Small Countries Initiative impact report 2021–2024: four years of progress

Overview

The Small Countries Initiative (SCI), established in 2013, serves as a collaborative platform for 12 Member States in the WHO European Region, each with populations under two million. This report reviews the SCI’s progress and impact from 2021 to 2024, assessed through high-level meetings of the SCI and the implementation of the European Programme of Work and the Roadmap towards better health in small countries in the WHO European Region (2022–2025). During this period, the SCI has acted as an initiator, catalyst, convener and connector—raising awareness, fostering collaboration and driving action on key health issues. It has brought visibility to small countries’ priorities at the regional and international levels, while supporting innovative, context-specific solutions to improve health outcomes and system resilience. The Initiative has functioned as a laboratory for innovation, encouraging cross-country learning and experimentation. Its emphasis on international cooperation and knowledge exchange has enabled participating countries to address shared challenges through mutual support and collective problem-solving. The report highlights the SCI’s unique role in amplifying the voices of small countries, advancing health equity and promoting innovation. It underscores the Initiative’s continued relevance as a model for regional cooperation and a driver of transformative change in public health.