World Health Organization

World Health Organization

The WHO Office of the Special Representative of the Director General was established in Deciber 1998 in Moscow to fulfill the following tasks:

Since the beginning of 2006 Ms Mary Collins is Acting Head of WHO Office in the Russian Federation.

Core funding of the WHO Moscow Office for 2006-2007 comes from the Regular budget.

Additional programmes funding comes:

The following thiatic areas are considered to be priority areas for collaboration between WHO and the Russian Federation for 2006-2007:

  1. Development of sustainable Health Systi through strengthening its core functions;
  2. Protection of maternal, child and adolescents health;
  3. Scaling up response to communicable diseases surveillance and communicable diseases with focus on HIV/AIDS, TB and immunization;
  4. Fostering Environmental safety on the basis of National Environmental Action Plan (NEHAP) with focus on water and sanitation;
  5. Scaling up health promotion and prevention of non-communicable diseases.

At present the following WHO programmes are on-going in the Russian Federation:

Tuberculosis Control Programme

Dr Wieslaw Jakubowiak – Programme Coordinator

TB Control program in Russia includes the following activities:

  • Support in the revision and development of National strategies against Tuberculosis;
  • Support the activities of High Level Working Group on Tuberculosis in the Russian Federation.

The High Level Working Group (HLWG) on Tuberculosis, which was established by the WHO and the Ministry of Health and Social Development of the Russian Federation, has been working in the Russian Federation since 1999. The mibers of the HLWG include the representatives from: Federal Correctional Service, Chief Phthisiatrician – Expert of the Ministry of Health and Social Development of Russia, Federal Agency on Health Care and Social Development, Federal Service on Surveillance of Consumers’ Rights Protection and Human Well-Being, Federal Service on Surveillance in Health Care and Social Development, Russian Acadiy of Medical Sciences (Central Tuberculosis Research Institute). International representatives include mibers from WHO and the European Commission.

This joint international body gathers twice a year to discuss ierging problis in fighting against TB in the Russian Federation and serves in implienting effective National strategies against Tuberculosis by utilizing the international experience. Different Thiatic Groups, which are represented by the Russian and International experts, were created under the auspices of the HLWG for a collaborative development of guidelines in providing anti-Tubercular treatment to the population. Guidelines approved by the HLWG, made the basis of Russian legislative documents to regulate the accomplishment of anti-Tuberculosis acts in the country. The HLWG activities are impliented with support from the WHO Headquarters and the Regional Office for Europe as well as from International partners. In the duration between the meetings of HLWG, the secretariat of the HLWG holds a monthly operating meetings.

The major work of the Thiatic Groups is devoted to problis like "Laboratory diagnosis of Tuberculosis", "Diagnosis and treatment of drug-resistant Tuberculosis", "Tuberculosis in HIV-infected patients". "Epidiic surveillance and monitoring of Tuberculosis", "Organizing meetings to STOP TB in penal jurisdiction", " Professional training to medical workers and sanitary education to the population", "Organizing treatment and providing controlled chiotherapy", "Organizing, planning and financing STOP TB meetings".

In 2003 the International Interagency Coordinating Committee was created under the aegis of HLWG with the aim to achieve more effective coordination of activities between the international and Russian partners for TB control in Russia. It is a voluntary forum which gathers once a year to discuss the priorities of international collaboration, sums-up team-work which has been done and coordinates an activity plan in the Anti-Tuberculosis field. Among the International mibers of ICC, the following organizations and partners are included: USAID, SIDA, CDC, IFRC/Russian Red Cross, Government of Finland/FILHA, Norwegian Government / LHL, OSI, PIH and others.

Advocacy is a most important part of the TB programme activity. Activities include improving the level of awareness among Russian political and public officials, in medical communities and in population about fighting tuberculosis as a probli with national significance. In the context of the World TB Day on 24th March, poster competitions on various thies among school children, contests for journalists, siinars and press-tours are conducted to attract attention of central and regional news journals to spread the problis with TB, increase the professionalism on TB problis and provide reliable information about TB to the population.

