Partnership Annual Conference (PAC) Fifth Conference Ottawa, Canada 19 November 2008

Transcription

1 Partnership Annual Conference (PAC) Fifth Conference Ottawa, Canada 19 November 2008 Title Submitted by Minutes from the 5 th Partnership Annual Conference Secretariat List of Annexes Annex 1 Approved NDPHS Progress Report for 2008 Annex 2 Adopted Terms of Reference and Timeline for the NDPHS ad hoc Strategy Working Group (SWG) Annex 3 Adopted NDPHS Work Plan for 2009 Annex 4 List of participants Annex 5 List of documents submitted to the Meeting Summary / Note This document presents the most important information and statements presented, as well as, where available, the conclusions and decisions made during the meeting. 1. Opening of the Conference and welcome The conference was opened by Ms. Toril Roscher-Nielsen, the NDPHS CSR Chair, who also chaired the conference. The Host Country, Canada (Robert Shearer and Gloria Wiseman) welcomed the participants and informed about the practicalities of the PAC 5 as well as side event, which was held the preceding day. 2. Adoption of the agenda The Conference adopted the provisional agenda (submitted as document PAC 5/2/1). 3. Statement by invited guests As SEEHN could not take part in the PAC, this agenda item was obmitted. 4. Information by the NDPHS Chair and the NDPHS Secretariat The Secretariat informed about the joint NDPHS Expert Group meeting held on 30 September 1 October 2008 in Oslo, Norway, which discussed possible collaboration and joint projects of all the Expert Groups; about the European Health Forum Gastein held on 1-4 October 2008, Bad Hofgastein, Austria, which was organised with the support of and in collaboration with the European Commission during which the NDPHS had participated in a workshop together with the South Eastern Europe Health Network. The workshop had demonstrated the added value of regional cooperation networking and could be considered as one more step to strengthen our links with SEEHN. The Secretariat also informed that it PAC 5_Minutes.doc 1

2 had attended and made presentations at the CBSS Observer State Consultations and a seminar on the occasion of the 10 th Anniversary of the CBSS Secretariat, which was held on 20 October 2008, Stockholm, Sweden. The Chair informed about her participation in the First Ministerial Meeting of the Renewed Northern Dimension, which was hosted by the Russian Federation on 28 October 2008 in St. Petersburg. The meeting provided a good opportunity to inform high-level Northern Dimension Policy stakeholders about the progress in work of the both partnerships operating within the ND framework. To that end, the CSR Chair delivered a speech describing the NDPHS progress as well as addressed to the attention of ministers several issues that Norway, as the Chair of the NDPHS, considers important for ensuring further successful work of the Partnership. 1 The Co-Chair country Russia provided further details regarding the First Ministerial Meeting of the Renewed Northern Dimension. The European Delegation also included delegates from Italy and Cyprus, who also took an interest in the developments in the North. The Ministers of the ND countries, that had attended the meeting, noted that the Northern Dimension is a successful initiative, which is able to come to results despite a large number of participants. The progress made by both the Partnerships on Environment and Health was recognized. Participants were particularly impressed by the NDPHS presentation and noticed the call for financial contributions to the NDPHS. As a result Russia succeeded to launch the processes of expediting the Russian contribution to the NDPHS. The Ministers launched a third Partnership on Transport and Logistics (NDTLP) and instructed the ND Steering Group to ensure that the NDTLP would be operational as of 1 January They further requested a feasibility study to assess the possibilities for a Partnership on cultural cooperation. Furthermore, the idea emerged to create an institute for the ND, which would serve as a think tank and would undertake analytical tasks and projects for the benefit of the Northern Dimension. The St. Petersburg University and the Technical University of Lappeenranta already expressed interest and negotiations with other Universities in Norway, Germany and other countries are underway. The Chair further informed about the South East European Cooperation Process (SEECP) Health Ministerial Meeting, held on 7 November 2008 in Chisinau, Moldova, which was attended by the CSR Chair and during which the NDPHS offer to share the NDPHS webtools was renewed. The Secretariat added that it had received a study visit from health experts and enforcement authorities from the St. Petersburg region in Stockholm on 20 October 2008, which was organized by the NCM. The Secretariat was able to inform the visitors about ongoing NDPHS activities and to create closer links to stakeholders of the St. Petersburg region. Another study tour was expected to visit the Secretariat on 8 December The Conference took note of the presented information with appreciation. 1 Distributed by the Secretariat as a handout and uploaded on the NDPHS website as document PAC 5/4/Info 3, PAC 5_Minutes.doc 2

