ISAGS Triennial Working Plan (2012-2015) by ISAGS

THREE-YEAR WORKING PLAN 2012 – 2015

TABLE OF CONTENTS 1.

PRESENTATION ........................................................................................ 3

HISTORY OF THE INSTITUTIONALIZATION OF ISAGS.......................... 4

NATURE OF ISAGS ................................................................................... 5

OBJECTIVE ................................................................................................ 6

CHALLENGE .............................................................................................. 6

VALUES...................................................................................................... 6

OBJECT...................................................................................................... 7

NETWORKING ........................................................................................... 7

CONCENTRATION AREAS ....................................................................... 8

10. INTERVENTION ....................................................................................... 12 11. STRATEGIES ........................................................................................... 12 12. ACTION PROGRAMS .............................................................................. 13 13. EXPECTED RESULTS ............................................................................. 14 14. MONITORING, ASSESSING AND ACCOUNTING .................................. 15 15. ADMINISTRATING AND LEADING ISAGS ............................................. 17 16. THREE-YEAR WORKING PLAN (2012 – 2015) BUDGET ...................... 19 ANNEX I – Statute of the South American Institute of Government in Health .............................................................................................................. 21 ANNEX II – Budget Program of the South American Institute of Government in Health (ISAGS) – Base Year 2013 ....................................... 28

1. PRESENTATION The South American Institute of Government in Health (ISAGS) is an intergovernmental entity of public nature, member of the South American Health Council for the Union of South American Nations (UNASUR). It was created by the Council of Heads of State and the Government of UNASUR, on a proposal from the South American Health Council at a meeting in Cuenca, Ecuador, in April, 2010.

Structured in an agile and flexible way, ISAGS is shaped by the Directors and Advisory Boards and by the Executive Directorate.

In agreement with the Statute of ISAGS and item 2 of ISAGS Resolution 03/2011, the Executive Director of the Institute must prepare the proposed ISAGS working program/plan for consideration and review of the Members of the Board of Directors. The Advisory Board should propose strategic lines of action for ISAGS working program, as well as making recommendations for the planning, management, implementation and evaluation of the programs developed by the Institute.

After the first half of the Institute's activities, in which five workshops were conducted involving 207 specialists from 12 member countries of UNASUR, identified were - from the results of the discussions on these activities - three priority areas that contribute to the objective of UNASUR strengthening South America as a sovereign political space.

ISAGS proposal is to work in these three areas identified as Concentration Areas which will take place during the course of 2012 to 2015, in conjunction with the Five-Year Plan (2010 â&#x20AC;&#x201C; 2015) of the UNASUR Health Council.

2. HISTORY OF THE INSTITUTIONALIZATION OF ISAGS The UNASUR Constitutive Treaty, in Article 13, has established the possibility of creating institutions, organizations and programs within UNASUR. The South American Institute of Government in Health (ISAGS) was created by the South American Health Council (CSS) according to resolution 05/2009 and its statutes were approved by resolution CSS 02/2011 and endorsed by the Ministers of Foreign Affairs in August of 2011. Resolution 05/2009 (Guayaquil, Ecuador, 2009) of the South American Health Council of UNASUR creates the South American Institute of Government in Health (ISAGS) and accepts the offer of the Brazilian Government to establish the headquarters of the Institute in the city of Rio de Janeiro.

Resolution 03/2010 of the South American Health Council of UNASUR authorizes the Coordinating Committee of UNASUR Health, the Technical Group of Human Resources and the Brazilian National Coordination to maintain the continuity and to materialize the necessary steps for the gradual implementation of the ISAGS “blueprint”.

Resolution 02/2011 (Montevideo, Uruguay, 2011) of the South American Health Council of UNASUR approves the Statute of ISAGS.

On July 25, 2011 the Health Ministers of the Member States of UNASUR met in Rio de Janeiro, at the launching ceremony of PRO ISAGS and the inauguration of the physical headquarters of the Institute, to formalize the conformation of the agencies of ISAGS, approving the resolutions of PRO-ISAGS 01/2011, 02/2011 and 03/2011 that constitute the Board of Directors, the Advisory Board and approved the appointment of Dr. José Gomes Temporão as Executive Director of the Institute, respectively. The Ministers also recommended an urgent analysis of the ISAGS Host Agreement by the South American Health Council

of UNASUR, with the purpose that it can be forwarded to the Council of Delegates of UNASUR.

On August 24, 2011, the UNASUR Council of Foreign Affairs Ministers met at a special meeting in the city of Buenos Aires, Argentina and approved the Statute of ISAGS, thus also authorizing the Secretary-General of UNASUR to sign the Institute’s Host Agreement between UNASUR and the Federative Republic of Brazil.

