Invitation

E-kiri.eml

Tähelepanu! Tegemist on välisvõrgust saabunud kirjaga.
Tundmatu saatja korral palume linke ja faile mitte avada.

Sent on behalf of Dr Hans Henri P. Kluge, WHO Regional Director for Europe, and Dr Hosams Abu Meri, Minister of Health of Latvia

Dear Sir/Madam,

Please find attached the co-signed invitation letter to the Twelfth High-level Meeting of the Small Countries Initiative (SCI), to be held in Riga, Latvia, on 4–5 June 2026.

For your reference, the draft programme and related meeting documents are also attached.

We would be grateful if you could confirm your participation at your earliest convenience.

Yours sincerely,
SCI Secretariat
WHO Regional Office for Europe

EST_SCI 2026.pdf

UN City, Marmorvej 51 Ministry of Health of Latvia DK-2100 Copenhagen Ø, Denmark Brīvības iela 72 k-1, Rīga LV-1011, Latvia Tel: +45 45 33 70 00 | Fax: +45 45 33 70 01 Tel: +371 67876000 Email: [email protected] Email: [email protected]

Website: www.vm.gov.lv Website: http://www.who.int/europe

Date: 11 March 2026 Dr Karmen Joller Minister of Social Affairs Ministry of Social Affairs Suur-Ameerika 1 10129 Tallinn Estonia

Dear Madam,

Twelfth High-level Meeting of the Small Countries Initiative: “From Scarcity to Sustainability: Can Small Nations Lead Workforce Innovation?”

Riga, Latvia, 4-5 June 2026 We are pleased to inform you that the High-level Meeting of the Small Countries Initiative – “From Scarcity to Sustainability: Can Small Nations Lead Workforce Innovation?” – will be held in Riga, Latvia, on 4–5 June 2026. Jointly organized by the Ministry of Health of Latvia and the WHO Regional Office for Europe, the meeting will enable participating countries to reflect on shared challenges and identify collective and country-specific solutions relating to the health workforce. Despite the current financial situation that WHO and the global health community are facing, this meeting will continue to be held in person to provide an opportunity for high-level discussions. The meeting aims to reflect on why strengthening health security remains a major priority for small countries, alongside the effects of demographic change, ageing and urban–rural disparities, and the impact of internal and international migration flows on workforce sustainability and equitable access to health care. The meeting will enable participants to explore shared solutions, focusing on how preparedness and resilience can be reinforced by optimizing the capabilities of the existing workforce through a better skills mix, leveraging the use of digital technologies and artificial intelligence, and more deeply integrating health and social care to meet long-term population needs. The meeting will last for one and a half days. The working language will be English. In view of logistic considerations, delegations are requested to comprise the minister or head of delegation plus two additional delegates. Accommodation for the minister or head of delegation of each Member State will be provided by the Ministry of Health of Latvia. Please refer to the attached information circular for further details. Each participant should register by 15 April 2026 (the registration form can be accessed at the registration link and is also available in the attached information circular). We look forward to continuing our collaboration through this unique initiative and to welcoming you to Latvia. Yours very truly,

Dr Hans Henri P. Kluge WHO Regional Director for Europe

Dr Hosams Abu Meri Minister of Health, Latvia

– 2 –

Encls: Scope and purpose Draft preliminary programme Information circular Copy for information to: Ms Helen Sõber, Adviser, European Union Affairs and International Co-operation Department, Ministry of Social Affairs, Suur- Ameerika 1, 10122 Tallinn, Estonia Ms Agne Nettan-Sepp, Head, European Union Affairs and International Co-operation Department, Ministry of Social Affairs, Suur-Ameerika 1, 10129 Tallinn, Estonia H.E. Ms Riia Salsa-Audiffren, Ambassador Representative of the Republic of Estonia, Permanent Mission of the Republic of Estonia to the United Nations Office and other international organizations in Geneva, Chemin du Petit-Saconnex 28A, CH-1209 Genève, Switzerland H.E. Mr Andre Pung, Ambassador Extraordinary and Plenipotentiary, Embassy of the Republic of Estonia, Frederiksgade 19, 4th floor, 1265 Copenhagen K, Denmark Ms Kristina Köhler, Head of WHO Country Office, WHO Country Office, Estonia, Paldiski Road 81, 10617 Tallinn, Estonia

