COMMISSION OF THE EUROPEAN COMMUNITIES 
Brussels, 15.01.1997 
COM(96) 720 final 
REPORT FROM THE COMMISSION TO THE COUNCIL 
AND THE EUROPEAN PARLIAMENT 
ON 
THE IMPLEMENTATION OF THE 
"EUROPE AGAINST AIDS" 
ACTION PLAN 1994-1995 

I. INTRODUCTION 
In a Decision of 4 June 1991 the Council and the Ministers for Health of the Member 
States, meeting within the Council, adopted a 1991-1993 plan of action within the 
framework of the "Europe against AIDS" programme1. As required by this Decision, the 
Commission presented to the Council on 10 March 1993 a report on activities undertaken 
in 1991 and 19922, and another report on 25 November 1994 for 19933, so that the 
Council and the Ministers for Health could evaluate their effectiveness. 
The entry into force on 1 November 1993 of the Treaty on European Union, and in 
particular Article 129 EC, provided new Community prerogatives in the field of public 
health. Pending the adoption of the Community programme on the prevention of AIDS 
and certain communicable diseases (1996-2000) proposed by the Commission on 
9 November 19944, the European Parliament and the Council adopted a Decision on 
19 June 1995 intended to extend the "Europe against AIDS" programme5 for a period of 
two years until 31 December 1995. 
In accordance with Article 3 (2) of European Parliament and Council Decision No 
1729/95/EC, the aim of this report, which takes up again and complements certain points 
of the 1994 implementation report6, is to give an account of the implementation of the 
"Europe against AIDS" action plan 1994-1995. 
II. IMPLEMENTATION OF THE "EUROPE AGAINST AIDS" ACTION 
PLAN 1994-1995 
1. Selection criteria for projects submitted to the Commission 
The first criterion concerns whether a project falls clearly within the general 
framework of the programme, relates to one or more of the programme's areas of 
activity and involves the participation of Member States. Projects relating to non-
Community countries or largely comprising research with no immediate practical 
application in the field of public health are thus excluded. 
Decision 91/317/EEC, OJ L 175, 4.07.1991, p. 26. 
COM (93) 42 final. 
COM (94) 525 final. 
COM (94) 413 final of 9 November 1994. 
Decision No 1729/95/EC, OJ L 168, 18.07.1995, p. 1. 
COM (95) 521 final of 7 November 1995. 
The second criterion is whether the project offers a "Community added value", in 
contrast to a purely national or local value. There are various ways in which a project 
may offer a Community added value, for example: 
if a project is to take place in more than one Member State; 
if it involves a number of organisations from various Member States; 
if the subject is of interest to the entire Community, for example international 
travel or migration; 
if it adopts an innovatory approach to a specific problem and does not duplicate 
work already being done elsewhere. In this context, a purely national project could 
be supported if it could act as a model for application in other Member States or 
if the results might be of direct relevance to other Member States. 
The third criterion relates to whether the projects involve specific technical/scientific 
and preventive activities which can be prepared and implemented within a fixed period. 
The aim is to support scientifically and technically valid projects, or pilot projects, 
and not to subsidise ongoing basic services. 
Lastly, the final criterion relates to financial matters. The Commission provides some 
financial support for projects in accordance with the principle of shared costs, but cannot 
finance them fully as a general rule. 
2. The Advisory Committee 
As required by Decision No 1729/95/EC, the Commission was assisted in the 
implementation of the programme by an Advisory Committee comprising representatives 
of the Member States. This Committee met twice in 1994 (in February and September) 
and three times in 1995 (in February, April and September). Each project application 
preselected by the Commission was passed on to the Advisory Committee for an opinion. 
In order to simplify the work of the Advisory Committee, an evaluation chart was drawn 
up (see Annex I) with its approval, to be completed by each member for each project. 
The total number of points obtained was then compared with the maximum possible score 
for each project. 
After consulting the members of the Advisory Committee, the Commission decided 
whether to fund or to reject each project. 
3. Calls for proposals published in the Official Journal of the European 
Communities 
European Parliament and Council Decision No 1729/95/EC on the extension until the end 
of 1995 of the 1991-1993 action plan adopted as part of the "Europe against AIDS"7 
programme was only adopted on 19 June 1995. Being authorised only to fund ad hoc 
measures in 1994, the Commission published a call for proposals containing the Annex 
to the proposal for a Decision8. 
Similarly, the Commission published a call for proposals in April 19959 concerning 
projects relating to the prevention of HIV/AIDS. 
In addition, the Commission issued a restricted invitation to tender based on a call in 
199210 for the expression of interest in the evaluation and dissemination of information 
resulting from the implementation of the programme. The Advisory Committee on 
Procurements and Contracts, however, deemed the number of bidders to be insufficient 
and therefore issued an unfavourable opinion on this restricted invitation to tender. 
4. Overview of projects supported under the 1994-1995 action plan 
These projects were selected on the basis of applications to the Commission by 
organisations engaged in work on the prevention of HIV/AIDS. 
During the implementation of the 1994-1995 action plan, a total of 134 projects (59 in 
1994 and 75 in 1995) received financial support from the Commission. These various 
projects are distributed among the different areas of activity as follows: 
Knowledge, attitudes and behaviour of 33 projects 
the general public and certain target 
groups; information and awareness-
raising campaigns for the public and 
these groups 
Measures for children and young 19 projects 
people 
Prevention of HIV transmission 29 projects 
among particular groups and in 
particular settings 
Social and psychological support 19 projects 
COM (93) 453 final. 
No 94/C 108/08, OJ C 108, 16 April 1994, p. 19. 
No 95/C 82/09, OJ C 82, 4 April 1995, p. 9. 
No 92/C 181/08, OJ C 181, 17 July 1992, p. 15. 
Gathering data on HIV/AIDS 19 projects 
Combating discrimination against 5 projects 
people with HIV and AIDS and those 
close to them 
Altogether, these projects represented a total Community contribution of ECU 17.7 
million (ECU 9.0 million in 1994 and ECU 8.7 million in 1995). The average Community 
contribution per project funded was ECU 132 000, with a rate of funding generally 
between 50 and 70%. By way of comparison, the "Europe against AIDS" action plan 
Î 991-1993 supported 150 projects with total funding of ECU 12.36 million, giving an 
average Community contribution of ECU 82 400 per project. 
III. WORK CARRIED OUT UNDER EACH AREA OF ACTIVITY OF THE 
ACTION PLAN 
The various actions are classed in accordance with the areas of activity set out in the 
Annex to European Parliament and Council Decision No 1729/95/EC. As these areas are 
interdependent, some projects have aspects which relate to a number of areas. A project 
is therefore classified by taking the predominant aspect into account (Annex II contains 
a summary table). 
AREA OF ACTIVITY 1: Knowledge, attitudes and behaviour of the general 
public and certain target groups; information and 
awareness-raising campaigns for the public and these 
groups 
Providing information and raising awareness about the problem of AIDS are key elements 
in any prevention strategy. Also, precise information is a prerequisite in order to be able 
to affect behaviour and thus combat discrimination. 
The Commission funded 33 projects in this area: 
- A Franco-Belgian information and awareness-raising campaign was carried out, 
aimed at populations of non-European extraction through the dissemination of 
information material translated into ten non-European languages: video cassettes, 
information brochures, posters and discussions. 
- A pilot information project on the transmission and prevention of HIV/AIDS 
aimed at the Turkish and Kurdish populations of the Lower Rhine border region 
was organised with Commission support. This initiative took into account the 
cultural practices of these target groups and tried to overcome the difficulties of 
inter-cultural communication by establishing contact with key persons such as the 
Imam, teachers and sports coaches in order to obtain their support and cooperation 
and to establish, in cooperation with health professionals and social workers, what 
teaching materials to use. 
An action aimed at those on the fringes of society in the Mediterranean area was 
carried out. This action encouraged both the raising of awareness among this 
target group with regard to the prevention of HIV/AIDS and training for those 
dealing with young people, psychological and social support for HIV-positive 
persons and access by them to financial and social assistance. 
Members of the European and various national Parliaments were invited to a 
European conference organised for them, the aim of which was to encourage 
exchanges of information and to raise the awareness of the entire European 
political stratum with regard to the transmission of infection by HIV/AIDS. 
An exhibition in public areas and meeting-places of posters by artists on the 
subject of AIDS was organised in Spain following a similar experiment in France, 
with the aim of making information accessible to all levels of the population. 
More than 1 000 exhibition kits and information brochures were distributed in 
towns, youth organisations, local authorities and educational and health 
organisations. The advantage of the exhibition is that it can be interpreted by the 
public without requiring any specialist knowledge on their part. 
