COMMISSION OF THE EUROPEAN COMVIUNITIES 
COM(94) 525 final 
Brussels, 25.11.1994 
"EUROPE AGAINST AIDS" PROGRAMME 1991-1993 
COMMISSION REPORT 
ON THE IMPLEMENTATION OF THE ACTION PLAN ES 
1993 
I. PREAMBLE 
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" programme (OJ L 175 of 4 July 1991). 
As required by this Decision, the Commission presented to the Council on 10 March 1993 
a report on the implementation of the plan of action in 1991 and 1992, so that the 
Council and the Ministers for Health could evaluate the effectiveness of the activities 
undertaken. 
This present Communication supplements the abovementioned report, detailing the 
activities undertaken by the Commission in each of the plan's ten areas of action in 1993 
and presenting conclusions on the impact and effectiveness of the programme so far. 
IL INTRODUCTION 
On 4 June 1991 the Council and the Ministers for Health of the Member States, meeting 
within the Council, adopted a Decision establishing the "Europe against AIDS" 
programme (OJ L 175 of 4.6.1991, p. 26). 
This public health programme, scheduled to run from 1991 to 1993, focused principally 
on preventive actions such as information and education. As required by the Decision, the 
Commission sent to the Council on 10 March 1993 a report on the implementation of the 
plan of action in 1991 and 1992, The Commission reported on the means deployed to 
achieve the objectives laid down in the Decision and commented on the early results 
obtained as well as on the relative weight and pertinence of the activities undertaken or 
requiring to be undertaken to give full effect to the aims of the Decision, set against the 
backcloth of the spread of the epidemic. The Commission also stated its view that there 
would be value in further actions on the public health aspects of HIV and AIDS being 
undertaken by the Community after the plan of action expired. 
Following consideration of the Commission's report, the Council and the Ministers for 
Health, at their meeting of 27 May 1993, agreed to invite the Commission to take the 
initiatives necessary for continuation of the actions of the "Europe against AIDS" 
programme in 1994, in anticipation of the entry into force of the Treaty on European 
Union, which provides in its Article 129 for Community action in the field of public 
health The subsequent evaluation in the Council of the effectiveness of the work 
undertaken concluded that the broad structure of the areas of action contained in the 
Council Decision could be maintained, but with a number of modifications in the 
objectives pursued, the introduction of new areas, and the deletion of others in order to 
reflect the changing needs of the Member States, increased knowledge of the problems 
posed by the disease, as well as its evolution and trends. 
In order to avoid any break in the actions carried out under the programme, and in order 
to respond to the wishes of the Council, the Commission submitted to the Council on 
29 September 1993 a proposal for a Decision concerning the extension to the end of 1994 
of the 1991-1993 plan of action in the framework of the "Europe against AIDS" 
programme. 
IIL IMPLEMENTATION OF THE PROGRAMME 
1. Criteria governing selection of projects submitted to the Commission 
The first criterion is whether the project sits within the general framework of the 
programme and relates to one (or more) of the programme's areas of action. 
Projects relating to non-Community countries or largely comprising research with 
no immediate practical application in the field of public health mus find 
themselves excluded. 
The second criterion is whether the project offers a '^Community added value", in 
contrast to a purely local value. There are various ways in which a project may 
offer such "Community added value", for example: 
if it is to take place in more than one Member State; 
if it involves organisations from various Member States; 
if it involves a subject of interest to the entire Community, such as 
international travel or migrations; 
if it adopts an innovatory approach to a specific problem and does not 
duplicate work already undertaken elsewhere. In this context, a purely 
national project could be supported if it were deemed to constitute a model 
which other Member States could apply, or if the results might be of direct 
relevance to other Member States. 
The third criterion is whether the project involves precise activities which can be prepared 
and implemented within a fixed period. The aim is to support pilot studies and projects 
rather than subsidise ongoing basic services. 
