On December 12-13, 2023, WHO/Europe and the Ministry of Social Affairs of Estonia will jointly host a high-level health systems conference titled "Trust and transformation: resilient and sustainable health systems for the future" to mark the 15th anniversary of the Tallinn Charter: Health Systems for Health and Wealth, adopted by all WHO European Region Member States in 2008. This milestone conference takes place amidst the backdrop of the lessons learned from the COVID-19 pandemic and a changed geopolitical, social, and economic landscape. It addresses the pressing challenges faced by health systems today, including an aging population, digitalization in healthcare, costly novel medical advancements, climate change impacts, and growing patient discontent, which appear to challenge the pursuit of universal health coverage (UHC). The event aims to envision new and integrated health systems that prioritize patient and health worker roles, emphasizing trust as a prerequisite for transformation, co-creation in policy design, updated performance assessment frameworks considering digitalization and climate change, and comprehensive discussions on critical policy areas. Featuring high-level speakers and parallel sessions showcasing transformative best practices, the conference seeks to rejuvenate regional commitment to the values of the 2008 Tallinn Charter, fortifying and securing European health systems for today and the future.