3 5. Information by the Partner Countries and Organizations The Danish Presidency of the Council of the Baltic Sea States (CBSS) reiterated its interest in participating and in contributing to the Partnership s activities. The international conference on "Reducing Alcohol Problems in the Baltic Sea Region: Effective Approaches to Tackle Alcohol Related Problems in Local Communities," which was organised jointly by the CBSS and the NDPHS on March 2007, in Riga, Latvia, was but one of the activities jointly carried out by CBSS and NDPHS. The CBSS input was also marked by specific activities, such as Children at risk and combating trafficking in human beings. Taking note of the NDPHS evaluation, the CBSS expressed its willingness and readiness to support the NDPHS social well-being activities. The CBSS is already involved in several new project initiatives, such as the Baltic Sea Labor Network, a project on youth unemployment and a project idea on commuters, all of which could be of interest for the NDPHS to collaborate closer with the CBSS, and thus enriching the social well-being part of NDPHS work. The CBSS also appreciated the NDPHS initiative to establish an expert level cooperation between NDPHS and Belarus. The CBSS reiterated that it is proud to host the Secretariat of the Partnership under its roof in Stockholm, as a temporary project. This was seen as an example of co-habitation that has proven useful and mutually enriching. The Joint Working Group on Health and Related Social Issues (JWGHS) of the Barents Euro-Arctic Council (BEAC) had held its 9th Meeting on 13 November 2008 in Arkhangelsk. One important item was an assessment of the TB situation in the Barents Region. The Prime Ministers' declaration in 2003 had urged the Barents authorities to gain full control of the tuberculosis situation in the region within 10 years. The meeting had been satisfied to note important progress. At the same time it was agreed that more needs to be done on TB to meet the set targets for 2013, and the Co-chairs, together with the WHO representative in Arkhangelsk, had been tasked to work out a proposal for the next meeting. Furthermore, an evaluation of the Barents HIV/AIDS programme had been made and the preliminary results showed that the programme was successful. Finally, the sub-programme on Children and Youth at Risk (CYAR), aimed at increasing of the overall competence of the social services in the region, would now be able to start, as Norway had kindly contributed a chairman to the Steering Committee of the programme. Sweden informed about its forthcoming EU presidency in the second half of The Ministry of Health and Social Affairs was working on identifying possibilities to provide a good opportunity to increase the visibility of the Partnership. Informal meetings of the Ministers of Health and the Ministers of Social Affairs and Labour were planned on 6-7 July and 8-9 July 2009 respectively. The priorities of the Swedish EU Presidency of most interest to the Partnership were: - Alcohol (to further develop the EU alcohol strategy and to bring alcohol in all relevant policy areas. An expert conference on alcohol and health was planned to discuss the marketing of alcohol, children born with alcohol related disorders and problems in the family, harmful alcohol consumption as a threat to a dignified and healthy ageing, the importance of the price and spending over alcohol and health. Back to back, a WHO Global Expert Meeting on alcohol and global development was planned as an input to the work on a global alcohol strategy); - Antimicrobial resistance (to stimulate new pharmaceutical with the same functions as antibiotics, etc.); - Social inclusion, linked to the Lisbon Strategy (to break the exclusion in society). They would all result in conclusions adopted by the EU Council. Sweden noted with PAC 5_Minutes.doc 3

4 appreciation that the SIHLWA EG was already engaged in part of the preparations for the alcohol initiative. The NCM announced the adoption of a new framework agreement on Cooperation with North-West Russia, The combating of HIV/AIDS and the fight against trafficking in human beings are some of the areas of action included in this agreement, and should also be connected to the NDPHS. In 2008, NCM had also initiated a number of activities together with the St. Petersburg City administration, such as: (1) HIV/AIDS, (2) the development of social service centers for families and children in crisis, (3) trafficking in human beings, and (4) disabled people. The Vice-governor of St. Petersburg (Ms. Koskina), who visited a number of social institutions in Denmark and Norway in September 2008 sent a clear message that the social service systems in St. Petersburg would need to be further developed. Canada informed about its numerous initiatives on health of indigenous people. A multistakeholder dialogue with WHO participation was held to develop a strategy on alcohol, the indigenous people s food guide was recently updated and a health-guide for the first nations was in the making. Furthermore, a new health initiative was launched which offers Canadian parents a tax credit, if they put their children into physical activity programmes. Lithuania provided an update on the 5th Baltic Policy Dialogue on Public Health, which was held on October 2008 in Vilnius. The next meeting will be hosted by Latvia in 2009 and Lithuania hoped that the Baltic Policy Dialogue could provide a window of opportunities for the NDPHS to increase its visibility. Lithuania was also hosting a conference on alcohol control and prevention policy, on 20 November 2008 in Vilnius. The conference aimed at creating a coalition of non-government organizations of the three Baltic countries to better cooperate on alcohol issues. Lithuania mention that it could be a good opportunity for the the Prison Health Expert Group to attend the 19th anniversary of the Lithuanian prison health department in More detailed information will follow in the course of the organisation of this event. The Conference took note of the presented information. 6. NDPHS Progress report for 2008 The Secretariat introduced the main part of the NDPHS Progress Report for 2008 (submitted as document PAC 5/6/1) and asked for permission to include later into it any activities, which may still be carried out before the end of the year The NDPHS had been able to implement its very ambitious Work Plan in 2008, which was only possible through the active involvement of the Expert Groups and NDPHS Partners. The Database Project activities for 2008 (Action Line 1) are all implemented except for two, one of them being the preparation of the final report, and the project will be closed in early The NDPHS progress was also related to the financial resources that were made available through the Partners (Action Line 2). Besides the regular contributions, the Secretariat had received additional contributions, for instance from Germany for the NDPHS evaluation, or from Finland, Norway and Sweden, that had paid for Belarusian and Russian experts to participate in Expert Group meetings. The Secretariat thanked the Expert Groups for the excellent cooperation and input they had provided to the work plan. All Expert Groups (Action Line 3) enjoyed the support of a Lead Partner and have an ITA in place. The coordination of regional efforts to fight trafficking in human beings (Action Line 4) will be addressed by NCM in a meeting in Copenhagen on 5 December The Partnership engaged non-partner Countries and Organizations (Action PAC 5_Minutes.doc 4

