Nomination letter

WORLD HEALTH ORGANIZATION REGIONAL OFFICE FOR EUROPE WELTGESUNDHEITSORGANISATION REGIONALBÜRO FÜR EUROPA

ORGANISATION MONDIALE DE LA SANTÉ BUREAU RÉGIONAL DE L'EUROPE

ВСЕМИРНАЯ ОРГАНИЗАЦИЯ ЗДРАВООХРАНЕНИЯ

ЕВРОПЕЙСКОЕ РЕГИОНАЛЬНОЕ БЮРО

Sub-regional Technical Meeting on Identifying Mid- to Long-term Solutions related to Ukraine Refugee Health Response Venue: Prague, Czech Republic

/2

Dates: 11-12 June 2024 Original: English

CONCEPT NOTE

1. Background: The war in Ukraine continues to have dramatic impacts both in Ukraine and in surrounding countries. With over four million displaced persons within Ukraine, close to six million Ukrainian refugees were registered across Europe and 6.5 million worldwide as of February 2024. Movement from and to Ukraine remains pendular as the situation continues to ebb and flow in volatility. Since February 2022, some refugees staying in refugee-hosting countries continue to seek health care access and treatment in Ukraine. The majority of refugees are women and children, with 65% of displaced households having children under 18 and 41% including an elderly person over 60. Vulnerable groups among refugee populations include persons with disabilities and pre-existing conditions. Disruptions in health care services, compounded by conflict conditions, have heightened the population's vulnerability to communicable diseases like COVID- 19, tuberculosis, polio, and measles. Low vaccination coverage, lack of medical documentation, and language barriers continue to impede access to care, especially for refugees with chronic diseases or mental health conditions. Refugees with chronic diseases, non-communicable diseases, and other conditions, including cancer, often experience interruptions in treatment, which can still lead to emergent and non- emergent health needs on arrival and may cause considerable, long-term burden on the health care system of refugee-hosting countries. The impact on host communities’ health and infrastructure has also been significant. While some health systems have managed to accommodate both refugees and host communities, the crisis has exposed gaps and inconsistent health care coverage, exacerbating unmet needs for both refugees and host populations. Communities and governments of countries hosting refugees have demonstrated exceptional generosity by keeping borders open and continuing to welcome refugees as the war enters its third year. However, with the protracted crisis, there is a growing need to establish long-term sustainable services for all affected individuals, recognizing that refugee health is public health, and comprehensive attention is necessary for addressing all needs. In 2023, the WHO Regional Office for Europe conducted a sub-regional high-level consultation in Bratislava, Slovakia, focused on lessons learned and best practices sharing among refugee-hosting

countries during the Ukraine crisis. Participants joined from Czechia, Hungary, Poland, Republic of Moldova, Romania, and Slovakia. The consultation served as a platform for discussion and proposals leading to further cooperation and coordination between the participating countries to solidify emergency response capability in the coming years. The delegates emphasized the necessity to strengthen international and interregional cooperation during times of multiple and ongoing health and humanitarian crises.

2. Purpose and objectives: The proposed technical meeting is to follow-up to the recommendations of the 2023 sub-regional high- level consultation on lessons learned and best practice sharing between refugee-hosting countries in the context of the Ukraine war, held in Bratislava, Slovakia. The overarching goal of the meeting is to define longer-term priorities for refugee-receiving countries by identifying major policy options, operational directions, and address thematic areas such as refugee response inventory, sustainable health financing, human resource strengthening, twinning projects implementation, and enhanced health information management, fostering collaboration, knowledge sharing, and advocacy efforts for resource mobilization in the region. Objectives:

 To foster stronger sub-regional collaboration and jointly identify and implement innovative

solutions to address the complex healthcare needs of refugee populations and health system challenges to be able to meet both host and refugee population health needs while promoting equity, dignity, and resilience.