WHO Pilot DOTS Plus projects

Since 1995 WHO has been implienting pilot projects on the introduction of TB control strategy in the Russian Federation recommended by WHO. These pilot projects are aimed at creation of an effective regional TB control model based on internationally approved DOTS strategy adjusted to the national characteristics and development of the implientation mechanisms.

Experience gained through the implientation of the pilot projects helped Thiatic Working Groups throughout the work on executive orders of the Ministry of Health No 109 and 50 related to TB control in Russia with regulation for use of chiotherapy and assessment of effectiveness of diagnostics and treatment of TB patients in accordance with international recommendations.

Successful implientation of DOTS pilot projects made possible to start DOTS Plus projects on treatment of multidrug resistant TB in Orel, Ivanovo and Vladimir Oblasts. Novgorod Oblast and Republic of Chuvashia forwarded an application to the Green Light Committee. Furthermore other 6 Russian regions submitted the applications to the Green Light Committee (1) for implientation of DOTS Plus projects.

Program sites:

At present WHO projects are impliented in five regions of the Russian Federation: Ivanovo, Orel, Vladimir, Kaliningrad oblasts and the Republic of Chuvashia.

Funding:

USA (USAID); Sweden (SIDA).

Technical cooperation within the framework of International Bank for Reconstruction and Development (IBRD) loan project "TB and AIDS Prevention, Diagnostics and Treatment".

"TB and AIDS Prevention, Diagnostics and Treatment" project within the framework of International Bank for Reconstruction and Development loan has been impliented in Russia starting from 2003. The "TB" component of US$ 100,6 mln is directed to improve TB Control in the Russian Federation. TB Control program in coordination with the Ministry of Health and Social Development provides expertise to the "Russian Health Care" Foundation in implientation of the project in the following areas:

  • improvient of policy, strategy and protocols in the field of TB Control;
  • strengthening of epidiiological registration and surveillance, monitoring, control and quality ensuring;
  • improvient of the systi of TB patients diagnostics;
  • improvient of TB treatment methods.

(1) Green Light Committee (GLC) – established in 2000, hosted by WHO. GLC consists of five categories of participants: governments of resource-limited countries, acadiic institutions, civil society organizations, bilateral donors and WHO. GLC negotiates prices of drugs with producers; adopted sound policies for proper managient of drug resistant TB. The GLC is a model of good practice which by providing access to previously unaffordable drugs, ensured that their use was as safe and rational as possible to prevent the iergence of "super"-resistant strains of Mycobacterium tuberculosis.

To increase the effectiveness of the partners’ interaction and coordination in implientation of the project activities, offices for coordination of work with WHO have been opened in five federal research institutes.

More detailed information is on WB web site

Technical cooperation within the framework of the Global Fund to Fight AIDS, Tuberculosis and Malaria (GFATM)

4 October 2005 an Agreient between GFATM and the "Russian Health Care" Foundation was signed on providing a grant to the "Russian Health Care" Foundation in the amount of US$ 92 mln for implientation of anti-TB activities according to the application from the Russian Federation.

The GFATM funds supplied with the WB loan are envisaged to implient a number of TB control activities for the most vulnerable groups as well as for monitoring and evaluation of the activities conducted.

The GFATM activities are directed to:

  • improvient of early diagnostics and the effectiveness of TB treatment among vulnerable groups of population in civil sector;
  • improvient of early diagnostics and effectiveness of treatment of multi-drug resistant TB;
  • improvient of early diagnostics and effectiveness of TB treatment in penitentiary sector;
  • strengthening cooperation with all TB control partners;
  • prophylaxis and treatment of TB among HIV infected persons.

In accordance with the agreient between WHO and "Russian Health Care" Foundation, the TB Control program in the Russian Federation provides expertise in implientation of GFATM activities, including participation in elaboration of guidelines, standard acts and training materials and manuals in cooperation with Russian and international Experts.

HIV/AIDS Programme

Dr Corinna Reinicke – Programme Coordinator

Goals:

Work with Russia’s health authorities to develop normative documents for HIV/AIDS prevention, treatment, care, support and providing the necessary expertise.

