Committee of Senior Representatives (CSR)

Twenty-fifth Meeting

Stockholm, Sweden

21-22 October 2015

Title / Minutes from the 25th 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 25th meeting of the CSR
Annexes / Annex 1 – Generic Expert Group’s Terms of Reference
Annex 2 – Individual Expert Groups’ Terms of Reference
Annex 3 – NDPHS Work Plan for 2016
Annex 4 - Definition of various types of projects vis-à-vis which the NDPHS plays a role
Annex 5 – NDPHS procedure for issuing letters of support to projects applying for Interreg Baltic Sea Region Programme 2014-2020
Annex 6 – NDPHS criteria and procedure for issuing letters of support for Policy Area Health project applications for submission to the EUSBSR Seed Money Facility
Annex 7 – List of participants
Annex 8 – List of documents submitted to the meeting

1. Opening of the meeting and welcome

The meeting was opened and chaired by Ms. Dagmar Reitenbach, the NDPHS Chair Country Representative, the Federal Ministry of Health of Germany.

Ms. AgnetaKarlsson, State Secretary to the Minister for Health Care, Public Health and Sport, Sweden, who welcomed the participants on behalf of Sweden, stressed that,whereasthe overall healthcare in the Northern Dimension area is good and many areas are improving, the inequity within different groups in society and between and within the cities is growing. The equity of healthcare, which is an important issue for the Swedish government, does not only concern health itself, but also other areas such as education, city planning and environment. Reaching this equity in the long run requires patient-centeredness and treating everybody as an individual. However, equity does not concern treatment, but also the prevention of diseases, which again is an issue that is not just for the healthcare system to deal with. The primary care system needs to be strengthened, for which, for example, knowledge-based IT technology can be helpful with which patients can monitor their own health.

Further, she emphasized that a global commitment to combat AMR is needed, for example by supporting and implementing the WHO global action plan and by creating knowledge by systematically collecting data from local, regional and global surveillance programmes. The NDPHS can substantially contribute to this important task. She wished the Partnership a lot of success with implementing the new Strategy and Action Plan with the newly established Expert Groups.

2. Adoption of the agenda

The Chair proposed to discuss agenda item 9.2 as the first item on the second day of the meeting after the welcome by the Swedish State Secretary, due to the AMR TG Chair’s availability.

The Meeting adopted the Provisional agenda with timetable (cf. document CSR 25/2/1) with the requested change included.

3. Information by the NDPHS Chairmanship and the NDPHS Secretariat

While recalling that the NDPHS Strategy 2020 and its accompanying Action Plan have been adopted, Germanythanked all those involved for their constructive work.

The Secretariat informed that the 23rd Meeting of the Northern Dimension Steering Group on 28May 2015 in Brussels, Belgium, confirmed the formalization of the observer status of Belarus by amending paragraph 8 of the ND Policy Framework document to read: "The Northern Dimension Policy includes Belarus as an observer. This was granted by the Northern Dimension partners in the context of the second Northern Dimension Ministerial Meeting, which was held in Oslo on 2 November 2010. Belarus is invited to participate fully in all Northern Dimension partnerships and any other practical Northern Dimension cooperation in accordance with their rules and practices".

The Meeting took note of the presented information, encouraged all Expert Groups to involve Belarusian partners whenever possible and mandated the Secretariat to senda diplomatic note withthe Chair Country’s letterto the Belarusian Ministry of Foreign Affairs informing that Belarusian experts are welcome to participate fully in the NDPHS, also including meetings of the NDPHS Expert Groups.

With reference to document CSR 25/3/Info 1, the Secretariat informed about the successful completion of the Secretariat-led project “Building capacity in prevention of HIV and associated infections among youth at high risk in the Northern Dimension Area” and thanked the EU for its co-financing and all Project Partners for their engagement and support. The HIV/AIDS & AI EG ITA summarized the main activities implemented within the project and emphasized that the project concluded that there is a big need for prevention work among the target group, children and youth at high risk of getting HIV and associated infections. She further thanked the Secretariat for its very accurate and goodmanagement of the project.

Russiastated that the project was not formally supported by the CSR and Russia has stated several times that all Russian experts providing data for any NDPHS project must be verified by the Ministry of Health and it was not the case in this project. The data provided within the project does not correspond to the official data.

The Meeting agreed to postpone theissue raised by Russia until agenda item 7.

Further, the Secretariat informed about the state of affairs of the Secretariat-led EU co-financed project “Northern Dimension Antibiotic Resistance Study (NoDARS)”, for which the first year of the implementation has justbeen completed. Further, with reference to document CSR 25/3/Info 3, itinformed about the progress in the implementation of the “PA Health Support” projectIt highlighted that many of the planned activities have already been successfully implemented. For example, the NDPHS side-event to the 24th Baltic Sea Parliamentary Conference (BSPC) featuring the topic “Health is wealth and wealth is health” has received very positive feedback from the participating parliamentarians and the conclusions from the side-event were reflected in the BSPC resolution (cf. document CSR 25/3/Info3). Further, the speech of the Parliamentary State Secretary to the Federal Minister of Health of Germany, Ms. Annette Widmann-Mauz[1] during the BSPC increased the partnership’s visibility. The Secretariat thanked the EU for the financial support provided for the previously mentioned three projects led by the Secretariat.

