Committee of Senior Representatives (CSR)

Twenty-seventh Meeting

Gdynia, Poland

4 April 2017

Title / Minutes from the 27th Meeting of the NDPHS Committee of Senior Representatives
Submitted by / Secretariat
Summary/Note / This document outlines the main discussion points and decisions made during the 27th meeting of the CSR.
List of Annexes / Annex 1 – Information about the NCM Thematic Programme on Health Promotion and Prevention in NW Russia
Annex 2 – List of participants
Annex 3 – List of documents submitted to the meeting

1. Opening of the meeting and welcome

The meeting was opened and chaired by Mr. Jürgen Ojalo, the NDPHS CSR Chair Country representative, the Ministry of Social Affairs of Estonia. He invited for a minute of silence to commemorate victims of the attack in St. Petersburg on 3 April.

Mr. Marcin Rynkowski, Director of the Department of International Cooperation, Ministry of Health of Poland, welcomed the participants on behalf of the hosting country.

The participants introduced themselves.

2. Adoption of the agenda

With reference to agenda item 6 "Implementation of the NDPHS Action Plan and the health component of the EUSBSR Action Plan," Russia invited to place, in the future, EUSBSR and NDPHS matters underdifferent agenda items and first discuss the latter.

The Meetingtook noteof Russia's request andadoptedthe Provisional agenda with timetable as submitted in document CSR 27/2/1.

3. Information by the NDPHS Chair and the NDPHS Secretariat

The Chairrecalledthat Iceland had re-joined the Partnership and invited the EGs to involve Icelandic experts in their work as far as possible.

The ASA EG Chair informed that Iceland had already expressed an interest in participating in the ASA EG's work.

The Secretariat informed about the on-going recruitment of a NDPHS Secretariat Project Assistant within the Secretariat’s run EU co-funded "PA Health Support 2" project. When recruited, the Assistant will be able to support the EGs with regard to the EUSBSR matters.

The Meetingtook noteof the presented information.

4. Information by the NDPHS Partners

Finland informed that it would chair the Arctic Council from the beginning of May 2017 until 2019. The four priority cooperation topics in the field of health and social well-being willbe the "One Health" project, mental health, occupational safety and health and gender equality. Furthermore, Finland informed about chairing the Alliance for Country Assessments for Global Health Security and International Health Regulations implementation. Finally, Finland informed about chairing until the end of the year 2017 the BEAC Working Group on Health and Related Social Issues together with the Archangelsk region (Russia).

Germany suggested approaching Iceland with an offer to include items of interest to Iceland in the NDPHS Strategy 2020 and its Action Plan. Furthermore, Germany informed about its Presidency of G20 and stressed that for the first time a meeting of health ministers would take place in this format. The ministerial meeting would take place in May 2017 and the issues to be tackled included the AMR, strengthening of health systems and health crisis management. Germany was optimistic that some outcomes of the Health ministers' meeting might be reflected in the Communiqué of the G20 Summit.

Norway informed about chairing the Nordic Council of Ministers in 2017 and the meeting of the Nordic Ministers for Health and Social Well-being held in Oslo on 30 March 2017. Furthermore, Norway would chair the BEAC Working Group on Health and Related Social Issues after Finland. Finally, Norway mentioned signing a cooperation programme with Russia in the field of health for the period of 2017-2020, covering issues such as prevention of communicable diseases, drug abuse, preparedness, e-health cooperation in primary health and specialist health care services.

Russia (Ministry of Health) informed about active participation and cooperation at the expert level in almost every area of the NDPHS Action Plan, especially in the ASA EG, as well as organization of several NDPHS meetings, including the EG Chairs and ITAs meeting on 25 August 2016 in Moscow. Furthermore, Russia invited the participants to the First Tuberculosis Conference on 16-17 November 2017 in Moscow.

Russia (Ministry of Foreign Affairs) informed about a productive and well-attended Northern Dimension (ND) Senior Officials meeting, which Russia saw as a step in the right direction to normalize the whole process, and expressed a hope to see the ND ministerial meeting being convened soon. Furthermore, the Parliamentary Forum of the ND, last time held in 2013, would be held in Brussels in October 2017 at the premises of the European Parliament. Russia appreciated hearing information from the previous speakers about cooperation in different formats since Russia's principal position was that there is a need to coordinate activities of all these cooperation formats. Finally, Russia informed about its BEAC chairmanship and its proposal to hold a deputy ministers level meeting together with representatives of the regional councils and asked for support to this proposal, with an aim of having the meeting by the end of the year.

Sweden informed that it would assume chairmanship in BEAC after Russia, as well as in the Council of the Baltic Sea States after Iceland later in 2017. The work on setting the cooperation priorities in the two above mentioned forums was on-going. Furthermore, in 2018 Sweden would assume the chairmanship of the Nordic Council of Ministers where the main priority would be ageing population. Finally, Sweden mentioned that the Ministry of Health and Social Affairs had just organized a national meeting of health and social affairs experts working in the Baltic Sea area, Barents area and Arctic area. The aims of the meeting were to: (i) widen the understanding of experts of the Swedish policies in these areas; (ii) increase the knowledge of experts about ongoing activities in order to avoid duplication and gaps; and (iii) to emphasize the importance of cross-border cooperation with neighboring countries.

