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Background The 2030 Agenda for Sustainable Development presents an unprecedented opportunity to apply an ecological perspective in public health. It’s success relays on the capacity to interpret and translate embodied principles into policies and actions. Regional policy document (PDs) guide the actions taken by the World Health Organization (WHO) and the Member States. This study aims to explore the alignment between these tools and the health-related Sustainable Development Goals (SDGs) in the WHO European Region. Methods PDs were identified scanning the contents of the 2015-2018 Sessions of the Regional Committee for Europe - the WHO decision-making body. 17 PDs endorsed during this period were directly included. 39 Progress reports were scanned to find additional valid PDs. The Final list included 32 items. A content analysis of the PDs was used to establish alignment to 64 health-related SDGs targets. Results Preliminary results found that each PD aligned to multiple targets within and beyond SDG 3. 24 PDs addressed all targets of SDG 3. A gap within target 3.b was identified (development of medicines and vaccines). Three PDs dealt with health issues outside SDG 3: target 2.1 and 2.2 (end hunger and malnutrition), 15.8 (prevent and reduce the impact of invasive species), and 16.2 (end violence and abuse against children). Five crosscutting PDs aimed to reduce the impact of social, economic and environmental determinants of health on specific population groups, aligning to several targets at the time. Gaps in Target 8.7 (eradicate forced labor) and 14.2 (protect marine and coastal ecosystems) were found. Conclusions PDs have the potential of contributing to several targets simultaneously, linking health to diverse aspects of sustainable development. The SDGs open the possibility for multisectoral actions. PDs invite decision-makers to venture into unconventional policy fields to address public health concerns raised by climate change and sustainable development. Key messages Policy documents are a valuable instrument to advance the 2030 Agenda as they enjoy the commitment of Member States and guide the action taken by international and national decision makers. The ecological perspective in public health promised by the 2030 Agenda demands actions beyond SDG 3, to address the health dimension of all aspects of sustainable development.

How aligned are the WHO European Region policy documents to the Sustainable Development Goals?