COMMISSION OF THE EUROPEAN COMMUNITIES 
Brussels, 07.11.1995 
COM(95) 521 final 
"EUROPE AGAINST AIDS" 
COMMISSION REPORT 
ON IMPLEMENTATION IN 1994 

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 p.!an 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. For this reason, on 19 June 1995 the European Parliament and the Council 
adopted a Decision intended to extend the "Europe against AIDS" programme4 in the 
expectation of adopting the Community programme on the prevention of AIDS and 
certain communicable diseases proposed by the Commission on 9 November 19945. 
This Communication is intended to supplement the implementation reports previously 
drawn up under the "Europe against AIDS" programme and to provide details of activities 
undertaken by the Commission in order to implement the plan's seven areas of activity 
in 1994. 
H IMPLEMENTATION OF THE "EUROPE AGAINST AIDS" PROGRAMME 
IN 1994 
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 
Decision No 1729/95/EC, OJ L 168, 18.07.1995, p.l 
COM (94) 413 final of 9 November 1994 

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 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 and pilot projects 
and not to subsidise ongoing basic services or structures. 
The final criterion relates to financial matters. The Commission provides some financial 
support for projects but cannot finance them completely (100%) (see also Annex I). 
In addition, the Decision of the European Parliament and the Council on extending the 
"Europe against AIDS" programme paid particular attention to: 
- groups at risk or in particular situations (for example, young people and migrants); 
- women; 
social and psychological support and combating discrimination. 
2 The Advisory Committee 
As required by the 1994 Decision, the Commission was assisted in the implementation 
of the programme's actions by an Advisory Committee comprising representatives of the 
Member States. This Committee met twice in 1994, in February 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 II) 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, based on the number of responses received 
from the Advisory Committee for each project under consideration. 
After consulting the members of the Advisory Committee, the Commission decided 
whether to fund or to reject each project. 
3 Project support by the Commission 
a Projects submitted to the Commission 
The bulk of the programme centres around providing support for projects undertaken in 
the Member States. These have been selected on the basis of applications submitted to 
the Commission by organisations engaged in orwishing to engage in AIDS-related work. 
In 1994, the Commission received 173 applications, of which 59 were selected for 
funding from a total budget of ECU 9 million following a favourable opinion by the 
Advisory Committee. 
By way of comparison, 78 applications were selected for 1991 and 1992, with a total 
budget of ECU 4 060 000, and 72 in 1993 with a budget of ECU 8.3 million. The sharp 
rise in the number of projects funded in 1993 in relation to the preceding years was due 
primarily to the increase in the budget between 1991-1992 (ECU 1.43 and 2.63 million 
respectively) and 1993 (ECU 8.3 million). In 1993, priority was given to funding a 
relatively small number of large-scale projects. In contrast, the number of projects funded 
in 1994 with a similar budget was lower than the total for 1993 because the Commission 
concentrated on large-scale transnational projects, leaving established networks in place. 
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. Nevertheless, projects have been supported in all Member States with the 
exception of Portugal, which, however, has taken part in a number of projects in other 
Member States (see Annex III). 
However, bearing in mind epidemiological data on AIDS and HIV-positive cases in the 
Mediterranean countries (see Annex V), particular efforts must be devoted to prevention. 
b Projects initiated by the Commission 
- The proposal for a Decision of the Council and the Ministers for Health of the 
Member States, meeting within the Council, extending until the end of 1994 the 
1991-1993 plan of action adopted within the framework of the "Europe against 
ADDS" programme6, the content of which was based on an evaluation by the 
Council of measures undertaken in the context of the programme, was not adopted 
on 1 January 1994. For this reason the Commission, with authorisation only to 
fund ad hoc measures in 1994, published a call for proposals using the contents 
of the Annex to the proposal for a Decision7. 
In addition, the Commission issued a restricted invitation to tender on the basis 
of a call for expressions of interest in 1992s in the evaluation and dissemination 
of information resulting from the implementation of the programme. The number 
of applicants, however, was considered insufficient by the Advisory Committee 
on Procurements and Contracts, which, as a result, issued an unfavourable opinion 
on this restricted invitation to tender. 
m WORK CARRIED OUT UNDER EACH AREA OF ACTIVITY OF THE 
PLAN OF ACTION 
For information or clarification, the various actions are classed in accordance with the 
areas of activity listed in the Annex to the 1994 Commission proposal for a Decision. As 
these areas are all more or less interdependent, some projects have aspects which relate 
to a number of projects simultaneously. A project is therefore classified by taking the 
predominant aspect into account (Annex IV contains a summary table). 
