Koostöömemorandum

soTLAAFFAIRs

stryofHeaIth Republic of Latvia

MEMORANDUM OF UNDERSTANDING

BETWEEN

THE MINISTRY OF SOCIAL AFFAIRS OF THE REPUBLIC OF ESTONIA,

THE MINISTRY OF HEALTH OF THE REPUBLIC OF LATVIA AND

THE MINISTRY OF HEALTH OF THE REPUBLIC OF LITHUANIA

ON COOPERATION AND MUTUAL ASSISTANCE

IN THE HEALTH RELATED CRISIS MANAGEMENT

The, Ministry of Social Affairs of the Republic of Estonia, the Ministry of Health of the

Republic of Latvia and the Ministry of HeaLth of the Republic of Lithuania, hereinafter

collectively referred to as “the Participants”, and individually as “the Participant”:

being conviriced of the need for cooperation between the Participants in the event of a natural

or man-made emergency to protect people’s life and health;

wishing to further improve their cooperation through this Memorandum of Understanding,

which can be regarded as a framework for cooperation and possible further Agreements;

mindfiul of the commitments imposed on the Participants by the International Health

Regulations (2005) as weII as the commitments imposed on the European Union Member States

by the Regulation (EU) 2022/2371 of the European Parliament and of the Council of

23 Novernber 2022 on serious cross-border threats to health and repealing Decision

No 1082/2013/EU (Text with EEA relevance);

being aware ofand not duplicating the EUassistance mechanismsprovided in the Decision No

13 13/201 3/EU of the European Parliament and of the Council of 17 Decernber 2013 on a Union

1(7)

civil protection mechanisrn; Comrnission irnplementing decision (EU) 2019/1930 of 18

Noveniber 2019 amending irnplernenting Decision (EU) 20 19/570 as regards RescEU

capacities and Cornmission Dccision 2021/C 393 1/02 of 16 Septernber 2021 Establishing the

Ilealth Ernergency Preparedness and Response Authority;

acknowledging and refraining frorn overlapping the Agreement between the Ministry ofllealth

of the Republic of Latvia, the Ministry of Social Affairs of the Republic of Estonia and the

Ministry of Interior of the Republic of Estonia on mutual aid for providing arnbulancc services

in border areas, signed electronically on 22 Septernber 2022; and the Agreernent between the

Government of the Republic of Lithuania and the Government of the Republic of Latvia on the

cross-border cooperation in the provision ofarnbulance services in the border area between the

Republic ofLithuania and the Republic ofLatvia, signed in Bauska on 3 October 2018; and the

Agreernent between the Ministry of Health of the Republic of Latvia, the Ministry of Social

Affairs of the Republic of Estonia and the Ministry of Health of the Republic of Lithuania on

Joint Procurements of Medicinal Products and Medical Devices and Lending of Medicinal

Products and Medical Devices Procurable Centrally, signed electronically on 5 April 2022.

without prejudice to any present or future bilateral or trilateral agreements or other forms of

cooperation in the field of emergency prevention, preparedness and response;

have reached the following understanding:

Section 1

Definitions

The terrns in the present Mernorandum of Understanding will have the following rneaning:

a) emergency — any situation which has or may have a severe impact on people’s life and

health;

b) crisis management - strategic and coordinated approach that organizations, professionais,

and authorities take to effectively respond to and mitigate critical situations or emergencies

that can disrupt the normal functioning of healthcare systems, cornpromise patient safety,

or pose a significant threat to puhlic health. The four stages of the crisis rnanagement cycle

are emergency prevention, preparedness, response and assistance during recovery;

2(7)

c) prevention — any action aimed at reducing risks or mitigating advcrsc consequences of an

ernergency for people’s life and health. Therefore, activities and measures taken in advance

to ensure effective response to the irnpact ofhazards, incLuding the issuance oftirnely and

effective early wamings and the temporary evacuation of people and property from

threatened locations;

d) preparedness — a state ofreadiness and capability ofhuman and material means, structures,

cornrnunities and organisations enabling them to ensure an effective rapid response to an

emergency, obtained as a resuit of action taken in advance, Therefore, pre-disaster activities,

including an overali strategy, policies and institutional and managernent structures, that are

geared to helping at-risk cornrnunities safeguard their lives and assets by being alert to

hazards and taking appropriate action in the face of an imminent threat or the actual onset

ofa disaster;

e) response — any action taken upon request for assistance under the present Memorandum of

Understanding in the event of an imminent ernergency, or during or after an emergency, to

address its immediate adverse consequences;

f) recovery — aiiy action taken upon stabilizing and restoring healthcarc system functions and

capabilities after the ernergency;

g) response capacity — assistanee that may be provided under the present Mernorandum of

Understanding upon request, including exchange of rnedicines and medical supplies and

experts, patient transport to assisting Participant with necessary equiprnent and personnel,

patient treatment in assisting Participant hospitais and other necessary measures, which is

needed to protect people’s life and health;

h) Competent Authority — the national authority or authorities designated by the Participant

for the practical development and impiementation of the collaboration within the framework

ofthis Meniorandum ofUnderstanding, including matters related to requests for assistance

and decisions to render assistance;

i) requesting Participant — Participant, whose Cornpetent Authorities request assistance

frorn another Participant;

3(7)

j) assisting Participant — Participant, whosc Cornpetcnt Authorities cornply with a request of

assistancc from another Participant;

k) expert/medical team — organised group of hcalthcare professionais and other specialists

(experts), who participate in the provision ofhealthcarc services of the assisting Participant,

assigned for rendering assistance and having the necessary equiprnent.

Section 2

Scope

The priinary aim of the Mernorandum of Understanding is to protect people’s life and health.

The Mernorandum of Understanding enabies the Participant to enhanccd cooperation in health

related crisis rnanagernent, share expertise, best practices, available resources while ensuring

preparedness and prevention as weII as in events ofan emergency or an imrninent threat.

Section 3

Competent Authorities and Points of Contact

1. The Participants will designate one or more Competent Authorities for the purposes of this

Memorandum of Understanding. The Competent Authorities are:

1) In the Republic ofEstonia:

The Ministry ofSocial Affairs

Estonian Health I3oard (serves also as Early Warning and Response System 24/7 contact

P0 int).

2) In the Republic ofLatvia:

The Ministry ofHealth

Latvian State Ernergency Medical Service (serves also as Early Warning and Response

System 24/7 contact point).

3) In the Republic ofLithuania:

The Ministry ofHealth

1-Tealth Ernergency Situations Centre of the Ministry of Health (serves also as Early

Warning and Response System 24/7 contact point).

2. The Competent Authorities wjll inform each other without delay of any changes to the

Compctcnt Authorities and Points ofContac[.

4(7)

Section 4

Cooperation measures and initiatives

1. Participants dccidc to cooperate in the following areas:

1 1 Share knowledge and expertise by organising joint activities, such as comrnon training.

exercises, exchange ofexperts, seminars or workshops, and projects aimed at improvement

ofhealth related crisis management;

1.2 Exchatige ofdata related to health related ciisis rnanagernent and risks;

1.3 Engage in discussions to further cxplore cooperation in the foLLowing aspects of mutual

assistance:

- providing assistancc in vaccination and other supportive epiderniological activities;

- providing psychological crisis aid to the disaster victims;

- providing assistance in receiving and distribution offoreign hurnanitarian aid;

- sharing other medical resources and capabilities in a way that iS fbi regulated by other

agreernents;

- providing non-rnedical capacities in order to secure healthcare services providers

operational continuity;

- sharing rnedical teams to increase requesting Participant rnedical capacities;

- sharing resources for rnedical transport within or forth requesting Participant territory.

1.4 These measures could be employed in instances where national legal acts afford such

assistance and do not replicate or duplicate corresponding EU legal provisions.

2. Participants mayjointly take measures and initiatives to facilitatc the rendering ofassistance

and cooperation during an ernergency.

3. If the Participants wish to establish a joint response capacity it would be regulated by a

separate agreement signed by the Cornpetent Authorities or other responsible authorities

within the scope of their cornpetence.

Section 5

Impiementation and follow-up

1. The Participants convene a meeting at least every two years on the rotation basis to monitor

the impiernentation of the Memorandum of Understanding, analyse future actions and draw

up plans for further developrnent ofcooperation in accordance with Section 4. At the level

5(7)

of Competent Authorities the meeting could take piacc more often. Every Participant has

the right to convene a rneeting.

2. The Participants may give detailed guidance on and adopt the procedure for measures and

initiatives in connection to Section 4.

Section 6

Financing

In the case ofjoint trainings and exercises, each Parlicipant wiiI cover the costs reiated to the

participation of its experts and resources. Joint costs wiil be covered as agreed separately.

Section 7

Final provisions

1. This Memorandum ofUnderstanding is not legally binding and is not intended to supersede

the iaws and regulations applicabie in the territories of the Participants’ States or

international obligations, which the Participants are bound up with.

2. The Participants will notify each other in case of any conflict arising frorn this

Memorandum of Understanding. Ali disputes regarding the interpretation or

impiementation of this Memorandum of Understanding will be settled by negotiation

between the Participants.

3. This Memorandum ofUnderstanding will remain in effect for an unlirnitcd period of time.

This Memorandum ofUnderstanding wiII corne into effect on 24th1 ofApril 2024.

4. This Memorandum of Understanding may be amended at any time by the mutuai written

consent of the Participants. The Amendments wili come into effect and rnay be terminated

by any Participant in accordance with Paragraph 6 of Section 7 of this Memorandum of

Understanding.

5. This Mernorandum ofUnderstanding rnay be supplemented by cooperation agreements that

Participants may deem necessary for more effective impiernentation of this Memorandum

of Understanding. Cooperation agreements shall becorne an integral part of this

Memorandum of Understanding and shall enter into force upon the signature of these

agreements by ali Participants.

6(7)

6. Each Participant rnay terminate this Mernorandum of Understanding by giving a written

notice to the other Participants. Such termination shall take effect 6 (six) rnonths after the

date on which the Participant sends out such written notice. The Participants will consult to

determine how any outstanding matters should be dcalt with.

7. Ali information provided or generated pursuant to this Memorandum of Understanding will

be safeguarded, used, transmitted, stored, handled in accordance with the laws and

rcgulations applicable in the tclTitories of the Participants’ States.

Signed in three copies at Brussels on 24nh1 ofApril 2024 in English.

For the Ministry of Social

Affairs of the Repubiic of

Estonia

Riina Sikkut

Minister of Health

For the Ministiy ofHealth

of the Republic ofLatvia

74

I-Iosams Abu

Minister of Health

For the Ministry ofllealth

of the Republic ofLithuania

Dulkys

Minister of Health

7(7)