Greater Cross Border cooperation promised in Covid-19 response

Another three people have died from Covid-19 in Northern Ireland.

It brings to 73 the number of people who lost their lives to the virus north of the border.

97 new cases were reported, bringing the total number of reported cases to 1,255.

Meanwhile, a Memorandum of Understanding has been formally agreed to underpin and strengthen North South co-operation on tackling COVID-19.

The document focuses on facilitating greater co-operation in areas such as public health messaging, research, and ethics. Other areas such as procurement will also be considered.

The text has signed by the two Chief Medical Officers, Dr Tony Holohan and Dr Michael McBride.

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Memorandum text in full -

MEMORANDUM OF UNDERSTANDING
COVID-19 RESPONSE – PUBLIC HEALTH COOPERATION
ON AN ALL-IRELAND BASIS
BETWEEN:
THE DEPARTMENT OF HEALTH, IRELAND (AND ITS AGENCIES);
AND
THE DEPARTMENT OF HEALTH, NORTHERN IRELAND (AND ITS AGENCIES).
1. CONTEXT
1.1 This Memorandum of Understanding (“MoU”) is between the Department of
Health, Ireland and its Agencies and the Department of Health,
Northern Ireland and its Agencies (herein referred to as “the Participants”)
who have expressed their mutual willingness to promote cooperation and
collaboration in response to the COVID-19 pandemic.
1.2 In response to COVID-19 Ministers from the Irish Government and Northern
Ireland Executive met on 14 March 2020 to discuss North-South cooperation
in dealing with the pandemic. The COVID-19 pandemic does not respect
borders, therefore there is a compelling case for strong cooperation including
information-sharing and, where appropriate, a common approach to action in
both jurisdictions.
1.3 At that meeting Ministers affirmed that:
“Everything possible will be done in co-ordination and cooperation between
the Irish Government and the Northern Ireland Executive and with the active
involvement of the health administrations in both jurisdictions to tackle the
outbreak. Protection of the lives and welfare of everyone on the island is
paramount, and no effort will be spared in that regard”.

2. COOPERATION
2.1 Cooperation on the public health-driven response to COVID-19 will build on
existing and long-established cooperation on the island of Ireland between the
Participants and the health services including across cancer, ambulance and
congenital heart services, and the strong pre-existing cooperation between
the respective offices of the Chief Medical Officers in both jurisdictions.
3. PRINCIPLES
3.1 The principles upon which our cooperation is based are:
• Agility - in order to ensure timely and responsive communications and
decisions in a fast moving emergent environment;
• Openness - to ensure transparency of approach;
• Consistency - to ensure where possible, both governments adopt similar
approaches as guided by the scientific evidence; and
• Trust-that information shared is reliable and is shared and managed within
agreed protocols.
4. COMMITMENTS
This Memorandum of Understanding records the commitments of the
Participants; it does not create legally binding obligations.
The cooperation envisaged by this Memorandum of Understanding may need
additional authority, including legislative, for expenditure, data sharing and for
any new action not already within the power of the Ministers.
The Memorandum of Understanding will focus primarily on a number of key
areas.
4.1 Modelling
4.1.1 The Participants are committed to working in partnership to predict the likely
impact of COVID-19 and to enable evidence-based decisions on how best to
respond across the island of Ireland. This may involve using published
evidence and data from outbreaks elsewhere and international work in
modelling infectious disease. This will be adapted to and informed by the

relevant demographics, healthcare structures and health policies of both
jurisdictions.
4.2 Public health and non-pharmaceutical measures
4.2.1 The Participants will work to develop evidence based public health measures
central to the response to COVID-19 in both jurisdictions, including measures
such as, but not limited to case detection, testing regimens and contact
tracing recognising that the introduction of such measures may differ as a
consequence of variation in COVID-19 transmission, local outbreaks and
health consequences at different stages of the public health response. Such
decisions will be informed by the advice of the offices of the Chief Medical
Officers in both jurisdictions
4.2.2 The Participants will share information and discuss appropriate social
distancing measures being considered, including public health-mandated
travel restrictions.
4.2.3 Consideration will be given to the potential impact of measures adopted in
one jurisdiction on the other recognising that the introduction of such
measures may differ reflecting differences in COVID-19 transmission at
different stages of the public health response.
4.3 Common public messages
4.3.1 Where appropriate the Participants will adopt consistent public messaging to
build and reinforce core communications around handwashing, respiratory
hygiene, no handshaking and other social distancing measures.
4.3.2 Communications may be targeted to support particular vulnerable groups,
including older people.
4.4 Behavioural change
4.4.1 The Participants will work together on relevant programmes of behavioural
change. As part of the Participants’ commitment to social outreach and
engagement, civil society organisations, many of whom already work in both

jurisdictions, will be encouraged and assisted in their important work that
supports public health priorities.
4.5 Research
4.5.1 The Institute of Public Health, established by the Participants, will consider
what practical research it could conduct in the context of strengthening the
COVID-19 response. In addition, the Participants and their agencies will
explore opportunities for cooperation and collaboration in any identified
priority research areas, such as research calls, clinical trials and sharing of
samples and data.
4.6 Ethics
4.6.1 The Participants will collaborate on frameworks which can be drawn on to
help inform an ethical approach to respective decision-making, and research.
4.7 Supporting Cooperation
4.7.1 The Participants will work together in appropriate areas that may arise, such
as procurement, to support the response to COVID-19, where it is of mutual
benefit to do so.
5. ENGAGEMENT
While regular agile arrangements for communication will be the modus
operandi between the Participants, a weekly teleconference will be held
between the respective Offices of the Chief Medical Officers to ensure mutual
ongoing understanding.
6. REPORTING
Given that the response to COVID-19 requires a whole government approach,
the Participants will provide an agreed regular update report to our respective
administrations.
7. VARIABILITY
While the Participants will seek to ensure consistency where possible, for
justifiable reasons the public health approach and measures adopted in the

respective jurisdictions may not always mirror each other in identical fashion.
However, strong collaborative arrangements, including good informationsharing, should help to mitigate possible negative consequences.
8. NON-BINDING
This MoU represents the common understanding of the Participants upon the
matters referred to therein. It is not of itself intended to create legally binding
rights or obligations on any Participant. Further it does not constitute an
international agreement and does not create rights and obligations governed
by international law.
It has been agreed that this Memorandum of Understanding shall come into effect by
the exchange of emails between the Participants confirming agreement to its terms
and that the date of the last of the said emails shall be the date on which the
Memorandum of Understanding comes into operation.
Signatories:
__________________________ ___________________________
Dr Tony Holohan
Chief Medical Officer
Department of Health (Ireland)
On behalf of the Minister for Health
Simon Harris TD
Dr Michael McBride
Chief Medical Officer
Department of Health (Northern Ireland)
On behalf of the Minister for Health
Robin Swann MLA