13th (3) NCD EG Meeting

28 April 2017

Moscow, Russian Federation

Reference / NCD EG meeting 13 (3) - 05
Title / 05-13(3) 2017 Progress Report_NCD EG CSR
Submitted by / NCD EG Secretariat
Summary / Note / This 2ndrevised document includes the Progress Report submitted by the NCD EG. Adopted by CSR.
Requested action / For information

1

Table of Contents

1. Background...... 3

2. Introduction...... 4

3. Achievements of the Partnership during 2016...... 5

4. Conclusions...... 19

Annexes

Annex 1: AMR Expert Group Progress report...... 20

Annex 2: ASA Expert Group Progress report...... 35

Annex 3: HIV, TB AI Expert Group Progress report...... 44

Annex 4: NCD Expert Group Progress report...... 59

Annex 5: OSH Expert Group Progress report...... 70

Annex 6: PH Expert Group Progress report...... 81

Annex 7: PHC Expert Group Progress report...... 91

Annex 8: Projects led by the NDPHS Secretariat in 2016...... 95

Annex 9: Leadership and coordination in the Partnership EGs...... 98

Abbreviations and acronyms used in the general part of the report

  • AI – Associated infections.
  • AIDS – Acquired immunodeficiency syndrome.
  • AMR – Antimicrobial resistance.
  • AMR EG – NDPHS Expert Group on Antimicrobial Resistance.
  • ASA EG – NDPHS Expert Group on Alcohol and Substance Abuse.
  • BEAC – Barents Euro-Arctic Council.
  • BSN – Baltic Sea Network on Occupational Safety and Health.
  • BSSSC – Baltic Sea States Subregional Cooperation.
  • CAESAR – Central Asian and Eastern European Surveillance of Antimicrobial Resistance.
  • CSR – NDPHS Committee of Senior Representatives.
  • CPT – Council of Europe’s Committee for the Prevention of Torture and Inhuman and Degrading Treatment or Punishment.
  • DG NEAR – Directorate-General for Neighbourhood and Enlargement Negotiations.
  • EARS – Net – European Antimicrobial Resistance Surveillance Network.
  • ESAC – Net – European Surveillance of Antimicrobial Consumption Network.
  • ESBL – Extended Spectrum Beta-Lactamases.
  • EU – European Union.
  • EUSBSR – EU Strategy for the Baltic Sea Region.
  • FIOH – Finnish Institute of Occupational Health.
  • HA-REACT – European Union Joint Action on HIV and Co-infection Prevention and Harm Reduction.
  • HIV – Human immunodeficiency virus.
  • HIV, TB AI EG – NDPHS Expert Group on HIV, Tuberculosis and Associated Infections.
  • ILO – International Labour Organization.
  • ITA – International Technical Adviser.
  • MDR – Multi drug resistant tuberculosis.
  • NCD – Non-communicable diseases.
  • NCD EG – NDPHS Expert Group on Non-Communicable Diseases.
  • 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 –Occupational safety and health.
  • OSHA – European Agency for Safety and Health at Work.
  • OSH EG – NDPHS Expert Group on Occupational Safety and Health.
  • PA – Policy Area (in relation to the EUSBSR).
  • PAC (in relation to the NDPHS) – Partnership Annual Conference.
  • PAC (in relation to the EUSBSR) – Policy Area Coordinator.
  • PHAS – Public Health Agency of Sweden.
  • PH EG – NDPHS Expert Group on Prison Health.
  • PHC EG – NDPHS Expert Group on Primary Health Care.
  • PYLL – Potential years of life lost.
  • TB – Tuberculosis.
  • UTIs – Urinary tract infections.
  • WHO – World Health Organization.
  • WHO/HIPP – WHO Health in Prisons Project.
  • XDR – Extensively drug-resistant tuberculosis.

Further information is available at the NDPHS website at .

1

NCD EG CSR_27-5-1-Rev_2__2nd_revised_draft_NDPHS_Progress_report_for_2016

1. Background

The Northern Dimension Partnership in Public Health and Social Well-being (NDPHS) is a cooperative effort of ten 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 fulfil 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.”

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 2016. Information contained herein is provided with reference to and against the action lines included in the NDPHS Work Plan for 2016 adopted by the Committee of Senior Representatives on 21-22 October 2015.

Annexed to this report are the progress reports of the NDPHS Expert Groups.

As regards the action lines, five of them were included in the NDPHS Work Plan for 2016:

  • Action Line 1: Working toward implementing the NDPHS Strategy 2020
  • Action Line 2: Leading and coordinating the Health Policy Area in the EU Strategy for the Baltic Sea Region Action Plan
  • Action Line 3: Providing adequate funding for the NDPHS and Partnership-relevant activities and projects
  • Action Line 4: Increasing the Partnership’s visibility
  • Action Line 5: Exploring and implementing new approaches for collaboration within the NDPHS

3. Achievements of the Partnership during 2016

This Progress Report lists the Action Lines and corresponding Specific actions that have been included in the NDPHS Work Plan for 2016 and describes the progress towards achieving them in 2016.