The Meeting took note of the presented information.

Finally, the Secretariat informed that in casethe Partnership would like to receive funding from the ENI Regional East Programmenext year, it would need to make an assessment of the work done so far with financial support from the Programme and agree on priority areas that could be subject to the EU’s support.

Russia noted that before giving its approval, it would need to know the conditions for this kind of financial support.

The Meeting mandated the Secretariat to (i) carry out such an assessment in cooperation with the respective Expert Groups and to present it to the CSR (ii) approach all NDPHS Expert Groups for their possible proposals regarding priority (project) ideas to be compiled by the Secretariat into one paper by the end of January, which wouldbe submitted to the CSR for endorsement, before being sent to the European Commission.

4. Information by the NDPHS Partners

WHO Europe informed about the outcomes of the recently held Regional Committee meeting in September 2015, which focused on the work on inter-sectorial actions, which is part of the implementation of Health 2020. WHO also presented and adopted a new vision on strengthening people-centeredness, which fits well to the NDPHS Strategy. In addition, several action plans have been adopted. Further, Heads of States of all UN Members States have adopted 17 Sustainable Development Goals, of which one is focusing explicitly on health and manyothers are linked to health and its social determinants.

Sweden informed that within the framework of the Barents Euro-Arctic Council the BEAC Working Group on Health and Related Social Issues is currently chaired by the Murmansk region and Sweden. A new framework for collaboration covering the period 2016-2019 was adopted at a recent meeting in Lulea, which sets communicable diseases (as Tuberculosis, HIV/AIDS),non-communicable diseasesand targeting vulnerable children and youth as the top three thematic programmes of the group’s work in the future.

Estoniainformedthat Ms. Liis Roovälihadleft the Ministry of Social Affairs and Mr. Jürgen Ojalohadtakenover her NDPHS-related duties.

Russia informed that after structural changes within Russia as well as the European Union, the development of joint priorities of the EUSBSR Action Plan and the Strategy for the socio-economic development of the North-West Federal District of the Russian Federation for the period until 2020is continuing to develop possibilities for future cooperation. Furthermore, the Strategy for the socio-economic development of the North-West Federal District of the Russian Federation for the period until 2020 is currently being reviewed.

The Meeting took note of the presented information.

5. Future NDPHS expert-level structures

5.1 Generic Expert Group Terms of Reference

With reference to document CSR 25/5.1/1, the EGTOR 2015 Chairintroduced the draft generic Expert Group Terms of Reference (ToR) and thanked the members of the EGTOR for their productive participation. He briefly summarized the development process and stressed that according to the current proposal there will be no distinction between Expert and Task Groups any more. He emphasized that after the adoption of the generic and individual Terms of Reference, the newly established Expert Groups wouldstill have apossibility to review their own ToR and approach the CSR with requests for amendments to be approvedthrough a silent procedure.

Germany highlighted the importance of finalizing the necessary steps during the meeting to be able to present the establishedexpert level structures to the ministers during PAC 11.

Norway suggested adding the words “if possible” on page 3, V. “Lead Partner and co-Lead Partner,” so that the first sentence of the second paragraph will read: “In the case that the Lead Partner or the co-Lead Partner decides to step down, prior to its resignation, it should inform the CSR of its intentions and propose a replacement, if possible.” Further, on page 5, VIII. “Coordination, Supervision and Financial Aspects,” regarding the Lead Partner’s financial responsibilities, in the last paragraph the employment costs of the Vice Chair are included. This should be deleted, since it is the Vice Chair country’s or organization’s responsibility to finance this position. The changed wording under V. and VIII.should be revised in the individual Terms of Reference, correspondingly.

The EGTOR 2015 Chair clarified that all changes made to the generic Terms of Reference will also automatically be included in the Individual Terms of Reference.

Russia asked for item III. “Aims and functions” to be changed to allow for Expert Groups that are chaired by Russia to have English and Russian as official languages.

Having thoroughly discussed the issue, the Meeting agreed on the following wording:

“The official language of the Expert Group is English.

If Russia is the Lead Partner of the Expert Group, the official languages are English and Russian. Such meetings are conducted in English, documents are provided in both languages. Related costs for translation and interpretation, if necessary, are covered by the Russian Federation.”

The Meeting thanked Estonia for leading the EGTOR work and approved the generic Terms of Reference, with the amendments requested by Norway and Russia included (cf. Annex 1 to the Meeting minutes).

