1
Conference on Health in the Mediterranean Italian Presidency of the Council of the European Union
Rome
Ministry of Health Conference Centre
27-28 October 2014
2
DAY 1
9,30-13,30
Welcoming and Introduction
Daniela Rodorigo, Italian Ministry of Health (MoH)
John Ryan, Directorate General for Health and Consumers (DG SANCO)
Enrico Granara, Italian Ministry of Foreign Affairs (MoFA)
Agis Tsouros, World Health Organization (WHO) EURO
Foad Aodi, Associazione medici di origine straniera in Italia (AMSI)
Session 1
Presentation of the Mediterranean Projects in the field of Public Health
promoted and funded by the Italian MoH
Introduced and Moderated by Pasqualino Rossi, Italian MoH
Presentation by project leaders
Nereo Segnan, A.O. Città della Salute e della Scienza TO: NCDs (Non
Communicable Diseases) Projects
Silvia Declich, Istituto Superiore di Sanità – CNESPS: CDs (Communicable
Diseases) Projects
Alessandro Nanni Costa, Centro Nazionale Trapianti / Marwan Masri of Lebanon
MTN:
The MTN (Mediterranean Transplant Network) Project
Marina Bagni, Italian Ministry of Health FORE-Med: Animal Health Research Foresight for the Mediterranean
Stefano Cinotti, Istituto Zooprofilattico Sperimentale della Lombardia e dell’Emilia
Romagna: Cooperation Italy – Libya: Technical assistance and capacity building to
diagnostic and surveillance programme on FMD control.
Georges Saliba, Union for the Mediterranean(UfM) / Andreas Ullrich, World
Health Organization, Geneva: UfM Mediterranean Projects: the way forward
Giancarlo Belluzzi, Italian MoH: Participation of the neighborhood countries in
EFSA and Member states project
~
Coffee break
3
Session 2
International Health Regulations
Introduced and Moderated by: Ranieri Guerra, Italian MoH
Presentation of main issues
Paola Testori Coggi, DG SANCO: EU action on IHR – Decision 1082 /2013:
intersectoral cooperation, link with international cooperation including GHSA
agenda
Implementation of the International Health Regulations (2005): opportunities
and challenges in putting strategies into practice
Daniel Lins Menucci, WHO Headquarter/Lyons: Perspectives from the European
Region of WHO
Jaouad Mahjour, WHO Eastern Mediterranean Region: Perspectives from
the Eastern Mediterranean Region of WHO
Implementation of the IHR (2005)
Michael Gdalevich, Israel MoH: Criticalities and solutions - 1
Silvia Bino, AL Focal point: Criticalities and solutions - 2
Loredana Vellucci, Italian MoH: The Italian experience
Maria Grazia Dente, ISS: Fostering IHR implementation: the contribution of the
EPISOUTH and CELESTE studies
General discussion
Conclusions
Rapporteur: Giuseppe Ruocco, Italian MoH
4
Session 3
Antimicrobial Resistance
Introduced and moderated by: Athanassios Tsakris, University of Athens
Presentation of main issues
John F. Ryan, DG SANCO: Key Issues and presentation of the AMR Action Plan at
UE level (including AMR/HAI)
Jaouad Mahjour, WHO EMRO: The issue of AMR in the EMRO Region
Danilo Lo Fo Wong, WHO EURO: The WHO European action plan on AMR
Nicola Petrosillo, Istituto Nazionale per le Malattie Infettive Lazzaro Spallanzani:
Italian initiatives against AMR
Antonio Battisti, Head Animal Health Diagnostic Unit - National Reference
Laboratory for Antimicrobial Resistance: The “One health” approach: the veterinary
perspective
Maria Luisa Moro, Agenzia Sanitaria e Sociale Regionale Emilia-Romagna
“Cooperating to fight antimicrobial resistance”
Discussion
Michael Borg, Department of Infection Prevention & Control, Mater Dei
Hospital, Malta
Murat Akova, European Society of Clinical Microbiology and Infectious Diseases
(ESCMID), Hacettepe University, Department of Infectious Disease, Ankara
Mario Poljak, University of Ljubljana, SLO
Marina Bagni, Italian MoH
Conclusions
Rapporteur: Marc Sprenger, European Centre for Disease Prevention and Control
(ECDC)
~
13,30 - 14,30 Lunch
5
14,30-16,00
Session 4
Lifestyles
Introduced and moderated by: Egita Pole, Latvian MoH
Presentation of main issues
Gauden Galea, Division of Non communicable Diseases and Life-course at WHO-
EURO: Common nutrition challenges for the Mediterranean region
John F. Ryan, DG SANCO: The EU approach(es) to Nutrition and the
Mediterranean region
Franco Sassi, Organisation for Economic Co-operation and Development (OECD):
The economic burden of NCD in the Mediterranean Region
Daniela Galeone, Italian MoH: The Italian Experience – Guadagnare salute/PNP
Discussion
Jafaar Heikel, International University of Casablanca,
Riccardo Lampariello, Global Education and Training Initiative (GETI) Union for
International Cancer Control (UICC)
Giuseppe Gorini, Istituto per lo studio e la prevenzione oncologica di Firenze (ISPO)
Other discussant
Conclusions
Rapporteur: Roberto Bertollini, WHO Representative to the European Union
~
Coffee break
6
16,00- 18,00
Session 5
Health and Migration
Introduced and moderated by Karoline Fernandez de la Hoz, General Secretariat for
Health & Consumers Spanish Ministry of Health, Social Services and Equity
Presentation of main issues
Santino Severoni, WHO EURO: Public Health Aspects of Migration in the WHO
European Region: Strengthening the health sector capacity to manage large influxes of
migrants.