5 Line 5) in its activities, such as the South Eastern Europe Health Network (SEEHN), Belarusian experts as well as local and regional stakeholders in North-West Russia. It also managed to dramatically increase its visibility (Action Line 6) through the attendance at various conferences, meetings and workshops, but also through the website, the folder with fact sheets, the database and the pipeline. The overall review and evaluation of the Partnership (Action Line 7) had been successfully conducted in The NCM provided additional info on the above-mentioned meeting on trafficking and recalled that several international organizations and task forces will attend this meeting to share information and to coordinate the activities in the regions. NCM was also prepared to organize a similar activity in The Chair thanked the Secretariat and invited the Expert Groups to provide more specific information about their work achievements in 2008 (cf. Annexes of the Progress Report). The Chair of the HIV/AIDS EG informed that its Lead Partner, Finland, has secured the financial basis for the Expert Group to continue working for the next two years. In 2008, the HIV/AIDS EG had held two meetings, one in Tallinn, 3-4 April 2008 and one in Oslo, 30 September -1 October 2008, where it had welcomed new representatives from Sweden and Norway and also a new expert from Belarus. Canada has been participating in the meetings as an observer and the Polish member was elected as the Co-Chair. In 2008, the Expert Group was involved in 29 ongoing projects, 9 project proposals and 10 completed projects as well as the continuous work with the Barents HIV/AIDS Programme. The HIV/AIDS EG s Lighthouse project on the development of low threshold services had started in 2005 in Murmansk and was now being duplicated (Phase 2, ) in Kantalahti (Kandalaksha). The Group had also completed its thematic report and was conducting regular reviews of epidemic trends and prevention policies in Partner countries. However, it was not having enough flexible financing tools for innovative approaches or seed money for project planning. The Chair of the HIV/AIDS EG further informed that according to Euro HIV, the fastest rise of new HIV cases in the recent years was noted in Estonia. It was particularly astonishing that for the first time ever, the numbers of TB cases had risen in parallel to the numbers of HIV infected people. In order to better address the emerging challenges, the HIV/AIDS EG had drawn up a list of priorities addressing topics such as: regional collaboration; surveillance and analysis of risk factors; prevention of HIV among drug users; promoting harm reduction policies among drug users; prevention of HIV/TB dual infections; prevention of HIV among MSM (men having sex with men); prevention of MTCT (mother to child transmission); enhancing implementation of common best practices; enhancing cross-border bilateral activities; and the integration of social and health care for HIV-infected individuals. The ITA of the Expert Group on Prison Health (PH EG) informed that in addition to the requested information in the Progress Report, the Expert Group had also produced a background document, which provides a good overview of the Prison Health developments in the region 2. He hoped that the background document would become an integral part of each annual NDPHS Progress Report in the future. In accordance with the Work Plan for 2008, the EG had held three meetings and had also participated in a series of international and regional meetings to advocate and promote the work of the Expert Group. In addition, the PH EG s expertise has come more and more in demand. For instance, the annual WHO Conference on Prisons and Women s Health, which was held November 2008 in Kiev, Ukraine, took account of several recommendations of the thematic report that the PH EG had produced earlier this year. The PH EG had also started to work on a Strategy on 2 Available at PAC 5_Minutes.doc 5

6 Prison Health. NDPHS Partner countries are actively involved in the work of the PH EG; however, the Co-Chair position is still vacant. Russia and Finland have been able to identify suitable experts that might attend the forthcoming PH EG meetings. However, the challenge remains that there are no representatives from the Ministries of Justice of the NDPHS Partner countries appointed, yet. The Chair of the Expert Group on Primary Health Care (PHC EG) informed that funding for the work of the PHC EG has been provided by the East Europe Committee of the Swedish Health Care Community and the Swedish Ministry of Health and Social Affairs. The PHC EG had held two meetings in The 6 th Meeting in Oslo, 30 September - 1 October 2008 was attended by a Belarusian expert. The 5 th Meeting was held in Vilnius, May 22, 2008 back to back with a Seminar on PHC in the Northern Dimension Countries (May 23, 2008, Vilnius), where priority gaps in PHC development were discussed and recommendations for future project based activities were developed. The PHC EG was in the process of submitting a project proposal on primary health care to the Central Baltic INTERREG IVa Programme ( ). It had also finalised its thematic report and is providing input to the discussions on the Baltic Sea Region Strategy. The Coordinating Chairman of the Expert Group on Social Inclusion, Healthy Lifestyles and Work Ability (SIHLWA) informed that SIHLWA had succeeded in recruiting an ITA in According to the Work Plan, two meetings were held in 2008, the 5 th Meeting on 6-7 March and the 6 th Meeting on 30 September - 1 October, both in Oslo. SIHLWA actively participated in several other meetings for visibility and policy influence. The coordinating Chair informed about the partner participation in SIHLWA Expert Group meetings and pointed out that some members and even a Co-Chair from a SIHLWA Sub-group are not able to attend, because of a lack of travel funds, which hampered the SIHLWA progress. The SIHLWA EG had also produced a thematic report on occupational safety and health (OSH), which provided an analysis of the OSH situation in the region and followed up on the Health at Work Strategy, which had been adopted during PAC 4. SIHLWA had developed its fact-sheet which was available in English and in Russian languages. A study on Potential Years of Life Lost (PYLL) was ongoing, with the objectives to assess the problems of early deaths, direct preventive measures and to evaluate the performance of prevention and treatment. Besides, the SIHLWA Sub-groups had continued working on their flagship projects: Alcohol & Drug Prevention among Youth in St. Petersburg (phase 1 and phase 2); Early Identification & Brief Intervention on hazardous & harmful use of alcohol (EIBI), feasibility project in St. Petersburg & Leningrad Oblast and the occupational safety and health project in Leningrad Oblast & the Republic of Karelia. The Conference thanked the Expert Groups for the good and committed work carried out in Further, the Conference approved the Progress Report (attached as Annex 1) and, considering that the presented Progress Report only covers the period from January until October 2008, it authorized the Secretariat to update this report with new relevant information that would become available during the remaining time of this year. PAC 5_Minutes.doc 6

