SNF Health Initiative 12th Progress Update

The SNF 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

The new SNF hospitals in Greece have been designed by internationally renowned architect Renzo Piano and the architectural firm Renzo Piano Building Workshop (RPBW), in collaboration with Betaplan. The ultimate goal is the simultaneous delivery of three new hospitals, which will serve as reference points for both geographic peripheries of the country and the international health care infrastructure sector, to the Greek public in late 2025.

On June 23, 2022, the SNF hospital town hall meetings took place in the context of the SNF Nostos Health Conference held at the Stavros Niarchos Foundation Cultural Center (SNFCC) in Athens. The Design Team presented progress on design and implementation to an audience that included stakeholders from the three future hospitals as well as international health practitioners, researchers, state representatives, and the broader public. Apart from the architectural and environmental specifications, the audience saw the final designs of the hospitals, their enhanced clinical programs, and, in the case of Sparta, preparatory works in progress for the construction of the future hospital.

Representatives of the Hellenic Ministry of Health reaffirmed their commitments to the completion of road and public utility connections that will support the operation of the SNF hospitals, as well as the execution of workforce plans that will ensure the three health facilities work at full capacity from day one.

The three SNF hospitals not only aspire to act as catalysts for the Greek national health system, but they are also raising the bar as templates for future hospitals. They are designed to operate in a way that puts people at the center while following three core values: the importance of nature and its therapeutic power, environmental sustainability aiming to reduce the hospitals’ carbon footprint and prepare for a zero-emission future, and medical excellence paired with holistic patient-centric care. As part of this effort, the hospitals will be serving as pilot projects under an ambitious new partnership between SNF and the U.S. Green Building Council to develop a framework that recognizes the readiness of buildings to operate as carbon-zero facilities. In the spirit of collaboration and exchange that permeates SNF’s global grantmaking, partnerships with Johns Hopkins Medicine International and New York Presbyterian are also being pursued and carefully crafted to help enhance the clinical profile and future standing of the three SNF hospitals.

• New Stavros Niarchos Foundation (SNF) General Hospital of Komotini

Since the previous 11th Update on SNF’s Health Initiative, progress on the new SNF General Hospital of Komotini passed a major milestone, namely the launch in April 2022 of the tender for the construction and outfitting of the hospital.

Once the construction design, clinical program, and medical equipment lists were finalized, Health Initiative S.A. issued the tender documents to shortlisted tenderers in April 2022. With the hospital’s building permit issued in May 2022, construction is due to commence in the first quarter of 2023. In parallel, the tendering of the infrastructure work for the hospital’s connection to roads and public utility networks under the purview of the Greek state has started, with completion of the tender projected for the first quarter of 2023. According to the Grant Agreement ratified by Greek laws no. No.4667/2020 and No.4812/2021, this work is expected to be completed one year prior to the delivery of the new facility to the Greek state.

During SNF Nostos 2022, multiple stakeholders from the public sector who have played a key role in the development of the future hospital’s clinical program and design participated in a rich discussion on the hospitals. Representatives from the 4th Health District commented on SNF’s consultation process, highlighting the involvement of hospital staff whose input contributed to the revamped clinical program and also led to enhancements to the future hospital’s workforce plan. Representatives from the Ministry of Health explained the steps taken to ensure the timely activation of the new SNF General Hospital of Komotini and affirmed the Greek state’s continued commitment to the agreed timetable.

According to the current timeline, the new SNF General Hospital of Komotini will be delivered to the Greek public at the end of 2025.

• Stavros Niarchos Foundation (SNF) University Pediatric Hospital of Thessaloniki

Since the Hellenic Parliament ratified the Grant Agreement between SNF and the Greek state in February 2022 (Law no. 4889/2022), the Design Team continued the preparation of the construction design package which was submitted in July 2022. This laid the groundwork for the launch in early August 2022 of the tender for construction and outfitting of the new SNF University Pediatric Ηospital of Thessaloniki that will be located on the outskirts of the city, in Filyro.