Marc Sprenger, ECDC: Migrant health and key infectious diseases in the EU/EEA:
Key issues
Isabel de la Mata, DG SANCO: Migrants and health in the EU
Ranieri Guerra, Italian MoH: The Italian response: “Mare Nostrum” and other
Initiatives
Francesco Bongiorno, Sicilia Region: Preparedness and response at local level
Concetta Mirisola, Italian National Institute for Health, Migration and Poverty
(NIHMP)
Davide Mosca, International Organization for Migration (IOM) Geneva: Logistics
and assistance. The needs for migrants
Jenny Kremastinou, Hellenic Center for Disease Control & Prevention: The Greek
experience
Stefano Campostrini, University Ca' Foscari Venice: Health promotion and migrants'
health: some thoughts from the italian system passi
Discussion
Beatriz Padilla, University of Minho, Portugal
Pierre Verbeeren, Doctors of the World Belgium
Ursula Trummer, Center for Health and Migration
Conclusions
Rapporteur: Aldo Morrone, IFO
7
DAY 2
Moderated by: Paolo Russo (La Stampa)
10,00- 13,00
Welcoming and Introduction
Beatrice Lorenzin, Italian MoH
Tonio Borg, DG SANCO
Szuzanna Jakab, WHO EURO
Ala Alwan, WHO EMRO
Fathallah Sijilmassi, UfM
Roundtable 1
International Health Regulation
Introduction and opening statement Italian Minister of Health
Presentation of highlights
Rapporteur Giuseppe Ruocco
Discussion Ministers/Heads of Delegations
Conclusions
Italian Minister of Health
~
Coffee break
8
Roundtable 2
Health and Migration
Introduction and opening statement Italian Minister of Health
Presentation of highlights
Rapporteur Aldo Morrone
Discussion Ministers/Heads of Delegations
Conclusions
Italian Minister of Health
~
13,00 - 14,00 Lunch
14,00- 17,00
Roundtable 3
Lifestyles
Introduction and opening statement Italian Minister of Health / Moderator: Ala Alwan
Presentation of highlights
Rapporteur Roberto Bertollini
Discussion Ministers/Heads of Delegations
Conclusions
Italian Minister of Health
~
Coffee break
9
Roundtable 4
Antimicrobial Resistance
Introduction and opening statement Italian Minister of Health
Presentation of highlights
Rapporteur Marc Sprenger
Discussion Ministers/Heads of Delegations
Conclusions
Italian Minister of Health
Closing remarks and presentation of the outcomes by the Italian Minister of
Health
10
WHO IS WHO
Akova Murat, President ESCMID - Professor of Medicine Hacettepe University School of Medicine
Department of Infectious Disease, Turkey
Aodi Foad, President of Amsi (Associazione medici di Origine straniera in Italia dal 1999), Italy
Bagni Marina, General Secretariat, European Research coordination of the IZS (Istituti Zooprofilattici
Sperimentali) network, MoH, Italy
Battisti Antonio, Head Animal Health Diagnostic Unit - National Reference Laboratory for
Antimicrobial Resistance, Italy
Belluzzi Giancarlo, Head of UVAC Emilia Romagna, MoH, Italy
Bertollini Roberto, Chief Scientist and WHO Representative to the European Union, WHO
Bino Silvia, Head of Control of Infectious Diseases Department, Institute of Public Health, Albania
Bongiorno Francesco, Officer Director, Regione Sicilia, Italy
Borg Michael, Head of Department of Infection Prevention & Control, Mater Dei, Malta
Campostrini Stefano, Professor of Social Statistics Dean of the Ca' Foscari Graduate School,
University Ca' Foscari, Italy
Cinotti Stefano, Director General, IZSLER, Italy
De la Mata Isabel, Principal Adviser for Public Health, DG SANCO, EC
Declich Silvia, Head of Epidemiology of Communicable Diseases Unit, National Centre for
Epidemiology, Surveillance and Health Promotion Istituto Superiore di Sanità, Italy
Dente Maria Grazia, Senior researcher, Epidemiology of Communicable Diseases Unit, National
Centre for Epidemiology, Surveillance and Health Promotion, Istituto Superiore di Sanità, Italy
Fernandez de la Hoz Karoline, Manager of the International Technical Coordination Unit of the
General Secretariat for health & consumers, MoH, Spain