Info Circular_2026.pdf

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WORLD HEALTH ORGANIZATION REGIONAL OFFICE FOR EUROPE WELTGESUNDHEITSORGANISATION REGIONALBÜRO FÜR EUROPA

ORGANISATION MONDIALE DE LA SANTÉ BUREAU RÉGIONAL DE L'EUROPE

ВСЕМИРНАЯ ОРГАНИЗАЦИЯ ЗДРАВООХРАНЕНИЯ

ЕВРОПЕЙСКОЕ РЕГИОНАЛЬНОЕ БЮРО

Twelfth High-level Meeting of the Small Countries Initiative (SCI): From Scarcity to Sustainability: Can Small Nations Lead Workforce Innovations?

Riga, Latvia 11 March 2026 4-5 June 2026

Original: English

INFORMATION CIRCULAR

Dear Participant, We are pleased to provide you with the following information regarding the practical arrangements for the above meeting.

1. Site of the meeting

Wellton Riverside SPA Hotel Address: 11. novembra krastmala 33, Riga, LV-1050 Phone: +371 66777850 Web: https://www.wellton.com/en/hotels/wellton-riverside-spa-hotel

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2. Working language The meeting will be held in English only.

3. Meeting venue and services The Twelfth High-level meeting of the Small Countries Initiative will take place at: Panorama Hall in Wellton Riverside SPA Hotel on Thursday and Friday, 4 – 5 June 2026 starting at 09:00. The meeting will end at 12:45 on Friday, 5 June 2026 and will be followed by light lunch. Afterwards, the interested participants might have an opportunity to participate in a cultural programme. A bilateral meeting room will be available on 4 – 5 June. Participants are kindly invited to make a reservation request by writing to [email protected]. Luggage storage and wi-fi are available. IT services and support Wireless internet access (WiFi) will be available throughout the meeting venue. Staff at the venue will be available to provide technical and IT support. Name of the WiFi network at the venue: conference • Password: riverside Green printing Latvia is said to be one of the greenest countries in the world not only in terms of the vast amount of land covered in forests and fields, but also in the way people work. During the meeting we want to prove this by working in a green and sustainable manner. All participants are invited to think carefully about whether they need to print documents, and to use their electronic devices instead. Printing facilities will be available at the venue, but participants are encouraged to use them as little as possible. Persons with disabilities The meeting premises are fully accessible to persons with disabilities and assistance will be provided if needed.

4. Working hours The working hours of the Twelfth High-level Meeting of the Small Countries Initiative will be from 09:00 to 17:00 on 4 June 2026 (onsite registration and badges as of 08:00) and from 09:00 to 12:45 on 5 June 2026.

5. Documentation Documentation for the Twelfth High-level meeting of the Small Countries Initiative includes:

● Scope and Purpose ● Information Circular ● Provisional Programme ● Provisional List of Participants ● Statement to be adopted at the Twelfth High-level meeting

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6. Registration Please fill in the REGISTRATION FORM no later than 15 April 2026 using the following link: REGISTRATION Folders and badges will be provided at the registration desk in front of the Panorama Hall at the Wellton Riverside SPA Hotel between 08:00 - 09:00 on 4 June 2026.

7. Accommodation and meals Rooms1 have been reserved at the Wellton Riverside SPA Hotel (unless other/private arrangements are in place). The Ministry of Health of Latvia will kindly cover the accommodations for the Heads of Delegations at Wellton Riverside SPA Hotel. For stays longer than two nights, we will inform the hotels based on the information provided in your registration form. In this case, the hotels may contact you directly to request your credit card details. Please note that we cannot guarantee your hotel booking unless you complete the registration form by the deadline indicated above. Rooms will be assigned upon the closure of the registration process and the rooming list finalized by the mid of April. All other participants (for whom accommodation is not covered by the Ministry of Health of Latvia) are kindly invited to book their room at the Wellton Riverside SPA Hotel for a discount price (standard rooms) here: https://www.wellton.com using the promo-code “SCI2026Riga” (subject to availability). Please settle your bill directly with the hotel for any other charges (for accompanying persons, laundry, room service, bar bills, telephone calls, any extras etc.). All participants will be invited to two lunches and one dinner.

