Burazeri G, Laaser U. Health status of the populations in the Western Balkans region (Editorial). SEEJPH 2021, posted: 11 March 2021. DOI: 10.11576/seejph-4232 P a g e 1 | 3 EDITORIAL Health status of the populations in the Western Balkans region Genc Burazeri1,2, Ulrich Laaser3 1 Department of Public Health, Faculty of Medicine, University of Medicine, Tirana, Albania; 2 Department of International Health, School CAPHRI (Care and Public Health Research Institute), Maastricht University, Maastricht, The Netherlands; 3 Section of International Health, Faulty of Health Sciences, University of Bielefeld, Bielefeld, Germany. Corresponding author: Genc Burazeri, University of Medicine, Tirana; Address: Rr. “Dibres”, No. 371, Tirana, Albania; Telephone: 00355674077260; Email: genc.burazeri@maastrichtuniversity.nl Burazeri G, Laaser U. Health status of the populations in the Western Balkans region (Editorial). SEEJPH 2021, posted: 11 March 2021. DOI: 10.11576/seejph-4232 P a g e 2 | 3 For more than twenty years by now, the coun- tries of the Western Balkans have enjoyed peace after a terrifying warfare in the nineties of the last century. It is time to look at the progress made since. All countries in the Western Balkans region are undergoing deep reforms aiming at accession to the European Union (EU) which is a priority and a key pol- icy driver for all sectors. Albania, North Mac- edonia, Montenegro, and Serbia are cur- rently candidate countries (1). Conversely, Bosnia and Herzegovina and Kosovo are po- tential candidate countries with a prospect for EU accession in the future (1). Regarding the health domain, countries re- port on acquis, which includes a chapter on Consumer and Health Protection (2,3). The EU commission monitors these criteria in line with the administrative capacities of each country in their respective stages of the ac- cession process (4). Health status of the populations in the West- ern Balkans region is characterized by an ex- cessive mortality compared with the EU av- erage (5). Life expectancy in the Western Balkan countries ranges from 76.3 years in Serbia (the lowest) to 77.3 years in Bosnia and Herzegovina (the highest), whereas the average value in the EU countries in 2017 was 80.9 years (5). According to the Global Burden of Disease (GBD) estimates (6), the age-standardized all-cause mortality rate in Albania in 2019 was the lowest in the Balkans region (about 575 deaths per 100,000 population), whereas in North Macedonia it was the highest (around 929 deaths per 100,000 population). However, the overall mortality rates have de- clined steadily in all Balkan countries in the past decade (Figure 1). Figure 1. Age-standardized all-cause mortality rate (deaths per 100,000 population) in the Western Balkan countries in the past three decades [source: Institute for Health Metrics and Evaluation - http://ghdx.healthdata.org/gbd-results-tool (6)] The vast majority of mortality is due to non- communicable diseases (NCDs), which ex- plain from 93% of all deaths in Albania (the lowest NCD share) to more than 95% in Ser- bia (the highest) (6). Age-standardized mor- tality rate due to cardiovascular diseases in Albania Bosnia-Herzegovina Montenegro Serbia North Macedonia http://ghdx.healthdata.org/gbd-results-tool Burazeri G, Laaser U. Health status of the populations in the Western Balkans region (Editorial). SEEJPH 2021, posted: 11 March 2021. DOI: 10.11576/seejph-4232 P a g e 3 | 3 © 2021 Burazeri et al; This is an Open Access article distributed under the terms of the Creative Commons Attrib- ution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and repro- duction in any medium, provided the original work is properly cited. 2019 was the lowest in Albania (estimated at 314 deaths per 100,000 population) and the highest in North Macedonia (569 per 100,000 population) (6). For the same year, the age-standardized mor- tality rate due to neoplasms was the lowest in Albania (113 deaths per 100,000 population) and the highest in Serbia (184 per 100,000 population) (6). On the other hand, the age-standardized mor- tality rate from diabetes in 2019 was esti- mated at only 4 deaths per 100,000 in Albania (the lowest in the region), but more than 38 deaths per 100,000 population in Bosnia and Herzegovina (the highest) (6). Regarding the universal health coverage (UHC) index reported by the World Health Organization (WHO), the service coverage index in 2017 ranged from 59 in Albania (the lowest in the region) to 72 in North Macedo- nia (the highest) (5). However, the coronavirus disease (COVID- 19) pandemic has undermined the health sys- tems and UHC reforms in all countries of the Western Balkans region, similar to the rest of the world. The excessive mortality and mor- bidity associated with COVID-19 in the past year has highlighted the lack of preparedness of most of health systems in the region, influ- encing rather negatively the achievement of the Sustainable Development Goal for Health (SDG 3) (5). There is an urgent need to in- crease investments in order to strengthen health systems and improve the service cov- erage in all countries of the Western Balkans to face the current health challenges imposed by the ongoing Corona crisis. References 1. European Commission. Candidate countries and potential candidates. https://ec.europa.eu/environment/en- larg/candidates.htm#:~:text=Alba- nia%2C%20the%20Repub- lic%20of%20North,possible%20re- quest%20for%20transition%20peri- ods (accessed: February 26, 2021). 2. Mckee M, Maclehose L and Nolte E. Health policy and European Union enlargement. Open University Press; 2004. 3. Grabbe H. European Union Condi- tionality and the Acquis Communau- taire. Int Polit Sci Rev 2002;23:249- 68. 4. Copeland N. The European Union Accession procedure; 2013. https://www.europarl.europa.eu/Reg- Data/bibliotheque/brief- ing/2013/130437/LDM_BRI(2013)1 30437_REV3_EN.pdf (accessed: February 26, 2021). 5. World Health Organization. World Health Statistics 2020: Monitoring health for the SDGs, sustainable de- velopment goals. Geneva: World Health Organization; 2020. https://apps.who.int/iris/bit- stream/han- dle/10665/332070/9789240005105- eng.pdf (accessed: February 26, 2021). 6. Institute for Health Metrics and Evaluation (IHME). Global Burden of Disease estimates. http://ghdx.healthdata.org/gbd-re- sults-tool (accessed: February 26, 2021). ____________________________________________________________________________ http://ghdx.healthdata.org/gbd-results-tool http://ghdx.healthdata.org/gbd-results-tool