Galea Gauden, Director of the Division of Non communicable Diseases and Life-course, WHO EURO
Galeone Daniela, Head of Unit 2 – Planning and Control, Secretariat General, MoH, Italy
Gdalevich Michael, MD, MPH, MoH, Israel
Gorini Giuseppe, Chief of Hygiene, Epidemiology and Health Department, ISPO, Italy
Granara Enrico, Min.Pl. Coordinator for Euro-Mediterranean multilateral activities, MFA, Italy
Guerra Ranieri, Director General, MoH, Italy
Heikel Jafaar, Professor of medicine, International University of Casablanca, Morocco
Kremastinou Jenny, President, Hellenic HCDC
11
Lampariello Riccardo, Head of GETI and UICC, Switzerland
Lo Fo Wong Danilo, Senior adviser, AMR Control of Antimicrobial Resistance, WHO/Copenhagen
Mahjour Jaouad, Director Programme Management, WHO Office for the Eastern Mediterranean,
WHO
Masri Marwan, President, MTN, Lebanon
Menucci Daniel Lins, Technical Officer, IHR Capacity Assessment, Development & Maintenance,
WHO/Headquarters/Lyons
Mirisola Concetta, Director General, NIHMP, Italy
Moro Maria Luisa, Head of Infective Risk Area, Agenzia Sanitaria e Sociale Regionale Emilia-
Romagna, Italy
Morrone Aldo, Director, Dept. For Tropical Dermatology, Istituto S. Gallicano Roma
Mosca Davide, Director Health Division IOM, Geneva,
Nanni Costa Alessandro, Director General of Centro Nazionale Trapianti, Italy
Padilla Beatriz, Professor of the University of Minho, Portugal
Petrosillo Nicola, Chief of the Department of Infectious Diseases , INMI, Italy
Pole Egita, Under-Secretary of State for Health, MoH, Latvia
Poljak Mario, Professor of Microbiology Institute of Microbiology and Immunology, Faculty of
Medicine, University of Ljubljana, Slovenia
Rodorigo Daniela, Director General, MoH, Italy
Rossi Pasqualino, Head of Unit 4 – Relations with EU, CoE and OECD, Directorate General for
Communication and European and International Relations, MoH, Italy
Ruocco Giuseppe, Director General, MoH, Italy
Ryan John F., Director for Public Health, DG SANCO, EC
Saliba George, Ambassador, Secretary General of the Union for the Mediterranean, UfM
Sassi Franco, Senior Health Economist, Health Division, Directorate for Employment, Labour and
Social Affairs, OECD
Segnan Nereo, Director of Department “Interaz. Prevenzione Secondaria dei Tumori”, Azienda
Ospedaliera Città della Salute e della Scienza, Italy
Severoni Santino, Coordinator Public Health and Migration at WHO Regional Office for Europe,
Sprenger Marc, Director of ECDC, Sweden
Testori Coggi Paola, Director General in the Direct orate-General for Health and Consumers, DG
SANCO, EC
Trummer Ursula, Director of Center for Health and Migration, Austria
12
Tsakris Athanassios, Professor of Clinical Microbiology at the University of Athens, Medical School
Tsouros Agis, Director of the Division of Policy and Governance for Health and Well-being, WHO
EURO
Ullrich Andras, Medical Officer Cancer Control, Department of Chronic Diseases and Health
Promotion, WHO Headquarter, Geneva
Vellucci Loredana, Head of Unit 3- USMAF Coordination Office, DG for Health Prevention, MoH,
Italy
Verbeeren Pierre, General Director of Doctors of the World, Belgium
13
www.italia2014.eu
Directorate-general of communication and of European and International Relations
www.salute.gov.it
Communicable Diseases Projects in theCommunicable Diseases Projects in the Mediterranean Region
in the field of PH promoted and funded by the Italian MoH
Silvia DeclichSCommunicable Diseases Epidemiology Unit
National Center for Epidemiology, Surveillance and Health PromotionIstituto Superiore di SanitàIstituto Superiore di Sanità
Conference on Health in the MediterraneanItalian Presidency of the Council of the European UnionItalian Presidency of the Council of the European UnionRome, 27-28 October 2014
The support of the Italian MoH to CDThe support of the Italian MoH to CD projects in the Mediterranean Region
EuropeanProject
Aim Italian MoHProject
EpiSouth Network of Epidemiologists for communicable diseases EPIMEDp(2006‐10)