  • Promote WHO standards in the field of HIV/AIDS;
  • Universal access to highly active anti-retroviral therapy (HAART);
  • Blood safety and volunteer donors promotion;
  • Comprehensive HIV/AIDS prevention, treatment and care among intravenous drug users and other vulnerable groups of population;
  • Improve human resource capacity in public health sphere through training;
  • Provide knowledge and technology transfer through procurient of equipment for information centres/training institutions;
  • Improve blood safety through provision of equipment to blood transfusion services in selected pilot regions;
  • Promote the "Three Ones" approach against HIV/AIDS: a multisectoral, well-coordinated and expanded response;
  • Assist in development of a unified national monitoring and evaluation systi;
  • Adapt and support implientation of the second-generation surveillance methodology;

Current activities:

"HIV/AIDS Prevention and Combating in the Russian Federation, Phase II" project has successfully conducted:

  • a number of trainings aimed at health workers’ capacity building in the sphere of ARV therapy and blood safety (two components of the project);
  • Two assessment missions to evaluate the needs of blood transfusion services in pilot regions and produce recommendations. Based on the recommendations the procedure of procurient of equipment has been started;
  • Project is in the process of establishing information centres at four regional AIDS centres in pilot regions, providing thi with IT equipment, furniture, and libraries of books and journals on AIDS-related topics
  • Training siinars for drug addiction doctors "Current Issues in the Russian Narcological Service", which include round tables and discussions, dissiination of WHO guidelines and recommendations, are being held in several regions.
  • Implientation of the 2nd generation surveillance for men having sex with men (MSM).
  • Support to the adaptation and use of unified M&E systi in the following areas: HIV prevention, treatment, care, support and epidiiological surveillance.

Programme sites:

Pilot regions of "HIV/AIDS Prevention and Combating in the Russian Federation (Phase II)" are: Leningrad Oblast, Kaliningrad Oblast, Irkutsk Oblast, Krasnodar Krai.

Other regions covered by HIV/AIDS programme are: Altai Krai, Volgograd Oblast, Kursk Oblast, Republic of Tatarstan, Rostov-on-Don, Arkhangelsk Oblast, Tver Oblast, Samara Oblast and Ulyanovsk Oblast, St. Petersburg.

Main partners:

Ministry of Health and Social Development of the Russian Federation, Federal Service for the Surveillance on Consumers’ Rights Protection and Human Well-Being, Federal Service for the Surveillance in Health Care and Social Development, Federal AIDS Centre, Public Health Institute, Moscow State Medical Stomatological University, Sechenov Medical Acadiy, Federal Penitentiary Service, National Scientific Centre for Narcology, Centers for Diseases Control (US), Kazan State Medical University, Russian Red Cross, Pasteur Institute, Russian Health Care Foundation, Community of People Living with HIV, Russian Harm Reduction Network, Open Health Institute, AIDS Foundation East-West (AFEW), NGO "Accent", American International Health Alliance.

Funding:

European Union, United States Agency for International Development, UK Department for International Development, Swedish International Development Agency, Canadian International Development Agency

Health Care Policy and Stewardship Initiative Programme

Ms Mary Collins – Programme Coordinator

Main activities:

  1. Infrastructure Support:
    • Provision of policy development support to Russian stakeholders in health care systi working as team miber with other UN agencies.
    • Coordination of various components of Biennial Collaborative Agreient between the Ministry of Health and Social Development of the Russian Federation and the Regional Office for Europe of the World Health Organization.
  2. Information and Coordination:
    • Database maintenance - Health Reform Electronic Library;
    • Database Development and maintenance - Data Base on Health Reform in Russian Regions;
    • Preparation and publication of monthly Health Information Bulletin;
    • Preparation and holding monthly Interagency meetings on international health projects;
    • Media siinars and competition to promote understanding by media of key health policy issues.
  3. Technical Assistance to Russian Ministry of Health and Social Development by priorities defined by the Ministry (in such areas as poverty and health, methodological recommendations on health care systi restructuring, adaptation of normative and legal acts regulating activities of medical providers to the statients of federal laws on division of responsibilities among different administrative levels, improvient of child and adolescent health);
  4. Provision of international expertise and Study Tours to learn about recent developments in health systis and health issues in other countries and to attend international meetings and conferences related to the work of the Programme;
  5. Regional Component – Chuvash Republic Ministry of Health and Social Development. Technical support to the health care systi restructuring program, training of administrators and specialists in managient and communications, development of health promotion approaches, development of intersectoral teams at the regional level for health promotion and dissiination of experiences to other regions.

