WHO Report Lauds Andorra's Top-Tier Health System in 2025 Review

The European Observatory on Health Systems and Policies has published its 2025 report on Andorra's health system, developed at the request of the WHO Regional Office for Europe in coordination with the Ministry of Health. This assessment, stemming from the WHO regional director's 2024 visit, profiles non-EU member states' health frameworks, outlines future challenges, and supports international and temporal benchmarking.

Andorra's CASS provides public health coverage to 98% of residents through an extensive benefits package tailored to local needs. The Ministry of Health continues to expand this scope periodically, including coverage for select procedures performed in Spain and France. Household out-of-pocket payments accounted for just 11% of total health expenditure in 2023, among the lowest shares in the WHO European Region. Only 2.1% of households encountered catastrophic health costs—those risking family finances—positioning Andorra as a leader in financial protection and equitable access.

Health outcomes remain robust. Life expectancy at birth climbed from 83.4 years in 2016 to 84.6 years in 2023, placing the country at the top of the region. Vaccination coverage spans 94-99% across age groups, infant mortality is 1.5 per 1,000 live births, and no maternal deaths were recorded. Non-communicable diseases drive most fatalities, primarily cancers and cardiovascular issues, with tuberculosis incidence dropping to 4 cases per 100,000 people. Leading risk factors are hypertension, smoking, and suboptimal diets.

The report highlights multisector collaboration, including government, professional colleges, and civil society. It cites the 2024 National Pact for Health System Sustainability and Efficiency, backed by more than 40 entities, to build a more resilient, equitable, and innovative framework. The Comprehensive Mental Health Plan (PISMA), aligned with WHO mental health action plans, advances governance, professional training, and a shift from hospital-based to community-focused care. The preferred pathway mechanism receives commendation for strengthening primary care physicians' roles and enhancing system efficiency.

Health workforce expansion is notable: doctors rose from 295 in 2010 to 507 in 2023, nurses from 364 to 451, and general practitioners by 27%. WHO figures reflect active staff counts, not full-time equivalents. A key challenge is workforce aging, with 36% of doctors over age 55.

Digital progress includes the shared electronic health record and ongoing enhancements to the Andorra Salut app, enabling access to medical reports, referrals, and vaccination records.