EG on SIHLWA

9th meeting

24-26 March, 2010

Copenhagen, Denmark

WHO-EURO and Nordic Council of Ministers

Title / SIHLWA-9 Meeting report FINAL-DRAFT
Submitted by / SIHLWA Coordinating Chair and ITA
Summary / Note / This document recalls the main discussion points and decisions made during the SIHLWA-9 plenary meeting.
All the meeting documents can be found on the SIHLWA-9 meeting page

The reports of the three subgroup meetings(ADO/ALC, IMHAP, OSH) of 25 March and the open space meeting held on 24 March can be found as separate documents on the above mentioned SIHLWA-9 meeting page. They are also compiled to a SIHLWA-9 Annexes to the meeting report -document, which contains all the post-meeting documentation:
Annex 1 A.: Report of joint subgroup on alcohol and adolescent health and socially-rewarding lifestyles [ADO/ALC]
Annex 1 B.: Report of subgroup on indigenous mental health, addictions and parenting [IMHAP]
Annex 1 C.: Report of the subgroup on occupational safety and health [OSH]
Annex 2: Report of the Open-space meeting on Alcohol & Drug Prevention among Youth [afternoon 24 March]
Annex 3: Final list of participants
Annex 4: Evaluation summary of the meeting
Annex 5: List of meeting documents

SIHLWA-9 MEETING REPORT

A. PLENARY SESSION 24 March, 2010

1. Opening of the meeting and welcome

Dr Mikko Vienonen, Coordinating chair of SIHLWA opened the meeting by stating how pleased we are to have the meetinghosted byboth WHO-EURO and the Nordic Council of Ministers (NCM), both founding members of NDPHSandalso EG SIHLWA.We are now in the process of stepping to a new era with new NDPHS Strategy and reorganization of its Expert Groups SIHLWA included. The area where we are working, namely lifestyle related non-communicable diseases, their prevention and health promotion are actually been brought even higher on the NDPHS agenda, which will certainly call for certain organizational and contextual changes and challenges in our work in 2010 -2013. But there is no doubt that all our input and effort will be needed.

Ms Zsuzanna Jakab, newly appointed Regional Director of WHO Regional Office for Europe welcomed SIHLWA-9 participants by saying that with her leadershipnew priorities will be defined. Partnership in public health will be on the top of the list of WHO-EURO. Effective collaboration with other sectors is gaining more and more importance. This autumn in September the Regional Committee of WHO-EURO will be held in Moscow and hosted by Russia, which will give even more visibility to the Northern Dimension also.

WHO-EURO will recommit itself to strengthen the fight against NCD-burden. The role of social determinants in achieving health will be brought up even more than before.WHO will work on Global Alcohol Strategy building on the work and recommendations of 2010 World Health Assembly.Also in the field of tobacco control the NDPHS new strategy interlinks well with WHO’s work. High significance will be given toovercoming obesity and promoting physical activity. The April 2010 WHO-EURO Conference on Environment and Health was a good example of cross-sectoral cooperation.Mental health is another area of NCDs with growing importance.

Chronic disease management is a new area where WHO-EURO is exploring what its cutting edge could be. Secondary level health promotion, disease management (chronic and elderly)call for new initiatives and innovation. Although not in the area of NCDs, WHO has challenges in every sector of public health, including mass immunization campaigns (measles and rubella eradication; H1N1-influenza epidemic threat as an eye opener, etc.)

All activities of the SIHLWA Expert Group – and in whichever format they may re-emerge - are very close to WHO and it will look forward to working hand in hand with NDPHS both in the policy area as well as practical work.

Ms Maria-Pia de Palo, Senior Adviser of Nordic Council of Ministerswarmly welcomed the participants to Copenhagen on behalf of the Nordic Council of Ministers and its General Secretary Halldor Asgrimmson. She expressed the importance of cooperation in the frame of Northern Dimension for the Nordic countries and NCM, which will take an active role in promoting regional cooperation within the frame of the NDPHS in cooperation with Canada - establishing the Expert Group on Indigenous People and Health under SIHLWA. The Northern Region - through joint efforts - have a lot of potential to be “first mover” in developing innovative and research based solutions to change the negative trend in life-style related illness.

De Palo's presentation on Nordic cooperation:

Mr Marek Maciejowski, Head of Secretariat of NDPHSgreeted the meeting on his behalf.

The new strategy and goals of NDPHS set an important task to reshape the way we worked, pave for successful work. He expressed his wishes for good and productive work.

Mr. Evgeny Slastnykhofthe Ministry of Health and Social Development of Russian Federation shared welcoming words on behalf of the new NDPHS chair country, Russia. The field of work and activities of the SIHLWA EG are of special importance to Russia, and the Ministry is now putting much emphasis on health promotion, including the work in the fields of alcohol and tobacco prevention, as well as promotion of physical activities. Russia is to chair NDPHS for a 2-year period of 2010-2011, Finland as a co-chair.

Introduction tour-de-table of participantswas held (see participant list, Annex 3); altogether there were 46 participants in the SIHLWA-9 meeting (ADO/ALC -21, OSH-6, IMHAP-12, WHO observers -7)

2. Key note speech: "Prevention and control of non-communicable diseases in the European Region of WHO"

The first key note speech was given byDr Nedret Emiroglu, Director a.i., Division of Health Programmes, WHO Regional Office for Europe.

She started her presentation by reminding of the regional commitments:

•Prevention and control of noncommunicable diseases in the WHO European Region (RC56 Resolution)

•Prevention of injuries in the WHO European Region (RC55 Resolution)

•Framework for alcohol policy in the WHO European Region (RC55 Resolution)

•The Mental Health Declaration – Helsinki 2005

•WHO European Ministerial Conference on Counteracting Obesity 2006 – Istanbul Charter

These regional commitments call for the active supporting of:

  • Political leadership and commitment;
  • Development of national policies, strategies and plans;
  • Forging of alliances for advocacy and action;
  • Networking and capacity building;
  • Provision of evidence and tools;
  • Research;
  • Exchange of information and good practices;
  • Establishment of surveillance and monitoring systems;
  • Development of partnerships for multisectoral action and resource mobilization.

There is a formidable agenda for action:

•Place and maintain prevention and control of noncommunicable diseases (NCD), high on the political and social agendas

•Develop partnerships across sectors and integrated approaches:

–tackling obesity and unhealthy lifestyles

–implementing the WHO Framework Convention on Tobacco Control

–understanding and acting on the social determinants of health

–addressing health inequalities and the needs of vulnerable groups

–creating environment supportive of healthy living

•Develop scientific evidence and effective interventions to support priority setting and implementation

•Strengthen health systems’ capacity to improve prevention and control

Examples of making progress on the policy front:

•32 Member States[1] have national policies for NCD prevention and control.

•47 Member States[2] have developed nutrition policies, including 39 with policies on physical activity.

•46 Member[3] States have ratified the Framework Convention for Tobacco Control.

•60% of Member States[4]have integrated policies for unintentional injury prevention, and 46% for violence prevention.

Increased country demand is met by the increased Regional Office capacity to support countries in many ways.

Dr. Emiroglu listed highlights of the achievements in the fields of NCD, alcohol, violence and injuries, mental health, tobacco control, nutrition and physical activity (for the concrete examples, see the presentation slides on

Opportunities and legitimacy:

•Vision of the Regional Director; address the burden of NCD as a high priority and renew political commitments to policies and action plans

•Political commitment through WHO resolutions and strategies

•Strong commitment from several international agencies, the European Union (EU) and MemberStates

•Strong legitimate action through WHO resolutions and strategies

•Unexplored potential for prevention

•Stronger-than-ever evidence to set priorities and improve implementation

•Growing momentum for action.

The way forward:

•Scale up work for comprehensive and integrated approaches

•Develop integrated NCD Regional Action Plan to be endorsed at Regional Committee in 2011,

•Focus on target groups and individuals at high risk, and address social determinants and health inequalities

•Renew commitment to health promotion

•Strengthen health systems’ functions and capacity

•Develop effective collaboration with other sectors in multi-sectorial responses

•Strengthen partnership with international agencies, the EU and MemberStates committed to prevention and control.

3. Opening remarks of SIHLWA subgroup chairs:

The chairs of the four subgroups presented shortly the current issues on their agenda.

OSH/ Wiking Husberg

  • OSHcooperates closely with Baltic Sea Network on Occupational Safety and Health, which has annual meeting yearly; SIHLWA OSH 2 meetings per year (1 combined with BSN)
  • ILO North West Russia OSH project now received funding for the phase III (2010-2012) and is working closely with Finnish Institute of Occupational Health (FIOH) project Developing the National OSH System and Improving Health and Preventing Accidents in the High-risk Sectors in North-West Russia (2008-2010)
  • The new NDPHS Strategyactually gives us twomore years time to implement the Health at Work strategy (we are following up the progress made after last Riga meeting in October 2009), and OSH group can live with the strategy formulation.
  • Besides for the ongoing projects and linking BSN work plan to Health at Work Strategy, the group puts emphasis on developing projects for the Baltic countries; OSH into the EU Baltic Sea Region strategy and improved cooperation with EG on Primary Health Care.

IMHAP/ Maria-Pia de Palo

  • Unfortunately the IMHAP chair Eric Costen had to cancel his participation in last minute, but luckily, Robert Shearer (Canada's Mission to EU) was able to replace him.
  • Progressing since Ottawa meeting in 2008, Canada and NCM have agreed to be the lead partners. We are still quite young, 1st official meeting now, previously 2 meetings in Östersund and Riga (in connection with SIHLWA meetings)
  • Main things on agenda: 1) Work plan for 2010 and over, 2) Terms of reference for the group 3) Organising of key note conference.

ALC/Lars Møller

  • Presented situation related to alcohol consumption in our region, consumption figures, harms caused by alcohol (presentation can be found among meeting materials on )
  • Recently the ALC group's activities have been lacking behind, probably because the group doesn't have a clearly defined Chair.
  • Plans include: thematic report - Northern Dimension country profile on alcohol consumption harm and policies in NDP region.
  • Work plan for 2010, hope for chair and solution for funding & resources.

ADO/Mikko Vienonen

  • ADO has been working on Youth Health Profiles (collaboration with WHO, digesting info). Subreport on youth sexual health already exists. We have found out that it is actually more laborious to produce short and snappy papers than longer reports.
  • The group worked a lot for the input for Prison Health Conference (PAC side event last November)
  • St.Petersburg Alcoholprevention among youth -project -> III phase now ongoing, can be seen as a test pilot for flagship project (here "messages from East to West")

4. NDPHS new strategy and work plan for 2010

NDPHS Head of Secretariat, Mr.Marek Maciejowskiintroduced the topic. It was reminded that both the NDPHS new strategy and the NDPHS work plan for 2010 can be found among meeting materials on

The NDPHS Strategy and work plan were adopted by Partnership Annual Conference in Oslo, Nov 2009. Both documents call for reshaping the present Expert Groups. The strategy is related with the EU Baltic Sea Strategy where NDPHS is the lead partner for the health priority sub-area.

The Strategy, which guides the NDPHS from the year 2010 onwards, addresses the following issues: Mid-term vision; Policies, Strategies and projects; social well-being facet within the NDPHS; Goals, Operational Targets and Indicators; Expert Groups; Financial matters; NDPHS membership/partner status.

The political circumstance we operate in, the economic difficulties faced by the region, call for being useful, focusing on tangible results. Russia as the new NDPHS chair wants very constructive partnership, wants to achieve and show concrete results.

The Midterm vision indicates that by 2013, activities which have been implemented, or are under implementation, balance both health and social dimensions and involve relevant actors and stakeholders in the region. The Partnership’s functioning has been strengthened by the implementation of clear rules concerning organizational matters.

NDPHS contributes to achieving the goals through time-bound operational targets which are grouped under four thematic areas. This is a challenge to you, as related to expert level (SIHLWA chair is to present the related goals more closely).

According to the strategy, new/restructured Expert Groups will be time bound (4 years), and bound to the achievement of certain operational target. Another challenge: Each EG should have a flagship project under implementation. The meeting was informed about the forthcoming PAC side event with a focus on the EU Strategy for the Baltic Sea Region(tentatively end of October), concept of which is to bring together the donor community and experts for elaborating onproject based activities. Participants were asked to prepare mature outlines of projects (incl. budget outline, timetable) for the event. The project planners can also count on some seed money from the NDPHS secretariat.

An ad hoc working group to develop templates for the new EG Terms of References (EGTOR)

was put up following the strategy; drafted ToRs submitted to this meeting are based on this template.

The Coordinating Chair of SIHLWAMikko Vienonen then presented the core ideas and documents to elaborate further on ToR of SIHLWA and tentatively 5 TG ToRs related to the NDPHS Strategy's Thematic area 4: Lifestyle-related non-communicable diseases and good social and work environments, and the five goals under this thematic area:

  • GOAL 7:"The impact in the ND countries on society and individuals of hazardous and harmful use of alcohol and illicit drugs is reduced" - relatedTerms of Reference for NDPHS Task Group on Alcohol and Drug Prevention among Youth in NDPHS Area: Fast-track Flagship Project (ADPY-FLAGSHIP) Draft 110310
  • GOAL 8: "Pricing, access to and advertising of alcoholic beverages is changed to direction, which supports the reduction of hazardous and harmful use of alcohol" - related Terms of Reference for NDPHS Task Group on Access to and Advertising of Alcoholic Beverages in NDPHS Area (ALC-POL) Draft 110310
  • GOAL 9: "Tobacco use and exposure to tobacco smoke is prevented and reduced in the ND area" - related Terms of Reference for NDPHS Task Group on Tobacco Control in NDPHS Area (TOB-Contr.) Draft 220310
  • GOAL 10: "The NDPHS Strategy on Health at Work is implemented in the ND area" - related
  • Terms of Reference for NDPHS Task Group on Occupational Safety and Health (OSH) Draft-rev1 180310
  • GOAL 11: "Public health and social well-being among indigenous peoples in the ND area is improved" - related Terms of Reference for NDPHS Task Group on Indigenous Mental Health, Addictions and Parenting (IMHAP) - Draft 080310

He emphasized that it is crucial that each Task Group just as Expert Group must have explicitly nominated Lead Partner and Co-Lead Partner.Nomination of EG and TG member/representative need to become much more regulated and supported. They also need to have an alternate-member/representative system.

The subgroups were tasked to elaborate on the presented draft ToRs of their field of expertise, but it is to be remembered that the final ToR documents are to be submitted to the CSR by the Lead Partner of each planned Expert or Task Group (next opportunity 19-20/4 in Moscow[5]).

The participants were informed that this time the subgroups ADO and ALC would work together during the subgroup day 25 March (e.g. to work on the ToRs for the TGs related to goals 7 and 8).

The SIHLWA Expert Group new Terms of Reference would be discussed as a separate agenda item in the morning plenary of 26 March.

5. Flagship Project Alcohol & Drug Prevention among Youth: From Idea to reality

The topic was presented by Maria Renström (Swedish Ministry of Health and Social Affairs), HåkanLeifman (STAD) and Matilda Hellmann (Nordic Centre for Welfare and Social Issues,NVC).