Opinion on the proposal for a Decision of the Council and the Ministers for Health of the Member States, meeting within the Council, concerning the extension to the end of 1994 of the 1991-1993 plan of action in the framework of the 'Europe against AIDS' programme

(94/C 217/07)

THE COMMITTEE OF THE REGIONS

Having regard to:

- the provisions of Title X of the Treaty of Maastricht relating to the Community's public health policy, and particularly Article 129 thereof;

- the Decision of the Council and Ministers for Health of the Member States, meeting within the Council on 4 June 1991, adopting a plan of action for 1991-1993 in the framework of the Europe against AIDS programme;

- the Commission Report on the implementation of the Europe against AIDS plan of action in 1991 and 1992, which describes the means deployed to achieve the objectives, comments on the initial results, and suggests that further action be taken when the current plan of action expires at the end of 1993;

- the conclusions of the Council and Ministers of Health, meeting within the Council on 27 May 1993, which underline the need to continue and to expand activities within the Europe against AIDS programme so as to take account of the changing needs of the Member States, the increased knowledge of the problems posed by the disease, and its evolution and trends;

- the Council letter of 17 March 1994 asking the Committee of the Regions, under Article 198c of the Treaty, to draw up an Opinion by 17 May 1994 at the latest,

UNANIMOUSLY ADOPTED

the following Opinion, drawn up by the Rapporteur-General, Mrs Claude du Granrut, at its third Plenary Session held on 17 and 18 May 1994 (meeting of 17 May 1994).

1. Introduction

1.1. The Committee of the Regions endorses the proposal to extend the Europe against AIDS plan of action to the end of 1994.

1.2. The Committee of the Regions emphasizes the importance, from the point of view of a Citizens' Europe, of European-level coordination in the field of public health.

2. General comments

2.1. The latest figures from WHO show that there has been an increase in the number of HIV carriers in the Member States of the European Union. The current total is put at approximately 500,000.

Although the AIDS population is no longer increasing as rapidly as in previous years, disturbing phenomena such as the relatively high rate of transmission within certain groups (prison population, migrants, homosexuals), the increased incidence of heterosexual transmission, and the fact that neither a vaccine nor treatment for the virus are yet available, heighten the need for additional efforts to prevent the transmission of the virus and ensure that the public, and particularly young people, are aware of and informed about the problems. More research also needs to be carried out.

2.2. In keeping with the principle of subsidiarity, action by the European Union must be conceived in such a way that it helps Member States to fully achieve their aims in the fight against AIDS. The purpose of European Union action is to give 'added value' to pilot projects launched by the Member States. The European Union must also take into account the variety of situations existing in the Member States and facilitate the introduction of mechanisms to evaluate future action.

The Committee of the Regions considers that the European Union should promote close coordination of current Member State initiatives. Such coordination is all the more justified because, with the opening of borders and the free movement of persons, it is increasingly important to provide all European citizens with equal protection.

2.3. So much is at stake in the fight against AIDS that the Committee of the Regions regrets the relatively modest ECU 9 m earmarked for the programme, even though it realizes that the principal objective of Community funding is to promote the coordination of national programmes and give them 'added value'.

2.4. Given the continuing spread of AIDS and our current state of knowledge about the disease, the Committee of the Regions considers that the one-year extension of the Europe against AIDS plan of action should be accompanied by guarantees that it will be extended again.

2.5. The Committee of the Regions would like to be sent the Report on the implementation of the action plan.

3. Specific comments

3.1. Area of activity 1: Evaluation of the knowledge, attitudes and behaviour of the general public in relation to AIDS, and measures to inform the public and improve its perception of the disease and its implications (ECU 996,000)

The Committee of the Regions approves these measures, and particularly the planned information campaigns, but suggests that emphasis be laid on assessing any changes in attitude, behaviour and knowledge, and on evaluating the surveys carried out to this end by the Member States.

The Committee of the Regions would warn against the tendency of television to sensationalize and/or trivialize the issue of AIDS. Television campaigns must be targeted at specific objectives such as use of condoms, distribution of syringes and educating the public about the real risks of contamination.

3.2. Area of activity 2: Measures for children and young people (ECU 2,526,000)

Campaigns designed to inform young people about AIDS, raise their awareness of the disease and discuss prevention, are suitable for the school context at all levels provided they are adapted to the age of the children and adolescents in question and are part and parcel of the provision of normal sex education.

Local and regional authorities, which are generally responsible for educational establishments, are particularly concerned by this essential plank of the Europe against AIDS programme. They are aware of their irreplaceable role in promoting educational pilot projects designed to protect the public health of future generations and to instil a sense of responsibility in all those living in their area or region.

The Committee of the Regions therefore proposes that local and regional authorities be involved in actions in this area.

3.3. Area of activity 3: Prevention of HIV transmission among high-risk groups (ECU 2,204,000)

The Committee of the Regions is aware of the risks of transmission in particular settings and among particular groups of the population, and considers that specific measures should be taken.

As far as the prison environment is concerned, the specific measures would concern admission procedures, the education of prisoners and the training of staff. The Committee of the Regions supports Member State pilot projects in these areas.

In addition to the prison population, we should not forget intravenous drug takers. The Committee underlines the need to evaluate the possible role of methadone-based therapeutic programmes and to analyze the results of the frequently varying policies of Member States on drug addiction.

As far as women are concerned, the Committee of the Regions recalls the increasing importance of action to help prostitutes and female drug takers, who are particularly liable to be contaminated by the HIV virus and to pass it on to their partners and above all their children.

Major efforts should be made as soon as possible to help such 'multiple risk' persons.

As far as the risks associated with tourism are concerned, preventive action should be encouraged in tourist resorts and border areas.

Last but not least, there remains the problem of contamination through the use of blood-based products. The Committee of the Regions would make it clear that the techniques used to prepare blood-based products should render them perfectly safe.

The Committee of the Regions considers that controls should be tightened up, and accompanied by a campaign to stimulate Community blood-doning in order to achieve self-sufficiency in Europe and so eliminate the need for blood imports from high-risk countries.

The Committee of the Regions also calls for labelling of the origin of blood products in order to permit relevant controls and provide the consumer with full information.

3.4. Area of activity 4: Social and psychological support for HIV/AIDS sufferers (ECU 1,660,000)

The Committee of the Regions considers that it is important for HIV/AIDS sufferers to be able to continue living normal lives and avoid being isolated from society for as long as possible. It advocates support for measures by non-governmental organizations to improve the quality of life of people with HIV or AIDS. Community support could take the form of making information available to non-governmental organizations, constantly updating information about the disease, treatment, therapy, etc. and exchanging information about initiatives taken in individual Member States.

The Committee of the Regions would nevertheless wish to make the point that no special new structures should be created, but existing organizational structures should be used, and if possible, expanded.

3.5. Area of activity 5: Gathering epidemiological data (ECU 249,000)

The Committee of the Regions considers that this area of activity is a prime target for Community action, but is worried about its low level of funding.

The Committee of the Regions reaffirms the importance of supporting the European Centre in Paris, which ensures cooperation between the WHO and the EU; the Committee also underlines the need to standardize epidemiological methods.

The Committee of the Regions does not support mandatory screening, except in the case of blood donors. The Committee does however believe that voluntary, free and absolutely confidential screening should be encouraged.

The Committee of the Regions recognizes the importance of the role played by various regions in monitoring epidemiological data in the field of AIDS and calls for greater coordination between different levels of government, including the European Community.

3.6. Area of activity 6: Combatting discrimination against people with HIV and AIDS and those close to them (ECU 415,000)

The Committee of the Regions draws attention to the measures to combat actual and potential discrimination in employment, insurance, housing, education and health care. The Committee underlines in particular the impact of such measures on people in daily contact with HIV/AIDS victims. Information about the real risks can help to lessen the drama of the plight of HIV/AIDS sufferers and facilitate their acceptance by their family and at work.

3.7. Area of activity 7: Coordination of research and other AIDS programmes at European and international level, especially in the developing countries (ECU 250,000)

The Committee of the Regions suggests that the genuine synergies to be gained from cooperation between European research centres (whose effectiveness has been demonstrated in the discovery of the virus) should be exploited with a view to finding and developing a vaccine against AIDS. This would be proof of the scientific capability of the European Union and a triumph for Europe's pharmaceutical industry.

Done at Brussels, 17 May 1994.

The Chairman

of the Committee of the Regions

Jacques BLANC