Transcript Document 7135121

EU external relations and
financial cooperation in
health – focus on Russia
European Commission
DG RELEX
Unit E1 Russia and Northern Dimension
21 April 2008
Summary
I.
II.
Political and Legal Framework
•
Partnership and Cooperation Agreement
•
Common Spaces
•
Northern Dimension
•
Political and Sector Dialogues
Financial Cooperation
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III.
TACIS 1991-2006
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National Program
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Cross border cooperation: Neighbourhood Programmes
ENPI 2007-2013
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National Program, including Common Space Facility
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Interregional Program: TAIEX
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Cross Border Cooperation Programs
Medium Term Outlook
I. Political and Legal Framework
Political and Legal Foundation of
EU-Russia Relationship
PARTNERSHIP AND COOPERATION AGREEMENT (PCA)
1997 – ?
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Founded on shared principles & objectives: promotion of
international peace and security, support for democratic norms &
for political & economic freedoms
Sets principle common objectives: establishes institutional
framework for bilateral contacts, calls for activities & dialogue in
a number of areas
Trade provisions: Most-Favoured-Nation (MFN); eventual
establishment of bilateral free trade area (FTA); support Russia in
its preparations for WTO accession

Provides a mechanism for dispute settlement
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“Mixed” agreement covering matters falling under EU & under
national competence of the Member States
Health sector covered under social provisions
PARTNERSHIP AND COOPERATION AGREEMENT (PCA)
1997 – ?
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Negotiated in early 1990s, finalised in 1994
Health largely a Member States competence at the
time
Some provisions referring to health and safety at
work
No mention of other health policy issues
The EU-Russia Common Spaces
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Creation of 4 Common Spaces at St
Petersburg Summit, May 2003
1.
2.
3.
4.
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Common
Common
Common
Common
Economic Space
Space of Freedom, Security and Justice
Space on External Security
Space of Research, Education and Culture
Adoption of Road Maps May 2005
Road Maps are short- to medium-term instruments for
the implementation of the Common Spaces
1. Common Economic Space
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Create open, integrated market between EU & Russia
Reduce trade and investment barriers
Strengthen cooperation on regulatory policy,
investment issues, competition, financial services,
telecommunications, transport, energy, space
activities, etc.
Focus on environmental issues, including energy
efficiency, Kyoto Protocol, nuclear safety
Based on transparency, non-discrimination, & good
governance
HEALTH: protection of intellectual property
rights; fight against counterfeiting and
piracy, notably in priority sectors such as
pharmaceuticals
2. Common Space of Freedom, Security,
and Justice
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Implementation of Visa Facilitation and Readmission
Agreements since 1 June 2007
Cooperation on inter alia combating terrorism, money
laundering, trafficking in drugs and Human Beings
Cooperation aiming at document security
Support for border management, and reform of
Russian judicial system
Development of operational cooperation between
FRONTEX & Federal Border Security Service of Russia
HEALTH: prevention, treatment and rehabilitation
of drug addiction, paying particular attention to
high-risk groups to prevent the spread of
HIV/AIDS and other diseases
3. Common Space on External Security
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International order based on effective
multilateralism, central role of UN, effectiveness of
OSCE and Council of Europe
5 priority areas:
- strengthening dialogue & cooperation on
international scene;
- fight against terrorism;
- non-proliferation;
- crisis management;
- civil protection
Ensure stability in the regions adjacent to the EU &
Russian borders
4. Common Space on Research, Education,
and Culture
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Research: Capitalise on strength of EU-Russia
research communities & cultural and intellectual
heritage; promote joint research activities in areas
of common interest
Education: TEMPUS Programme; Erasmus Mundus
programme; Bologna Process (education reform);
European Studies Institute in Moscow
Culture: Lay firm basis for cooperation in cultural
field, and strengthen and enhance European identity
on basis of common values
HEALTH: promoting the development of
life skills education programmes for
youth (on smoking, physical exercise,
drugs, alcohol, HIV/AIDS etc)
Political Dialogue
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Summits (biannual)
Permanent Partnership Councils (ministers)
Parliamentary Cooperation Committee
Sector Dialogues
• >20 ongoing with latest on Regional Policy and on
Investment
• discussions ongoing on launching a dialogue on Public
Health and another one on Social issues
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Expert meetings
Human rights consultation
Aim for productive and balanced political dialogue
with Russia, covering all fields, at political, high
official and expert level
Public Heath Dialogue in the making
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First EU-RU health expert meeting in Feb. 2008 in BXL
Concept paper lists the modalities of establishing a new
dialogue on public health under Common Space IV
Specific areas of cooperation to include
• prevention of non communicable diseases (tobacco, alcohol,
healthy lifestyle etc.) with particular attention to high risk
groups, such as youth as specifically foreseen in the Road Map
• infectious diseases where there is a need to strengthen
surveillance&monitoring of the spread of HIV/AIDS, TB, malaria
• a range of cross cutting issues of health in all policies such
as cooperation on health statistics, cooperation in medical and
public health education, climate change effects on health etc.
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Dialogue expected to be officially launched by EURussia Summit June 2008. Signature may take place
during Health Commissioner Moscow visit May 2-5
Northern Dimension
Northern Dimension
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Fosters relationship between Baltic Sea States,
Norway, Iceland, North-West Russia, including
Kaliningrad
Aim
- strengthen dialogue & cooperation in the region
- through subsidiarity and active participation of
all stakeholders
HEALTH:
Northern Dimension Partnership for
Public Health and Social Well-being:
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Expert groups on HIV/AIDS, Primary Health
Care, Prisons Health, Social Inclusion,
Healthy Lifestyle and Work Ability
II. Financial Cooperation
TACIS - Technical Assistance
Technical Assistance to the Commonwealth of
Independent States (TACIS) 1991-2006
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Since 1991, EU has provided appr. 2.7 billion €
to Russia under TACIS Programme
EU is Russia’s largest provider of economic &
technical assistance
Programme focus: institutional, legal, &
administrative reform; economic & social
development; freedom, justice, & security; fight
against organised crime & terrorism; migration &
asylum
TACIS National Indicative Program
– Health Sector (1)
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"Social consequences of transition" was one of the
three priority areas for the EU-Russia Cooperation
programme in the period 1994 – 2006
A total of 20 large projects (each with a budget over
1 million euros) have been implemented in the field
of public health (some of which are still ongoing)
The overall budget spent on supporting Russia health
sector reforms and health care services totals to
approximately 60 million EUR
TACIS National Indicative Program
– Health Sector (2)
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Covered various aspects of health care: primary health
care, health education at schools, communicable
diseases, health care in the penitentiary system
In several geographical zones: Karelia, Vologda,
Leningrad, Pskov, Belgorod, Ulyanovsk, Buryatiya,
Irkutsk, Tjumen, Lipetsk, Kaliningrad etc.
Partners included the Ministry of Health and Social
Development, Ministry of Justice , Federal Service for
Implementation of Punishments, Moscow Medical
Academy, Federal AIDS centre, ministries of health in
regions such as Kaliningrad, North Caucasus republics.
Implemented through different channels: private sector
consultants, international organisations, NGOs
HIV/AIDS: PHASE I
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Duration: January 2004 - March 2006 (completed)
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The project targeted prevention of HIV and AIDS
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Major activities included public awareness raising,
including through the “Time to Live” telemarathon
(Ulyanovsk and Buryatiya transmissions), and
encouragement of HIV workplace policies
The project had two pilot regions: Buryatiya and
Ulyanovsk Oblast
The main operating partner was the Federal AIDS
Centre
HIV/AIDS: PHASE II
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Duration: September 2005 – December 2007
(completed)
The project was targeted at improving
possibilities for treatment of HIV+ patients
Pilot regions: Leningrad Oblast (+SPB),
Kaliningrad Oblast, Krasnoyarsky Krai, Irkutsk
Oblast
The main partner was the Federal Ministry of
Health and Social Development
This project was implemented through a cofinancing agreement with the WHO
Preventive Health Clinics:
“POLYCLINICS” PROJECT
 Duration: January 2006 - June 2009
 Cardiovascular, diabetes, mental health, elderly
 In cooperation with the MHSD (Moscow), as well
as in two pilot regions: Tjumen, Lipetsk
 Implemented by GTZ
 The first year of implementation focused on
analysis of current situation. Study tours to other
regions of Russia and abroad have also been
organised.
 During 2007 and 2008, the project introduced new
working methods at pilot polyclinics, and is making
recommendations to federal MHSD.
KALININGRAD HEALTH
 Duration: September 2006 – March 2009
 The project targets different aspects of health
sector needs including public awareness on healthy
life styles, primary health care, maternity care
services, TB and HIV/AIDS, health care in
penitentiary system (in particular the Ozerki prison
hospital)
 Equipment provision
 The main operating partner is the Ministry of
Health of Kaliningrad
NORTH CAUCASUS HEALTH
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Duration: September 2006 – September 2009
Equipment procurement for two hospitals:
Roddom n. 2, Republican Children’s hospital
Capacity building, training for medical
personnel and personnel of the Ministry of
Health of Chechnya
Establishment of Health Learning Resource
Centres
Major operating partner: Ministry of Health of
Chechnya
Implemented through direct agreements with
WHO and UNICEF
TACIS Cross-Border Indicative Program
- Neighbourhood Programs
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Under TACIS Cross Border Cooperation Indicative
Program 2004-2006
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EURO 35 million allocated to six programs benefiting
Russian regions (incl. Kaliningrad from NIP)
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Jointly funded under EU structural funds (INTERREG
under European Regional Development Fund) and
TACIS
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Joint selection of projects but regulations/procedures
still separate
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Small scale projects for regional and national
administrations; micro-projects for very local initiatives
TACIS Neighbourhood Programs
- Health Sector
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6 regions:
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South East Finland-Russia
Kareila
Kolarctic
Lithuania-Poland-Russia (Kaliningrad)
Estonia-Latvia-Russia
Baltic Sea Region
>200 projects across sectors, all funds committed
Examples of health and social projects:
• Establishment of rehabilitation centre for children with
disabilities (Kaliningrad)
• Challenges to wellbeing – violence against women, prostitution
and risk behaviour as challenges for cross border cooperation
(Murmansk)
• Artic children cross border training supporting education to
promote psychosocial well being in Barents region (Murmansk)
• Cross border network for disabled people (Pskov)
Changing approach
TACIS
 National and
 Neighbourhood Programmes
are still ongoing
but in 2007 we moved to a new type of
financial cooperation...
European Neighbourhood and
Partnership Instrument (ENPI)
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Policy driven – it supports the implementation of the
roadmaps for the Four Common Spaces (thematic priority)
and Kaliningrad Oblast (geographic priority). These
roadmaps have been agreed by the Russian Government.
It is not about technical assistance for transition. There is a
distinct move from past donor-recipient relationship, clearly
no longer appropriate, to emphasise the consolidation of a
partnership.
More focus on programming - National Indicative
Programme 2007-2010 is our joint document setting out
priorities for financial cooperation (€ 30 million per annum).
The NIP is agreed by the Russian Government.
The ENPI regulation is a much more “enabling” regulation as
it allows for co-financing. ENPI projects could become truly
joint projects where Russian funds match EU funds.
Key elements of ENPI in Russia
National programme
Regional programme
Content agreed annually with the
Russian Government (National
Coordination Unit in Min. of
Economic Development and Trade)
Contents developed centrally in
Brussels
Multi-country projects in Eastern
Europe Central Asia region (e.g.
FLEG)
Budget: EUR30 mill/year
Contains programmes such as
IBPP, Common Spaces Facility
Priorities: four Common Spaces,
Kaliningrad
Interregional programme
Contains:
Erasmus Mundus External
Cooperation Window
Tempus
TAIEX and SIGMA
Priorities: the fourth Common
Space (education)for Erasmus and
Tempus, four Common Spaces for
TACIS
ENPI
Priorities: defined on an ad hoc
basis
Cross-border Cooperation
(CBC) programme
Highly innovative program
EU structural funds and external
cooperation budget pooled with single
procedures
Russia benefits from 7 programmes:
Kolactic, Karelia, SE Finland, Est-LatRus, Lit-Pol-Rus, Baltic and Black Sea
Priorities: Common Spaces, Northern
Dimension
ENPI National Indicative Program
Process:
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Annual Program 2007 completed and approved by the
European Commission, awaiting Russian signature.
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Projects for the AP2008 have already been identified,
program being finalised.
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Project identification for the national AP2009 will start at
the end of 2008 year and continue until March 2009.
Content:
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In view of changing policy context, focus shifting to
programmes and facilities that make it possible to make
financing available for "lighter" policy dialogue related
needs on an ad hoc basis.
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New instrument: Common Space Facility (already under
TACIS AP2006, expected to be continued under ENPI)
Common Space Facility (1)
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Aiming to support policy dialogues under Common
Spaces
The fist budget of EUR5.5 million available under
the AP 2006
Eligible activities include
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Policy studies
Seminars
Workshops
Expert mobilisations
Study tours
Publicity actions
Policy and legal advice
Research papers
Procedure for applications is being discussed with
Russian Ministry of Economic Development and
Trade and Ministry for Foreign Affaires
Common Space Facility
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It is likely that applications will be submitted by
Russian line ministries (including the Ministry of
Health and Social Development) and by European
line DGs (including SANCO and Relex) using a
standard questionnaire aiming to identify the
Common Space and policy dialogue relevance
Once a proposed action is approved by all parties
procurement will be through call for proposals to EC
member states administrations (for MS expertise) or
through framework contract procedure (for private
sector consultants), possibly also through
international organisations in specific cases
Due to external cooperation programme deadlines,
all funds must be committed to specific activities by
July 2009
ENPI Interregional Program - TAIEX
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The ENPI interregional programme contains, among
other instruments, the programme "TAIEX“
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Seminars, study visits, expert mobilisation
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Demand Driven instrument. There is no budget
allocation per country. Instead the funds are utilised
for events on a first come first served basis. The
available budget covers all countries of ENPI/east
TAIEX is administered in a specific TAIEX unit in DG
Enlargement. Applications can be put forward by line
DGs (e.g. SANCO) or Russian line ministries (including
Ministry of Health and Social Development)
Events implemented in Russia or for Russians should
ideally be related to the four common spaces
ENPI Cross Border Coop. Program (CBC)
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The ENPI/CBC programme is an innovative region-to-region
cooperation between EU and the North West of Russia
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In line with the new EU-Russia Regional Policy Dialogue
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The priorities under the CBC programme include:
 promote economic and social development in regions on both
sides of common borders
 address common challenges, in fields such as environment,
public health and the prevention of and fight against organised
crime
 ensure efficient and secure borders
 promote local cross-border “people-to-people” actions
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Bottom up approach:
Joint Management
countries and regions
JMA will launch calls
contracts
Joint Operational Programs prepared by
Authorities (JMA) representing the
concerned. Decentralised management:
for proposals, evaluate offers and sign
ENPI CBC - Russia
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Russia can benefit from 7 CBC programmes:
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Kolarctic (Finland-Russia)
Karelia (Finland-Russia)
South-East Finland-Russia
Estonia-Latvia-Russia
Lithuania-Poland-Russia
Baltic Sea
Black Sea
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The indicative EU contribution in the 2007-2013 period is EUR308
million for the 7 programmes concerning Russia
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Russia has indicated it will provide EUR 122 million (an exact
mechanism for this co-financing is being discussed)
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Baltic Sea Program already approved by Commission Decision
December 2007, awaiting Russian signature (Deadline end 2008)
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Other 6 Joint Operational Program Documents must be finalised,
approved by participating states and sent to Commission in June
2008 the latest or funds will be lost
Global Fund
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In addition to national and regional programs, the Commission
channels substantial support to health sector through the Global
Fund to fight HIV/AIDS, Tuberculosis and Malaria
We have contributed more than € 600 million over a period of 6
years. The Commission, together with the Member States, account
for over half of the total financial contributions to the Fund
Russia benefits considerably from the Fund, for iinstance providing
support to two programs aiming to fight tuberculosis:
• The Tomsk Oblast Comprehensive Strategy to Contain and Control
Tuberculosis (2004-09, approved funding USD10,766,486) is aiming
to address the currently high rates of tuberculosis and multi-drug
resistant tuberculosis in the general and the prison populations
• The Promoting a Strategic Response to TB Treatment and Care for
Vulnerable Populations in the Russian Federation (2005-2010 ,
approved funding USD49,436,016) program directly benefits TB
patients from these groups, particularly the homeless, disabled and
unemployed, former and current prisoners, people living with HIV and
people diagnosed with multi drug-resistant TB.
ENPI CBC - Health
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Public health mentioned as area for cooperation in the Cross
Border Cooperation Strategy Paper 2007-2013 and Indicative
Program 2007-2010
The strategy stresses that activities in the health sector must
take into account specifically the cross-border context for
instance for communicable diseases (Tuberculosis, HIV/AIDS)
or possible epidemic or pandemic diseases
Consumer protection, food safety and quality assurance and
surveillance system likewise mentioned as relevant in crossborder context
If health is included in the Joint Operational Programs as a
priority, projects can be later developed in this area
III. Medium Term Outlook
Medium-term Outlook
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Continued implementation of Road Maps
New EU-Russia Agreement replacing the
PCA, taking into consideration Russia’s WTO
accession
Energy security and investment will play a
key role in relationship
Reinforcing sector dialogues
Work together to promote solutions for
regional conflicts and global challenges
HEALTH:
 A new EU-RU public health dialogue
under preparation
 A specific article on public health in New
Agreement could be envisaged
Conclusions
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EU & Russia are inextricably linked through
geography, history, culture, joint interests and
challenges
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Two largest entities on the European continent, but
with an economic and trade asymmetry
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European security is inseparable from Russian security
and unthinkable without Russia
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Large number of shared challenges and opportunities
reflected in growing number of dialogues
HEALTH:
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Move away from financial assistance to dialogue based
partnership and co-financing
Exchange of statistics, best practices in areas of mutual
interest, common initiatives along the Road Map
Contacts and Further Information (1)
European Commission Russia Unit website:
http://ec.europa.eu/comm/external_relations/russia/intro/ind
ex.htm
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European Commission Delegation to Moscow website:
http://www.eur.ru/en/index.htm
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EC Russia Unit Secretariat email:
[email protected]
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On EU-Russia relations and Northern Dimension:
• Michael Webb, Deputy Head of Unit, DG RELEX Russia Unit
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On EU-Russia economic, social and health cooperation:
• Monika Hencsey, Desk Officer responsible for health sector, DG
RELEX Russia Unit
Contacts and Further Information (2)
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ENPI National Program
• EC: Mr. Jyrki TORNI, geo-coordinator for Russia, AIDCO
• Russia: coordinated by the National Coordination Unit: Mr. Dmitry
LEVCHENKOV, Head of Department of Investment policy, Ministry of
Economic Development and Trade
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ENPI Common Space Facility
• EC: Ms. Outa HERMALAHTI, programme coordinator for EU-Russia
cooperation programme, EC Delegation Moscow
• Russia: coordinated by the NCU: Mr. Dmitry LEVCHENKOV, Head of
Department of Investment policy, Ministry of Economic Development and
Trade
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ENPI Interregional Program: TAIEX
• EC: Ms. Miriam TOPLANSKA, DG Elarg, coordinator for TAIEX in Russia
• Russia: coordinated by the NCU: Ms. Elena KOLEROVA, TAIEX contact point,
Department of Investment policy, Ministry of Economic Development and
Trade
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ENPI Cross Border Programs
• EC: Ms. Bodil PERSSON, project manager for ENPI / CBC programme, AidCo
• Russia: coordinated by the Ministry of Foreign Affairs: Mr. Dmitry BUKIN,
Counsellor, Department of Common European Cooperation, Ministry of
Foreign Affairs