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Friday, March 29, 2013

A good reading before the SEE Health Network develops the Health Aspects of the SEE 2020 Strategy

Though published in 2011, this WHO Europe publication is still valid.

How can the health equity impact of universal policies be evaluated?

Available at the following link:

This report presents arguments and case studies from an expert group meeting convened to clarify the importance and challenges of evaluating universal policies, and to outline potential approaches to assessing the impact of universal policies on health inequities. It also identifies key research and policy questions that need evaluating as a matter of priority, and sets the agenda for partnership working to develop these methods further

Thursday, March 28, 2013

Inauguration of the SEE Health Network Secretariat, Skopje, 07 March 2013: Now full CD-rom available

The SEE Health Network Secretariat, recently inaugurated officially and hosted by the Government/Ministry of Health of the  Republic of Macedonia, has just uploaded the final  compillation of documents, speaches, photo album, audio album and media coverage clipping of the event on the MKD Ministry´s Website.

It can be found through the following link:

The SEE Health Network Executive Committee expresses its high appreciation and gratitude to the SEE HEalth Network Secretariat and to Studiourum, the Centre for Regional Policy Reseach and Cooperation  (CRPRC), and in particular to Ms. Neda Milevska who has kindly offered the Studiourin kind support.

Wednesday, March 27, 2013

News from Moldova

Extended Migration Profile - Republic of Moldova

By Ghenadie Cretu, IOM

Friday, March 22, 2013

The Extended Migration Profile (EMP) of the Republic of Moldova is the result of intense work of a team of independent experts, Moldovan Government officials as well as IOM experts, both in Chisinau and Vienna, as well as the International Labour Organization. European Union institutions provided financial and moral support. The present EMP Report is a country-owned tool to be used to enhance policy coherence, evidence-based policy-making and the mainstreaming of migration into development planning.

This analytical report is part of a complex exercise that will help to improve the data collection and sharing, promote greater coherence and a more comprehensive and coordinated approach to policy development related to migration.

The work will continue with regular independent production of the Report by the Government of Moldova, specifically under the coordination of the Bureau for Migration and Asylum of the Ministry of Interior, jointly with the Technical Working Group members. IOM, together with the UNCT partners will provide all the support needed to build further the capacity of the national institutions for an efficient migration data collection, exchange and analysis for better strategic development policy making.

You can read or download the report by clicking

Friday, March 22, 2013

Just published: Tuberculosis surveillance and monitoring in Europe 2013

The latest report on tuberculosis surveillance and monitoring in Europe, jointly developed by the European Centre for Disease Prevention and Control and WHO Regional Office for Europe was just published.

This is fifth report launched jointly by the European Centre for Disease Prevention and Control (ECDC) and the WHO Regional Office for Europe (WHO/Europe) following on from reports under the EuroTB project, established in 1996.

