Addressed to: Nikos Panagiotopoulos, Minister of Migration and Asylum; Stellina Siarapi, Secretary-General for the Reception of Asylum Seekers; Herakles Moskoff, Special Secretary-General for the Protection of Vulnerable People; Adonis Georgiadis, Minister of Health; Irini Agapidaki, Alternate Minister of Health

CC to: Gianluca Rocco, Chief of Mission IOM Greece; Beate Gminder, Deputy Director-General of the European Commission (Task Force Migration Management), Kostas Gogogis, Director of Operational Preparedness for Public Health Emergencies at The Greek Ministry of Health.

We, the undersigned NGOs working on Lesvos, wish to express our profound concern regarding the continuation of the PHILOS II Programme and the transition to the HIPPOCRATES programme, specifically in relation to its impact on access to healthcare (including mental health and psychosocial support) for asylum seekers and refugees and the registration and continuity of asylum procedures.

The provision of healthcare to asylum seekers and refugees in reception facilities on the Greek islands and mainland is a State responsibility^[1] delegated to the Greek National Public Health Organisation (EODY) through the PHILOS II programme.^[2] The abrupt end to the contract of EODY staff means that effective healthcare provision, registration and screening by authorities would cease imminently.^[3]

We are deeply concerned about the feasibility of a smooth transition from the PHILOS Programme II to the HIPPOCRATES Programme, particularly given the short notice after the contract was awarded to the International Organisation for Migration (IOM).^[4] There are indications that IOM’s intended implementing partner(s) may not be ready to commence the HIPPOCRATES Programme until mid-September this year.^[5]

We also express concern about the potential disruption to legal proceedings. EODY’s ongoing responsibility for conducting medical and psychological screenings, as well as registering new arrivals to the islands, is critical for the continuity of the asylum procedure. Any disruptions of these processes would impair the efficiency of the asylum procedure, delay the identification of vulnerable groups^[6], and ensure access to necessary services, including (chronic and specialised) healthcare.

In the absence of official authorities, relying solely on NGOs, even temporarily, to cover a gap in (healthcare) services is unprecedented. NGOs lack the legal mandate and authority to take on the role of primary service providers and effectively coordinate with national authorities, health systems and across multiple sectors.

Greek authorities must maintain a central, coordinating role to fulfil their legal and moral obligations and ensure the well-being of asylum seekers and refugees under their care. Therefore, we respectfully request the following clarifications from the Greek authorities:

• Provision of healthcare: Provide clarity on how authorities ensure the provision of and access to healthcare (including MHPSS care) at Reception facilities.
• Continuity of screenings and registrations: Provide clarity on how authorities intend to continue medical and psychological screenings as part of the asylum procedure and for registering new arrivals.
• HIPPOCRATES programme: Provide clarity on the start, implementation and monitoring of the HIPPOCRATES Programme to ensure that requirements are met and access to healthcare, including screenings and registration, is ensured.
• Role of NGOs: Clarification on the role and responsibilities of NGOs in providing services during the transition to and implementation of the HIPPOCRATES Programme.

We remain at your disposal for any further information and look forward to your prompt response.S

Signed by:

• Boat Refugee Foundation
• Centre for Gender Rights and Equality DIOTIMA
• Fenix Humanitarian Legal Aid
• HIAS Greece
• Legal Centre Lesvos

^[1] Reception Directive Article Article 19 and 21; Charter of Fundamental Rights of the European Union Article 35; Refugee Convention Article 23

^[2] Hellenic Ministry of Migration and Asylum ‘Παρατείνεται μέχρι τις 15 Φεβρουαρίου το Πρόγραμμα “PHILOS”’ (5 September 2023)

^[3]AVGI ‘ΕΟΔΥ / Με e-mail απολύουν 400 εργαζόμενους στο πρόγραμμα Philos’ (17 June 2024); Stonisi ‘Ερώτηση ΚΚΕ για τους εργαζόμενους υγειονομικούς στο προσφυγικό’ (18 June 2024); ERT News ‘Λέρος – Ρ. Σωτηριάδου: Λύνουν τις συμβάσεις εργαζόμενων του Προγράμματος Philos με τον ΕΟΔΥ νωρίτερα αφήνοντας κενές τις δομές’ (18 June 2024); ERT News ‘Εργαζόμενοι ΕΟΔΥ: “Απεργούμε 26 και 27 Ιουνίου για τη δουλειά και την αξιοπρέπεια μας”’ (26 June 2024)

^[4] Hellenic Ministry of Migration and Asylum ‘Πρόγραμμα «Ιπποκράτης» για την αναβάθμιση της υγειονομικής κάλυψης των αιτούντων άσυλο στην Ελλάδα’ (29 May 2024)

^[5]AVGI ‘ΕΟΔΥ / Με e-mail απολύουν 400 εργαζόμενους στο πρόγραμμα Philos’ (17 June 2024)

^[6] People with a disability, elderly people, (pregnant) women, (Unnacompanied) children, single parents, people with serious (mental) health problems, survivors of torture or (gender based) violence and LGBTQ+ people