The final construction design study has been officially approved by the Ministry of Health, incorporating, to the extent possible, proposals put forward by the medical and academic community of Thessaloniki in the consultations SNF organized. In October 2022, the Ministry of Infrastructure and Transport awarded the contract for upgrading road connections and installing public utility networks that will support the future hospital’s operation and which are due to be completed by the first half of 2025.

During the town hall meeting held in the context of the SNF Nostos Health Conference, the President of the School of Medicine at the Aristotle University of Thessaloniki commended the vision and ambition that inspires the University Pediatric Hospital’s design, while the Mayor of Pilaias-Hortiatis highlighted the transparency of a substantive consultation process conducted by SNF and the Design Team. Moreover, the discussion highlighted the continued collaboration between SNF and the Ministries of Health and Education, which led to provisions for additional positions within the Medical School specifically for the future Pediatric Hospital, with the budget being shouldered by both Ministries.

The tender process for the construction and outfitting of the hospital is reaching its final stages, and the building permit has been issued by the relevant authorities. Based on the current timetable, the new SNF University Pediatric Hospital of Thessaloniki is scheduled to be completed and delivered to the Greek public in late 2025.

• New Stavros Niarchos Foundation (SNF) General Hospital of Sparta

The Grant Agreement between SNF and the Greek state for the new SNF General Hospital of Sparta was ratified by Parliament on March 31, 2022 (Law no. 4917/2022). With the construction design package completed in early July 2022, Health Initiative S.A. launched the tender process for the construction and outfitting of the new hospital in August 2022.

The construction design study incorporated the new infrastructure layout agreed upon in summer 2021 by SNF and the Greek state with the necessary change of location of the new hospital which resulted in the (two-phase) demolition of the existing Ioanni & Ekaterini Gregoriou General Hospital of Sparta.

The above plan was devised based on proposals and suggestions by the existing hospital and involves the relocation and reconfiguration of the operating rooms, the central sterilization unit, the hemodialysis unit, the COVID-19 clinic and COVID-19 emergency department, the CT scanner, laboratories, and administrative services. These reconfigurations aim to secure the full functionality and continuity of medical services at the existing hospital throughout construction of the new infrastructure.

Following completion of technical studies by Betaplan Architects & Planners subsequently approved by the Ministry of Health, issuance of the building permit, and a tender process to select a contractor, Ballian Techniki was awarded the relocation and demolition works in April 2022. The contractor commenced the relocation works on site in May with the sequential delivery of units to the hospital starting in July with the hemodialysis unit, followed by the CT scanner and the laboratories. In August, the contractor delivered the COVID-19 clinic and COVID-19 emergency department as well as the storage areas. The relocation works were completed in September with the delivery of the new, temporary operating rooms. This process has necessitated the continuous cooperation between the hospital, the contractor, the Project Manager, the Ministry of Health, and SNF, which all together have successfully steered the relocation works within a hospital in operation.

According to the current timetable, the new SNF General Hospital of Sparta is expected to be completed and delivered to the Greek public in late 2025.

As SNF works to update the public regularly and accurately about the progress of the three new hospitals, and ensure the projects are developed with transparency and in the best interest of the local communities, the next round of town hall discussions will take place in early 2023.

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

The grant to revamp the 2nd Intensive Care Unit (ICU) and the Emergency Department of Evangelismos Hospital is underway in collaboration with the Athanasios and Marina Martinou Foundation and Ms. Aliki Perroti.

Following inevitable delays in the implementation of the grant due to the critical role of Evangelismos Hospital amid COVID-19, activity has picked up significantly since summer 2022. The design studies for the renovation of the ICU have been finalized, reflecting feedback and changes by the hospital’s end-users—including an enhanced scope combining the renovation of the 2nd ICU with the works foreseen by the grant under SNF’s global relief initiative for COVID-19 for the renovation of the hospital’s old Stroke Unit. The integration of these two grants will allow unified revamping of spaces and future operation of a single enlarged ICU. The legal modalities of the two donations were adjusted accordingly, and ratification of the amended Health Initiative law is expected imminently.

