07 JANUARY 2019 / SNF Health Initiative – 3rd Regular Quarterly Progress Update

The Stavros Niarchos Foundation (SNF) Health Initiative, when announced in September 2017, included seven new individual grants, which further support the Health Sector in Greece, in coordination with the Greek Ministry of Health, taking into account the existing needs of the country.

With a total budget expected to exceed $290 million, the initiative follows a series of important SNF grants in Greece and around the world aimed at enhancing public health and ensuring equal access to high-quality health services for all.

Specifically, the Health Initiative includes the design, construction, and outfitting of new infrastructure projects, the procurement of new medical equipment for the modernization and improvement of existing health infrastructure, the reinforcement of the National Center for Emergency Care (EKAV) air ambulance services, and the establishment of educational programs on in-hospital infections and the treatment of trauma. The architectural design of the infrastructure projects is being conducted by the internationally renowned architectural firm Renzo Piano Building Workshop (RPBW), while Johns Hopkins University and Johns Hopkins Medicine International, long-term partners of the Foundation, contribute in an advisory capacity to share the expertise of major U.S. health institutions with Greece.

We are committed to providing regular quarterly updates with timely and comprehensive information on the Initiative’s progress, and following the first quarterly update that was published on June 20, 2018 and the second update published on October 5, 2018, we present the third quarterly progress update. Upon the ratification of the Grant Contract, the nonprofit Special Purpose Vehicle (SPV) “Health Initiative SA” was established. This organization operates as an implementing body, undertaking the coordination, management, and implementation of the projects, until their completion and delivery to the Greek state.

As of early January 2019, four meetings of the Special Advisory Committee for the Health Initiative have so far taken place between the relevant bodies of the Greek state; Hill International, which has undertaken the project management of the infrastructure projects; and the SNF, ensuring the effective partnership between all stakeholders and keeping participants updated on the development of the overall project.

Progress of individual grants:

> General Hospital of Komotini
The building program for the new General Hospital of Komotini was presented to, finalized by, and approved by the Ministry of Health. At the beginning of 2019, the second phase of the project is expected to begin with studies for the tenders and construction of the new hospital building. At the same time, complementary infrastructure projects are already underway by the Greek state. Specifically, these include the traffic and public transportation access studies and the planning of utility networks, including water, drainage, and wastewater treatment.
  
> Children’s Hospital of Thessaloniki
The SNF is coordinating with representatives of the Health Ministry to finalize the design of the Children’s Hospital of Thessaloniki, which will be established in order to provide fundamental medical care for the people of Northern Greece and surrounding areas and will complement the functions of existing health infrastructures. At the same time, the building program being prepared is expected to be finalized in cooperation with other stakeholders.

> Nursing Department of the School of Health Sciences of the University of Athens – Evangelismos General Hospital
No significant progress was made during the last quarter in the design of the building to be erected in the current location of Sisters’ House and Nursing Sisters’ buildings on the premises of Evangelismos General Hospital in Athens, due to reservations expressed by the Hospital’s Board of Directors and the Workers’ Union about the project.

The reactions of the Board of Evangelismos Hospital concerned the exclusive use of the new building by the Nursing Department of the University of Athens in order to operate as the Chair of the University’s Faculty of Nursing, indicating that, due to the saturation of existing spaces, the new structures should only house existing Hospital services.

In order to advance the project, we held extensive discussions with the Ministry of Health and the relevant bodies during which we emphasized the magnitude of the specific project, taking into account the importance we give on the sector of nursing and its development on a global scale. In addition, the involvement of the world-renowned architect Renzo Piano in the project would open further possibilities for the overall nursing sector in Greece. To that end, the SNF proposed the modification of the original architectural plans to provide additional spaces for the Hospital’s existing Department of Nursing. However, the proposal did not proceed, as the position of the Hospital’s Board remains that new services should not be accommodated in the new premises.

As part of the effort to find common ground between the parties involved, and at the request of the SNF, a meeting was held on Thursday, December 20, 2018 between the Foundation, Health Ministers, and members of the Board of Directors of Evangelismos Hospital, which includes employee representatives. During the meeting the Hospital’s Board of Directors informed the SNF that it does not agree for the project to move forward in the manner that it was originally agreed upon.

As a result, it was decided among all relevant parties to immediately proceed with the cancellation of the grant for the infrastructure construction project at Evangelismos General Hospital.

This cancellation does not affect the progress of any other project under the Health Initiative, including the grant for the procurement and installation of equipment for Evangelismos, which are proceeding as planned.