The IOM informed about several ongoing initiatives at the national, regional and global level, such as consultation on migrant health with Member States held in June 2016 in Lisbon, development ofMigrant integration health policy index, development of Expert consensus on provision of Health care for migrants in irregular situation, backed by a published study on cost of non-provision of health care, development and implementation of training for health providers and law enforcement officers (first line staff) on migrant’s health.

Furthermore, the IOM noted that one regretfully seesarising tide of disinformation that are feeding into the stigmatization, discrimination and further marginalization of migrants globally and that despite the fact that many migrants are vulnerable to health risks due to migration related circumstances, they face obstacles in accessing essential healthcare services due to language barriers, lack of migrant inclusive health policies, lack of awareness of the availability of services, and when they are irregular, to their legal status.This, in turn, can have negative consequences on their well-being and that of their communities, and undermine the realization ofthe Global Sustainable Development goals (SDGs) and Universal Health Coverage commitment by all MS. IOM, as the leading UN migration agency, called upon all governments to mainstream the “right to health” in their policies and programmes and ensure that all people, regardless of their status, be given access to health services.

Finally,IOM thankedfor the support of Member States through the WHO EB decision of January 2017, which called for action to ensure that health needs of migrants are adequately addressed in the Global Compacts for Safe, Orderly and Regular Migration and the Global Compact for Refugees.[1]

The ASA EG ITAinformed that BEAC for the first time would hold a meeting of coordinators of all BEAC Joint Working Groups and that BEAC Working Group on Healthand Related Social Issues would also take part in it and thanked Russiafor the initiative to hold this coordination meeting.[2]

Germanyinvited participants to use opportunities to raise the issue of Denmark’s participation in the Partnership.

The Secretariat informed about the NCM Thematic Program on Health Promotion and Prevention, which was launched in early 2017 and would continue until the end of 2018. It supports cooperation between the five Nordic countries and the six regions in Northwest Russia, closest to North. The total budget for the program is 6 million Danish kroner.The program aims to broaden and strengthen the Nordic-Russian cooperation in health promotion and prevention of diseases affecting the Nordic countries and Northwest Russia - first and foremost, HIV, tuberculosis and resulting infections, with a focus on capacity development, study visits and the sharing of expertise and best practices.Finnish Institute for Health and Welfare (THL) administers the program and will also act in partnership with the Norwegian and Swedish Public Health Agencies. Eligible partners in Russia are government agencies, relevant NGOs and stakeholders from the business sector.

The Meeting took note of the provided information.

5.Approval of the NDPHS Progress report for 2016

The Secretariatbriefly introduced a (draft) NDPHS Progress Report for 2016 (submitted as document CSR 27/5/1/Rev 2). With regard to a footnote on page 8 of the report the Secretariat mentioned that the NCD EG had agreed to submit a revised NCD EG Progress Report, therefore the NDPHS Progress Report for 2016 as submitted in document CSR 27/5/1/Rev 2 could not be considered as final and ready for adoption during the meeting.

The HIV, TB & AI EG Chairinformed that the HIV, TB & AI EG members had been very active and committed and all Partner Countries except Estonia are represented and take part in activities. All four relevant resultareas included in the NDPHS Action Plan had been tackled to some extent in 2016. The HIV, TB & AI EG had received responses from every Partner Country to the assessment of the current state of how many countries and to what extent implement the recommendations of the NDPHS Statement “Impact of the HIV/AIDS and tuberculosis on people and economies of the Northern Dimension Countries – status quo and the way forward”. Furthermore, the HIV, TB & AI EGhad actively supported the EU’s Joint Action HA-REACT (Joint Action on HIV and Co-infection Prevention and Harm Reduction), as well as the planning and implementation of the Vilnius Communicable Disease Summit 2016. Finally, the HIV, TB & AI EG participated actively in the International Congress “HIV Infection and Immunosuppressive Conditions. Epidemiology and Modern Strategies” held on 17-18 October 2016 in St. Petersburg.

The HIV, TB & AI EG ITA complemented information provided by the Secretariat in agenda item 4 about the NCM Thematic Program on Health Promotion and Prevention (cf. Annex 1 to the meeting minutes), as well as added, with regard to the survey on the implementation of the NDPHS Statement “Impact of the HIV/AIDS and tuberculosis on people and economies of the Northern Dimension Countries – status quo and the way forward” that this activity was being implemented with the HIV, TB & AI EG’s own resources and the analysis of the countries’ responses was still on-going and the report would be prepared later in 2017.