2. Hie Advisory Committee 
As required by Article 1 of the Decision, the Commission was assisted in the 
implementation of the programme's Actions by an Advisory Committee composed 
of representatives of the Member States. The Committee met three times in 1993, 
namely in February, June and September. Each project application received by the 
Commission was passed on to the Committee for evaluation, using an evaluation 
chart approved by the Committee (see Annex 1). Each committee member 
completes a chart for each project, using the ratings: A = Excellent; B = (Very) 
good; C = Average; D = Poor. Once the charts have been returned the points are 
then totalled up for each project using the following scoring system: A = 3 points; 
B = 2 points; C = 1 point; D = 0 points. The total obtained is then compared with 
the maximum score possible for the project, based on the number of responses 
received from the Advisory Committee. 
The Commission also published an invitation to tender in order to ensure that all 
areas of the programme were covered, since certain areas had either attracted no 
project applications or only applications which were deemed unsatisfactory. In 
selecting successful bids the Commission's internal tender-selection procedures 
were followed. These involve seeking the opinion of the Advisory Committee on 
Procurements and Contracts. The Advisory Committee for the AIDS programme 
was kept closely informed at every stage of the selection procedure. 
3. Project support by the Commission 
- Projects submitted to the Commission 
The bulk of the programme centres around providing financial support for projects 
undertaken in the Member States These are projects selected from applications 
submitted to the Commission by organisations engaged in or wishing to engage 
in AIDS-related work. 
The Commission received 160 such applications in 1993 and passed them on to 
the Advisory Committee. All were examined by the Committee, and 72 were 
selected for funding after receiving the Advisory Committee's approval. 
By way of comparison, only 78 projects were selected in 1991-1992 combined. 
This sharp rise in the number of projects funded in 1993 was due primarily to the 
increase in the budget (MECU 1.43 in 1991 and MECU 2.63 in 1992, compared 
with MECU 8.3 in 1993). In 1993, priority was given to funding a relatively small 
number of large-scale projects. 
In implementing the programme the Commission has tried to ensure a certain 
balance in the distribution of projects supported per Member State. However, the 
quality and price criteria applied during the selection process have sometimes 
made it impossible to keep that balance. All the same, projects have been 
supported in all Member States except Luxembourg. 
- Projects initiated by the Commission 
Experience with the implementation of the programme in 1991 and 1992 showed 
that certain areas of the programme had not been sufficiently developed (cf. Doc. 
COM(93) 42 final). These included: 
Examination of the results of surveys carried out in the Member States and 
at Community level on knowledge, attitudes and behaviour in respect of 
AIDS, and evaluation and dissemination of the results (Action I). 
Feasibility studies (Action 2): 
for coordinated Community action to foster the awareness of the 
general public and certain target groups, as a complement to the 
campaigns carried out in the Member States and, where 
appropriate, for the drafting of proposals for action; 
- for the drawing up of a European code, written in layman's 
language, and placing particular emphasis on non-discrimination 
against persons infected by the human immunodeficiency virus 
(HIV). 
- Development of exchanges of information on health education measures 
in schools and various training and apprenticeship structures; 
encouragement of exchanges of professionals and teaching materials, and 
fostering of cooperation through the organisation of specific seminars, 
intended particularly for teacher-training staff and geared towards the 
dissemination of new methods (Action 3). 
- Exchange of experience, evaluation and, where appropriate, promotion of 
"helplines" which respect the confidentiality of calls, and encouragement 
of appropriate ways of informing the public that such helplines exist 
(Action V). 
Examination of the parameters used in the Member States for identifying 
the health and social costs of managing HIV infection; feasibility study for 
developing common approaches in this area (Action 6). 
Appraisal of existing HIV cost-projection models with a view to planning 
social and health services and access to early treatment; feasibility study 
for a common approach (Action 6). 
- Survey on pre- and post-qualification training for public health workers 
and other health care, social support and counselling personnel working 
with HIV- positive persons and persons close to them, followed by an 
exchange of experience in this area (Action 8). 
A general invitation to tender was therefore published in the Official Journal of the 
European Communities on 18.6.1993 (OJ No C 167 of 18.6.1993, p. 19) in order to rectify 
these shortcomings. Ten projects were financed by the Commission on the basis of the 
responses to to this invitation to tender. 
IV. WORK CARRIED OUT UNDER EACH ACTION OF THE PLAN OF ACTION 
This chapter describes the work carried out under each Action, including projects funded 
and other types of activity. Since the Actions are all interlinked, however, many of the 
activities undertaken relate to several Actions. Thus, their attribution to a particular 
Action is, of necessity, somewhat arbitrary. (An analysis of expenditure on the 
programme is presented in Annex II). 
