Health in all policies – Health in all SDGs: call for action on climate change: the Monaco Statement: Third High-level Meeting of the WHO Small Countries Initiative, Monaco, Principality of Monaco: health and sustainable development: the inherent advantages of the small countries

Andorra MaltaIceland MontenegroCyprus MonacoLuxembourg San Marino HealtH in all policies – HealtH in all sDGs: call for action on climate cHanGe tHe monaco statement third high-level meeting of the WHo small countries initiative, monaco, principality of monaco Health and sustainable development: the inherent advantages of the small countries We, the Ministers and delegates of the eight Member States of the European Region of the World Health Organization (WHO) with populations of less than one million inhabitants, met in Monaco on 11–12 October 2016 to participate in the third high-level meeting of the small countries initiative. We reconfirm the commitment made in the San Marino Manifesto (2014) and in the Andorra Statement (2015) to implement the core principles, approaches and values of Health 2020 – the WHO European policy framework for health and well-being – in our national strategies, policies and plans. We, as Member States of the United Nations, agreed on the 2030 Agenda for Sustainable Development, for people, planet, prosperity, peace and partnership. As small countries, we are committed to working together in implementing the Sustainable Development Goals (SDGs), sharing experiences and using our joint voice internationally to improve the lives of our people in a sustainable way and reduce inequalities. Health is a precondition for sustainable development, and the new dynamics created by the 2030 Agenda for Sustainable Development provide us with new opportunities. Intersectoral action to address social, economic and environmental determinants of health, enacted through whole-of-government, whole-of-society and life-course approaches to reducing health inequities will be reinforced by the universal and holistic approach taken by the 2030 Agenda and its commitment that no one will be “left behind”. Health in all policies means health in all SDGs. While we acknowledge the need to address all the SDGs together in a consistent manner, we, the small countries, advocate action particularly on one outstanding priority of our times; namely, urgent action to combat climate change and its impacts on health. Climate change has no borders. The health consequences are already felt worldwide and will affect the achievement of SDG 3, “Ensure healthy lives and promote well-being for all at all ages”, from changes in the distribution of infectious diseases to increased mortality and morbidity from more frequent and intense extreme weather events. These will be amplified by the consequences climate change has on the economy, the environment and our social system. Globally, some of the small countries are affected in their very existence and need our full solidarity. However, action is possible. Interventions to reduce greenhouse gas emissions improve health locally and immediately, contributing to reducing the burden of noncommunicable diseases and obesity. Building on the Fifth Ministerial Conference on Environment and Health in 2010, which saw the adoption of the Parma Commitment To Act that aims in particular to protect health and the environment from climate change, and the 2015 Paris Agreement of the United Nations Framework Convention on Climate Change (UNFCCC)’s Conference of Parties, we, the small countries, will use our experience and resources to respond, using some of our intrinsic strengths – the structural qualities we share; namely, adaptation, innovation and participation. • We are responsive and can adapt quickly and strategically to external events. • We are early adopters and, in many instances, pioneers of innovations. • We are close to our communities and hear the voice of our citizens, enabling a participatory approach. Capitalizing on our inherent strengths, we therefore commit to: • further improve and develop technical capacity, including using innovative tools, in relation to climate change, sustainable development and human health; • share information, good practices, experiences and lessons learned with regard to science, planning, policies and implementation of prevention of the health effects of climate change (adaptation) and sustainable measures to achieve health co-benefits of reducing greenhouse gas emissions (mitigation); • support the scale-up of innovations and the sharing of good practices aimed at responding to the increasingly numerous urgencies caused by climate change; • engage with other governments (including those of small states), civil society, scientists, and the wider global health and development community, for intersectoral action; in particular, through cooperation across formal and informal structures within the education sector, with a view to raising awareness on climate change, sustainable development and health among all citizens from the earliest stages of life; • advocating for concrete action on climate change and health at the Sixth Ministerial Conference on Environment and Health in 2017. With this statement, we, the members of the small countries initiative, accept responsibility in maintaining and improving health and sustainable human development for our young and future generations.