7 The Secretariat informed about the current financial situation of the NDPHS Secretariat 3. Annual contributions for the FY 2008 were received from Canada, Estonia, Finland, Germany, Iceland, Latvia, Lithuania, Norway, Poland and Sweden. However, as there were still contributions missing, the Secretariat was faced with a deficit. Russia explained that the internal decision making process had not yet been completed, but a positive answer was expected from the relevant authorities by the end of November In case budgetary rules would not allow paying for the outstanding 2008 contributions before the end of the year, Russia would pay its 2008 contribution in Denmark announced that it would set aside the Danish contribution for 2008 and would pay as soon as the Russian contribution for 2008 has arrived at the Secretariat. Denmark stressed that the same precondition of Danish payment applied, not only to Russian contribution but to all countries that might not pay their contributions for the FY The Chair reminded the Partner countries that a letter, requesting the establishment of the Secretariat s legal capacity had been sent out on 09 September 2008 by the Norwegian Minster of Health and Care Services to all NDPHS Partner countries. The Partner responses to the letter should be received well before the forthcoming PAC 6 meeting in Oslo. Questions regarding the formalities should be dealt with by Ministries of Foreign Affairs directly. The Norwegian Ministry of Foreign Affairs was therefore acting as a focal point for any questions related to these formalities. The Chair also informed the Conference that a letter had been sent to France, asking to pay the outstanding fees and consider their participation in NDPHS meetings and Expert Group related activities. France was also informed that the NDPHS could consider offering an observer status in case France was unable to pay the annual contributions. The Conference took note of the information provided. 7. NDPHS Evaluation and its follow-up 7.1 Update on the work of the Evaluation Team and the proposed follow-up actions The Chair of the Evaluation Team presented the final evaluation document (submitted as document PAC 5/7.1/1). The Evaluation Team had met immediately after the CSR 14 and compiled this document. The latter contained the consultant s report, the three evaluation questions, the summary of the answers received and the slides presented during CSR 14, which proposed the most important recommendations to be followed up by an ad hoc NDPHS Strategy Working Group. He informed that a reminder had been sent out to France, Iceland and Russia to provide their answers to the three questions. As CSR 14 had decided to set up an ad hoc Strategy Working Group to ensure a proper follow-up on recommendations, the Evaluation Team had developed a set of evaluationrelated questions, which were distributed to the Partners prior to the CSR Meeting (submitted as document PAC 5/7.2/1). 3 Due to practical reasons during the meeting, this agenda item was discussed before the progress report presentations from the Expert Groups. PAC 5_Minutes.doc 7

8 The Chair thanked the Evaluation Team, with special recognition for the support from the Secretariat, for the work. 7.2 Tour de table With reference to the document PAC 5/7.2/1 (Questions related to the NDPHS future scope and focus) the Chair invited the Partner countries to provide their answers. Question 1: What are your top priorities/aims within the NDPHS? a. Would you envisage a stronger focus on strategies & policies or on project implementation? If both priorities are of importance to you, what would be your first priority? b. Which health (thematic) areas do you consider important for the NDPHS to cover? Is the NDPHS addressing these thematic areas sufficiently? If not, how could they be addressed and would you be willing to play an active role therein? Question 2: Would you like the NDPHS move towards becoming a financer of projects (by for instance contributing to the pipeline) or a facilitator of projects (by making better use of the national resources, knowledge and bi-lateral contacts). And which of these two options could be most supported by you? Canada (Question 1) stated that it remained most interested in the strategies and policy aspects. It was happy to work together with the Expert Groups (both on best practice and policy development exchange) and to bring Canadian experts to the table. Canada realised that most approved project work can complement this work; however it is difficult for Canada to become an active project funder or participant. Like Denmark and others, Canada believes that social well-being is an area to be looked at. Canada (Question 2) explained that both the financing of projects and the facilitation/participation in projects remains a challenge. However a possible way to be involved in some project work could be through involving interested Canadian university, Professional Associations or NGO networks. Denmark (Question 1) emphasised that the impact of the Partnership must primarily be judged by the extend to which it has proven to be able to promote and facilitate concrete results in terms of concrete projects and similar initiatives, involving local and regional professionals and aiming at improvement and reinforcement of health promotion, disease prevention and health care and the social intervention and care actually provided to citizens at local and regional levels. It has to be proven whether the Partnership will be able to redirect its efforts more directly towards the primary aim of promoting and facilitating concrete activities at regional and local levels that would not have been created without the efforts of the Partnership. It also gives rise to concern if the need of concrete projects and similar initiatives at local and regional level are not demanded, defined, initiated and formulated primarily by the authorities professional and voluntary contributions, locally and regionally affected, rather than by the Expert Groups. Denmark considered the evaluation report of a very high quality, and while referring to the evaluation report, stated that it was important to develop a clear and common view on success criteria for the Partnership. PAC 5_Minutes.doc 8

