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WFSA statements on UHC, AMR and workforce strengthening at 73rd WHO Regional Committee for Europe

WFSA urges European member states to engage with WFSA Member Societies to strengthen and invest in the anaesthesia workforce as a means to realise universal health coverage goals and improve patient safety.

WFSA representatives at the meeting were WFSA Council and Board member Dr. Emilia Guasch and Prof. Else-Marie Ringvold who sits on the ESAIC’s Board of Directors.

Written Statement – Update Report Reaffirming commitment to health systems strengthening for universal health coverage, better outcomes and reduced health inequalities Progress report

The World Federation of Societies of Anaesthesiologists (WFSA) is the largest global anaesthetic network, representing over 500,000 anaesthesiologists in 133 countries, 40 of which are from Europe. We work with the WHO and other organisations towards universal access to safe anaesthesia.

WFSA welcomes the progress made by member states to realize Universal Health Coverage (UHC) through an integrated primary health care approach. 

A primary healthcare approach to universal health coverage must include emergency and critical care services provided without delay, the delivery of basic anaesthesia, surgical, obstetric, and trauma care at first-level hospitals and health centres, and robust systems for referral and transport when more complex or specialized perioperative services are needed.

WHO continues to be very clear on the centrality and need to engage with anaesthesiologists as a means way to implement a primary health care approach to UHC. This is evidenced by both Resolution WHA68.15 which identified anaesthesia and surgery as essential components of UHC and by WHA76.2 which emphasized the need to integrate emergency, critical care and operative services including anaesthesia as being key to the primary health care approach.

Successful integration of these services with primary health care brings them closer to the populations that need them. The sooner people can access care the better (and less costly) the health outcomes. It also enables clinical providers to combine efforts, resources, and expertise.

Sadly we risk not realising our UHC ambitions due to the chronic and lasting inequalities that patients in different parts of the continent face when trying to access safe and affordable anaesthesia and surgery. These inequalities of access mirror inequalities in both the prioritisation and investment in vital anaesthesia services and workforces across Europe.

These inequalities are well illustrated by the experiences of Europe’s anaesthesia workforce and their reactions to those inequalities.

We are seeing a significant brain drain of anaesthesia professionals migrating from low- resource to high-resource settings in pursuit of work. This has unbalanced Europe’s workforce map resulting in overstretched and under-resourced workforces in southern and eastern Europe and bloated workforces in northern and western European countries.

Anaesthesia workforce shortages have been further exacerbated by investment-strapped health services increasingly looking to save money by reducing administrative staff. This has had the knock-on effect of taking anaesthesia professionals away from their clinical work and patients to complete administrative duties.

As the workload increases and the number of available anaesthesiologists drop, more and more countries are looking to compensate for this shortfall by shortening and fast tracking their anaesthesia education and training programmes. This results in undertrained and ill prepared anaesthesia professionals with lower clinical standards which ultimately reduces patient safety.

We must vigorously fight these attempts to water down the expertise and clinical focus of our anaesthesia professionals.

There is a growing need to align anaesthesia education across Europe.  Approaches such as the well-established European Diploma in Anaesthesiology and Intensive Care and European Training Requirements ETR in Anaesthesiology provide countries with an approved and assured standard of anaesthesia expertise and patient care.

For European member states to realise a patient-focused continuity of care as outlined in the United Action for Better Health in Europe workplan there is an urgent need to develop, implement and integrate national policy and financing frameworks that will sustainably strengthen vital anaesthesia services.  

WFSA calls on European member states to:

  1. Need to embed national surgical, obstetric and anaesthesia plans into integrated national health plans and strategies.
  2. Engage with anaesthesiologists in the development of integrated primary health care programmes and initiatives. 
  3. Address chronic workforce deficiencies through investment in approved continued medical education programmes. 

Civil Society Joint Statement – WHO European framework for action on the health and care workforce 2023–2028 

Constituency statement co-signed by WFSA

We congratulate the WHO Regional Office for Europe for their landmark report ‘Time to act’, as well as for their efforts to mobilize 37 Member States to co-sponsor the resolution. The health workforce well deserves this prominent place on the agenda, and this Framework for Action shows a clear way forward.

As civil society organizations, we would first like to highlight the following:

During and after Covid-19, international health and care worker mobility became more dynamic and complex. Some returned home, while many others left the sector or their countries for reasons like burnout, stress and under-appreciation. Migration typically favours health systems with better working and living conditions, whether real or perceived. However, these systems often have high attrition rates themselves and resort to international recruitment as an easy fix, harming the countries of origin, who for their part also fail to adequately retain their health and care workers.

Since all Member States face similar health workforce shortages and challenges, now and in many years to come, we call on Member States to cease the international competition for skilled health and care workers in crisis-ridden systems, and to work together to provide them with the working conditions they need to thrive and to deliver the best possible health care, for all in the European Region.

In addition, we have four more specific asks:

1)      The healthcare workforce includes many different professions and roles. We urge Member States to tailor their health workforce strategies to their specific population needs, and to organize education, training, recruitment, and retention of the different cadres accordingly.

2)      We strongly urge Member States to prioritize people-centered primary healthcare, delivering a full range of services in integrated systems and to undertake specific and concrete efforts to reach those in greatest need and reduce health inequities.

3)      We also ask that Member States strive to upgrade the status and societal appreciation of all categories of health and care workers and to make sure they are remunerated, supported and protected accordingly;

4)      Finally, we ask Member States to guarantee optimal working conditions for health and care professionals by investing in safe and secure working environments, in high quality facilities, with appropriate support staff and streamlined administrative processes, and  in continued professional development, all to the benefit of patient safety and population health outcomes.

