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The Stavros Niarchos Foundation (SNF) Health Initiative in Greece, drawing on a budget expected to exceed $450 million and implemented in partnership with the Greek Ministry of Health, aims to ensure high quality medical care for all by enhancing the country’s public health sector. The Health Initiative encompasses a suite of hospital infrastructure projects, equipment procurement, and educational programs.

This update is the sixth issued since the launch of the SNF Health Initiative. In the spirit of transparency, SNF is committed to providing regular updates with timely information on the range of projects included in the Initiative.

Since the last update, there have been a number of important developments, emerging from discussion between SNF and the Greek state. The most significant of these are the decision to pursue, first, the addition to the Health Initiative of the design, construction, and outfitting of the new SNF General Hospital of Sparta and, second, the procurement of two new helicopters for EKAV’s Air Ambulance Services rather than the repair of existing helicopters as initially proposed.

These developments have taken place in an atmosphere of continuous close cooperation between SNF and the Greek state—delays in implementation, both expected and otherwise, notwithstanding. In particular, an amendment to the main Health Initiative grant contract reflecting these and other developments is expected to be ratified in the near future. In the Initiative’s efforts to strengthen the nursing sector, ratification of individual contracts with Evangelismos Hospital and the School of Health Sciences of the National and Kapodistrian University of Athens (NKUA), initially scheduled for late September, is expected to be forthcoming. Once these items have been ratified, SNF will move forward with signing contracts with third parties for the completion of each individual project.

The individual grants comprised by the Health Initiative are as follows:

> The New SNF General Hospital of Komotini
Following finalization and approval of the preliminary study for the new SNF General Hospital of Komotini by the Ministry of Health, architectural firm Renzo Piano Building Workshop (RPBW) is working on the final study, which is expected to be completed on January 2020.

Studies for the required complementary infrastructure associated with the new hospital have been completed, and their approval by the Ministry of Infrastructure is pending. Per the initial planned timetable, provided there are no further delays in the implementation of the infrastructure projects, the new SNF General Hospital of Komotini is expected to be completed and delivered to the Greek State and the people of Greece in June 2024.

> The New SNF University Pediatric Hospital of Thessaloniki
The preliminary study for the SNF University Pediatric Hospital of Thessaloniki by architecture firm RPBW is fully underway. The deadline for the completion of the preliminary study and presentation of a proposal to SNF and the Ministry of Health is November 2019. Meanwhile, the Ministry of Health has assigned the study of associated infrastructure projects to a consulting firm, with delivery set for December 2019. The new SNF University Pediatric Hospital of Thessaloniki, which will be the first pediatric hospital in Greece, is expected to be completed and delivered to the Greek state and the people of Greece in October 2024.

>New SNF General Hospital of Sparta
Following the announcement by SNF Co-President Andreas Dracopoulos of SNF’s intention, within the context of a major initiative for the region of Laconia, to make a grant for the creation of a new General Hospital in Sparta, progress is being made towards the official launch of the project. The next step is the ratification of an amendment to the main Health Initiative grant contract between SNF and the Greek state to include the construction and outfitting of the new SNF General Hospital of Sparta.

Meanwhile, the same team responsible for the coordination, management, and implementation of the infrastructure projects in Komotini and Thessaloniki has been enlisted to manage the Sparta project. That team consists of representatives from international architecture firm RPBW and Greek firm Betaplan; from Ηill International, which manages and oversees the project; and from British company Llewelyn Davies, which is offering consulting services on hospital design. According to the schedule established, provided that the relevant amendment to the main contract is ratified immediately, the new SNF General Hospital of Sparta is expected to be completed and delivered to the Greek state and the people of Greece in December 2024.