9 Denmark (Question 2) stressed that it would like to see the Partnership as a facilitator of projects which could, for example, be financed through the pipeline. Estonia (Question 1) welcomed that the Partnership s work on strategies and policies in general, while taking into account that project implementation was important. It considered HIV/AIDS to be one of the most important areas for the NDPHS to cover. Estonia (Question 2) preferred the Partnership being a facilitator of projects, as it saw a need to make better use of the already existing national resources in the Partner countries. Finland (Question 1) considered it important to have a focus on the Northern Dimension overall strategies and on project implementation as the areas complement each other. But the Partnership should not turn itself into a project implementation organisation. It should focus its work on combating infectious diseases. As infectious diseases, such as TB and HIV/AIDS are dependent on lifestyles, poverty and social exclusion, there was a need for a systematic drawing up of social and health profiles. In the future, there would also be a need to invest in health promotion among children and young people as well as the working population. Finland (Question 2) saw the Partnership as facilitator of projects. The Secretariat could administer, manage and monitor pipeline projects and be a centre for advice for all ongoing project implementation activities. The Sámi representative from Finland asked if indigenous aspects were included in the work of the Partnership and suggested to add more data on the health on indigenous people in the NDPHS database and also tackle alcohol issues of indigenous people in the SIHLWA Expert Group. Germany (Question 1) stated that the expertise available in the NDPHS Partner countries provided a good basis for a transfer of know-how. Consequently, the focus of the NDPHS should be on "strategies and policies". The NDPHS should be a facilitator and provider of ideas, find regional partners and sponsors locally, if necessary, and support them in implementing projects by means of know-how. Germany deemed the issue of communicable diseases such as HIV/AIDS, tuberculosis, hepatitis and their modes of transmission to be highly important. In addition, the Partnership should address the issue of prevention on a broad basis. Here, experience and know-how concerning, for instance, campaigns on drug use, alcohol abuse, obesity, can be shared with interested partners. Moreover, clinic partnerships could be initiated in an effort to promote scientific and medical exchange and establish and enhance quality standards. Germany (Question 2) assumed that the Partner countries can, for the most part, finance models and campaigns they consider interesting themselves. Irrespective of the foregoing, the NDPHS should promote health standards of the highest possible level, for instance on health care provision and prevention. Latvia (Question 1) underlined that the main focus of the NDPHS should be on project implementation. Strategy and Policy documents are usually developed in cooperation with international and European organisations and new policies should complement these documents rather then duplicate them. The Partnership already covered the most important health issues through the work of its four existing expert Groups and this work should be continued. Latvia (Question 2) felt that health-related issues might be better addressed if the PAC 5_Minutes.doc 9

10 Partnership was a financier of projects, however, if this was not possible, then it should certainly act as a facilitator of projects. Lithuania (Questions 1 & 2) believed that the NDPHS owns excellent mechanisms to coordinate cooperation and financing of projects. This good model needed to be pursued. The financing mechanism should therefore be recognised and used by the respective authorities. Lithuania itself tries to become a donor country, and little by little contribute to the financing mechanism as well. The top priority for the Partnership was project implementation. However, the Strategy on Health at Work has demonstrated that it is of value for the Partnership to also conduct strategic work. Future Partnership strategies should focus on local realities as there is no need to copy and duplicate the tools developed by the WHO or the EU. Nonetheless, the Partnership should consider how the WHO and other international organisations can be better included in the work of the NDPHS. Lithuania also supported the suggestion to include indigenous issues in the work of the NDPHS and proposed that mental health and the alcohol consumption of indigenous people should be further addressed in more practical terms. Norway (Questions 1 & 2) proposed the Partnership to focus its work on strategies and policies, as it has already done in the past, for example by formulating recommendations in the thematic reports or developing the Strategy on Health at Work. But there should also be project related work. Norway supported NDPHS project work, also in view of its projectfinancing provided through the pipeline. The health areas currently covered by the NDPHS Expert and Associated Expert Groups were representing the main health areas that the NDPHS should focus on, and Norway also welcomed possible initiatives for the NDPHS to be more active in the area of social well-being. The Ministry of Foreign Affairs of Russia informed that it had not yet received the answers to these questions from the Russian Ministry of Health. However, it was hopeful that these contributions would come in soon. On a general note, Russia expressed its interest to increase the impact of the Partnership in the framework of the Northern Dimension Policy. Sweden (Question 1) stated that strategies and policies were going hand in hand with project work. Projects often have a strategy and policy component included. Sweden felt that project implementation was not a job for the Partnership, but that project promotion and facilitation certainly was part of the NDPHS activities. Sweden stated that it was satisfied with the work and thematic health-coverage of the NDPHS Expert Groups. However, it was important to make the social aspects more visible, in the work of the Expert Groups. In addition to the health areas, already covered by the Expert Groups, the Partnership should address the issue of antimicrobial resistance. Other avenues that could be covered are, for example, social services or people with disabilities. Sweden (Question 2) saw the Partnership more as a facilitator of projects, rather than a financer and felt that the pipeline was an important tool, but it could not include all kinds of financing. The Chair noted that there were different views, but that there was also the overarching question of better definitions in order to gain clarity on terms, such as, facilitation and promotion of projects, policies and strategies, etc. Many of these activities might go hand in hand and necessite each other. It was also important to try to avoid overlaps. The Northern Dimension cooperation might have to deal with areas, which are presently not actively pursued by the EU or the WHO. The Chair also felt that it was important for the Partnership to be able to define its success and asked the Strategy Group to look further into these issues raised by the Partners. PAC 5_Minutes.doc 10