The CSS Five-Year Plan 2010-2015 has as one of its results (No. 27) the creation of ISAGS, and in July of 2011, in Rio de Janeiro, the first meetings of its Board of Directors, Advisory Board was held and appointed its first Executive Director. On March 07 and 08, 2012, the 2nd Ordinary Meeting of ISAGS’ Advisory Board was held with the aim to discuss the preliminary proposal of ISAGS’ Three-Year Working Plan (2012 – 2015). The members of the Advisory Board will record in the minutes the six recommendations of the meeting that were incorporated into the working plan.

The institution has started its operation as Pro ISAGS (FIOCRUZ/Brazil temporary project) waiting for the Heads of State to sign the resolution approving the Statute of ISAGS, as well as the UNASUR Secretary General and the Brazilian Government to sign the Host Agreement and approve the ISAGS budget.

3. NATURE OF ISAGS The South American Institute of Government in Health has the 12 countries of South America as members.

Other States can obtain the position as a

Member, once they have joined UNASUR and organizations whose mission is convergent with the vision and mission of ISAGS, and whose application and membership have been approved by the South American Health Council. 5

ISAGS is an institution that belongs to the State Members of UNASUR and exercises its activities in representation and delegation thereof. Thus, in nature they are inherently the concepts of State, Sovereignty, Governance and Mandate. The official and formal partners of consultation are the Ministries of Health and Foreign Affairs of the countries.

ISAGS initiatives are always of a delegate nature and must be understood as instruments of intergovernmental policy, which respond to agreed common interests among Member States, expressed by a Working Plan approved by its Board of Directors.

4. OBJECTIVE ISAGS aims at becoming a center of higher studies and discussion on policies to develop leaders and strategic human resources in health, pointing to promote governance and leadership in the health of South American countries and giving inputs to articulate regional performance in global health.

5. CHALLENGE The ISAGS is an agency of UNASUR Health that aims at contributing to the production and management of strategic knowledge that is available for decision-making by the South American Health Council to transform health systems and reduce social inequalities within the context of building South American political identity.

6. VALUES ISAGS reiterates and assumes the values that have inspired the creation of UNASUR and the principles of the South American Health Council expressed in its Constitutive Declaration, and are summarized below: 6

Health as: 1. A fundamental right of a human being and of society and a vital component for human development; 2. Driving force of regional integration. 3. Central component of social protection and harmonious social development. 4. Space for the reduction of existing asymmetries among countries. 5. A public good that regards the joining of society and space as vital for citizen participation. In addition, the constituent declaration emphasizes the need to incorporate the principles of solidarity, complementarity, respect for diversity and interculturality.

7. OBJECT Public Health Policies.

8. NETWORKING ISAGS is inserted into the South American Health Council of UNASUR and interacts with the structures which also make up this Council: the Pro-Tempore Presidency, the Council of National Coordinators, Technical Groups and the Structural Networks.

Furthermore, in order to achieve its objective, ISAGS

should also be linked, with the aim of achieving its mission, with other UNASUR Thematic Councils, the Secretary General of UNASUR and the Ministries of Health of South America.

According to its Statute, ISAGS enjoys legal capacity to execute and hold events and manage or dispose of rights. It can also carry out actions and efforts that are conducive to the achievement of their objectives or necessary for the implementation of their activities.

ISAGS will guide their institutional actions according to the principles, values and strategic plotters of the South American Health Council and promote the concept of networking with the South American Health Council agencies. 7

Figure 1: Structure of the South American Health Council

9. CONCENTRATION AREAS ISAGS defines itself as one of the most expressive results of the initiative by the South American Health Agenda, proposed by the Health Council through the Human Resources Technical Group.

It has intended on structuring an institution capable of contributing to the success in implementing health policies that meet the consensual principles and values in the Region. The main idea has been to clearly identify the need to strengthen the governmentâ&#x20AC;&#x2122;s capacities in the health sector of the member countries to fulfill the directives expressed by the actual Health Agenda.

Within this context, “Government capacity” or “governance” is understood as the accumulation and achievement of political, economic and technological feasibility.

The assertive has implications on the design of ISAGS' programmatic outline.

To contribute to UNASUR, ISAGS will have to be involved in critical discussion on the main structural issues that limit social and health development of the region, without disguising the political and financial contradictions.

ISAGS needs to consolidate itself as a space to form strategic thinking and critical analysis, which implies examining and studying issues such as universality, rights, accessibility, free of charge, among others.

Furthermore, as a consequence, the investigation and training of strategic human resources must be stimulated, capable of leading and sustaining spaces for discussion and building public health policies.

For this, ISAGS must identify and study the existing divergences and convergences to be able to contribute to the issues that are intended to be added or influenced, since the ideology of universal rights presents important contradictions that go much more beyond improving the shortages within the countries in aspects on technical and administrative conduction and human resources training for management. Nor is it its fundamental role to limit itself to answer to the demands of the health sector and technical cooperation of the countries individually.

Taking as a reference these conceptual considerations on the programmatic outline of ISAGS, added to the already mentioned accumulated experience, in the first semester of the Institute’s activities, it is proposed that ISAGS focuses on its Action Programs according to three Large Concentration Areas, which contribute to broadening and strengthening the capacity of the government in

the Regionâ&#x20AC;&#x2122;s health sector and to facilitate attaining the South America Health Agenda and Five-Year Plan of the UNASUR Health Council. Figure 2: Diagram of Working Plan Flowchart

We will explore the political economy of health through a focus on the following sub-topics: Social Health Determination Considering one of the priority pivots of the Health Agenda, observing that within the Ministries of Health of UNASUR the theme is essentially guided towards Promoting Health and exchanging lifestyles.

Studies on social health determination must be examined starting with the relations and medications for social health determinants, social inequalities and the search for critical knots in STD intervention. There are more comprehensive studies that fulfill the need to understand how to modify the conditions that set 10

within the world an imperative situation with respect to the level of life of large population groups and for this the state of health at a global level.

Universal Health Systems This Concentration Area, also avoided within the Health Agenda and which, without a doubt, synthesizes the response that is up to the health sector, must analyze in a way that the reforms of the health systems resulting from the arising new political social models affect the structure of the health sector, as well as understanding its consequences in terms of equality and governability in the different countries of the region.

Health Economics Policy The political economy of health refers to a body of analysis and a perspective on health policy which seeks to understand the conditions which shape population health and health service development within the wider macroeconomic and political context. This Concentration Area seeks investigating however, the relationships between economic development and health development are complex and can be analyzed in terms of a range of different linkages: the conditions that interfere in the health of the population and the development of health systems within a broader context for relations between economy and health.

Within the same one there are issues related to the dynamics of health markets, productive

restructuring,

technological

transition,

information

and

communication systems, knowledge productions, social protection, working processes and regulatory capacity within the sector, which are habitually "outside" of health systems and which are little considered within the Five-Year Plan.

10.

INTERVENTION

Creation of Critical Thinking and Discussion Centers ISAGS intends to strengthen the institutional development of critical and innovative thinking in health within the scope of UNASUR in topics selected starting with Concentration Areas.

This institutional development must be built with the fundamental participation of the countries and the structures of UNASUR â&#x20AC;&#x201C; Councils, Pro-Tempore Presidency, Technical Groups and Networks.

The process proposed is to identify initiatives and delegates that work with the topics relative to Concentration Areas in the member countries of UNASUR, identify the knowledge centers within these countries and join these groups to discuss the topics.

11.

STRATEGIES

a. Generation, production and dissemination of critical, innovative and transforming knowledge on health policies and systems to reduce social inequalities.

b. Support for strategic personnel training to form policies and management of health systems.

c. Intersectoral articulation to create spaces for communication among the other sectors and health within the member countries of UNASUR.

d. Contribution to democratizing access to knowledge and information on health.

12.

ACTION PROGRAMS

Strengthening the Capacity for Critical Analysis and Formulation ISAGS as a shared space that serves as a base to create knowledge, exchange information, opinions, collaboration, mobilization and relationships to improve policies and responses of the health sector in South America.

Actions:  Creation of systematic investigative lines;  Building Reference Terms;  Joining integration groups with Technical Groups and Networks of the UNASUR Health Council.

Strengthening Strategic Human Resources

ISAGS as a space to support the training of leading staff to strengthen the capacity of the member countries of UNASUR in formulation and intervention of public health policies.

Actions: 

Participant elaboration of a Strategic Preparation Plan for midterm Health Personnel;

 Development of a data bank on offers and demands for training, qualification and specialization in collective health;  Linking with training institutions in the countries of UNASUR to form strategic alliances;  Promotion and disclosure of qualification programs, in class and/or long distance.  Investments in information technologies and in education that provides using international virtual space.

Strengthening the component of External Health Policy of the UNASUR Block 13

ISAGS is understood as a space to strengthen the political capacity for negotiation, discussion and representation of UNASUR within an international scope.

Actions:  Regular monitoring of International Forum agendas to identify and map critical, regional health issues.  Support for building common positions on health for international collective, regional or global decisions.  Leadership training in external health policy capable of acting as a counterpart for Health in international negotiations.  Forming policies for the region to link with alliances and international strategic cooperation.

Conducting Political Integrating Regional Health ISAGS is understood as a space to promote access to critical and qualified information on health for member countries, supporting the progressive incorporation of new social participation practices.

Actions:  Exchanging intersectoral experiences and social participation;  Promoting spaces among member countries as an integrating strategy;  Building working groups to develop multicentric investigation records;  Maintaining the website with information management and generation of bulletins and periodic virtual alerts.

13.

EXPECTED RESULTS

The greatest result that ISAGS intends on obtaining with its Working Plan is fundamentally to meet the objective of UNASUR to strengthen South America 14

as a cohesive political and progressive space by means of strengthening knowledge networks and through continuously stimulating critical reflections on health topics. Building Critical Mass As a result, ISAGS intends on constant critical reflection to examine, investigate and analyze public health policies, forming as such critical mass capable of forming proposals that broaden its potential for social inclusion and integration.

