Partnering with the EU to strengthen health systems through innovative, evidence-based reforms
WHO is partnering with the European Union (EU) through the Technical Support Instrument (TSI) to support health system reforms across the EU region. Europe is experiencing a profound demographic shift marked by an ageing population and a rising burden of noncommunicable diseases. These long-standing challenges have been further exposed and intensified by the COVID-19 pandemic, revealing deep vulnerabilities in health systems across the region.
Addressing these complex challenges requires transformative approaches. The TSI plays a key enabler role by supporting EU Member States in designing and implementing ambitious health reforms.
TSI
The TSI project, funded by the European Commission, supports selected EU Member States in designing and implementing health system reforms.
Building on the results of the 2022 TSI multicountry project with Austria, Belgium and Slovenia (also known as the EU Health Resources Hub), the project runs for 24 months and focuses on critical technical areas. Its implementation is organized into 3 thematic clusters:
- Cluster 1: Strengthening the health-care workforce in Italy and Spain
- Cluster 2: Rethinking the role of hospitals in preventive health-care delivery in Germany and Sweden
- Cluster 3: Long-term care in Malta.
Despite differing contexts, the projects are closely aligned in their objectives, methodologies and strategic focus on system transformation.
Clusters 1 and 2 have a multicountry component. This joint component leverages horizontal activities coordinated by the European Observatory on Health Systems and Policies to ensure an exchange of learning within the clusters.
This creates synergies with past and on-going TSI projects and European and national initiatives, as well as the joint WHO-EU Nursing Action for the retention and recruitment of the nursing workforce in the EU, the WHO’s efforts on the implementation of the WHO Framework for Action on Health and Care Workforce and the WHO initiative “Ageing is living: promoting a lifetime of health and well-being (2026–2030)”.
Thematic clusters of the TSI project
Cluster 1: Strengthening the health-care workforce in Italy and Spain
The Italian and Spanish health and care workforce landscape is facing significant challenges in terms of reduced workforce and needs mismatch, particularly relating to a shortage in nurses. In response to these shared challenges, the project supports tailored national reforms in each country.
Cluster 2: Rethinking the role of hospitals in preventive health-care delivery in Germany and Sweden
Germany and Sweden are grappling with ageing populations, which places additional strain on their already burdened systems. A key shared challenge is the underutilization of preventive services, despite their critical role in reducing disease burden and supporting the long-term sustainability of health, social care and welfare systems. In the context of this TSI project, Germany and Sweden work in parallel and together towards addressing these challenges.
Cluster 3: Long-term care in Malta
Malta is committed to strengthening its long-term care sector to better support its ageing population. While various initiatives and services are already in place, evolving demographic trends are increasing the demand for care, highlighting the need for a more comprehensive and structured approach.
The project will develop a proposal for updating the legal framework in Malta to promote accessible, high-quality and person-centred long-term care for older people.
Horizontal and cross-cutting activities
A suite of horizontal and cross-cutting activities are facilitated to foster the exchange of evidence, learning and experiences within and across project clusters; create synergies; and expand the pool of countries and practitioners involved, amplifying messages, increasing impact and encouraging continuity across past and on-going projects.