p gcontrol in the Mediterranean
EpiSouth Plus
Networks of Epidemiologists and Laboratories for strengthening the preparedness to common PH threats in
EpiSouthPlus(2010‐14)
strengthening the preparedness to common PH threats in the Mediterranean
Medilab‐ Establishment of a Network of laboratories (Human and l l d l l ) d hsecure
(2014‐17)Animal virology, Medical entomology) and strengthening the Episouth epidemiology network to increase the health security in the Mediterranean
MedPreMIER
MOMIH (2014‐15) Monitoring Migrant Health and Infectious Diseases
EPISOUTH & EPIMED Projects (2006-2010)The Project’s aim was to create a framework of collaboration on The Project s aim was to create a framework of collaboration on epidemiological issues in order to improve communicable diseases surveillance, communications and training
The network worked four years focussing on:Cross-border epidemic intelligenceV i t bl di d i tVaccine preventable diseases and migrantsCross-border emerging zoonosesTraining in field/applied epidemiology
Co-funded by the EU DG-SANCO, with the support of the Italian Ministry of Health, which was essential for the participation of non UE countriesnon-UE countries
From an European project…
9 EU countries at the Project starting (October 2006)
… with the support of the Italian MoH…
Countries as per August 2007
to a Mediterranean Network
27 countries as per June 2010
… to a Mediterranean Network
27 countries as per June 2010 (9 EU countries, 17 non-EU countries and 1 acceding country)
The enlargement implied i d i iprogressive adaptation in
terms of management and coordination strategies to allow concrete participation of all Countries
L L t (2006 2010)Lessons Learnt (2006-2010)
The approach based on expectations and regional needs has facilitated countries’ interest in participationparticipation
The governance model adopted has enhanced co-hi f ti i t C t iownership of participant Countries
The presence of international institutions (ECDC, EC, WHO-EURO, WHO-EMRO, WHO-HQ) has allowed sharing views while avoiding overlapping
Add d V l (2006 2010)Added Values (2006-2010)
The Network:The Network:- raised awareness on regional and countries cross-
b d iborder issues
- succeeded in creating trust, cohesion and concrete collaboration among PH officers of 27 countries in the Mediterranean region and South-East Europe
- filled a geographical area with common public health problems that is not addressed, as a whole, neither by the European Union nor by WHO
More details are available at
EpiSouth Activities (2006-2010)
More details are available at www.episouth.org
Th C t i d th d t hift N t k’
EpiSouth Plus (2010-2014)
The Countries expressed the need to shift Network’s activities to a wider approach, building on the knowledge and the regional gaps and needs identified g g g pin the 1st phase
General Objectivejto increase the health security in the Mediterranean area and South-East Europe by enhancing and p y gstrengthening the preparedness to common health threats and bio-security risks at national and regional levels in the countries of EpiSouth Network in the framework of the IHR implementation
EpiSouth Plus (2010-2014)
E t bli hi M dit R i l
EpiSouth Plus (2010-2014)
● Establishing a Mediterranean Regional Laboratories Network to facilitate common threats d t tidetection
● Promoting common procedures in Generic Preparedness and Risk Management Plans
● Enhancing Early Warning Systems and cross-g y g yborder Epidemic Intelligence
● Facilitating IHR implementation● Facilitating IHR implementation
12
The new phase of the network activities called “EpiSouth
EpiSouth Plus (2010-2014)
The new phase of the network activities called EpiSouthPlus” has been
