The Wittenberg Statement 2025 draws inspiration from the historical Reformation as a metaphor for structural transformation. Just as the 16th-century movement challenged centralised authority, democratised access to knowledge, and empowered local actors, this Statement advocates for a revision of healthcare policy and wider systems to focus on the health and well-being of rural populations across Europe.
This Statement is underpinned by the conviction that equitable healthcare cannot be achieved without recognising the distinct needs, strengths, and contributions of rural communities. The following core insights, derived from cross-national dialogue among rural health professionals, researchers, and system thinkers, articulate a contemporary vision for reform.
Decentralisation and Local Authority
Current healthcare governance structures remain overly centralised, often failing to reflect the operational realities of rural practice. There is a pressing need for greater regional autonomy, flexible funding mechanisms, and localised decision-making that empowers rural communities and healthcare professionals as co-architects of care delivery rather than as policy end-users.
Translation of Knowledge into Practice
Medical education and clinical guidelines frequently lack relevance to rural contexts. Reform efforts must prioritise the translation of evidence into rural-proofed, context-sensitive and actionable tools and protocols. Digital and health literacy initiatives should support rural practitioners and communities in navigating and applying complex medical knowledge effectively.
Empowerment of the Rural Frontline healthcare practitioners and Community-centred practice
Rural practitioners must be recognised not merely as implementers of policy but as active drivers of systemic change. Grassroots innovations - particularly those involving community needs assessment and engagement, digital platforms, and collaborative networks - should be acknowledged, supported, publicly funded and scaled. The potential role of a range of health professions in primary care should be assessed and developed to support and supplement the work of rural family doctors in the interests of the future of community-based interprofessional primary care.
Research
Funding opportunities should be made available for rural research, as strengthening research capacity at the rural level is essential to ensuring that policy is informed by lived experiences. Bringing together knowledge, needs and community assets can inform and shape future research to address an inform future practice.
Rural populations participation must be actively considered and included in the design and delivery of healthcare research and clinical trials. Rural recruitment and participation should be monitored by national research bodies.
Researchers should be able to develop their careers within rural settings. Universities, educational institutions and organisations must ensure that staff from rural areas can take up research positions through providing flexible working opportunities and access to financial support for accommodation and travel costs.
Strategic Use of Technology
Contemporary digital tools must not replace rurally placed service provision from local healthcare professionals and community services. Smart technologies, telemedicine, artificial intelligence, and open health data, have transformative potential. However, their deployment must be contextually appropriate, and equity driven. Investment in technological infrastructure and training in rural regions is necessary to ensure that these tools serve as instruments of inclusion rather than further marginalisation. When services are digitalised, monitoring of impact and outcomes must be undertaken to ensure rural communities are not disadvantaged.
Redefining Norms of Excellence
Rural practice must be recognised for its adaptability, generalist expertise, resilient and potential to pioneer integrated, community-based care models. Prevailing models of healthcare excellence often reinforce urban-centric norms and must be challenged.
Moral Imperative and Social Justice
The persistence of rural health disparities constitutes a systemic injustice. Reform must be underpinned by moral clarity and an explicit commitment to social equity. This Statement - analogous to a modern set of Martin Luther’s 95 Theses - must serve as a unifying framework to mobilise policymakers, practitioners, and the public.
Sustained Commitment to Rural Health Reform
Rural actors bring deep-rooted connections, knowledge and expertise, but often struggle to navigate wider organisational structures. Bureaucratic and organisational structures should actively engage and support the rural voice in re-designing and delivering sustainable services in rural areas.
Legacy-Oriented Reform
A successful Rural Reformation will lay the groundwork for lasting structural change: health systems that are place-sensitive, a workforce trained in and for rural realities, and research agendas shaped by and responsive to rural experience.
Building Alliances Around Shared Values
The future of rural health care depends on the strength of its coalitions. Shared values such as equity, sustainability, and solidarity must guide cross-sector collaboration. Strategic alliances - with patients, policymakers, academic institutions, and technology developers - are essential to ensure the translation of vision into lasting impact.
One Health
The One Health approach to rural communities is essential for environmental sustainability and the wellbeing of future generations. Empowering rural communities and reinforcing the strategic capacity of the agricultural, forestry, and other economic sectors will underpin the stability of our countries. In the face of growing geopolitical challenges, sustained investment in Europe’s rural medicine and comprehensive rural health reforms is more vital than ever.
The Wittenberg Statement 2025 was accepted by all delegates of the 14th EURIPA Rural Health Forum and is both a call to action and a roadmap for transformation. It affirms that rural communities do not seek exceptional treatment, but demand equitable recognition, structural investment, and sustained partnership. This Statement invites all stakeholders to participate in shaping a healthcare future that is inclusive, evidence-based, and responsive to the voices of those who live in rural communities and who serve rural communities and are central to the health of the continent.