EG Chairs and ITAs

Twentieth Meeting (enlarged)

Gdańsk, Poland

26 February 2016

Reference / EG Chairs and ITAs 20/4/1
Title / Draft NDPHS Progress Report for 2015
Submitted by / Secretariat
Summary / Note
Requested action / For discussion and comments

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EG_Chairs_and_ITAs_20-4-1__Draft_NDPHS_Progress_report_for_2015.docx

Table of Contents

1. Background

2. Introduction

3. Achievements of the Partnership during 2015

Action Line 1: Development of the NDPHS Strategy 2020

Action Line 2: Setting up new and restructuring the existing NDPHS expert-level structures

Action Line 3: Development and facilitation of policies, strategies and projects

Action Line 4: Strengthened and more visible role of health and social well-being on the regional agenda in the Northern Dimension area

Action Line 5: Leading and coordinating the Health Policy Area in the EU Strategy for the Baltic Sea Region Action Plan

Action Line 6: Providing adequate funding for the NDPHS and Partnership-relevant activities and projects

4. Conclusions

Annexes

Annex 1: ASA Expert Group Progress report...... 13

Annex 2: HIV/AIDS&AI Expert Group Progress report......

Annex 3: NCD Expert Group Progress report......

Annex 4: PPHS Expert Group Progress report......

Annex 5: AMR Task Group Progress report......

Annex 6: OSH Task Group Progress report......

Annex 7: Leadership and coordination in the Partnership......

Abbreviations and acronyms used

  • AI – Associated infections.
  • AIDS – Acquired immunodeficiency syndrome.
  • AMR TG – NDPHS Task Group on Antimicrobial Resistance.
  • ASA EG – NDPHS Expert Group on Alcohol and Substance Abuse.
  • CSR – NDPHS Committee of Senior Representatives.
  • EU – European Union.
  • EUSBSR – EU Strategy for the Baltic Sea Region.
  • HIV – Human immunodeficiency virus.
  • HIV/AIDS&AI EG – NDPHS Expert Group on HIV/AIDS and Associated Infections.
  • ITA – International Technical Adviser.
  • NCD EG – NDPHS Expert Group on Non-Communicable Diseases related to Lifestyles and Social and Work Environments.
  • ND – Northern Dimension.
  • NDPHS – Northern Dimension Partnership in Public Health and Social Well-being.
  • NGO – Non-governmental organization.
  • NoDARS – Northern Dimension Antibiotic Resistance Study project.
  • OSH TG – NDPHS Task Group on Occupational Safety and Health.
  • PAC (in relation to the NDPHS) – Partnership Annual Conference.
  • PAC (in relation to the EUSBSR) – Policy Area Coordinator.
  • PHAS – Public Health Agency of Sweden.
  • PPHS EG – NDPHS Expert Group on Primary Health Care and Prison Health Systems.
  • TB – Tuberculosis.
  • WHO – World Health Organization.

Further information is available at the NDPHS website at .

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1. Background

The Northern Dimension Partnership in Public Health and Social Well-being (NDPHS) is a cooperative effort of nine governments, the European Commission and eight international organizations. The overall objective of the Partnership is to promote sustainable development in the Northern Dimension (ND) area by improving human health and social well-being.

The Partnership works according to the provisions spelled out in the Declaration concerning the establishment of a NDPHS (the Oslo Declaration),[1] which stipulates that the Partnership shall promote co-operation and internationally coordinated actions in order to fulfill specific objectives within the following two priority areas:

(i)Reducing major communicable diseases and prevention of lifestyle related non-communicable diseases

The main focus shall be on HIV/AIDS, tuberculosis, sexually transmitted diseases and antibiotics resistance. Concerning non-communicable diseases, special attention shall be paid to the determinants of cardiovascular diseases, including excessive use of alcohol and smoking as well as the use of, and the risk factors associated with excessive consumption of alcohol and illicit drug use.

(ii)Enhancing and promoting healthy and socially rewarding lifestyles

Under this objective, the Partnership shall focus on nutrition, the enhancement of physical activity, creating smoke-, alcohol-, and drug-free environments, the practice of safe sexual behaviours, and supportive social and work environment and constructive social skills. Children and young people shall be the main target groups.

