vii, 48 p. ; The Ninth High-level Meeting of the Small Countries Initiative (SCI) brought together ministers of health and secretaries of state from the 11 countries of the Initiative in Luxembourg on 10–12 May 2023. Small country perspectives, challenges and needs emerged on the following themes: advancing health, equity and well-being; preventing and providing a quality response to noncommunicable diseases; access to medicines; improving mental health at the community level; advancing human resources for health; and leveraging digital health transformation. Participants also celebrated International Nursing Day on 12 May. Globalization of the SCI was proposed for consideration by the Government of Malta. The meeting was an opportunity to share progress in implementing the Roadmap towards better health in small countries in the WHO European Region, 2022–2025, and to address the challenges of small countries in the Region and beyond. Ministers of health from other WHO regions and other small countries within the European Region also attended and provided insights and perspectives.