The WHO European Region
The 2015 Millennium Development Goal (MDG)  target of halting the prevalence and death associated with tuberculosis (TB) and reversing its incidence has been partially achieved in 2011, with TB incidence falling in the Region at a rate of about 5% per year between 2000 and 2011. Nevertheless, the prevalence of TB was estimated at 56 cases per 100 000 population (about 500 000 prevalent cases) in the Region and TB mortality was 4.9 deaths per 100 000 population (around 44 000 in total). It will therefore not be possible to reach the target of 50% reduction by 2015. 
The incidence of TB in the European Region varies among and within the countries, from a range of less than one TB case per 100 000 population to above 200 TB cases per 100 000 in others. The 53 countries of the WHO European Region account for around 4.4% of the world’s cases, representing an estimated 380 000 individuals with a new episode of TB (or relapse), or 42 cases per 100 000 population.
Since 2005, TB notifications have decreased by almost one quarter, from 41 to 33 cases per 100 000 population. In 2011, the countries of the WHO European Region detected 295 968 new TB cases and relapses. When compared to the incidence for the Region, this indicates that 78% of the estimated cases were detected, making the Region’s surveillance system one of the most sensitive in the world. Among the 380 366 cases of all types and forms of TB, 71% (271 288) were identified as new cases in 2011. Of those 55% (123 525) were confirmed by sputum smear microscopy and/ or culture. The number of laboratory  confirmations was higher in the western part of the Region than in the eastern countries (74% and 50.3% respectively).
Overall, there were twice as many male cases reported as female cases, however a large variation was observed for male predominance in the gender distribution of TB cases, ranging from almost even distribution in some western countries (1.2:1) to around three times greater in others (2.9:1).
In 2011, most of the new TB cases registered in the European Region were in the 25–44 years age group (41%). Over the last five years, region-wide trends in overall TB notification among children (age group 0–14 years) have decreased by 23%, from 8.7 to 6.7 cases per 100 000 population, accounting for 11 054 cases in 2011. However, the average percentage of patients within this age group in the Region has remained stable at around 6% over the same period. There were ten countries where under-fives accounted for more than half of the cases detected among children. In 2011, 12 751 TB cases with HIV co-infection (56.5%) were detected from the 22 500 estimated cases in the European Region. The estimated prevalence of HIV infection among TB patients was 6%.The fact that prevalence among all tested TB cases was very similar (6.2%) gives an indication of the accuracy of TB-HIV surveillance in the Region.
However, since HIV testing coverage is at 60%, the status was only known for 205 578 new and previous TB cases, 12 751 of which had an HIV co-infection. Given that so few countries report TB from correctional institutions it was difficult to calculate the extent to which prisons contribute to the regional TB burden. However, there were some countries in eastern Europe where TB cases in prisons exceeded 10% of the countrywide total of new TB cases, and in others the  notification rate was close to or exceeded 1 000 cases per 100 000 prison population. In some low-incidence countries however, there was a higher risk of TB in prisons than in the general population. This was related to the higher rate of TB transmission there due to poor control measures and/or the concentration of vulnerable population sub-groups (such as immigrants from countries with a high TB incidence).
In 2011, of an estimated 78 000 multidrug-resistant tuberculosis (MDR-TB) cases in the European Region, 29 473 (38%) were detected. The prevalence of MDR among new TB cases in the Region amounted to 14% and 47.7% among previously treated cases. Testing coverage for resistance to second line drugs almost doubled compared to last year, however it is still at a very low level (9% of MDR-TB cases). Nevertheless, this allowed detection of 381 cases of extensively drug-resistant tuberculosis (XDR-TB), representing 11% of the MDR-TB cases tested for second line drug susceptibility in the Region. New rapid methods to support TB diagnosis have recently been introduced in some countries within the Region. During the last five years, a gradual decrease in treatment success has been observed. Success rates are now down to 67.2%, 49.2% and 48.5% among new, previously treated and MDR-TB cases respectively. A decrease in the first two of the three cohorts is mostly related to an increase in the proportion of MDR-TB among them. In the third cohort it might be due to a rapid increase in the reporting coverage to nearly double that of last year (from almost 7 000 to over 12 000) and the lack of quality-assured administration of second-line drugs according to the most efficient regimens recommended by WHO.
Given the above and the fact that the vast majority of the TB burden occurs in the 18 high-priority countries of the Executive Summary. 4 Tuberculosis surveillance and monitoring in Europe 2013 SURVEILLANCE REPORT European Region1 (87% of the TB incidence, 87% of the prevalence, 92% of the mortality caused by TB, 91% of TB/HIV co-infections, and 99% of the MDR-TB), the main efforts to combat and prevent TB in the Region need to be focused there. However, in western Europe and particularly in the large cities, the TB situation still needs continuous attention.
In cooperation with national and international partners and civil society organisations, WHO Regional Office for Europe has been implementing a Consolidated Action Plan to Prevent and Combat Multidrug- and Extensively Drug-Resistant Tuberculosis and helping Member States to adopt evidence-based interventions in order to improve TB and multidrug- and extensively drug-resistant TB (M/XDR-TB) prevention and control. All countries with a high burden of MDR-TB, except the Russian Federation, have prepared and finalised their national MDR-TB action plans in line with the regional plan. In some countries the national plans are yet to be endorsed officially by the Ministries of Health.
The WHO Regional Office for Europe has established the European Green Light Committee and the European Laboratory Initiative to help countries develop and/or adjust their national plans in response to the M/XDR-TB threat. This will help countries to reduce the proportion of MDR-TB cases among those previously treated by 20% detect 85% of estimated MDR-TB patients and successfully treat at least 75% of them.
European Union and European Economic Area countries
In 2011, 72 334 cases of TB were reported in 29 EU/EEA countries, which was 4% less than in 2010. The EU/EEA notification rate was 14.2 per 100 000 population, continuing the long-term decreasing trend.
In total, 80% of all notified TB cases were newly diagnosed and 69% of all new pulmonary TB cases were culture-confirmed. Adult age groups were equally affected by TB while the notification rate in children under the age of 15 years was 4 per 100 0000, consistent with a slightly decreasing longterm trend. Overall, ales were overrepresented by 80%. In total, 26% of all TB cases were of foreign origin, mostly residing in low-incidence countries. MDR-TB was reported for 5% of cases with drug susceptibility testing results (2% of new TB cases and 17% of previously treated cases) and continues to be most prevalent in the three Baltic countries. The overall trend is slightly decreasing. Extensively drug-resistant TB (XDR-TB) was reported for 13% of 1 017 MDR-TB cases tested for second-line drug susceptibility. In all, 5% of TB cases with known HIV status were co-infected with the virus. Seventy-four percent of TB cases notified in 2010 and 32% of MDR-TB cases notified in 2009 had successfully completed their treatment. In total, 22% of all cases were notified with exclusively extrapulmonary TB (mostly lymphatic and pleural TB); 35% of them were confirmed by culture, 1% was multidrugresistant and 82% were labelled treatment successes.
Children and cases of foreign origin were at least twice as likely to be reported with extrapulmonary TB as adults and native cases, respectively. The distribution of clinical presentations in each of these two risk groups was distinctly different from the remaining cases.
1 The 18 high-priority countries (HPC) are: Armenia, Azerbaijan, Belarus, Bulgaria, Estonia, Georgia, Kazakhstan, Kyrgyzstan, Latvia, Lithuania, Moldova, Romania, Russia, Tajikistan, Turkey, Turkmenistan, Ukraine and Uzbekistan.