Action Line 1.Working toward implementing the NDPHS Strategy 2020

Specific actions

  • (1.1) Plan the implementation process in 2016 and 2017.

Progress in 2016:

As stipulated in the NDPHS Work Plan for 2016, “In order to ensure the achievement of the targets by the set deadline, the NDPHS Expert Groups shall elaborate their own two-year work plans for 2016 and 2017, which shall specify the methods, milestones and resources with which the respective targets will be pursued.”

The CSR 26 Meeting decided that“work plans have to be developed annually, with the understanding that if a group experiences problems with implementing this approach, the situation could be reviewed in the future.”

Consistent with the above CSR decision, almost all Expert Groups[6] developed their work plans for 2016, which were adopted by the PAC 12 on 28 October 2016.

  • (1.2) Continue/initiate new efforts towards reaching the targets defined in the Action Plan and keep the governing bodies informed on the progress.

Progress in 2016:

Consistent with their Terms of Reference, the Expert Groups facilitated the implementation of the respective activities and reaching the respective targets defined in the Action Plan accompanying the NDPHS Strategy 2020. They reported on their progress during the CSR 26 meeting on 29 April 2016 and PAC 12 event on 28 October 2016.Further details can be found in the Expert Groups’ progress reports annexed to this document.

The table below summarizes the progresstowards reaching the targets defined in the Action Plan. It has been prepared, based on the Progress Reports for 2016 submitted by the Expert Groups.

Target (2017) as specified in the NDPHS Action Plan / Achieved / In progress / No progress reported in 2016

Objective 1: Reduced impact of HIV, TB and associated infections among key populations at risk, including prisoners, through strengthened prevention and access to treatment

2-3 more countries which have integrated the HIV and TB action recommendations (cf. the NDPHS Statement) into national health policies / ✓
2-3 more HIV, TB and AI stakeholder cooperation platforms involving NGOs and representatives of other sectors / ✓
3-4 (by 2020) national HIV, TB and AI prevention actions in the Northern Dimension area supported / ✓
2 more monitoring and best practice reports produced and disseminated to decision-makers and general public / ✓
At least one more country fulfilling diagnostic processes for TB resistance in line with international standards
At least one more country monitoring the number of TB (with detected resistances MDR or XDR) plus HIV cases, according to international standards / ✓
At least one more country developing measures to achieve CPT standards
At least one more country developing measures to achieve WHO/ HIPP standards / ✓
At least one more country establishing a through care situation for HIV & TB patients / ✓

Objective 2: Contained antimicrobial resistance - through inter-sectoral efforts supporting the implementation of regional and global strategies and/or action plans

At least 50% of the population in each of NDPHS Partner Countries covered by EARS-Net and CAESAR
Data on ESBL carriage rate in place in all NDPHS Partner Countries
Data on resistance levels in E. coli causing uncomplicated UTIs in place in all NDPHS Partner Countries / ✓
80% of the NDPHS Partner Countries have national data on antibiotic use gathered according to international standards (e.g. ESAC-Net/WHO ESAC Working group methodology) / ✓
80% of the NDPHS Partner Countries have a dedicated governmental budget where AMR prevention and control is acknowledged and supported / ✓
Objective 3: Reduced impact of non-communicable diseases (NCDs) - through strengthened prevention and addressing lifestyle-related risk factors[7]
At least 3 more evidence-based measures addressing lifestyle-related risk factors and health implications developed in the project pilot sites in addition to national action / ✓
At least 3 more evidence-based measures in preventing overweight and obesity among school age children involving stakeholders in the project pilot sites in addition to national action / ✓
At least 2 more NDPHS Partner Countries with assessed health system response to NCD outcomes based on the 2014 WHO Europe assessment guide principles / ✓

Objective 4: Reduced social and health harm from alcohol, tobacco and illicit use of drugs - through strengthening and promotion of multi-sectoral approaches

2 countries with drafted/adopted national guidelines for implementing effective community based interventions / ✓
2 countries with drafted/adopted national guidelines on early identification and brief intervention / ✓
4 countries having available and comparable data on drinking habits and patterns
2 countries having available and comparable data on responses to illicit drug challenges / ✓
4 countries with relevant policy measures regarding the public health impact of cross-border trade of alcoholic beverages / ✓

Objective 5: Adequately addressed health needs related to chronic conditions and demographic changes – through strengthened integration and coordination of care and prevention throughout life course at primary care level

At least 3 countries with approved policy documents addressing multi-morbidity / ✓
At least 3 countries where active role of patients and their families is recommended for inclusion in the integrated care plans / ✓
At least 3 countries with revised resource allocation and introduced incentives to support integrated and better coordinated care / ✓
At least 3 countries introducing new methodologies and/or models for identification of psychosocial causes of NCD-related risky behaviour among children and adolescents for the purpose of developing adequate preventive measures / ✓
At least one more country developing procedures in accordance with international standards and recommendations on prison health and building more healthy conditions in prisons / ✓

Objective 6: Strengthened occupational safety and health and well-being at work - through information and reporting systems, workplace activities and occupational health services

10 countries with developed/ revised national OSH profiles
One additional ratification of ILO Conventions C155, C161 and C187 / ✓
At least 7 countries with developed / updated programme documents for health and safety at work and for the provision of working conditions conducive to health and well-being / ✓
At least 4 countries with programmes with action plan for the development of occupational health services for all working people / ✓
At least 3 countries reporting high-risk sector actions/ campaigns / ✓
One regional training event/ year for OHS staff in the Northern Dimension area / ✓
3 Barents Newsletter editions per year[8] / ✓
  • (1.3) Continue efforts towards achieving the horizontal results through horizontal activities listed in the Action Plan.

