National Pact for the Quality, Efficiency and Sustainability of the Healthcare System.

This pact, initiated by the Head of Government, brings together a wide range of stakeholders—including government bodies, political parties, the social security fund (CASS), healthcare providers, professional associations, and civil society—to strengthen and modernize Andorra’s public health system.
The system is built on principles such as patient-centred care, co-responsibility, equity, solidarity, and free choice of professionals. It is financed through a mix of social security contributions, government funding, and patient co-payments. Andorra’s healthcare ranks among the best in Europe, but the system faces growing challenges: an ageing population, rising chronic diseases, and increasing costs.
The COVID-19 pandemic tested the system but also demonstrated its resilience and capacity for rapid adaptation. Now, the pact aims to build on those lessons by reinforcing four strategic pillars: Health promotion and disease prevention, with a focus on healthy lifestyles, vaccination, early detection, mental health, and environmental health (One Health approach); Access to quality care, ensuring sufficient and well-trained professionals, updating service portfolios, strengthening primary and hospital care, and improving mental health, oncology, and chronic care services; Sustainability and equity, by reviewing financing mechanisms, optimising resource use, strengthening inspection and control, and evaluating the impact of digital tools and telemedicine; Research and innovation, to attract talent, foster collaboration with reference centres, and stimulate economic diversification through health-related R&D; Key supporting tools include the shared medical record, electronic prescription, the Andorra Salut app, and a robust health data system. Legal reforms are also planned in areas such as pharmaceuticals, tobacco control, and cross-border cooperation.
The pact establishes a follow-up mechanism with periodic meetings and progress reports, and all signatories commit to working together to ensure a sustainable, high-quality, and responsive health system for the future.