I am speaking on behalf of the European Union and its Member States.

We welcome WHO’s efforts in maintaining and developing the International Classification of Diseases.  The adjustments made as a result of the external review of the revision process (in 2015) were very welcome. In particular, the emphasis on the production of a classification, that meets the needs of the official statistical community, and improvements in two-way communication with external users.

We appreciate that the original plans for the 11th revision, dating from 2007, had a very high level of ambition. This is reflected in the level of detail, in fitness for universal use, speed of updates, and the use of advanced IT tools for development and cooperation. We welcome the commitment expressed by WHO that ICD-11 should be of undisputed quality and be ready-for-use, when it is released.

However, those original ambitions are for now, elusive; and so choices need to be made. As the ICD is intended for worldwide use, the EU believes that priority should be given to stability and ease of use, rather than sophistication and constant changes.

The introduction of a new ICD incurs high transition costs and recurring maintenance costs in many Member States.  Therefore, ICD-11 must add real value compared to ICD-10.

In terms of mortality statistics, multi-year stability and infrequent changes are a prerequisite. As many Member States are using or considering to use software systems for automated coding of causes of death, the computerised decision tables for such software must be available before ICD-11 can be called ‘ready-to-use’.

The successful completion of the 11th revision, even a simplified one requires considerable resources. We propose that WHO and the Member States agree on a comprehensive project plan, which considers all the remaining tasks, including    ICD-10 to ICD-11conversion tables, translation, testing, implementation and maintenance issues, with realistic estimates of required and available resources. The submission of ICD-11 to the World Health Assembly will need to be contingent upon the demonstration of its usefulness.

We request the Secretariat to update the 140^th Executive Board in January 2017 on the outcome of the ICD Revision Conference taking place later this year, in Tokyo.

Thank you