Report of the Joint Working Group on Health and Related Social Issues (JWGHS) for

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Ministry of Social Affairs and Health Finland Ministry of Health, Arkhangelsk Region Report of the Joint Working Group on Health and Related Social Issues (JWGHS) for 2016 2017 1. Chairmanship During the period 2016 2017 the chairmanship in the JWGHS has been shared between Finland and the Arkhangelsk Region, co-chairs being Mr. Pasi Korhonen, Director of International Affairs, Ministry of Social Affairs and Health, Finland, and Mr. Anton Karpunov, Minister of Health of the Arkhangelsk Region, Russia. 2. Members of the JWGHS Members of the Joint Working Group are Norway, Sweden, Finland and Russia. Both the central government level and the Barents regions in all four countries are represented. The Working Group is open to representatives of indigenous peoples and representatives of the WHO, the Nordic Council of Ministers and the Northern Dimension Partnership in Public Health and Social Well-being (NDPHS), the European Commission, and other bodies upon invitation. 3. Priorities of the Chairmanship The chairmanship is circulating with an interval of two years with a Nordic country and a Russian region working together. Shared chairmanship promotes an active participation on equal terms between different actors in the programme. In its activities, the JWGHS is guided by the Programme for Cooperation on health and related social issues, which is accepted for a four-year period. The new program (5th Framework Programme for Cooperation on Health and Related Social Issues in the Barents Euro-Arctic Region) is in force and covers the period 2016 2019. With reference to the public health and related social situation in the Barents region, the JWGHS has identified the following main priority areas for cooperation: - prevention of non-communicable diseases, including reduction of lifestyle-related risk factors, environmental factors and new emerging risks - prevention and control of communicable diseases - strengthening of health systems and social services with relevance for health. 1

Priorities during the JWGHS chairmanship in 2016 2017 are: strong involvement of the regional and local actors into the Barents cooperation promotion of innovative approaches and technologies such as telemedicine and e-health services active information exchange on current social welfare and health care reform processes going on in the region 4. Meetings during 2016 2017 The JWGHS had two meetings during 2016 and two meetings in 2017. In 2016 the meetings were held on 14-15 April in Rovaniemi, Finland (the 22 nd meeting with 27 participants) and on 6-7 October in Solovki archipelago in Arkhangelsk region, Russia (the 23 rd meeting with 24 participants). The 24 th meeting of JWGHS on 22-23 March 2017 was organized in Oulu, Finland with attendance of 30 participants, and the 25 th meeting on 20-21 September 2017 with 27 participants took place in Malye Karely and Arkhangelsk, Russia. Participants of the JWGHS meetings discussed the issues of implementation of the three expert programmes, the current and future activities concerning health and social issues. On the 25 th JWGHS meeting held in Arkhangelsk Finland and the Arkhangelsk Region delegated the chairmanship in the JWGHS for the period 2018-2019 to Norway and Komi Republic. JWGHS co-chair Mr. Anton Karpunov reported about the work of the JWGHS at the SCO meeting held on 22 March 2016 in Arkhangelsk. In addition to this Mr. Anton Karpunov took part in the Information event for the Chairs of the Barents Working Groups organized by IBS and in Moscow on 27 April 2017. The JWGHS oversees and has worked through three expert programmes, namely Barents HIV/AIDS Programme, Barents Programme on Tuberculosis and Barents Programme on Children and Youth at Risk (CYAR). 5. Programme on HIV/AIDS in the Barents Region The JWGHS adopted a new expert programme on HIV/AIDS in 2015. The goal of the Barents HIV/AIDS Programme is to secure HIV prevention and care, reduce the morbidity and mortality caused by HIV and to minimize the impact of HIV and AIDS on individuals and society as a whole within the Barents Region. The Programme addresses the needs of all relevant groups key populations, general population, institutions and organisations. The Barents HIV/AIDS Programme has a framework nature and does not have earmarked financing but supports projects which are carried out in the Barents Region and share their purposes with the Barents Programme. The Programme did not arrange special meetings in 2016-2017. 6. The Barents Tuberculosis Programme The Barents Tuberculosis Programme was developed within the framework of cooperation in the Barents Euro-Arctic region by the JWGHS and adopted in 2012. The aim of the programme is to take more active measures to prevent the spread of tuberculosis and HIV/TB co-infection in the Barents region, through intensive international collaboration. 2

