Preparing for the next big one: health ministers gather in Istanbul where scientists predict a major earthquake in the coming decades

Istanbul, 1 July 2026

Earthquakes are the deadliest of all natural hazards, causing more than half of all deaths from natural-hazard disasters worldwide between 2000 and 2023. Across the WHO European Region, millions of people live in homes and are treated in health facilities that would not survive a major earthquake.

That is why health ministers, heads of country delegations and senior officials met in Istanbul this week to agree how countries can protect health systems and their people before the next earthquake strikes. Around 200 participants, including 8 ministers of health from the WHO African, European, Eastern Mediterranean and Western Pacific regions, attended the conference, hosted by the Government of Türkiye and the WHO Regional Office for Europe.

Earthquake-prone region

They met in one of the most earthquake-prone cities in the European Region. The North Anatolian Fault, one of the most active in the world, runs south of Istanbul, a city of more than 15 million people. Research published in 2025 identifies a fault line beneath the Sea of Marmara just south of Istanbul that is capable of a magnitude 7 earthquake. Peer-reviewed estimates put the chance of a magnitude 7 or greater earthquake affecting Istanbul over the coming decades at around 40-60%.

The risk is not confined to Türkiye. The 53 Member States of the WHO European Region cover 2 of the world's major earthquake belts. In the west and south, four countries - Greece, Italy, Romania and Türkiye - account for almost 80% of the modelled average annual economic loss from earthquakes in Europe, estimated at € 7 billion a year. In the east, nearly all of Kyrgyzstan and Tajikistan, and parts of Kazakhstan, Turkmenistan and Uzbekistan, along with the South Caucasus, sit in zones of very high seismic risk. A single large earthquake there is likely to cross borders: for example, the Fergana Valley, home to 11 million people, is shared by Kyrgyzstan, Tajikistan and Uzbekistan.

Yet public awareness lags well behind the real danger. In the European Union, more than 1 in 3 people (35%) live within a moderate or high seismic hazard zone, but only 1 in 8 (13%) consider themselves at risk.

"As we meet, our thoughts are with the people of Venezuela, where a powerful earthquake has just taken many lives and damaged health facilities that families depended on. It is the clearest possible reminder of why we are here," said Dr Hans Henri P. Kluge, WHO Regional Director for Europe. "Earthquakes come without warning. In cities like Istanbul and Naples, and across much of central Asia, millions of people live, work and receive care in buildings that would not survive a major earthquake. A health facility that collapses in the first minutes of a quake cannot save lives in the hours and days that follow. Today in Istanbul, ministers will agree on what protecting health from earthquakes requires: hospitals built to stay standing, teams ready to respond within hours and plans tested before they are needed. The lesson of 2023 is that the time to act is now, in the quiet years, not in the rubble."

Lessons from Türkiye

The conference drew on the lessons of the earthquakes that struck southern Türkiye and north-west Syria on 6 February 2023. In Türkiye, official figures record 53 697 deaths, 107 213 injuries and more than 3.5 million people evacuated. At least 15 hospitals were damaged, and health facilities and other non-residential buildings accounted for around 28% of the total damage. When hospitals fail during an earthquake, the demand for trauma and emergency care rises just as the capacity to provide it falls, creating a dangerous bottleneck that can lead to avoidable harm or even death.

The harm does not end when the shaking stops. Rates of depression, anxiety and other mental health conditions rise sharply after a major earthquake, and the need for rehabilitation, including for people left with long-term disabilities, runs for years afterwards. Even the responders are affected: nearly half of those who worked on the 2023 response in Türkiye reported physical or mental health effects during or after their deployment.

When Türkiye's own health system came under extraordinary pressure, WHO coordinated the deployment of 39 emergency medical teams from 22 countries, the largest such deployment to a disaster in the WHO European Region's history.

"On 6 February 2023, Türkiye lived through one of the worst disasters in our history," said a spokesperson from the Ministry of Health of Türkiye. "We learned, at great cost, what it takes to keep a health system working when the ground gives way beneath you: teams ready to move within hours, hospitals built to stay standing and response plans tested long before they were needed. We have been sharing those lessons with other countries and today is the culmination of those efforts. The next earthquake will come. The time to prepare for it is now."

Protecting health before, during and after earthquakes

The conference will close with an outcome statement agreed by participants, setting out in concrete terms what protecting health from earthquakes requires.

At its centre is the health system itself. The statement calls on countries to build new hospitals and clinics to seismic standards and to retrofit existing ones, and to plan for backup power, water and supplies so facilities keep working when the services around them fail. Incorporating disaster protection into the design of a new hospital is estimated to add less than 4% to its total cost and retrofitting a hospital's critical contents can cost as little as 1% while protecting up to 90% of its value, according to the United Nations.

The statement also calls on countries to keep trained emergency medical teams ready to deploy within hours, to test their response plans through regular simulation exercises, to coordinate across borders and sectors such as urban planning, water and civil protection, and to keep the public informed and counter misinformation during a crisis. Finally, the statement also calls for the protection of health workers, while prioritizing the people most exposed, including older people, people with disabilities and displaced populations.