MONTENEGRO TECHICAL COOPERATION WITH CANDIDATE COUNTRIES EXPERIENCE OF MONTENEGRO IN THE PUBLIC HEALTH SECTOR Public Health Institute of Montenegro Boban Mugosa Ljiljana Golubovic Tatijana Djurisic

COOPERATION WITH: EMCDDA – European Monitoring Centre for Drugs and Drug Addictions EFSA – European Food Safety Authority ECDC – European Centre for Disease Prevention and Control EMEA – European Medicines Agency Approved IPA project for 2010 “Implementation of the European blood transfusion system in Montenegro”

CARDS-EMCDDA technical cooperation project first January 2008: first CARDS-EMCDDA technical cooperation project - “Assessment of the capacity of Western Balkan countries to establish drug information system compatible with the European Monitoring Centre for Drugs and Drugs Addiction” EMCDDA assessment mission (April 2008) Country Overview (Country Situation Summary) and Information Map (May-October 2009) ESPAD ( ) Expert cooperation in production/introduction of treatment demand register

Cooperation with ECDC Centre for Disease Prevention and Control of the PHI of Montenegro delivers regular reports about status of infectious diseases in Montenegro since 2009 Cooperation is focused at quick exchange of data and updated information and transfer of know-how Expectations: Cooperation in the area of current and new infectious diseases prevention programmes and health promotion Encouragement in conducting reform of the legislation in the area of infectious diseases Technical support needed in: Application of methodology of gathering comparable data Development and strengthening of disease surveillance system Development and strengthening of the early warning system

Cooperation with EMEA Montenegrin Agency for Medicines and Medical Devices follows up and applies recommendations and guidelines of the EMEA with the aim of protecting health of humans and animals IPA programme component for development of national Agencies (2010) will enable participating countries to take part in EMEA activities, with a view to become partners in all areas of work after the accession The programme will include, among others, the following activities: Participation of representatives of the Agency at EMEA meetings (as observers), including the programme kick-off meeting in London Participation in trainings Attendance/organisation of conferences in participating countries

Cooperation with EFSA Since October official cooperation with the National Council for Food Safety within the Ministry of Health (exclusively on advisory basis) Cooperation includes: Enforcement of food safety control and risk assessment system Information exchange and usage of data Application of measures and recommendations Obligations of Montenegro towards EFSA currently include: Reporting on the achieved in the area of food safety and risk assessment Harmonisation of legislation Needs: Technical assistance in educational programmes in the area of food safety Technical assistance in implementation of risk assessment in food safety

CHALLENGES Coping with financial procedures estimated as overly time- consuming, complex, weakly motivating but poorly cost- beneficial Lack of knowledge about competences of EU agencies among practitioners/experts in the field, at times accompanied by unrealistic, inadequate expectations from EU agencies Lack of motivation at the national level for voluntary work (experts/ associates/ administrative assistants do expect to be additionally paid for their additional work load), and at the same time existence of such expectations by the EU partners in the very beginning absorption capacity Inadequate staffing in the institutions to meet the demands and to take part in meetings/trainings (insufficient absorption capacity)

CRITICAL OUTLOOK Still better insight into and understanding of the local context Still better feedback in all stages of the process Swifter fulfilment of contracted financial arrangements towards local partners Prior to beginning of the technical cooperation projects, national counterparts should be comprehensively and in- depth introduced with, and trained in, all areas of interest, so as to be able to coordinate work at the national level more efficiently

LESSONS LEARNT KEY for achieving high-quality results - good, thorough, precise and realistic plan of project implementation and equivalent planning of all kinds of resources! KEY for achieving high-quality results - good, thorough, precise and realistic plan of project implementation and equivalent planning of all kinds of resources! It is equally important: It is equally important: to plainly delegate technical responsibility for project implementation on the national level (responsible institution and responsible person) to clearly and precisely define and respect deadlines; to clearly define all phases of project implementation and dynamics of implementation in order to avoid delays in project launch as well as inappropriate use of resources to regularly organise well structured and well-timed coordination meetings between stakeholders in order to maintain extensive and effective interdisciplinary and inter- institutional cooperation and regular information exchange

cont. to involve persons with specific expertise as relevant partners in project activities to continuously strengthen partnership with civil society to continually coordinate activities and exchange information with relevant European institutions and other participating countries Previous experience also suggests: Previous experience also suggests: it is necessary to systematically and continuously evaluate project realisation and project outcomes, in order to incorporate findings in the following projects as lessons learned significance of interesting, memorable and continual trainings of project participants and experts – associates

cont. T hrough learning how to assure implementation of European regulations and standards on the national level, that is, how to harmonise national systems with the European, we have learnt the most valuable lessons of them all: European standards are not unattainable European standards are not easily attainable either Process of ever - learning and ever - improving Rules, forms, legislation are not “carved in stone”, but changeable in compliance with changing reality

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