was launched at the Inaugural Non-State Actor Event – “Celebrating and strengthening engagement opportunities to promote health in the WHO/European Region”.
During the RC74 proceedings, 6 NSAs not in official relations with WHO were accredited to attend RC sessions, including:
- Association of European Cancer Leagues
- European Alcohol Policy Alliance
- European Association for the Study of Obesity
- European Independent Foundation in Angiology/Vascular Medicine
- European Junior Doctors Association
- Institute for Healthcare Improvement.
High-level technical briefing on One Health
During the High-Level technical briefing on One Health, attendees were informed about a new Adaptation Guide. This enables Member States to tailor their strategies to implement a One Health approach that suits their specific contexts and addresses country challenges and gaps in health. It introduces 6 regional priorities:
- building and strengthening governance, leadership and partnerships;
- strengthening prevention and preparedness capacities;
- promoting and supporting equitable, inclusive and sustainable solutions to tackle inequalities;
- building evidence on the effectiveness of One Health through data and research;
- facilitating the allocation of sustainable financing; and
- cultivating and sustaining core competencies in the One Health approach for the health workforce and other workforces.
The briefing also saw the launch of WHO/Europe’s first collaborating centre on One Health, based at University College Dublin, Dublin, Ireland.