 To facilitate the sharing of insights and best practices in refugee health responses.  To support refugee-hosting countries in long-term sustainable and strategic planning and

cooperation. This meeting is organized by the WHO Regional Office for Europe in agreement with the Ministry of Health of Czechia, and will bring together experts from ten refugee hosting countries (Bulgaria, Czechia, Estonia, Hungary, Latvia, Lithuania, Poland, Republic of Moldova, Romania, and Slovakia) and Ukraine to discuss suggestions and solutions to common overarching problems identified during the current refugee response, such as:

 financial limitations,  shortage of health workforce,  challenges of health information systems, and  health service delivery challenges including access to Primary Health Care, mental health, non-

communicable and communicable diseases. Expected Outcomes:

 The meeting will provide a platform for the exchange of ideas, knowledge, best practices and will facilitate collaboration and networking amongst participating countries

 The meeting will provide the opportunity to discuss and build on the WHO draft report on “Impacts of the large-scale displacement from Ukraine on health systems in refugee-receiving countries in

the WHO European Region: challenges and opportunities for transformative actions and policies” and draft policy options and considerations papers focused on health financing and service delivery.

 The meeting will identify next steps for mid- to long-term strategic planning and sustained efforts by refugee-hosting countries, through implementing innovative solutions to address the complex healthcare needs of refugee populations in the following areas: a. development of sustainable health system financing mechanisms, b. strengthen health care workforce capacity, c. enhance service delivery for both host and refugee communities, and d. to improve health information management system to guide evidence-based decision-making

in emergencies.  The meeting will generate key insights and actionable recommendations, informed by participants’

examples, along with the necessary steps for implementation.

3. Dates, Location and Language: The technical meeting will take place on 11-12 June 2024 in Prague, Czech Republic. Participants are advised to arrive on 10 June, afternoon and depart on 13 June, morning. The meeting will be in English language.

4. Participants: Approximately 60 participants are expected to take part in the meeting. Invited participants will include technical experts from:

 Refugee-hosting countries (Bulgaria, Czechia, Estonia, Hungary, Latvia, Lithuania, Poland, Republic of Moldova, Romania, and Slovakia) and Ukraine

 Countries with similar experiences with previous health and humanitarian emergencies and large- scale displacement (e.g., Germany, Türkiye, France, Sweden)

There will also be WHO representation from all three levels of the organization. Representatives from the European Commission, UN partners, donors, and academia will be invited as well.

5. Format of the meeting: The meeting will feature interactive plenary and group discussions on sustainable health financing, health workforce, health services delivery, and health information as cross cutting issues (evidence -based decision making).

WORLD HEALTH ORGANIZATION REGIONAL OFFICE FOR EUROPE WELTGESUNDHEITSORGANISATION REGIONALBÜRO FÜR EUROPA

ORGANISATION MONDIALE DE LA SANTÉ BUREAU RÉGIONAL DE L'EUROPE

ВСЕМИРНАЯ ОРГАНИЗАЦИЯ ЗДРАВООХРАНЕНИЯ

ЕВРОПЕЙСКОЕ РЕГИОНАЛЬНОЕ БЮРО

Sub-regional Technical Meeting on Identifying Mid- to Long-term Solutions related to Ukraine Refugee Health Response Venue: Prague, Czech Republic