5.2 Establishment of the NDPHS expert-level structures and adoption of their individual Terms of Reference

With reference to document CSR 25/5.2/1, the Partners announced/confirmed their readiness to lead and co-lead future NDPHS Expert Groups:

Finland confirmed its readiness to lead theExpert Group on HIV, AIDS and Associated Infections and an Expert Group on Occupational Safety and Health.

Poland announced its readiness to co-Chair the Expert Group on HIV, AIDS and Associated Infections.

Russia confirmed its readiness to lead theExpert Group on Non-communicable Diseases and theExpert Group on Primary Healthcare.

Norway confirmed its readiness to lead theExpert Group on Alcohol and Substance Abuse.

Germany confirmed its readiness to lead theExpert Group on Prison Health.

Sweden confirmed its readiness to lead theExpert Group on Antimicrobial Resistance and to co-lead an Expert Group on Primary Healthcare.

Latvia announced its readiness to co-Chair the Expert Group on Prison Health.

Germany thanked Latvia for its commitment and announced its readiness to co-Chair the Expert Group on Antimicrobial Resistance.

The Chair thanked all Partner Countries for their commitment and noted that the OSH, ASA and NCD Expert Groups still neededa co-Chair.

The Meeting took noteof the announcements and confirmationswith appreciation and established the following NDPHS Expert Groups:

  • Expert Group on Antimicrobial Resistance (AMR EG);
  • Expert Group on Alcohol and Substance Abuse (ASA EG);
  • Expert Group on HIV, AIDS and Associated Infections (HIV, AIDS&AI EG);
  • Expert Group on Non-communicable Diseases (NCD EG);
  • Expert Group on Occupational Safety and Health (OSH EG);
  • Expert Group on Prison Health (PH EG);
  • Expert Group on Primary Healthcare (PHC EG).

Further, with reference to document CSR 25/5.2/2, the EGTOR 2015 Chair introduced the Terms of Reference for the individual NDPHS Expert Groups.He asked the Secretariat to insert the new information about co-Chair countries in the respective documents. Further, he introduced a proposal of the HIV/AIDS&AI EG to rename the group to “Expert Group on HIV, TB and Associated Infections” to make the title more in line with the Action Plan.

Sweden announced that Russia and Sweden have agreed on the name “Expert Group on Primary Healthcare”.

Germany announced that it agreed on the name “Expert Group on Prison Health”.

Following a remark from the NCD EG Chair regarding the overlapping of several objectives, the EGTOR 2015 Chair highlighted that the Expert Groups are welcome to include more than the currently listed objectives in their ToR and,in casemore than one group works on one issue, they should cooperate to avoid overlapping.

Russia and Germany supported this idea.

The ASA EG Chair stressed the importance of the EG Chairs & ITAs meetings, which should be used not only to discuss administrative issues, but also to exchange views about health issues. This is a necessity to achieve the planned results.

Having thoroughly discussed the issue, the Meeting;

  • Agreed to change the name of the EG on HIV/AIDS & AI to EG on HIV, TB and Associated Infections (EG HIV,TB & AI);
  • Agreed on the model ofthe individual Terms of Reference for the groups, with the revisions agreed in the generic Terms of Reference included in all individual Terms of Reference (cf. Annex 2 to the Meeting minutes);
  • Invited the Expert Groups to discusstheir individual Terms of Reference during their first meetings and submit their proposedrevisions concerning their ownTerms of Reference through the Secretariat to the CSR for final adoptionthrough a written silent procedure.

5.3 Other matters

The Chairrequested the Partners to nominate experts to the newly established groups and suggested that the Secretariat wouldsend a letter with a formal request to the Partners to nominate their experts within two weeks.

Sweden and Finland voiced their concerns that this time might be too short.

The Meeting mandated the Secretariat to send a letter with a formal request to the Partners to nominate their experts as soon as possible.

6. NDPHS Work Plan for 2016

The Secretariat introduceda proposed NDPHS Work Plan for 2016 (submitted as document CSR 25/6/1) and drew the Meeting’s attention to the fact that the individual work plans of the Expert Groups were not included since during this transitional year the groups were not in a position to develop them. However, Action Line 1, specific action 1.1 foresees that the Expert Groups woulddevelop work plans and discuss and adopt them during their first meetings and, finally, submit these plansto the CSR meeting in spring 2016. The Secretariat also noted that the Chair Country raised this proposal during the 19th EG Chair and ITAs meeting and there had beenno objections voiced against this idea.

Further, the Secretariat drew the Meeting’s attention to the fact that Action lines 1 and 2 contain references to three documents to be discussed during the CSR 25 meeting. If revisions weremade in those documents, they wouldalso be includedin the Work Plan.

Finally, the Secretariat encouraged the Expert Groups to update their sections of the NDPHS website, since some of them were last updated a very long time ago and contained references to, e.g. work plans from 2010, and, therefore, urgently requiredupdating/revision.