11 NCM added that the Partnership should deal with project implementation as well as project development/ facilitation. But the projects should be strategically selected, and should cover areas of high political attention. Question 3: Do you see the need for the NDPHS to define mid-term goals? If yes, what would be your criteria to define such goals? Canada stated that the NDPHS Work Plan was more focussed on the short term goals as a follow up to the recent Evaluation Report and through the new formed Strategy Group, and it therefore would be of advantage to also define mid-term goals for the Partnership. The criteria to define such goals would best be handled by the Strategy Group. Denmark had no observations on mid-term goals. Finland preferred to have defined mid-term goals for a period of maybe 5-10 years and added that the currently practiced definition of one year targets was too short. Estonia supported the idea of having mid-term goals for the NDPHS, especially with the purpose to ensure that initiatives from the WHO and the EU similar to the ones from the NDPHS would not oppose each other. Germany emphasised that the definition of mid-term goals was useful and necessary. Objectives needed to be realistic, achievable and aligned with the NDPHS operational capacity. Latvia was of the opinion that mid-term goals were important for every organisation to evaluate the success of the organisation and especially important when speaking of international cooperation and project management. Lithuania reiterated that the progress in health was difficult to assess and therefore doubted that mid-term goals would be able to measure the success of the Partnership unless clear success criteria were agreed upon. Norway agreed with Lithuania and considered it a great challenge to define clear indicators that would measure the success of the Partnership. Sweden felt that well defined mid-term goals could be useful to evaluate the success of the Partnership. The Chair noted that the majority of the Partners considered mid-term goals as useful, but that the right criteria /indicators were yet to be developed. Question 4: How would you describe your willingness and possibilities to contribute to the Partnership beyond the current scope (in cash or kind), in particular regarding: a. the funding of projects b. the work and support of the Expert Groups (participation, Lead /Co-Lead Partner, etc) c. the participation in NDPHS ad hoc Working Groups d. other possible NDPHS activities PAC 5_Minutes.doc 11

12 Question 5: How is your NDPHS work coordinated in your country/organisation? For instance: a. is there a continuous political and/or financial support for the NDPHS ensured? b. are all major decision makers actively involved in NDPHS matters? c. is it a single person or a group of people dealing with NDPHS matters? d. is the current set up beneficial to the NDPHS? Sweden (Questions 4 and 5) reiterated that, in the future, it was probably becoming more and more difficult to fund projects beyond the current scope. Sweden was for instance engaged in providing project support to Belarus and in supporting the work of the Expert Groups. It was also willing to take part in ad hoc NDPHS Working Groups and offered to take a lead role in exploring possibilities for the Partnership in the field of anti-microbial assistance. The continuous Swedish support for the payment of annual contributions to the NDPHS main budget was ensured. Sweden also recalled that its Lead Partner support to the PHC EG was on track. Two persons, one from the Ministry of Health and Social Affairs and one from the Swedish Health Care Community (SEEC) were actively working on the NDPHS matters, while other ministries or state authorities where only involved, when needed. Russia (Questions 4 & 5) stated that the will and possibilities in Russia for a broader participation in the Partnership activities have increased recently. The Partnership needed to be seen in the broader scope of the Northern Dimension Policy, which meant both project funding and strategy work. Russia believed that the NDPHS could only exist with serious and significant contributions from the Partner countries. Due to limited resources in the Ministry of Health and Care Services to mange the processes in the NDPHS, it was difficult for Russia to provide additional support at this point in time, even though the current situation was not necessarily satisfactory. However, the political understanding for the work and importance of the NDPHS had been noted at the highest political level. Norway (Questions 4 & 5) reassured its willingness to contribute to the Partnership. It recalled that it had been funding projects through the pipeline, and that it was the Lead Partner and provider of financial resources of the Prison Health Expert Group. In addition, Norway was committed to host the PAC 6 meeting in Oslo. Both the financial and the political support for the Partnership were ensured under the leadership of the Ministry of Health. Decisions are taken in collaboration with the Ministry of Foreign Affairs and collaboration is ongoing with the Ministry of Children and Equality and the Ministry of Labour and Social Inclusion. More than one person was working on Partnership issues and it was believed that it was a beneficial set up for the Partnership. Latvia (Questions 4 & 5) informed that it supported the Expert Groups and their experts, and had also hosted EG meetings in Vilnius. The Ministry of Health was coordinating the activities of the Partnership and is providing regular financial contributions. Recently, the Ministry of Justice and the Ministry of Welfare became more involved through the Partnership s work at an expert group level. Several persons were working on Partnership issues and trying to do the maximum of activities possible within their available capacities. Lithuania (Questions 4 & 5) hoped that it could provide seed money for some specific activities of interest to Lithuania in the NDPHS. Lithuania also hoped to co-finance the new project of the PHC EG. Furthermore, it was a Co-lead partner in the SIHLWA OSH Sub- PAC 5_Minutes.doc 12

13 group and was also willing to participate in the work of ad hoc Working Groups and proposed to further pursue the issue on indigenous people in the framework of the NDPHS. The coordination of the NDPHS work could be described as work in progress and currently there was only one single person assigned to dealing with the NDPHS tasks. Germany (Questions 4 & 5) reiterated that it had already committed itself to the NDPHS in many ways, taking its support of projects and its willingness to take part in Expert Groups as two examples. Germany s future willingness to contribute to the NDPHS depended, inter alia, on the Partnership s willingness to implement the evaluation recommendations. NDPHS matters are dealt with at the Federal Ministry of Health in Division Z 34 Multilateral Cooperation in the Field of Health, and political decisions are coordinated at this Ministry as far up as its leadership. Furthermore a good cooperation has been established with the Federal Foreign Office concerning the Northern Dimension and the NDPHS issues. Finland (Questions 4 & 5) stressed that it was willing to contribute in several ways to the Partnership. It funded projects, led two Expert Groups and participated in several other activities. The NDPHS activities were coordinated by the Ministry of Foreign Affairs and the Ministry of Health and Social Affairs. The cooperation between the Ministries has been continuous and fruitful. Finland originally took the initiative for the Northern Dimension Policy and has during the past years allocated a significant amount of resources to this cooperation. Estonia (Questions 4 & 5) mentioned that it was willing to contribute to the Partnership within the resources available and explained that the NDPHS work was coordinated by the Ministry of Social Affairs. Major decisions are being coordinated in the Public Health department while supportive action is provided from the EU department. Estonia is planning to contribute to the NDPHS main budget as well as, depending on the possibilities of the state budget, to Expert Group activities. Denmark (Questions 4 & 5) stated that its funding priorities were directed towards Africa and that no funding was foreseen for ND activities. Its involvement in the Partnership was managed by the Ministry of Health and Prevention and the Ministry of Welfare, while the Ministry of Foreign Affairs was not involved in any way. Canada (Questions 4 & 5) explained that its ability to fund projects in the EU and the NDPHS geographical area remains limited, but that Canada will continue to look for opportunities to support to the Partnership. Canada has chaired the work of the Evaluation Team and was now actively involved in 3 out of the 4 NDPHS Expert Groups and may also be involved in the 4 th one. In addition, Canada hosted PAC 5 and its side event, and is interested in having a deepened dialogue on indigenous people remaining where possible, with the NDPHS network. Funding for the Partnership is determined on an annual basis, working with those who are interested in both the activities and results of the NDPHS. Question 6: In view of the consultant s evaluation report and the future possible scope of the NDPHS, do you see a need to a. do any major adjustments for the NDPHS at this point in time, which were not mentioned in your above-given answers? b. address any other issues, which were not mentioned in your above-given answers? If yes, which ones? (reference to social well-being) Germany proposed to take a closer look at the structure of the Northern Dimension Environmental Partnership. While the NDEP operated on a different financial scale, its way of PAC 5_Minutes.doc 13

14 operation, including the Steering Group, worked well. Therefore, it might be useful to arrange for an exchange of experience between the Secretariats of the two Partnerships in an effort to profit from this pooling of know-how and approaches. Partners should develop, with support from the Secretariat, a common, precise and narrow working definition of social well-being which can serve as a point of departure for addressing social well-being issues in a targeted manner. Denmark stressed that a better definition of the term social well-being was needed before t could be used as a point of departure for action and that action on social well-being is required to give sense to the Oslo Declaration. Denmark pointed to the challenging task, mentioned in the evaluation report that the Expert Groups mandate, procedure of establishment, duration, would need to be addressed in the Strategy Working Group. Canada also calls for a definition for social well-being and NDPHS activities. It may also broaden the scope to another Federal Government Departments in Canada which could result in new participants and resources. The Chair of the HIV/AIDS EG remarked that the NDPHS did not cover all the aspects of health, and believed that it would also not be able to cover the entire aspects of social wellbeing either. Finland pointed out that it would like to see the Northern Dimension as a whole, with different Partnerships at work and effective cross-boarder cooperation. Similar to the Environmental Partnership, which shall in the future cover new areas, the NDPHS should also actively try to broaden its scope in the same way. As the NDPHS does not receive big grants, the Partners should consider new ways to finance this Partnership, at different levels, from bi-lateral to multilateral talks, including the EU. Finland concluded that the new Strategy Working Group could be the right place to tackle these issues. The Chair noted that there were no further comments regarding question 6 and the issue of social well-being. The Conference took note of the views provided and decided to further work on these issues through the setting up an ad hoc Strategy Working Group. 7.3 Ad hoc Strategy Working Group The Secretariat recalled the decision CSR 14 to present Terms of Reference and a Timeline for the to-be established NDPHS ad hoc Strategy Working Group (SWG) for discussion and approval by PAC 5. With reference to document PAC 5/7.3/1, the Chair asked for comments and suggestions concerning the Terms of Reference and Timeline, and possible Partner nominations to participate in the SWG. She further suggested to create a small ad hoc Working Group that would develop concrete proposals for the Partnership to better address social well-being issues and to provide these proposals as an input to the work of the SWG. The Conference PAC 5_Minutes.doc 14