Strengthen Knowledge Network As a result, ISAGS intends on strengthening knowledge networks that have the convergence points of cooperation and interaction with the clear purpose of identifying its essential components. The proposal is to strengthen the interaction among the actors that share and build knowledge, developing ideas and processes by means of moving information. The knowledge networks must be articulated and set by the actions and interactions of organizational actors, networks in which the shared information processes and knowledge building are particular to them.

Continuous, permanent advance is important for consolidating a knowledge network among the member countries of UNASUR to disseminate information, granting the possibility of interaction among the countries. This interaction will lead to shared participation, boosting the flow of information and knowledge that are a consequence of the movement of a network and determined by the links that are set and reset.

14.

MONITORING, ASSESSING AND ACCOUNTING

Figure 3: ISAGS Agencies

Monitoring In accordance with the dispositions of the statute of ISAGS, the Executive Director will present to the Directive Council annual advance reports of the Three-Year Working Plan. The Director may also render additional reports whenever one of the members of the Directive Council requests it or when it is considered necessary. The ISAGS website will be a space to socialize activities carried out by the institute and will serve to check the transparency and publicity of its actions.

Assessing Fulfilling the results of the Three-Year Working Plan of ISAGS will be annually assessed by the General Directorate. The results of the annual assessment will be shared with the Advisory Board, which must make recommendations on reformulations to the General Directorate. At the end of the Three-Year Working Plan period, as assessment will be done on the achievements of the results and a new Plan will be prepared.

Accounting The Executive Director will present, at an ordinary meeting of the Directive Council, the financial state of the previous year and the short, mid and long term budget. The Director will render additional reports whenever one of the members requests it or when it is considered necessary.

15. ADMINISTRATING AND LEADING ISAGS 15.1. Institutionalization of ISAGS

Objective Consolidating ISAGS as an intergovernmental entity of a South American character.

Expected Result: Legally, administrative and financially institutionalized ISAGS. End of PRO ISAGS project of Brazil

Outline of steps 

Statute Approval (in progress)



Signing of Agreement for headquarters (in progress)



Approval of financial sources and quotas (in progress)



Approval of budget (in progress)

15.2. ISAGS Functioning

Objective Structuring the institutional response capacity of ISAGS to meet its objectives and functions.

Expected Result

ISAGS installed and functioning as an intergovernmental Institute supporting the development of thought and strategic training of the South American Health Council.

Outline of steps  Strengthening of the capacity for insertion, integration and regional coordination of ISAGS.  Support for political coordination meetings with the Secretary General of UNASUR, South American Health Council, Pro Tempore Presidency.  Support for political coordination meetings with the Secretary General of UNASUR and its other Councils, South American Health Council, Pro Tempore Presidency, Directive Council and Advisory Board of ISAGS. Intersectoral articulation.  Mobilizing intersectoral articulation of the Health Council, extending the relationship with other sectoral councils of UNASUR.  Management of insertion and participation of ISAGS Directive Structure in issues related to political and technical representation in its areas of competence, within the scope of UNASUR.  Organizing Regulatory Meetings of the Directive Council and Advisory Boards of ISAGS.  Strengthening relations and alliances with intelligence counterparts in the Region.  Articulation with strategic actors that have sectoral incidence within a regional scope.  Administration and operation of ISAGS: o Maintaining the physical infrastructure, o Personnel Administration, o General operational expenditures of ISAGS: operational services, third party contracts, consumption material, permanent material, and others, o Maintaining the ISAGS website.

15.3. Information and Knowledge Management

Objective  Promote knowledge management within the scope of UNASUR Health.

Expected Results  Platforms for information technology management, information flow management

and

knowledge

management

make

decisions

implemented to the headquarters of ISAGS and the countries.

Outline of steps  Compilation, systemization and organization of health information.  Analysis and selective dissemination of sources on health information.  Organization and management of long distance training.  Developing the installed hardware and software capacity at the headquarters and within the countries.  Commitment to multilingual inclusion, maintaining access to the website, in person and virtual meetings and all documents in Spanish, English and Portuguese and mid-term in Dutch.

16. THREE-YEAR WORKING PLAN (2012 – 2015) BUDGET In compliance with the Programmatic Budget of the South American Institute of Government in Health – ISAGS (ANNEX II) presented to the instances of the Union of South American Nations – UNASUR for analysis and approval in December of 2011, presenting below an estimated chart of the budget for the Three-Year Working Plan of ISAGS.

