NCD_6_Final_Report
NCD EG on Non-Communicable Diseases related to Lifestylesand Social and Work Environments
6th NCD EG meeting 21-22 February 2013 in Riga, Latvia
Meeting venue: Latvian Centre for Disease Prevention and Control
Address: 22 Duntes Street, Riga
Title Draft Meeting Report Submitted by NCD EG Secretariat Requested For approval action
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Agenda item 1. Opening of the meeting NCD-6 (Chair of NCD EG Mikko Vienonen)
Chair of the NCD Expert Group Mikko Vienonen welcomed the participants of the meeting. In his opening remark he reminded the audience of the 10th birthday of the NDPHS in 2013 and of end of the 4-year period of the current Terms of Reference of the NDPHS Expert and Task Groups. Mikko Vienonen presented Mr. Dirk van den Boom from CEval (Germany) who was assigned to do evaluation of the five-year activity by NDPHS.
Agenda item 2. Welcome of the NCD-6 participants (Host Country)
Director of the Latvian Centre for Disease Prevention and Control (CDPC) Inga Šmate welcomed the participants and told them about the history of the Centre's establishment and current role of the CDPC in the national NCD response and on the international arena, including cooperation with NDPHS and Russia.
Afterwards the audience was welcomed by Elīza Čipote from the Latvian Ministry of Health, who greeted the meeting on behalf of the Ministry and in her welcoming words underlined the importance of the NDPHS in networking and encouraging cooperation among countries and regions. She remarked the growing role of the NCD EG, as the disease burden is shifting now from communicable diseases to non-communicable diseases.
Agenda item 3. Adoption of the agenda for NCD-6
Mikko Vienonen presented the agenda of the meeting. The agenda was adopted.
Agenda item 4. Introduction of meeting participants
The participants were asked to introduce themselves and say a few words about their NCD-related achievements (or failures) in the last year. The participants introduced themselves and few remarks were added about NCD- related developments. For example, Russia contributed to WHO some 5-6 million US dollars to run prevention capacity building programmes in Asia, especially among decision-makers and politicians. Latvia is focusing now on development of a health promotion network for municipalities and on prevention of circulatory system diseases. Norway reported about their input into the WHO targets and indicators, and besides Norway hosts a WHO conference on nutrition in November 2013. Finland is now finalizing the planning of the national obesity control programme and the implementation phase is to commence shortly.
Agenda item 5. Election of Rapporteur(s)
Dmitry Titkov, ITA for NCD EG was elected as the rapporteur. Iveta Pudule (Latvia) was asked to be the co- rapporteur.
Agenda item 6. NCD-EG updates Chair of NCD EG Mikko Vienonen and ITA of NCD EG Dmitry Titkov
6.1 Approval of report of NCD-5 meeting (October 2012)
The NCD-5 report was approved.
6.2 Information about NDPHS Annual Report 2012. The role of NCD EG.
Mikko Vienonen presented the Annual Report 2012 and concisely told about the progress of the NCD EG last year.
6.3 NCD-EG Work-plan 2013. Discussion about the process of implementation.
Mikko Vienonen presented the document to the audience for information and underlined that the more focus is placed now on project activity.
6.4 The 8th Global Conference on Health Promotion will be held in Helsinki 10th - 14th June 2013. The NCD EG will participate in the Conference as will be agreed by organizers (the Ministry of Social Affairs and Health of Finland and WHO) through special workshops and poster presentations on NCD prevention elucidating NDPHS role and action in the fight of NCD epidemic in our region. 2 NCD_6_Final_Report
Mikko Vienonen presented the objectives and expected outcomes of the 8th HP Conference. Finland is the host of the Conference. The Conference will be on 10th to 14th June in Helsinki. The Chair then made suggestions about what the NCD EG could do in this regard and how it could be involved.
