The European Region has passed the half-way point of the Health 2020 implementation period. In this chapter we assess the extent to which progress has been made towards the targets as defined in the Health 2020 monitoring framework. It provides an overview of progress made by the Member States towards reaching the Health 2020 targets at the regional level in relation to the agreed 2010 baseline. The Health 2020 monitoring framework (Annex 1) is the backbone of this report. It has three main components: burden of disease and risk factors; healthy people, well-being and determinants; and processes, governance and health systems. Each area is linked to one or more targets (six in total). There are 19 core indicators and 18 additional indicators by which to measure progress.

Tobacco smoking rates present a challenge for Europe as rates for the adult population are the highest of the six WHO regions though the figures varied between countries and age groups. Similarly, despite the decreasing trend of alcohol consumption in the Region, levels of consumption among the adult population are still the highest in the world which poses a threat to population health. Differences in the levels of alcohol consumption between countries remain large.