In order to provide a basis for planning preventive measures against AIDS and to 
measure their effectiveness, precise information is required on the knowledge, 
attitudes and behaviour of the general population of the European Community or 
of target groups within that population, using suitable indicators. This is a 
fundamental exercise which is worthwhile supporting financially in order to assess 
shortcomings and priorities for the future on the one hand and, on the other, to 
avoid any duplication of effort within the European Community. The Commission 
accordingly subsidised three analytical projects at Community level. The first was 
aimed at the general public, the second at target groups such as women, 
homosexuals, young people and ethnic minorities and the third at travellers and 
tourists. Three universities therefore concentrated on collecting and examining 
studies already carried out in the various Member States relating to operations and 
strategies with regard to information, awareness-raising and prevention in relation 
to AIDS on the one hand and, on the other, on a critical analysis and summary 
of the methods followed in these studies and the results obtained. The aim was 
to carry out a comparison between Member States in order to evaluate the 
strategies and methods chosen and identify any differences between Member 
States and aspects specific to them, so that the possibility of carrying out 
coordinated measures at Community level could be determined. 
The Commission supported a project involving four Member States intended to 
verify the impact of information on changes in the knowledge, attitudes and 
behaviour of the groups involved and to propose a teaching model aimed in 
particular at primary prevention. The role of social and cultural values and 
standards, and of socio-cognitive factors associated with information processing, 
in mediating between the information given to individuals and any changes in 
attitudes and behaviour was analysed in this context. 
The Commission supported a project which utilised extensive statistical and 
interview data derived from a major multi-country study on "Managing AIDS" 
supported by the WHO European Centre. The findings of this study have practical 
implications for better ways of managing and preventing AIDS, but their diffusion 
will not produce sufficient motivation to change policy and behaviour. This 
project therefore proposed a motivational change method in each of four Member 
States (Belgium, Italy, Netherlands and Portugal) to work through the major 
findings. It will permit the enhancement of interactive learning between the 
organisations and the initiation of an accurate evaluation of past successes and 
failures, leading to new action-oriented policies. 
Knowledge of the measures and of the bodies involved in combating HIV/AIDS 
infection is essential. To this end, the Commission supported a project aimed at 
drawing up an education guide for the general public, identifying and describing 
key organisations and persons in the field of AIDS and collecting campaign 
material on specific subjects relating to AIDS. The results of this work were 
published internationally. 
A pilot project studying the feasibility of an electronic system providing 
information on HIV/AIDS to general practitioners and pharmacists in order to 
assist them in their work was carried out in three Member States. 
In dealing with AIDS, doctors and health care systems are faced with social, 
ethical and political problems. Similarly, governments must organise and bring 
about international solidarity. In order to analyse the correlations between the 
epidemiology of AIDS, social phenomena and population movements, an 
international interdisciplinary conference was held under the auspices of the 
Commission. This took place in Paris on 17 and 18 October 1995 and provided 
non-specialists, political decision-makers and journalists with information on the 
impact of AIDS on society and on demographics. 
A conference on the subject "Nurses and AIDS" was organised under Commission 
auspices in Barcelona from 24 to 27 November 1995. The aim of this conference 
was to meet the need felt by nurses to exchange information and experience and 
to reduce their feeling of vulnerability in relation to HIV/AIDS. 
The Commission provided financial support for a project to translate the brochure 
"AIDS: the facts, the hopes" into all the languages of the Community, adapting 
these translations to the specific realities of each Member State. 
A programme for exchanging experience based on the one hand on training trade 
union delegates and raising their awareness of the problem of AIDS in the 
workplace and, on the other, on trade union actions to defend against and combat 
discrimination at work against people with HIV/AIDS involved Spanish and 
Italian trade unions. An analysis and comparison of labour and social protection 
legislation in these two countries with regard to workers with HIV/AIDS was 
carried out. Recommendations were formulated for the European Trade Union 
Confederation. 
The sexual behaviour of and knowledge of AIDS among a representative sample 
of female university students in Greece were analysed in cooperation with various 
European partners. Their perception of the obstacles to and advantages of using 
condoms were examined. 
The "Europe Against AIDS" summer campaign, which the Commission supported 
in 1994 and 1995, was aimed at improving AIDS prevention among young 
holidaymakers and tourists through use of the media (posters in stations and 
airports, press advertisements, particularly in youth magazines, television and 
radio advertising and distribution of T-shirts and stickers) and in conjunction with 
national AIDS agencies and youth networks in the majority of Member States and 
some non-member countries (use of "Europe Against AIDS" images in the 
communications media of tourist bodies such as youth hostels and camp sites and 
in magazines for members of, for example, the Youth Card and Interrail schemes). 
The messages and logos used were identical in all participating countries. 
An information campaign aimed at young people was organised in 1994 and 1995 
through the cooperation of 300 radio stations in various Member States. This 
provided an opportunity to reach young people through advertisements, news 
bulletins, personal testimonies, discussions and interviews. Provision was also 
made for link-ups between the stations and off-the-air measures such as the free 
distribution of condoms, information packs specially designed for young tourists, 
tape compilations of the above-mentioned radio programmes and lists of telephone 
helpline numbers. 
Better than any other medium, local radio often reaches excluded or marginalised 
groups in urban and rural areas throughout Europe. The Commission therefore 
supported the establishment of a monthly European-scale radio broadcast aimed 
at these groups. Seven Member States were involved in this measure, the main 
objective of which was to provide information on high-risk behaviour, methods 
of transmitting the disease, associations and institutions, the most effective 
preventive measures, etc. This was done by means of examples from each 
Member State of the European Community, through the European network of the 
World Association of Local Radio Stations (AM ARC-Europe). 
In order to make ethnic minorities in four Member States more aware of the 
problem of HIV/AIDS, the Commission assisted with a project using radio 
programmes and helplines for transmitting information in the various languages 
of the groups concerned. 
The Commission supported a three-day event (TRANSMISSION '96) aimed at 
developing strategies for using new information technologies in AIDS prevention. 
The main aim was to encourage people working in the prevention and/or treatment 
of HIV/AIDS to understand and use these technologies. 
In order to promote cinema and video as means of providing information on the 
HIV/AIDS epidemic, the Commission supported the second International Film 
Festival on HIV and AIDS, held in Paris from 4 to 9 April 1995. 
- There is a need to collect more information than currently exists about how 
Community citizens regard their own health status and the health systems of their 
Member States, as well as their perception of priorities in health. Such 
information can play a valuable role in supporting health programmes at 
Community level and in enabling Member States to plan and evaluate their 
policies and priorities and make comparisons with those of other Member States. 
The problem of HIV/AIDS infection has been a regular subject of Eurobarometer 
surveys since 1989. These have examined three main parameters: the attitudes of 
Europeans to HIV/AIDS infection; their attitudes to the measures to be taken; 
knowledge and proximity of the phenomenon. A Eurobarometer survey on blood 
safety, blood transfusion and HIV/AIDS was carried out at the request of the 
Council of Health Ministers in April-May 1994. In 1995, the Commission carried 
out a Eurobarometer survey on "Europeans and public health" containing a chapter 
on HIV/AIDS. This survey provided an up-to-date picture of the opinions of 
European citizens, while also analysing trends over a six-year period. It was also 
the first Eurobarometer survey on this subject in the new Member States. 
AREA OF ACTIVITY 2: Measures for children and young people 
Obviously, young people are a primary target group for the information, education and 
prevention measures implemented in the context of the "Europe against AIDS" 
programme. 
In this area of activity, the Commission contributed to nineteen projects: 
- It supported an initiative by the French Ministry of National Education aimed at 
harmonising sex education in schools. The intention was to devise a methodology 
to assist education establishments in introducing sex education measures by 
establishing a network of teachers and by exchanging know-how with the other 
Member States. In addition, the Commission took part in the implementation of 
two projects relating to methodological aspects. One concerned the exchange of 
information on health education in schools and training centres within the country 
and also the promoting of exchanges of personnel and of material intended for 
staff training (teachers, monitors, etc.). The second project related to the 
organisation of a European conference in Rome on health education and 
HIV/AIDS prevention in schools, to which those invited included representatives 
and AIDS and health education specialists from all the Member States. The 
conference led to the drawing up of a European consensus document with regard 
to HIV/AIDS prevention in schools. 