Annual Amount (in US$) Nature 2013 Projects Operational Staff TOTAL

2014

2015

Total Amount (in US$)

1,477,997.00

4,433,991.00

874,650.00

2,623,950.00

1,549,060.00

4,647,180.00

3,901,707.00

3,901,707.00 11,705,121.00

ANNEX I â&#x20AC;&#x201C; Statute of the South American Institute of Government in Health Statute of the South American Institute of Government in Health (ISAGS) Final draft approved by Resolution Article I Legal Entity The South American Institute of Government in Health (ISAGS) is an agency of an intergovernmental, public, integrating and member character to the South American Health Council, established in compliance with the terms of Articles 5, 12 and 13 of the Constitutive Treaty of UNASUR and with headquarters in the city of Rio de Janeiro where it operates based on a Headquarters Agreement signed between UNASUR and the Government of the Federative Republic of Brazil. ISAGS is programmatically linked to the South American Council of Health Ministers for the Union of South American Nations, through which their activities must form part of the Working Plan for the Council of Health Ministers and will render accounts to it during ordinary meetings in the fields of human resource development, technical assistance, investigation, information and communication and resource mobilization. Its activities in relation to national programs and institutions will be carried out in coordination with the Ministries of Health of the countries. ISAGS will enjoy legal capacity to execute and enter into every class of act and contract; acquire, posses, administer or provide any class of rights or assets in accordance with the UNASUR normative and respective regulations. As such, it will be able to appear before legal, administrative or any other order and general authorities, carry out actions and management that are conductive to compliance with its purposes or necessary to execute its activities. Legal representation of ISAGS will correspond to the Instituteâ&#x20AC;&#x2122;s Executive Directorate or whoever exercises its functions, able to delegate this authority exclusively to the effects of legal representations. Article II Objective ISAGS aims at becoming a center of higher studies and discussion on policies to develop leaders and strategic human resources in health, pointing to promote governance and leadership in the health of South American countries and giving inputs to articulate regional performance in global health. ISAGS will guide their institutional actions according to the principles, values and strategic plotters of the South American Health Council and promote the concept of working network, involving the associated institutions and/or of the same type. Article III Positions To achieve its objective, ISAGS will fulfill the following positions: 1. Identify needs, develop programs and support strategic human resource and leadership training and qualification processes in health for the Member

States in articulation with national and international institutions of the same type. 2. Organize existing knowledge and carry out investigations on health policies and health governance, human resources and other relevant topics, which can be instructed by the South American Health Council, in articulation with the national and international institutions of the same type. 3. Systemize, organize, diffuse and transmit scientific and technical information on global and regional health with the purpose of supporting decision making of conduction centers, strengthen health leadership development processes, promoting the participation of society and reporting on the governmental and governance processes in health. 4. Advise on forming common external policies for UNASUR to back up negotiations on topics linked to health in international global and regional agendas. 5. Technical Consultation for national health institutions through new methodological and assessment focuses in order to promote the application and transfer of knowledge, long distance education and in turn develop models to assess products, causes and effects of such cooperation. Article IV Membership Members of ISAGS are those entities defined as the continuation of the agreement with the following categories: Member States and Associated Organizations 1.

Member States of ISAGS: All Member States of UNASUR. Other States may acquire the status of Member provided that they have adhered to UNASUR in terms of Article 20 of the Constitutive Treaty. The Members have the right to voice and vote during deliberations at meetings of the Advisory Board and Directive Council.

Associated Organizations: Associated Institutions may be organizations whose mission is convergent with the vision and mission of ISAGS and whose request and membership have been approved by the South American Health Council but without the right to vote. Associated Institutions may be able to request to participate in meetings of ISAGS agencies with prior approval from these agencies.

Every Member of ISAGS, in order to assure the rights and benefits inherent to its conditions of such, will fulfill in good faith the obligations undertaken in compliance with this. As such, it will provide every class of aid in any action that ISAGS exercises in accordance with this. Any Organization Associated to ISAGS may be able to withdraw, giving notice in writing to the Directorate, which will report to the Directive Council on the notices of withdrawal that it receives. Having passed six months as of the date in which it receives the notice for withdrawal, its effect will end with respect to the Associated Organization and it will remain cut off from ISAGS, having to comply with the financial commitments and other obligations emanated from this document until the date of withdrawal.