ACTION I: Assessment of the knowledge, attitudes and behaviour of the general 
public and target groups 
As in 1991-1992, the Commission supported a number of projects aiming to evaluate the 
knowledge, attitudes and behaviour of certain risk groups, such as injecting drug users. 
To obtain an overview of the various surveys and activities already completed or 
currently being carried out in Member States concerning knowledge, attitudes and 
behaviour with regard to the HIV/AIDS risk, the Commission financed two studies in this 
area, one relating to the general public and the other to specific target groups. The 
purpose was to gather all the information currently available, to make comparisons 
between Member States, and to reach conclusions regarding the general situation in the 
Community. 
As regards methodologies, the Commission supported two projects, namely: 
a project designed to improve methods for measuring and monitoring changes in 
knowledge, behaviour and attitudes through the use of trend charts containing a 
series of standardised indicators; 
the organisation of a seminar on the methods used in Member States for assessing 
the impact of preventive measures and strategies on the knowledge, attitudes and 
behaviour of the general public and target groups. This initiative envisages the 
setting up of a European network of university researchers and administrators 
involved in the assessment of preventive measures and strategies. 
The Commission also continued to support initiatives concerning the psychosocial and 
behavioural aspects of AIDS, through the organisation of a conference in Berlin and the 
updating of a guide cataloguing the activities carried out in this area within the European 
Community. 
ACTION 2: Informing and increasing the awareness of the public and certain target 
groups 
The Commission expanded its support for projects designed to strengthen information and 
prevention activities, cooperation between Member States and network schemes. 
As regards the general public, the Commission financed a feasibility study to 
examine possibilities for developing a coordinated, Community-wide public 
awareness campaign as a supplement to Member States' own campaigns. 
The Commission also financed a feasibility study for the creation of a 
computerised information system on HIV/AIDS to help general practitioners and 
pharmacists in their preventive work, as well as a feasibility study for a European 
code on AIDS prevention. 
As regards migrants, activities included: 
Support for the establishment of an information centre for certain 
immigrant communities to provide more in the way of information, 
guidance and support for these types of communities in Europe. 
Support for transnational activities designed to educate immigrants living 
in the European Community about HIV prevention and to influence their 
behaviour in this regard. These activities take account of the cultural 
practices of these social groups and seek to overcome the problems of 
intercultural communication. They involve establishing appropriate 
methods for educating these groups and increasing their awareness. 
Support was provided for the following two projects covering bom the general 
public and specific target groups. 
1. The collation and analysis by a specialist university institution of all 
information and prevention campaigns conducted in the twelve Member 
States, with a view to identifying the main themes, comparing campaigns 
and evaluating Member States' information strategies. 
2. The organisation of a seminar for administrators and communicators in the 
field of HIV prevention in the twelve Member States, to provide a 
platform for an exchange of experience in this area. 
ACTION 3: Health education for young people 
The Commission continued to finance the activities of the "AIDS and Youth" European 
Information Centre, which promotes exchanges and collaboration on AIDS prevention for 
the young people of the Community (whether at school or not). 
This Centre organises meetings and workshops on particular themes and publishes reports 
of its activities, with practical results and conclusions. 
The Commission also encouraged exchanges of information on health education initiatives 
in schools and in training and apprenticeship structures, and promoted exchanges between 
professionals, especially teacher trainers, through the organisation of seminars. In the 
same context, it financed a European conference on health education and HTV/AIDS 
prevention in schools. 
In addition, the Commission supported two peer education projects (projects in which 
peer group members act as informal teachers): 
A training programme for young workers, using theatre, art and music to 
communicate health and sex education messages to the young. Video cassettes of 
this training programme have been distributed in most Member States. 
- A project for the establishment of peer education programmes in schools and 
community settings, involving young people from different Member States (abroad 
on language courses during their summer holidays) and young people with HIV 
or AIDS. 
ACTION 4: Prevention of HIV transmission among certain groups and in particular 
contexts 
a) Travel and tourism: 
The Commission financed a feasibility study concerning the establishment of coordinated, 
Community-wide information and prevention campaigns for international tourists 
travelling within the European Community. The study is designed to reveal whether or 
not joint campaigns are practicable and to identify those categories of international 
tourists most likely to engage in high-risk behaviour. 