15 agreed on the following composition of the ad hoc Strategy Working Group (SWG): Sweden (Chair of the SWG), Canada, Finland, Germany, Lithuania, Norway and Russia, as well as the NDPHS Secretariat, recalling that other countries, such as Poland, which did not attend PAC, are welcomed to join the Group; mandated Denmark and the NCM to brainstorm on possible social well-being areas of action, and, if of relevance, also include the NDPHS Expert Groups in their discussions and feed their results into the SWG.; and adopted the SWG Terms of Reference and Timeline (attached as Annex 2 to the minutes). 8. NDPHS Work Plan for Contracts of the present NDPHS Secretariat staff The Chair informed that the process of authorizing legal capacity to the NDPHS Secretariat was expected to be completed before the end of Until then, the NDPHS Secretariat would continue to be hosted as a temporary project by the CBSS Secretariat. Consistent with the ongoing process of establishing the Secretariat s legal capacity, the Terms of Reference for the Secretariat foresee a five year duration of the work contracts of the Secretariat s staff, while the current work contracts only cover a three year contract period. As the work contracts of the NDPHS Secretariat s staff will expire in 2009, the Chair asked that the Conference would authorize her to prolong, if necessary, the contracts of the NDPHS Secretariat staff in 2009, consistent with the new Terms of Reference for the Secretariat. Canada added that the extension of the duration of the work contracts to five years was also suggested by the evaluation report and the Evaluation Team had recommended that this be dealt with through the NDPHS regular business process. The Conference agreed to the Chair s proposal. 8.2 Adoption of the NDPHS Work Plan for 2009 The Secretariat presented the proposed NDPHS Work Plan for 2009 (submitted as document PAC 5/8.2/1). It underlined that the Work Plan might be subject to change, as it could have implications with the work of the ad hoc Strategy Working Group. The proposed Work Plan featured 6 main action lines which defined the NDPHS future work on (1) the NDPHS Database Project, (2) the Financing of NDPHS and other parties undertakings, (3) the work of the NDPHS Expert Groups, (4) the NDPHS Cooperation with non-partner Countries and Organizations, (5) the efforts to further increase the visibility of the Partnership and (6) the follow up on the Partnership evaluation. In the context of action line 1, the Secretariat plead to the Partners taking part in the Database Project to ensure timely submission of the information required for the completion of the final project implementation report for the Executive Agency for Health and Consumers. The Chair asked the Expert Groups to present their Work Plans for 2009, annexed to the overall NDPHS Work Plan for PAC 5_Minutes.doc 15

16 The Chair of the HIV/AIDS EG explained that the prevalence in certain ND regions remained high (especially in Estonia and certain Russia regions). The HIV/AIDS EG was therefore planning to set up a special project in the Russian - Estonian cross-boarder region of Narva to address these challenges. Furthermore, a new project concerning prevention and treatment of TB among high risk groups including HIV-infected persons and another TBprevention project is being developed in collaboration with the Prison Health Expert Group and its implementation will probably start in Other priorities of the HIV/AIDS EG include, but are not limited to, the prevention of HIV among drug users, the promoting harm reduction policies among drug users, the integration of social and health care for HIVinfected individuals, the prevention of HIV/TB dual infections, the prevention of HIV among MSM, the prevention of MTCT and the implementation of common best practice in projectrelated activities. The HIV/AIDS EG will also continue a dialogue with Canada on the issues related to HIV prevention among indigenous populations in the region and will also continue its dialogue with other NDPHS Expert Groups, other expert networks, such as the HIV/AIDS Think tank, or SEEHN and with the Barents Euro-Arctic (BEAС) programme HIV group. Furthermore, the HIV/AIDS EG plans to include a new section dealing with HIV prevention among MSM in its thematic report. The spring meeting of the EG will be held in Canada in March A side-event with strong Canadian involvement will be included into the programme. The autumn meeting will probably be held in Gdańsk in early September The ITA of the Expert Group on Prison Health (PH EG) reminded that the prevalence rates that the HIV/AIDS EG had presented are 5-10 times higher in prisons. The danger is that diseases that are not treated in the prisons are being distributed to the general population after release of the infected prisoners. In 2009, the PH EG intends to pay special attention to the health needs of female prisoners and will follow the recommendations proposed in the thematic report on Women s Health in Prison. A project proposal on prevention of HIV/AIDS among female prisoners will be developed and submitted for the possible funding to the EUBSR Programme In the light of the current development and the situation with HIV and TB within the prison settings, the EG will facilitate collaboration between TB and HIV programs, will assist in the implementation of best practices collaborative TB/HIV activities aimed to reduce the impact of HIV related TB. One of the priorities of the EG in 2009 will be to raise awareness among the countries within the NDPHS Region of the current situation of health and healthcare provided to prisoners in order to increase political and resource commitment for issues related to the medical service. The PH EG intends to further continue the close collaboration with UN organizations, NGOs and other interested institutions working in the field of prison health, linking them in a network of NDPHS, for sharing tools, materials and best practices. In addition, the PH EG plans an analysis of the health situation, within the penitentiary systems of NDPHS Partner Countries; and to develop a project proposal on HIV/AIDS prevention among female prisoners, covering Estonia, Lithuania, Latvia, Poland and Belarus. The aim of the project will be to create a prison environment that supports gender sensitive approaches to HIV prevention, treatment, care and support services to female prisoners. The PH EG plans to have three working meetings in 2009, whose places are yet to be determined. The Chair of the Expert Group on Primary Health Care (PHC EG) informed that the PHC EG s implementation strategy aimed at ensuring an effectively functioning Expert Group and delivering added value to health systems development in the ND region. It covered several working areas that the group will address in The PHC EG will consider setting up medium-term goals as proposed in the NDPHS Evaluation Report of 2008 and will hold two meetings in It will also re-edit the thematic report on Primary Health Care and will apply for funding for a Primary Health Care project, which if granted will start being PAC 5_Minutes.doc 16