6 COM (93) 453 final 
7 No 94/C 108/08, OJ C 108, 16.04.1994, p. 19 
8 No 92/C 181/08, OJ C 181, 17.07.1992, p. 15 
AREA OF ACTIVITY 1 : Assessment of the 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 is a key element 
in any effective prevention strategy, and precise information is a prerequisite in order to 
be able to affect behaviour and thus combat discrimination. 
The Commission funded 12 projects in this area: 
- It supported a Franco-Belgian information and awareness-raising campaign aimed 
at populations of non-European extraction through the dissemination of 
information material translated into ten non-European languages. It is well-known 
that this target group forms a significant proportion of the population of a number 
of Member States. 
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 
supported by the Commission. 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 national Parliaments were invited to a European 
conference organised for them under the auspices of the Commission in 1995, 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 with Commission support, with the aim 
of making information accessible to all levels of the population. This is a pilot 
project which could be transferred to all Member States and has the advantage 
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 redundancy of effort within the European Community. The Commission 
accordingly subsidised two analytical projects at Community level, one aimed at 
the general public and one aimed at target groups such as women, homosexuals, 
young people and ethnic minorities. Two universities therefore concentrated on 
collecting and examining studies already carried out in 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. 
It is clear, however, that in order to carry out the tasks referred to above, 
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. This project will lead ultimately 
to the organisation of a conference in May 1995 on public education with regard 
to AIDS in Europe. 
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 with 
Commission support. 
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 supported by the Commission. An analysis and comparison 
of labour and social protection legislation with regard to workers with HIV/AIDS 
and the drawing up of criteria in relation to the above-mentioned subjects is to 
follow, for dissemination internally (industrial federations, regional and provincial 
unions, etc.) and externally (public administrations in other Member States and 
non-governmental organisations with competence in this field). 
2) 
- The Commission also supported an examination of sexual behaviour and 
knowledge of AIDS among female students in Greece, as well as observing 
preventive measures taken by this group. The results will be discussed and 
compared with those from partners in other Member States. The intention is to 
establish a European network with common standards and a coordinated use of 
questionnaires and study methods relating to attitudes and behaviour in the light 
of HIV/AIDS in Europe. 
- Finally, the Commission carried out a Eurobarometer survey among the public in 
April-May 1994 on blood, blood transfusion and HIV/AIDS at the request of the 
Council of Health Ministers. The results of this survey show that much remains 
to be done with regard to information (see conclusion). 
AREA OF ACTIVITY 2: Measures for children and young people 
Obviously, young people are a primary target group in the context of the implementation 
of the "Europe Against AIDS" programme. 
In this area of activity, the Commission contributed to nine 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 resulted in the drawing up of a European consensus document with 
regard to HIV/AIDS prevention in schools. 
- In addition, a conference was held in Denmark in the spring, with Commission 
support, 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 
impact in all Member States, as approximately 6 million young Scouts and Guides 
were directly or indirectly involved. 
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. 
An information campaign aimed at young people was organised with Commission 
support and with the cooperation of radio stations in various Member States. This 
action made it possible to reach young people through advertisements, information 
bulletins, personal testimonies, discussions and interviews. Provision was also 
made for relays between stations and off-the-air measures such as the free 
distribution of condoms, basic information packages compiled especially for 
young tourists, tape compilations of the above-mentioned radio programmes and 
lists of telephone helpline numbers. 
The second phase of the "Europe against AIDS" summer campaign, which the 
Commission supported, was aimed at improving AIDS prevention among young 
holiday makers and tourists through use of the media (posters in stations and 
airports, visual advertising in the press, particularly in youth magazines, television 
and radio advertisements, distribution of T-shirts and stickers) and through 
cooperation with national agencies and youth networks in the 12 Member States 
(insertion of "Europe against AIDS" images in the communications media of 
tourist bodies such as youth hostels and camp sites, and in members' magazines 
for those holding certain cards (Carte Jeune and Interrail, for example)). The 
messages and logos used were identical in all Member States. 