- A joint prevention programme was set up in Spain and Portugal aimed primarily 
at schoolchildren aged 13-14 (approximately 100 000). The interesting feature of 
this project is that it involved cooperation by teachers and parents. One of the 
fundamental aspects was to combat discrimination against infected people, and 
particularly HIV-positive children in schools. Under the project, educational 
material was widely distributed in the two countries concerned. 
The Commission funded a week of HIV/AIDS prevention measures :: .1 region 
of France between 27 November and 1 December 1995. This campaign was 
organised with a view to informing and making young people awa e of the 
problem of AIDS (means of transmission, protection, etc) and overci. iiing the 
taboos surrounding the disease in order to be able to talk about the problem of 
AIDS in a spirit of frank discussion based on the principle of tolerance. Two 
similar measures were also carried out in the United Kingdom and in Germany. 
The United Kingdom project was aimed at young people in schools and involved 
the use by the pupils themselves of audio-visual technologies. The German project 
was intended specifically for young people (in or out of school) in the region 
bordering on Belgium, and took into account the specific cultural characteristics 
of that region. 
The Commission helped to carry out a training project for an HIV/AIDS 
prevention network in two Member States (Spain and Portugal) aimed at} oung 
people and involving conscientious objectors. The aim was to contribute to the 
dissemination of knowledge on HIV/AIDS, to increase the awareness of the group 
vulnerable to infection and to change attitudes and sexual behaviour. 
The Commission supported a Spanish project aimed at developing and testing a 
model for intervention and formulating specific recommendations for introducing 
measures aimed at young people not in schools. 
A conference was held in Denmark in the spring of 1994 to establish a European 
network relating to young people and education in HIV/AIDS prevention and 
epidemiology, travel and sexual behaviour, problems associated with migrants and 
drug consumption. The network involves both non-governmental organisations and 
public health authorities in the Member States. A second conference subsequently 
took place in order to assess progress in this field and to develop common 
indicators with regard to prevention. 
In the context of information, awareness-raising and AIDS prevention among 
young people, a major European assembly, which took into account the cultural 
and social differences between young people, took place in the Netherlands under 
the auspices of the Commission, bringing together a large number of Scout and 
Guide organisations from the European Community. This project had an enormous 
and widespread impact in all Member States, as approximately 6 million young 
Scouts and Guides were directly or indirectly involved. This event was supported 
by the "Europe against AIDS" programme in 1994 and 1995. 
Pilot prevention projects aimed at groups of disadvantaged young people made it 
possible to evaluate, with Commission support, the attitudes and behaviour of this 
target group in the Netherlands and Germany. These projects were adapted for a 
similar target group in County Cork in Ireland, taking into account specific 
aspects of Irish culture. The results and experience acquired in implementing these 
projects will be transferred to other regions of those Member States facing similar 
problems. 
10 
- The Commission supported an action and analysis project carried out in three 
Member States (France, Belgium and Luxembourg) relating to images of AIDS 
among young people in difficulties, based on a series of photographs. This in-
depth survey into images of the HIV-positive state and of the disease is likely to 
provide better working tools and to develop preventive strategies better suited to 
this target group. 
- Finally, two projects aimed specifically at young people and using theatrical 
techniques were supported by the Commission. The establishment in Spain and 
the United Kingdom of a street theatre group gave young people an opportunity 
to take part in plays dealing with AIDS. In addition, a workshop on sexuality 
aimed at young people between the ages of 13 and 21 was established in 
education centres in Belgium, the United Kingdom and Spain. To this end, the 
countries concerned provided common training for monitors, and a manual setting 
out the results of the experiment was drawn up for distribution in other Member 
States to serve as a basis for similar projects. The Commission ensured that all 
activities in this area were carried out in cooperation with the European "AIDS 
and Youth" Information Centre established under the 1991-1993 action plan. 
AREA OF ACTIVITY 3: Prevention of HIV transmission among particular 
groups and in particular settings 
Under this area of activity, the Commission supported twenty-nine projects: 
Travel and tourism 
- A programme was established to prevent HIV/AIDS transmission, aimed at young 
European tourists visiting Greece. The project was implemented with Commission 
support and in partnership with two other Member States. Following consultation 
with key people in the tourism sector on how to achieve the objectives, a 
campaign was carried out involving the dissemination in all European languages 
of radio messages, brochures and posters in tourist areas and places of 
entertainment. Methodological results, and those relating to the campaign itself, 
were collected and distributed to the five largest travel organisations, the 
municipal authorities of European cities receiving large numbers of tourists, 
various religious institutions and all interested organisations. 
- The importance of HIV/AIDS prevention measures targeted at migrant groups and 
support services for migrants infected with the virus has been recognised on many 
occasions. The "AIDS and Mobility" network, with the support of the 
Commission, continued to act as coordinator between the various European 
organisations working in the field of HIV/AIDS prevention among migrant 
groups, ethnic minorities and travellers. In particular, these activities include the 
provision of documentation services such as databases, educational material and 
information on the various projects carried out in this area, as well as organising 
seminars dealing with the interaction between AIDS and migratory movements. 
11 
- In cooperation with this network, a major meeting was organised bringing 
together the coordinators of national programmes to combat AIDS on the 
one hand and, on the other, representatives of ethnic minority organisations 
which are also fighting this scourge. The aim of this meeting was to gain 
an understanding of the problems and specific requirements of ethnic 
minorities with regard to health and HIV/AIDS and to permit an exchange 
of ideas which might lead to the development of national strategies more 
suited to the specific needs of the groups involved. 
The Commission also considered it worthwhile subsidising a project aimed 
in particular at monitoring and evaluating services provided to Irish 
migrants travelling between Ireland and the United Kingdom. This project 
was also incorporated into the "AIDS and Mobility" network. 
A German institute undertook an analysis of the typical problems r^Lting to 
HIV/AIDS/STDs in the external border regions of the European Community. 
Given the high degree of movement of people, these regions present a particular 
problem with regard to HIV/AIDS/STD prevention. The main aims of this 
measure were to develop specific preventive methods adapted to the situation in 
these regions and to identify the measures to be taken. This work will help in 
establishing a European network devoted to the problem. 
In Galicia (Spain) and in northern Portugal approximately 9% of people with 
AIDS are seamen. Studies show a high prevalence of HIV infection in this group 
and, especially, a lack of preventive measures. For this reason, the Commission 
considered it worthwhile supporting a pilot project in Spain and Portugal in order 
to determine the attitudes and behaviour of the groups of seamen concerned in 
relation to HIV/AIDS and to sexually transmitted diseases and to reduce the risks 
of HIV/AIDS transmission. 
Prisons 
Having identified a higher rate of HIV infection among reoffenders in a French 
prison, it was assumed that infection had occurred during previous periods of 
imprisonment. In the absence of data for Europe, it was necessary to evaluate the 
risks of infection in prison in order to draw up specific prevention policies. The 
Commission supported a pilot study project carried out by a French institution, 
which enabled it to: 
estimate the prevalence of high-risk practices and of certain socio-
demographic and psychosocial determining factors among prisoners before 
and during imprisonment; 
- document the rate of infection during imprisonment and compare high-risk 
practices among prisoners in the light of the concept of reoffending. 
12 
The results of this experiment will provide a basis for similar studies in other 
Member States and for drawing up preventive policies. 
In this context, and thanks to the efforts of the Commission, France and Germany 
cooperated on a feasibility study into the establishment of a European network for 
the prevention of HIV infection in prisons. Six Member States are currently 
involved in this network, with the aim of developing common tools for 
epidemiological surveillance, observation of high-risk behaviour in prisons and the 
development of joint primary prevention strategies in the European Union. 
Intravenous drug users 
- In order to measure the effectiveness of their policies on public health and the 
prevention of AIDS and drug abuse, a number of European cities felt the need to 
establish a register of drug users taken into care, particularly those following a 
methadone treatment programme. This trend towards the quantitative and 
qualitative growth of registers, however, runs the risk of infringing individuals' 
privacy by exceeding established legal standards. For this reason, the Commission 
supported a programme aimed on the one hand at promoting the development and 
adaptation of local HIV/AIDS prevention policies among drug users and, on the 
other, at identifying new common guidelines to enable registers to continue to be 
drawn up while respecting individual rights. 
- A university in the United Kingdom carried out a project in that country and in 
Germany analysing risk factors in HIV infection among female intravenous drug 
users. As part of this measure, HIV prevalance and high-risk behaviour among 
these women were examined, as were their knowledge and attitudes with regard 
to health. Their experiences in relation to preventive measures were than analysed. 
This project should make it possible to introduce appropriate HIV/AIDS 
prevention programmes and define general social policies with regard to women 
drug users. Finally, the various results and conclusions of this measure were 
compared with data gathered through similar measures in Spain. France and Italy 
under the 1991-1993 plan. 
Women exposed to particular risk of HIV contamination 
Within this area of activity, the Commission also stressed support for preventive 
measures aimed at women, particularly those in certain target groups such as 
prostitutes. To this end, a French pilot measure funded in 1993 by the 
Commission, intended to help prostitutes to become their own health workers in 
order to take part in developing new HIV/AIDS prevention strategies, was 
continued in 1994. The aim of this new measure was to systematise the 
experience acquired during the 1993 project by developing a joint practical 
measure in the field in France, Belgium, Spain, Italy and Germany. Women 
involved in prostitution in these five countries were recruited and trained in order 
to help establish bilateral relations between these countries and the body 
concerned and to serve as a link between prostitutes and HIV/AIDS specialists in 
the social and health network of the participating countries. A prevention and 
13 
psychological/social support project, aimed at women prostitutes - particularly 
those with major social problems - and modelled on the experiment carried out 
in France, was launched in Spain with Commission support. 
After evaluating the results obtained in the first phase, funded in 1993, the 
Commission considered it necessary to renew support for the EUROPAP 
(European network for the prevention of AIDS among prostitutes) project. This 
second phase was used to: 
- develop and extend preventive measures among prostitutes in eleven 
Member States, taking account of the conclusions and results of the first 
phase; 
- develop models of good practice for the prevention of HIV and sexually 
transmitted diseases, as well as access to support services for prostitutes; 
strengthen the international network of those involved in the prevention 
field and help with the training of social workers; 
exchange material on health education through the establishment of a 
library centralising all existing material on HIV prevention and 
prostitution. 
In order to obtain maximum benefit from HIV and STD prevention measures 
intended for migrant prostitutes, as well as from contacts established with the 
medical services of the countries concerned, the Commission also considered it 
necessary to repeat the TAMPEP project, first funded in 1993. One of the main 
aims is to encourage the use and dissemination of the TAMPEP method of 
prevention among health services and to enable those persons interested to obtain 
information and training within the organisations involved in carrying out the 
project. 
The Commission provided financial support for the development of a pilot project 
on the prevention and detection of HIV/AIDS among female prostitutes in the city 
of Valencia, with the aim of reducing the incidence of sexually transmitted 
diseases and HIV/AIDS infection among prostitutes, in particular by organising 
optional screening tests and by providing assistance to women infected with the 
HIV virus by providing counselling adapted to their situation. Exchanges of 
information arising from this pilot experiment with other organisations in the 
European Community working in the same area have taken place, particularly 
with organisations involved in the working party established by the European 
Commission. 
Two primary prevention projects aimed at women were implemented with 
Commission support, one in the border region of Germany, France and 
Luxembourg (Saar-Lor-Lux), and the other in the United Kingdom and the 
Netherlands. With regard to the first project, several categories of women were 
approached (women with an HIV-positive, bisexual, intravenous drug-using 
partner or women drug users, prostitutes, women who change partners frequently, 
etc). The second project was aimed more specifically at lesbian or bisexual 
women. 
14 
Vertical HIV transmission from mother to child 
- The Commission supported a comparative analysis of antenatal HIV screening 
carried out in various European centres. This required, in particular, a survey 
relating to the psychological barriers and difficulties encountered among health 
professionals and pregnant women in relation to screening, and an analysis of 
existing training programmes in the field of obstetrics dealing with the subject of 
HIV/AIDS. 
Other populations 
A Danish prevention project aimed at homosexuals visiting Spanish tourist sites 
was carried out with Commission support. To this end, volunteers were specially 
trained in cooperation with the authorities and local organisations combating aids. 
The activities, which included the distribution of material relating to prevention 
and information, as well as diseussions, also involved the managers and staff of 
leisure facilities in the areas concerned. 
- A primary prevention project aimed at young male prostitutes was implemented 
with Commission support in the border region of Germany, France and 
Luxembourg (Saar-Lor-Lux). 
Safety of blood and blood products 
- The continuation of efforts aimed at promoting European Community self-
sufficiency in blood is specifically mentioned in the Decision extending the 
"Europe against AIDS" programme. Accordingly, two analyses carried out in the 
Netherlands received Commission support in 1994. 
- The Commission also supported a project in 1995 to examine issues relevant to 
the inspection and accreditation of blood transfusion establishments; this was 
carried out under the coordination of a Greek university. 
AREA OF ACTIVITY 4: Social and psychological support 
The Commission supported nineteen measures under this heading: 
Encouraging the exchange of experience, with models for assisting and supporting 
those with HIV and AIDS, is an integral part of the Commission's action 
programme. Thus, meetings bringing together the seven most important telephone 
helplines in the European Community were organised with Commission support 
in order to promote exchanges of experience and to develop ideas and methods 
aimed at improving and extending the services provided. Other subjects such as 
staff training, evaluation of activities, exploiting information gathered, technical 
problems and the possibility of establishing new services were discussed. 
Furthermore, the Commission encouraged a project to examine and assess the 
impact of existing telephone helplines. Questions relating to access, confidentiality 
and promoting these lines among the public were discussed, and recommendations 
for improving them were then made. 
15 
The drafting and dissemination of manuals, information bulletins and directories 
providing up-to-date information on the prevention of HIV transmission is a 
subject of particular interest to the Commission, as is the development within the 
European Community of computerised methods for responding to requests for 
information from the public and the groups involved. In this context, a project for 
an electronic system was launched for dissemination and exchanges between 
information and documentation centres. 
The programme also supported a conference held in Copenhagen from 15 to 19 
August 1995 on the subject of AIDS and social work, bringing together social 
workers, non-governmental organisations, representatives of European authorities 
and the press. The conference provided an opportunity to discuss and develop 
methods, strategies, models and recommendations relating to social work in the 
context of HIV/AIDS. It also provided an opportunity to examine the possibility 
of establishing a network of social workers and other interested parties. 
The Commission supported a project by a United Kingdom university seeking to 
define the psychological and emotional consequences of HIV infection for people 
infected for five years or more, their requirements and the impact of the infection 
on the provision of support services. An analysis of the constraints and 
adjustments facing those with HIV or AIDS was carried out in Greece. Questions 
dealt with related to the basic needs of HIV-positive people, the way in which 
they react to their condition, changes in their everyday lifestyle and the obstacles 
or constraints affecting their quality of life. The conclusions were the subject of 
exchanges of information and comparisons with other Member States. 
A similar analysis to the two preceding ones, but relating specifically to women 
with HIV/AIDS, was also carried out in the United Kingdom with Commission 
support. One objective of this was to strengthen the links between organisations 
to assist women with the virus or the disease and between these bodies and 
existing European networks. This project involved all Member States directly or 
indirectly. In addition, a support measure aimed specifically at women with HIV 
was carried out in Germany, Belgium and the Netherlands. 
The Commission ensured the continuation of activities under a social action 
programme intended to provide psychological and social support to 20 households 
in major difficulties, in which at least one member is HIV-positive. This 
programme, carried out in partnership, made it possible on the one hand to 
encourage exchanges of experience and transfers of know-how from one Member 
State to another and, on the other, to promote the introduction of similar systems 
in other Member States. In addition, a measure aimed at the social reintegration 
of drug addicts and/or HIV-positive persons was carried out in Belgium. In order 
to make this project transferable to other Member States, the conditions governing 
access to the project for drug addicts and/or HIV-positive persons were analysed 
in three other Member States. 
16 
The Commission also encouraged a pilot project in the Valence region for the 
reintegration of young HIV-positive people or AIDS patients into social and 
working life, enabling them to confiront social, emotional, economic and 
educational prejudices. To this end, courses and workshops were organised to 
provide them with psychological support and encourage their personal expression, 
creativity and autonomy. 
A pilot project to assist and support those with HIV or AIDS was set up with 
Commission support. This measure, established in the Athens region, was aimed 
particularly at, on the one hand, people who were unemployed or had few 
resources as a result of their HIV infection and, on the other, at families 
financially dependent on the income of an infected person. As a result of this 
project, cooperation between various organisations working on AIDS in different 
fields was reinforced through exchanges of information and experience. 
The Commission contributed to a project aimed at collecting information and 
describing the medical and social services available to families affected and 
children infected with HIV/AIDS. This measure was carried out in ten Member 
States. In order to carry out this work, the extent of the problem of families 
affected by HIV/AIDS was estimated and the socio-demographic origins thereof 
was studied. Subsequently, the medical services provided for these families and 
their interaction with the services offered by non-governmental organisations were 
described. The aim of this measure was to provide comprehensive information on 
those services best suited to the needs of families. 