8. Transfer from Riga (RIX) International Airport to the hotel and vice versa Riga International Airport (Latvian: RIX Rīgas lidosta) is the international airport of Riga, and the largest airport in the Baltic states. Transfer from/to the RIX Airport will be arranged only to Ministers in accordance with the information entered on registration form. For arrivals on 3 June and departures on 5 June from RIX Airport, the VIP Lounge will be booked and available for use by Ministers only. To avail of this option, full travel details (names, flight numbers, dates, and times) should be provided. Otherwise, the above-mentioned option cannot be organized. Arrivals and departures to RIX: You can get to/from the city center by bus No. 22 or taxi. More information available here: https://www.riga-airport.com/en/transport-0.

1 The reservations automatically include breakfast.

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The bus stop for bus No. 22 to the city centre is located in the P1 car park in the middle between arrival exits E and C. More information about prices and timetables can be found here: https://www.riga-airport.com/en/public-transport

The easiest way to get to the hotel is through Bolt app. However, taxi services are also available at Riga airport 24 hours a day and are located just outside the arrivals area. The average fare from the airport to the hotel is € 20-35. The fare depends on time of the day and traffic. We suggest using Xtaxi company (cars are marked in orange and white) https://www.xtaxi.lv/. Please note that for licensed taxi services purchase of pre-paid vouchers at the Airport (€ 33.50) is an option (please see: Taxi service | RIX). Taxi ride to/from Riga Airport to the center of Riga takes an average of 20 minutes, the bus to the city center takes about 40 minutes. Please note – although the Riga International Airport is actively working to ensure maximum safety and convenience for clients using taxi services, we advise to stay vigilant regarding unlikely but possible unfair pricing practices of taxi companies providing services at the Airport.

9. Visa policy of Latvia

Visas are not required for the citizens of the EU Member States when travelling to Latvia. Citizens of these countries can travel with their national ID card or passport. Citizens from other countries may require a visa. Further details on required visas are available at the official website of the Ministry of Foreign Affairs of Latvia: https://www.mfa.gov.lv/en/applying-visa.

10. Insurance

The organizers cannot accept liability for personal accidents or loss of or damage to the private property of participants and accompanying persons, either during or indirectly arising from attendance at the meeting. Participants should make their own arrangements with respect to health and travel insurance.

11. Hospitality All delegates are cordially invited to join the Dinner on 4 June at 18:30 – location is to be confirmed, within walking distance from the Hotel.

12. Climate, time zone, currency, emergency contacts, water safety & power supply, language etc. Climate: The average daily temperature in Riga during June ranges from 11°C to 20°C Time zone: (GMT+2) Currency: Euro, other currencies can be exchanged for euros at most banks and exchange offices located in the city centre and at the airport. Emergency numbers: In cases of emergency, call 112 Water safety: tap water is potable Plug types: In Latvia, power plugs and sockets (outlets) of type F are used. The power supply in Latvia is 220V AC at 50 Hz. An adaptor for the (European standard) round two-pin sockets may be required. Language: Latvian is the official language of Latvia. English is widely spoken.

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Ground floor: In Latvia the counting of the floors in multi-storey buildings is started from the 1st floor. In Latvia we have no “ground floor”.

13. About Riga

Riga is the capital of Latvia, officially founded in 1201, the city presents a mix of cultures and architectural styles developed throughout different historical periods.

Historic Centre of Riga is a World Heritage Site, which consists of numerous high quality medieval and Art Noveau architecture, unparalleled 19th century wooden buildings.