- led by the Italian ISS and implemented by 27 countries’ led by the Italian ISS and implemented by 27 countries public institutions (MOH & PHI & National Lab)- funded by a partnership from:funded by a partnership from:● European Union DG-SANCO/EAHC● European Union DG-DEVCO/EuropeAidp / p● Italian Ministry of Health● and ECDC● together with the national partner Institutions (public officials)
EU Partners in EpiSouth Plus1. ITALY● Institute of Health Rome;
4. BULGARIA (National Center of Infectious and Parasitic
EU Partners in EpiSouth Plus
● Institute of Health, Rome; ● Local Health Unit, Turin; ● General Hospital, Padua; ● National Institute of
Infectious and Parasitic Diseases, Sofia);
5. CROATIA (Institute of Public Health) as acceding country● National Institute of
Infectious Diseases, Rome;● CINECA, Bologna;2. FRANCE
Health) as acceding country6. CYPRUS (Ministry of Health,
Nicosia);7. GREECE (Hellenic Centre for
● Institute Pasteur, Paris; ● Institut de Veille Sanitaire,
Saint Maurice Cedex
(Disease Control and Prevention, Athens);
8. MALTA (Ministry of Health, 3. SPAIN (Istituto de Salud
Carlos III, Madrid);Valletta);
9. ROMANIA (Institute of PH, Bucharest);
10.SLOVENIA (Institute of Public Health, Ljubljana);
Non-EU Partners in EpiSouth Plus1. ALBANIA, Tirana (Institute of Public
Health);2 ALGERIA Al (N ti l I tit t f
9. LEBANON, Beirut (Ministry of Public Health);
Non EU Partners in EpiSouth Plus
2. ALGERIA, Alger (National Institute of Public Health);
3. BOSNIA & HERZEGOVINA (Ministry of Civil Affairs, Sarajevo; Ministry of Health
10. LIBYA, Tripoli (Infectious Diseases Department Tripoli Central Hospital)
11.MONTENEGRO, Podgorica (Institute of Public Health);
and Social Welfare, Banja Luka, Republic of Srpska; Public Health Institute, Mostar, Federation of B&H);
4. EGYPT, Cairo (Ministry of Health and
);12.MOROCCO, Rabat (Ministry of Health);13. PALESTINE, Ramallah (Ministry of
Health);14 SERBIA Belgrade (Institute of Public 4. EGYPT, Cairo (Ministry of Health and
Population);5. FYROM–Former Yugoslav Republic of
Macedonia, Skopje (Institute for Health Protection; Clinic of Infectious Diseases);
14.SERBIA, Belgrade (Institute of Public Health);
15.SYRIA, Damascus (Ministry of Health);16.TUNISIA, Tunis (Ministry of Health);17 TURKEY Ankara (Ministry of Health; Protection; Clinic of Infectious Diseases);
6. ISRAEL (Center for Disease Control, Tel Hashomer; Ministry of Health, Jerusalem);
7 JORDAN A (Mi i t f H lth)
17.TURKEY, Ankara (Ministry of Health; Refik Saydam National Hygiene Center);
18.MECIDS-Middle East Consortium on 7. JORDAN, Amman (Ministry of Health);8. KOSOVO UNSCR 1244, Prishtina
(National Institute of Public Health);
Infectious Disease Surveillance;19.WHO-IHR International Health
Regulations Coordination, Lyon, France
Collaborating Institutions in EpiSouth Plus
1. ECDC-European Centre for Disease Prevention and Control, Stockholm,
Collaborating Institutions in EpiSouth Plus
Sweden;
2. EUROPEAN UNION DG SANCO Public Health Directorate, Luxembourg;
3 EUROPEAN AGENCY FOR HEALTH AND CONSUMERS L b3. EUROPEAN AGENCY FOR HEALTH AND CONSUMERS, Luxembourg;
4. EUROPEAN UNION EuropeAid, Brussels, Belgium;
5 MOH Mi i t f H lth R It l5. MOH-Ministry of Health, Rome, Italy;
6. WHO–EMRO Regional Office for Eastern Mediterranean, Cairo, Egypt;
7 WHO EURO Regional Office for Europe Copenhagen Denmark;7. WHO-EURO Regional Office for Europe, Copenhagen, Denmark;
8. SHIPSAN- Ship sanitation project
9 SEEHN- South East Europe Health network9. SEEHN- South East Europe Health network
www. Episouthnetwork.org
in english in french in french in arabic
For more information:For more information:Dissemination TeamTel: +39 06 49904266Fax: +39 06 49904267E-mail: [email protected]
EpiSouth Plus ProjectEpiSouth Plus ProjectEuropean Health Award 2014 Winner 2014 Winner
● “The project is of particular importance for strengthening preparedness to health threats, health security and bio-preparedness to health threats, health security and biosecurity, also outside the EU“, EHFG President Prof Helmut Brand said in his praise of the project.
● “The achievements of EpiSouthPlus are an eloquent example that in the field of public health, cross-border cooperation is not just useful but in many cases such as these simplynot just useful but in many cases such as these, simply indispensable.”
After January 2014After January 2014After January 2014… After January 2014… good sustainability of the Networkgood sustainability of the Network
“EpiSouth is the biggest inter-country collaborative effort for health threats control in collaborative effort for health threats control in the Mediterranean region” (DEVCO evaluation) EPIS f E iS th ( l t h i l tf ) t● EPIS for EpiSouth (secure alert sharing platform) at ECDC
● MediEPIET (coordinated by ECDC, funded by DG DEVCO, managed by Spanish cooperation and ISCIII)
● MediLabSecure for Laboratory and Epidemiology networks (coordinated by IP, funded by DG DEVCO) ( y , y )& MedPreMier (funded by MOH, coordinate by ISS)
MedPreMIER Network (2014-2015)(Rete del Mediterraneo per la Preparazione e Controllo delle Malattie
Infettive Emergenti e Riemergenti)
To strengthen the preparedness and control of emerging and re emergingcontrol of emerging and re-emerging
communicable diseases, potential public health threats in the
Mediterranean basin
MedPreMIER NetworkMedPreMIER NetworkSpecific Objective 1
To promote the exchange of the “good practice” for a f i l i i f h ill i hfunctional integration of the surveillance in the Mediterranean Region in order to strengthen the early identification and diagnosis of emerging and ri-identification and diagnosis of emerging and ri-emerging pathogens
European DEVCO ProjectMediLabSecure
MEDILABSECURE MedPreMierMEDILABSECURE MedPreMier
WP5 PH ISS/CNESPS Leadership
Synergy with MedPreMier
MedPreMIER NetworkMedPreMIER NetworkActivities 1
Identification and exchange of “success i ” i h f h i i f hstories” in the context of the integration of the
surveillance between Human and Animal virology Medical entomology and the nationalvirology, Medical entomology and the national infectious diseases surveillance system in the Mediterranean Region.g
MedPreMIER NetworkMedPreMIER NetworkSpecific Objective 2
Monitoring Migrant Health and Infectious Diseases in the Mediterranean Region among the Countries involved theMediterranean Region among the Countries involved the Episouth Network for the prevention and monitoring of potential epidemic threats also in the context of complex migration emergencies
European ECDC ProjectMonitoring Migrant Health (MoMIH)Monitoring Migrant Health (MoMIH)
MoMIH MedPreMierMoMIH MedPreMier
Screening for infectious diseasesScreening for infectious diseases among newly arriving migrants in EU/EEA
Strenghtening of the Communicable Diseases surveillance among
● Screening among migrants is one possibility for monitoring migrant h lth tl i l t d i
surveillance among migrants in the Mediterranean Region
health, currently implemented in a number of countries and, Screening procedure
in non EU● to verify how the migration flows to the EU/EEA are influencing screening practices/policies at
in non EU mediterranean Countries (EpiSouth
national level is needed and relevant also for possible harmonization of screening
ti f th EU/EEA t i
( pNetwork)
Synergy with the E j tpractices of the EU/EEA countries European project
MOMIH
MedPreMIER NetworkMedPreMIER NetworkActivities 2
fEvaluation of screening procedures and practices in Episouth non-UE Countries affected by relevant
i i flmigration flows
complementing the MoMiH Survey on screening in EU/EEA just published
The projects described have contributed to the efforts of theThe projects described have contributed to the efforts of the Italian Ministry of Health towards a regional health strategyin the Mediterranean constantly promoted and discussed since the 2° EuroMed Ministerial Conference on Health (Cairo, November 2008) to the Union for the Mediterranean health Forum (Brussels June 2011) up to the currenthealth Forum (Brussels, June 2011), up to the current Ministerial Conference on Health (Rome, October 2014)
AcknowledgementsAcknowledgementsThe EpiSouth and EpiSouth-Plus projects was co-funded by the E U i DG SANCO/EAHC ( CHAFEA) d European Union DG SANCO/EAHC (now CHAFEA), and DEVCO/EuropeAid together with the participating national partner Institutions. The fin n i l ppo t of the It li n Mini t of He lth nd ECDC i l o The financial support of the Italian Ministry of Health and ECDC is also acknowledged.
The MedPremier is funded by the Italian Ministry of Health and is The MedPremier is funded by the Italian Ministry of Health and is carried on in synergy with the European Project MediLabSecure for Laboratory and Epidemiology networks ( funded by DG DEVCO and coordinate by IP for Lab and by ISS for Epi areas) and the European coordinate by IP for Lab and by ISS for Epi areas) and the European Project MOMIH ( funded by ECDC and coordinate by ISS)
The contents of this presentation are the sole responsibility of the authors and can in no way be taken to reflect the views of the European Union.
FOSTERING IHR IMPLEMENTATION AT NATIONAL AND REGIONAL LEVEL
The Contribution of the EPISOUTH AND CELESTE studies
Maria Grazia DenteCommunicable Diseases Epidemiology Unit
National Center for Epidemiology, Surveillance and Health PromotionIstituto Superiore di Sanitàp
Conference on Health in the MediterraneanItalian Presidency of the Council of theItalian Presidency of the Council of the European UnionRome, 27-28 October 2014
THE EPISOUTH PLUS National Situation Analysis (ENSA) on
coordination of surveillance between ports, airports and ground crossings – Points of Entry (PoE)- and national health systemscrossings – Points of Entry (PoE)- and national health systems
(NHS)
Communicable Diseases Epidemiology Unit Team: F Riccardo, MG Dente and S Declich
IMPLEMENTATION OF IHR IN THE MEDITERRANEANIMPLEMENTATION OF IHR IN THE MEDITERRANEAN
In order to assess the level of IHR implementation in the Mediterranean, the pquestionnaires of the WHO monitoring framework filled in 2010 by EpiSouth countries were analysed separately in an aggregated fashion.
Weaknesses such as the lack of experience and resource sharing between countries, and the lack of reports and Standard Operating Procedures (SOPs) to guide the implementation of procedures have been reported.
Major gaps have been reported in the fields of risk assessment, preparedness, risk communication, human resources, laboratory biosafety and biosecurity, and
di ti f ill b t P E d NHScoordination of surveillance between PoE and NHS
As other priorities were being already addressed it was decided to focus on coordination of surveillance between PoE and NHScoordination of surveillance between PoE and NHS.
IMPLEMENTATION OF IHR IN THE MEDITERRANEAN COUNTRIESIMPLEMENTATION OF IHR IN THE MEDITERRANEAN COUNTRIES
The “EpiSouth Plus National Situation Analysis” (ENSA), was designed to how four countries of the EpiSouth network have addressed coordination of surveillance pbetween PoE and NHS:
How the exchange of information is organized; Availability of formal procedures in place and legal constraints;Main strengths and challenges.
F. Riccardo, P. Nabeth, G. Priotto, M.G. Dente, A. Leventhal, L. Vellucci, T. F. Melillo, S. A. Saleh, A. Rguig on b h lf f th E iS th WP7 St i T Th E iS th Pl P j t Sit ti l i di ti fbehalf of the EpiSouth WP7 Steering Team. The EpiSouth Plus Project. Situation analysis on coordination of surveillance between points of entry and the national health system- Methodology Available at: http://www.episouthnetwork.org/sites/default/files/outputs/wp7_ensa_methodology.pdf
F. Riccardo, P. Nabeth, G. Priotto, MG. Dente, S. Declich. The EpiSouth Plus Project. WP7 – EpiSouth Plus Strategic Document: Coordination of epidemiological surveillance between points of entry and the national health system in the framework of the international health regulations 2005 in the EpiSouth region. Available at: http://www.episouthnetwork.org/.
