Policy responses for Albania - HSRM

Albania


Policy responses for Albania

5. Governance

5.1 Governance

The GOVERNANCE of the health system with regard to COVID-19 relates to pandemic response plans and the steering of the health system to ensure its continued functioning. It includes emergency response mechanisms, as well as how information is being communicated, and the regulation of health service provision to patients affected by the virus.

The following plans were in place before the outbreak:
• National Emergency Response Plan: "National Civil Emergency Plan of Albania".
• The Health Sector also had its plan: "Ministry of Health Emergency Operation Plan"
• 2 contingency plans that addressed the viral respiratory diseases: 1) "National Pandemic Influenza Preparedness and Response Plan" and 2) "Infectious Diseases Hospital (IDH) Crisis Prevention Plan, Focused on Pandemic Flu H1N1".

The COVID-19 Action Plan of Albania “Prevention, preparedness and response against COVID-19” was developed based on the National Pandemic Influenza Preparedness and Response Plan.

Emergency legislation has been adopted to deal with the pandemic. Most importantly, the Decision of the Council of Ministers No.243 of 24 March 2020: “On the Declaration of Natural Disaster Situation” declared a state of natural disaster due to the COVID-19 epidemic, and stipulated the following:
1. Declaration of the state of natural disaster throughout the Republic of Albania due to the epidemic caused by COVID-19.
2. Limitation of the rights guaranteed by Articles 37, 38, 41, points 4, 49 and 51 of the Constitution to the extent considered necessary, to achieve the protection of the health of citizens.
3. Inter-Ministerial Committee on Civil Emergencies (KNEC), established by Decision No. 750, dated 27.11.2019, of the Council of Ministers, "On the declaration of the state of natural disaster in the regions of Durres, Lezha and Tirana", as amended, is the highest body for the coordination of actions of state institutions and private entities, as well as of financial and material resources to cope with the natural disaster due to the COVID-19 epidemic, up to 30 (thirty) days from the date of entry into force of this Decision. The KNEC member is also designated the Minister of State for Reconstruction.
4. KNEC meetings shall be attended, at the request of the Chair, by representatives of the various public, business, medical / public health experts / professionals and representatives of civil society or NGO leaders, with the object of its work public health and humanitarian aid.
5. The Institute of Public Health is assigned the role of the KNEC Technical Secretariat for natural disaster issues declared due to the COVID-19 epidemic.
6. Extraordinary measures shall be taken to cope with and mitigate the consequences of the natural disaster, as follows:
6.1. Public institutions:
a) to implement organizational and administrative measures plans to cope with the situation of the
natural disaster;
b) use the financial resources provided for in the annual budget, as well as reassess their annual budget, in accordance with the provision of additional contingency expenditure;
c) make available human and logistical resources;
ç) to designate state-owned facilities in their administration responsibility, which may be assigned for the sheltering of evacuated population;
(d) restrict access to public places that are widely frequented;
e) limit the activities to the minimum necessary for all public bodies;
ë) quarantine all persons confirmed or suspected to be affected by COVID-19;
f) establish and provide staffed quarantine zones, with personnel provided with protection equipment to avoid infection;
g) to guarantee conditions and qualified staff for specialized treatment in quarantine centres; k) to provide all staff of hospital and health centres with the necessary equipment/ materials to avoid infection.
6.2. Operational Structures of the Civil Protection System:
1
a) establish and implement special measures to ensure and increase the security of citizens in disaster affected areas;
b) to activate and organize the quarantine procedure for the endangered population;
c) to organize unilateral inspections of dwellings and private facilities for identification and treatment of persons affected by the virus;
ç) to restrict free movement within or outside the country in accordance with the requirements dictated by natural disaster;
d) restrict the organization of strikes;
dh) restrict the development of economic activities of private entities in accordance with the needs dictated by natural disaster;
e) to provide first aid to persons affected by the virus and to carry out transportation of those affected to hospital centres or quarantine infrastructure;
ë) to organize the procedures required for the performance of funeral services.
6.3. Private entities:
a) respect the quarantine procedures and measures;
b) to provide information to assist public institutions and civil protection structures in coping with the disaster;
c) be involved in specific tasks, in accordance with their preparation, skills and need for helping to overcome the state of natural disaster;
ç) to cease or temporarily limit their activity;
d) not to collect road toll charges for vehicles engaged in coping with the condition of natural disaster.
6.4. Citizens:
a) to comply with the orders, measures and instructions of the civil protection authorities and to follow procedures required, in particular for quarantine and suspension of activities;
b) to provide information to assist public institutions and civil protection structures in coping with the disaster;
c) be involved in specific tasks, in accordance with their preparation, skills and need for help overcome the state of natural disaster.
7. All rights and freedoms restricted by acts, pursuant to Law No.15 / 2016, “Prevention and fight against infections and infectious diseases”, as amended, and Normative Act No.3, dated 15.3. 2020, of the Council of Ministers, "On special administrative measures for the duration of the period of infection caused by COVID-19", as amended, shall remain in force.
8. The Inter-Ministerial Committee on Civil Emergencies and all state and public institutions are responsible for the implementation of this decision.

Other relevant legislation includes 15 normative acts (having the power of the law, but for a limited period of time as dictated by the emergency) and over 70 by-laws (Decisions of the Council of Ministers and Ministerial Orders).

National response mechanisms to COVID-19 include the following:
- The Inter-Ministerial Committee on Civil Emergencies (KNEC), chaired by the Prime Minister.  The Institute of Public Health is assigned the role of the KNEC Technical Secretariat. (Reference: Decision of Council of Ministers No.243 of 24 March 2020: “On the Declaration of a Natural Disaster Situation”)
- The Task Force of the Ministry of Health and Social Protection “For the prevention of infection spread by the new Coronavirus". The Task Force consists of 10 members and is chaired by the Deputy Minister of Health and Social Protection. Members include representatives of the State Health Inspectorate, the Institute of Public Health, the University Hospital Centre “Mother Tereza”, the University Hospital “Shefqet Ndroqi”, the Operator of the Health Care Services, the National Agency of Medicines and Medical Devices, the National Centre of Medical Emergency, the General Directorate of Border and Migration, and WHO. The Task Force coordinates the implementation of planned measures according to the degree of risk of COVID-19 infection. (Order of the Minister of Health and Social Protection No. 53/1 of 31 January 2020: "On the establishment of the Task Force for the prevention of infection spread by the new Coronavirus")
- The Technical Committee for the preparedness and response to the infection caused by the new Coronavirus. The interim committee consists of 12 members chaired by the Deputy Minister of Health and Social Protection. The members are experts in Public Health, Infectious Diseases (adults), Infectious Diseases (children), Microbiology, Regulation of Medicines and Medical Devices, Health Inspection, Health Services (Order of Minister of the Health and Social Protection No. 53 of 31 January 2020: "On the establishment of the Interim Committee, for the infection spread by the new Coronavirus")

Fast track procedures
There are fast-track procedures for the importing of unregistered medicines and medical devices.

Coordination of surveillance; communications; international reporting (e.g. WHO and EU); and testing
The coordination is conducted by the National Institute of Public Health, upon the approval of the Ministry of Health and Social Protection. The National Institute of Public Health is the IHR Focal Point.