The tender documents for the above works have been completed, in close collaboration with all parties, and the tender is expected to be launched shortly by Evangelismos Hospital. Completion of the new ICU is expected in summer 2023.

• Design, construction, and outfitting of two new buildings at Attikon General University Hospital of Athens

This grant under the Health Initiative pertains to the design, construction, and outfitting of two new buildings with the complex of Attikon General University Hospital—one of the largest public hospitals in the Attica region. One building will house on-call rooms and dedicated rest areas for doctors, and the second building will consolidate the headquarters of the Coordination Center for Mobile Medical Units (MMUs).

The preliminary design study is currently being finalized, providing different design scenarios for the end users and SNF to consider. Throughout this extensive design phase, the Design Team has remained in consultation with the hospital as well as the nonprofit Regeneration & Progress (R&P), which has been implementing the MMUs program since 2014 with an exclusive grant from SNF. Upon completion of the preliminary design, drafting of the individual Grant Agreement for the project will ensue, along with the launch of the construction design study. According to the current timetable, the project is expected to be completed and delivered to the Greek state and relevant organizations in early 2024.

• Sant Joan de Déu (SJD) Pediatric Cancer Center Barcelona

In June 2022, the new Pediatric Cancer Center at SJD Barcelona Children’s Hospital was inaugurated, opening its doors for young patients from Spain and across the world. In collaboration with the Leo Messi Foundation, SNF has been a strategic starting funder for the construction of the new Center, having helped SJD bring its fundraising goals to completion back in 2018.

Building on SJD’s long history and internationally acclaimed excellence in pediatric medical care and oncology, the new Pediatric Cancer Center houses outpatient and inpatient care, treatments, procedures, and research under one roof—with enormous impact for patients. It has the capacity to receive 400 new patients each year and ranks fourth worldwide as a center for developmental cancer patient care. The Center was designed and developed in close and continuous collaboration with SJD’s doctors, nurses and professionals as well as with over 80 patients and their families who have experienced childhood cancer.

The exemplary patient- and family-centric approach followed by SJD in every aspect of delivering medical and emotional care is a source of inspiration for the Health Initiative and the development of the SNF University Pediatric Hospital of Thessaloniki. Beyond the completion of the grant for the new Pediatric Cancer Center, SNF and SJD aim to grow their partnership in support of advances in pediatric diseases as well as of the activation of the SNF University Pediatric Hospital and the establishment of collaborative frameworks on pediatric oncology between the two hospitals.

• Procurement of a Nurse Call System for Evangelismos Athens General Hospital   

After the completion of the three Health Initiative grants for the procurement of two new airplanes and two new helicopters to strengthen Greece’s National Center for Emergency Care (EKAV), medical equipment for Evangelismos Athens General, and new dental chairs and simulators for the NKUA School of Dentistry, SNF’s grant for the procurement of a new nurse call system for Evangelismos Hospital was concluded in October 2022.

Implemented against a challenging backdrop of supply-chain disruptions, equipment delivery delays and heightened emergency operations at Evangelimos Hospital due to COVID-19, the grant ensured smooth installation of a comprehensive nurse call system in the inpatient units of the hospital’s AHEPA and PATERA buildings. The system is modern, digital, flexible, and expandable, and includes call units at 798 patient beds for 23 nursing stations in corresponding clinics, with the option of centralized monitoring. As elaborated in a recent press release, the new system is a critical tool that provides a lifeline between nurses and the over 62,000 patients hospitalized at Evangelismos each year.

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

In accordance with the relevant Health Initiative law (Law no. 4839, Gov. Gazette 181 A'/ 02.10.2021), SNF’s grant for the procurement and installation of PET/CT equipment at four University Hospitals in the geographic peripheries of Greece, namely in Alexandroupoli, Ioannina, Larisa, and Heraklion, is nearing completion.

