No C 13/6 Official Journal of the European Communities 19. 1.91 
thirdly, expanding the promotion of cooperation and 
partnership between enterprises, especially small and 
medium-sized ones, in the different regions of the 
Community and the different sectors of economic 
activity, and opening up external markets to them. 
Consequently, for the period 1990 to 1993, a further 
amount of ECU 25 million, as provided for in Article 7 
THE COUNCIL AND THE MINISTERS FOR HEALTH OF 
THE MEMBER STATES, MEETING WITHIN THE 
COUNCIL, 
Having regard to the Treaty establishing the European 
Economic Community, 
Having regard to the proposed decision submitted by the 
Commission, 
Having regard to the opinion of the European 
Parliament, 
Having regard to the opinion of the Economic and 
Social Committee, 
Whereas, the increase in the AIDS epidemic is of major 
concern to Member States and the Community; 
Whereas the resolution of the European Parliament of 
30 March 1989 on the fight against AIDS called on the 
Commission for action in particular in the fields of infor­
mation and training of health professionals; 
Whereas the resolution of the representatives of the 
governments of the Member States, meeting within the 
Council, of 29 May 1986, on AIDS, requested the 
Commission to organize an exchange of information and 
experience; 
Whereas the resolution of the Council and of the 
Ministers of Education meeting within the Council of 23 
November 1988, concerning health education in schools, 
expressed concern about the high incidence of AIDS, 
and invited the Commission to undertake a series of 
actions at Community level; of Decision 89/490/EEC, is deemed necessary in order 
to achieve the aims set out in Article 1. 
The appropriations for implementing the programme 
shall be determined each year under the budgetary 
procedure. 
This Decision shall be published in the Official Journal of 
the European Communities. 
Whereas the conclusions of the Council and Ministers 
for Health of the Member States, meeting within the 
Council of 16 May 1989, regarding the prevention of 
AIDS in intravenous drug users, requested the 
Commission to prepare and submit to the Council a 
programme in this area; 
Whereas the conclusions of the Council and the 
Ministers for Health of the Member States, meeting 
within the Council of 16 May 1989, on the improvement 
of the general system for collecting epidemiological data, 
including the application of the new definition of AIDS 
cases, asked the Commission to compare the system for 
recording notifications of AIDS cases at national and 
Community level in order to pinpoint where the 
improvement of coverage can take place, as well as the 
reliability and the comparability of the data used; 
Whereas the conclusions of the Council and the 
Ministers for Health of the Member States, meeting 
within the Council of 16 May 1989, regarding future 
activities on AIDS prevention and control at Community 
level called upon the Commission to examine the possi­
bilities for harmonization with regard to condoms and 
HIV self-testing kits; 
Whereas the resolution of the Council and Ministers for 
Health of the Member States, meeting within the 
Council of 22 December 1989, on the fight against 
AIDS, requested the Commission to develop exchanges 
of information and experience defining in priority the 
details and contents of an action plan integrating appro­
priate measures to prevent and control AIDS; Article 2 Article 3 
Proposal for a decision of the Council and the Ministers for Health of the Member States 
meeting within the Council adopting a plan of action in the framework of the 1991 to 1993 
'Europe against AIDS' programme 
COM(90) 601 final 
(Submitted by the Commission on 11 December 1990) 
(91/C 13/06) 
19. 1. 91 Official Journal of the European Communities No C 13/7 
Whereas the conclusions of the Council and the 
Ministers for Health of the Member States, meeting 
within the Council, of 17 May 1990, on medical and 
psycho-social care services in relation to the AIDS 
epidemic, requested the Commission to examine the 
feasibility of developing a consistent approach to costing 
the management of care for HIV-seropositive persons; 
"Whereas the present plan of action for the programme 
'Europe against AIDS' contains the aforementioned 
requests; whereas it also contains other measures 
intended to contain the AIDS epidemic, 
HAVE DECIDED AS FOLLOWS: 
Article 1 
1. The Commission shall implement the 1991 to 1993 
action plan set out in the Annex in close coordination 
with the competent authorities of Member States. 
2. The Commission will cooperate with International 
Organizations active in this field such as the WHO and 
the Council of Europe. 3. The Commission will regularly publish technical 
information on the progress of the action plan. 
Article 2 
1. The Community funds required for the work to be 
undertaken under this Decision shall be determined by 
the budget authority within the context of the appropri­
ations available for each year. 
Article 3 
1. The Commission will continuously assess the action 
undertaken and the priorities taking into account 
emerging urgencies. 
2. The Council and the Ministers for Health of the 
Member States meeting within the Council will carry out 
an evaluation of the effectiveness of the actions 
undertaken. To this end the Commission will submit a 
report on the subject during the second half of 1992. 
ANNEX 
CHAPTER I 
INFORMATION AND HEALTH EDUCATION IN THE PREVENTION OF HIV INFECTION 
The importance of prevention cannot be stressed enough as there is no vaccine nor effective treatment 
available. The Member States have been active for several years in promoting information and health 
education for the general public in this field. It is of fundamental importance to continue this work in 
order to ensure the success of prevention efforts. 
Different approaches are used in the Member States in preventive strategies and prevention intervention 
methods are under development and evaluation. This diversity of approach can be used to maximum 
benefit if there is an interactive knowledge of what is being done. Therefore, exchanges of information are 
necessary and need to be promoted. 
A key role at Community level is to facilitate exchanges of experience, to evaluate results and to promote 
new approaches, so that the most effective approaches can be promoted taking into account local needs 
and characteristics. 
Health education in schools is an essential part of health promotion, and within the limits of specific 
national educational policies and structures, appropriate arrangements should be made for coordinating 
health-promotion measures, so that health education can be seen by children as a practical part of their 
lives. 
No C 13/8 Official Journal of the European Communities 19. 1.91 
Repeated efforts are necessary for prevention messages to be retained by the public and relevant target 
groups. This will help them develop a real understanding of AIDS problems and their consequences, in 
order to contribute to a change in their attitudes. 
Simple messages can increase the general public's awareness, and can improve the efficiency of an AIDS 
prevention information campaign, in particular by the use of a European code against AIDS which will 
take into account the work already carried out in the Council of Europe ('). 
Objectives: 
— to prevent the spread of the epidemic by providing information on HIV risk factors, and therefore to 
avoid discrimination and stigmatization of HIV seropositive persons, 
— to monitor attitudes towards AIDS in the general population of the Community. 
Action 1: Informing the public about AIDS prevention campaigns 
Member States have already gained valuable experience in the use of publicity campaigns to inform the 
public about AIDS. A survey of current AIDS prevention campaigns will be carried out with a view to 
improving the existing campaigns and to designing more effective ones in the future. 
At Community level, a publicity campaign will need to take into account the experience of the Member 
States in order to ensure maximum impact on the general public, resulting in increased awareness. This 
campaign will also aim at providing information to prevent discrimination against HIV seropositive persons 
and AIDS sufferers. 
The public and private organizations involved in the fight against AIDS will be closely associated with the 
preparation and implementation of this action. Broad coverage will be given to the results of the actions. 
With the help of appropriate experts, the Commission will establish a European code against AIDS and 
ensure its transformation into layman's language. Dissemination of the code will be made in all appropriate 
fora, including schools and the workplace. 
Action 2: Prevention of HIV infection and health education in schools 
Exchanges of information will be encouraged and supported within the framework of health education in 
schools. Specific seminars for teachers from the Member States will provide not only an opportunity for 
exchanging experiences and knowledge but also lay down the foundations for broader cooperation. 
Where appropriate, exchanges of teaching materials produced in Member States on health education 
related to AIDS and HIV infection will be promoted and supported. 
Action 3: Eurobarometer surveys on AIDS and its prevention 
Repeated monitoring of public opinion and attitudes is necessary in order to assess the effectiveness of 
prevention efforts. 
Regular updating of Eurobarometer surveys will be carried out in close cooperation with European 
specialists in this field so as to determine to what extent Europeans are informed about AIDS issues and 
prevention. 
.(') In particular recommendation No R(87) 25 of the Committee of Ministers concerning a common European public 
health policy to fight the Acquired Immunodeficiency Syndrome (AIDS) adopted on 26 November 1987 and recom­
mendation No R(89) 14 of the Committee of Ministers on the ethical issues of HIV infection in the health care and 
social settings adopted by the Committee of Ministers on 24 October 1989. 
19. 1.91 Official Journal of the European Communities No C 13/9 
CHAPTER 2 
PREVENTION AND TREATMENT, SOCIAL CARE AND COUNSELLING 
Clinical trials have shown that the available treatments do not cure the disease although they do appear to 
delay its onset. New approaches are under development and evaluation. Persons with AIDS need specific 
care, in particular the rapid treatment of multiple infections due to immunodeficiency. 
Counselling is an important element in both care and preventive strategies. Intravenous drug users are a 
high-risk group for which treatment and social care are of particular importance. 
Objectives: 
— to improve medical and psycho-social support to HIV-positive and AIDS symptomatic drug users, 
— to make counselling more accessible to all HIV-positive people, 
— to prevent the spread of HIV infection among drug users, their sexual partners and offspring, 
— to reduce HIV transmission in blood and blood based products. 
Action 4: Exchanges of experience on counselling and treatment services 
Accessibility to counselling services, as well as telephone directories and other telephone information 
systems, are necessary to assist both HJTV seropositive persons and AIDS sufferers. 
Crisis intervention helplines are increasingly available in Member States. The first European Conference on 
AIDS hotlines, which took place in Amsterdam (April 1989), has demonstrated their effectiveness not only 
in providing support in cases of crisis but also to serve as an anonymous personalized information system. 
