SNF GHI 13th Progress Update

This is the thirteenth Progress Update on the Stavros Niarchos Foundation (SNF) Global Health Initiative (GHI), published as part of SNF’s commitment to ensuring full transparency and updating the public with timely and accurate information on the development of all projects included in the initiative.

The Three New SNF Hospitals

The new SNF hospitals in Thessaloniki, Komotini, and Sparta are now entering the construction phase, following an extensive planning and design cycle that began in 2018. This represents a major milestone for the three projects, especially given recent challenges entailed in the cancellation of the tender for their construction in February 2023 due to the exceptionally high bids received. To address this void tender outcome, SNF, together with Hill International, the Design Team, and expert consultants, engaged in renewed deliberations and carried out an intensive direct negotiation process over the past several months, which led them to award the construction and outfitting of the three hospitals to AVAX S.A., one of the largest construction groups in Greece and Cyprus.

In the coming years, the Foundation will be concentrating its efforts on bringing these three landmark projects to fruition and implementing each of the other projects included in the GHI, aspiring to help achieve lasting improvements in access, quality, and equity in health care for all.

Further Global Expansion

The global expansion of the GHI beyond Greece, which began in 2022, has progressed further with new partnerships that strengthen SNF’s commitment to expanding access to quality health care around the world. New collaborations with leading organizations in Europe, Sub-Saharan Africa, and the United States aim to enhance the provision of lifesaving care, the promotion of child and adolescent mental health, and the exchange of knowledge across borders. Since the last Progress Update, SNF has launched partnerships with:  

• National Children’s Alliance (NCA) to launch and scale a national training program in trauma-informed therapy, designed specifically to reduce traumatic stress symptoms in children who have been victims of abuse in the US.
• Yorkshire Cancer Research to support a pioneering exercise oncology program to improve outcomes and quality of life for cancer patients in the UK. SNF support also establishes an exercise oncology fellowship program between Yorkshire Cancer Research and Regeneration & Progress (R&P), a nonprofit affiliated with SNF.
• Sant Joan de Déu (SJD) Barcelona Children’s Hospital for the construction and outfitting of the new ÚNICAS Center for Rare Pediatric Diseases, consolidating specialized care and support for children and families affected by rare diseases.
• Tygerberg Hospital Children’s Trust (THCT) to support renovation and other critical improvements in the Adolescent Psychiatric Unit at Tygerberg Hospital in Western Cape province in South Africa.

In addition to the forging of new partnerships, recent months have also seen the formal launch of the previously announced SNF Institute for Global Infectious Disease Research at The Rockefeller University, as well as the SNF Center for Precision Psychiatry and Mental Health at Columbia University. In the coming years, these innovative and interdisciplinary centers will carry out pioneering research with practical applications, addressing urgent global priorities in their respective fields. SNF’s support to the Hospital for Special Surgery (HSS) and the New York Stem Cell Foundation (NYSCF) in the US is also ongoing under the GHI. Moreover, SNF is in discussions with Memorial Sloan Kettering Cancer Center (MSK) in the US for a new program aimed at fostering and strengthening international collaborations in the field of pediatric oncology. More details from these discussions are expected in the coming months.

The updated plans for the three new SNF hospitals and new international partnerships under the initiative have brought SNF’s total commitment to the GHI to $1 billion.

Ongoing Grants in Greece

Grants under the GHI in Greece continue to proceed as envisioned. Implementation of the Child and Adolescent Mental Health Initiative (CAMHI) has advanced considerably. CAMHI outlined and discussed its programming and future direction during its inaugural conference on January 26, 2023, published a comprehensive Landscape Analysis assessing needs and priorities for child and adolescent mental health in Greece, and completed implementation of the first year of the Youth Engagement Scheme (YES). Additionally, multiple grants providing vital equipment and modern systems at public hospitals have been completed, including most recently, in April 2023, the delivery of new PET/CT scanners and renovated spaces at four university hospitals in Greece’s geographic peripheries—namely in Alexandroupoli, Ioannina, Larissa, and Heraklion. Additional support to revamp critical clinical units and vital infrastructure at major public hospitals in Athens is underway, while a wide range of educational and training programs in nursing, trauma, intensive care, and infection control are ongoing and have already enhanced the skills of hundreds of health professionals across the country.

The following is a detailed look at the main developments in the SNF Global Health Initiative’s constituent grants since the previous Progress Update.

The SNF Global Health Initiative’s infrastructure projects include the design, construction, and outfitting of three new state-of-the-art hospitals in Komotini, Thessaloniki, and Sparta, as well as infrastructure expansion and renovation projects at existing hospitals in Greece, Spain, and the United States.

• The Three New SNF Hospitals 

In recent months, the projects for the creation of the SNF University Pediatric Hospital of Thessaloniki, the new SNF General Hospital of Komotini, and the new SNF General Hospital of Sparta reached a critical juncture. The construction tender that had been unfolding since spring 2022 was cancelled by SNF in February 2023, as the bids received far exceeded the financial scope of SNF’s grant, which had already taken into account the implications of recent international developments (e.g. war, inflationary pressures, supply chain disruption, etc.). In some cases, the offers received were more than double the projected cost. To address the void tender outcome, SNF re-engaged in intensive deliberations with all project partners, including Hill International, Renzo Piano Building Workshop (RPBW), Betaplan, and expert consultants, and launched a renewed competitive dialogue with candidate construction firms.