/2

Dates: 11-12 June 2024 Original: English

CONCEPT NOTE

1. Background: The war in Ukraine continues to have dramatic impacts both in Ukraine and in surrounding countries. With over four million displaced persons within Ukraine, close to six million Ukrainian refugees were registered across Europe and 6.5 million worldwide as of February 2024. Movement from and to Ukraine remains pendular as the situation continues to ebb and flow in volatility. Since February 2022, some refugees staying in refugee-hosting countries continue to seek health care access and treatment in Ukraine. The majority of refugees are women and children, with 65% of displaced households having children under 18 and 41% including an elderly person over 60. Vulnerable groups among refugee populations include persons with disabilities and pre-existing conditions. Disruptions in health care services, compounded by conflict conditions, have heightened the population's vulnerability to communicable diseases like COVID- 19, tuberculosis, polio, and measles. Low vaccination coverage, lack of medical documentation, and language barriers continue to impede access to care, especially for refugees with chronic diseases or mental health conditions. Refugees with chronic diseases, non-communicable diseases, and other conditions, including cancer, often experience interruptions in treatment, which can still lead to emergent and non- emergent health needs on arrival and may cause considerable, long-term burden on the health care system of refugee-hosting countries. The impact on host communities’ health and infrastructure has also been significant. While some health systems have managed to accommodate both refugees and host communities, the crisis has exposed gaps and inconsistent health care coverage, exacerbating unmet needs for both refugees and host populations. Communities and governments of countries hosting refugees have demonstrated exceptional generosity by keeping borders open and continuing to welcome refugees as the war enters its third year. However, with the protracted crisis, there is a growing need to establish long-term sustainable services for all affected individuals, recognizing that refugee health is public health, and comprehensive attention is necessary for addressing all needs. In 2023, the WHO Regional Office for Europe conducted a sub-regional high-level consultation in Bratislava, Slovakia, focused on lessons learned and best practices sharing among refugee-hosting

countries during the Ukraine crisis. Participants joined from Czechia, Hungary, Poland, Republic of Moldova, Romania, and Slovakia. The consultation served as a platform for discussion and proposals leading to further cooperation and coordination between the participating countries to solidify emergency response capability in the coming years. The delegates emphasized the necessity to strengthen international and interregional cooperation during times of multiple and ongoing health and humanitarian crises.

2. Purpose and objectives: The proposed technical meeting is to follow-up to the recommendations of the 2023 sub-regional high- level consultation on lessons learned and best practice sharing between refugee-hosting countries in the context of the Ukraine war, held in Bratislava, Slovakia. The overarching goal of the meeting is to define longer-term priorities for refugee-receiving countries by identifying major policy options, operational directions, and address thematic areas such as refugee response inventory, sustainable health financing, human resource strengthening, twinning projects implementation, and enhanced health information management, fostering collaboration, knowledge sharing, and advocacy efforts for resource mobilization in the region. Objectives:

 To foster stronger sub-regional collaboration and jointly identify and implement innovative

solutions to address the complex healthcare needs of refugee populations and health system challenges to be able to meet both host and refugee population health needs while promoting equity, dignity, and resilience.

 To facilitate the sharing of insights and best practices in refugee health responses.  To support refugee-hosting countries in long-term sustainable and strategic planning and

cooperation. This meeting is organized by the WHO Regional Office for Europe in agreement with the Ministry of Health of Czechia, and will bring together experts from ten refugee hosting countries (Bulgaria, Czechia, Estonia, Hungary, Latvia, Lithuania, Poland, Republic of Moldova, Romania, and Slovakia) and Ukraine to discuss suggestions and solutions to common overarching problems identified during the current refugee response, such as:

 financial limitations,  shortage of health workforce,  challenges of health information systems, and  health service delivery challenges including access to Primary Health Care, mental health, non-

communicable and communicable diseases. Expected Outcomes:

 The meeting will provide a platform for the exchange of ideas, knowledge, best practices and will facilitate collaboration and networking amongst participating countries

 The meeting will provide the opportunity to discuss and build on the WHO draft report on “Impacts of the large-scale displacement from Ukraine on health systems in refugee-receiving countries in

the WHO European Region: challenges and opportunities for transformative actions and policies” and draft policy options and considerations papers focused on health financing and service delivery.

 The meeting will identify next steps for mid- to long-term strategic planning and sustained efforts by refugee-hosting countries, through implementing innovative solutions to address the complex healthcare needs of refugee populations in the following areas: a. development of sustainable health system financing mechanisms, b. strengthen health care workforce capacity, c. enhance service delivery for both host and refugee communities, and d. to improve health information management system to guide evidence-based decision-making

in emergencies.  The meeting will generate key insights and actionable recommendations, informed by participants’

examples, along with the necessary steps for implementation.

3. Dates, Location and Language: The technical meeting will take place on 11-12 June 2024 in Prague, Czech Republic. Participants are advised to arrive on 10 June, afternoon and depart on 13 June, morning. The meeting will be in English language.