It is obvious the NCD EG cannot just "gatecrash" the event because of its high level. But the NCD EG members can brief respective ministries, who are attending the event. Mr. Vienonen told that he had had a talk with Dr. Gauden Galea, Director of the Division on NCDs and Health Promotion in WHO EURO, who welcomed the idea of the NDPHS being involved - as an example of what a network can bring in a process of change. 1. Besides, the Conference has a Europe Day on the agenda, and the NCD EG can consider opportunities for its contribution. 2. Also, the NCD EG can hold its ad hoc meeting in the space of the conference. A try can be made to involve higher-rank experts and politicians to such a meeting. 3. Another option is to take part in the poster presentation. The NCD EG has at least one from the Healthier People project and one old from the SIHLWA times, which needs updating. The posters should emphasize achievements. 4. And one more option is participation at side events, of which one will be at the Finnish National Museum, and the Baltic Region Healthy Cities Association plans to be involved in that side event, as well as in the Europe Day.
Besides, on the week preceding (5-8 June) the WHO Conference in Helsinki, the National Institute for Health and Welfare of Finland organizes the traditional international seminar on non-communicable disease prevention "From Theory to Practice. From Community-Based Programme to National Action and Policies". The brochure about the event can be found at: http://www.thl.fi/thl- client/pdfs/1eb32800-8d82-4829-8a17-e535f0c57b11.
6.5 Update of NCD Thematic Report
Mikko Vienonen pointed that most data for the thematic NCD report, available now at the NDPHS website, was taken from WHO databases two years ago. There is a need now to have a small team of three people working with the NCD Secretariat on the report update. The NCD EG Chair asked for comments from the audience.
Arnhild Rimestad (Norway) asked if the WHO-approved factsheet-based approach can be considered instead of the report size, and added that this should be a special product with larger focus on what we are doing. Besides she asked if evaluation had ever been done about usage of documents to assess reasonability of effort.
Iveta Pudule (Latvia) made a remark that the current NCD Thematic Report carries no information about children, for instance vegetable consumption among children. She added that Latvia makes effort to increase vegetable consumption and decrease salt intake among children, but so far with little positive changes, and therefore analysis of such failures would be useful.
Anna Korotkova (Russia) pointed out that the NCD EG could show examples of success, for example between the areas where NDPHS is active in health promotion and other regions of Russia. The NDPHS and NCD EG should promote and make visible its achievements.
Ms. Iveta Pudule and Ms. Arnhild Rimestad agreed to join the report editorial board, and the other members will contribute with data input. Ms Aida Laukaitiene was asked to contact the member of the NCD EG from Lithuania (Dr Audrone Astrauskienė - officially appointed by order of the minister of health of the Republic of Lithuania, No. V - 330 on the 3rd of April, 2013) to inquire about the possibility to be on the editorial board.
Mikko Vienonen proposed that the first task would be to agree the format of the document and explore possibilities applying for the seed-money grant or obtaining resources from another resource.
6.6 Other NCD-issues for updating
Mikko Vienonen referred to the webpage of the NCD EG at http://ndphs.org/?ncd_eg. The page was written in 2010 and is outdated now. He drafted a new text for the webpage, which was distributed to the participants beforehand.
A few comments were made from the audience: 1) When the WHO NCD Action Plan is adopted in May 2013 a reference should be created to the document, 2) The list of the NCD EG members can be expanded with information about workplaces of the members, 3) A Russian-language version could be 3 NCD_6_Final_Report
made also, 5) A few technical errors were noticed in the text. It was proposed that Anna Korotkova and Dmitry Titkov (NCD EG ITA) could contact each other and agree the corrections. The next version could be then sent within a week.
A good approach would be to look at the EG's webpage before each EG meeting.
Agenda item 7. NDPHS Secretariat's updates and messages (NDPHS Secretariat Silvija Juscenko)
7.1 Feed-back from the PAC 9 (30 Oct. 2012) and its side event (29 Oct. 2012)
Silvija Juscenko (NDPHS Secretariat) mentioned several key moments from the PAC 9, for example, she reminded the audience about the new reporting template for the EGs and TGs, which, according to feedback, is better than the previous one. The complete information about the PAC 9 meeting can be found from the meeting report, which is available at the NDPHS website. The side event was not health-related but rather accented on team-building and communication enhancing.
7.2 Feed-back from the 15th NDPHS Chairs’ and ITAs’ meeting held in Helsinki (4-5 Feb. 2013)
The meeting was attended by the Head of the ENPI Karelia Programme Secretariat located in Oulu/Finland Mr. Markko Ruokangas, who made a presentation at the meeting. The aim is to have health more visible in the programme's implementation. The NDPHS Secretariat will be a contact point for negotiations with the ENPI Karelia Programme. The new programming period is under discussion. And contributions from EGs are expected by the NDPHS Secretariat.
