Health data are essential to modern health care delivery, health system management and research and innovation, and must be well governed to foster their use while protecting privacy and data security. The 2016 OECD Recommendation on Health Data Governance provides a roadmap towards more harmonised approaches to health data governance across countries. It recommends implementing national health data governance frameworks and sets out the key principles to follow when doing so, while promoting trans-border co-operation in data governance and interoperability. This report provides an overview of the implementation of the Recommendation from 2016-2021 and finds that while there are examples of good progress, overall many Adherents are still working towards implementation in areas including data sharing, accessibility, quality, interoperability and security and privacy protections. Efforts to support the implementation and dissemination of the Recommendation will continue for the next reporting cycle (2022-27) with a focus on cybersecurity, harmonising health data governance to allow for multi-country projects and improving global health data interoperability.