Recently, the impact of environmental degradation and climate change and the strategies to put small states’ concerns on the policy agenda also received attention. There is a gap in the literature on small states when it comes to health policy and more specifically European health policy and the stance of small states in the European integration of health policy. WHO Europe launched a small country project in 2014 to support small states in the implementation of the Health 2020 agenda. The WHO network is meant to foster political commitment in small states and exchange information and advance collaboration among them. WHO Europe acknowledges that small states have certain advantages such as a high social cohesion but face challenges such as reduced capacities compared to larges countries (WHO Europe, 2014). Recently, the activities related to the Jean Monnet Chair in European Public Health Professor Helmut Brand developing and distributing knowledge about European integration and health more broadly identified and raised the issue of small states at the intersection of national and European health policy making. In addition, the work by Azzopardi-Muscat (2015), a PhD candidate of the Jean Monnet Chair has started to conceptualise the impact of European integration on small member states (SMS) in the area of health by a literature review and scoping study with Maltese experts using interviews. There are no comparative studies related to European integration and health related to small states.