Along the same lines, an Italian institution collected information on the activities 
and functions of non-hospital services and structures for HIV carriers, in order to 
disseminate this information at European level. This information may be useful 
for various categories of people, particularly those affected by HIV/AIDS and 
their families or health professionals. 
The programme funded a project relating to the quality of assistance and support 
services in Europe. A comparison was made of the organisation of these services 
in the various Member States. A survey was carried out with the aim of 
identifying more closely and understanding the needs of people with AIDS, 
Finally, recommendations for good practice were drawn up. 
Lastly, the Commission supported a project with the main aim of: 
- improving the quality of assistance given to children with HIV and to their 
families, by the practical adaptation of current health and social assistance 
schemes to the needs of the children and their families; 
- integrating the activities of governmental and non-governmental 
organisations helping infected children. 
17 
The Commission made efforts to coordinate measures by the bodies responsible 
for the four projects referred to above, particularly with the activities of the 
European Forum for HIV-positive children, established under the 1991-1993 
action plan. 
AREA OF ACTIVITY 5: Gathering data on HIV/AIDS 
It is essential to have exact and relevant epidemiological information available in order 
to define effective strategies for combating the disease. Furthermore, collection and 
analysis of these data at Community level offers two important advantages: firstly, 
Member States thus have the opportunity of placing their national figures in a wider 
context and assessing the development of the epidemic in their country in relation to the 
situation in other Member States. Secondly, all the data collected at Community level 
make it easier to determine the main trends within the general population and significant 
developments in certain defined groups, thus permitting better targeting of prevention 
activities. 
Under this area of activity, the Commission supported 19 projects: 
It continued to assist the European Centre for the Epidemiological Monitoring of 
AIDS in 1994 and 1995. The main aim of this project is to maintain and develop 
the European surveillance system for AIDS and HIV infection. The system 
enables national surveillance data to be collected, analysed, interpreted and 
disseminated at Union level and for each Member State. The secondary objectives 
developed on the basis of the programme include an evaluation of surveillance 
methods, determination of the incubation period and of life expectancy with 
AIDS, analysis of epidemiological trends and forecasting, together with an 
analysis of diseases whose epidemiological characteristics are associated with the 
HIV epidemic (tuberculosis, hepatitis, sexually transmitted diseases). During the 
period covered by the programme, the Centre developed: 
- an analysis of the incidence of AIDS by year of birth; 
- surveillance of perinatal HIV infection (children infected by their 
mothers); 
- analysis of factors associated with various pathologies indicative of AIDS; 
- an analysis of the association between the incidence of AIDS and HIV in 
the various countries on the one hand and, on the other, factors such as 
sexual behaviour, behaviour in relation to drug abuse, prevention 
programmes, the demographic structure of the population, the socio­
economic level of the countries, etc.; 
- an estimate of the incidence of HIV on the basis of repeated data for 
seroprevalence among pregnant women, obtained through non-correlated 
anonymous surveys, and data on fertility broken down by the women's 
age; 
- an analysis of survival among AIDS patients; 
18 
- an evaluation of the impact of the dissemination of methods of preventing 
Pneumocystis carinii; 
- a geographical data system which would enable an improvement in graphic 
representation and spatio-temporal analysis of data. 
The European Centre also received financial support from the Commission for a 
feasibility study aimed at drawing up a development plan for the publication of 
a bilingual (French-English) European bulletin on surveillance of communicable 
diseases, including AIDS. 
The Institute for Hygiene and Epidemiology in Brussels carried out an analysis 
of the collection of data relating to the demand for HIV tests and other 
consultations of general practitioners relating to HIV/AIDS in cooperation with 
five countries involved in a sentinel network. This institute also carried out a 
survey of HIV/AIDS counselling by general practitioners. 
The Public Health Laboratory Service Board of London conducted an enquiry in 
order to advise the Commission on the feasibility of setting up an epidemiological 
network for the surveillance of communicable diseases in the European 
Community and to provide expert advice on the surveillance priorities and 
functions, such as the development of electronic exchange of information. This 
enquiry also led to the elaboration of a Communicable Diseases Charter (including 
AIDS) at Community level. 
The Commission supported a Greek project studying the possibility of using 
epidemiological data on sexually transmitted diseases as markers in the 
development of AIDS, with the aim of establishing a system to predict such 
developments and enable a more effective distribution of resources for AIDS 
prevention. 
Another Greek project involving Italy, the United Kingdom, Spain and Germany 
was carried out with Commission support, identifying the prevalence of HIV and 
hepatitis (B and C) among intravenous drug users in Greece in order to provide 
information on the risk factors associated with these infections. A comparison 
with the results of studies carried out in other European countries and non-
member countries is to follow, thus enabling the formulation of joint preventive 
measures in this field. 
The Commission contributed to the realisation of a project aimed at setting up 
guidelines for control and management of hepatitis C. This project is broadly 
based on epidemiology and on focusing on host factors as predictors of disease 
outcome. 
19 
Three universities (in Greece, Belgium and the United Kingdom) analysed the 
costs engendered by HIV/AIDS for the health and social services ;n Member 
States, and analysed ways of controlling them using methods common to all these 
countries; the aim was to make it possible to distribute effectively the financial 
and human resources assigned to combat HIV/AIDS. 
The Commission also took an interest in activities aimed at increasing and 
improving epidemiological training in HIV/AIDS and associated fields within the 
European Community. To this end, it assisted in drawing up a manual for the 
training of nursing auxiliaries dealing with the risk of HIV infection among drug 
users. This is now being published internationally. In addition, the Commission 
helped to finance the production of a bilingual supplement to the magazine 
"SIDALERTE", which has the primary aims of informing European health 
professionals about the prevention of HIV/AIDS infection, health education and 
respect for the rights of and protection of patients. This supplement deals 
specifically with HIV infection and its interaction with tuberculosis, making it 
possible to cover shortcomings in information about and prevention of these 
associated diseases. This multidisciplinary approach, overcoming barriers between 
countries and disciplines, met with a favourable response both from the 
international bodies involved in combating these two epidemics and from doctors 
in the countries concerned. For this reason, the Commission considered it 
worthwhile continuing this measure in 1995. 
The Commission also continued to provide support for a Belgian project on the 
training of health professionals in 1994 and 1995. The aim was to improve 
communication between doctors and patients affected by HIV/AIDS and reduce 
discrimination against those with HIV or AIDS. To this end, health professionals 
underwent training to enable them to improve their communication techniques. In 
the light of the results obtained, this training was evaluated, adapted and 
disseminated in nine Member States. 
The Commission funded a project carried out by a group of United Kingdom 
universities to evaluate the training given to people working in the field of AIDS. 
Two similar measures were carried out by Spanish institutes, relating to the 
training of people working for non-governmental organisations active in the field 
of AIDS (in cooperation with the United Kingdom group referred to above) on the 
one hand and in the field of drug prevention on the other. 
An international seminar was held under the auspices of the Commission, dealing 
with methodological aspects and scientific priorities in relation to the study of 
asymptomatic patients (long-term HIV-positive patients showing no apparent 
clinical or immunological progression). The results of this activity led to the 
publication of recommendations for rationalising research strategies on the non-
progression of HIV infection. 
20 
AREA OF ACTIVITY 6: Combating discrimination against people with HIV and 
AIDS and those close to them 
The Commission supported five projects under this area of activity: 
- An analysis of the status of implementation of the Council Resolution of 
22 December 1989 . In addition, legal measures and administrative practices in 
Member States which give rise to discrimination against persons contaminated 
with HIV/AIDS or other fatal contagious diseases, or which aim to combat 
discrimination against such persons, were analysed and compared. This made it 
possible to identify proposals for changes in order to improve respect for the 
rights of those concerned. A European conference for national experts and 
members of organisations active in the field was organised to this end, to enable 
evaluation and discussion of the results of this analysis. 
- The Commission supported a project by a group of United Kingdom universities 
with the aim of measuring whether Community action to improve awareness 
among the population of the European Community with regard to the problem of 
HIV/AIDS was desirable and feasible. In addition, the possibilities of drawing up 
a European Code relating to discrimination against those afflicted by HIV/AIDS 
were analysed. Another project attempting to identify existing barriers in alUhe 
Member States to the adoption of anti-discrimination measures was supported, 
with particular reference to employment, insurance, housing, education and the 
health system The second objective was to encourage the application of these 
measures in the Member States. 
