Opportunities at International level regarding Roma health

1. OSI Network Public Health Program Conference Istanbul, May 2005 Cristi Mihalache Opportunities at International level regarding Roma health

2. Opportunities at international level for a specific agenda on Roma health • There is momentum to be taken advantage on due to unprecedented attention to Roma issues in Europe. • Tendency to agree that the health status and access to health care of Roma is poor. Still, the claim is not based on comprehensive data to ascertain this situation. • Both governments and intergovernmental institutions and organizations have developed various policy frameworks in which Roma as a group at risk and excluded group should fit. • In fact – Roma should be prioritized into core policy documents at both national and international level as currently for the most part they are not.

3. Stakeholders • National level: • Government – Ministry of Health, Ministry of Social Affairs, Office on Roma. • Local authorities: County council, Local council, Health public authority, Health-care institutions. • NGOs (Roma and non-Roma) working both at local and national level, social workers (preferably Roma), community representatives • Research institutions • International level: • Intergovernmental organizations: UN – WHO, OSCE, Council of Europe, and the European Union. • International NGOs: OSI, ERIO, ERRC and other partner organizations.

4. Organisation for Security and Co-operation in Europe -- OSCE • Very politicized, soft approach vs. “behind-the-scene” diplomatic approach. • OSCE missions in post-conflict countries directly or indirectly involved in policy-making. • OSCE Plan of Action on Roma and Sinti includes a distinct chapter on Health. OSCE looks at revisiting its working methods. • This forum can be used in order to look at the assessment –monitoring and evaluation – of the implementation of the Action Plan and connected policy measures.

5. Council of Europe • CoE Draft Recommendation on Roma access to Health-care • European Health Committee: the possibility to look further at the situation of Roma. • Health and Ethics unit within the DG III Social Cohesion: deals with vulnerable groups such as Roma.

6. United Nations • WHO – explore more the possibility of using the system. Encourage and ensure that Roma organizations working on Roma health are aware of and do explore these possibilities to get Roma higher on UN health-related agenda. • The implementation of the Millennium Declaration should be followed closer.

7. European Union • Full member state countries: Hungary, Czech Republic, Slovakia + Poland and Slovenia. • Acceding countries: Bulgaria and Romania. • Candidate countries/countries starting the negotiation process soon: Croatia, Turkey/Serbia& Montenegro, Macedonia, Bosnia& Herzegovina

8. A. EU Inclusion Process • Lisbon and Feira European Council as the starting point (2000) for the “open method of co-ordination” in the field of tackling poverty and social exclusion. • Primary and secondary indicators have been agreed (e.g. life expectancy at birth and self perceived health status). • Countries had to produce periodic reports: the new member states + Romania and Bulgaria had transitional ones (JIMs) while the old member states and from 2006 on the new member states also have to produce NAPs on social inclusion. • The process will be reformed: important for those working in the field of Roma health to ensure that governments include specific measures aimed at the improvement of the situation of Roma, including in the field of health • A better co-ordination between policy-makers, CSOs and the Roma communities themselves is needed.

9. B. DG Health and Consumer Protection • Developing a system of health monitoring – comparable information on health as well s agreed indicators – core task of DG Health: it is important that this takes into account the lack of comprehensive data about Romani communities. • Within the Community action program in the field of public health, organizations can participate in open tenders publicized periodically by the European Commission. • Countries about to start negotiations for accession to the EU (Croatia, Serbia& Montenegro, BiH, Macedonia) in the near future, it is essential that when they translate EU legal framework into domestic legislation issues related to Roma health are prioritized because: (1) national policies have to be implemented in this respect; and (2) pre-accession id schemes of funding will be designed and implemented. • The EU Health Forum

10. National level • Lack of capacity of most Romani organizations aimed at a strategic approach in dealing with public authorities. • Need for capacity-building aimed at: • Better communication with other organizations and institutions working in the field of public heath. • Strategic and consistent approach in the work with public authorities. • More substantial input in policy-making: core policy documents and budgets. • Better co-ordination between peer CSOs. • ALL aimed at ensuring that issues related to the health status and access to health care for Roma are prioritized and adequately budgeted, while closely monitoring the implementation of existing measures.