Conference on Health in the Mediterranean · 2018-04-04 · Cross-border epidemic intelligence V i tbl di d i tVaccine preventable diseases and migrants Cross-border emerging zoonoses

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


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


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


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



Rapporteur Aldo Morrone


Conclusions


~

13,00 - 14,00 Lunch

14,00- 17,00

Roundtable 3

Lifestyles

Introduction and opening statement Italian Minister of Health / Moderator: Ala Alwan


Rapporteur Roberto Bertollini


Conclusions


~

Coffee break

9

Roundtable 4

Antimicrobial Resistance



Rapporteur Marc Sprenger


Conclusions


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

http://italia2014.eu/it/

http://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


E t bli hi M dit R i l


● 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


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.

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