The above direct negotiation process was concluded in early August, culminating in the awarding of the construction and outfitting of the three new hospitals to AVAX S.A., one of the largest construction groups in Greece and Cyprus. The resumption of the construction process marks a key milestone in the creation of the three hospitals, which will be a central focus of SNF’s work in the coming years. As SNF Co-President, Andreas Dracopoulos said, “The end justifies the means and sometimes the means are to justify themselves to fulfill the end. Our commitment to supporting public health, expanding access to its services, enhancing quality of care for all, and empowering frontline health care professionals is unwavering, even in today's particularly challenging global conditions. The new agreement for the construction of the three new hospitals fills us with pride and responsibility, proving that while our resources are not inexhaustible, our strength and dedication to the benefit of society is unlimited.”

The three new SNF hospitals are designed by internationally renowned architect Renzo Piano and the architectural firm RPBW, in collaboration with Betaplan. They follow a vision shared with SNF for the projects to serve as catalysts for the Greek national health system and to raise the bar as templates for future hospitals internationally.

The extended and revisited bidding process has resulted in updated project timeframes, with completion of construction and delivery of the three fully equipped and outfitted hospitals by SNF to the Greek public anticipated in late 2026. Upon handover to the Greek state, the new hospitals will operate under the public health system and act as reference points in their respective regions, with an aim of strengthening quality health care provision in the country’s geographic peripheries.

Parallel to the construction process, SNF will continue to work with the Hellenic Ministry of Health and competent authorities for the execution of staffing plans and the accompanying public infrastructure works under the purview of the Greek state.

In the spirit of collaboration and exchange that permeates SNF’s global grantmaking, partnerships with international organizations such as Johns Hopkins Medicine International and New York Presbyterian will also be tapped to further enhance the clinical profile and standing of the three SNF hospitals.

As SNF works to update the public regularly and accurately about the progress of the three new hospitals, and to ensure that they are developed in full transparency and in the best interest of local communities, the next round of Town Hall discussions in Komotini, Thessaloniki, and Sparta will take place in November 2023.

• Support for the Renovation of the 2nd Intensive Care Unit and Emergency Department at Evangelismos Athens General Hospital

SNF’s grant to revamp the 2nd Intensive Care Unit (ICU) and the Emergency Department at Evangelismos Hospital in Athens is underway, in collaboration with the Athanasios and Marina Martinou Foundation and Ms. Aliki Perroti.

To reflect the updated implementation modalities agreed with the hospital and the Ministry of Health, the relevant Health Initiative legislation has been amended and ratified accordingly to provide for: (a) an enhanced scope for the creation of a larger ICU by combining the renovation of the 2nd ICU with work for the renovation of the hospital’s old Stroke Unit under a grant made as part of SNF’s global relief initiative for COVID-19, and (b) overall, unified implementation of the enhanced scope by Evangelismos Hospital. Moreover, the preliminary design for the Emergency Department of the hospital has been completed and approved by the competent authorities.

The tender for the reconfiguration and renovation of the enlarged ICU was launched by Evangelismos Hospital in May 2023. Offers from construction companies were received through the end of June 2023, and review is under way and nearing completion. The construction contract is anticipated to be finalized in September, after which the works will begin. Completion of the project is expected in early 2024.

• Design, Construction, and Outfitting of Two New Buildings at Attikon General University Hospital of Athens

SNF’s grant under the GHI to Attikon General University Hospital of Athens pertains to the design, construction, and outfitting of two new buildings within the hospital complex. One building will ensure that on-call rooms and modern rest areas are available to doctors, and the second will consolidate the headquarters of the Coordination Center for the Mobile Medical Units (MMU) operated by Regeneration & Progress (R&P).

Since the 12th Progress Update, SNF approved, at the request of end users and in direct consultation with Attikon hospital, a budget increase to accommodate an enhanced scope for the MMU building. Additionally, the expanded plans will allow the MMU Coordination Center to house supplementary services for patients, including cancer exercise and telemedicine, via long-term collaborations with clinics and departments at Attikon hospital. The design development study is currently being finalized to reflect the updated scope and the design scenario suggested by the end users. The target completion date for the design phase is September 2023. Upon conclusion of the design study, the individual Grant Agreement will be submitted for ratification by the Greek state, and the construction design phase will be pursued.

According to the current timetable, the two buildings will be completed and delivered to the Greek state and relevant organizations in late 2024.

• Sant Joan de Déu (SJD) ÚNICAS Center for Rare Pediatric Diseases

In May 2023, SNF finalized a new partnership with the Sant Joan de Déu (SJD) Barcelona Children's Hospital to support the construction and outfitting of the ÚNICAS Center for Rare Pediatric Diseases, which will provide specialized care and support to children and families affected by rare diseases. This support builds on SNF’s long-standing collaboration with SJD, as well as with the Leo Messi Foundation, most notably, for the creation of the new SJD Pediatric Cancer Center which was inaugurated in June 2022.

The ÚNICAS Center will provide access to specialized care and support to children and families affected by rare diseases. Despite being called “rare,” these more than 7,000 diseases affect at least 300 million people globally. The majority first appear during childhood, and are progressive, chronic, and often disabling. As a result, patients and families often face high levels of health, social, and economic burden.

As one of the leading specialized pediatric centers, SJD has treated over 12,000 children with more than 1,200 types of rare diseases, making it one of the top hospitals in Europe in this field. Building on this track record, the new ÚNICAS Center will bring together and expand existing departments at SJD in a new building near the main hospital, aiming to:

• Improve access to quality care, offering precision diagnosis and advanced therapies,
• Provide comprehensive, personalized care through multidisciplinary teams including psychosocial support,
• Operate a telemedicine program to ensure that essential care reaches patients no matter where they are, and
• Facilitate critical research, including a data science program focused on rare pediatric diseases, with the goal of developing new treatments.

Preparations for implementation by SJD are already underway, and designs for the new Center will be finalized in the coming months.

• Hospital for Special Surgery (HSS)

A recent grant from SNF under the GHI is supporting the construction of the new Anna-Maria and Stephen Kellen Tower at the Hospital for Special Surgery (HSS) in New York, which will expand space for HSS joint replacement and spine care services. This support builds on a nearly two-decade partnership with HSS and helps the world-leading orthopedics institution expand and modernize its facilities.

Part of a larger transformation of its campus, the creation of the new Kellen Tower will help HSS better serve patients’ musculoskeletal health needs and advance clinical research that aims to raise the standard of care available to all. A Digital Inpatient Experience spanning three floors of the new building, including patient rooms equipped with state-of-the-art technology for optimal care and recovery, will reflect SNF’s support.

The Kellen Tower is expected to open and begin serving patients in late 2025. At that point, the Kellen Tower will also become the new home of the SNF Complex Joint Reconstruction Center (CJRC). The SNF CJRC specializes in care of and research into the most challenging cases in the already demanding field of joint replacement, centralizing the world-class resources of HSS to create a one-stop experience that improves patient outcome

• New York Stem Cell Foundation (NYSCF)

A major new GHI grant from SNF for the Susan L. Solomon Center for Precision Medicine at the NYSCF Research Institute is now helping the institution significantly expand its clinical research capabilities. The grant builds on a longstanding collaboration between SNF and NYSCF since 2008 and assists NYSCF in further accelerating medical breakthroughs through stem cell technologies.

As the largest nonprofit stem cell research institute in the world, NYSCF seeks to bridge the gap between the academic institutions where research with healing potential takes place and the companies translating that research into treatments that can reach patients. The new facilities created by the SNF-supported expansion—which will be adjacent to NYSCF’s existing premises—will include clinical-grade laboratories, a precision medicine drug discovery center, and a cancer drug screening laboratory. The Center for Precision Medicine is named in honor of late NYSCF co-founder and CEO Susan L. Solomon, whose tireless efforts helped catalyze the field of stem cell research, transforming the future of medicine in the process.

SNF support for this expansion was provided alongside Bloomberg Philanthropies and the Druckenmiller Foundation.

NYSCF has engaged the architects, engineering firm, and construction group for the project. Construction will commence in early 2024 with completion forecasted by the end of 2024.

• Specialized Medical Equipment (PET-CT) Installation at Four University Hospitals

Following completion of the four GHI grants for the procurement of two new airplanes and two new helicopters to strengthen Greece’s National Center for Emergency Care (EKAV), medical equipment and a new digital nurse call system for Evangelismos Athens General Hospital, and new dental chairs and simulators for the School of Dentistry of the National and Kapodistrian University of Athens (NKUA), SNF’s grant to ensure the availability of new PET-CT scanners at four university hospitals in Greece was concluded in spring 2023.

The grant includes the procurement and installation of PET-CT scanners, as well as accompanying renovation works, in four university hospitals in the country’s geographic peripheries, namely in Alexandroupoli, Ioannina, Larisa, and Heraklion. Per the provisions of the procurement process by the Health Initiative Single Member S.A. and in accordance with Health Initiative law no. 4839/2021, the PET-CT scanners were delivered in all four locations in fall 2022, followed by the reconfiguration and renovation of spaces, pre-installation checks, equipment testing, and training of medical staff in each of the hospitals. In March and April 2023, Departments of Nuclear Medicine (PET-CT) at each of the four hospitals were inaugurated, marking the full completion and handover of the grant to the Greek state. As reflected in the aforementioned law, the Greek state has undertaken responsibility for staffing the new departments, for the operation of the equipment, as well as for the maintenance costs after the end of the two-year warranty period.

These inaugurations were attended by representatives of the Greek state, the Hellenic Ministry of Health, hospital leadership, and SNF. The new PET-CT equipment is expected to yield significant positive impact for patients in the four regions, ensuring access to specialized examinations and care for oncology patients who would previously have needed to travel to Athens or Thessaloniki to receive such services.

• Child and Adolescent Mental Health Initiative (CAMHI)

The Child and Adolescent Mental Health Initiative (CAMHI) in Greece has been developing and growing since its inception in 2021, in partnership with the Child Mind Institute and a countrywide network of public child mental health providers and with support from the Hellenic Ministry of Health. The inaugural CAMHI conference held in Athens on January 26, 2023, was a unique occasion bringing together the country’s mental health and child protection community, along with international partners, for a rich discussion on priorities in the field and the initiative’s capacity-building effort to help address them.

In February 2023, the relevant Grant Agreement between SNF and the Greek state was ratified and incorporated into national legislation (law no. 5015/2023), delineating the scope and programmatic pillars of the CAMHI as well as provisions for ensuring continuity and sustainability of the initiative after the five-year pilot implementation period supported by the Foundation.

Further to the establishment of the initiative’s regional hubs in Alexandroupoli, Ioannina, and Heraklion, in recent months, the CAMHI advanced partnerships with the child mental health clinics of Papanikolaou, Ippokateio, and AHEPA hospitals as well as with the Paidon Agia Sofia Children’s Hospital for the formalization of the hubs in Thessaloniki and Athens, respectively. The corresponding Memorandums of Understanding (MoUs) have been drafted and agreed with the aforementioned parties and will be submitted for execution within September.