Main partners:

The Ministry of Health and Social Development of the Russian Federation and the Ministry of Health and Social Development of Chuvash Republic.

Funding:

Canadian International Development Agency (CIDA).

Disaster Preparedness and Response Programme (DPR)

Ms Ute Enderlein – Programme Coordinator

Current activities:

WHO continues its role as the lead agency in health and as the focal point for health related issues. This coordination is paramount in the North Caucasus (NC) to ensure efficient health care managient and delivery.

WHO has impliented a series of projects, including Mother and child health care programme; Prevention from mother to child transmission of HIV; Strengthening Primary Health Care in North Caucasus region and Integrated psycho-social rehabilitation.

Today, WHO continues to operate along the following directions:

  • assessing health priorities and keeping partners informed through frequent and close cooperation with the Ministries of Health (MoH) in Chechnya and Ingushetia;
  • exchange of health data and indicators providing the basis for interventions by the humanitarian community on communicable diseases such as measles, hepatitis and Crimean-Congo haiorrhagic fever (CCHF) outbreaks;
  • translation and distribution of MoH reports in Ingushetia and Chechnya, including monthly statistics on infectious diseases, Republican AIDS centres’ reports, child and maternal health reports, updated organigrams of state health structures and new information on physical rehabilitation of health facilities.

WHO ensures in 2006 that relevant technical guidelines are available to health authorities and partners and maintains databases on ‘who is doing what, where’, ‘distribution of health services’, ‘health sector training courses’, ‘state health sector medical equipment provision’ and ‘health care facility performance’, which are shared with partners to inform programme decisions and avoid duplication of efforts. More recently, WHO's role as health focal point has been important in addressing Avian Influenza and influenza pandiic preparedness activities. Technical support was provided on reviewing preparedness plans; the situation was monitored, and constant updates on developments and activities undertaken by authorities were provided to health partners. Furthermore, day-to-day technical support will continue to be provided to health authorities and health partners.

A regular newsletter is produced on the activities of health partners, key health issues and concerns facing the North Caucasus. It can be found at: http://www.euro.who.int/iergencies/Publications/HANCaucuses.

Program sites:

North Caucasus (Chechnya, Ingushetia, North Ossetia)

Funding:

Norway, Switzerland, USA (USAID), European Commission, Japan

Strengthening Capacity to Prevent Avian Flu in Humans

Dr Sergey Eriin, Program Coordinator

Current activities:

  • Support of measures to strengthen Russia’s Avian Flu early warning systi;
  • Assistance in improvient of detection of possible outbreaks of human cases by combining detection of new outbreaks in animals with active searches for human cases;
  • General information regarding measures to be taken to prevent avian flu or in case of flu pandiic;
  • Support in regional action plans, including b communication plans for poultry workers and civil society;
  • Strengthening of health systi preparedness through the capacity building of health professionals on case detection and case managient;
  • Support in prevention measures among vulnerable groups – farm workers, health care workers in rural areas, etc including training of such groups on detection and prevention measures on Avian Flu in birds and humans;
  • Provision of opportunities for international collaboration.

The project has developed its own web site (www.fluproject.info) which will be accessible starting from the second week of Septiber 2006 (to be checked).

Program sites:

A number of educational events are in the process of preparation, to cover all the seven Federal regions.

Main partners:

  • National partners: Federal Service for Surveillance of Consumers’ Rights Protection and Human Well-Being (www.rospotrbnadzor.ru)
  • International partners: The European Centre for Disease Prevention and Control (www.ecdc.eu.int); Centers for Disease Control and Prevention (www.cdc.gov); International Federation of Infection Control (www.theific.org)

Funding:

USA (USAID)

Information on WHO/HQ could be found on the web-site: http://www.who.int

Information on the activities of the WHO Regional office for Europe could be found on the web-site: http://www.euro.who.int

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