-Working with other relevant stakeholders in implementing the activities listed in the Action Plan.

Progress in 2016:

  • The NDPHS Secretariat organized a Conference promoting policy-to-project-to-policy concept on 28 April 2016. Speakers at the Conference included representatives of the Joint Secretariat of the Baltic Sea Region Programme 2014-2020. During the event the role that the NDPHS can play in the policy-to-project-to-policy process has been underlined;
  • The NDPHS Secretariat in cooperation with the eHealth for Regions Network organized a NDPHS event “Where are we heading – wealthier and healthier in the decades to come, or just the opposite?” within the framework of the 7th EUSBSR Annual Forum on 8 November 2016. The event addressed linkages between health of populations and the economic prosperity of their countries, discussed current and possible future regional challenges to health and social care, and debated how big impact what is happening now can have on our future lives – all this in the changing environment featuring growing pressure on the economies of our countries;
  • OSH EG delivered and presented results of the reliable occupational accidents reporting project (Realloc) as well as the cost of labour input project (Cost). Realloc method will be utilized in the Eurostat and the Cost method in EU OSHA work in 2017.

-Identifying networks and experts with co-operation potential and inviting them to support/engage in the Partnership’s activities.

Progress in 2016:

  • Nordic Alcohol and Drug Policy Network (Nordan) took part in the ASA EG meeting on 3-4 November 2016 to discuss the preparations of the NDPHS PAC side-event focused on alcohol;
  • HIV, TB & AI EG collaborates with the EU’s Joint Action HA-REACT (Joint Action on HIV and Co-infection Prevention and Harm Reduction);
  • OSH EG works jointly with the Baltic Sea Network (BSN) on OSH to guarantee that policy, research and implementation are merged[9]. The EG OSH and BSN have formed a partnership with the Arctic OHS Network with the aim to improve knowledge and working conditions in the Arctic regions as a part of the Finnish chairmanship of the Arctic Council.

-Using the CSR and PAC meetings to communicate the results of relevant projects (external and NDPHS-facilitated) to the policy level.

Progress in 2016:

During PAC 12, the NCD EG leadership together with the Coordinator of the PYLL Study Projectpresented the outcomes of the PAC side-event (held the day before) during which the results of the PYLL Project were presented focusing on the differences in premature deaths in seven NDPHS Partner Countries (Estonia, Finland,Germany, Latvia, Lithuania,Polandand Sweden) as well as Belarus.The Conference took note with appreciation of the work done by the PYLL Project team andagreed that the PYLL Project data should be kept as the NDPHS Partners value this work and there is a need to preserve this data for the future work.

-Exploring the possibility of further elaborating on the topic of “Health is wealth and wealth is health”.

Progress in 2016:

The Secretariat, in cooperation with the eHealth for Regions Network, organized the NDPHS Seminar “Where are we heading – wealthier and healthier in the years to come, or just the opposite?” during the 7th Annual EUSBSR Strategy Forum, 8 November 2016, Stockholm, Sweden. Furthermore, in 2016 the Secretariat commissioned, published and distributed the report “Economic Dimensions of Health and Social Care[10]”.

Both activities took place within the framework of a “PAHealth Support 2” supported by the EU through its InterregBaltic Sea Region Programme 2014-2020.

Action Line 2.Leading and coordinating the Health Policy Area in the EU Strategy for the Baltic Sea Region Action Plan

Specific actions

  • (2.1) NDPHS Secretariat, Expert Groups: engage other actors in regional health cooperation and work with them towards the achievement of the targets as spelled out in the Health Policy Area of the EUSBSR Action Plan.

Progress in 2016:

  • The NDPHS Secretariat continued advising various actors in the development of project proposals subsequently submitted for funding from the EUSBSR Seed Money Facility and the InterregProgramme Priority 1;
  • The results of the PYLL project (“International Comparison of Differences in Premature Deaths and their Causes in NDPHS Partner Countries Measured by Potential Years of Life Lost Indicator”) implemented under the auspices of the NCD EG in 2016 will be indispensable for monitoring achievement of the targets of the Health Policy Area of the EUSBSR Action Plan as a baseline measurement to which progress will be compared in 2020.
  • (2.2) NDPHS Secretariat, with support from the interested Expert Groups: organize a conference promoting the concept of a policy-to-project-to-policy cycle, aimed at raising the awareness of the regional stakeholders about the possibilities and tools to promote the results of the projects to a political level using well-established regional networks, such as the NDPHS, as a vehicle.

Progress in 2016: