1. EG on Non-Communicable Diseases related to Lifestyles and Social and Work Environments Second Meeting NCD-2 Saint Petersburg, Russian Federation from Thursday 24 March 2011 (starting at 11:00) to Friday 25 March (ending at 14:00) Meeting venue: Hotel Ambassador www.ndphs.org

2. EG on Non-Communicable Diseases related to Lifestyles and Social and Work Environments First Meeting NCD-1 Helsinki, Finland Tuesday 28 September 2010 (time 10:00 -16:00) TitleMinutes from the 1st Meeting of the NDPHS Expert Group on Non-Communicable Diseases related to Lifestyles and Social and Work Environments Submitted byNCD Secretariat Summary / Note This document recalls the main discussion points and decisions made during the NCD-1 meeting. All the meeting documents can be found on the NCD- 1 meeting page http://www.ndphs.org/?mtgs,ncd_1__helsinki List of Annexes Annex 1 – List of documents submitted to the meeting Annex 2 – List of participants NCD-2: Agenda item 7a

3. Northern Dimension Partnership in Public Health and Social Well-being Progress Report for 2010 Approved during the 7 th Partnership Annual Conference 28 October 2010, Copenhagen, Denmark NCD-2: Agenda item 7b/1

4. Table of Contents 1.Political background 2.Introduction 3.Achievements of the Partnership during 2010 3.1 Executive Summary 3.2 Impl. of the activities in the NDPHS Work Plan for 2010 Action Line 1: Cont. orientation on policies, strategies and projects Action Line 2: Strength. two-fold approach to health and social well-being Action Line 3: Implementing the NDPHS goals and mid-term operational targets (OTs),and monitoring the progress in the implementation of the OTs Action Line 4: Setting up new and restructuring the existing Expert Groups andtheir subsequent launching Action Line 5: Ensuring coordination of regional efforts to fight trafficking in human beings Action Line 6: Providing adequate funding for the NDPHS and Partnership- relevantactivities and projects 4. Conclusions NCD-2: Agenda item 7b/2

5. Annexes Annex 1: ASA Expert Group Progress report23 Annex 2: HIV/AIDS&AI Expert Group Prog. report28 Annex 3: NCD Expert Group Progress report37 Annex 4: PPHS Expert Group Progress report45 Annex 5: ADPY Task Group Progress report60 Annex 6: AMR Task Group Progress report62 Annex 7: IMHAP Task Group Progress report64 Annex 8: OSH Task Group Progress report69 Annex 9: Leadership and coord. in Partnership83 NCD-2: Agenda item 7b/3

6. NCD-2: Agenda item 7c/1

7. NCD-2: Agenda item 7c (pp23-24)

8. NCD-2: Agenda item 7c (pp 25-26)

9. NCD-2: Agenda item 7d(pp23-24) NCD QUESTION: NCDs = Alcohol, tobacco & drug abuse?

10. xxxxxx NCD

11. xxxxxx NCD

12. xxxxxx NCD

13. xxxxxx NCD

15. SUGGESTED NEW GOAL & OPERATIONAL TARGET GOAL 12: The impact in the ND countries of all main causes/risk factors of lifestyle related NCDs (in addition to alcohol, tobacco and substance abuse) is reduced Operational target 12.1: By 2012 the Partnership will have developed a 1-2 regional flagship project(s) on NCD prevention in cooperation with relevant actors. Indicator 12a: Project application(s) submitted to donors for funding. Operational target 12.2: By 2014 the the above mentioned project(s) will have been implemented in coordination with other international actors active in this thematic area, such as EU, WHO/EURO and ILO Indicator(s) 12.2A: Relevant indicator(s) used by donors and implementing agencies will be used. Required expertise on the NDPHS side is currently available in the NCD Expert Group

16. NCD-2: Agenda item 8 EUSBSR Report 2011 Priority Area 12 To maintain and reinforce attractiveness of the Baltic Sea Region in particular through education and youth, tourism, culture and health Northern Dimension Partnership in Public Health and Social Well- being 18 March 2011

17. “Prevent lifestyle-related non-communicable diseases and ensure good social and work environments” Several steps were taken towards the strengthening commitment and involvement of the decision and policy makers in the prevention of the lifestyle-related non-communicable diseases (NCD) and ensuring good social and work environments in the Baltic Sea region. The NDPHS delivered a speech and submitted a background paper on lifestyles’ impact on health and well-being to the 2nd Northern Dimension Parliamentary Forum held on 22-23 February 2011 in Tromsø, Norway. The NDPHS contribution provided a basis for the discussions during the Forum and the NCD-related contents of the Conference Statement. Another example of such activities is the abovementioned established and evolving cooperation with the BSPC. In addition, major progress has been reported by the Member States in the implementation of the NDPHS “Health at Work” strategy, a merger of the ILO, WHO and EU occupational safety and health (OSH) strategies, committing the countries to improve OSH systems and improve working environment, as a part of the general health system. According to the informal surveys performed during the BSN Annual Meeting in September – October 2010 in Tartu, Estonia, substantial progress has been achieved. Estonia, Finland, Germany Latvia, Lithuania, Norway, Poland, Russia and Sweden reported that work is in progress or partly ready for all or almost all items of the NDPHS Strategy on Health at Work

18. Furthermore, the NDPHS is developing several project proposals to prevent lifestyle-related NCDs and ensure good social and work environments. A Concept Note of the “Healthier and Wealthier Cities and Villages: Management of change through monitoring, partnership, promotion and commitment” project has been submitted to the Delegation of the European Union to the Russian Federation for the financing from the Non-State Actors and Local Authorities Programme for the Baltic Sea Region. A project proposal “Nutrition, Physical Activity and Prevention of Obesity and Diabetes in Schoolchildren” and a project proposal “Stop NCD-epidemic now!: Health policy and strategy support to combat NCD epidemic in Northern Dimension geographical area” will be discussed at the first planning workshop in St. Petersburg, Russia on 23-24 March 2011. Estonia, Latvia, Lithuania, Finland, Poland and Russia have expressed their interest in participating in the abovementioned two projects. In addition, the NDPHS is developing other new multi-country project proposals that will focus on industrial sectors and targets with high risk working conditions, as well as return to work after work disability.

19. Among the challenges in the prevention of the lifestyle- related NCD and ensuring good social and work environments in the Baltic Sea region is the fact that these issues are often given a low priority among the decision-makers. For example, there is a clear difference between the increasing availability and affordability of alcohol beverages in many countries and those countries’ capability and capacity to meet the additional public health burden that follows. This problem needs to get more attention from the policy and decision makers in order to reduce the spread of harmful drinking practices, which are among the main causes of the NCD.

20. NCD-2: Agenda item 9 PAC-8 (Partnership Annual Conference,) 24-25 Nov 2011 Saint Petersburg Ministry of Health and Social Development of the Russian Federation The 8th Ministerial Partnership Annual Conference (PAC 8) and its side-event will take place on November 24-25, 2011 in Saint- Petersburg, Russia. Taking into account the First Global Ministerial Conference on Healthy Lifestyles and Noncommunicable Disease (NCD) Control that will be held in Moscow on 28-29 April, 2011 and that is jointly organized by the Russian Federation and the WHO it is proposed to address the NCD issue during the NDPHS PAC 8 side-event with a focus on alcohol abuse.

21. continued…: The aim of the Global Ministerial Conference is to support Member States in developing and strengthening policies and programmes that promote healthy lifestyles and prevent noncommunicable diseases. Having in mind that the NDPHS partner countries have its peculiarities in different spheres of life, in particular regarding substance abuse, such support could also be provided by means of PAC 8 side-event aimed at the Northern Dimension area. The Russian Federation proposes to hold a Conference on NCD (the PAC side-event) with a focus on alcohol abuse. We expect to have speeches and presentations on the issue made by the NDPHS NCD EG, ASA EG, and ADPY TG as well as by respective invited guests/organizations. During the event we would like to learn about most successful practices seen from different prospective and stakeholders. The intended outcome of the PAC 8 will be a Declaration which would state the importance and necessity for taking proper actions in order to reduce alcohol consumption in our countries. Yours sincerely, Oleg Chestnov

22. What does this PAC-8 side-event scope and purpose mean to NCD EG? From NCD EG point of view the scope of PACp8 side event is difficult, because it so explicitly focuses ob alcohol abuse only. Already if the wording had provided on alcohol use in general, it would have made our involvement easier. NOTE: most of harm and disease caused by alcohol is does not happen to abusers but to “normal” users. N.B. NCD-Chairs suggestion to Secretariat and Chair-Country Russia after Chair & ITA mtg 1/3 was to focus on NCDs (reflecting the pan-European process) and elaborating what challenges this up- coming new Health 2020 gives to ND NCD prevention in general and alcohol in particular.

23. Cont. …What does this PAC-8 side-event scope and purpose mean to NCD EG? Quickly thinking, we might be able to provide information what is the impact of alcohol USE on cancer, heart disease, brain damage, HIV/STDs, FAS, depression, suicide, obesity etc, which are not commonly first thought as alcohol induced problems. We might be able to demostrate through PYLL (“potential years of life lost”) the huge loss of human potential/capital and impact to national economy due to alcohol. We might be able to reflect innovative process concerning the FLAGSHIP-B (and EU/SPb “Healthier People” project. Views from Flagship-B team? WHAT ARE YOUR VIEWS AND SUGGESTIONS? What would be outcome:Declaration, Charter ? ASK CALLL ASA

24. “I have six honest serving men, They taught me all I knew. Their names are: What and Why and When and Where and How and Who ?” R. Kipling NCD-2: Agenda item 10 Developing NCD Thematic reports

25. NCD-2: Agenda item 10 Developing NCD Thematic reports

27. regarding the Partnership in Public Health and Social Well-being, to give priority to the implementation of the NDPHS Strategy and ensure their active engagement and sufficient financial resources. take determined action based on scientific knowledge and exchange best practices to promote healthy lifestyles in order to avoid early mortality and chronic conditions leading to the loss of human and economic potential. work forcefully to prevent alcohol related harm, diseases and accidents as use of alcohol represents the biggest health challenge in the Northern Dimension area. increase cooperation on controlling access to alcohol products. take due note of the threat to social well-being caused by high unemployment, particularly among the young, and look at the possibilities to increase the cooperation to fight this problem. include into the Partnership to secure and promote the traditional livelihoods in the Northern Dimension area. cooperate closely with the human health groups working under the auspices of the Arctic Council, and the indigenous peoples, where the synergies from existing work are utilized to provide for better human health in harmony with cultural values. improve the labeling of healthy food products and work towards limiting the use of trans fat in food.

28. Regarding the Partnership in Public Health and Social Well-being, to 1.give priority to the implementation of the NDPHS Strategy and ensure their active engagement and sufficient financial resources. 2.take determined action based on scientific knowledge and exchange best practices to promote healthy lifestyles in order to avoid early mortality and chronic conditions leading to the loss of human and economic potential. 3.work forcefully to prevent alcohol related harm, diseases and accidents as use of alcohol represents the biggest health challenge in the Northern Dimension area. 4.increase cooperation on controlling access to alcohol products. 5.take due note of the threat to social well-being caused by high unemployment, particularly among the young, and look at the possibilities to increase the cooperation to fight this problem. 6.include into the Partnership to secure and promote the traditional livelihoods in the Northern Dimension area. 7.cooperate closely with the human health groups working under the auspices of the Arctic Council, and the indigenous peoples, where the synergies from existing work are utilized to provide for better human health in harmony with cultural values. 8.improve the labeling of healthy food products and work towards limiting the use of trans fat in food.

29. NCD EG Challenge ahead? What thematic reports we would need? Who would produce them? Distribution and use?

30. Closing business NCD-2 EG mtg: Agreement on the FLAG-Pro-2 meeting A? Thu-Fri 5-6 May 2011 Kaliningrad B? Thu-Fri 12-13 May 2011 Kaliningrad Who will be needed and why? Process? How we work between now and FLAG-Pro-2 meeting Agreement on NCD-3 mtg 4-5 Oct. 2011 Kalingrad. Agreement on the approval of minutes of FLAG- Pro-1 and NCD-2 Any other business?