European Centre for Disease Prevention and Control/WHO Regional
Office for Europe. Tuberculosis surveillance and monitoring in Europe
Stockholm: European Centre for Disease Prevention and Control, 2013.

For all that are interested in the full report it can be found at:

Thursday, March 21, 2013

The SEE Regional Health Centre on Organ Donation and Transplant Medicine supports the Ministry of Health of the Republic of Serbia to improve its current state of art

Just two weeks ago a successful mission  took place in Republic of Serbia organized and conducted by the SEE Regional Health Development Centre on Organ Donation and Transplant  Medicine, designated and acting since 2011 in Zagreb, Croatia, one of the countries with best experience in the area not only in in SEE and Europe but globally.

The purpose was to support the Ministry of Health of the country to further develop its own policies, strategies and action on the subject. During the mission series of meetings and discussions were held with the Ministry of Health and other relevant national institutions in Belgrade.

Important conclusions and recommendations were provided to the Serbian Ministry of Health on the current weaknesses of the system and the areas for follow up actions and improvements. They are related to under staffing, existing knowledge and practices in the hospitals, lack of proper information system, lack of Transplant Coordination Committees in the hospitals, need of introducing accountability for organ donation performance, etc.

This successful mission follows and builds up on  a very intensive and successful SEE regional cooperation activities on Organ Donation and Transplant Medicine in 2012 when several major accomplishments happened:

  • the First SEE Ministerial Conference on Organ Donation and Transplant  Medicine took place on 6th June 2012 in Zagreb, Croatia under the auspices of the President of the country;
  • the first-ever successful transplantation was performed in Montenegro by a team of Croatian leading experts, lead by the Minister of Health of Croatia, as an immediate practical action of support to another SEE Health Network member country;
  • series of regional workshop and training were held to improve capacities of the region in this important and very sensitive public health and health system area.

Tuesday, March 19, 2013

An interesting article from Canada

Everybody's business: economic surveillance of public health services in Alberta, Canada

  1. Egon Jonsson3
+Author Affiliations
  1. 1 Department of Medicine, University of Alberta, Institute of Health Economics, Edmonton, Canada
  2. 2 School of Public Health, University of Alberta, Institute of Health Economics, Edmonton, Canada
  3. 3 Institute of Health Economics, University of Alberta, Edmonton, Canada
  1. Correspondence: Jessica Moffatt, Institute of Health Economics, 1200-10405 Jasper Avenue, Edmonton, Alberta T5J 3N4, Canada, tel: 780 448 4881, fax: 780 448 0018,


Background: To address public health risk factors, governments conduct interventions in many different ministries, including non-health ministries. In order to understand the scope and cost of public health in Alberta, we developed a survey of government public health interventions. We included any government ministry or public organization, which includes health as a stated objective. Methods: A grey literature search was initially conducted, followed by 69 consultations with federal, provincial and municipal organizations. We captured information related to (i) the type of public health service provided; (ii) the associated costs (if available); and (iii) any additional ministry that may collaborate on the initiative. This information was then presented to lead ministry personnel for validation and verification. Results: We covered 15 areas of public health and identified 23 federal and 21 provincial agencies and departments that were providing these services. Public health spending on current operations amounted to $327 per capita, of which 60.5% came from provincial non-health ministries. Capital expenditures were $256 per capita, of which 32.5% were from the federal government.Conclusions: Public health expenses by non-health ministries were greater than those for health ministries. Capital expenses were much greater than non-capital expenses. In order to measure the full impact of government public health, it is necessary to take a cross-ministerial approach.