During the same meeting, the SNF Co-President, Mr. Andreas Dracopoulos, expressed the intention for the SNF to evaluate and potentially support proposals for the development of the nursing sector in the country through the Nursing School at Evangelismos Hospital (which was created with the original purpose of providing training and education to the Nursing Sisters) as well as the Nursing Department of the School of Health Sciences of the University of Athens.

> Procurement and installation of equipment for Evangelismos General Hospital
The individual Grant Contract, with a total budget of €8.5 million, was ratified under law by the Greek Parliament on Thursday, September 20. During the meeting held on Thursday, December 20, 2018 between representatives of the SNF and members of the Board of Directors of the Evangelismos Hospital, the SNF stressed that the grant for the procurement of equipment for the Hospital would proceed normally, regardless of the cancellation of the construction project, taking into account our fellow countrymen who benefit from the hospital’s services as well as the SNF’s overall philosophy to try, wherever and whenever possible, to contribute to the common good.

> Procurement of new equipment and maintenance of existing equipment for the National Center for Emergency Care’s (EKAV) air ambulance services
Following the submission of a comprehensive grant proposal by the relevant Project Team of the Greek state, a cost assessment report for the repair of 3 AGUSTA A109E helicopters has been commissioned. At the same time, the Johns Hopkins team is in the process of evaluating financial bids for the purchase of two new airplanes for air ambulance services and the provision of enhanced nursing care during air transport.

> Procurement and installation of special medical equipment (PET scanners) across Greece
The joint evaluation process to finalize the exact scope of the grant is underway, including the timetable, for the procurement and installation of special medical equipment (Positron Emission Tomography [PET] scanners), as well as the creation of radiopharmaceutical production units in selected public medical institutions. The initial plan provided for the installation of the PET equipment in selected public hospitals across the country, in the areas of Thessaloniki, Crete, Larissa, and Ioannina. At the initiative of the SNF, the Hospital of Alexandroupoli is also being considered for the program. At the same time, the SNF is in contact with the relevant Project Team of the Greek state to finalize the obligations of the parties involved, in order to subsequently ratify the individual Contract by law in the Greek Parliament, and to proceed with the implementation phase.

> Creation and Implementation of Educational Programs
This grant consists of the design and implementation of two individual educational programs. Specifically, one pertaining to the treatment of trauma and another to the treatment of in-hospital infections. With regard to the educational program on the treatment of trauma, during the finalization of the grant proposal, the parties involved (the SNF and the relevant Project Team of the Greek state) did not reach an agreement on the budget and the proposed operating model. Following this, new proposals are being examined in order to reach a mutually agreeable solution.

The new proposal includes a five-year plan, to be implemented by the National Center of Advanced Trauma Life Support (ATLS), which is based at the 1st Orthopaedic Department of the National & Kapodistrian University of Athens at Attikon Hospital and is supported by the NGO Regeneration & Progress.

With regard to the educational program on the treatment of in-hospital infections, the SNF awaits from the relevant Project Team of the Greek state the proposal, which is under development.

SNF Health Initiative Milestones

September 6, 2017: Announcement of the Health Initiative by the SNF
March 21, 2018: Signing of a Memorandum of Understanding between the SNF and the Greek state
June 20, 2018: Presentation of preliminary plans by Renzo Piano at the Maximou Mansion
September 20, 2018: Ratification under law by the Greek Parliament of the Grant Contract for the Health Initiative
September 27, 2018: First Meeting of the Special Advisory Committee for the Health Initiative

 
A few words on the SNF’s healthcare actions in Greece

The new grant initiative follows on the heels of a previous SNF grant to the National Center for Emergency Care (EKAV), totaling $15 million, which was recently completed, and which covered the procurement of 143 state-of-the-art ambulances and their full maintenance for a period of eight years, as well as the digital upgrade of EKAV’s operations center. Since 1996, when the SNF began its grant making activity, the SNF has already provided grants of more than $130 million for the support of health programs in Greece.

Past grants in the health sector include the grant, totaling $23 million, to support the replacement of ten obsolete linear accelerators in seven public hospitals around the country, the grant for the renovation of all Pediatric Intensive Care Units (ICUs), as well as the grant for the construction and complete outfitting of hostels to house the relatives of patients in hospitals around the country, in areas such as Alexandroupoli, Ioannina, Patra, Crete. In addition, the SNF’s initiative for the establishment of the Mobile Medical Units, in collaboration with the NGO “Regeneration and Progress”, has wielded significant results in providing healthcare programs to residents of islands and remote areas in Greece, such as Kastelorizo, Schoinousa, Astypalaia, Agathonisi, Kasos, Prespes and more.