The Commission assisted with the carrying out of a project analysing the 
consequences of discrimination against people with HIV/AIDS in relation to 
access to public health services, and examining access to legal services in the field 
of discrimination. This analysis was carried out in six Member States. The 
particular aim of this project was to develop models of good practice and to 
identify strategies and policies in a European context. 
AREA OF ACTIVITY 7: Coordination with other programmes dealing with 
HIV/AIDS 
In order to ensure coordination of the different Community programmes and policies 
relating directly or indirectly to the prevention of HIV transmission and the combating 
of AIDS, the Commission established an Interservice Group on AIDS, bringing together 
on a regular basis the various Directorates-General involved. This group met 4 times in 
1994 and 1995. These meetings make it possible to exchange information at regular 
intervals on the implementation of the programmes concerned, on measures in progress 
and on initiatives being prepared in the main areas: public health, prevention and 
education, research, the pharmaceuticals industry, cooperation with the developing 
countries, etc. 
OJ C 10, 16.1.1990, p. 3. 
21 
The Commission took an active part in the International Conference on AIDS held in 
August 1994 in Yokohama. A preparatory conference was organised in order to present 
the different Community programmes and certain other projects. The Commission was 
also represented by a stand in the exhibition hall. It ensured that many of the contractors 
who had obtained funding under the "Europe against AIDS" programme were present. 
Commission representatives also chaired working parties at the conference. 
At the end of 1995, arrangements were also made for the Commission to play a very 
active part in the International Conference on AIDS to be held in Vancouver in July 
1996: 
- direct participation by Commission representatives in the organisation of the 
conference and in the sessions; 
- a stand setting out the activities and achievements of the European Community 
in combating HIV/AIDS; 
a preparatory conference on "Public health - AIDS" in the European Community. 
IV. THE FIGHT AGAINST AIDS IN THE CONTEXT OF OTHER 
COMMUNITY POLICIES 
1. Research 
Medical research at EU level aims at: 
- pooling of data; 
- avoiding duplication of efforts; 
- standardisation of methods and reagents; 
better selection of cohorts for clinical trials; 
bringing together complementary skills in multi-faceted projects; 
improving training possibilities for young researchers in specialised fields; 
- improved exploitation of the results in the public health industry; 
creating better access to research results for all parts of Europe; 
establishment of European shared facilities for animal experimentation in order 
to reduce the overall number of animals used in experimentation; 
- increased cost-effectiveness. 
Ever since 1983, only two years after the first case of AIDS was diagnosed, the European 
Commission has taken an active role in the fight against the AIDS epidemic. Funding of 
research on AIDS began in 1987 under the Fourth Medical and Health Research 
Programme. The ambitions of the programme as well as the budget available have been 
significantly increased over the years. A total of 38 projects including several hundred 
research teams were funded under the BIOMED 1 programme (1990-1994). Within the 
framework of the BIOMED 2 programme (1994-1998), 13 AIDS-related projects were 
initiated in response to the First Call in 1995-1996. The current Second Call will add to 
this number. 
22 
The projects are all closely related to the three main priorities of the programme: 
- development of safe and effective vaccines against HIV infection; 
- development of therapeutic agents suppressing progression of the disease in 
infected individuals; 
- research on the epidemiology of the virus in Europe. 
Under the INCO international cooperation programme, and its section concerned with 
research into health in the developing countries, the Commission is supporting a number 
of important projects involving cooperation between European and African research 
teams. 
One of these multilateral projects, also supported by DG VIII, has become widely known 
as the Mwanza study; here, in Tanzania, it was shown that HIV transmission could 
effectively be halved in a population receiving screening and treatment for STDs, the key 
role of which in the transmission of HIV had been highlighted in earlier projects 
supported in Zaïre and, subsequently, in Kenya. 
A project aimed at defining criteria for qualifying for STD services, in order to establish 
the maximum level of efficiency, is under way in the Mwanza region, following up the 
first study. 
The first call for proposals also made it possible to select joint research projects into the 
dissemination of HIV sub-types in Africa and their significance, particularly with a view 
to developing vaccines. 
The Commission is also supporting a large-scale project in cooperation with, in particular, 
UNAIDS on the differential distribution of HIV in Africa. 
2, The policy of the Community with regard to AIDS in developing COUP'HPS 
In 1994 and 1995 the Commission continued its activities in connection with HIV/AiDS 
in developing countries. 
In a communication to the Council and the European Parliament'2, the Commission set 
out its priorities in terms of policy principles, strategies and actions with reg^d to 
HÎV/AIDS in developing countries. On this basis, the Council adopted a Resolution m 
May 1994 approving the guidelines proposed by the Commission. The Commissi-™ has 
also prepared a legal basis for the use of the AIDS budget line, This basis is under 
discussion in Parliament and the Council. 
COM 193) 479 final of 7 Jutuuy 1994. 
23 
The measures supported by the Commission, with resources from the European 
Development Fund and the budget, concentrated on the following main strategies: 
promoting an effective policy and actions to minimise sexual and perinatal 
transmission of HIV/AIDS and to prevent discrimination; 
breaking the "poverty-instability-HIV/AIDSM cycle by paying particular attention 
to population groups in risk environments (refugees, migrants, etc.); 
strengthening the healthcare and social sectors to enable them to bear the 
increasing burdens associated with the spread of the epidemic and its prevention; 
supporting governments in assessing and planning for the impact of the epidemic 
on the various economic sectors and social groups ; 
developing scientific knowledge of the epidemic, its impact and the possible 
interventions and responses, with the aim of improving the quality thereof. 
In general, the Commission is meeting regularly with experts from the Member States and 
a study on operational coordination on HIV/AIDS at headquarters and country level was 
launched. 
The Commission published an information brochure on the HIV/AIDS programme for 
developing countries as well as two books on safe blood in developing countries: "Safe 
blood in developing countries: Principles and organisation" - ISBN 92-827-5279-8; and 
"Safe blood in developing countries: The lessons from Uganda" - ISBN 92-827-5281-X. 
3. Activities in the pharmaceutical sector relating to AIDS prevention and 
treatment 
Two aspects of the fight against AIDS are currently being tackled in the pharmaceutical 
sector. The first relates to the rapid and simultaneous dissemination throughout the 
Community of medicinal products for AIDS patients. The second relates to measures 
taken to ensure, as far as possible, that medicinal products derived from human blood or 
plasma are free of the virus. 
1. Medicinal products for AIDS patients 
Until recently, the pharmaceutical approach for patients with AIDS and associated 
conditions was to use viral reverse transcriptase products which prevent replication of the 
virus. Three medicinal products of this type were authorised: zidovudine, ralcitabine and 
didanosine. 
The advent of protease inhibitors, which inhibit the enzyme which breaks down protein, 
represented a different approach, and the clinical benefit to patients looks promising. A 
number of companies have submitted applications for this type of medicinal product to 
the European Agency for the Evaluation of Medicinal Products (EMEA). 
24 
These applications will benefit from the newly introduced centralised procedure, 
providing access to the entire Community market. Following the scientific opinion of the 
EMEA, the Commission takes a decision which is valid for the whole Community. 
Medicinal products for AIDS are considered a priority for the EMEA and the Committee 
for Proprietary Medicinal Products, which is the scientific committee that evaluates the 
application and prepares the opimon. 
2. Safety of blood products 
Council Directive 89/3 81/EEC extended the scope of Community legislation on 
pharmaceutical products to cover stable blood derivatives of industrial origin, namely 
albumin, coagulants and immunoglobulins. As a result, these products are subject to the 
general provisions of the legislation relating to authorisation for manufacture and 
marketing. In addition, this Directive set out a number of measures relating more 
specifically to blood products, in particular compulsory measures for the selection and 
monitoring of blood donors recommended by the Council of Europe and the World 
Health Organisation. 
Improving the safety of blood products is a continuous process, developing with the state 
of knowledge and of techniques. In 1994, the Committee for Proprietary Medicinal 
Products (CPMP), on which the competent authorities of the Member States are 
represented, adopted a supplementary measure aimed at reinforcing the safety of blood 
products. This measure involves the compulsory introduction of plasma pool checks and 
the selection of the different donations. From 1 November 1994, it has been 
recommended that manufacturers of blood products test plasma pools for a series of viral 
markers, including the HIV-1 and HIV-2 antibodies. 
V. EVALUATION 
Ex-ante evaluation of proposals: 
Ex-ante evaluation of proposals submitted for funding under the programme was carried 
out in consultation with the programme committee. In this context, care was taken to 
select projects likely to contribute to achieving the objectives and activities set out in the 
1994-1995 action plan. The objectives of the programme as set out in the Decision of 4 
June 1991 are as follows: 
to develop exchanges of information and experience; 
to promote cooperation and coordination of national activities; 
to encourage Community activities. 