From the beginning of 2007, the Northern Dimension process is defined by two documents, namely the Political Declaration on the Northern Dimension Policy[2] and the Northern Dimension Policy Framework Document[3] – both endorsed at the Northern Dimension Summit on 24 November 2006 in Helsinki, Finland.

The new Northern Dimension policy puts a strong emphasis on cooperation between the EU and Russia, with the full participation of the other two partners, namely Iceland and Norway, in matters relevant to the ND. These four partners committed themselves to continuing and further developing cooperation within the framework of the NDPHS, which is a tool to pursue the ND policy objectives of one of the six priority sectors agreed upon in the ND Policy Framework Document, namely “social welfare and health care, including prevention of communicable diseases and life-style related diseases and promotion of cooperation between health and social services.” Iceland, however, has withdrawn from the Partnership as of 1 January 2014.

From2015until 2020 the work of the NDPHS is guided by the NDPHS Strategy[4]and its accompanying Action Plan[5], which were developed by the Partnership during 2014 and 2015 and subsequently adopted by the NDPHS Committee of Senior Representatives (CSR) in June 2015 and September 2015, respectively. The NDPHS Strategy is based on the national priorities and strategies of the NDPHS Partner Countries and takes stock of global and regional policies, strategies and political agendas relevant for and existing in the Northern Dimension area, including e.g. the WHO Europe Health 2020 and the European Union Strategy for the Baltic Sea Region.

2. Introduction

This NDPHS annual progress report presents the main activities carried outby the Partnership during the year 2015. Due to the process of the development of the NDPHS Strategy 2020 and its Action Plan during 2015, as well as reshaping of the NDPHS expert-level structures, the Partnership did not adopt an annual work plan for 2015. Therefore, unlike in previous annual progress reports, information contained in this report is not provided with reference to an annual work plan. It, however, follows the previously set pattern of the NDPHS’ annual progress reports.

Annexed to this report are the progress reports of the NDPHS Expert Groups and Task Groups operating until October 2015, i.e. before the CSR 25 meeting of 21-22 October 2015, which decided on the reshaping of the existing NDPHS Expert Groups.

As regards the Partnership’s main actions in 2015, six of themhave been included in the present NDPHS Annual Report:

  • Action Line 1: Development of the NDPHS Strategy 2020.
  • Action Line 2: Setting up new and restructuring the existing NDPHS expert-level structures.
  • Action Line 3: Development and facilitation of policies, strategies and projects.
  • Action Line 4: Strengthened and more visible role of health and social well-being on the regional agenda in the Northern Dimension area.
  • Action Line 5: Leading and coordinating the Health Policy Area in the EU Strategy for the Baltic Sea Region Action Plan.
  • Action Line 6: Providing adequate funding for the NDPHS and Partnership-relevant activities and projects.

3. Achievements of the Partnership during 2015

The following main actions have been taken by the Partnership in 2015:

Action Line 1: Development of the NDPHS Strategy 2020

In 2015 the Partnership’s main focus was on finalizing and adopting the new NDPHS Strategy for the period until 2020and its accompanying Action Plan. The inclusive nature of the process enabled all NDPHS actors – PAC, the CSR, expert-level structures and the Secretariat - to contribute proposals to the NDPHS Strategy 2020 and its Action Plan. The development of the NDPHS Strategy 2020 and its accompanying Action Plan was facilitated by the NDPHS Strategy Working Group, led by Finland and assisted by aStrategy Consultant who providedmethodical advice in planning processes and reviewing the inputs submitted by NDPHS actors. The financial support provided by Finland and Germany was indispensable for successful completion of the task.

The NDPHS Strategy 2020 and its accompanying Action Plan were adopted by the NDPHS Committee of Senior Representatives on 5 June 2015 and 24 September 2015, respectively. Both documents were presented to the ministerial-level Partnership Annual Conference held on 20 November 2015.

The NDPHS Strategy 2020 is a guiding instrument assisting the Partner Countries and Organisations in their joint efforts to achieve improvementsin the priority areas agreed upon by the NDPHS Partners during the ministerial-level Partnership Annual Conference held in 2013. The Partnership immediately beganworking towards accomplishing these objectives in cooperation with several other organizations and stakeholders.The accompanying Action Plan contains information on expected results and their indicators, planned activities and available resources in the implementation of the NDPHS Strategy in 2015-2017.