It was remarked that the NDPHS Secretariat could think of establishing contacts with the South-East ENPI Programme, if such are not established yet.
7.3 Revised EUSBSR Action Plan (The European Union Strategy for the Baltic Sea Region)
The revision process continued last year, the document was not yet ready but was expected to be approved in the near future. Health is a self-standing priority area now, and the NDPHS did a hard job to elevate its importance to this level. The new status will have many links with the programming period of 2014-2020 and there are well-justified hopes for practical benefits from the new status. As for the targets and indicators, many Priority Areas of the EUSBSR undergo problems with this. The EU Commission rejected the NDPHS proposal as whole/as package because considered it as not global enough. The NDPHS has to have 2-3 targets, and of more global nature. Mr. Ali Arsalo (Chair of HIV/AIDS and AI Expert Group) was asked to chair a target and indicator team, who are collecting now opinions from EGs and TGs. And the NCD EG can forward their proposals to Mr. Ali Arsalo. PYLL is one of the possible options. Deadline for indicator submission to the NDPHS Committee of Senior Representatives is end of March.
Active discussion followed with regards to the target and indicator issue. While WHO has a range of indicators, the EU wants to have preferably one, and PYLL can be considered, yet there are developments and conditions, like healthcare systems development or diabetes, which cannot be measured by mortality or PYLLs. Another proposed option was life expectancy as an indicator, or some WHO indicator could be reformulated and proposed to the EU. Yet, it is evident, that the EU wants to have an indicator easy for reporting, which would not require much extra burden for data collection and analysis.
7.4 NDPHS Work Plan for 2013
The document is available at the NDPHS website.
7.5 New funding opportunities for NDPHS Flagship projects
No new opportunities at the moment of the meeting. A project concept note (Stopping NCD-epidemic in the Baltic Sea Region NOW 1st phase: Become Aware – Beware – Act!) was submitted, with NCD EG members involved, to the EU Delegation to Russia with EU SANCO – ENPI East Indicative Programme 2011-2013, and short-listed, the final decision was expected within a week 1. Seed money from the EUSBSR, the facility was launched the same week when the meeting took place – 30.000-50.000 euros for project development for programming period 2014-2020 – a flexible mechanism, no deadlines, 4 selections per year, website would open the same week 2. Funding from Swedish Institute. But NCD EG has no member from Sweden. 4 NCD_6_Final_Report
3. Project pipeline supported by Norway, which requires a Norwegian lead partner and a Russian partner.
7.6 Ongoing evaluation of the NDPHS in 2013.
This agenda item was discussed under agenda item 9.
7.7 Other matters
Silvija Juscenko referred to the 3rd Ministerial Meeting of the renewed Northern Dimension, which was held in Brussels on 18 February. The NDPHS was highly appraised for the work done, and in her turn, Ms Silvija Juschenko thanked the NCD EG for their contribution into this high appreciation.
Agenda item 8. EUSBSR Action Plan - targets and indicators (NDPHS Secretariat and all members of NCD EG - discussion)
This agenda item was discussed earlier under 7.3.
Agenda item 9. NDPHS evaluation exercise (Evaluators’ team)
Mr. Dirk van den Boom (CEval, Germany, and leader of the evaluation team) briefly reminded of evaluation history of NDPHS in 2008, told about the scope of current evaluation and remarked that the focus of the evaluation is not at projects but administrative structures and proceedings in the last 5 years, he made an overview of current evaluation from January 2013, then meeting of Chairs and ITAs, then Evaluation Team meeting, referred to the methodology, which is data collection from documentation, participation at meetings, interview face to face, telephone interviews, online questionnaire (will be open in March and valid for 2 months), visits to all EG meetings, but not TG meetings, CSR meeting in Tallinn with interviews, reporting in summer time, and his last appearance will be in October at CSR meeting in Iceland. The evaluation is aimed at improving the processes and structures, commitment and donorship, ownership and input-outcome balance. The customer of the evaluation is the NDPHS Secretariat, and the report will go to the Evaluation Team, and the Evaluation Team will report to the CSR, and then CSR to the PAC.