Finally, two projects aimed specifically at young people 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. 
AREA OF ACTIVITY 3: Prevention of HIV transmission among particular 
groups and in particular settings 
Under this area of activity, the Commission supported seven projects: 
- A programme was established to prevent HIV/AIDS transmission, aimed at young 
European tourists visiting Greece. The project was implemented in partnership 
with two other Member States. Following consultation with key people in the 
tourism sector on how to achieve the objectives, an intensive 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 campaign reached approximately 
100 000 tourists. 
- 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 (the "Women's Bus") 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 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. 
- The continuation of efforts to promote European Community self-sufficiency in 
blood products is specifically mentioned in the Decision extending the "Europe 
against AIDS" programme. Accordingly, two examinations carried out in the 
Netherlands received Commission support. 
10 
AREA OF ACTIVITY 4: Social and psychological support 
The Commission supported nine 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. 
Along the same lines, 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. 
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. This covers the 
introduction of a system for a European Bulletin, an electronic dissemination system 
authorising communication and exchanges between cooperating information and 
documentation centres and also the provision of the above-mentioned information to non-
specialists. 
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. This analysis will provide a useful model for individual support 
strategies to be applied in other life-threatening situations. In addition, an examination 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 persons, 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 and comparisons with other Member States and may also be used in the 
context of prevention at European level. 
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. 
11 
Finally, 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, will make 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. This analysis will lead to the 
drawing up of a proposal to harmonise the relevant regulations. 
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, classification 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 activities. 
Under this area of activity, the Commission supported 14 projects: 
- It continued to assist the European Centre for the Epidemiological Monitoring of 
AIDS in its programme of collecting, analysing and disseminating national data 
at Community level and for each Member State. In this regard, the Centre has 
drawn up reports relating to anonymous individual data for each new case of 
AIDS declared in European countries and incorporated into the corresponding data 
base (European Non-Aggregate AIDS Data Set (ENAADS)) (see also Annex V). 
In addition, the Centre has drawn up a documented situation report on the 
prevalence and incidence of HIV infection in Europe on the basis of the 
continuous updating of the European HIV data base. Finally, it has drawn up 
reports on the monitoring of tuberculosis and its resistance to treatment and on 
evaluation of the impact of dissemination of methods of preventing Pneumocystis 
carinii in the context of HIV infection. 
- The European Centre also received financial support from the Commission for a 
feasibility study on the drawing up of a development plan for the publication of 
a bilingual (French-English) European bulletin on communicable diseases, 
including AIDS. 
12 
The Institute for Hygiene and Epidemiology in Brussels carried out a study in this 
field with Commission support on the collection of data relating to the demand 
for HIV tests and other consultations of general practitioners relating to 
HIV/AIDS. The Institute will attempt to provide an indicator for the reaction of 
general practitioners and the general public to information given by the media, 
scientific organisations and other bodies on the subject of AIDs, and on their 
perception of the risk of HIV infection. 
An analysis was carried out by the Public Health Laboratory Service's 
Communicable Disease Surveillance Centre in London on the drawing up of an 
agreement and on cooperation through the establishment of a network within the 
European Community relating to communicable diseases. The European Centre 
is responsible for aspects relating to AIDS. 
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 airri 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. 
Under the auspices of the Commission, two universities carried out an analysis of 
the costs engendered by HIV/AIDS, particularly for the health and social services 
in Member States, and an analysis of ways of controlling them using methods 
common to all these countries. The aim here 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 dealing 
with the risk of HIV infection among drug users, to be used in the training of 
nursing auxiliaries in all Member States. 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 is to deal specifically with HIV 
infection and its interaction with tuberculosis, making it possible to cover 
shortcomings in information about and prevention of these associated diseases. 
13 
- The Commission also continued to provide support for a Belgian project on the 
training of health professionals. The aim of this was to apply a communication 
training prototype aimed at doctors in order to improve contact between them and 
patients affected by HIV/AIDS. 