The Commission also focused on supporting the organisation of European campaigns to 
persuade young people travelling around the European Community to use condoms. 
b) Injecting drug users: 
As regards HIV prevention among drug users, funding was provided for a pilot prevention 
programme involving former drug users in a health education campaign, and for a project 
to give drug users travelling around in the Community more information about and more 
access to Member States' information and treatment facilities. 
c) Women particularly exposed to the risk of HIV contamination: 
The Commission financed the activities of a European network on AIDS Prevention for 
Prostitutes (EUROPAP). The network's aims are to support and extend Member States' 
existing initiatives in this area, to develop a common methodology for evaluating such 
initiatives, and to develop a standardised intervention protocol which could be used at 
Community level. Also supported was a study of the problem of cross-border mobility 
and HIV prevention, particularly as regards the Community's borders with the former 
countries of Eastern Europe, with a view to identifying the most appropriate preventive 
methods. 
d) Other populations with high-risk habits: 
Support was provided for prevention programmes promoting the use of condoms among 
risk groups such as homosexuals and male bisexuals. 
On the basis of earlier pilot experiments in transnational cooperation in this area, a 
working party was set up in order to coordinate initiatives, optimise the use of the media* 
vectors identified, and identify the most effective ways of promoting condoms. 
ACTION 5: Social support, counselling and medical treatment 
The Commission supported the following projects in the area of social support, 
counselling and medical treatment for people with the HIV virus: 
1 The preparation of a European self-care manual for persons with HIV and AIDS. 
Tailored to the particular social and medical context of each Member State, the 
handbook endeavours to meet each individual's specific requirements and is based 
on the pooled experiences of professionals involved in social support, counselling 
and medical care for people with HIV and AIDS. 
2. The establishment of a European support network for families and children 
infected with the virus, designed to identify their needs, promote contacts and 
cooperation between the agencies helping these people, and develop appropriate 
programmes and policies. 
3. Identification of the social support and counselling needs of specific categories of 
people infected with the virus, such as migrants. 
As regards the promotion of telephone helplines, two projects were supported: 
1. A general study of existing helplines, the ways in which they operate, and their 
respective advantages and drawbacks. 
2. A seminar for the seven existing telephone helplines in the Member States, with 
a view to setting up an exchange of experience and examining ideas for 
cooperation between them. 
Also in this area, the Commission continued to support non-governmental 
organisations in developing exchanges of experience and setting up networks, 
particularly with organisations in the southern regions of the Community which 
are not yet so fully mobilised. 
The Commission thus contributed towards improving the dialogue between 
homosexuals, health professionals and government agencies. 
ACTION 6: Estimating the cost of managing HIV infection 
Financial support was provided for an International Conference on the Econometrics of 
AIDS, attended by experts from all Member States. The discussion ranged over the most 
recent quantitative analyses of the epidemic and its socio-economic impact. 
Funding was also provided for two feasibility studies concerning the establishment of a 
common methodology for evaluating the costs of HIV: 
1. The first looks at the feasibility of developing common approaches concerning the 
parameters used by Member States for determining the health and social costs of 
HIV infection, the type of data collection, the national networks concerned and 
the parties involved. 
2. The second begins with an appraisal of Member States' existing HIV cost 
projection models, followed by an assessment of the potential for common 
approaches, their advantages and disadvantages, and their precise objectives. 
ACTION 7: Gathering data on HIV/AIDS 
The Paris Centre continued to receive funding for the operation and development of the 
European system for the epidemiological monitoring of HIV and AIDS. The most recent 
epidemiological data concerning the progression of AIDS within the European 
Community are presented in Annex III. 
In the course of the year four quarterly reports were produced on AIDS monitoring in the 
European Community, and a study was made of ways of improving the usefulness of the 
data and making sure they reached the widest audience. 
Additionally, the Centre is required to produce reports for the Commission on the 
following themes: 
Evaluation of the methods used to measure HIV prevalence in Europe. 
Analysis of the epidemiological data on HIV/AIDS using repeated prevalence 
studies. 
Collection of data concerning the observation of specific diseases linked to HIV, 
such as tuberculosis and certain sexually transmissible diseases. 