The Steering Committee (SC) of the Barents TB Programme had two meetings during the reporting period. The SC has organized a special session on Migrants and TB Situation at the International TB Congress in St. Petersburg. The Project Stop TB in North West Russia in our lifetime is being implemented in Arkhangelsk region and will be introduced soon in Republic of Komi. The project covers issue related to the monitoring of TB situation in the prison settings, health communication training for TB Health workers, preparation of information materials and its distribution, improving of living conditions for children at TB Sanatorium and skill training for TB patients. 7. Programme on Children and Youth at Risk in the Barents Region (CYAR) The CYAR programme for 2016-2019 (CYAR III) aims at protecting children s rights, developing and improving the services for children and families and preventing violence against children. In this way CYAR III continues its work towards improving the life conditions of the most vulnerable groups of children and families in the Barents region. In 2017, one meeting of the CYAR Steering committee was held. The SC members met in Oulu on June 8 th and discussed possible future work perspectives if external financing was granted. Among the topics discussed were the establishing and development of houses for the child (specialized facilities for the police to talk with children who were abused, or are suspected to have been abused), the recent changes in the Russian legislation on decriminalization of first incidents of domestic violence. The planning of project activities was postponed till the results of the project application submitted earlier are known. During the meeting of the Steering committee, a new collaboration initiative was discussed, namely research on youth in industrialized areas. Despite lack of financial support for project activities, the partners maintained (to various degrees) the competence accumulated during the past project period. The steering committee continues to communicate regularly. 8. Cooperation with the Northern Dimension Partnership in Public Health and Social Wellbeing (NDPHS) The Joint Working Group stresses the importance of cooperation and coordination with the NDPHS. The Framework Programme for Cooperation on Health and related Social Issues in the Barents Euro-Arctic Region plays an important role in contributing to the achievements of the goals of the Northern Dimension Partnership. The priorities of the Northern Dimension Partnership are similar to the Barents Programme: reduction of major communicable diseases and prevention of lifestylerelated non-communicable diseases as well as enhancement and promotion of healthy and socially rewarding lifestyles. International Technical Advisor for the NDPHS Expert Group on HIV, TB and Associated Infections Mr. Dmitry Titkov has made presentations on recent developments in the NDPHS in all four JWGHS meetings during the chairmanship. The participants of the Committee of Senior Representatives of the NDPHDS have been informed on the recent developments in JWGHS on a continuous basis. Also, tight synergies have been set with the Nordic Council of Ministers Thematic Cooperation Programme with Northwest Russia Mobilizing Resources for Better Response: Immunodeficiency virus and associated infections (HIV&Co), 2017-2018, which plans to support and scale up cooperation both with the Barents HIV/AIDS and TB Programmes, and also NDPHS. 9. Activities 3

Within the framework of Programme for Cooperation on Health and Related Social Issues in the Barents Euro-Arctic Region the following activities have been implemented in the period 2016-2017 in the Murmansk Region: Within the framework of the Agreement on Emergency Medical Care for Patients and Victims in Emergency Situations and on the planned transportation of patients / injured in the territory of Finnmark, Norway, and the Murmansk Region, Russia, in 2016 one medical evacuation of a Norwegian citizen was carried out. Within the framework of the Memorandum on Cooperation between the Murmansk region Ministry of Health and the Northern Norway Regional Health Authority (HelseNord): 1) in March-April 2016, a delegation of HelseNord and Helgeland Hospital Trust visited Murmansk in order to exchange experience in the organization of medical care, emergency medical assistance, laboratory diagnostics, use of telemedicine technologies; 2) in June 2017, a delegation of infectious disease specialists, TB specialists from hospitals in Northern Norway visited Murmansk to share knowledge and experience in diagnostics, treatment and prevention of tuberculosis. Scientific and practical conference Actual Health Issues" is annually held within the framework of the Memorandum on Cooperation between the Murmansk region Ministry of Health and Finnmark Hospital Trust (Kingdom of Norway). On 22-23 November, 2016, such a conference was held in Zapolyarny, Murmansk region; in 2017, the conference is scheduled to be held on 9-10 November in Kirkenes, Norway. Within the framework of the Agreement on Scientific Cooperation between the Norwegian Institute of Public Health (NIPH) and the Murmansk region Ministry of Health, collaboration work on the project Registration of road traffic injuries associated with alcohol and narcotic consumption in the Murmansk region is being continued. The following international projects are being implemented in the Arkhangelsk region: 1. The program "Stop tuberculosis in the North-West of Russia in our time". Partner: the LHL International Tuberculosis Foundation (LHL International) (Oslo, Norway) 2. Cooperation between the "Olafia" Clinic (Oslo) and the Arkhangelsk STI Clinic and the Arkhangelsk AIDS Center. 3. Improving the provision of mental health services in the Arkhangelsk region by integrating the primary and specialized psychiatric care the development of the model, its application and evaluation. Partner: University Hospital of Northern Norway. 4. Treatment and rehabilitation of patients with comorbid disorders. Partner: Sørlandet Hospital (Kristiansand, Norway). 5. Prevention of traffic accidents and improving the quality of medical care for patients with trauma. Partner: University Hospital of Northern Norway. 6. Cardiovascular diseases in Russia: strengthening the knowledge base on causes, mechanisms, prevention and treatment. Partner: Norwegian Institute of Public Health 7. Development of a tool to monitor the effectiveness of the health care system for improvement of mother and child health. Partner: University Hospital of Northern Norway. 8. Improving the provision of services to people with mental and behavioral disorders in remote areas of the Arkhangelsk region. Partner: University Hospital of Northern Norway. 9. Cooperation in the field of nursing between the University Hospital of Northern Norway and healthcare institutions of the Arkhangelsk region. 4

10. Nordic-Russian Cooperation on preventive healthcare. Thematic Programme for Health Promotion and Prevention Mobilizing Resources for Better Response: Immunodeficiency virus and associated infections (HIV&Co), 2017 2018. Partners: Arkhangelsk region, Murmansk region, Pskov region, Kaliningrad region, Republic of Karelia, City of St. Petersburg, Finland, Sweden and Norway. 10. Results of the year 2017 Agreement on collaboration between the Helse Nord, Norway and the Health Ministry of Arkhangelsk region for 2017 2020 was signed on 20 September 2017 in Arkhangelsk. Two agreements on collaboration have been under consideration: - Between Finnmark Hospital Trust, Sweden and Health Ministry of Murmansk region - Between Helse Nord, Norway and the Health Ministry of Murmansk region 5