The EpiSouth National situation analysisThe EpiSouth National situation analysis
ItalyParticipating for scenario 2: Large States with extensive coastlines and
PARTICIPATING COUNTRIES
strongly decentralized health systems
JordanParticipating for scenario 3: States with little or no
tlicoastlines
MaltaParticipating for scenario1: Small Morocco
coastal states and islandsParticipating for scenario 4: Large States with extensive
coastlines and centralized HS
The EpiSouth National situation analysisRecurring strengths> reccomandationsRecurring strengths> reccomandations
● Invest on a solid legal framework that is supportive to the g ppimplementation of coordinated surveillance between PoE and NHS in the framework of IHR. This framework should establish a strong link between the IHR NFP and the Competent Health Authoritieslink between the IHR NFP and the Competent Health Authorities (CHA) at PoE;
● Ensure the presence of dedicated personnel covering the function f CHA i P E Thi l h ld k ith th t i thof CHA in PoE. This personnel should work with other actors in the
PoE, in liaison with the IHR NFP;● Elaborate and update national protocols and local processes and p p p
procedures on coordination of human health surveillance between PoE and the NHS;
● Ensure through training that those protocols processes and● Ensure, through training, that those protocols, processes and procedures are known and applied consistently at central and PoElevel.
CELESTE: Study on the state of play as regards the availability of preparedness plans in the field of health in the Member
States.
Communicable Diseases Epidemiology Unit Team: MG Dente, C Rizzo, F Ri d C N li d S D li hF Riccardo, C Napoli and S Declich
Specific Contract No EAHC/2013/Health/17● Specific Contract No. EAHC/2013/Health/17
in support of the new EC Decision on serious cross-border threats to health (http://ec europa eu/health/preparedness response/policy/hsi/)(http://ec.europa.eu/health/preparedness_response/policy/hsi/).
– Purpose of the studyyTo verify the availability of plans in the area of preparedness planning in the Member States, in sectors, other than health, whose performance in the event of a crisis could impact public health.
– MethodsObservational, cross-sectional survey. yThirty-five countries were contacted for the compilation of the online questionnaire (31 EU/EEA plus 4 candidateof the online questionnaire (31 EU/EEA plus 4 candidate countries). All the national sectors mentioned in the EC Decision onAll the national sectors mentioned in the EC Decision on serious cross-border threats to health with the exclusion of Health were considered in the final Study Protocolof Health were considered in the final Study Protocol
Distribution of countries participating in the survey (in green countries that Distribution of countries participating in the survey (in green countries that responded to the survey with at least one capacity/sector and in yellow the country that give detailed information by e-mail).
Capacity/Sectors reported by respondents
25
30
35
15
20
25
%
0
5
10
…
Agric
ulture
mical Safe
ty
Protectio
n
tion Expe
rt
Energy
ironm
ental
Food
safety
matio
n and …
Othe
r
RASFF‐N
FP
Security
Transport
Veterin
ary
A
Chem Civil
Comm
unica
t
Envi F
Inform
C
- Preliminary results y● 45 completed questionnaires from 27 (77%) countries of
the 35 EU/EEA and candidate EU countries● Main sectors: Food Safety sector (30%); Veterinary
(21%); Rasff - the Rapid Alert System for Food and F d t (13%)Feed sector (13%).
● 33/45 responders (76% countries) reported having a generic preparedness plan that covers events whichgeneric preparedness plan that covers events which impact on human health.
● 88% (29/33) reported that this plan included measures to● 88% (29/33) reported that this plan included measures to ensure interoperability between different sectors.
● Civil protection seems to be the sector that● Civil protection seems to be the sector that experienced more frequently events of national and international concern.
Preliminary conclusions and recommendations ● It seems that health matters are under the coordination
of the Health Sector in several country: the questionnaire was forwarded to the health sector byquestionnaire was forwarded to the health sector by other sectors who received it but felt not to be the appropriate responder.appropriate responder.
● This could represent the actual situation at national level or just the fact that a concrete coordination and jcollaboration on preparedness planning for aspects related to health is not considered and health issues are l d l t d t th h lth talways delegated to the health sector.
● Encourage and identify networks of sectors other than health in order to sustain their preparedness planninghealth in order to sustain their preparedness planning activities .
● Awareness and capacity building is needed on the link● Awareness and capacity building is needed on the link of some non health sectors to health related response.
AcknowledgementsgThe EpiSouth-Plus project was co-funded by the European Union DG SANCO/EAHC, now renamed Consumers Health And Food Executive Agency (CHAFEA), and DEVCO/EuropeAid together with the participating national partner Institutions. The financial support of the Italian Ministry of Health and ECDC is also acknowledged.
The “Celeste” Survey was produced under the Health Programme (2008-2013) in the frame of a specific contract with the Executive Agency for Health and C (EAHC) d C H lth A d F d E tiConsumers (EAHC), now renamed Consumers Health And Food Executive Agency (CHAFEA), acting on the mandate from the European Commission.
The contents of this presentation are the sole responsibility of the authors and can in no way be taken to reflect the views of the European Union.