If you would be interested to read the whole article, please sign in at:

Monday, March 18, 2013

EuroHealthNet welcomes focus on longer lives but regrets growing inequalities in new European health report

EuroHealthNet, a partner to the SEE Health Network, is one of the vital and important organizations promoting and supporting the work of both WHO Regional Office for Europe and the European Union in their goals to deal with inequalities in Europe.

See more at:

EU Newsletter, issue 106

Investment in Health a priority in the Social Investment Package
By Paola Testori Coggi, Director General for Health and Consumers, European Commission
By Paola Testori Coggi, Director General for Health and Consumers, European Commission
The European Commission adopted its Social Investment Package for Growth and Cohesion on 20th February 2013. As highlighted in the Commission paper on Investing in Health included in the package, health is an integral part of the Europe 2020 strategy.
The paper recommends reforming health systems to ensure the twin aims of providing access to high quality healthcare and using public resources more efficiently. It follows on from the 2013 Annual Growth Survey,which recognises the contribution of health for a job-rich recovery and recommends reforming health systems to ensure their cost-effectiveness and [...]
Read more:

Friday, March 15, 2013

Just published

The UNDP has just published the Human Development Report 2013 entitled "The Rise of the South: Human Progress in a Diverse World".
Ms. Helen Clark, Administrator of the United Nations Development Programme, highlights in the Foreward:
The 2013 Human Development Report, The Rise of the South: Human Progress in a Diverse World looks at the evolving geopolitics of our times, examining emerging issues and trends and also the new actors which are shaping the development landscape
The Report argues that the striking transformation of a large number of developing countries into dynamic major economies with growing political influence is having a significant impact on human development progress. The Report notes that, over the last decade, all countries accelerated their achievements in the education, health, and income dimensions as measured in the Human Development Index (HDI)—to the extent that no country for which data was available had a lower HDI value in 2012 than in 2000. As faster progress was recorded in lower HDI countries during this period, there was notable convergence in HDI values globally, although progress was uneven within and between regions.
The Report also suggests that as global development challenges become more complex
and transboundary in nature, coordinated action on the most pressing challenges of our era, whether they be poverty eradication, climate change, or peace and security, is essential. As countries are increasingly interconnected through trade, migration, and information and communications technologies, it is no surprise that policy decisions in one place have substantial impacts elsewhere. The crises of recent years—food, financial, climate— which have blighted the lives of so many point to this, and to the importance of working to reduce people’s vulnerability to shocks and disasters.
Finally, the Report also calls for a critical look at global governance institutions to promote a fairer, more equal world. It points to outdated structures, which do not reflect the new economic and geopolitical reality described, and considers options for a new era of partnership. It also calls for greater transparency and accountability, and highlights the role of global civil society in advocating for this and for greater decision-making power for those most directly affected by global challenges, who are often the poorest and most vulnerable people in our world.
As discussion continues on the global development agenda beyond 2015, I hope many will take the time to read this Report and reflect on its lessons for our fast-changing world. The Report refreshes our understanding of the current state of global development, and demonstrates how much can be learned from the experiences of fast development progress in so many countries in the South."

For those who are interested, the full report could be found using the following link: 



Thursday, March 14, 2013

Human Resources for Health Observatory in South-eastern Europe

The SEE Health Network Regional Health Development Centre and SEE Observatory on Human Resources for Health, set up in Chisinau, Republic of Moldova since 2011 has its own blogspot where all news on this important subject could be followed.

For more information see the link below:

Saturday, March 9, 2013

The new Secretariat of the SEE Health Network is already a reality: Official Inauguration on 07 March in Skopje, Republic of Macedonia

Address of Ms. Snezhanna Chichevalieva, Public Health Officer, WHO Regional Office for Europe and former Chair of the SEE Health Network Executive Committee:
"    Dear National Health Coordinators,
      Dear Members of the Executive Committee,
      Dear Representatives of the Partners,
Allow me to express my gratitude for your contribution to the overall process of sub-regional cooperation in health in South East Europe and in the SEE Health Network that has brought it to this point of the Inauguration of the Seat of the SEEHN Secretariat in Skopje, republic of Macedonia on the 7th of March, 2013.
I commend you for the success of the event. I also sincerely thank the Ambassadors of the  SEEHN Member States who were present at the event , that have given it a high level international profile, thus, making the SEE commitment to further develop SEEHN as a health diplomacy tool a reality.