4. Participants: Approximately 60 participants are expected to take part in the meeting. Invited participants will include technical experts from:

 Refugee-hosting countries (Bulgaria, Czechia, Estonia, Hungary, Latvia, Lithuania, Poland, Republic of Moldova, Romania, and Slovakia) and Ukraine

 Countries with similar experiences with previous health and humanitarian emergencies and large- scale displacement (e.g., Germany, Türkiye, France, Sweden)

There will also be WHO representation from all three levels of the organization. Representatives from the European Commission, UN partners, donors, and academia will be invited as well.

5. Format of the meeting: The meeting will feature interactive plenary and group discussions on sustainable health financing, health workforce, health services delivery, and health information as cross cutting issues (evidence -based decision making).

UN City, Marmorvej 51 Tel.: +45 45 33 70 00 Email: [email protected] DK-2100 Copenhagen Ø Fax: +45 45 33 70 01 Website: https://www.who.int/europe Denmark

WORLD HEALTH ORGANIZATION ORGANISATION MONDIALE DE LA SANTÉ

WELTGESUNDHEITSORGANISATION ВСЕМИРНАЯ ОРГАНИЗАЦИЯ ЗДРАВООХРАНЕНИЯ

Date: 18 April 2024

REGIONAL OFFICE FOR EUROPE BUREAU RÉGIONAL DE L’EUROPE

REGIONALBÜRO FÜR EUROPA ЕВРОПЕЙСКОЕ РЕГИОНАЛЬНОЕ БЮРО

Head office:

UN City, Marmorvej 51, DK-2100 Copenhagen Ø, Denmark

Tel.: +45 45 33 70 00; Fax: +45 45 33 70 01 Email: [email protected]

Website: https://www.who.int/europe

. .

Ms Helen Sõber Adviser European Union Affairs and International Co- operation Department Ministry of Social Affairs Suur-Ameerika 1 Tallinn 10122 Estonia

. .

Our reference: Notre référence: Unser Zeichen: См. наш номер:

WHE/EMO Your reference: Votre référence: Ihr Zeichen: На Ваш номер:

Dear Ms Sõber,

Sub-regional Technical Meeting on Identifying Mid- to Long-term Solutions related to Ukraine Refugee Health Response

Prague, Czech Republic, 11-12 June 2024 I have the honour to inform you that the World Health Organization Regional Office for Europe, in agreement with the Government of the Czech Republic, plans to hold the above-mentioned meeting. The aim of the meeting is to identify next steps for mid- to long-term strategic planning and sustained efforts by refugee-hosting countries, such as fostering trans-national cooperations and partnerships to collaboratively identify and implement innovative solutions to address the complex healthcare needs of refugee populations, sustainable health system financing mechanisms, strengthening health care worker capacity and service delivery for both host and refugee communities, and to improve health information management to guide evidence-based decision-making in emergencies. An outline of the concept note of the meeting is enclosed. I have pleasure in inviting you to nominate two to three experts responsible for health financing, health workforce planning, and health services delivery to actively participate in and contribute to plenary and group discussions of this meeting. The working language will be English. Travel for participants will be arranged and paid for by the WHO Regional Office for Europe, and they will also receive a daily subsistence allowance for the duration of the meeting in accordance with our travel regulations.

– 2 –

I look forward to receiving your nominations, giving the names, functional titles, and email addresses of the proposed participants at your earliest convenience. We shall then communicate with them directly and provide them with the necessary documentation and administrative information in good time.

Dr Ardita Tahirukaj is responsible for this activity, and it would be appreciated if you would address your reply to her by email ([email protected]).

Yours sincerely,

Dr Gundo Weiler Director Country Support and Partnerships Acting Regional Emergency Director

Encls: Concept note

Copy for information to: Ms Triin Uusberg, Head, European Union Affairs and International Co-operation Department, Ministry of Social Affairs, Suur-Ameerika 1 Tallinn 10129, Estonia H.E. Ms Riia Salsa-Audiffren, Ambassador Representative of the Republic of Estonia, Permanent Mission of the Republic of Estonia to the United Nations Office and other international organizations in Geneva, Chemin du Petit-Saconnex 28A Genève CH-1209, Switzerland Ms Kristina Köhler, Liaison Officer, WHO Country Office, Estonia, Paldiski Road 81 Tallinn 10617, Estonia

p.p.

UN City, Marmorvej 51 Tel.: +45 45 33 70 00 Email: [email protected] DK-2100 Copenhagen Ø Fax: +45 45 33 70 01 Website: https://www.who.int/europe Denmark

WORLD HEALTH ORGANIZATION ORGANISATION MONDIALE DE LA SANTÉ

WELTGESUNDHEITSORGANISATION ВСЕМИРНАЯ ОРГАНИЗАЦИЯ ЗДРАВООХРАНЕНИЯ

Date: 18 April 2024

REGIONAL OFFICE FOR EUROPE BUREAU RÉGIONAL DE L’EUROPE

REGIONALBÜRO FÜR EUROPA ЕВРОПЕЙСКОЕ РЕГИОНАЛЬНОЕ БЮРО

Head office:

UN City, Marmorvej 51, DK-2100 Copenhagen Ø, Denmark

Tel.: +45 45 33 70 00; Fax: +45 45 33 70 01 Email: [email protected]

Website: https://www.who.int/europe

. .

Ms Helen Sõber Adviser European Union Affairs and International Co- operation Department Ministry of Social Affairs Suur-Ameerika 1 Tallinn 10122 Estonia

. .

Our reference: Notre référence: Unser Zeichen: См. наш номер:

WHE/EMO Your reference: Votre référence: Ihr Zeichen: На Ваш номер:

Dear Ms Sõber,

Sub-regional Technical Meeting on Identifying Mid- to Long-term Solutions related to Ukraine Refugee Health Response

Prague, Czech Republic, 11-12 June 2024 I have the honour to inform you that the World Health Organization Regional Office for Europe, in agreement with the Government of the Czech Republic, plans to hold the above-mentioned meeting. The aim of the meeting is to identify next steps for mid- to long-term strategic planning and sustained efforts by refugee-hosting countries, such as fostering trans-national cooperations and partnerships to collaboratively identify and implement innovative solutions to address the complex healthcare needs of refugee populations, sustainable health system financing mechanisms, strengthening health care worker capacity and service delivery for both host and refugee communities, and to improve health information management to guide evidence-based decision-making in emergencies. An outline of the concept note of the meeting is enclosed. I have pleasure in inviting you to nominate two to three experts responsible for health financing, health workforce planning, and health services delivery to actively participate in and contribute to plenary and group discussions of this meeting. The working language will be English. Travel for participants will be arranged and paid for by the WHO Regional Office for Europe, and they will also receive a daily subsistence allowance for the duration of the meeting in accordance with our travel regulations.

– 2 –

I look forward to receiving your nominations, giving the names, functional titles, and email addresses of the proposed participants at your earliest convenience. We shall then communicate with them directly and provide them with the necessary documentation and administrative information in good time.

Dr Ardita Tahirukaj is responsible for this activity, and it would be appreciated if you would address your reply to her by email ([email protected]).

Yours sincerely,

Dr Gundo Weiler Director Country Support and Partnerships Acting Regional Emergency Director

Encls: Concept note

Copy for information to: Ms Triin Uusberg, Head, European Union Affairs and International Co-operation Department, Ministry of Social Affairs, Suur-Ameerika 1 Tallinn 10129, Estonia H.E. Ms Riia Salsa-Audiffren, Ambassador Representative of the Republic of Estonia, Permanent Mission of the Republic of Estonia to the United Nations Office and other international organizations in Geneva, Chemin du Petit-Saconnex 28A Genève CH-1209, Switzerland Ms Kristina Köhler, Liaison Officer, WHO Country Office, Estonia, Paldiski Road 81 Tallinn 10617, Estonia

p.p.