Art Noveau/Jugendstil centre with its perimetral blocks was created during renovation after 1812 fire that fully destroyed the suburbs of the city, restoring former streets and roads. This is why right angle street network is at times having an irregular shape. 19th century wooden architecture has managed to squeeze in between of tenements in some places.

Perimetral wall of multi-storey buildings often hides a different world - second and third line of buildings. One can also find old factories, workshops and warehouses behind these walls, sometimes discovering nice green yards, passages or partially public space.

The symbolism of the river Daugava in the history of Riga and Latvia is so important that it is known as the River of Destiny and Mother Daugava. Originally, it was the only transit route between East and West (“a road from the Vikings to the Greeks”), and Riga is a strategic and significant point along this way. It flows through Riga into the Gulf of Riga about 10 kilometres from the city centre. Because of its location and harbour, which rarely freezes, Riga has developed into a significant transportation hub.

Riga has always been a dynamic and innovative centre, and remains to this day a vibrant and lively city with a host of creative quarters to explore. It is therefore with good reason that Riga has been called the ‘city of inspiration’. Enjoy a leisurely walk around the Old Town – the historic centre of Riga – and its surroundings.

Useful information about Riga can be found on https://www.liveriga.com/en/1-about-riga/

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14. Queries We hope we have covered all the administrative issues you need to know in connection with the meeting. If you have any questions, please do not hesitate to contact: WHO Regional Office for Europe, Country office in Riga, Latvia • Laima Bauvare at [email protected], mob.: 00371 29495523 Ministry of Health of Latvia, European Affairs and International Cooperation Department

• Kārlis Panteļejevs, at [email protected], mob.: 00371 27889336

For more tourist-related information about Latvia, please visit: https://www.latvia.travel/en

We look forward to seeing you in Latvia!

SCI Mtg_Programme 2026.pdf

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WORLD HEALTH ORGANIZATION REGIONAL OFFICE FOR EUROPE WELTGESUNDHEITSORGANISATION REGIONALBÜRO FÜR EUROPA

ORGANISATION MONDIALE DE LA SANTÉ BUREAU RÉGIONAL DE L’EUROPE ВСЕМИРНАЯ ОРГАНИЗАЦИЯ ЗДРАВООХРАНЕНИЯ ЕВРОПЕЙСКОЕ РЕГИОНАЛЬНОЕ БЮРО

Twelfth Meeting of the Small Countries Initiative High Level Meeting

From Scarcity to Sustainability: Can Small Nations Lead Workforce Innovations?

Wellton Riverside Spa Hotel, 11. Novembra krastmala 33, Riga, Latvia

4 – 5 June, 2026

High level Preliminary Programme

DAY 1 — Understanding the Challenges: Health Security, Demographic Pressures & Workforce Vulnerabilities and addressing the solutions

Time Session

08:00-09:00 Registration & Welcome Coffee

09:00–09:30

Welcome Address

Minister for Health, Latvia

Opening Remarks

Regional Director, WHO Regional Office for Europe

09:30–09:50 Keynote Address

Shifting Power, Shifting Populations: Health Security and Health Workforce for Small Countries in a New Global Order

The challenges Small Countries face

09:50-10:50 High level panel discussion

Panelists: Minister of Health, Latvia; WHO Europe Regional Director; High level panelist (TBC)

Securing the Future Workforce: Health Security, Ageing, and Health System Resilience

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10:50–11:15 Networking Coffee Break

11:15-11:30 Adoption of the Small Countries Statement

11:30– 11:50 Press conference

The solutions - Small Countries taking the initiative forward

11:30–11:40 1) Optimizing the health workforce

11:40–12:45 Optimizing the health workforce: service redesign, skills mix and multidisciplinary teams – panel discussion

12:45–12:50 Family photo

12:50–14:05 Working lunch

14:05–15:15 Leveraging Digital Technology & AI for Health Workforce Optimization and Capability Strengthening - panel discussion

