Since 2011 the geopolitical instability in the Middle East and North Africa has been contributing to exceptional flows of migrants to South European countries. According to IOM estimates, 769,399 refugees and migrants crossed the Mediterranean Sea to reach Italy, Greece and Malta during the period 1 January - 6 November 2015. WHO does not recommend obligatory screening of refugee and migrant populations for diseases, because there is no clear evidence of benefits but strongly recommends offering and providing health checks at the entry points to ensure access to health care for all refugees and migrants in need of health protection, specific population groups (children, pregnant women, elderly) included. But migrant’s health deserves to be profoundly understood and clinical attitude accordingly adapted. That’s why migrants’ health needs are at the very centre of the today discussion and multidisciplinary teams identified as the most appropriate approach to tackle them. This model results to be effective particularly in approaching even more fragile subgroups, such as minors, pregnant women and victims of violence. The project, which can count upon the endorsement of 5 MS governments experiencing strong migration flows, deploys its potential throughout 8 WPs, all tailored addressing different aspects of migrant’s health, with a view to hosting societies. Among them, three WPs are horizontal, namely coordination, results dissemination and evaluation. Other WPs do sustain the health of migrants within the hotspots and migrants’ centres, produce evidence based instruments to manage health threats and syndromic surveillance, offer a way for tracking migrant’s health on the move, produces training and information material for health staff and general public as well as intervene into the public/private relationships to promote a new governance model for migration public policies.
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The SHARP Joint Action will strengthen implementation of Decision 1082/2013/EU, supporting the EU level preparedness and responses to health threats and the implementation of the International Health Regulations (2005). The Joint Action implements actions mentioned in Annex 1 of the Annual Work plan 2018 of the EU Health Programme 2014-2020.
Through the Joint Action, the member and partner states and the Unions common ability to prevent, detect and respond to biological outbreaks, chemical contamination and environmental and unknown threats to human health will be strengthened. Special efforts will be employed to fill gaps that have been or will be identified in priority countries (countries that have biggest gaps in the capacity required for full IHR capability). The Joint action consists of 10 Work Packages, covering core public health capacities according to the IHR (2005). In addition to a coordination function, these will cover areas such as Communication, Evaluation, Sustainability, IHR core capacity, Preparedness, Laboratories, Training and exercises, Chemical threats and Clinical management.
SHARP will also collaborate with several other Joint Actions, specifically the “Healthy Gateways” that addresses Points of Entry, the Joint Action on Vaccination (EU-JAV) and the Joint Action on Antimicrobial Resistance (EU-JAMRAI).
The partnership of the joint action consists of 26 Associated Partners and 33 Affiliated Entities, which all will receive Commission co-funding. In addition there are 9 Collaborating Partners that will self-fund all activities that they participate in. Totally 30 countries (24 EU members, 3 EEA/EFTA members and 3 European neighborhood countries) participate in the Joint Action. The SHARP JA will liaise with and collaborate with the ECDC, the WHO EURO regional office and the WHO Health Emergency and IHR unit in Lyon, and IANPHI in relevant activities. Special emphasis will be made to avoid duplication of work for the member states.

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Topic: Joint Action to strengthen preparedness including laboratories in the EU against serious cross-border threats to health and support the implementation of International Health Regulations (IHR)
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TOB-G project aims to develop and implement an innovative and cost effective approach to prevent chronic diseases related to tobacco dependence. The specialized guidelines for high risks groups will be developed according to ENSP’s evidence based and good practices in tobacco cessation and with ERS TCC scientific material on smoking health hazards. High risk populations are considered those who suffer from cardiovascular diseases, COPD, type 2 diabetes, adolescents & pregnant women.The developed guidelines will contain strategies and recommendations designed to assist health professionals in delivering and supporting effective treatment of dependence on tobacco. Recommendations will be made as a result of scientific reviews and evidence of good practices from scientific groups that will consist of health professionals of different expertise. To monitor the quality of the approach a pilot implementation of the tobacco cessation will be conducting for each group. The assessment of the effectiveness of the tobacco cessation guidelines will be the primary aim of the scientific groups and will be measured by the number of people quitting smoking after the pilot implementation. Since the tobacco cessation guidelines will be addressed to health professionals, the partnership will develop and implement an e-learning training for guidelines use.The project fits perfectly the objectives and priorities of the 3rd Health Programme, as it will assist health professionals to provide guidance and targeted prevention to high risk populations engaged to the unfavourable lifestyle of smoking. Training primary care physicians addresses the lack of specialist doctors in EU and increases access to tobacco cessation specialists. TOB-G project will enhance the overall European capacity in the treatment of tobacco dependence, thus, in the prevention of chronic diseases, through offering smoking cessation tools, appropriately assessed and fitted to the specific needs of high risk groups.