Activities taken in 2015 to implement the NDPHS Strategy 2020 and its accompanying Action Planincluded, but were not limited to, the projects led by the NDPHS Secretariat. For example, successful regional events organised in 2015 by the Secretariat during the 6th EUSBSR Annual Forumand on the side-lines of the 24th Baltic Sea Parliamentary Conference (see Action Line 4 further down) helped strengthen the recognition of health and social well-being on the political agenda in the region and ensure a stronger stakeholder commitment to include the aspects of health and the quality of life in policy-making more broadly. Both events were organised within a project currently being implemented by the NDPHS Secretariat and co-financed by the EU.

Action Line 2: Setting up new and restructuring the existing NDPHS expert-level structures

The successful implementationof the NDPHS Strategy 2020 and its accompanying Action Planalso required reshaping the NDPHS expert-level structures. To that end, on 21-22 October 2015 the NDPHS Committee of Senior Representatives established the following seven Expert Groups in place of the former ones:

  • Expert Group on Antimicrobial Resistance (led by Sweden);
  • Expert Group on Alcohol and Substance Abuse (led by Norway);
  • Expert Group on HIV, TB and Associated Infections (led by Finland);
  • Expert Group on Non-communicable Diseases (led by Russia);
  • Expert Group on Occupational Safety and Health (led by Finland);
  • Expert Group on Prison Health (led by Germany);
  • Expert Group on Primary Healthcare (led by Russia).

Furthermore, on 21-22 October 2015 the NDPHS Committee of Senior Representatives approved the generic Terms of Reference of the Expert Groups, as well as agreed on the model ofthe individual Terms of Reference for the groups. The Expert Groups were invited to discuss their individual Terms of Reference during their first meetings and submit their proposed revisions concerning their own Terms of Reference through the Secretariat to the Committee of Senior Representatives for final adoption through a written silent procedure. The Terms of Reference were developed by thead hoc Working Group on NDPHS Expert Groups' Terms of Reference, led by Estonia.

The reshaped Expert Groups were presented to the ministerial-level Partnership Annual Conference held on 20 November 2015, which appreciated the effort and thanked Finland, Germany, Norway, Russia and Sweden for assuming the leadership of the groups.

Action Line 3: Development and facilitation of policies, strategies and projects

Expert and Task Groupscontinued (i) policy and strategy development as well as exchange of best practices and policies, and (ii) identifying problems in the region and developing project ideas and facilitating projects.The NDPHS Expert Groups’ and Task Groups’ activities performed in 2015 are reflected in Annexes 1-6 of this report. A few examples of Expert and Task Groups’ achievements during 2015 include:

  • FEW EXAMPLES TO BE PROVIDED BY GROUPS (one main achievement, maximum two main achievements per group please, so that the text is not too long. The rest will be included in the groups’ reports annexed to the Progress Report).

The NDPHS Secretariat continued leading several projects, among them:

  • “Building capacity in HIV prevention targeted at youth at risk in the Northern Dimension area” project

The project’s implementation period was from 1 September 2013 until 31 August 2015. The Secretariat was the Lead Partner/Beneficiary of the project. Other Project Partners were five organizations from Finland, Latvia, Poland and Russia. The project was funded through an EU grant and an own co-financing of the participating organizations. The project supported the work of the NDPHS Expert Group on HIV, TB and Associated Infections (AI) in mapping best practices in HIV prevention among youth at high risk of HIV/AI in North-western Russia and other countries in the Northern Dimension area, disseminating those best practices among the participating countries and training professionals in Northwest Russia to implement the best practices.

During 2015 the following project activities were implemented:

  • Posters and leaflets on HIV and AI prevention were translated and adapted to the localcontext. A set of additional prevention materials was prepared following the requests of local authorities and stakeholders;
  • Programs of activities on HIV and AI prevention to be piloted were developed and focus groups were selected for testingthe adapted tools and materials;
  • HIV and AI prevention activities were piloted in the group of young people at high risk of getting HIV and AI by stakeholders trained within the project. In total 100 young people took part in the piloting of 26 prevention activities and even more people were reached with information materials;
  • Project results were summed up in the Guidelines “HIV and associated infections prevention among adolescents and young people at high risk of getting HIV and AI.”
  • “Northern Dimension Antibiotic Resistance Study (NoDARS)” project

The project implementation period is from 1 October 2014 until 31 September 2017. The Secretariat is the Lead Partner/Beneficiary of the project. Other Project Partners are seven organizations from Finland, Germany, Latvia, Norway, Poland, Russia and Sweden. The project is funded through an EU grant and an own co-financing of the participating organizations. The project aims at assessing the antibiotic resistance level and penetration of antibiotic resistance in the healthy population to provide healthcare professionals with accurate data and to prevent unnecessary prescription of broad-spectrum antibiotics.