 Thank you for your attention.


  1. European Cancer Organisation
  2. Wemos
  3. WONCA Europe
  4. European Public Health Alliance
  5. European Forum for Primary Care
  6. International Diabetes Federation
  7. International Council of Nurses
  8. World Federation of Societies of Anaesthesiologists
  9. WHO Collaborating Centre on Family Medicine and PHC – Ghent University (Belgium)

Civil Society Joint Statement – WHO/EURO Roadmap of Action on AMR

Constituency statement co-signed by WFSA

Antimicrobial Resistance (AMR) causes 35.000 deaths every year in the WHO European Region alone,  posing one of the greatest threats to global health, food security, biodiversity, and development.

The Roadmap for Action on Antimicrobial Resistance for the WHO European Region represents an important step towards strengthening Europe’s collective response to AMR, with One Health Approach as a guiding principle.

The European Public Health Alliance, on behalf of its members and other civil society organisations, welcomes the Roadmap for Action on Antimicrobial Resistance, and fully embraces its vision of people and animals safer from resistant infections by 2030.

As a complex health challenge, AMR requires the engagement and coordination of all stakeholders committed to improving human and animal health through ambitious policymaking.The participation of civil society is therefore indispensable to achieve progress on the main pillars of the Roadmap, including the successful prevention, control and surveillance of AMR, as well as the effective implementation of the AMR compass.

The undersigned European civil society organisations commit to the effective implementation of this roadmap  by contributing to four key areas: 

  1. raising awareness among (and in collaboration with) citizens and healthcare professionals, patient organisations and policy-makers, fostering their education on the prudent use of antimicrobials; this, among others, includes topics of  infection prevention, surveillance and control, health literacy, correct disposal;
  2. improving antimicrobial stewardship by sharing best practices in the healthcare sector and beyond, taking the inter-disciplinary, multi-stakeholder approach;
  3. advocating for AMR  prioritisation on the global agenda; 
  4. promoting transparent evidence-based policymaking through translating research into policy recommendations

Furthermore, we  call upon the WHO European Region Member States to promote the prudent use of antibiotics in all sectors by:

  • investing into independent public research on the development of new antibiotics, and into innovative solutions for prevention, diagnostic and treatment strategies;
  • supporting cooperation between public and private actors by providing incentives for innovation and by setting fair, goal-driven conditions for collaboration.

We call upon governments, international organisations, and the private sector to keep the One Health Approach to AMR a priority on their agendas. The health of humans, animals, and the environment are interlinked, and addressing AMR requires collective action that encompasses these three dimensions. Policymakers and citizens must cooperate to ensure accountability, transparency and equity in the design, implementation and evaluation of such policies. AMR knows no borders. It affects us all, and only by working together, we can ensure that our collective efforts are effective, sustainable, and inclusive. We must leave no-one behind!

Furthermore, we call for the financing of new evidence to provide harmonised solutions at local, national, and international levels, to address the market’s inability to meet patients’ needs concerning the availability of essential antibiotics.

We also call for increased support and renovated investments in civil society organisations, recognising the pivotal role they have in raising awareness, bringing expertise and innovative solutions, advocating for policy change, as well as in monitoring and evaluation of policy implementation.

The Roadmap is one big invitation to collaborate. Only by committing to taking comprehensive and decisive actions across sectors can we prevent future health crises and ensure the healthy living environments and well-being of our communities, our families, and future generations. Inaction is not an option.

On behalf of EPHA, its members, and other civil society organisations signing this statement, we pledge to continue working together with the WHO European Regional Office and reinstate the importance of involving the people in tackling AMR, with health equity as guiding principle. 


  1. AMR Patient Alliance
  2. Association for Natural Medicine in Europe (ANME)
  3. Bangladesh Breastfeeding Foundation (BBF)
  5. EuroHealthNet
  6. European Association of Hospital Pharmacists (EAHP)
  7. European Central Council of Homeopaths (ECCH)
  8. European Federation of Allergy and Airways Diseases Patients’ Associations (EFA)
  9. European Federation of Nurses Associations (EFN)
  10. European Forum of National Nursing and Midwifery Associations (EFNNMA)
  11. European Hospital and Healthcare Federation (HOPE)
  12. European Medical students’ Association (EMSA)
  13. European Network of Medical Residents in Public Health (EuroNet MRPH)
  14. European Respiratory Society (ERS)
  15. European Specialist Nurses (ESNO)
  16. Greek Patients Association
  17. IAPO Patients for Patient Safety Observatory (IAPO P4PS Observatory)
  18. International Baby Food Action Network (IBFAN)
  19. International Pharmaceutical Students’ Federation European Regional Office (IPSF EURO)
  20. International Society of Doctors for Environment (ISDE)
  21. IntraHealth International
  22. MedTech Europe
  24. Norwegian Cancer Society
  25. Rete Italiana Medici Sentinella per l ‘Ambiente (RIMSA)RIMSA
  26. TB Europe Coalition (TBEC)
  27. The European Institute of Women’s Health (EIWH)
  28. The European Patients’ Forum (EPF)
  29. The European Pharmaceutical Student’s Association (EPSA)
  30. The European Public Health Alliance (EPHA)
  31. The European Society of Intensive Care Medicine (ESICM)
  32. The International Federation of Anthroposophic Medical Associations (IVAA)
  33. VAS-European Independent Foundation in Angiology/Vascular Medicine
  34. World Federation of Societies of Anaesthesiologists (WFSA)