- Finally, the Commission financed a project carried out by a group of United 
Kingdom universities to evaluate the training given to people working in the field 
of AIDS. 
AREA OF ACTIVITY 6: Combating discrimination against people with HIV and 
AIDS and those close to them 
The Commission supported two projects under this area of activity: 
An analysis of the status of implementation of the Council Resolution of 
22 December 19899. 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 English 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/ADDS 
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. Questions of European law relating to the principles of subsidiarity and 
proportionality, as well as to freedom of movement for persons, will be dealt with 
in the context of this project in order to assess the advantages and disadvantages 
of such a code and its operation. 
OJC 10, 16.1.1990, p. 3. 
14 
AREA OF ACTIVITY 7: Coordination with other programmes dealing with 
HIV/AIDS 
The Commission took an active part in the International Conference on AIDS and 
Sexually Transmitted Diseases held in August 1994 in Yokohama. A preparatory 
conference was organised which included a representation of the different Community 
programmes dealing with HIV/AIDS prevention (BIOMED, a research programme in the 
field of biomedicine and health, including AIDS research10, and PHARE, intended for the 
countries of eastern Europe) and certain other projects. The Commission was also 
represented by a stand in the exhibition hall with a wide choice of information material. 
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. 
IV THE FIGHT AGAINST AIDS IN THE CONTEXT OF OTHER 
COMMUNITY POLICIES 
1 Research 
AIDS research in the context of the BIOMED programme has the following aims: 
* to promote research into more effective means of combating AIDS, and HIV 
infection, particularly by producing a vaccine, pharmaceutical products and 
treatments; basic research, epidemiology and research into behaviour, socio­
economic factors and health services; 
* to increase knowledge of the pathogenesis of AIDS; 
* to study ways of meeting the new challenges rapidly; 
* to complement and participate in international AIDS and HIV research. 
In accordance with the above-mentioned four aims, HIV/AIDS research is split into four 
sub-programmes: 
* control and prevention of the disease; 
* viral-immunological research; 
10 Source: Work programme for BIOMED 1 (1990-1994). 
15 
* clinical research; 
* production of a vaccine and treatment testing of anti-viral drugs. 
It is still too soon to assess the results, successes and shortcomings of BIOMED. 
Nevertheless, one of the aims of the European Community, namely scientific cooperation 
in Europe, has been achieved, since over 400 teams in 17 countries have received 
financial assistance in order to work on BIOMED projects. Disseminating the results of 
these projects will enable other scientists to exchange their knowledge and experience 
with teams already taking part in this European research network. 
On 1 December 1994, the Council of Research Ministers signed an agreement on the last 
ten specific programmes under the 4th Framework Programme for Research and 
Technological Development (RTD). The Council thereby approved the Specific Research 
and Technological Development Programme in the field of Biomedicine and Health 
(1994-1998). This BIOMED 2 programme will continue the efforts of previous 
programmes to contribute to solving the AIDS problem. 
In 1994, 13 new contracts for concerted measures were signed, representing a network 
of 160 research laboratories taking part in the fight against AIDS at European level, with 
a total budget of ECU 4 000 000. 
The majority of projects centre on the development of new therapies, the production of 
new medicinal products to prevent an HIV-positive state developing into full-blown 
AIDS, and the discovery of a vaccine or vaccines. Emphasis is also given to studying the 
epidemiological, social and economic impact of the disease on society as a whole. 
2 The policy of the Community with regard to AIDS in developing countries 
In 1994 the Commission continued its activities in connection with HIV/AIDS in 
developing countries. 
In a communication to the Council and the European Parliament, the Commission set out 
its priorities in terms of policy and strategies with regard to HIV/AIDS in developing 
countries. On this basis, the Council adopted a Resolution in May 1994 approving the 
guidelines proposed by the Commission. 
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 of preventing the sexual, perinatal and blood-borne 
transmission of HIV/AIDS and of preventing discrimination; 
breaking the "poverty-instability-HIV/AIDS" cycle by paying particular attention 
to population groups in risk environments (refugees, migrants, etc.); 
16 
strengthening the healthcare and social sectors to enable them to bear the 
increasing burdens associated with the spread of the epidemic; 
supporting governments in assessing the impact of the epidemic on the various 
economic sectors and social groups and in determining the implementation of care 
strategies; 
developing scientific knowledge of the epidemic in biomedical and sociological 
terms and of the impact of operations, with the aim of improving the quality 
thereof. 