Per the provisions of the procurement process of Health Initiative S.A., the PET/CTs were delivered in all four locations in fall 2022, while the work to reconfigure and renovate relevant spaces in the respective hospitals are in a final stage. Pre-installation checks, equipment testing, and training of the hospitals’ medical staff are underway and will be concluded in early 2023.

The new PET/CT equipment and accompanying renovation work will allow the opening and operation of expanded nuclear medicine departments and labs in the four hospitals, thus 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. As enshrined in the above 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.

Since the start, project implementation has been taking place in close collaboration and with weekly coordination between SNF, the Ministry of Health, the four hospitals, and the contractor. Full completion and handover of the grant to the Greek state is estimated in February 2023.

• Support for the Nursing Sector

The SNF Health Initiative is supporting training, research, and scholarship programs via the Nursing School of the National and Kapodistrian University of Athens (NKUA), and Evangelismos Athens General Hospital. SNF’s support to the two institutions moreover entails large-scale procurement of specialized equipment for training purposes. The procurement process for this equipment advanced substantially over recent months and is nearing completion, with on-site deliveries at NKUA and Evangelismos Hospital expected to take place progressively over the following months.

At the same time, at NKUA, significant progress has been made in the design and implementation of various training  programs:

1. Providing Care for Deaf Patients: This training program will train 20+ nurses in caring for deaf patients, including communication in Greek Sign Language, and will create a digital aid for communication with deaf patients about medical issues. To date, development of a 30-hour in-person portion of the training has been completed, and development of an additional 10-hour distance learning portion is ongoing. A 40-hour educational program for nurses entitled "Ensuring the right of deaf people to health" has been successfully completed with 21 participants.
2. Basic & Advanced Nursing Skills for Patient Care: The objective of this course is to update and enrich the knowledge and skills of nurses in clinical care, safety and quality assurance, evidence-based practice, interpersonal communication, and other topics. The training program has begun; since May 2022, 13 out of a total of 26 modules have been completed with 56 students selected out of a total of 940 applicants.
3. Leadership in Palliative Care: With the aim of improving palliative care and advocating for greater access to services, this program will train at least 60 healthcare professionals. A total of 20 participants completed the first cycle of training in June 2022; ongoing monthly small group meetings serve to guide and monitor their progress and empower them as leaders. The second training cycle is expected to begin in January 2023.
4. Advanced Skills for the Management of Acute and Chronic Pediatric Pain: The aim of this program is to enhance nurses’ skills and practical experience in assessing pediatric pain with age-specific assessment tools and use of up-to-date guidelines. To date, the first of 6 training cycles has been completed via distance learning, with 30 trainees selected from 356 applicants, and an Oxygen Therapy Guide has been developed as part of the program. The course will conclude with the use of forthcoming simulation equipment. Relatedly, under this grant, three program personnel have obtained further training at Johns Hopkins University Hospital in the use of simulators for nurse training courses.
5. Community Nurses in School Settings: This program is training a total of 220 community nurses to provide high-quality care in school settings. A model school health center will also be created in collaboration with Maraslio Elementary School to serve as an example for general and special education schools. The first cycle of this three-month distance learning program began in June 2022 with 140 trainees. A second cycle of the training is expected to take place between January and April 2023.
6. Smoking Cessation Techniques in General and Psychiatric Hospitals: This blended learning program trains nurses practicing at general and psychiatric hospitals in the application of smoking cessation techniques. Thus far, training material has been developed, and training of trainers will soon conclude with a clinical briefing in a smoking cessation clinic. The training program is taking place between September and December 2022 and will train up to 15 nurses from each of four participating hospitals.
7. Information and Communications Technology (ICT) for Nurses: This training provides continuing education for nurses to refresh ICT skills, covering basic software applications, health records, telehealth, and other topics. The objective is to train up to 2,000 individuals through blended learning. Out of 650 applicants, 156 were selected to participate in the first cycle of training, and 103 successfully completed the program in July 2022. The second cycle began in fall 2022 with around 200 participants.
8. Stress Management for Emergency Assistance Rescuers: This program will provide training in stress prevention and management to National Center for Emergency Assistance (EKAV) rescue crews. This training is paired with a research study aiming to better understand their unique health care needs. The program is currently in the process of coordinating with EKAV regarding program participation and implementation methods.

SNF Health Initiative support to NKUA is also being provided for faculty research, with ongoing projects including:

• Migrants’ Access to Health Services: This project looks to identify migrants’ health needs and barriers to care, while investigating health professionals’ attitudes and knowledge in managing patients with diverse cultural backgrounds. It aims to develop tools to help migrants navigate the health care system, as well as to strengthen health professionals’ cultural competence. To date, a systematic review has been published addressing barriers to care, and tools have been developed for quantitative and qualitative data collection.
• Stress Management Strategies for Women with Neoplasia and their Partners: This project aims to study the role of patients’ social environment in their emotional reactions, stress management, and psychological quality of life. To date, a questionnaire has been developed, hospital partners have been trained in data collection, and data collection is underway at hospitals in Crete, Athens, and Cyprus, along with some preliminary analyses. A paper from this project was presented at the Panhellenic Conference of Psychological Research which took place in October 2022.
• Theory of Mind and Empathy in Bipolar Disorder: A program which aims to study theory of mind and empathy among those with bipolar disorder is in the planning stages.

Scholarship programs for the Nursing School of NKUA have supported 4 full-time and 10 part-time academic scholars in nursing. During the previous academic year, these academic fellows enhanced the nursing education offered through clinical supervision of undergraduate students, coordination of tutorials and workshops for nursing courses, preparation of educational materials, supervision of examinations, and support for faculty member research and student exchange programs. These scholars continue to support the NKUA Nursing programs during the current academic year. For students, nurses, and physicians at Evangelismos Hospital, the first round of scholarships was awarded beginning in September 2021, and a total of 25 scholarships have been awarded to date for master’s programs, continuing education, and specialized training in Greece and abroad. Over the next academic year, a similar number of scholarships are expected to be awarded to additional students and health care workers.

• Greek Infection Prevention Program

The Greek Infection Prevention Program (GRIPP-SNF) is a five-year (2021-2026) program exclusively funded by SNF under the Health Initiative with the goal of improving prevention and control of hospital-acquired infections (HAIs) and antimicrobial resistance (AMR). The program is fully under implementation, led by the Center for Clinical Epidemiology and Outcomes Research (CLEO) working in collaboration with the National Organization for Quality Assurance in Health (O.D.I.P.Y.), 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).

As mentioned in prior Quarterly Updates, infection surveillance nurses have been successfully integrated into each of the 10 participating hospitals (five of which are located in Athens and the rest of which are in Patras, Larissa, Thessaloniki, Alexandroupoli, and Heraklion). Additionally, important progress has been made in the below programmatic areas in recent months:

• The unified electronic surveillance database has been successfully installed at each of these hospitals. This is a major achievement, as there was previously no such system which allows for near real-time monitoring of the rates of hospital-acquired infections. Notably, national stakeholders have expressed their intention to roll out the database at all public hospitals in the near future, far ahead of the plan to do so at the end of the current five-year period of the SNF-funded program, signaling strong buy-in from national stakeholders and sending positive indications for future sustainability.
• GRIPP-supported infection surveillance nurses have completed input baseline data for two key program indicators: (i) the rate of Central-Line Associated Bloodstream Infections (CLABSIs), and (ii) compliance with hand hygiene. Presentations to each of the 10 hospitals for the baseline situation of these two indicators took place in July 2022. Registration of baseline data for other HAI indicators will continue and be analyzed and presented to hospitals on a rolling basis. Monthly reports on HAI indicators will be delivered thereafter to infection committees and hospital directors to facilitate timely monitoring.
• Three cycles of infection prevention and control trainings have been completed to date. A total of 213 nurses have been trained, 148 have been certified, and the trainings are in high demand with another 530 people having indicated their interest in participating in future cycles. About 70% of trainees passed to receive certification. Infection control trainings have received positive feedback from participants so far. Trainees have completed pre- and post-training tests and will also be tested 6 months after the conclusion of the trainings, so that CLEO can assess the extent to which the training content is retained over time.