The ASA EG ITA informed that the ASA EG hadidentified the hosts and scheduled theASA EG’s meetings for the next two years, which shows the commitment of the Partner Countries. The ASA EG is a collaborative partner of the EU Joint action on alcohol,which had produced a comparative report on data on drinking patterns and the ASA EG’s members and ITA are authors of several chapters of this report. Furthermore, the ASA EG was implementing the project “Surveillance of Alcohol and drug use among hospitalised somatic patients,” which had been presented during the signing of the Norwegian-Russian collaboration programme mentioned before. In addition, the ASA EG had started discussions on developing the project proposal “Prevention Approaches - learning, experience, training (PALET),” which would improve knowledge of effective community-based interventions targeting use of alcohol, tobacco and drugs among local level policy makers and authorities.Finally, he mentioned that the last ASA EG meeting had been held at the NCM premises in Copenhagen and the NCM is also very interested in alcohol and substance abuse work.

The OSH EGinformed about its joint meeting[3] with BSN on 21– 22September 2016 in Tampere, Finland, where nine NDPHS Partners were present, whereas representatives from Poland, WHO and IOM were missing. A Skype-meeting had also been suggested, but it was rejected by the OSH EG members. Among the main achievements in 2016 were the organization of a Conference “From Occupational Safety and Health Strategies to Practice”held on 20 September 2016 in Tampere, Finland, which gathered more than 100 participants, as well as the “Reliable occupational accidents reporting project (Realloc)“ and the “Cost of labour input project (Cost)”. The “Realloc” method would be utilized in the Eurostat work and the “Cost” method in the EU OSHA work in 2017. Furthermore, the OSH EG had developed the Terms of Reference for the EU-funded project “Better prevention, identification and reporting of work-related and occupational diseases and emerging risks,” which was currently being implemented by the selected company. In addition, OSH EG had started working on the draft questionnaire and survey of quality standards of OH-specialists’ training. Finally, OSH EG had establishedcooperation with the new Arctic OSH knowledge network, which would publish three newsletters in 2017 and to each of them OSH EG would provide its input.

The NCD EG ITAinformed about developing two new project ideas – “Assessment of NCDs and their risk factors through screening and following up programs in NDPHS Partner Countries for best practices approval and adoption” and “Platform for health literacy promotion.”Furthermore, the NCD EG Vice-Chair had delivered a presentation “Human capital losses and gains, and wealth of countries” during the NDPHS seminar “Healthier and wealthier, or just the opposite?” at the EUSBSR Annual Forum on 8 November 2016. Finally, the NCD EG ITA noted that the EG leadership had faced some inconveniences while preparing the NCD EG’s Progress Report for 2016 and therefore had prepared written comments on a simpler and more logical reporting format and would be ready to submit these proposals to the Secretariat.

The PHC EG Co-Chairinformed about the two PHC EG meetings held in 2016 in Moscow and in Stockholm, as well as the “Workshop on methods for monitoring and analysing primary healthcare” held in October 2016 back-to-back with the PHC EG Stockholm meeting. She stressed that the PHC EG’s work on collecting indicators was a good basis for further cooperation towards implementing the respective activities of the NDPHS Action Plan. Furthermore, she also informed about a successful PHC EG meeting held on 29-30 March 2017 in Almaty hosted by the WHO and a Workshop on PHC performance in the context of changing health needsorganized together with the WHO on 31 March 2017 back-to-back with the PHC EG meeting, which contributed towards improving horizontal collaboration with other organizations, as well as the visibility of the NDPHS.

Germany (on behalf of the PH EG) apologized for the absence of PH EG representatives at the CSR meeting and expressed a hope that the Partners are still interested and committed to work in the PH EG. Germany expressed concern about the fact that it had been difficult to ensure participation of all nominated experts in the PH EG meetings, as well as obtain the necessary inputs from them. Germany stressed that tangible results of the PH EG work could be expected only if there was a commitment from all nominated experts.

Estoniaconfirmed that it was currently taking steps to nominate a new expert to the PH EG replacing the former one who had left position, as well as expressed appreciation for the work done by the PH EG so far.

The Chairencouraged the Partners to ensure the availability and participation of the nominated experts in the PH EG work.

Swedenand Finlandconfirmedtheir commitment to work with prison health issueswithin the PH EG.

Sweden (on behalf of the AMR EG) apologized for the absence of AMR EG representatives at the CSR meeting and confirmed that the AMR remains Sweden’s very strong global and regional priority. Sweden also expressed its concern about the fact that some Partners who had nominated experts had faced difficulties in raising the funding for participation in the AMR EG meetings.

The ASA EG ITA noted that the requirements regarding the reporting on progress in actions 5.2 and 5.3 were not clear and asked for clarification on reporting format, as well as the statement that no progress had been reported in 2016.

The Secretariat recalled that the actions 5.2 and 5.3 had been included in the NDPHS Work Plan for 2016 by the NDPHS governing body as a follow up to the NDPHS evaluation, the Secretariat had sent an email to the EGs with a request to provide input to this part of the draft Progress Report and it was for the EGs to judge what they wished to report on with regard to these actions. Finally, the Secretariat invited the interested EGs to submit any additional information regarding the progress in action lines 5.2 and 5.3.