I, hereby, inform you that Ms. Zsuzsanna Jakab, Director of WHO Regional Office for Europe with her high level delegation , has met the President of the State, the Prime Minister, the Minister of Foreign Affairs, and, of course, the Minister of Health, thus expressing WHO support to the SEEHN, but also acting as the SEEHN Ambassador. We are most grateful to Mrs. Zsuzsana Jakab for this extraordinary and continuous support to the SEEHN and innovative approach to partnerships in health. Further aligning SEEHN sub-regional policy with the European Health 2020 and especially the SEEHN Health 2020 implementing plan, were stressed as a priority for further SEEHN actions both by the SEEHN Member States at the event and by the SEEHN Executive Committee at their meeting.
We are grateful that at those high level meetings of WHO RD with country leadership, an understanding and support has been expressed to the SEEHN and its Secretariat' further strengthening.
We express our appreciation for the host country efforts, and especially Minister of Health, Mr. Todorov for investing in the SEEHN (Secretariat) and organizing such an successful event.
I would also wish to thank our people at the Secretariat: Mr. Jovica Andovski, Deputy Minister of Health (Acting Head of the Secretariat) and Mrs. Sanja Sazdovska and Aleksandar Kacarski, the MoH MKD seconded persons for their extraordinary efforts and huge work done in organizing this huge event. They were brilliant.
The Secretariat will now proceed with its regular activities, which are quite of a number and a scope, as discussed at the Executive Committee meeting on the 7th March (back to back with the round table), but with your support, I have no doubt of the results that we will achieve.
We have got a clear message by our ExeCom to focus on :

  • providing sustainable development of the SEEHN and collect member states contributions (as per MoU 2009 and amendments 2011) not later than the end of Moldova Presidency (30 June, 2013)
  • providing for increased visibility of our efforts through adopting both the SEEHN Communication Strategy and develop contemporary tools for communication and exchange
  • Developing the SEEHN H2020 Action plan.
  • Mobilize our partners to work with the SEEHN on concrete actions (Many thanks to HPH (Hanne), Project HOPE (Katerina) and our new partner aboard the SEEHN: Center for regional research and cooperation in the SEE -Studiorum (Neda) that have been working on the 7th and 8th March together at a concrete program, together with Maria (Ruseva) that we will be all presented at the SEEHN June 2013 Plenary meeting in Moldova)
  • Mobilize further resources to support the SEEHN 2013 agenda (Thank you Alex (Berlin) for working (on the 6th and 8th of March) with SEEHN RHDC in Skopje and with MNE delegation in this direction.
As for the immediate action, the Secretariat will come up with full scale report on the event next week, based on which we will organize further activities.
The photo album will be shared with you shortly. For now, please find enclosed the press clipping to inform you of the excellent and very positive media coverage of the event, despite of ongoing process of local elections in the country.
With my best regards, Snezhana"


See the video clip of the Macedonian Information Agency at:

Monday, March 4, 2013

The SEE Health Network is among the founding partners of the Global Network "Connecting Organizations for Regional Disease Survellance" (CORDS)

The SEE regional network on surveillance and control of communicable diseases, an important sub-network of the SEE Health Network, is among the founding partners and became part of the recently established Golbal Network  "Connecting Organizations for Regional Disease Surveillance" (CORDS).
CORDS was established in Lyon in 2012 and was launched in PMAC 2013 on 29 January 2013 in Bangkok during the conference "A World United Against Infectious Diseases –Cross Sectoral Solutions". CORDS has six founding regional disease surveillance networks, with plans to expand.

The World Health Organization (WHO), the World Organization for Animal Health (OIE) and the Food and Animal Organization of the United Nations (FAO) are all affiliated with CORDS and welcome its activities.
CORDS promotes global exchanges of best practices, surveillance tools and strategies, training courses, innovations, successful operating procedures, case studies and other technical data. CORDS will speed the development, capabilities and sustainability of all its network members to improve global surveillance to detect disease outbreaks early and mitigate their global impact. CORDS will speed the detection of significant changes in endemic disease agents through cutting edge molecular epidemiology techniques .

In Bangkok, during parallel session 2.3 on Making Regional Networks Work, Dr.Silvia Bino, Director of the SEE Health Network Regional Health Development Centre for communicable diseases sureveillance and control, presented the experience of SEEHN in that important public health area.  Dr. Bino is also a member of international organizing committee of PMAC 2013.
Other representatives of the SEE regional network on surveillance and control of communicable diseases, in particular Dr. Angel Kunchev, Chief Public Health Officer, Ministry of Health, Bulgaria, Dr. Semra Cavaluga, University of Sarajevo, Bosnia and Herzegovina and Dr. Stela Georghita, Ministry of Health, Republic of Moldova participated during the launch of CORDS and contributed to the conference discussions and proceedings.
To learn more about CORDS, please visit its website on: