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GESUNDHEITSPROJEKTE IN ENTWICKLUNGS- UND TRANSFORMATIONSLÄNDERN WELTBANK GRUPPE 6.5.2021 AUSSENWIRTSCHAFTSCENTER WASHINGTON
GESUNDHEITSPROJEKTE IN ENTWICKLUNGS- UND TRANSFORMATIONSLÄNDERN
WELTBANK GRUPPE
6.5.2021
AUSSENWIRTSCHAFTSCENTER
WASHINGTON
VERANSTALTUNGSVORSCHAU AC WASHINGTON
AUSSENWIRTSCHAFTSCENTER WASHINGTON
IFI Kalendar
• 27.5.2021: Integrity & Compliance in IFI funded projects (Webinar)
• 17.6.2021: How to work with USAID (Webinar)
• In Planung:
• Digital Health (16.6.2021 Webinar Netzwerk Projekte International)
• IFI Masterclass (mehrere Termine 2021, online)
• World Bank Health Forum (Dezember 2021, Wien)
Veranstaltungen zu anderen Themen
• 1.6.2021: US-Präsident Bidens Billionen Plan für die USA (Webinar)
• 1.7.2021: US-Sanktionen (in Planung, Wien)
AUSSENWIRTSCHAFTSCENTER WASHINGTON
• Projektdatenbankhttps://projects.worldbank.org
• WBG e-consult 2 https://wbgeconsult2.worldbank.org
• Financing & Procurement App
WELTBANK
• UN Development• Business
Development Aid• DGMarket• Devex
Ausschreibungs- plattformen
• Country Partnership Framework (CPF)
• Monthly Operational Summary
• Project Document (PID + PAD)
Projekt-
informationen
WO FINDE ICH PROJEKTE UND GESCHÄFTSCHANCEN?
2
PROJEKTDATENBANK - WELTBANK
AUSSENWIRTSCHAFTSCENTER WASHINGTON
3
AUSSENWIRTSCHAFTSCENTER WASHINGTON
Source: worldbank.org
383 Projekte263 Projekte243 Projekte143 Projekte125 Projekte121 Projekte118 Projekte101 Projekte101 Projekte95 Projekte
WELTBANK UND GESUNDHEIT – ANZAHL PROJEKTE NACH SEKTOREN (MOMENTAUFNAHME)
AUSSENWIRTSCHAFTSCENTER WASHINGTON
Source: worldbank.org
806 Projekte354 Projekte351 Projekte312 Projekte299 Projekte266 Projekte236 Projekte208 Projekte195 Projekte167 Projekte
WELTBANK UND GESUNDHEIT – ANZAHL PROJEKTE PER KATEGORIE (MOMENTAUFNAHME)
GESUNDHEITSPROJEKTE IN ENTWICKLUNGS- UND TRANSFORMATIONSLÄNDERN
Dr. Andreas Seiter
6. Mai 2021
Outline
• Introduction to the World Bank Group
• Overview of the World Bank’s COVID-19 Response
• The Path Forward: Reimaging Primary Health Care & Creating Effective Delivery Systems
Introduction to the World Bank GroupOur twin goals set a roadmap for sustainable growth and development
End extreme povertyby reducing the share of the global population that lives in extreme poverty (<$1.90 per day)
to 3 percent
Promote shared prosperityby increasing the incomes of the poorest 40
percent of people in every country
Introduction to the World Bank GroupFive institutions, one Group
Knowledge Sharing
Advisory Services
Financial Products &
Services
Introduction to the World BankOur country-led model supports long-term engagement
Systematic Country Diagnostic
(SCD)
Country Partnership
Framework (CPF)*
Individual Projects & Programs
Performance and Learning Reviews
(PLRs)
Completion and Learning Reviews
(CLRs)
* CPF cycle typically runs over 4-5 years
Introduction to the World BankHealth sector commitments ($m) and share (%) of total World Bank commitments, FY16-20
1,191 1,2462,062 1,736
4,2951,181 1,189
2,204
1,674
3,980
0
2
4
6
8
10
12
14
16
0
1,000
2,000
3,000
4,000
5,000
6,000
7,000
8,000
9,000
FY16 FY17 FY18 FY19 FY20
IDA IBRD Health as % of Total
Investment Project Financing (IPF)
• Investment loans, credits and grants provide financing for a wide range of activities, aimed at creating the physical and social infrastructure necessary to reduce poverty and create sustainable development.
• In health, this would typically be investment into infrastructure, training and capacity building, equipment and supplies.
PforR (Program for Results)
1. Finances and supports borrowers’ programs. PforR can support entire programs or subprograms; new
or existing ones; as well as programs that are national or subnational, sectoral or multi-sectoral in nature.
2. Disburses upon achievement of program results.
3. Focuses on strengthening the institutional capacity and the processes and procedures needed for
programs to achieve their desired results
4. Provides assurance that Bank financing is used appropriately, and that the program’s environmental
and social aspects are addressed.
PforR has four main features:
Development Policy Financing (DPF)
• Supports a Member Country's program of policy and institutional actions that promote UHC, for example,
strengthening health financing, improving the quality of care, addressing bottlenecks to improve service
delivery.
• DPF financing helps a borrower address financing requirements through general budget financing that is
subject to the borrower's own implementation processes and systems.
• The Bank makes the funds available to the client upon satisfactory implementation of the overall reform
program; and completion of a set of critical policy and institutional actions agreed between the Bank and the
client.
Strategic priorities for Health, Nutrition and Population (HNP)
1. High Quality Healthcare for All
• Ensure universal and equitable access to affordable, people-centered and integrated quality care with reimagined Primary Healthcare as the foundation of health systems
• Safeguard good governance of health systems for sustainable financing and accountability for health outcomes
• Augment service delivery value chain with innovation, data-driven precision public health and medical care, digital technologies, and private sector accelerators of service delivery
2. Strengthen Public Health
• Reinvigorate essential public health functions for preventive and promotive health, and timely, effective and resilient pandemic preparedness and response
3. Invest in Health beyond Healthcare
• Harness whole-of-Government and multisectoral and institutional response to strengthen Health, Nutrition and Population outcomes
About IFC
16
IFC is the largest global development institution focused exclusively on the private sector in emerging markets
• A member of the World Bank Group
• AAA Credit Rating
• Over 60-year history in Emerging Markets (EM)
• A Global Institution, now owned by 185 member countries
• 100+ offices in ~100 countries worldwide
• 3,940 staff (55% are based outside Washington DC)
• US$6.5B Total Healthcare Sector Investments by the IFC
300+Billion Invested
in EM since 1956
~2,000Private Sector
Clients
~100Countries with
Global Presence
900+Network of
Financial Institutions
Common Trends
D
em
an
d f
or
Healt
hc
are
Changing Population Profile
Increasing Ability to Access Healthcare Services
COVID-19 Impact
Changing Disease Profile
S
up
ply
of
Healt
hc
are
Growing Role for the Private Sector
Evolving Business Models
Digital Health and MedTech Innovations
Health Worker Shortage
Reg
ula
tio
ns
New Regulatory Developments
Global Health Trends
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Demographics, changes in disease profiles and technology are shifting the healthcare landscape
Global Health Platform (GHP): A Snapshot
18
Global Healthcare Platform launched in 2020, is a critical pillar of the WBG response with IFC committing US$2billion and mobilizing private
investment to close the massive healthcare supply gaps faced by developing countries
Meet the urgent needs of developing countries access to critical Healthcare Products and Services
1
Create manufacturing and delivery capacities for Healthcare Products and Services currently under development
2
Strengthen the regional and local manufacturing and service capacities of developing countries health systems
3
Objectives Target Companies
Suppliers of Raw Materials
and Components
Manufacturers of HealthcareProducts and
Vaccines
Service Providers
Location & Availability
Developing Countries
Availability
3 years
Developed1
Countries
Availability
1.5 year
Platform Amount
US$4 BillionTotal Investment
US$2Billion
IFC’s Own Account
US$2Billion
Mobilization
US$60 billionUS$2billion US$2billion
=
Continued push for newer and
integrated models of care.
Expansion of secondary and some specialist care with
more effective referral processes.
Government fundingto improve public
sector service access in rural
areas.
Social insurance to better manage funds to continually review
benefit and tariff structures.
For example: Diagnostic PPPs
For example: Networks not silos
For example: Private sector model expansion for NCDs
For example: Private sector systems and processes
contract negotiation with providers will be more protracted
and a push for improved volume:
cost focus.
Opportunity forincreased use of
relevant and appropriately
supported medical technology.
Revised health professional
retention strategies to offset the
migration challenge posed by EU membership.
Increased focus by Government to
support better early detection and rolling care management.
For example: New contracting models (volume for price)
For example: Better access to finance
For example: Expanded private education
For example: DigtialHealth
Evolving Social Insurance
Continued growth and demand for NCD services
Improving Access, Equity, & Quality
Push for value and need to manage financial burden (co-payment)
Greater integration of care & use of digitization
Increasing role for the private sector across health service sub-sectors
Slow move to consolidation models and increased focus on integrated health systems.
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Health Services Looking to the Future
Key Drivers of Change in the Health Services Sector
Anticipated implications (and a role for the private sector)
Ethical Principles in Health Care (EPiHC)
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Ten fundamental principles, adding clarity to decisions, transactions, practices, and encounters that affect every
aspect of operations
Find more information on the EPiHC initiative and how to become an
EPiHC signatory here: https://www.epihc.org/
Founding Signatories
Respecting Laws and Regulations
Making a Positive Contribution to
Society
Promoting High Quality Standards
Conducting Business Matters Responsibly
Respecting the Environment
Upholding Patients’ Rights
Safeguarding Information & Using
Data Responsibly
Preventing Discrimination,
Harassment, Bullying
Protecting and Empowering Staff
Supporting Ethical Practices and
Preventing Harm
IFC Health and Life Sciences Strategy – Focus Areas of Investment
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Objective: Expand access to affordable, quality health products and services
Health Service Providers
• Scalable Healthcare Providers
including integrated service
providers, hospital groups/clinic
chains, specialty care chains,
and diagnostics/lab groups
• “Centers of excellence”/ stand-
alone facilities in more
immature healthcare markets
(mainly IDA countries and on a
very selective basis)
• Scalable Elderly Care Models
• Investment in PPPs
• Regional generics manufacturers
to support the development of
pharmaceutical hubs in key
development markets
• Pharmaceutical Distribution and
Retail
• Biopharma
Pharmaceuticals Medical Technologies
• Medical devices and equipment
manufacturers of products
appropriate for developing
market conditions
• Distribution networks for high
quality medical equipment
• Digital Health (Services and
Technology Support)
New Growth Areas
Representative Transactions in Life Sciences & MedTech
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China
Jointown Pharma$198.5m Debt
2019, 2020
Mexico
Genomma Lab$50.0m Debt
2018
Turkey
Nobel Ilac$25.0m Debt
2017
Mexico
Siegfried$75.0m Debt
$85.0m Mobilization2019
Africa
Trivitron Africa$2.8m Debt
2018
Eastern Africa
Goodlife Pharma$3.0m Debt
2017
Brazil
Farmoquimica$31.0m Debt
$73.0m Mobilization2019
India
Biological E$60.0m Debt
2017
Tanzania
Pyramid Pacific$7.5m Quasi-Equity
2018
Colombia
Procaps$90.0m Equity
2017
China
Weigao$327.7m Debt
2007, 2015, 2020
MENA
Hikma$314.5m Debt and Equity 1987, 1989, 1993, 1994, 2003, 2011, 2012, 2017
India
Glenmark$75.0m Quasi-Equity
2016
China
Essex Bio-Technology$20.0m Quasi-Equity
2016
Africa
Adjuvant (GHIF)$20.0m Fund 1 Equity$25.0m Fund 2 Equity
2013, 20162020
Cumulative Investments in Health & Life Sciences by Sector & Region
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US$6.5 billion in cumulative investments by sub-sector and region over the last 20 years
Support private Healthcare and Life Sciences companies in 57 countries
23%Latin America and the Caribbean
1%Global
19%Europe and Central Asia
15%Middle East and North Africa
6%Sub-Saharan Africa
17% South Asia
20%East Asia and the Pacific
31%Life Sciences
62%Health Services
7%MedTech
•Make in EMs• Build local manufacturing capacity for essential medical products
•Design or Produce for EMs• Solutions appropriate for lower resource settings• Market creation, market expansion for value segment products• Leverage digital health and new service model
•Finance the access • Help hospitals, clinics, labs access capital equipment• Finance procurement and distribution
Build sustainability• Develop local talents• Develop better service and repair capacity• Facilitate the acquisition of technology and know-how
Goal: Access to medical technology for all
24
MedTech strategy for Emerging Markets (EMs)
25
Up to US$300 m to support healthcare SMEs in 9 African countries
Medical Equipment Financing Facility in Africa
Private healthcare facilities
Manufacturer
IFC
Partner banksAdvisory Services
Risk-Sharing
Loans&
Leases
Products&
Services
Risk-Sharing
Partner Banks50%
IFC40%
OEM10%
Risk Sharing Structurewww.ifc.org/amef
The World Bank’s COVID-19 ResponseInitial response to pandemic was rapid
March 3, 2020
$6 billion Fast-Track COVID-19 Facility established
April 2, 2020
Global Strategic Preparedness and Response Program and first 25 country operations approved
June 2020
COVID-19 Crisis Response Approach Paper
October 13, 2020
Additional $12 billion in financing for vaccines
World Bank Group Fast Track COVID-19 Facility
Up to $4 billion
Up to $2 billion
World Bank
Strategic Preparedness &
Response Program
IFC $8 billion
New IDA & IBRD financing
Existing IDA & IBRD portfolio
Up to $12 billionAdditional IDA & IBRD financing
The World Bank’s COVID-19 ResponseFinancing is aligned to service provision and population needs, with a focus on saving lives
Ghana: 4,410 health professionals; 1385 contact tracers, 318 laboratory technicians trained; 20,000 persons treated; ↑ from 2 to 10 active
laboratories; rented 29 treatment centers; ↑ ICU beds from 86 to 129; US$1.9 million worth of medicines purchased.
Papua New Guinea: 6,846 infection, prevention, control (IPC) supplies and 31,200 PPEs distributed
Ethiopia: Procured PPE for HCWs; ↑ national capacity for COVID-19 testing; ↑ screening points, temporary isolation units set up; ↑surveillance & contact tracing, e.g., toll-free 24/7 call centers
India: +5k physicians, 17k nurse deployed, established +15k treatment facilities; +1.3m isolation beds; +231k oxygen-supported beds; +62k ICU
beds; ↑ testing laboratories to 1,678 (1,040 gov/638 private)
17 countries: financing for a total of 1.4 billion vaccine doses approved. Another approximately 50 countries are in financing negotiations
• 14.2% of world’s adult have received one dose of a COVID-19 vaccine
• Vaccine roll-out has not yet started in 25 countries (many of them are LICs/LMICs)
• 1.3 percent of Africa’s adult population has received at least one vaccine (April 26, 2021) vs. 27% in the European Union and 44.9% in North America
• >1.02 B vaccines have been administered globally, of which 16.8% has been in LMICs and 0.2 % in LICs
• Major challenge especially in IDA-IBRD countries, where instances of ‘elite capture’ have been reported
Global inequities are evident, and distributing vaccines at scale will be challenging
Equity & fair access across countries
Fair access within countries
0% 10% 20% 30% 40%
Sub-Saharan AfricaCentral Asia
Central AmericaOceania
MENAEast Asia
South AsiaWorld
South AmericaRest of Europe
European UnionNorth America
COVID-19 vaccination,% of adults with first dose
April 26th 2021
Source: The Economist, Our World in Data
PURCHASE READINESS & DEPLOYMENT
HEALTH SYSTEM STRENGTHENING
WBG is working with global partners, private sector to ensure fast access to vaccines for countries
+ OTHER MDBs
PRIVATE SECTOR
VACCINE MANUFACTURERS
, SUPPLIERS, SERVICE
PROVIDERS
PRODUCTIONCOUNTRIES
* Mapping is indicative; organizations are oriented based on primary activities vis-à-vis WBG collaboration
COVAX + BILATERAL DEALS + REGIONAL
INITIATIVES
UN SYSTEM + GLOBAL HEALTH PARTNERS*
WB’s operational support to countries addresses gaps identified by readiness assessments
PROGRESS IN READINESS
ASSESSMENT ACROSS SELECT
INDICATORS133 countries
reporting
0% 10% 20% 30% 40% 50% 60% 70% 80% 90%100%
PUBLIC CONFIDENCE, TRUST & DEMAND…PROCESSES FOR VACCINE DEPLOYMENT…
COLD CHAIN CAPACITIES ASSESSED
VACCINE SAFETY SYSTEMS IN PLACE
EXPEDITED REGULATORY VACCINE…TARGET POPULATION IDENTIFIED
NATIONAL COORDINATION BODY IN PLACE
NATIONAL DEPLOYMENT VACCINATION…
Yes
In progress
No
Not reported
• 88% of countries have established a national coordinating body for COVID-19 vaccine introduction
• 79% have an expediated regulatory pathway for approval of COVID-19 vaccine in place
• Less than half of the countries have a plan in place to generate public confidence, trust, and demand for COVID-19 vaccines to address demand and hesitancy issues
• Only 52% have process for training vaccinators
STRENGTHS GAPS
• Stakeholder engagement plans are mandatory for all IPF operations and build confidence and trust (e.g., Ethiopia, The Gambia)
• Operations support training of staff involved in deployment and delivery of vaccines (e.g., El Salvador, Ethiopia)
• Most countries putting in place data innovations over the longer-term, to strengthen data and tracking systems and other aspects of health systems (e.g., Cabo Verde)
WB RESPONSE TARGETING GAPS*
*Other includes general COVID health response, systems strengthening, M&E, project
management, training, communication, vaccine storage, regulatory.
IBRD IDA Total
Purchase ($M) 686 734 1,420
Deployment ($M)
78 320 398
Other ($M) 76 163 239
# of doses (M) 50 107 157
• Bank financing for the 17 approved projects will support the purchase of an estimated 157 M doses
• WB is supporting training of community leaders, communication strategies to build public trust/confidence and pharmacovigilance capacity
• All the 17 approved Bank operations have indicated plans to acquire some vaccines through COVAX. 11 out of 17 operations are using Bank financing to purchase vaccines through COVAX.
• In addition, countries are sourcing vaccines through:
• Direct Purchase from manufacturers
• Pooled procurement: e.g., African Union’s African Vaccine Acquisition Task Team (AVATT) and the PAHO Revolving Fund
• WB financing is complemented by financing from MDBs and Trust Funds
• Several bilateral contracts have been signed, e.g., Lebanon (Pfizer) and Philippines (Moderna).
1420
398239
Purchase Deployment Other*
$ m
illio
n
Estimated Allocation of Bank
Financing for Approved Projects
($M)
WB financing is largely supporting vaccine purchase and deployment
The Path Forward: Reimagining Primary Health CareCountries around the world are reporting more deaths this year than in previous years due to COVID-19 and existing
systemic problems
• Excess death can account for mortality
directly or indirectly attributed to
COVID-19
• Mortality data in 32 countries reveal at
least 263,000 excess deaths during the
pandemic than reported COVID-19
deaths
• Contributing factors include reduced
access to health care; additional
economic burden because of the
pandemic; limited testing capacity; and
existing systemic bottlenecks
The Path Forward: Reimagining Primary Health Care
These excess deaths are compounding underlying system fragility due to inadequate public health measures, low utilization rates, and poor quality of care
• An estimated 60% of deaths across SSA pre-pandemic (status quo) were avoidable deaths
• Effectively and systemically strengthening systems to lower the burden of these diseases will
result in systems that are able to absorb exogenous shocks such as epidemics and
pandemics while removing the continuous pressure on health systems from avoidable deaths
0.0 0.5 1.0 1.5 2.0 2.5 3.0 3.5
Central SSA
Eastern SSA
Southern SSA
Western SSA
Millions
Total Deaths in Status Quo Avoidable deaths in the Statuo Quo COVID-19 Deaths, unmitigated scenario
The Path Forward: Reimagining Primary Health Care
An unfolding secondary crisis due to significant disruptions to essential health services
0
5
10
15
20
25
30
35
40
Liberia Nigeria Afghanistan
Pe
rcen
t D
rop
Disruption in Childhood Vaccination Services as of June 2020
The Path Forward: Reimagining Primary Health CareBottlenecks are symptoms of underlying, systemic issues
SUPPLY CHAIN MANAGEMENT
• Poor coordination and distribution of commodities
• Poor data visibility into consumption and trends
CASE DETECTION, CASE MANAGEMENT, SURVEILLANCE
• Weak infrastructure for remote consultations• Poor quality of disease surveillance systems
LABORATORY, DIAGNOSTICS
• Limited capacity to integrate COVID-19 testing with other services
• Insufficient quality control measures
FINANCING
• Fragmented payment systems
COMMUNITY ENGAGEMENT
• CHWs lack adequate information on public health measures
• Insufficient coverage of CHWs
OTHER ESSENTIAL HEALTH SERVICE DELIVERY
• Health workforce shortages for screening, contact tracing, case management, lab testing
• Poor communication between health workers and managers
HUMAN RESOURCES MANAGEMENT
• Health workforce shortages for screening, contact tracing, case management, lab testing
• Poor communication between health workers and managers
DATA COLLECTION, MANAGEMENT, USE
• Poor available data, poor quality data
• Limited capacity for data visualization and forecasting
The Path Forward: Reimagining Primary Health CareCOVID-19 becomes an entry point to assess where service delivery models and health
systems leadership can be strengthened or redesigned through 4 key shifts
• Health systems must move away from vertical, fragmented service delivery toward an integrated and connected system that leverages resources and provides continuity of care
Strategy: Shift from a siloed to a systems approach
• Health systems must move away from delivering services from the provider perspective toward designing for the extreme user first by bringing a connected set of services closer to communities through CHWs and tech-enabled platforms
Design: Shift from supply-drivento people-centric service delivery
• Health systems must move away from being reactive and episodic to proactive and capable of harnessing data and AI toward identifying / allocating resources in preparation to mitigate high risk situations
Planning: Shift from forecastingto foresight
• Health system leaders must move away from incremental changes that maintain business-as-usual to bold, transformational change that empowers stakeholders through decentralized decision making, continuous training, and restored trust
Organization: Shift from “what” is being delivered to “what and how”
A young mother and her child are enrolled in the system. She receives
health information on her mobile phone tailored to her
needs and gets timely answers to her questions.
The baby gets sick. The mother reaches out for
help using a phone and receives prompt information and care
through her phone and health worker.
The mother travels to the nearby private pharmacy
where her prescription has already been verified and
the medication is available and free.
The mother provides direct feedback on her
experience and feels empowered when her
feedback is heard.
The Path Forward: Reimagining Primary Health CareWhat could health systems look like with these shifts and next generation models of care?
The Path Forward: Reimagining Primary Health CareEarly lessons on the promise of innovative yet practical approaches to managing COVID-19 and maintaining essential
services
The COVID-19 response is “forcing” the integration and acceleration of
novel service delivery models at scale. As a result, transformational shifts
are happening — in policies, societal norms, and individual behaviors
Health systems that were flexible, with high access and high quality of
care, were able to respond and make the shifts necessary for an effective
COVID-19 response. For example, those that had telemedicine systems in
place scaled them up; countries with health hotlines could update the
messaging with COVID-19 information
Individuals experience a connected and continuous journey through the
system restoring their trust and sense of empowerment
The Path Forward: Reimagining Primary Health CareSnapshot of PHC shifts – and promising innovations – happening around the world
Shift Service Delivery Models Example Countries Examples of Innovations
Strategy: Shift from siloed to systems approach
• System redesign: optimization of existing service delivery channels or introductions of new channels
El Salvador, Iran, Kenya, Nepal, Thailand
• Harvard• Nyaya Health Nepal• Jacaranda Health• KEMRI
Design: Shift from supply-driven to people-centric service delivery
• Swab-testing using drive through and courier services
• Virtual triage & consultations• Home/self testing• Mobile self-triage; chatbot to check
symptoms
Kenya, Indonesia, Malawi, Mozambique, Tanzania, Rwanda, South Africa; global
• WhatsApp• Viamo• WHO Health Alert• U-Report• ada
Planning: Shift from forecasting to foresight
• Collecting quality data (also part of Organization)
• Supply chain analytics• Data integration & visualization for
decision making
Rwanda, Liberia, Pakistan, Mozambique, Tanzania; global
• CommCare• DHIS2• Zenysis• Macro-Eyes Health
Organization: Shift from “what” is being delivered to “what and how”
• Task shifting• mHealth to coordinate CHWs• Distance learning/mentoring for clinicians• Digital job aides• App-based clinical cases
Liberia, Burkina Faso, Bangladesh, Malawi, Pakistan, Indonesia, Tanzania, Zambia; global
• mHero• CommCare• Project ECHO
CDC Jeffrey P. Koplan Lecture 2020
Thank you
Dr. Irene Lack-Hageneder / Mag. Teresa Weiss
AUSSENWIRTSCHAFTSCENTER WASHINGTON
T +1 202 656 0060
ÜBER IHRE FRAGEN FREUEN WIR UNS!
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