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Indoors, but active and open more than ever to collaboration. From Italy, a story of ordinary civic commitment to protect health as a common good (Guest blog)

Like every week, on Monday at 12:00 we meet for the weekly coordination meeting, no longer in the meeting room, but guests of StarLeaf, and it will be like this for who knows how long. However, already at 11:45 - in the office it never happened... - we are all already connected greeting and observing each other, as well as giving each other the first smiles that pierce the cold monitor in front of us.

Staying indoors at home to work remotely is not easy, but it didn't take us long to reorganize ourselves, to reshape priorities and modus operandi, a little bit similarly to what had happened years ago after the earthquake in Central Italy. 
Evidently, it is in the DNA of this citizens' organization - which for over 40 years has been working to protect health as a common good - the ability to quickly read the needs of people in situations of fragility and to reinterpret their needs in concrete requests and initiatives of civic activism.

Since the beginning we have worked on the protection of citizens: our website hosts a guide with specific insights on health, transport, tax and taxes, school; links to official websites; short videos from experts; the contact details of our protection centres to avoid scams, fake news and speculation; even a chatbot.

Moreover, for the information and empowerment of people, especially those at greatest risk of exclusion, together with Assogenerici and the Equivalente.it portal, we launched the social campaign "Why no one remains excluded", with the aim of providing all foreign communities present in Italy mother tongue information on how to avoid dangerous behavior and therefore contribute to stop the spreading of the infection. The campaign unfolds thanks to a video in 11 languages: English, French, Spanish, Portuguese (Brazilian), Romanian, Arabic, Russian, Filipino, Punjabi (India and Pakistan), Hindi (India), Bengali.

In parallel with the protection activities, the campaign "#KeepCalm, Together, without fear" has started and it sees Cittadinanzattiva alongside the Italian Federation of General Practitioners (Fimmg): it is just started from Northern Italy the distribution of disinfectant gel, information material and the first PPE-personal protective equipment, found with many difficulties thanks to the support of Roche who, in such a difficult and ever-changing situation, was the first company to comply with our request for support to family doctors. We think it is an important sign of corporate social responsibility, and a qualifying result for our action which, at this moment, is aimed above all at strengthening the local dimension of continuity healthcare.

Another initiative that goes in this direction is the availability that Cittadinanzattiva has received from Federfarma (the national federation representing over 16,000 private pharmacies in Italy) to deliver home medical devices, in addition to medicines. Federfarma and Cittadinanzattiva together asked the Regions to simplify as much as possible the procedures with which the chronically and rare patients can obtain directly in the pharmacy the drugs and the medical devices usually distributed in public structures. This measure is in line with the indication to limit the displacements and necessary to avoid exposing many patients to infection.

With the same aim, in a letter addressed to the presidents and health councilors of the Regions, together with Periplo - which represents the Italian cancer networks - and the Foundation for personalized medicine, we asked to take the necessary measures to guarantee therapeutic continuity to cancer patients. Therapies in a more secure regime and to relieve congestion of outpatient clinics and Day Hospitals.

Furthermore, through the National Coalition of Associations for Patients suffering Chronic Diseases (CnAMC), with a letter sent to the Presidents of the Regions, to the Regional Councilors for Health and to the Ministry of Health, we asked for an extension for at least 90 days of the supply of medical goods throughout the national territory indispensable for chronic patients, whose demand expires in the months of March and April. We are talking about people who use medical goods such as bags, plates, diapers, catheters, strips for measuring blood glucose, bags for special nutrition, protein-free foods, the periodic and extraordinary control of devices implanted for patients with heart failure, the devices for outpatient hemodialysis, for peritoneal dialysis and home hemodialysis and immunosuppressive drugs with direct and on-account distribution for organ transplant recipients, trachea-aspiration tubes, matte as well as all devices for mechanical ventilation and enteral nutrition.

In recent days, together with the Italian Scientific Society of Internal Medicine (FADOI), we turned to the Italian Medicines Agency (AIFA) to extend the therapeutic plans, a request that the Agency accepted after a few hours. A similar request has been sent to the Regions and to the Ministry of Health to ensure continuity in the use of the indispensable devices throughout the national territory, including through remote monitoring of clinical data, limiting the exposure of patients and healthcare professionals to the risk of infection and without distracting health workers from their emergency activities. The Sardinia Region has already responded to our request for information.

A warning sign has come to us in the last few days, when 13 other pharmaceutical companies, those with Italian capital associated with Farmindustria (the so-called "Fab13": Abiogen Pharma, Alfasigma, Angelini, Chiesi, Dompè, IBN Savio, Italfarmaco, Kedrion, Neopharmed Gentili, Menarini, Molteni, Recordati SpA, Zambon) have joined the fundraising of Fimmg and Cittadinanzattiva by donating instrumental resources for an economic value of three million euro to the use of the entire National Health System.

The pharma companies are important actors and they demonstrate it also on this occasion. This signal is fundamental and very comforting, and fortunately it is not isolated, on the contrary. At March 28, Farmindustria (the national association representing pharmaceutical companies, member of EFPIA) quantified the contribution recorded in Italy for the emergency that comes from pharmaceutical, multinational and Italian companies into 49 companies and a total of 21.8 million euros. In addition to research projects, companies have put in place many initiatives to support patients, doctors and all staff in the health supply chain and healthcare facilities. Our thanks go to each of them and especially to those who fight every day against that invisible enemy that I do not even name. In fact, we have fixed it in our mind for days that it does not deserve to be remembered further.

Mariano Votta

Mariano Votta is Responsible EU Affairs at Cittadinanzattiva and Director Active Citizenship Network, EU branch...
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