Mr. van den Boom then asked the NCD EG members for comments and issues to be included in the evaluation report.
Arnhild Rimestad wondered how NCDs, which are high on the agenda, fit into other countries/organisations policies and strategies. Besides, would be interesting to see the competence of other EGs – mix of project experts with politicians. According to her, an option would be to link project activities to policies and split the groups accordingly. And the value of the EG network is often underestimated in countries.
Anna Korotkova noted that the number of projects must not be the only indicator, but also impact at political level must be assessed. CSR members can be asked about evidence of NDPHS importance/impact.
Mikko Vienonen added that it is often forgotten that the NCD EG does not only facilitate projects, but also work in between the meetings, which is crucial for success. The NCD EG is not an organisation or structure like WHO or NDPHS Secretariat. Besides, the NCD EG only has public health experts on board and no social welfare experts. He also added that there is no need to focus on avoiding duplication because in the NCD response we often have to repeat one and the same exercise or intervention.
Aida Laukaitiene/Lithuania complained that quite a few members of the NCD EG have no government funds for participation at the EG meetings. There is no extra funding foreseen for expert travel and participation in the meetings. Representatives have to be funded by they own organizations and it creates uncertainty of expert posibility to participate in the meetings
It was also noted that the social aspect very much depends on other sectors (education, culture, etc.), although indirectly social wellbeing is being dealt with through chronic disease control.
One of the assets of the NCD EG, and NDPHS in general, is a well-established dialogue with Russia, and there is mutual wish to continue this dialogue farther. The question of public health is high in the EU-Russia agenda, and the Russian Ministry of Health is supportive to the process. And NDPHS EGs and TGs have networks to keep the health issues on the agenda at different levels, and their role can be seen as advocates for public health.
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Mr. van den Boom also welcomed further comments from the EG by email. He also added that the final report will be available on the website of the NDPHS.
Agenda item 10. Further development and facilitation of NCD EG projects (Chair of NCD EG Mikko Vienonen and all NCD participants)
1. On-going: HEALTHIER PEOPLE: MANAGEMENT OF CHANGE THROUGH MONITORING AND ACTION IN ST.PETERSBURG (2012-1213) Mikko Vienonen presented the project to the audience, reminded of what is PYLL, and then shared surprising findings from the PYLL exercise, which among other things also demonstrates economic benefits. Karolina Mackiewicz (Baltic Region Healthy Cities Association) reported about the progress in the Healthier People Project and underlined that the development of a strategic intervention plan for Kalininski District was begun, which included a meeting in autumn 2012 with local policy-makers and NGOs and City Administration and one planning seminar in December 2012, and now the 1st draft for 2013-2014 was prepared. She also commented on a study tour to Finland, which was organized within the project a week before the NCD EG meeting. Katja Lahikainen (Northern Dimension Institute) added that there will be 6 consultative meetings and one seminar outside Kalininski District for dissemination purposes, the Final Seminar of the project, and the project will be over in January 2014. The total budget of the project is 250,000 euros with 50,000 from other sources than EU. As for interventions to be undertaken, this question is under negotiations because the list of expectations and wishes is long, and priorities should be defined. As an example of possible interventions, Ms Karolina Mackiewicz referred to the health kiosk in Lahti, which was demonstrated during the study tour, also reflectors for schoolchildren (which will likely be sponsored by an insurance company) and plans for screening programmes (cancer). Aida Laukaitiene asked for floor to inform the audience about the new funding instrument by EU Health Programme – Joint Actions. Area 3 of the Joint Actions dwells upon chronic diseases and Area 4 with alcohol issues might be of much relevance and importance for the NCD EG activities.