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Vaccination is a valuable investment in health with highly positive return for the sustained development of populations. It is a preventive tool involving much less cost than the cost of targeted diseases and their consequences. Vaccination is a truly complex cross sectoral issue, as pertaining to basic immunology discovery, benefit/safety evaluation and epidemiological surveillance, to public health policies and health system planning, to forecasting and financing, to health professionals’ education and health literacy, to cultural identities and social norms. By involving a wide variety of stakeholders, the EU-JAV project aims at building concrete tools to improve vaccination coverage in EU and therefore improve population health. EU-JAV will also capitalise on the numerous existing initiatives and projects, to challenge and strengthen the European cooperation of Member states on vaccination while contributing to sustainably integrate EU-JAV achievements in health policies of European countries. The JA Vaccination proposes to address several important issues, common to many countries such as establishing a sustained cooperation of relevant Member State authorities, defining basic principles for vaccine demand forecasting, developing a concept and prototype for a data warehouse for EU-wide sharing of vaccine supply and demand data among dedicated stakeholders, defining common stages and criteria for priority-setting of vaccine research and development, developing a concept and prototype for a vaccine R&D priority setting framework, defining structural, technical and legal specifications as regards data requirements for electronic vaccine registries/databases/immunisation information systems and providing a framework to cooperate on confidence from research to best practices and implementation. To achieve this ambitious concrete actions, the project gathers 20 partners from 20 different countries as well as international organisations and relevant stakeholders.
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The “Joint Action on integrating prevention, testing and link to care strategies across HIV, Viral Hepatitis, TB & STIs in Europe” (INTEGRATE) has the overall objective to increase Integrated early diagnosis and linkage to prevention and care of HIV, viral hepatitis, TB and STIs in EU Member States by 2020.
A number of tools have been developed to reduce transmission, optimize early diagnosis and linkage to care for one or more of these four diseases. INTEGRATE will map relevant existing tools for cross-linking. A peer-review process will identify which of these tools are complimentary or redundant for other disease(s), and which could be adapted or require further innovation.
HIV, viral hepatitis, TB and STIs are cross-borders public health threats of concern to Europe that affect vulnerable populations disproportionately and require personalised interventions. As multiple dimensional approaches are required to reduce the public health burden, the most optimal profile of approaches that provide additive effects (and that are reasonably cost-effective) should be identified and implemented broadly.
INTEGRATE provides a platform to disseminate and exchange best practice among Member States and facilitate discussions on innovations and emerging issues within the four diseases. In this respect, INTEGRATE is a shared European effort that extends beyond the partners and can create important synergies across European stakeholders, projects and initiatives.
INTEGRATE supports the implementation of the Commission Communication on ‘Combating HIV/AIDS in the European Union and neighboring countries’ and the ‘Action Plan on HIV/AIDS in the EU and neighboring countries’ by ensuring better preparedness across the EU and by identifying innovative evidence-based testing and prevention tools to reduce new cases of HIV, viral hepatitis, TB and STIs in priority groups.
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Antimicrobial resistance (AMR) is a serious public health threat that is gaining swift ground. The increase of multi-resistant bacteria associated to the lack of new antibiotics represents a threat to global health. Some patients are faced with no therapeutic solutions as some bacteria resist to all antibiotics. Moreover, “old” antibiotics and to some extent more “recent” ones are gradually removed from the market because they are not economically sustainable, albeit being still possibly efficient. The issue of antimicrobial resistance is a real challenge that decision-makers are well aware of and has gained a high priority among public health challenges.
A closely related challenge is the issue of Healthcare Associated Infections that shall not be considered separately. In fact, infection prevention and control strategies should go hand in hand with i) prudent use of antibiotics ii) appropriate tools for monitoring and surveillance and iii) accurate diagnostic tests to decide on the right therapy.
The various national, European and international initiatives that have emerged over the last decade have shown a great commitment to actively tackle these issues.It is essential that all actors in the field of AMR join forces so as to avoid duplication of efforts and ensure greater coherence. Moreover, it is essential that the strategies adopted extend beyond the sole human health domain and bring a global One Health response.
The overall objective of the AMR-HCAI JA is to ensure that policies for control of AMR and HCAI are adopted and implemented across EU MS in a coordinated way, ensuring national specificities are accounted for, in line with the ECDC and WHO guidelines and recommendations, and in conjunction with other European initiatives.This will be made possible by bringing together different networks of policy makers, experts and organizations on AMR and HCAI working in different European and International initiatives and projects relevant for policy decision.
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The Joint Action proposal on “HIV and Co-infection Prevention and Harm Reduction” (HA-REACT) addresses existing gaps in the prevention of HIV and other co-infections (especially tuberculosis and hepatitis) in priority areas of the EU. Despite huge advances in treatment and care and successful implementation of evidence-based preventive interventions in many EU member states, these infections are still not controlled among certain population groups and regions. The HA-REACT Joint action (JA) directly addresses the Communication from the Commission [COM(2009)569] on “Combating HIV/AIDS in the European Union and neighbouring countries, 2009 -2013” and relevant actions laid out in the associated [SWD(2014)106] action plan extension 2014-2016. The project takes a practical rather than a theoretical or purely guiding approach. It will implement concerted, multi-country, and multi-actor actions, strengthening evidence-based practices in the focus countries, where the situation and needs are particularly challenging. Focused action for greater impact is the leading principle of this proposal. The HA-REACT will focus on pragmatic actions targeting the most vulnerable populations, i.e. people who inject drugs (PWID). The focus countries for the JA were selected according to an objective and transparent selection criteria, developed by the ECDC and the EMCDDA in which the countries were ranked according to their epidemic situation and coverage of preventive measures. In addition to work packages of Coordination, Dissemination and Evaluation, HA-REACT actions are organized into five core work packages: Testing and linkage to care, Scaling up harm reduction, Harm reduction and continuity of care in prisons, Integrated care, Sustainability and long-term funding.
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