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The Director DIRECTORATE FOR EMPLOYMENT, LABOUR AND SOCIAL AFFAIRS Ms Elen Ohov Adviser European Union Affairs and International Co-operation Dpt. Ministry of Social Affairs Estonia DELSA/SS(2023)30 Thursday, 27 July 2023 Dear Ms Ohov, For the past years, the Health Committee and the Secretariat have been working to implement the mandate Health Ministers gave the OECD at their Ministerial meeting in January 2017: making health systems more people- centred, more-knowledge based, and more innovative, at the same time as maintaining fiscal sustainability and reducing waste. The COVID-19 pandemic further highlighted the importance of improving health system resilience. This work builds on intense activities in which the Health Committee and the OECD deliver in-depth analyses and data on health systems, often leveraging the OECD’s unique cross-sectorial expertise. At the start of the pandemic in 2020, the scale and responsiveness of our work increased remarkably. Under the current 2023-24 Programme of Work and Budget, we are continuing to undertake comparative policy analysis of health systems, and to deliver comparative health statistics. In particular, this work will: • Bring together Health Ministers at the OECD for a Meeting on 23 January 2024, preceded by a High-Level Policy Forum on 22 January 2024, to chart a forward-looking vision for more modern, sustainable and resilient health systems, building on the lessons from the COVID-19 pandemic and underpinned by a renewed health systems performance assessment framework. • Deliver the brand-new results of the Patient-Reported Indicators Survey (PaRIS) survey. The survey, currently on the ground in more than twenty countries, represents a critical milestone in the development of a new generation of indicators that measure the outcomes and experiences of healthcare that matter most to people. • Develop a resilience testing framework and methodology, to support ongoing health system recovery from the COVID-19 crisis and improved preparedness to future shocks. • Ensure the financial sustainability of health systems by improving dialogue between Ministries of Health and Finance, through collaboration with the Senior Budget Officials. The regular meetings of the OECD joint network of senior budget and health officials play a crucial role in balancing a need for further investments in health system resilience, with renewed focus on value-for-money, as policymakers confront the full scale of COVID-19 related debt and an ongoing cost-of-living crisis. ./.. 2, rue André-Pascal http://www.oecd.org/els/ Direct line 75775 Paris Cedex 16, France [email protected] Tel.: +33 (0) 1 45 24 19 88  • Support reforms to respond to the impact that the global megatrends of digitalisation, transition to a low-carbon economy and demographic change will have on the health of populations and on health systems. This will include new analysis and information gathering on the future of older people’s care after COVID-19, and a new report identifying health policies that offer good returns in terms of both health outcomes and the environment, as well as on policies to deliver a low-carbon health system. The ongoing work on digitalisation, in coordination with activities in other OECD Committees, will look at how to further accelerate change in telehealth and in health data use and governance, presenting new opportunities and challenges. • Identify the best strategies to transform the health workforce, reduce health workforce shortages and improve the attractiveness of the medical profession through a new analytical report, and expanded health workforce data. • Continue our core work developing comparable data on health spending, the quality of care, patient safety, and other indicators of health system performance; and modeling the cost-effectiveness of policies to tackle public health threats linked to risk factors and infectious diseases, including Antimicrobial Resistance as well as possible future epidemics with pandemic potential. We work in ever-closer collaboration with the WHO, the European Commission, the World Bank, the ILO, the Council of Europe, and other international bodies to ensure that we operate to our strengths, avoid any duplication, and avoid overburdening countries. The COVID-19 crisis showed the world how critically important resilient and responsive health systems are to our economies, and our societies. As countries look to learn the lessons of the crisis, this is a real transformative potential for health systems. But we need once more your support to allow the Secretariat to fully implement the Committee’s 2023-24 work programme. As you know, we rely on voluntary contributions for well over two thirds of the work and I hope that Estonia will be able to provide a financial contribution to support it. We look forward to support so that we can better help you deliver better health systems. Yours sincerely, Stefano Scarpetta CC: Ms. Eleri Lapp, Ministry of Social Affairs, Estonia Ms Francesca Colombo, OECD Health Division Mr. Guillaume Haquin, Head, OECD ELS Management Support Unit MODEL OFFER LETTER (On the letterhead of the donor) Date: Dear [Head of project], I am writing to inform you that [name of donor] will contribute [currency and amount] to support the work [ of the Health Committee or name of the project ] which is included in the Organisation for Economic Co-operation and Development (OECD) Programme of Work and Budget under [the Output Area 2.4.1 or Ouput Result of the project] . The continu ation of any outputs beyond 202 3 -2 4 is subject to the inclusion of such outputs in the OECD’s Future Programme(s) of Work and Budget. The OECD will issue the invoice in accordance with its standard invoicing procedures and may submit the invoice to the Donor in the form of a PDF file via email. Upon request, a paper copy invoice will be sent to the Donor. The OECD shall not be required to use any electronic system for submitting invoices / reports under this Agreement, including, but not limited to, by providing direct input through a platform operated by or on behalf of the Donor. I note that the OECD shall administer the contribution in accordance with its Financial Regulations and other relevant rules, policies and procedures which provide for an administrative cost recovery charge of 6. 48 % of the total contribution amount. This amount will be paid on [insert date] or upon receipt of an invoice from the OECD. To limit administration costs, should upon completion of the project an amount of EUR 2000 or less [for an offer of KEUR 100 or above]; or EUR 1000 or less [for offers of less than KEUR 100] remain unspent, the OECD shall not be required to return these funds to [name of Donor]. I note that the results of the work, in whatever form, shall be the sole property of the OECD. Any disagreement arising out of or relating to the interpretation of, compliance with or execution of this contribution shall be resolved by the Parties by mutual agreement. The present letter and your confirmation of acceptance shall form a binding agreement between us. Yours sincerely,