Article V Structure ISAGS will be composed of the following agencies: (1) Directive Council (2) Advisory Board (3) Executive Directorate Article VI The Directive Council The Directive Council is a permanent agency of ISAGS and fulfill directive positions before the South American Health Council. The Directive Council of ISAGS will be comprised of Delegates designated by the Ministers of Health of the Member States. The Directive Council will watch over the operation of ISAGS within the framework of its objective and institutional policies and follow the dispositions of this Statute. The following will correspond to the Directive Council of ISAGS: 1. Defining and guiding actions and general policies of ISAGS. 2. Holding an annual ordinary meeting and have special meetings when necessary. 3. Adopting an Internal Regulation on operation that will be approved by all its Members at an ordinary meeting. 4. Approving plans, programs and projects of ISAGS. 5. Approving the financial policy, budget of ISAGS and propose the financial contributions of the Member States. 6. Approving the reports on institutional work. 7. Approving the statutes, norms and regulations of ISAGS. 8. Defending, before national and regional authorities, for the fulfillment of the work of ISAGS in support of solving the problems identified by the Member States. 9. Establishing bonds of technical cooperation with the South American institutionality and international agencies of cooperation. 10. Annually presenting to the South American Health Council (UNASURHealth) for approval a planning and proposal report, as well as a management report. 11. Proposing for approval by the South American Health Council the designation of the Executive Director of ISAGS in compliance with regulations and statutes. The seat of the annual ordinary meeting of the Directive Council of ISAGS will be rotating, coinciding with the location established for the ordinary meetings of the South American Health Council, unless the Council agrees to hold it in another location. The annual ordinary meeting, as well as special meetings of the Directive Council of ISAGS will be presided by the country that exercises the Pro Tempore Presidency of UNASUR-Health.

Each Member of the Directive Council of ISAGS will have the right to one vote. The decisions will be made by consensus. The program for each meeting will be proposed by the Executive Director and must be sent to the Pro Tempore Presidency and the Members of the Directive Council in advance by at least thirty days before the meeting along with the convocation. In the case of special meetings, they must be called with sufficient advance to ensure participation of Member States. The final report of the meetings will be prepared by the Executive Directorate and sent to each one of the Members within the month following the holding of the meeting. Article VII The Advisory Board The Advisory Board is a permanent agency of ISAGS and fulfills consultative functions before the Executive Directorate of ISAGS. The Advisory Board will be comprised of Titular Coordinators from the Technical Groups of UNASUR Health, in addition to specialists indicated by the Executive Director and approved by the Directive Council of ISAGS. In case it is decided as such, the Advisory Board may be able to incorporate into its meetings the representatives from the different networks that form the body of the South American Health Council. The Advisory Council will operate according to internal regulation, approved by the Directive Council. The following will correspond to the Advisory Board of ISAGS: 1. Holding at least one annual ordinary meeting and have special meetings when necessary. 2. Proposing lines of strategic action for the working plan of ISAGS. 3. Forming recommendations relative to planning, administration, execution and assessment of the programs developed by the Institute. 4. Suggesting carrying out new programs and projects according to the context of this. 5. Supporting ISAGS in identifying opportunities and in mobilization resources. 6. Declaring itself on any other subject that it submits its consideration. Article VIII Executive Directorate Subject to the general authority and decisions of the South American Health Council, the Executive Directorate is a permanent agency of ISAGS and the entity responsible for technical management and execution and administration of the Working Program and Budget of ISAGS in accordance with the norms and procedures of UNASUR and the Hosting nation. The Executive Directorate will be comprised of the Executive Director of ISAGS and the necessary technical and administrative staff as determined by the Directive Council and subject to the availability of economic resources.

The Executive Director of ISAGS will be nominated by the South American Health Council in accordance with the norms and procedures of UNASUR. The selection of personnel from ISAGS will take place according to a regulation for such purpose, which must be approved by the Directive Council of ISAGS. Employees that occupy the positions in ISAGS will be nominated in accordance with norms and procedures of UNASUR. The Executive Director of ISAGS will be responsible before the South American Health Council for executive management of ISAGS in accordance with the norms and procedures of UNASUR and corresponding to it as such: 1. To administer the Institute according to its objective, functions, policies, plans, programs and projects determined and approved by the Directive Council of ISAGS. 2. To nominate technical, scientific and administrative staff in compliance with the dispositions and norms in force and supervise it optimal operation and development to comply with the working plan of ISAGS. 3. To call meetings for the Directive Council and Advisory Board and act as Former Office Secretary in them. 4. To prepare the program proposal and budget for ISAGS to consider and review the Members of the Directive Council by at least one month in advance of its ordinary meeting. 5. To present at the ordinary meeting of the Directive Council, the annual report on activities and the financial state of the previous year and the short, mid and long term plans, programs, projects and budget. The Director will render additional reports whenever one of the members requests it or when it is considered necessary. 6. To submit for consideration by the Directive Council the statutes, norms and regulations that are necessary to organize and administer the Institute. 7. To fulfill and enforce, within the scope of its competence, statutes, norms and regulations. 8. To fulfill the functions that are delegated to it by the Directive Council and, in general, undertake and perform as many actions that it considers necessary, in compliance with this. 9. To defend, before national, regional and international authorities in the search for solution in support of improving the commitments of ISAGS. 10. To maintain and strengthen bonds of technical cooperation with the South American institutionality and international agencies of cooperation. 11. To raise to the Directive Council the proposal for setting an internal organization in order to concentrate management and operation of ISAGS. Article IX Finances The resources for regular financing of ISAGS will come from the regular contributions of the Member States for the annual operating budget of UNASUR. The ISAGS budget shall be defined by the South American Health Council and will be

subject to the approval of the Council of Foreign Affairs Ministers of UNASUR, in accordance with Article 8, Paragraph F, of the Constitutive Treaty. The Directive Council will define the procedure applicable to the States that owe more than two years of contributions, as well as possible exceptions to it. The Institute may receive special contributions from the countries, as well as financial resources coming from donors, international agencies in agreement with the lineaments defined by the South American Health Council. All annual contributions will be payable as of January 1 of each year and must be effective no later than June 30 of the same year. The funds and assets of ISAGS will be treated as legal funds of UNASUR and will be administered in accordance with its financial norms. A Working Fund will be created in the name of ISAGS in compliance with the norms and procedures of UNASUR. Article X Privileges and Immunities The privileges and immunities of ISAGS in Brazil as a specialized institute of UNASUR, as well as the financial responsibilities of the Government of Brazil in relation to maintaining ISAGS in compliance with Article IX of this Statute, must be stipulated within a specific agreement between UNASUR and the Brazilian government. Article XI Facilities The repairs related to physical facilities and other services provided to ISAGS, whose headquarters is found in the city of Rio de Janeiro, must be stipulated in an agreement between UNASUR and the Brazilian Government. Article XII Modifications Modifications to this Statute that recommends the Directive Council of ISAGS to enter into force through its approval on behalf of the South American Health Council. Article XIII Entry into Force The dispositions of this Statute will enter into force as of the date of approval on behalf of the South American Health Council. Article XIV General Dispositions Fulfillment of this will be assessed at least every five years as a base to propose modifications that adapt to the reality of the development of the Member States. In case the number of Member States remains reduced to one as a result of separations, ISAGS will be sold off and the product of the assets that belong to it will be divided in common agreement among the States that have been Members.

Article XV Transitional To consolidate the implementation of the Institute, the Federative Republic of Brazil will have the prerogative of submitting to the South American Health Council the indication of the first Executive Director of ISAGS. It remains established a mandate of three (3) year for this first period as Executive Director. The Council of Health Ministers of UNASUR will propose the mandate time for future Directors.

ANNEX II – Budget Program of the South American Institute of Government in Health (ISAGS) – Base Year 2013 1- BACKGROUND ON THE FINANCING AND BUDGET OF UNASUR AND ISAGS 1.1 The UNASUR Constitutive Treaty, in Article 16, deals with the financing of UNASUR and establishes that financing from the regular budget of the functioning of the General Secretariat will be made based on differentiated quotas from Member States, which shall be determined by resolution of the Council of Ministers of Foreign Affairs, to the Council of delegates proposal taking into consideration the economic capacity of Member States, the common responsibility and the principle of equity. 1.2 Resolution 05/2009 of the South American Health Council of UNASUR, in item 4, affirms that the ISAGS Project must define the financing of the Institute. 1.3 Resolution 03/2010 of the South American Health Council of UNASUR, in item 5, requests the Member States to identify resources and national institutions that serve as counterparts and/or partners of ISAGS. 1.4 Provision 01/2011 of the Council of UNSASUR delegates requests, in article 1, that the Ministerial Councils and other bodies of UNASUR inform the Council of Delegates about the description of its annual forecasts in terms of technical and administrative support of the General Secretariat and define potential sources of budget for the implementation of its projects and activities. 1.5 The Statute of the South American Institute of Government in Health (ISAGS), in Article 9, sets out that the resources for regular financing of the Institute will come from the regular contributions of Member States to the annual operating budget of UNASUR. The ISAGS budget shall be defined by the South American Health Council and will be subject to the approval of the Council of Foreign Affairs Ministers of UNASUR, according to Article 8, paragraph f, of the Constitutive Treaty. 1.6 Resolution No. 02/2012 of the Council of Foreign Affairs Ministers has decided on financing ISAGS through the UNASUR budget for the year of 2013. 1.7 Resolution No. 02/2012 of the Council of Foreign Affairs Ministers has adopted, according to the Constitutive Treaty, the mechanism of distribution of quotas to Member States for financing the various components of the UNASUR budget for the year 2013, including ISAGS. 1.8 The statement by the Council of Foreign Affairs Ministers from UNASUR, at its meeting on March 17, 2012, held in Asunción, Republic of Paraguay, petitioned the South American Health Council early adoption of the budget for the South American Institute of Government in Health (ISAGS) for the year 2013. 2- PROPOSED ISAGS ANNUAL BUDGET AND QUOTAS PER MEMBER STATE 2.1 In accordance with the policy-making background presented above, as well as with the purpose of meeting the objectives of ISAGS, the Institute's Directorate directs ISAGS (Base year 2013) annual budget proposal, for analysis and approval by the South American Health Council of UNASUR and subsequent approval by the Council of Foreign Affairs Ministers of UNASUR in accordance with Article 8, paragraph f of the Constitutive Treaty of UNASUR and Article 9 of ISAGS Statute.

Table 1 ISAGS BUDGET – BASE YEAR 2013 (US$)

Nature

Annual Amount

Percentage

Projects Operational Staff

TOTAL

37.90%

1,477,997.00

874,650.00

22.40%

1,549,060.00

39.70%

3,901,707.00

100%

Table 2 BUDGET BASE YEAR 2013 – DESCRIPTIVE - ISAGS

Description Lease of the property for the Headquarters Material Consumption Telephone Internet with link for live broadcasts Seminars, Workshops and Courses – Exchange and Training Personnel Annual meetings of the Advisory Boards and Directors Tickets and Traveling allowance – participation in meetings and for research projects Consulting/Scholarships – research lines and thematic technical coordination Legal Entity Staff (security, cleaning, reception, telephony) Individual Entity Staff (Core Staff) Permanent Material (acquisition and maintenance) Legal Entity (suppliers) Taxes TOTAL

Total Annual Amount $ 157,407.00 $ 41,670.00 $ 23,300.00 $ 81,480.00 $ 820,600.00 $ 78,000.00 $ $ $ $ $ $ $ $

132,254.00 429,600.00 179,015.00 1,549,060.00 70,000.00 300,000.00 39,321.00 3,901,707.00

Table 3

QUOTA DISTRIBUTION - ISAGS 2013 MEMBER COUNTRY ARGENTINA BOLIVIA BRAZIL CHILE COLOMBIA ECUADOR GUYANA PARAGUAY PERU SURINAME URUGUAY VENEZUELA TOTAL

QUOTA (%)

AMOUNT IN US$ 16 0.8 39 7 8 4 0.1 1.6 10 0.1 1 12.4 100

$ $ $ $ $ $ $ $ $ $ $ $ $

624,273.12 31,213.66 1,521,665.73 273,119.49 312,136.56 156,068.28 3,901.71 62,427.31 390,170.70 3,901.71 39,017.07 483,811.67 3,901,707.00

The table was calculated based on the quotas defined by the "Reference Document - table of allocation for quotas (amounts)" of Resolution No. 01/2012 of the Foreign Ministers Council.

2.2 Justification of the Core Staff of the South American Institute of Government in Health (ISAGS) The Core Staff is justified based on the objectives of the South American Institute of Government in Health (ISAGS), especially set out in Article II of its Statute, as well as the lines of action described in Article I, namely, human resources development, technical assistance, research, information and communication and resource mobilization. Below is the Core Staff of ISAGS, necessary to ensure the technical, administrative-financial and operational viability for the purpose of fulfilling the commitments assumed by the Institute. Table 4 ANNUAL BUDGET - PERSONAL - ISAGS Position Gross Deductions Net Salary Benefits Quantity Gross Total Executive Director $ 139,074.00 19% $ 112,649.94 $ 7,304.00 1 $ 146,378.00 Technical Coordinator $ 115,134.00 19% $ 93,258.54 $ 7,304.00 1 $ 122,438.00 Administrative $ 94,268.00 19% $ 76,357.08 $ 7,304.00 1 $ 101,572.00 Manager Managers of Technical $ 94,268.00 19% $ 76,357.08 $ 7,304.00 $ 406,288.00 Areas Information Manager $ 94,268.00 19% $ 76,357.08 $ 7,304.00 1 $ 101,572.00 Chief of Staff $ 62,335.00 19% $ 50,491.35 $ 7,304.00 1$ 69,639.00 Executive Secretary $ 52,801.00 19% $ 42,768.81 $ 7,304.00 $ 180,315.00 Editor Journalist $ 52,801.00 19% $ 42,768.81 $ 7,304.00 1$ 60,105.00 Budget and Finance $ 52,801.00 19% $ 42,768.81 $ 7,304.00 1$ 60,105.00 Documentation $ 41,806.00 19% $ 33,862.86 $ 7,304.00 $ 98,220.00 Events and Travel $ 41,806.00 19% $ 33,862.86 $ 7,304.00 1$ 49,110.00 HR and Scholarships $ 41,806.00 19% $ 33,862.86 $ 7,304.00 1$ 49,110.00 IT Technician $ 27,432.00 19% $ 22,219.92 $ 7,304.00 1$ 34,736.00 General Advisors $ 27,432.00 19% $ 22,219.92 $ 7,304.00 2$ 69,472.00 TOTAL $ 1,395,676.00 $ 737,586.00 $ 153,384.00 21 $ 1,549,060.00 The basis of alignment used to determine the plan charges, salaries and benefits were practiced by the General Secretariat of UNASUR, available amounts in "Annex I - Ordinary Expenditure Budget of the Secretary-General of UNASUR - Year 2011-2012" Resolution No. 01/2012 of the Council of Foreign Affairs Ministers.

Table 5 ISAGS SCHEDULE – BASE YEAR 2013