In July 2022, CLEO received the distinction of a Gold-Level award from the Patient Partnerships Awards in the “Improving Health – Patient Safety” category. The award recognizes CLEO’s efforts, in collaboration with its partners, to implement GRIPP-SNF.

Intervention design is the next phase of the program, which began in September 2022. CLEO has been working with the Institute for Healthcare Improvement (IHI) to design the approach for this phase. In October 2022, CLEO led visits to each of the 10 participating hospitals to collaboratively design the bundle of interventions for each hospital, tailoring them to the situation and culture at each facility.

• 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 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. Following the signing of the Memorandum of Understanding between the two institutions in July 2021, the program entered the implementation phase.

The first cycle of the Basic Assessment and Support Intensive Care (BASIC) seminar was held on July 1-2, 2022. A total of 17 health professionals working in hospital intensive care units (ICUs) from across Greece participated in the seminar. SNF also supported the procurement of equipment specially designated for these ICU training seminars, all of which has been successfully delivered. As of September 2022, ICU training seminars are held monthly, providing training to hundreds of physicians and nurses each year, with immediate and long-term benefits for strengthening the quality of ICU care across Greece.

• 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 seven different types of modules and seminars for medical and nursing students, doctors, and rescuers.

Between April and June 2022, the following were implemented: three Advanced Trauma Life Support (ATLS) seminars (20 total to date), six Advanced Trauma Care for Nurses (ATCN) seminars (12 total to date), and three Pre-Hospital Trauma Life Support (PHTLS) seminars (23 total to date). In addition, one Advanced Pediatric Life Support (APLS) training seminar has been carried out to date along with two courses for operating room personnel (ORP). Plans are in place to run four ATCN seminars and seven PHTLS seminars before the end of 2022. Moreover, the Surgical Simulation Lab is now welcoming medical students, general surgeons, and orthopedists. The Lab operates under the scientific supervision of the 1st Orthopedic Surgery Clinic and the 3rd and 4th University Surgical Clinic of ATTIKON Hospital. 221 general and orthopedic surgeons have trained there so far.

In addition, in collaboration with the Nursing School of the NKUA, discussions are ongoing regarding the incorporation of the ATCN course into the Nursing School’s official student curriculum.

As of November 2022, a call for applications for fellowships in trauma management for general and orthopedic surgeons has opened. Trauma Management Fellowships will take place at the Chris Hani Baragwanath Academic Hospital (CHBAH) located in Johannesburg, South Africa, which is one of the world’s leading trauma training centers and affiliated with the University of Witwatersrand. Fellows’ scholarships and living expenses will be fully covered through SNF support. Fellows will gain experience in managing patients with severe trauma, including clinical and hands-on experience paired with supervision and support from the highly experienced personnel at CHBAH. To facilitate the implementation of the program and integration of Greek scholars into this program, a new partnership is under development between the University of Witwatersrand and the NKUA. Fellowships are three months in duration, with the possibility of extension for a total of six months. It is anticipated that the Fellowship program will welcome 16 fellows per year over five years. The first fellowship is expected to begin between January and March 2023.

• King Hussein Caner Foundation and Center

The new 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 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.

• Child and Adolescent Mental Health Initiative (CAMHI)

Since the previous Quarterly Update, implementation of the CAMHI in Greece has advanced considerably in an effort to help enhance access, quality, and equity in mental health care for children and adolescents across the country. The initiative runs on the basis of a partnership between the Child Mind Institute and a nationwide network of child mental health providers, with support from the Hellenic Ministry of Health.

In accordance with Health Initiative Law no. 4812/2021, the individual Grant Agreement between SNF and the Greek state on the CAMHI has been finalized and ratification is expected imminently. The Agreement crystalizes the scope of the initiative, implementation modalities, and collaboration pathways in the public health sector, delineating the state’s obligations in terms of continuity and sustainability of the program after the 5-year pilot period fully supported by SNF.

Over recent months, the CAMHI formalized its first set of partnerships with mental health care providers in Alexandroupoli, Ioannina, and Heraklion as part of the country-wide CAMHI Network. Underpinning these partnerships, three Memorandums of Understanding (MoU) have been signed to date between the program’s special purpose vehicle, the Ministry of Health, and the: (i) University General Hospital of Alexandroupoli, and Department of Child and Adolescent Psychiatry, (ii) University General Hospital of Ioannina and the Community Child and Adolescent Mental Health Service (Department of Psychiatry), and (iii) University of Crete and the Child Psychiatric Clinic at the University General Hospital of Crete. As provided by the MoUs, new CAMHI professionals are in place in the three locations working with the respective clinics to plan and roll out the CAMHI according to context-specific strengths and needs. The teams’ current focus is on local needs assessments, co-creation of basic and advanced training programs, outreach to schools, and other forms of support for the provision of mental health care. In parallel, the CAMHI is in the process of establishing the Network’s hubs in Thessaloniki and Athens, in partnership with local child and adolescent mental health professionals and institutions, including Paidon Agia Sofia Children’s Hospital.

On October 10, World Mental Health Day, the CAMHI launched its new website, offering peer-reviewed, evidence-based resources for adolescents, caregivers, educators, and mental health professionals, as well as first research findings and mappings of the initiative onto the national child mental health landscape. In the near future, the website will be enriched with platforms for the CAMHI’s new online training courses and asynchronous educational material for different groups.

Importantly, the CAMHI also launched its Youth Engagement Scheme (YES) as a planform for systematically listening and integrating the voices of young people into all aspects of program design and delivery. Under the leadership of George Moschos, Greece’s former Ombudsperson for Children’s Rights, the scheme is currently establishing five CAMHI Youth Advisory Groups in the five locations where the initiative is developing its activities. With official approval by the Ministry of Education, the YES program was announced in public schools across Greece in order to engage interested adolescents. Following two pre-consultation youth workshops in June and September 2022, in December 2022, YES groups were formed in Alexandroupoli, Thessaloniki, Ioannina, and Athens and conducted their first monthly meetings. In line with the best interests of children, the scheme follows international standards on participation by children and is developing specialized methodological tools and codes of ethics to govern the cooperation with the Advisory Groups.

Over the coming months, the CAMHI’s focus will be on finalizing the development of the first set of basic and advanced evidence-based trainings, with pilot implementation expected to start in the second quarter of 2023.

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

As provided by the Health Initiative’s umbrella legislation, SNF’s grant for the renovation and outfitting of a building at Paidon Agia Sofia Children’s Hospital will house the newly established collaboration between the Hospital’s Department of Child Psychiatry and the Child and Adolescent Mental Health Initiative (CAMHI), both for educational and clinical purposes.

The preliminary design study for the renovation was completed in November 2022, reflecting feedback from the leadership and end users of Paidon Agia Sofia Children’s Hospital, as well as from child psychiatrists and the CAMHI's international experts. The renovated building will host the Athens hub of the CAMHI Network and will include dedicated training spaces and assessment rooms to enable the Department’s clinical work in the context of the CAMHI. The renovation work also extends to the landscaping surrounding the building to create a green space for young visitors.

Immediate next steps in the grant include official approval of the design by the relevant authorities, securing all necessary permits, and launching the final design process. At the same time, the Grant Agreement between SNF and the Greek state is being prepared, specifying, among other things, the operating modalities of the new building and relevant sustainability provisions, in line with the vision to augment the Hospital’s child mental health work and services. According to the current timeline, the renovation is slated for completion in summer 2023.

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

Inspired by the Child and Adolescent Mental Health Initiative (CAMHI) in Greece and building on a longstanding partnership between SNF and the Child Mind Institute, the SNF Global Center for Child and Adolescent Mental Health at CMI was established with a foundational grant from SNF. This comes at a pivotal moment in the wake of the COVID-19 pandemic, amidst widespread recognition of a global crisis in mental health and urgent calls for action to meet the moment with equitable, culturally sensitive, and evidence-based care.

