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.
On 4 May, the President of the Republic and the Prime Minister submited to the Serbian parliament a joint proposal to lift the state of emergency on 7 May. The proposal has been made following a detailed study that states that active epidemiological surveillance of infectious disease COVID-19 had been established and there has been a decrease in the intensity of viral activity. Taking into account all the current parameters, the proposal submitted to the Serbian parliament states that COVID-19 can no longer be considered a disease of relevance to public health with the highest degree of risk, that is a public danger that threatens the survival of the state and its citizens.
On 6 May, the parliament of the Republic of Serbia lifted the state of emergency. The parliament also abolished 11 decrees that were in force during the state of emergency (among others, the Decree on organizing the work of employers during a state of emergency and others, mostly related to financial regulations) (http://www.pravno-informacioni-sistem.rs/SlGlasnikPortal/eli/rep/sgrs/skupstina/zakon/2020/65/1/reg).
On 12 November, the Serbian Parliament adopted changes in the Law on Preventing Infectious Diseases. The most significant changes within the law are:
• The communal police and inspectors will be able to sanction a person not wearing a face mask or disrespecting the physical distance in the open or indoors with a 42.5 Euro (5,000 Dinars) fine.
• For companies and other legal entities, if they do not take actions and activities for the application of measures of protection against infection or do not designate a person responsible for the direct application of these measures, the prescribed fine ranges from 425 to 2,552 Euro (50,000 to 300,000 Dinars).
• Self-isolation is introduced in the Law as a measure for people requiring treatment at home. It restricts the freedom of movement of patients with infectious diseases without symptoms and patients who do not require treatment in hospitals.
• A certificate from an epidemiologist is sufficient proof for the employer that the worker shall not work for a certain period, and that he/she is entitled to a salary.
• The Law also allows restriction of entry into Serbia for persons coming from countries with an unfavorable epidemiological situation.
• Supervision over the implementation of measures, in addition to the Sanitary Inspection, is performed by the local self-governments through the Communal Police, the sanitary inspector can issue a misdemeanor order, while the Communal Police can close an establishment for a maximum of 72 hours.
• The Law also prescribes that in the event of an epidemic of an infectious disease a health minister may determine, in line with the World Health Organization rules, the recommended or mandatory emergency immunization of the entire population, or specific groups if there is a danger of transmission.
There is a Pandemic Influenza Plan that has been recently revised and most of its provisions have been applied in this situation.
In addition, there are multiple, coordinating bodies, committees and headquarters that are in charge of different aspects of the response to the COVID-19 outbreak:
1. Govermental Crisis Headquarters/Crisis Response Team (led by the Prime Minister) for the response to the COVID-19 outbreak;
2. Govermental Crisis Headquarters/Crisis Response Team (led by the President) for the economic and financial aspects of the response to the COVID-19 outbreak;
3. Operational Inter-Sectoral Headquarters for the response to the COVID-19 outbreak, with a mandate to implement and inform of all the decisions of the two above-mentioned headquarters;
4. Special Task Force within the health sector, appointed by the Minister of Health, to prepare expert analyses and to recommend health measures that are to be undertaken;
5. National Expert Committee for Communicable Diseases;
6. National Expert Committee for hospital infections.
The functioning of these various bodies is based on the provisions of the Law on the Protection of the Population against Communicable Diseases, the Law on Public Health, the Law on Health Care, the Law on Disaster Risk Reduction and Emergency Management, the Law on Martial Law, the Law on Medicines and Medical Devices and all related sub-laws, regulations and rulebooks. This legislation defines the financing of the response and ensures fast-track procedures for the regulation and licensing of medical devices, as well as for emergency procurement and import.