Support was provided for a number of actions relating to the collection at European level 
of HIV/AIDS data, so that health professionals and researchers wishing to conduct 
documentary research can have easier access to such data. These actions include the 
production of thesauri and the establishment of computerised bibliographical databases. 
10 
ACTION 8: Enhancement of human resources 
The Commission supported a questionnaire survey on the training given in each Member 
State to public health workers and other professionals involved in the care and support 
of people with HIV. This survey will identify the strong points, weak points and 
shortcomings of the various training systems an,d will produce recommendations. 
Support was given for projects relating to the promotion of training (including course 
materials) for personnel involved in the health care, social support and counselling of 
HIV-positive persons. Examples include the production of an AIDS prevention training 
handbook for dentists (distributed in all Member States) and the incorporation of AIDS 
prevention modules into training courses for social workers, nurses and doctors. 
The Commission also assisted in the organisation of exchanges of experience for these 
professionals, via the organisation of summer schools and conferences (for example a 
symposium in Edinburgh open to all professionals involved in AIDS prevention among 
prostitutes). 
ACTION 9; Measures to combat discrimination against HIV-infected persons and 
persons close to them 
The Commission funded a comparative analysis of Member States' AIDS laws from the 
ethical and legal points of view. The project will provide an overview of the current 
situation in the twelve States in areas such as screening, confidentiality and reporting of 
the disease, patients1 rights to treatment, AIDS and imprisonment, and restrictions on 
freedom of movement and immigration. 
The Commission also expects this project to provide guidelines for any future Community 
initiative on AIDS. 
Funding was provided for a conference on the social and ethical problems raised by 
screening for genetic diseases and AIDS, and on the role of politicians and the media in 
this area. 
The Commission also supported cultural events and audiovisual productions to help 
combat discrimination against people with HIV. The cultural events took place in several 
Member States, in order to reach as wide a public as possible, while the audiovisual 
productions were broadcast on television 
ACTION 10: Research and international cooperation 
Close liaison has been established with specific programmes included in the Framework 
Programme for Research and Technological Development and with the support 
programme for developing countries, including regular meetings and exchanges of 
information. An important result of this cooperation has been the financing of activities 
which originally began as research projects but which have since developed into public 
health actions. One example is the setting up of the European network on AIDS 
11 
Prevention for prostitutes. This network today benefits from the expertise and information 
acquired in the course of a "concerted action" carried out under the BIOMED research 
programme. 
In the field of international cooperation, the main emphasis has been on working with the 
Council of Europe and the World Health Organisation. 
Cooperation with the World Health Organisation has taken a number of forms: the 
Commission and WHO have been jointly involved in a number of projects and activities, 
such as the work of the Paris Centre, the funding of the Eurocaso network and the work 
of the Berlin Sociopedagogical Centre on the links between cross-border mobility and the 
prevention of HIV transmission. The Commission and WHO have also supported various 
international conferences and symposia. 
The Commission participated in the meetings of the Management Committee of the WHO 
Global Programme on AIDS. 
Finally, the Commission subsidised and participated actively in the International 
Conference on AIDS held in Berlin in June 1993. 
V. THE FIGHT AGAINST AIDS IN THE CONTEXT OF OTHER COMMUNITY 
POLICIES 
1. Research 
The establishment of the Biomedicine and Health Research Programme (BIOMED 1 ) 
under the third Framework Programme has enabled more than 6 000 research teams to 
collaborate with each other within 400 networks set up to encourage cooperation between 
research teams throughout the European Union and the European Economic Area and 
between complementary disciplines, with a view to tackling health problems which would 
be difficult to resolve in a more limited context. 
Significant progress has been achieved in the fight against AIDS thanks to AIDS research 
supported and coordinated by the Community However, the immunosuppression caused 
by HIV can lead to the resurgence of old diseases, some of which may already be 
resistant to drugs, and the emergence of opportunistic cancers. 
The specific programme of research and technological development in the field of 
biomedicine and health focused on the following areas: 
- viro-immunological research, genetics, and the molecular and structural biology 
of EtIV and its variability; 
- research towards the development of a safe and effective vaccine against AIDS, 
and of markers to evaluate its effectiveness and to monitor the evolution of the 
disease; 
12 
the identification, synthesis and evaluation of anti-viral components and of drugs 
designed to combat AIDS; 
clinical research centred on clinical trials, the treatment of AIDS and its 
opportunistic diseases, including research of the prognosis and progression of 
these diseases and the impact of treatment; 
- studies of host response, pathogenesis, experimental models and new pathologies, 
and of resistance to conventional forms of therapy, taking into account the 
problem of hospital infections. 
2. The policy of the Community and the Member States with regard to AIDS in 
developing countries 
The policy of the Community and the Member States with regard to AIDS in developing 
countries has been directed towards: 
the introduction of comprehensive and efficacious measures designed to reduce 
the spread of HIV and other sexually transmissible diseases through sex or 
mother-to-child transmission, or through blood, 
the taking into account of the HIV/AIDS problem when formulating health 
policies and other social policies, and in particular the inclusion of measures for 
the prevention and treatment of HIV/AIDS and STDs at the various levels of the 
health pyramid; 
- the creation of instruments for evaluating the potential impact of development 
projects on HIV/AIDS transmission; 
- support to help governments evaluate the potential socio-economic impact of 
AIDS and to ensure that the planners take due account of this factor, notably by 
allocating adequate budgets for the various sectors concerned. 
Increased efforts to coordinate activities planned under the EC7ACP AIDS programme 
with those developed by the United Nations and those under bilateral aid arrangements 
have included regular exchanges and a concerted action (participation in meetings of the 
Management Committee of the WHO's Global Programme on AIDS and in the work of 
that programme's Task Force for the improvement of coordination). 
The Commission also organised regular consultations with Member States' experts. On 
the basis of the work performed by the experts, the Commission drafted and adopted a 
Communication to the Council setting out the basic principles and priority strategies of 
the AIDS policy to be adopted by the Community and Member States in the developing 
world. This Communication was the subject of a Resolution by the Development Council 
in May 1994. 
In the area of scientific research, the EC/ACP AIDS programme has contributed towards 
improving the balance between biomedical research and socio-economic research, 
reinforcing the research capacities of national and regional research institutes in 
developing countries, and making more use of research results in order to ensure that the 
findings are rapidly put into practice. 
13 
3. Activities in the pharmaceutical sector relating to AIDS prevention and treatment 
Two aspects of AIDS problem have been tackled in the pharmaceutical sector. 
The first concerns provisions to guarantee as far as possible the safety from viral 
contamination of medicinal products derived from blood or plasma. Since 1989 these 
products have had to comply with the provisions governing the production and placing 
on the market of medicinal products. Moreover, the measures recommended by the 
Council of Europe and WHO for the selection and monitoring of blood donors have 
become compulsory, as has the application of validated manufacturing and purification 
processes in order to guarantee as far as possible the absence of viral contamination. The 
Committee for Proprietary Medicinal Products, on which the competent authorities of the 
different Member States are represented, has adopted recommendations to producers to 
help them ensure the safety of their products from viral contamination. A group of experts 
meets regularly in order to assess the situation concerning the safety of blood-derived 
products and, where necessary, to suggest additional measures to the competent 
authorities. -
The second aspect tackled concerns measures to give patients speedy access to anti-HIV 
and anti-AIDS drugs as and when they become available. In 1993, on a proposal from the 
Commission, the Council adopted provisions for the introduction of a new, centralised 
procedure for the free movement of medicinal products. Because they fall into the 
category of high-technology medicinal products, anti-HIV and anti-AIDS drugs are 
covered by this centralised procedure and can thus be made speedily available in all 
Member States. 
VL CONCLUSIONS 
It should be stressed that when this report was being drafted the vast majority of the 
projects initiated in 1993 were still under way. It is thus not yet possible to make a 
detailed evaluation of the effectiveness of the Actions undertaken, either individually or 
collectively. All that can be provided at the moment is a description of how the Actions 
have been implemented, together with a broad assessment of the programme's impact and 
value. 
