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 For the Ministiy ofHealth For the Ministry ofllealth Affairs of the Repubiic of of the Republic ofLatvia of the Republic ofLithuania Estonia 74 Riina Sikkut I-Iosams Abu Dulkys Minister of Health Minister of Health Minister of Health 7(7)