At the same time, preparations for the rollout of the CAMHI basic and advanced trainings are fully underway, including in consultation with local school communities, with a target of commencing pilot implementation in the five above regions gradually within the year. Training priorities have been largely informed by the results of the CAMHI’s Landscape Analysis published in early July 2023. The analysis includes findings of an exhaustive review of the scientific literature on child and adolescent mental health in Greece, a summary of laws and policies substantiating a rights-based approach to mental health, results from a nationwide survey of almost 4,000 parents, teenagers, teachers, and mental health professionals, as well as a mapping of available child mental health and educational services across the country.

This summer also marked the conclusion of the first and pilot year of implementation of the Youth Engagement Scheme (YES), the CAMHI’s dedicated platform for listening to the voices of young people and integrating them into all aspects of the initiative’s design and delivery. During the 2022-2023 school year, four Youth Advisory Groups were established in Athens, Thessaloniki, Alexandroupoli, and Ioannina, in each of which 15-25 adolescents participated. With official approval from the Ministry of Education, a total of 82 teenagers from diverse school contexts and backgrounds, participated in the four YES Groups, meeting locally on a monthly basis with the support of specialized coordinators and facilitators as well as local psychosocial professionals from the CAMHI network. Overall, more than 1,650 children and adolescents from 40 different schools participated in activities and workshops organized by the YES program. Their ideas, feedback, and input brought to the spotlight adolescents’ concerns and views on specific issues affecting their mental health and wellbeing, all of which are being considered and incorporated in the strategic design of the CAMHI.

Implementation of the YES program will resume in the start of the 2023-2024 academic year, with plans to grow even further to include a new Youth Advisory Group in Crete as well as for greater outreach to marginalized youth.

• Renovation Works at Paidon Agia Sofia Children’s Hospital in Athens

As provided by the Global Health Initiative’s umbrella legislation, a building at the Paidon Agia Sofia Children’s Hospital will be renovated and outfitted through an SNF grant to house the Athens hub of the CAMHI network, in partnership with the hospital’s Department of Child Psychiatry. The renovated building will include dedicated training spaces and assessment rooms to enable the Department’s clinical and educational work in the context of the CAMHI, as well as a new green area for young visitors.

As per official process, the preliminary design study of the project has been concluded and approved by the hospital’s Technical Department and the regional health authority (YPE). The final design study is currently underway, in continued collaboration with end users and the CAMHI team. In accordance with law no. 4812/2021, the individual Grant Agreement between SNF and the Greek state has been finalized and will be submitted for ratification within the calendar month. According to the current timeline, the renovation is slated for completion in late 2023.

• The Stavros Niarchos Foundation (SNF) Global Center for Child and Adolescent Mental Health at the Child Mind Institute

Τhe SNF Global Center for Child and Adolescent Mental Health at the Child Mind Institute was established with a founding grant from SNF that came at a pivotal moment amidst widespread recognition of a global crisis in mental health and urgent calls for equitable, culturally sensitive, and evidence-based care.

Over the next five years, the SNF Global Center for Child and Adolescent Mental Health will carry out a wide range of efforts across six intersecting initiatives to enhance mental health care for children and adolescents globally by increasing access to information and to high-quality, evidence-based care, and reducing stigma and discrimination.

Deeply informed by ongoing work on the Child and Adolescent Mental Health Initiative (CAMHI) in Greece, the SNF Global Center’s specific planned work includes conducting regional needs assessments, multi-cultural adaptation of free informational resources as well as treatment protocols, developing technological innovations for mental health care and assessment, creating fellowship programs for clinicians and researchers in low- and middle-income countries, and accelerating global collaboration through expert gatherings. All activities will include a cross-cutting emphasis on open data, two-way knowledge exchange, and empowering and amplifying local efforts with a view toward sustainability.

Currently within its first year of implementation, the grant has seen the following progress to date:

• Recruitment of key SNF Global Center leadership positions and staff, with additional positions under ongoing recruitment and the full staffing of the center expected to be completed within the calendar year.
• Selection of the two initial countries of focus for developing partnerships, South Africa and Brazil. SNF Global Center leadership has been holding discussions with local governments, academic institutions, non-governmental and community organizations, professional associations, representatives from public health facilities, and other stakeholders to gain greater familiarity with the context and needs in each location and determine the possible modalities for partnerships.
• The SNF Global Center team is also actively exploring partnerships with other institutions including UNICEF and the International Association for Child and Adolescent Psychiatry and Allied Professions (IACAPAP). These partnerships are expected support the SNF Global Center’s efforts with global surveys, as well as with forming global networks of professionals and expanding the reach of its fellowship program, which is expected to be initiated during the second year of the grant.

The SNF Global Center is assembling its International Advisory Council (IAC), targeting prominent and dynamic members of the global child and adolescent mental health community. Members of the Council are expected to be announced by the end of 2023 and will play a key role in advising and guiding the SNF Global Center strategy in the coming years. The Child Mind Institute will hold an official launch event for the SNF Global Center that will occur simultaneously with its first Expert Gathering bringing CAMH experts from around the world for targeted discussions on the Center’s work and strategy in October 2023 in New York.

• The Stavros Niarchos Foundation (SNF) Center for Precision Psychiatry and Mental Health at Columbia University

In March 2023, the previously announced SNF Center for Precision Psychiatry and Mental Health at Columbia University in New York City was formally launched. Precision psychiatry, an emerging field at the nexus of multiple scientific disciplines, holds the unprecedented promise of highly efficacious personalized psychiatric care based on each individual’s unique genetic makeup and biology.

The new Center leverages Columbia’s leading work across the fields of genomics, neuroscience, and epidemiology, drawing on expertise at the Department of Psychiatry, the New York State Psychiatric Institute, the Mortimer B. Zuckerman Mind Brain Behavior Institute, and the Columbia-affiliated New York Genome Center.

In keeping with the values of the Global Health Initiative, the Center’s leadership is fully committed to making the resources it develops open and available to the global mental health community. The Center is also committed to fighting inequality in mental health care by leveraging its partnerships to ensure that innovations are accessible to all, regardless of background.

The SNF Center team is currently working to hone their strategic approach and build their team. A formal launch event is being planned for later in 2023.

Recently, Columbia University conducted an interview with SNF Center co-director Professor Joseph Gogos, MD, PhD, about the Center’s mission. In addition, in June 2023, a comprehensive and inspiring article published in the Washington Post highlighted the approach of the new SNF Center and featured compelling patient stories which were subsequently discussed at the 2023 SNF Nostos Conference on mental health, held at the Stavros Niarchos Foundation Cultural Center (SNFCC) in Athens on June 21-23.

• National Children’s Alliance (NCA)

In January 2023, SNF launched a new partnership with the National Children’s Alliance (NCA) to expand access to trauma therapy for children who have been victims of abuse. NCA is a national association and accrediting body for a network of nearly a thousand Children’s Advocacy Centers (CACs) across the United States, which provide integrated care and support for children who have been victims of abuse.

A shortage of therapists trained to deliver trauma-informed therapy for children remains a major gap that prevents at least 80 thousand children each year from accessing care. The new partnership seeks to help address this:

• Over the next 5 years, SNF will support NCA to launch and scale up a national training program for Child & Family Traumatic Stress Intervention (CFTSI), an evidence-based treatment specifically designed for children and adolescents and shown to significantly reduce symptoms of traumatic stress.
• Trainings will be delivered to clinicians affiliated with CACs via the NCA Institute for Better Mental Health Outcomes, an academy focused on strengthening the workforce that addresses child trauma.
• NCA aims to train 1,000 clinicians who will reach up to 44,000 children by the end of the five-year grant, and 25 thousand children per year thereafter. SNF’s support helps to close a critical care gap, thus helping more children heal.

NCA will also develop resources that help clinicians deliver CFTSI via teletherapy to further enhance access and flexibility; fact sheets and videos for caregivers and clinicians are expected to be produced and disseminated by the end of 2023. The first three training courses have been set for October 2023, January 2024, and March 2024, with the first call for participation announced in June 2023.

• Tygerberg Hospital Children’s Trust (THCT)

Embarking on a new partnership under the GHI’s mental health pillar, SNF is supporting the Tygerberg Hospital Children’s Trust (THCT), a non-profit based in South Africa, to carry out renovations and other improvements to benefit the Adolescent Psychiatry Unit at Tygerberg Hospital, one of the country’s largest public facilities.

THCT’s mission is to raise support for maternal and pediatric units at Tygerberg Hospital, a public tertiary care facility in Western Cape province providing specialized care to a large and geographically dispersed population, including low-income and rural communities.

The Adolescent Psychiatry Unit at Tygerberg Hospital is Western Cape’s only tertiary assessment unit for adolescents (13-18 years old) with psychiatric disorders and manages some of the most complex cases of mental illness. Despite its critical role in the provincial health system, the unit requires significant infrastructural upgrades and renovations to ensure a sufficiently adolescent-friendly, inviting, and safe space.

Over the next two years, SNF support will enable THCT to address critical needs of the Adolescent Psychiatry Unit, contributing to a vision of a more functional and adolescent-friendly space that promotes healing. Areas of support include:

• Repairs, upgrades, furnishings, and aesthetic improvements within the ward;
• Activities, sports, crafts, and games to engage and stimulate patients in healthy ways, as well as access to educational technology; and
• Transforming the unit’s dedicated and secure outdoor space into a garden and an area for recreation, physical activity, individual reflection, and contact with nature.

It is expected that about 300 adolescents annually will benefit from the improvements once completed, along with unit staff who will be able to better serve their patients. The THCT is planning and coordinating with hospital management and clinical units, with the planned works to be initiated within the Unit before the end of the 2023 calendar year.

• Support for the Nursing Sector

The SNF Global Health Initiative supports  training, research, and scholarship programs via the Nursing Schools of the National and Kapodistrian University of Athens (NKUA) and Evangelismos Athens General Hospital. SNF’s support for the two institutions moreover entails large-scale procurement of specialized equipment for training purposes.

NKUA:

• 7 training programs are currently being implemented, on a wide range of topics including care for deaf patients, advanced nursing skills, safety and quality of nurse training, management of acute and chronic pain, palliative care, nursing in school settings, smoking cessation, and information and communications technology for nurses. Several have implemented multiple cycles of training, and 3 programs are scheduled to be completed by the end of 2023.
• 3 faculty research projects are ongoing, addressing topics including migrant access to health care, stress in cancer patients, and bipolar disorder. Two are scheduled to be completed by the end of 2023, one of which is actively pursuing publication in a peer-reviewed journal.
• 14 academic scholars have been supported and have provided critical support to faculty through clinical supervision, teaching and research assistance, and course preparation. Contracts for all scholars have been renewed for the coming year.
  
  

Evangelismos Hospital:

• 41 scholarships have been awarded to date for postgraduate (24), doctoral (2) and post-doctoral (1) studies, as well as to support continued education for hospital nurses (7 in Greece, 3 abroad) and doctors (2 in Greece, 2 abroad); in addition, 3 visiting professorships have been completed.
• One of the continued education scholarships was awarded to the Director of the new Medical Simulation Lab at Evangelismos Hospital, who spent six months at the Johns Hopkins Medicine Simulation Center in the US in a customized program to gain practical experience with simulation training that will, in turn, benefit trainees in Greece.

Specialized Training Equipment at NKUA and Evangelismos:

Procurement for specialized training equipment has been completed and is in the final stages of delivery for the Nursing Schools of both NKUA and Evangelismos Hospital. The equipment includes a wide range of laboratory instruments, simulators, models, training devices, digital teaching technology, and other equipment. Delivery of equipment began on a rolling basis in November 2022; final deliveries are in progress.

• Infection Prevention and Control

The Greek Infection Prevention Program (GRIPP-SNF) is a five-year program exclusively funded by SNF under the Global Health Initiative with the goal of improving prevention and control of hospital-acquired infections (HAIs) and antimicrobial resistance (AMR). The program is led by the Center for Clinical Epidemiology and Outcomes Research (CLEO), working in collaboration with the National Organization for Quality Assurance in Health (ODIPY), the Hellenic National Public Health Organization (EODY), and NKUA’s Nursing Department through the digital platform of the Center of Continuing Education and Lifelong Learning (KEDIVIM).

• 7 cycles of infection prevention and control training have been completed to date, as part of the GRIPP-established national training program. Out of a total of 866 participants to date, 520 have been certified following post-program examination. The 8th cycle, out of the total planned 15, begins in September 2023.
• 11 additional infection surveillance nurses have been fully integrated to enhance the infection surveillance committees at each of the 10 participating hospitals in Athens, Patras, Larissa, Thessaloniki, Alexandroupoli, and Heraklion, as was previously reported.
• A unified electronic surveillance database is actively used at all participating hospitals, as was previously reported. A subset of key indicators is being tracked regularly and CLEO is currently working to expand the capacity of the database. There is continued support among national stakeholders for the rollout of this database to all public hospitals with the timing to be determined, as discussions remain in progress between ODIPY, EODY, and the Hellenic Ministry of Health. There is continued support among national stakeholders for the rollout of this database to all public hospitals with the timing to be determined, as discussions remain in progress between ODIPY, EODY, and the Hellenic Ministry of Health.
• In early 2023, the program initiated its intervention phase, which involves introducing new tools and practices at each hospital with the aim of reducing infections and increasing prevention. The interventions were developed by CLEO in consultation with US-based Institute for Healthcare Improvement (IHI), which leverages expertise and best practices worldwide for improving health care quality. In early 2023, CLEO and IHI hosted a series of regional learning sessions in Athens, Thessaloniki, and Patras with representatives of participating hospitals, to provide an opportunity for discussion and exchange of ideas. In early 2023, CLEO and IHI hosted a series of regional learning sessions in Athens, Thessaloniki, and Patras with representatives of participating hospitals, to provide an opportunity for discussion and exchange of ideas.
• ODIPY is playing an active role in monitoring the progress of GRIPP-SNF, acting within its supervisory capacity as envisioned in the HI legislation. ODIPY is also working to draw lessons which could be applied more generally within overall mission of enhancing patient safety and service improvement with Greece’s the health sector

During the remainder of 2023, the program will implement additional cycles of training, expand the surveillance database, monitor the progress of interventions, and collect, analyze, and report on baseline data for additional hospital infection indicators.

• Training Program in Intensive Care

Launched as part of SNF’s global relief initiative for the COVID-19 pandemic, the five-year program in intensive care training is supported exclusively by SNF and is implemented by the THORAX Foundation under the supervision of ODIPY. The programs are designed to cover a wide range of basic and specialized training for doctors and nurses, both in intensive care units and related specializations. 

These trainings are expected to have immediate and long-term benefits for strengthening the quality of intensive care across Greece.

• 17 training seminars have been completed to date, with a total of 289 participants comprising health professionals working in hospital intensive care units (ICUs) across Greece, including programs in BASIC, ILS, and training-of-trainer seminars. An additional 10 training seminars will be completed by the end of 2023.
• 5 scholarships have been awarded to clinicians to support their attendance of a masterclass offered through the European Society for Intensive Care Medicine (ESICM).
• SNF also supported the procurement of specialized equipment for these training seminars, all of which has been delivered and is being actively utilized.
• The program has completed certification of these seminars with continuing education credit by the Panhellenic Medical Association (ΠΙΣ) and the Hellenic Nurses Association (ΕΝΕ).

As was previously covered, there is ongoing discussion among national stakeholders in Greece, in which ODIPY is participating, regarding the potential of integrating the ICU training seminars into the required curriculum for medical students.

• Educational Programs for the Treatment of Trauma

The five-year educational programs for the treatment of trauma, implemented by the nonprofit Regeneration & Progress (R&P) in collaboration with the National and Kapodistrian University of Athens (NKUA), include several different types of modules and seminars for medical and nursing students, doctors, and rescuers.

Trauma Training Seminars:

To date, a total of 73 seminars have been completed:

• 20 Advanced Trauma Life Support (ATLS) seminars for medical students
• 24 Advanced Trauma Care for Nurses (ATCN) seminars for nursing students. Discussions are ongoing with the Nursing School at NKUA regarding the possible incorporation of ATCN into the School’s curriculum.
• 31 Pre-Hospital Trauma Life Support (PHTLS) seminars for first responders, doctors, and nurses
• 1 Advanced Pediatric Life Support (APLS) seminar
• 3 Operating Room Personnel courses for scrub nurses
  
  

Surgical Simulation Lab:

• Officially inaugurated in January 2023 after having started pilot operation in March 2022, the Surgical Simulation Lab is the first of its kind in Greece. The Lab runs under the scientific supervision of the 1st Orthopedic Surgery Clinic of Attikon General University Hospital for the field of orthopedic surgery, and the 3rd University Surgical Clinic of Attikon Hospital for the field of general surgery.
• SNF has supported the supply of the Lab’s four state-of-the-art virtual reality surgical simulators, benefiting trainees including medical students, general surgeons, and orthopedists. .
• More than 300 individuals have been trained in the Surgical Simulation Lab to date, with additional upcoming trainings planned.
  
  

Bioskills Surgical Lab:

• The Bioskills Surgical Lab was officially inaugurated in June 2023 and serves as a training facility for resident and certified surgeons to hone their skills using human cadavers donated for medical research as well as with anatomical models.
• The Lab is equipped with 9 surgical stations, each accommodating up to 4 trainees plus at least 1 instructor, allowing capacity for training 45 individuals at a given time. Each station is fully equipped with an operating table, a supplementary instrument table, a complete set of surgical tools, and overhead lighting.
• 3 hands-on cadaver courses have been completed, addressing topics such as wound management, advanced surgical techniques in joint reconstruction, and others.

Trauma Fellowships in South Africa:

• Officially launched in January 2023, Trauma Management Fellowships for general and orthopedic surgeons are ongoing at the Chris Hani Baragwanath Academic Hospital (CHBAH) in Johannesburg, South Africa, one of the world’s leading trauma training centers and affiliated with the University of Witwatersrand.
• Through the program, fellows gain clinical and hands-on experience managing patients with severe trauma paired with supervision and support from highly experienced personnel at CHBAH. The three-month fellowships include the possibility of extension for another three months.
• A total of 14 fellows have participated to date; 8 fellows participated in the inaugural cohort, and 6 fellows in the second cohort. Another 8 fellows were recently selected in July 2023 for participation in the next cohort. It is anticipated that going forward, the Fellowship program will welcome 16 fellows per year over five years.
• A new partnership was established between NKUA and the University of Witwatersrand to facilitate the implementation of the fellowship program.

• Yorkshire Cancer Research

In March 2023, SNF launched a new partnership with Yorkshire Cancer Research, to support the expansion of its Active Together Cancer Rehabilitation Service, a pioneering, evidence-based exercise program that aims to improve outcomes and quality of life for patients before, during, and after cancer treatment.

Yorkshire Cancer Research is the largest independent regional cancer charity in England, founded in 1925. For more than 95 years, the charity has funded research leading to improvements in the prevention, diagnosis, and treatment of cancer with the collaboration of the UK National Health Service (NHS) as well as leading research organizations, teaching institutions and hospitals around the country.

Yorkshire Cancer Research has been successfully implementing the Active Together service in Sheffield, South Yorkshire, delivering personalized exercise, nutrition, and psychological support programs for cancer patients as a free supplement to other treatment delivered through the NHS. Over the next three years, SNF will support the program’s expansion in North and West Yorkshire, including Leeds—through a new facility based in Harrogate—and to patients with all types of cancers. By 2025, an estimated one thousand patients will benefit through the expanded service, with the long-term vision that the service will become a standard part of care embedded in the UK’s NHS.

The SNF grant also supports the launch of an exercise oncology fellowship program implemented by Yorkshire Cancer Research in collaboration with SNF-affiliated nonprofit Regeneration & Progress (R&P), which will provide unique and valuable opportunities for exchange, learning, and collaboration for UK and Greek physicians alike.

Preparations are underway for the anticipated official launch of the expanded program in Harrogate in September 2023. The design of the fellowship program is expected to be finalized within the calendar year, with subsequent release of the first call for applicants.

• King Hussein Cancer Foundation and Center (KHCF/C)

The partnership between SNF and the King Hussein Cancer Foundation and Center (KHCF/C) in Jordan—the leading cancer center in the Middle East—entails a major grant under the Global Health Initiative to help ensure access to cancer care for children in need across the region. Specifically, the grant supports the KHCF/C Goodwill program with a fund to cover treatment costs for child patients on the waiting list for immediate medical care at the KHCC, including for bone marrow transplantation.

In line with the KHCF/C’s longstanding commitment to supporting underprivileged patients, SNF’s support is expected to ensure care for half of the pediatric cases treated by KHCC annually, including refugee and displaced children from the region.

The grant, which has reached the end of its first year of implementation, established a named and dedicated SNF Goodwill Fund, enabling KHCF/C to cover treatment costs for over 50 pediatric patients, including refugee minors, who have been on the Center’s waiting list for urgent care. The fact that SNF’s Fund is unrestricted has made a difference in the daily practice of the KHCC, allowing the Center to respond rapidly and flexibly to the most critical treatment needs.

• Stavros Niarchos Foundation (SNF) Institute for Global Infectious Disease Research at The Rockefeller University

In March 2023, the SNF Institute for Global Infectious Disease Research at The Rockefeller University was formally launched. The new SNF Institute is a landmark investment in global health and science that aims to combat infectious diseases around the world, from ancient pathogens like malaria and tuberculosis to recent and emerging threats. It is led by Nobel laureate Dr. Charles Rice, head of the university’s Laboratory of Virology and Infectious Disease and Chair of New York State’s COVID-19 Clinical Advisory Task Force, and co-directed by immunologist Michel Nussenzweig, and Barry Coller, physician-in-chief of The Rockefeller University Hospital.

• The Institute’s mission encompasses complementary efforts in research, global partnership building, scientific education and training, and public communication. The SNF Institute will expand opportunities for biomedical research and encourage young scientists to enter the field.
• It will also support clinical and translational studies at The Rockefeller University Hospital, a critical step to transform scientific innovations into real-world remedies.
• The SNF Institute will convene global conferences and expand Rockefeller’s efforts to provide trusted information to the public and governments.

In March 2023, the SNF Institute held an inaugural research symposium on campus which brought together faculty, researchers, and students from laboratories across the university working on or interested in global infectious diseases. This symposium introduced the vision and mission of the SNF Institute, including remarks from its leadership, and featured faculty talks that presented a full range of infectious disease-relevant research at Rockefeller University, to engender robust thinking and discussion as well as to encourage new partnerships and collaborations. The success of the symposium has yielded plans to repeat this event on an annual basis going forward, as a further platform for sharing research between labs on campus and spurring new potential collaborations.

Also at that symposium, SNF Institute research grant opportunities were announced for the first time with a call for applications; since then, the first grant recipients have been selected and awarded. In addition, under the aegis of the SNF Institute, a bimonthly seminar series has been initiated which features research in progress on campus in infectious disease-related topics. Under the leadership of Dr. Coller at The Rockefeller University hospital, 8 pilot projects in clinical and translational research have also been awarded pilot grants, and an SNF Clinical Scholar has been named. Under Dr. Michel Nussenzweig, an international consortium to study tick-borne encephalitis has been assembled and will soon begin the implementation of ambitious plans to study this disease and its emergence in new geographic regions. Additionally, SNF Institute leadership is working on new community engagement initiatives as well as on enhancing existing outreach efforts by The Rockefeller University, such as RockEdu which implements science outreach programming in schools, with additional support.

Further detailed updates on these and other aspects of the SNF Institute’s programming will be available in the coming months.

• ETH Zurich Foundation 

Engineering for Humanitarian Action (HAC) Initiative

The SNF GHI is also supporting the Engineering for Humanitarian Action (HAC) Initiative, which launched in 2020 as a partnership between ETH Zürich’s ETH for Development (ETH4D), the EssentialTech Center (ETC) at EPF Lausanne (EPFL), and the International Committee of the Red Cross (ICRC). The HAC initiative will incubate scientific and technological innovations that improve service delivery to populations affected by humanitarian crises—among the focus areas of the HAC is digital health and medical technologies. It is envisioned that solutions developed through the initiative will benefit the ICRC as well as the humanitarian sector more broadly.

The initiative has now launched its 3rd cohort of applied research projects, the first with SNF’s support. Projects are developed in close collaboration between researchers and practitioners at the ICRC and must address a demonstrated need in the humanitarian context. Feasibility and impact on beneficiaries are crucial factors in the selection process, with high value placed on the relevance and potential impact of the proposed solutions, and the potential for scale-up into a more widely distributed solution within the humanitarian sector, following the conclusion of the research phase. In the coming months, additional updates will become available about the selected projects.

In addition, the program has also developed two massive open online courses (MOOCs) on the topics of digitization in humanitarian action, and digital supply chain and cybersecurity, which will be freely available online.

• Hellenic Cooperative Oncology Group (HeCOG) CLIMEDIN Study

The Hellenic Cooperative Oncology Group (HeCOG) is a nonprofit scientific organization whose membership is largely comprised of oncologists affiliated with hospitals across Greece and Cyprus. HeCOG undertakes a range of clinical and translational research targeting the development of novel therapies and personalized treatment.

• With exclusive SNF support through the GHI, HeCOG is undertaking a study (CLIMEDIN) in 200 patients, ages of 18-78, with inoperable non-small cell lung cancer in Greece.
• The three-year study offers Next Generation Sequencing (NGS) to genetically test patients’ tumors. On this basis, the study investigates the efficacy and safety of personalized therapies and other quality-of-life interventions such as a mobile application offering remote clinical support for patients enrolled in the study.
• A total of 18 clinical centers are actively participating in the study (11 in Athens, 2 in Thessaloniki, 2 in Patras, 1 in Crete, 1 in Larissa, 1 in Kavala, and 1 in Cyprus).
• The study has nearly concluded recruitment with a total of 180 patients enrolled to date. HeCOG is conducting preliminary analysis of patient outcomes for an initial subset of study subjects.

The study will be completed at the end of 2024; findings will be presented at international conferences and submitted for publication in international scientific journals.

• SNF Bioethics Academy (SNFBA)

Launched in 2019 with exclusive support from SNF, the Stavros Niarchos Foundation Bioethics Academy (SNFBA) aims to expand awareness of bioethics in Greece through participatory workshops on timely ethical questions.

SNFBA is organized through a partnership between the Berman Institute of Bioethics at Johns Hopkins University and the Bioethics Chair at ETH Zürich and is co-directed by Professors Jeffrey Kahn, the Andreas C. Dracopoulos Director of the Berman Institute, and Effy Vayena, Head of the Health Ethics and Policy Lab at ETH Zurich.

In February 2023, SNF approved support for the program for an additional year. With this support, an additional 58 participants took part in the 4th Annual SNFBA Summer Course, held in June 2023 in Athens. To date, over 200 medical students, biomedical research scientists, and mid-career professionals in a variety of health-related disciplines have participated. Additional programming is being planned for fall 2023 and spring 2024 at each institution’s campus.

As the ultimate goal of the program is to build bioethics capacity in Greece, over the course of this program year, JHU and ETH are exploring new collaborations with several potential partners in Greece, including the National Bioethics and Technoethics Commission, the School of Public Health at the University of Western Attica, and the Laboratory for the Research of Medical Law and Bioethics of the Aristotle University of Thessaloniki, with an eye toward developing stronger partnerships for the program to help sustain it and create a more fertile environment in which alumni will grow their work.