During 2015 the following project activities were implemented:

  • A detailed set up of the Northern Dimension Antibiotic Resistance Studywas developed. During the first year of the NoDARS project four meetings had been held: two Project Steering Group meetings, as well as two workshops to discuss and plan in detail the implementation of work packages. The two workshops resulted in a common strategy on how to perform the laboratory studies;
  • Common study protocols, questionnaires and information leaflets were prepared and distributed and agreed upon by all co-applicants. Also the methods and materials to be used in the laboratory study were agreed upon by all co-applicants.

Despite the early implementation stage, the potential of the project was recognized by the 11th ministerial-level NDPHS Partnership Annual Conference (PAC) held on 20 November 2015, which welcomed the project. As noted in the Conclusions of the PAC 11 Chair, “While expressing its worry that there is a great variation in the availability and quality of surveillance data on AMR and antibiotic consumption and the data on the prevalence of AMR and usage of antibiotics in the region’s populations, which, altogether, contribute to an incomplete understanding of the regional AMR situation – the PAC welcomed the on-going NDPHS project “Northern Dimension Antibiotic Resistance Study (NoDARS)” that aims to help address many of these gaps.”

  • “Support to coordination and implementation of activities within the Health Priority Area of the EU Strategy for the Baltic Sea Region Action Plan” project

The project’s core implementation period is from 1 July 2015 until 31 June 2016. The Secretariat is the sole Beneficiary in the project. The project is funded through an EU grant and an own co-financing of the Secretariat.Itsoverall objectives are to further strengthen (i) the NDPHS capacity and coordinating rolein the EUSBSR PA Health and (ii) the PA Health activities aimed to help achieve a broader, more efficientand better targeted cooperation in addressing health-related regional challenges.

During 2015 several project activities were implemented, which are described further down, under Action Lines 4 and 5.

Action Line 4: Strengthened and more visible role of health and social well-being on the regional agenda in the Northern Dimension area

As stated by the ministerial-level Partnership Annual Conference (PAC 8 in 2011 and PAC 10 in 2013), health and social well-being have to be more widely recognised on the regional cooperation agenda in the Northern Dimension area. Further efforts are needed to convince the international, national and local policy- and decision makers of the need to grant the health and social dimension a status, which would be adequate to their role and importance for the region’s societies and economies.

Examples of activities carried outin 2015 towards the achievement of this result include the following ones being part of an Interreg Baltic Sea Region Programme 2014-2020-funded project led by the NDPHS Secretariat in its capacity as the Coordinator of the Policy Area “Health”:

  • Organisation of a thematic workshop during the 6th Annual Forum of the EU Strategy for the Baltic Sea Region (EUSBSR), 15-16 June 2015, Jūrmala, Latvia

Health was prominently featured at the Forum with a thematic workshop “Innovations and cross-border infrastructures for a better health care” organizedby the NDPHS Secretariat with contributions from various partners. The workshop attracted 35 participants that enjoyed four presentations[6] delivered by prominent speakers, followed by thought-provoking discussions dealing with innovations and cross-border infrastructures for better health care, with a focus on innovative solutions for tackling key challenges in health care in the Baltic Sea region.

  • Organisation of a side-event during the 24th Baltic Sea Parliamentary Conference,30 August -1 September 2015, Rostock, Germany

The NDPHS Secretariat commissioned a study “The Importance of Health and Social Well-being for the Economy and Other Policy Areas.”[7]Further, it organized aside-event to the 24th Baltic Sea Parliamentary Conference, which was dedicated to the above topic. The event was a success with the side-event participants agreeing that health and social well-being have a significant impact on the economy and other policy areas. During the main BSPC session, the participating parliamentarians recognised and agreed with the side-event’s conclusion that “Whereas economic prosperity is good for health, good health outcomes also favour economic growth and development. To that end, one should recognise the importance of health and social well-being for the economy and other policy areas, and vice versa, and consider health aspects in all policies”, which was included in the BSPC resolution[8].