2. In planning: FLAGSHIP-B PROJECT/ RESULTS! EFFECTIVE AND EFFICIENT IMPLEMENTATION OF NATIONAL NCD PREVENTION STRATEGIES [information about the present phase of EU Regio fast- track project funding options in collaboration with northern dimension Institute and NCD EG member countries “Towards healthier and more prosperous region through addressing the non-communicable diseases (NCD) epidemics]
Mikko Vienonen suggested going through the Work Packages of the project descriptions page by page to take care of the gaps or delete unnecessary parts. The project concept submitted to EU Delegation to Russia is actually WP 1, WP 2 and some Evaluation WP. Budget from Healthier People project was given as a model for possible application in the project planning. Anna Korotkova asked about the relation of the application submitted to the EU Delegation to Russia and Flagship B. Mikko Vienonen described in detail the project concept, which is not just PYLL exercise and dissemination, but also other actions are included for Riga, Vilnius, Turku, St Petersburg. We need to go into the Work Packages and add missing detail or delete. WP1 WP 1 will be modified according to requirements of financier. In Healthier People project there is no Management WP and certain problems are felt due to absence of resources for Steering Group meetings. It was remarked that the budget for project management cannot be over 10% of the project value. Anna was advised that the figure was not a reference at the moment, and the content of management was more important at the moment. The figure will be remodeled at later stages. It was noted that the duration of the action is estimated at 3 years maximum, and the management of the project would require country coordinators and a full-time manager. Besides, office and overhead costs and travels for SG members should be included in the budget. WP2 It was noted that some organization can be a leader of the WP but local research facilities were definitely needed. Northern Dimension Institute could act as the leader of the WP2. WP2 is not only about PYLL collection but also comparative analysis of NCD national policies. The partners may include Turku University, Latvian Centre for 6 NCD_6_Final_Report
Disease Prevention and Control, Lithuanian Centre for Health Education and Disease Prevention, Moscow Federal Institute of Healthcare Organisation and Information together with MIAC. Timeframe: min 6 months. Lead Partner: at least 3 months of working time. Not all countries have necessary data, and then WHO data can be used, and sometimes data needs digitizing. The outcomes of the WP2 are seen as policy reports, publication, an maybe a working meeting with administrators. One or two meetings of the analysis team could be arranged - first a launching meeting followed by an intermediate meeting, with no final meeting but a prepared publication
SHIFT FROM FLAGSHIP B to FLAGSHIP A WP1 Northern Dimension Institute took down its candidature for leading WP1. Finnish National Institute for Health and Welfare THL/International Affairs Unit could be an alternate. WP2 WP2 has a clearer structure. Russia/Ms Antonina Starodubova felt eager to lead the WP. It was proposed to ask the University of Jyvaskyla to act as partner – overall coordinator for physical activity. Lithuanian Centre for Health Education and Disease Prevention would be a partner for obesity, THL in Finland, Starodubova in Russia, Ilona Zabielene will be a contact person in Flagship A from Lithuania. Arnhild Rimestad will explore if Norway is interested. If yes, then who from the science side could come. The timeframe is estimated at 1 year minimum. WP3
WP4 The proposed content is still relevant. The toolkit is to be adjusted to country-specific requirements. The optimal way would be to gave meetings, and not just email correspondence. THL could coordinate the WP. The milestones proposed: toolkit and consultations/remote consultations, and final event. WP5 Who will coordinate? Lithuanian Centre for Health Education and Disease Prevention took down its candidature for leading partner, but expressed an interest to take part in the WP5 as partner coordinating toolkit pilot in the regions (some of municipalities) in Lithuania. Nationally, these must be physical territories. Some municipality in Lithuania, maybe Jurmala or Riga (which initially agreed to participate in the project) in Latvia. Duration: must be min 1 year or 1,5 year 6+6+6 WP6 WHO was interested in leading, but must be checked. Dissemination could be arranged through WHO event(s)
BACK TO FLAGSHIP B Healthy Cities Network collected a set of effective evidence-based interventions. Instead of rushing into collecting interventions from zero it could be possible to look at what others have to avoid duplication, eg. WHO maps best practices. WP4 With five countries the travelling budget is app. 100,000 euros, particularly if WHO experts are involved. A dispute occurred about the content of WP4. Anna Korotkova suggested she rewrite WP4 and send her proposal by mid-March.
Agenda item 11. Next NCD EG meeting
It was proposed to have the following meeting in Norway. Arnhild Rimestad will explore the possibilities.
Agenda item 12. Any other business
No other business
Agenda item 13. Adoption of the NCD-6 meeting minutes
The draft meeting minutes will be distributed for comments in mid-March 7 NCD_6_Final_Report
Agenda item 14. Closing of the NCD-6 meeting Mikko Vienonen declared the NCD-6 closed.
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