The Global Center aims to dramatically expand access to effective mental health care for children and adolescents worldwide through a set of six complementary initiatives that increase access to reliable information, improve quality of care, reduce stigma and discrimination, spur innovation, empower the next generation of leaders in child and adolescent mental health, and organize collaborative efforts across the globe around a cohesive and inclusive agenda. CMI is actively working to launch the activities of the Global Center with a view to develop the six initiatives in ways that leverage CMI’s unique expertise and the work of the CAMHI in Greece, guided by a vision to promote equity and quality of mental health care for young people in different regions across the world.

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

The new SNF Center for Precision Psychiatry and Mental Health at Columbia University in New York City is at the official launch stage, following the joint vision and commitment of the two institutions to reduce the toll of mental health conditions and fight inequality in care.

Precision psychiatry, an emerging field at the nexus of multiple scientific disciplines including genomics, neuroscience, and epidemiology, holds the unprecedented promise of highly efficacious personalized psychiatric care based on each individual’s unique genetic makeup and biology. As presented at the 2022 SNF Nostos Conference, the new Center will build on Columbia’s leading work in these fields, 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.

The Center will work to catalyze innovative new treatments to enhance care for people experiencing severe mental illness worldwide through improved diagnosis, prevention, and treatment. In keeping with the values of the Health Initiative, the Center’s leadership is fully committed to making the resources it develops open and available to the international 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.

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

First announced at the 2022 SNF Nostos Conference, the new SNF Institute for Global Infectious Disease Research at The Rockefeller University (RU)—one of the world’s foremost centers of scientific achievement in biomedical research—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.

The creation of the Institute, via a foundational grant from SNF, ensures that RU investigators have the resources to take scientific risks in anticipation of, and in reaction to, global health threats—an imperative underscored by the pandemic-related events of the past three years. The Institute’s mission encompasses complementary efforts in research, global partnership building, scientific education and training, and public communication. In these ways, the new SNF Institute aims to create and reinforce fast-acting and long-lasting platforms for responding to infectious diseases at a global level. The Institute will be led by Nobel laureate Dr. Charles Rice, who leads RU’s Laboratory of Virology and Infectious Disease and serves as Chair of New York State’s COVID-19 Clinical Advisory Task Force.

• ETH Zurich Foundation - Engineering for Humanitarian Action (HAC) Initiative

The SNF Health Initiative is 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. It is envisioned that solutions developed through the initiative will benefit the ICRC as well as the humanitarian sector more broadly. One of the program’s three priority areas is Digital Health and Medical Technologies—in line with ICRC’s institutional strategy for 2019-2022—along with Energy and Environment, and Data Science and Cyber Security. The initiative will identify, develop, test, and implement scalable solutions to address challenges in humanitarian response. It will also train humanitarian actors in technology and engineering to support the adoption of innovative technological solutions.

• Hellenic Cooperative Oncology Group (HeCOG) CLIMEDIN Study

The Hellenic Cooperative Oncology Group (HeCOG) is a non-profit 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 as part of the Health Initiative, HeCOG is undertaking a study (CLIMEDIN) in 200 patients between the ages of 18 and 78 with inoperable non-small cell lung cancer in Greece. The three-year study will investigate the efficacy and safety of personalized therapies, with goals of increasing survival and improving the patients’ quality of life. Treatment will be administered free of charge to all enrolled patients and Next Generation Sequencing (NGS) will be used to conduct genetic testing of tumors at the beginning of the study. Half of the study subjects will be randomized to receive extra supportive material through a digital platform, the effects of which will also be analyzed.

A total of 19 clinical centers are 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). More than half of the targeted 200 patients have been enrolled to date. The study is anticipated to be completed at the end of 2024; findings will be presented at international conferences and submitted for publication in international scientific journals.