Activities have been carried out under all ten Actions of the Plan of Action. Comparison 
of the 1993 expenditure breakdown (Annex II) with the 1991-1992 breakdown (Annex 
II of document COM (93) 42 final) reveals: 
1. the same disparities in terms of the number of projects financed under each Action 
and the corresponding expenditure per Action. 
a) Actions concerning prevention and actions concerning social support and 
counselling took the largest percentages of the total budget in 1993, as 
they did in 1991-1992. Actions concerning social support and counselling 
took a fifth of the total budget in 1993, and actions concerning prevention 
a quarter, while in 1991-1992 they each took 20%. 
14 
b) Actions to estimate the cost of HIV/AIDS continue to take the smallest 
share of the total budget (2% in 1993, compared with 3% in 1991-1992). 
2 differences as regards the implementation of certain Actions: 
a) It was established that actions to inform and increase the awareness of the 
public and certain target groups were one of the most important elements 
in the fights against HIV/AIDS, and their share of the total budget has 
therefore more than doubled, rising from 6% in 1991-92 to 14% in 1993. 
b) Actions to gather data on HIV/AIDS, while still being under-represented, 
increased from 3% to 6% of the total budget. This was the result of the net 
being widened to include not only epidemiological data but also objective 
indicators of the effectiveness of prevention campaigns (Member States are 
now beginning to find a consensus on the content of such campaigns). 
c) Actions concerning the enhancement of human resources saw their share 
of the total budget halved, from 19% m 1991-1992 to 9% in 1993, even 
though the number of projects remained similar (12 in 1991-1992, 10 in 
1993). This is mainly because the projects supported were less ambitious 
and thus less expensive, priority having been given to activities on the 
ground. 
3. changes in the categories of activities financed: 
a) Fewer conferences and congresses than the Advisory Committee had hoped 
for: 15 m 1991-1992 (17% of the total budget), but only 7 in 1993 (7% of 
the total budget). 
b) More surveys and more comparative analyses, only 5 in 1991-1992 (12% 
of the total budget), compared with 11 in 1993 (21% of the total budget). 
c) A doubling in the number of education and prevention campaigns: 6 in 
1991-1992 (10% of the total budget), compared with 12 in 1993 (18% of 
the total budget) 
Experience in implementing the programme in 1991 and 1992 revealed a number of areas 
in which the programme's effectiveness could be further improved. 
In 1993 the Commission took steps to: 
- open the programme up more: 
* by having all projects submitted to the Commission assessed by the 
Advisory Committee, in accordance with the procedure described 
in section III; 
* by providing the Advisory Committee with full details of all 
projects financed; 
- assess the impact of the work undertaken and broadcast the results of this 
assessment more effectively; 
15 
focus efforts in particular areas: 
* by improving the implementation of Actions which had remained 
relatively undeveloped in 1991-1992; 
* by financing only a limited number of small-scale projects and 
concentrating instead on large-scale projects involving as many 
Member States as possible. 
On the basis.of the work carried out under the programme so far, the Commission is 
certain that the "Europe against AIDS" programme has made a valuable contribution to 
the fight against AIDS. Since AIDS continues to represent a major, and growing, threat 
in Europe, the Commission took the necessary measures in 1993 to ensure that the 
programme's activities would be continued in 1994, taking account of the experience 
acquired during implementation of the programme to date. 
The entry into force of the Treaty on European Union, and particularly Article 129 
thereof, has given the Community the instruments it needs to pursue the fight against 
AIDS within the general framework of the Community's activities in the field of public 
health. The fight needs to be pursued within the framework of a pluriannual programme 
which can be adjusted in the light of regular impact assessments. 
16 
ANNI'X I 
PROJECT EVALUATION CHART 
1 .List number. 
2 Selection 
criteria: 
Clarity of slated 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 
Innovât iveness 
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 
-1) 
17 
ANNEX II 
ANALYSIS OF PROGRAMME EXPENDITURE 
PROJETS BY CATEGORY: This table categorises the projects supported according to the kind of activity 
involved 
. ' • • .... • •. ' '— . — , i , i 
CATEGORY NUMBER OF PROJECTS PERCENTAGE OF 
TOTAL BUIXII; f <I) 
ICONFERENCES and CONGRESSES 7 7% 
II SEMINARS 5 4% 
WORKSHOPS 
MEETINGS 
III. SURVEYS.- II 21% 
IV. EVALUATIONS 6 7% 
V. NETWORKS 4 5% 
VI. SERVICES 
A. TRAINING 2 1% 
B. PSYCHO-SOCIAL 4 11% 
C. CARE 
VII DATA COLLECTION 4 8% 
VIII .PREVENTION AND EDUCATION 12 I«% 
CAMPAKiNS 
IX INFORMATION 12 14% 
X. OTHERS 5 4% 
PROJECTS BY ACTION: This table categorises the projects supported under each Action of the Plan of Action. 
Many projects relate to more than one Action and have therefore been categorised according to the primary 
Action concerned. 
ACTION NUMBER OF PROJECTS PERCENTAGE OF TOTAL 
BUDGET (1) 
1 6 9% 
2 II . 14% 
3 6 10%, 
4 10 24%> 
5 II 19% 
(> • .1 ' 2% 
7 4 6% 
8 10 9% 
0 6 4%) 
10 2 3% 
TOTAL 72 100% 
(1) Percentage rounded to the nearest whole number 
18 
ANNEX III 
Cumulative total of AIDS cases reported among adults/adolescents* in the European Community by 30 June 1994 , broken down by country and transmission group* 
Country 
European 
Community 
Belgium 
Denmark 
France 
Germany 
Greece 
Ireland 
Italy 
Luxembourg 
Netherlands 
Portugal 
Spain 
United 
Kingdom 
EC Total Homosexual/ 
bisexual 
males 
N 
670 
1054 
14935 
7859 
498 
136 
3314 
44 
2370 
665 
3899 
6917 
42361 % 
42.4 
72.3 
48.4 
69.0 
52.6 
34.2 
14.6 
54.3 
76.0 
34.6 
15.5 
74.5 
38.9 Drug addicts 
N 
104 
97 
7317 
1510 
40 
177 
14929 
14 
296 
519 
16537 
518 
42058 ''•'o 
6.6 
6.7 
23 7 
13.3 
4.2 
44.5 
65.7 
17.3 
9.5 
27.0 
65.8 
5.6 
38.6 Homosexual/ 
bisexual 
drug addicts 
N 
16 
14 
462 
99 
9 
8 
508 
0 
30 
0 
536 
149 
1831 % 
1.0 
1.0 
1.5 
0.9 
1.0 
2.0 
2.2 
0.0 
1.0 
0.0 
2.1 
1.6 
1.7 Haemophiliacs/' 
Coagulation 
disorders 
N 
5 
33 
379 
415 
63 
27 
217 
48 
40 
477 
405 
2112 % 
0.3 
2.3 
1.2 
3.6 
6.7 
6.8 
1.0 
3.7 
1.5 
2.1 
1.9 
4.4 
1.9 Transfusion 
recipients*** 
N 
86 
24 
1393 
225 
45 
0 
263 
-> 
33 
64 
229 
91 
2455 % 
5.4 
1.6 
4.5 
2.0 
4.8 
0.0 
1.2 
2.5 
1.1 
3.3 
0,9 
1.0 
2.3 Heterosexual 
contact 
N 
681 
195 
4691 
689 
100 
45 
2415 
10 
294 
520 
2016 
1098 
12754 % 
43.1 
13.4 
15.2 
6.0 
10.6 
11.3 
10.6 
12.3 
9.4 
27.0 
8.0 
11.8 
11.7 Nosocomial 
infection 
N 
0 
0 
0 
0 
0 
0 
0 
0 
0 
0 
0 
0 
0 .'0 
0.0 
0.0 
0.0 
0.0 
0.0 
0.0 
0.0 
0.0 
0.0 
0.0 
0.0 
0.0 
0.0 Other/ 
Indeterminate 
N 
18 
41 
1653 
599 
191 
5 
1074 
8 
47 
116 
1444 
105 
5301 % 
1.1 
2.8 
5.4 
5.3 
20.2 
1.3 
4.7 
9.9 
1.5 
6.0 
5.7 
1.1 
4.9 TOTAL 
1580 
1458 
30.830 
11396 
946 
398 
22720 
81 
3118 
1924 
25138 
9283 
108872 
Cases aged 13 years or over (46 cases of unknown age could n6t be classed either as adults'adolescents or as infants) 
** Following case reclassification, the figures per transmission group have been modified in certain countries 
*** Includes patients having received transplants or blood products 
19 
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