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 measures taken to ensure, as far as possible, that medicinal 
products derived from human blood or plasma are free of the virus. The second relates 
to the rapid and simultaneous dissemination throughout the Community of medicinal 
products for AIDS patients. 
1. Safety of blood products 
Council Directive 89/381/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 is recommended that 
manufacturers of blood products test plasma pools for a series of viral markers, including 
the HIV-1 and HIV-2 antibodies. 
17 
2. Medicinal products for AIDS patients 
A certain number of medicinal products for the treatment of AIDS have been authorised 
under the Community coordination procedure (established by Directive 87/22/EEC). In 
some cases, these medicinal products must be used in isolation (monotherapy); in others, 
they must be associated with other products (combined therapy). 
As the first marketing authorisations have been granted, administration of these medicinal 
products has been extended, on the basis of the results of clinical trials, to children, 
asymptomatic patients (i.e. those who are HIV-positive but do not yet show any 
symptoms) and, in the near future, treatment of the causes of transmission through the 
mother. 
In addition to treating the disease itself, certain products have been authorised for the 
treatment of associated diseases such as Karposi's sarcoma. 
Medicinal products for AIDS and other viral diseases are a priority area for the 
Commission; in 1995, a special working party is to devote all its efforts to this subject. 
V EVALUATION 
At the time this report was drawn up, a large proportion of the projects funded for 1994 
were still under way. A detailed evaluation of the effectiveness and impact of the actions 
undertaken individually or collectively will be carried out during 19.95. 
In addition, in accordance with the conclusions of the 1993 implementation report, the 
Commission has taken the necessary measures to evaluate the impact of projects 
undertaken during the 1993 financial year. At the time this report was drawn up, almost 
half of the projects funded in this financial year had been completed and were being 
evaluated. 
VI CONCLUSION 
One of the most obvious improvements in the implementation of the programme is the 
strengthening of the trans-European approach to projects. The majority of Member States 
were involved directly or indirectly (see Annex III) through active cooperation, 
participation in the introduction of new networks and/or the strengthening of existing 
networks. 
Approximately 18% of the total budget was devoted to measures to evaluate the 
knowledge, attitudes and behaviour of the general public and of target groups. Analysis 
of the results of the Eurobarometer survey of the population of each Member State over 
15 years of age, carried out between 4 April and 6 May 1994 in the context of the 
programme, highlighted the fact that significant efforts were required in this field. 
In contrast to previous years, HIV prevention and social and psychological support 
measures attracted less expenditure. There were fewer projects, but they were larger in 
scale (9% and 7% respectively). As women constitute a growing proportion of those 
carrying the HIV virus or suffering from AIDS, the majority of measures were developed 
with this target group in mind. Increased tourism, travel and intravenous drug use has 
given rise to the need for a sustained prevention, information and assistance campaign. 
Approximately 41% of the total budget was allocated to activities concerned with 
collecting data on HIV/AIDS and transmissible diseases. These efforts make it possible, 
as a result of wider-ranging collections of data, to improve the targeting and adaptation 
of prevention and information measures in the Member States in future years. 
Combating discrimination against people with HIV and AIDS and those close to them is 
an area on which very few projects have concentrated. One explanation for this may be 
that the project to carry out a comparative analysis of European legislation on AIDS from 
an ethical and legal point of view, which was funded in 1993, will be completed in 1994, 
and the results were not yet available when this report was drawn up. 
The proportion of expenditure relating to coordination with other programmes dealing 
with HIV/AIDS increased significantly (4.7%) in relation to previous years (average 3%). 
This is due to the organisation of joint participation by the various Commission 
departments in the International Conference on AIDS and Sexually Transmitted Diseases 
held in Yokohama in August 1994. 
On the basis of work carried out and evaluated at this stage of the implementation of the 
"Europe against AIDS" programme, it is an undeniable fact that it has made an effective 
contribution to the fight against HIV/AIDS, particularly by avoiding any duplication of 
effort at Member State level and by permitting financial savings and economies of scale. 
The true impact and synergy of national and Community projects, however, can only be 
evaluated on the basis of epidemiological data collected over time. It is therefore essential 
to continue and step up support for the fight against this scourge, taking into account the 
experience acquired in the implementation and evaluation of the programme. 
19 

O PRESENTATION 
OF PROJECTS 
TWICE A YEAR EUROPEAN COMMISSION DG V 
PRESELECTION IN ACCORDANCE 
WITH BASIC CRITERIA 
00 00 
W 
RIGHT OF VETO 
ON PROJECTS 
OF OWN 
MEMBER STATE ADVISORY COMMITTEE 
B D UK DK GR NL FUNDING 
[xLââ*£^2 
IRL L 
NATIONAL AIDS 
COMMITTEE B D <~> 
UK DK GR NL <~> 
IRL <^L 
L 
ANNEX II 
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 
21 
ANNEX III 
ANALYSIS OF EXPENDITURE UNDER THE PROGRAMME by country and showing extent of contribution by countries 
TOTAL NUMBER OF SUBSIDIES: 59 
TOTAL AMOUNT COMMITTED: ECU 8 999 136 
COUNTRY 
BELGIUM 
DENMARK 
FRANCE 
FEDERAL REPUBLIC OF GERMANY 
GREECE 
IRELAND 
ITALY 
GRAND DUCHY OF LUXEMBOURG 
NETHERLANDS 
PORTUGAL 
SPAIN 
UNITED KINGDOM 
TOTAL 
SUPPLEMENTARY COMMITMENT FOR 
THE INTERNATIONAL CONFERENCE IN 
YOKOHAMA 
GRAND TOTAL AMOUNT 
GRANTED PER 
COUNTRY IN 
ECU 
3 3% 928 
93 663 
1 592 269 
6 024 
501 203 
228 243 
214 000 
292 232 
564 011 
0 
217 879 
1 887 472 
8 993 924 
5 212 
8 999 136 PERCENTAGE 
OF BUDGET 
GRANTED PER 
COUNTRY 
37.75% 
1.04% 
17.69% 
0.07% 
5.57% 
2.54% 
2.38% 
3.25% 
6.27% 
0.00% 
2.42% 
20.97% NUMBER OF 
SUBSIDIES PER 
COUNTRY 
8 
1 
13 
1 
6 
3 
1 
1 
4 
0 
3 
17 
58 
1 
59 PERCENTAGE 
OF SUBSIDIES 
GRANTED PER 
COUNTRY 
13.56% 
1.69% 
22.03% 
1.69% 
10.17% 
5.08% 
1.69% 
1.69% 
6.78% 
0.00% 
5.08% 
28.81% PERCENTAGE 
CONTRIBUTION 
TO SUBSIDIES BY 
MEMBER STATES 
10.63% 
5.97% 
14.92% 
10.36% 
5.53% 
5.69% 
5.71% 
6.36% 
5.66% 
1.51% 
9.69% 
12.59% 
22 
ANNEX IV 
SUMMARY TABLE OF SUMS COMMITTED BY AREA OF ACTIVITY 
TOTAL NUMBER OF SUBSIDIES: 59 
TOTAL AMOUNT COMMITTED: ECU 8 999 136 
AREA OF ACTIVITY 
I ATTITUDES AND BEHAVIOUR 
II CHILDREN/YOUNG PEOPLE 
III PREVENTION OF HIV TRANSMISSION 
IV SOCIAL AND PSYCHOLOGICAL 
SUPPORT 
V DATA COLLECTION 
VI DISCRIMINATION 
VII COORDINATION WITH OTHER 
PROGRAMMES AMOUNT 
COMMITTED PER 
AREA OF ACTIVITY 
1 633 810 
1 454 214 
810 414 
662 447 
3 716 175 
301 422 
420 654 PERCENTAGE OF 
BUDGET PER AREA 
OF ACTIVITY 
18.16% 
16.16% 
9.01% 
7.36% 
41.29% 
3.35% 
4.67% NUMBER OF 
SUBSIDIES PER 
AREA OF ACTIVITY 
12 
9 
7 
9 
14 
2 
6 
! 