15:15–15:45 Networking Coffee Break

15:45–16:00 2) Ageing of the health workforce

16:00–16:50 Panel discussion

16:50-17:00 Closing of day 1 session

18:30 Informal Networking Dinner (Hosted by the Ministry of Health of Latvia)

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DAY 2 — Advancing the Solutions

Time Session

09:00 – 9:10 Recap & Day 2 Overview

09:10 – 09:25 3) Retaining health workforce

09:25 – 10:20 Sustaining those who sustain us: Strengthening Mental Health & Wellbeing in the Health Workforce - panel discussion

10:20 – 10:50 Networking Coffee Break

10:50 -12:15

Retaining and attracting health workers in the public sector and in rural areas – panel discussion

12:15 – 12:45 Closing reflections and statements of SCI members

12:45 – 13:45 Lunch

SCI Mtg_Scope Purpose_2026.pdf

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WORLD HEALTH ORGANIZATION REGIONAL OFFICE FOR EUROPE WELTGESUNDHEITSORGANISATION REGIONALBÜRO FÜR EUROPA

ORGANISATION MONDIALE DE LA SANTÉ BUREAU RÉGIONAL DE L’EUROPE ВСЕМИРНАЯ ОРГАНИЗАЦИЯ ЗДРАВООХРАНЕНИЯ ЕВРОПЕЙСКОЕ РЕГИОНАЛЬНОЕ БЮРО

Twelfth Meeting of the Small Countries Initiative High Level Meeting

From Scarcity to Sustainability: Can Small Nations Lead Workforce Innovations?

Wellton Riverside Spa Hotel, 11. Novembra krastmala 33, Riga, Latvia

4 – 5 June, 2026

Draft Scope and purpose

Background

The Small Countries Initiative (SCI), established in 2013, is a network of 12 European countries with 2

million or less inhabitants: Andorra, Cyprus, Estonia, Iceland, Latvia, Luxembourg, Malta, Monaco,

Montenegro, North Macedonia, San Marino and Slovenia.

The forthcoming SCI meeting, jointly organized by the Ministry of Health of Latvia and WHO Regional

Office for Europe, builds on previous SCI commitments, ministerial statements, priorities as set out in the

Second WHO European Programme of Work 2026–2030 (EPW2), and the Framework for Action on the

Health and Care Workforce in the WHO European Region 2023–2030.

Context Setting

Across the WHO European Region, the healthcare workforce (HCWF) is now the decisive factor

determining whether health systems can meet rising citizen needs, protect populations during crises, and

sustain essential services.

Small countries face a convergence of pressures that threaten their ability to protect population health

and sustain a resilient healthcare workforce, including intensifying health security risks, dual population

and workforce ageing, persistent shortages and uneven distribution, and destabilizing migration and

public–private labour flows. These challenges are compounded by limited labour markets, constrained

training capacity and underdeveloped workforce optimization strategies, leaving systems highly exposed

to external shocks and increasingly strained in maintaining equitable, continuous and secure essential

services.

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The SCI meeting provides for a dedicated high-level policy dialogue for member countries to advance

strategic action on Human Resources for Health (HRH), recognizing the health workforce as a critical

foundation for resilient, secure and people-centred health systems.

In summary, the meeting will enable SCI countries to reflect on shared challenges and identify collective

and country-specific solutions. Particular attention will be given to emerging pressures affecting HCWF,

including geopolitical and health security risks, dual aging, mental health and well-being, workforce

mobility and migration, nursing and advanced practice roles, and leveraging digital technologies to

optimize the capability of the broader workforce.

When Small Leads, Others Follow: Scalable Pathways to Health System Resilience

The two-day SCI meeting is structured to first build a shared understanding of the pressures facing small

countries and then move decisively toward practical, scalable solutions. Day one will focus on examining

the core challenges to health system security, sustainability and workforce resilience, drawing on the

unique agility of small countries as early-warning, rapidly adapting health systems. Second half of day one

and day two will shift toward action, showcasing innovative approaches, peer learning and coordinated

strategies that small countries can champion and larger countries can later adopt. Together, the meeting

becomes a platform for collective problem-solving, deeper ministerial collaboration, and renewed

momentum behind regional workforce and health system transformation.