This could lead to the establishment of a Community-wide directory of helplines. This should be done in 
close coordination with drug helplines, since HIV-seropositive and AIDS symptomatic drug users may have 
recourse to both systems. 
With the growing mobility of people in the European Community, there is a need to promote exchanges of 
experience between health care professionals on treatment services and medical care, so that they can cope 
better with an increasing number of patients coming from different cultural backgrounds. 
Appropriate means will be established for exchanges of experience, and to develop effective treatment 
methodologies. That could lead to a European guide of medical care and treatment facilities, which can be 
used further by Member States and the Commission to promote exchange visits. 
Action 5: Development of models for the costing of the management of AIDS 
It is foreseen that there could be 150 000 persons with AIDS in the European Community in 1992. The 
average yearly cost for an AIDS patient has been estimated as being of the order of ECU 20 000 for 
medication, hospitalization, home care and psycho-social support. Thus ECU 3 billion will be required in 
1992 to cover these costs, and this amount could be expected to increase yearly as the number of AIDS 
victims rises. 
No C 13/10 Official Journal of the European Communities 19. 1. 91 
The Commission will examine the feasibility of developing models for the costing of the management of 
AIDS, taking account of the available findings of the WHO report on costs, and the conclusions of the 
European Health Committee with regard to the impact of AIDS on the organization of health care. 
Action 6: Reduction of HIV transmission in blood and blood based products 
In the past, a cause of AIDS was the transmission of HIV in blood and blood derived products. Several 
measures have now significantly reduced the risk of transmission. 
Selection of blood and plasma donors and screening of their donation for HIV antibodies is now systemat­
ically carried out, in accordance with the recommendations of the Council of Europe. Also, Directive 
89/381/EEC relating to medicinal products derived from human blood and plasma lays down requirements 
for manufacturing and purification processes to ensure, insofar as technology permits, the absence of 
specific viral contamination. 
However, the risk of transmission can be reduced still further. The attainment of European self-sufficiency 
in blood and blood derived products has become a Community objective, through the promotion of 
voluntary unpaid blood donations. The Commission will examine carefully the current situation and 
evaluate how best these objectives can be achieved, bearing in mind its current cooperation with the 
Council of Europe in this field. 
CHAPTER 3 
EPIDEMIOLOGICAL ASSESSMENTS 
Although statistics are available on the numbers of AIDS cases, there are no reliable statistics for HIV 
seroprevalence. 
Prevention, treatment and risk reduction strategies and the corresponding allocation of resources require 
knowledge of the patterns and trends of the AIDS epidemic. 
Objectives: 
— to ensure and improve the availability and comparability of data on AIDS, and HIV seroprevalence, 
— to provide through epidemiological studies on AIDS/HIV, appropriate information for preventive 
policies. 
Action 7: Improvements to the system for gathering the data on AIDS 
The European Centre for the Epidemiological Monitoring of AIDS (WHO-EC Collaborative Centre in 
Paris) is playing a major role in gathering and analysing epidemiological data on AIDS. 
In order to improve the quality of the data, support will be given to national monitoring systems; to the 
accessibility of the Paris Centre's data base; and to improving epidemiological information on the disease. 
Proposals will be made on the establishment of a Community-wide system, with a view to facilitating 
exchanges of information. 
Action 8: Common methodological approaches to ensure the availability and comparability of epidemio­
logical data on HIV seroprevalence 
HIV seroprevalence is becoming a central issue in developing strategies for prevention and care. The 
present lack of knowledge is not a sufficient basis on which to establish sound health policies. 
19. 1.91 Official Journal of the European Communities NoC 13/11 
As a first step, a methodology should be agreed at Community level. 
A survey will be made on current approaches determining HIV seroprevalence in the European 
Community, in order to provide information on the epidemiological situation regarding HIV transmission. 
CHAPTER 4 
MANPOWER TRAINING AND DEVELOPMENT 
The development of the actions contained in this programme in terms of prevention, treatment, risk 
reduction, socioeconomic integration, as well as epidemiological data collection and evaluation, requires 
the presence of adequately trained personnel. 
Adaptation and improvement of traning for health and social care professionals can be ensured through 
exchanges of experience. 
Objectives: 
— to provide health and social care professionals with an adequate knowledge of AIDS prevention and 
primary care of AIDS patients and HIV seropositive persons, 
— to develop an adequate core of specialists in AIDS prevention, treatment and psycho-social care of 
people with HIV or AIDS. 
Action 9: Systems of university training for health care workers; mobility of medical and nursing students 
Universities and bodies involved with professional training courses for health and social care should 
become more involved in the fight against AIDS with adequate information and training on AIDS issues 
being provided. 
To accelerate the education and continuous training of professionals, the development of appropriate 
teaching materials and supports is necessary. 
A survey will be made on the training and instruction given in university education and training, and 
exchanges of experience will be organized. 
A survey on existing teaching materials will be carried out, and if appropriate, the promotion of exchanges 
of materials, as well as the development of additional training material.