One of the three main criteria for ex-ante evaluation is the Community or transnational 
dimension of the project. Applying this criterion made it possible to select proposals 
likely to contribute to the overall objectives of the programme. 
25 
With regard to the implementation of the activities set out in the programme (detailed in 
the Annex to the Decision of 19 June 1995), the first criterion for ex-ante evaluation of 
proposals was aimed specifically at selecting projects which contributed directly to the 
carrying out of the activities set out in the Decision. 
In general, the result of ex-ante evaluation was that only between one quarter and one 
third of the proposals submitted to the Commission were adopted. 
In addition, it should be noted that, between the 1991-1993 action plan and its 1994-1995 
extension phase, the average financial significance of projects increased in parallel with 
the strengthening of their transnational dimension. 
Monitoring of projects: 
The contract terms relating to projects funded under the programme stipulate one or more 
interim reports and a final report on the execution of the project. Examination of these 
reports by the Commission makes it possible to verify that the work set out in the 
contract has been properly carried out; if necessary, the Commission can request 
adjustments. Verification of the work is a precondition for payment of the Community 
contribution. 
Ex-post evaluation of measures undertaken: 
Projects funded under the 1995 budget will, technically speaking, not be completed either 
administratively or financially until the end of 1996 or, in some cases, until some time 
during the first half of 1997. 
At the time this report was drawn up, it was therefore not possible to have an ex-post 
evaluation of the effectiveness of measures undertaken under the 1994-1995 action plan. 
To this end, the Commission intends to carry out an independent overall evaluation of the 
effectiveness of the measures undertaken once all activities have been completed. 
VI. CONCLUSION 
During the implementation of the "Europe against AIDS" action plan 1994-1995, three 
areas of activity under the programme (Nos 1, 3 and 5) accounted between them for over 
70% of the appropriations allocated and nearly two thirds of all projects. 
The area of activity relating to "attitudes and behaviour: information and awareness-
raising for the public" accounted for 25% of projects (20% of appropriations). This 
allocation of resources is justified if the vital importance of informing the public and the 
need to be aware of and bring about improvements in attitudes and behaviour as part of 
a global prevention strategy are taken into account. 
26 
Activities relating to the "prevention of HIV transmission among particular groups and 
in particular settings" represented 22% of all projects (26% of the budget). The 
importance attached to preventive measures aimed specifically at these groups and 
settings should be seen in connection with epidemiological data and their development 
during 1993-1995, as well as the analysis of methods of transmission (drug injection, also 
in relation to certain settings such as prostitution, prison, male homosexual relations, etc.). 
In the area of "epidemiological surveillance of HIV/AIDS and related fields", the 
programme also provided significant support: 22% of all projects (26% of the budget), 
reflecting the over-riding need for reliable epidemiological data at European level. This 
trend was emphasised in 1996 with the implementation of the new programme for the 
prevention of AIDS and certain communicable diseases (1996-2000). In this connection, 
there will be a case for measuring the effect of the development of surveillance measures 
for other communicable diseases at European level with regard to resources still available 
for HIV-AIDS prevention measures in the context of a total annual budget which remains 
relatively constant. 
The relative importance accorded to these areas of activity under the 1994-1995 action 
plan will of course be extended into the new programme on the prevention of AIDS and 
certain other communicable diseases (1996 to 2000) adopted on 29 March 1996 by the 
European Parliament and the Council13, the four aims of which are: 
- surveillance and monitoring of HIV/AIDS and other communicable diseases; 
- combating transmission of HIV and other sexually transmitted diseases, with 
particular regard to high-risk environments and behaviour; 
- information, education and training; 
- support for persons with HIV/AIDS and combating discrimination. 
At the end of the 1994-1995 "Europe Against AIDS" programme, it is possible to 
determine some of the main characteristics relating to the aims of the programme. 
Firstly, the 1994-1995 action plan aroused great interest among the various people 
involved in AIDS prevention in Europe, judging by the number of requests for 
information and the number of projects submitted to the Commission. 
The "Europe against AIDS" action plan thus made it possible to identify and mobilise 
those most involved in AIDS prevention who were likely to cooperate at Community 
level, for example universities, research institutes, non-governmental organisations 
(NGOs), national prevention or health education agencies, etc. 
As far as possible, the Commission encouraged full participation by all Member States 
in the activities of the programme. For some of them, particularly the new Member 
States, no national bodies received a grant in 1995. However, it should be noted that, in 
each of these Member States, organisations or institutions took part in projects or 
activities under the programme as associated partners (see diagrams in Annex III C). 
Decision 647/96/EC, OJ L 95, 16 April 1996, p. 16. 
27 
Finally, one aspect which deserves particular mention is the progressive affirmation of 
the Community or transnational dimension, and the fact that European cooperation 
networks have been established around specific topics relating to prevention. The new 
Community action programme (1996-2000) can thus count on the support of cooperation 
networks in areas such as: 
AIDS prevention in relation to prostitution; 
AIDS prevention in prisons; 
migrants and AIDS; 
AIDS prevention and cross-border problems, etc. 
The rapid developments currently under way in terms of therapies and antiviral medicinal 
products, given broad coverage at the International Conference on AIDS held in 
Vancouver in July 1996, have pushed back the boundaries of knowledge of this disease 
and opened up the possibility of remission in the longer term. It would certainly be 
wrong, however, to relax the efforts so far made with regard to prevention at both 
national and Community level. 
The first and only real bulwark against the scourge of HIV/AIDS is still, more than ever, 
prevention through information, education, the use of condoms and solidarity with the 
people affected. 
28 
ANNEX 1 
PROJECT EVALUATION CHART 
1. List number 
2. Selection criteria 
Clarity of stated aims 
Compatibility between work description 
and stated aims 
Quality of the method proposed 
Method of monitoring and evaluation 
Method of compiling the results 
Knowledge of the subject 
Transferability of the action 
Innovativeness 
Overlap with existing projects 
3. General assessment 
4. Financing proposed (expressed as a 
percentage of the total budget) 
5. Other remarks CATEGORY 
A B C D 
» 
ANNEX IIA 
DISTRIBUTION OF NUMBER OF PROJECTS AND TOTAL AMOUNTS COMMITTED PER AREA OF ACTIVITY IN 1994 
"EUROPE AGAINST AIDS" ACTION PLAN 1994-1995 
V AREA OF A&HWTY 
INFORMATION, ATTITUDES 
AND BEHAVIOUR 
MEASURES FOR CHILDREN 
AND YOUNG PEOPLE 
PREVENTION OF HIV 
TRANSMISSION 
SOCIAL AND 
PSYCHOLOGICAL SUPPORT 
GATHERING DATA ON 
HIV/AIDS 
COMBATING 
DISCRIMINATION 
COORDINATION WITH 
OTHER PROGRAMMES TOTAL AMOUNT 
COMMITTED PER AREA OF 
ACTIVITY IN ECU 
1 633 810 
1454 214 
810414 
662 447 
3 716 175 
301 422 
420 654 
TOTAL 1 8999136 FfRC^TAGE OF BUDGET 
COMMITTED PER AREA OF 
ACTIVITY 
18,16% 
16,16% 
9,01% 
7,36% 
41,29% 
3,35% 
4,67% 
100,00% NUMBER OF PROJECTS PER 
AREA OF ACTIVE 
12 
9 
7 
9 
14 
2 
6 
••^.^:•>^=: »-/f^^:-
ANNEX II B 
DISTRIBUTION OF NUMBER OF PROJECTS AND TOTAL AMOUNTS COMMITTED PER AREA OF ACTIVITY IN 1995 
"EUROPE AGAINST AIDS" ACTION PLAN 1994-1995 
AMAOFi^rrivny 
INFORMATION, ATTITUDES 
AND BEHAVIOUR 
MEASURES FOR CHILDREN 
AND YOUNG PEOPLE 
PREVENTION OF HIV 
TRANSMISSION 
SOCIAL AND 
PSYCHOLOGICAL SUPPORT 
GATHERING DATA ON 
HIV/AIDS 
COMBATING 
DISCRIMINATION 
COORDINATION WITH 
OTHER PROGRAMMES 
TOTAL TQTALAMOUNT 
COMMITTED PER AREA OF 
ACTIVITY IN ECU 
1 906 027 
432 649 
3 695 192 
771 056 
985 326 
714 446 
151 768 
8 656 464 PERCENTAGE OF BUDGET : 
COMMITTED PER AREA OF 
ACTIVITY 
22,02% 
5,00% 
42,69% 
8,91% 
11,38% 
8,25% 
1,75% 
100,00% 21 
10 
22 
10 
5 
3 
4 
••'.' •"' :y^'ifi^M^"-S;>i 
ANNEX m A 
DISTRIBUTION PER COUNTRY OF APPROPRIATIONS COMMITTED IN 1994 UNDER THE 1994-1995 ACTION PLAN 
£ COUNTRY 
B 
D 
DK 
E 
F 
GR 
I 
IRL 
L 
NL 
P 
UK 
T0TÀJ. 