Further details on core health system challenges facing small countries, along with the aim, objectives and

thematic areas that will guide the upcoming SCI meeting are provided at Annex.

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Annex - Health System Challenges, Aim, Objectives and Thematic Areas to be covered at the SCI

This annex provides a consolidated overview of the core health system challenges facing small countries,

along with the rational, aim, objectives and thematic areas that will guide the upcoming SCI meeting. It

outlines the pressures shaping health workforce sustainability, the implications for health security and

service continuity, and the opportunities for transformation through optimized workforce policies,

integrated healthcare models and digital innovation. The material that follows is intended to ground the

meeting’s discussions in a shared level of understanding, clarify the strategic focus for SCI members and

support.

1.1 The challenges facing SCI Countries

Small countries are confronting a convergence of pressures that directly affect their ability to protect

population health, maintain essential services, and sustain a resilient healthcare workforce.

Health security threats are intensifying, driven by geopolitical instability, pandemics, cyberattacks,

climate-related events, and supply chain disruptions. With limited surge capacity and smaller professional

pools, small countries face heightened vulnerability. Their health workforce remains the core of national

health security — yet also the most exposed asset during crises.

Population ageing is reshaping demand and shrinking supply simultaneously. Older citizens require

more continuous, complex and multidisciplinary care, while the healthcare workforce is ageing even

faster, particularly in rural and remote regions. This dual ageing dynamic threatens service continuity,

increases dependency ratios and places sustained pressure on already stretched systems.

Workforce shortages and uneven distribution undermine resilience. Urbanization continues to draw

younger professionals toward major cities, leaving rural and peripheral areas with ageing staff, limited

recruitment pipelines, and reduced capacity to modernize services. These patterns widen inequities and

weaken national preparedness.

Public–private imbalances in the movement of healthcare workers is a compelling challenge. For

example, this can sometimes be a factor that drains capacity from essential public services, weakening

surge readiness, continuity of care, and equitable access. Without coordinated governance, these shifts

distort labour markets, inflate costs, and threaten the long-term security and sustainability of health

systems.

Migration and mobility pressures destabilize workforce supply. Small countries are disproportionately

affected by outward migration and international recruitment competition, complicating long-term

planning and increasing reliance on temporary or foreign trained staff.

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Workforce optimization remains insufficiently developed. Opportunities to strengthen resilience

through enabling functions — such as leveraging digital technologies, skills mix redesign, advanced

practice roles, patient involvement and integrated health-social care models — are not yet fully realized.

Adoption is uneven; competencies vary, and systems are not consistently aligned to support modern,

efficient and secure models of care.

Structural vulnerabilities amplify all of these challenges. Limited labour markets, constrained training

capacity and high exposure to external shocks make it harder for small countries to absorb disruptions,

maintain essential services, and ensure long term workforce sustainability.

1.2 SCI meeting rationale

Given the challenges referred to, small countries are facing a convergence of pressures that directly

threaten health security and the ability to meet the healthcare needs of citizens in the context of an ageing

population. These challenges are directly aligned with the priorities of the Second WHO European

Programme of Work 2026–2030 (EPW2), which places strong emphasis on building resilient health

systems, protecting populations in emergencies, and ensuring that no one is left behind, a key

commitment as affirmed by SCI in their contribution to implementation of EPW2.

This aligns closely with previous SCI commitments, including the recognition that responding effectively

to multiplying, complex and multidimensional threats demand stronger health governance, as well as the

shared commitment to prioritize health workforce planning and strengthen national supply capabilities,

as reflected in the Montenegro SCI statement.

1.3 SCI meeting aim

To strengthen the health security, sustainability and resilience of small countries by accelerating

healthcare workforce transformation in response to demographic change, dual ageing, and evolving

population needs. The meeting will support SCI countries to develop future ready models of healthcare

by enhancing workforce policies, governance and planning; advancing skill mix optimization and

integrated care; and leveraging enabling functions such as digital technologies, nursing leadership and

patient involvement. Through shared understanding, mutual learning and coordinated action, SCI

members will generate scalable approaches that contribute to regional priorities under the EPW2 and the

Framework for Action on the Health and Care Workforce in the WHO European Region 2023–2030.