> Support for Nurses and Nursing
This grant aims to strengthen Greece’s nursing sector by procuring equipment and designing educational curricula for a total of four nursing schools: three Educational Nursing Units at Evangelismos General Hospital and the School of Health Sciences of the National and Kapodistrian University of Athens (NKUA). Following finalization of the aims and budget of the grant by SNF and the relevant project teams of the Ministries of Health and Education, ratification of the individual grant contracts and of an amendment to the main grant contract is expected. To bolster the nursing sector in Greece, this grant rests on three pillars: 1) Procurement of laboratory equipment, 2) Development of educational programs, and 3) Support for research programs and scholarship programs. Equipment is expected to be delivered to the three nursing units at Evangelismos Hospital and to the NKUA School of Health Sciences in October 2020.

> Procurement and Installation of Equipment at Evangelismos General Hospital
In July 2019, SNF collaborated with the relevant project team from Evangelismos General Hospital to complete selection of contractor companies, following a tender, for the procurement and installation of equipment at the hospital. SNF is awaiting the approval by the Greek state of the updated equipment list, submitted by Evangelismos Hospital, in order to move forward with signing relevant contracts with the contractor companies selected. Procurement and installation of medical equipment is set to be completed in March 2020. To enable installation of the equipment, the Hospital has committed to complete a series of construction projects by November 2019.

> Procurement of Equipment for the National Center for Emergency Care’s (EKAV) Air Ambulance Services
Discussions between SNF, the Ministry of Health, and the Prime Minister’s Office on the grant to upgrade EKAV’s Air Ambulance Services resulted in a decision that the most appropriate solution was to procure two new helicopters, instead of repairing existing ones as initially proposed. Accordingly, SNF will undertake the procurement of two new medivac airplanes and two new helicopters, and the Greek state is committed to providing for the full maintenance of all four aircraft. Following these developments, an amendment to the main grant contract, and separately the individual grant contract, will be ratified in order to reflect the new plan and obligations of the parties involved. At the same time, the tender for the selection of a contractor for the procurement of the two new airplanes is progressing smoothly, with final proposals expected before the end of October. The two new medivac airplanes and the two new helicopters are expected to be delivered to the Greek state in March of 2021.

> Procurement and Installation of Specialized Medical Equipment across Greece
As reflected in the relevant grant contract ratified under law by the Greek Parliament in June 2019, SNF and the Ministry of Health have agreed to install specialized medical equipment in hospitals around Greece. PET/CT equipment will be installed at the University Hospitals of Heraklion, Ioannina, Larissa, and Alexandroupoli, and radiopharmaceutical production units will be created at the University Hospitals of Heraklion, Ioannina, and Larissa, as well as at the Papageorgiou General Hospital of Thessaloniki. A tender for the procurement of equipment is currently ongoing, with October 11 being the deadline for proposal submissions. SNF is awaiting a detailed timetable from the Greek state covering the fulfillment of its obligations relating to required construction work and recruitment of necessary personnel. According to the current timetable, and provided that further delays do not arise, this grant will be implemented by August 2020.

> Design and Implementation of Educational Resources
SNF has repeatedly expressed a desire to contribute to the effective treatment of the critical problem of in-hospital infections. Following discussions between SNF and the Ministry of Health, the decision was made to reintegrate an educational program on treatment of in-hospital infections into the Health Initiative. This grant had been canceled in mid-April 2019, as detailed in the Fourth Health Initiative Update.

At the same time, SNF is awaiting the final proposal from the Ministry of Health on the implementation of the five trauma treatment training programs (including the Advanced Trauma Life Support [ATLS] trauma treatment program for medical students, re-inclusion of which in the Health Initiative is under consideration). The other four educational programs designed by the nonprofit Regeneration & Progress for trauma treatment are as follows: 1) The Advanced Trauma Care for Nurses (ATCN) program, 2) A training program for doctors at the largest trauma center in the world, Chris Hani Baragwanath Academic Hospital, 3) A training program for surgeons using laparoscopy and arthroscopy simulators, and 4) The Prehospital Trauma Life Support (PHTLS) educational program for the training of EKAV rescue personnel.

For the educational programs both for the treatment of in-hospital infections and for trauma treatment, SNF and the Greek state have agreed to set a deadline of December 30 for ratification of the individual contracts. In case ratification by the Greek state is not possible within the time limit, it is mutually agreed that the training programs will not be included in the Health Initiative.