SUPPLEMENTARY 
COMMITMENT FOR THE 
INTERNATIONAL 
CONFERENCE IN 
YOKOHAMA 
GRANDTOTAL NUMBER OF SUBSIDIES PER 
COUNTRY 
8 
1 
1 
3 
13 
6 
1 
3 
1 
4 
0 
17 
58 
1 
59 AMOUNT GRANTED IN ECU 
3 396 928 
6 024 
93 663 
217 879 
1 592 269 
501 203 
214 000 
228 243 
292 232 
564 011 
0 
1 887 472 
8993924 
5 212 
8 999136 PERCENTAGE OF BUDGET 
GRANTED PER COUNTRY 
37,70% 
0,10% 
1,00% 
2,40% 
17,70% 
5,60% 
2,50% 
2,40% 
3,20% 
6,30% 
0,00% 
21,00% 
y--^kj.ïïïÊ£&& 
0,10% 
W0»00% 
ANNEX III B 
DISTRIBUTION PER COUNTRY OF APPROPRIATIONS COMMITTED IN 1995 UNDER TEE 1994-1995 ACTION PLAN 
COUNTRY 
A 
B 
D 
DK 
E 
F 
GR 
I 
IRL 
L 
NL 
IP 
s 
|SF 
[UK 
ITOTAL 
(SUPPLEMENTARY 
[COMMITMENT FOR THE 
INTERNATIONAL 
[CONFERENCE IN 
[VANCOUVER 
K«MAJK8> 'TOTAL.-NUMBER OF SUBSIDIES PER 
COUNTRY 
0 
16 
6 
2 
9 
13 
3 
2 
0 
0 
5 
1 
0 
0 
17 
74 
1 
75 AMOUNT GRANTED IN ECU 
0 
1 765 158 
757 976 
148 163 
838 522 
2 004 868 
324 297 
257 980 
0 
0 
616 998 
77 809 
0 
0 
1 794 953 
8 586 724 
99 740 
8 686 464 GRANTED PWgL COUNTRY 
0,00% 
20,00% 
8,80% 
1,70% 
9,70% 
23,20% 
3,70% 
3,00% 
0,00% 
0,00% 
7,10% 
0,90% 
0,00% 
0,00% 
20,70% 
9M8% 
1,20% 
^yaMNMIH 
ANNEX IH C 
TRANSNATIONAL PARTNERSHD7S 
ESTABLISHED UNDER 
THE ACTION PLAN IN 1995 
2ft 
PARTNERS FOR GERMANY IN THE 6 PROJECTS LED BY IT WHICH RECEIVED A GRANT 
A B D DK E F GR I IRL L NL P S SF UK 
3> 
PARTNERS FOR DENMARK IN THE 2 PROJECTS LED BY IT WHICH RECEIVED A GRANT 
! ,\ II r> DK E F GR I IRL L NI. P S SF UK PARTNERS FOR BELGIUM IN THE a PROJECTS LED BY IT WHICH REVIVED A GRANT 
A B D DK E F GR I IRL L NL P S F- IK 
5 
4 
3 
2 
0 PARTNERS FOR SPAIN IN THE 9 PROJECTS LED BY IT WHICH HF.CF.IMJ) A 
1 1 " 1 CRAM 
1 
i 
A B D DK E F GR I IRL I. NL P S 
I'AK fMKS FOR FRANCE IN THE 13 I'KO.IF.CTS LEI) BY IT WHICH RECEIVE!) A GRANT 
A B D DK E F GR I IRL L NL P S SF UK 
» 
PARTNERS FOR iTALY IN THE 2 PROJECTS LEI) BY IT WHICH RECEIVE!) A GRANT 
I A B 0 DK E F GR I IRL L NL l> S SF UK PARTNERS FOR GREECE IN THE 3 PROJECTS LED BY IT WHICH RECEIVED A GRANT 
nr 
A B D DK E F GR I IRL L NL P S SF UK 
PARTNERS FOR PORTUCAL IN THE SOLE PROJECT LED BV IT WHICH RECEIVE» A GRANT 
A B D DK E F GR I IRL L NL P S SE IK 
PARTNERS FOR THE UNITED KINGDOM IN THE 17 PROJECTS LEI) HY IT WHICH RECEIVED A 
GRANT 
A B D DK E F GR I IRL L NL P S SF UK 
CP PARTNERS FOB TH£ M«TMK^APW IX TMC S PROJECTS JJ» »Y IT WMM3N BWOU* t» A «KANT 
A S D DK I raRIMLCMifS9FUK 
ANNEX IV 
EPIDEMIOLOGICAL DATA 1993-1995 
AIDS cases and rate f incidence per country and per year of diagnosis declared as at 31 December 1995, corrected for declaration deadlines 
% Country 
Germany 
Austria 
Belgium 
Denmark 
Spain CASES DECLARED 
YEAR OF DIAGNOSIS - •* 
1993 
Niimber 
1 766 
228 
245 
239 
5 172 
Finland 25 
France0 5 383 
Greece 158 
Ireland 
Italy 
Luxembourg 
Netherlands 
Portugal 69 
4 765 
20 
459 
498 
Sweden | 180 
United 
Kingdom 1 645 Rate 
21,8 
29,04 
24,4 
46,3 
103,9 
4,9 
91,1 
15,2 
19,6 
83,4 
50,6 
30,0 
50,6 
20,7 
28,4 1994 
Number 
1620 
161 
242 
234 
6 558 
44 
5 415 
192 
61 
5 405 
13 
450 
567 
180 Rate 
19,9 
20,3 
24,0 
45,2 
165,7 
8,7 
91,3 
18,4 
17,2 
94,6 
32,4 
29,2 
57,7 
20,6 
1565| 26,9 * 1995 
Number 
945 
161 
154 
201 
4 327 
36 
3 637 
156 Rate 
11,6 
20,2 
15,2 
38,8 
109,2 
7 
61 
14,9 
19i 5,3 
4 505 
15 
347 
395 
163 
1 024 78,8 
36,9 
22,4 
40,2 
18,6 
17,6 CASES CORRECTED FOR DECLARATION DEADLINES { . 
YEAROFPIAGISSfô 
1993 
Number 
1 816 
232 
248 
240 
5313 
25 
5 477 
165 
71 
4 828 
20 
461 
519 
181 
1 677 Rate 
22,5 
29,5 
24,7 
46,5 
134,5 
4,9 
92,7 
15,9 
20,1 
84,5 
50,6 
30,2 
52,8 
20,8 
29,0 l#M 
Number 
1 829 
171 
255 
239 
7 220 
44 
5 786 
228 
67 
5 650 
13 
460 • ™F ; 
22,5 
21,6 
25,3 
46,2 
182,5 
8,7 
97,5 
21,9 
18,9 
98,9 
32,4 
29,9 
661 67,2 
183! 20,9 
! i 
1693; 29,1 1995 
Number 
1 701 
202 
237 
233 
6 879 
39 
5 365 
239 
27 
6 079 
15 
474 
702 
191 
1 429 Rate 
20,8 
25,4 
23,4 
45,0 
173,6 
7,6 
90,0 
22,9 
7,6 
106,3 
36,9 
30,6 
71,5 
21,8 
24,5 " * _< Î * 
15 093 
1 551 
2 124 
1 872 
39 170 
230 
41948 
1422 
514 
33 701 
105 
3 979 
3 341 
1 356 
12 437 
Per million inhabitants 
14 Includes 324 cases with no known date of diagnosis 
0 Includes the Overseas Departments: Guadeloupe, French Guyana, Martinique and Réunion 
Source: European Centre for the Epidemiological Monitoring of AIDS - Quarterly Report No 33-1995/4 
ISSN 0254-1475 
COM(96) 720 final 
DOCUMENTS 
EN 05 
Catalogue number : CB-C0-96-732-EN-C 
ISBN 92-78-14124-0 
Office for Official Publications of the European Coinmunities 
L-2985 Luxembourg 
m