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1.4 SCI meeting objectives i. Review progress across SCI countries in strengthening healthcare workforce strategies, governance

and implementation in line with regional and global commitments.

ii. Build a shared understanding of the core pressures facing small countries — including health security

threats, dual ageing, workforce shortages, regional workforce disparities and migration dynamics —

and their implications for meeting population needs.

iii. Strengthen health system security and resilience by identifying actions that enhance surge capacity,

protect health workers, and ensure continuity of essential services during shocks.

iv. Assess the impact of demographic change and urbanization on service demand, workforce

sustainability and regional equity, and identify strategies to maintain access across all areas.

v. Advance workforce optimization by redesigning services, leveraging digital technologies (including

the use of AI), improving skills mix, including in nursing advanced practice, expanding multidisciplinary

teams and enabling more integrated models of health and social care.

vi. Identify ways in which to enhance the capability of the existing workforce through leveraging digital

tools, including AI, strengthened competencies, modernized education, and patient involvement to

support more efficient, coordinated and future-ready care.

vii. Promote mental health and wellbeing support as essential to workforce retention, performance and

long-term sustainability.

viii. Strengthen approaches to managing migration and mobility, including ethical recruitment, retention

strategies and regional cooperation to stabilize workforce supply.

ix. Generate scalable insights and transferable models that larger countries can adapt, positioning SCI

members as agile innovators in health system transformation.

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1.5 Thematic focus areas

i. Health workforce and security – understanding the role of HRH in preparedness, response and

recovery, including planning surge capacity and protection of health workers and maintenance of

essential services during crises.

ii. Demographic change, aging and urbanization – addressing the dual challenge of an aging health

workforce and the concentration of younger professionals in urban centres, and identifying strategies

to ensure equitable workforce distribution, sustain regional services and support modernization

across all areas.

iii. Optimizing the capability of the existing healthcare workforce - by strengthening skills mix,

expanding nursing leadership and advanced practice roles, enhancing interprofessional collaboration,

leveraging digital technologies and deepening integration between health care. This combined

approach enables more coordinated, efficient and sustainable models of care that can meet long term

population needs

iv. Retaining the health workforce, especially in rural areas and in the public sector – by improving

working conditions of healthcare workers, in terms of reducing long working hours, reducing the

number of nigh shifts, improving job flexibility, providing a fair remuneration among others. Also, by

providing specific financial and non-financial incentives for health workers to work in rural an

v. Mental health and well-being of the health workforce – policies and interventions to prevent

burnout, support psychosocial resilience and improve retention.

vi. Health workforce international migration – managing mobility in a manner that is sustainable, ethical

and aligned with national and regional workforce needs.

1.6 Expected SCI meeting outcomes

i. Adoption of an agreed SCI member state statement reflecting shared priorities for strengthening

health security, workforce sustainability and system resilience across SCI countries.

ii. A consolidated understanding of the key pressures facing small countries — including health security

threats, dual ageing, workforce shortages, geographic imbalances and migration dynamics — and the

policy options available to address them.

iii. Identification of good practices and scalable innovations in workforce optimization, service redesign,

skills mix transformation, advanced nursing roles, digital enablement and integrated healthcare

models that can be adapted across SCI contexts and inform larger countries.

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iv. Clear national and regional follow-up actions to accelerate implementation of the Framework for

Action on the Health and Care Workforce (2023–2030) and priority areas under EPW2 (2026–2030).

v. Strengthened collaboration between WHO/Europe and SCI members on workforce planning,

capability building, investment and governance reforms that enhance resilience and preparedness.

vi. Renewed political commitment to building a resilient, supported and future-ready healthcare

workforce capable of sustaining essential services, protecting population health, and advancing EPW2

priorities beyond 2030.