23 
ANNEX V 
EPIDEMIOLOGICAL DATA 
AIDS cases and rate of incidence' per country and per year of diagnosis (1989-1994) declared as at 31 December 1994, corrected for 
declaration deadlines (1992-1994) 
WHO European Region 
Country 
Albania 
Austria 
•Azerbaïdjan 
•Belarus 
Belgium 
*Bulgaria 
*Croatia 
*Czech. Rep. 
Denmark 
•Estonia 
Finland 
France 
Germany CASES DECLARED 
YEAR OF DIAGNOSIS 
1989 
No 
0 
141 
0 
0 
166 
4 
3 
7 
7 
0 
17 
3 782 
1 586 Rate 
0.0 
18.4 
0.0 
0.0 
16.7 
0.4 
0.7 
0.7 
0.7 
0.0 
3.4 
65.4 
20.1 1990 
No 
0 
162 
0 
0 
204 
4 
9 
5 
5 
0 
15 
4 282 
1 484 Rate 
0.0 
21.0 
0.0 
0.0 
20.5 
0.4 
2.0 
0,5 
0.5 
0.0 
3.0 
73.6 
18.7 1991 
No 
0 
195 
o 
3 
252 
2 
11 
2 
2 
0 
26 
4 576 
1 636 % 
0.0 
25.2 
0.0 
0.3 
25.3 
0.2 
•2.4 
0.2 
0.2 
0.0 
5.2 
78.2 
20.5 CASES CORRECTED FOR DECLARATION 
DEADLINES 
YEAR OF DIAGNOSIS 
1992 
No 
0 
189 
0 
5 
243 
6 
8 
9 
9 
1 
27 
5 100 
1 726 Rate 
0.0 
24.2 
0.0 
0.5 
24.3 
0.7 
1.8 
0.9 
0.9 
0.6 
5.4 
86.8 
21.5 1993 
No 
0 
227 
0 
2 
251 
6 
10 
15 
15 
1 
31 
5 586 
1 843 Rate 
0.0 
28,9 
0.0 
0.2 
25.0 
0.7 
2.2 
1.5 
1.5 
0.6 
6.1 
94.6 
22.8 1994 
No 
0 
160 
1 
2 
245 
8 
16 
12 
12 
1 
95 
6 062 
1 865 Rate 
0.0 
20.2 
0.1 
0.2 
24.3 
0.9 
3.6 
1.2 
1.2 
0.6 
18.7 
102.2 
22.9 t Cumul­
ative 
total 
0 
1 335 
I 
12 
1 375 
32 
76 
59 
59 
3 
253 
36 890 
13 452 
t<f 
Country 
Greece 
Hungary 
* Iceland 
Ireland 
Israel 
Italy 
•Kazakhstan 
•Latvia 
•Lithuania 
Luxembourg 
•Malta 
•Moldavia 
•Monaco 
Netherlands 
Norway 
Poland 
Portugal 
Rumania 
Russia CASES DECLARED 
YEAR OF DIAGNOSIS 
1989 
No 
97 
15 
3 
56 
33 
2 454 
0 
0 
0 
11 
0 
1 
2 
391 
43 
24 
192 
278 
25 Rate 
9.5 
1.4 
11.9 
15.9 
7.3 
43.1 
0.0 
0.0 
0.0 
29.2 
0.0 
0.2 
66.7 
26.3 
10.2 
0.6 
19.4 
12.0 
0.2 1990 
No 
137 
19 
3 
64 
44 
3 106 
0 
2 
1 
9 
1 
0 
2 
416 
58 
21 
246 
1 059 
38 Rate 
13.4 
1.8 
11.8 
18.3 
9.4 
54.5 
0.0 
0.7 
0.3 
23.6 
2.8 
0.0 
66.7 
27.8 
13.7 
0.6 
24.9 
45.6 
0.3 1991 
No 
147 
31 
6 
70 
37 
3 732 
0 
1 
1 
12 
7 
0 
4 
445 
58 
46 
286 
510 
32 % 
14.3 
3.0 
23.3 
20.0 
7.7 
65.4 
0.0 
0.4 
0.3 
31.2 
19.7 
0.0 
133.3 
29.6 
13.6 
1.2 
29.0 
22.0 
'0.2 CASES CORRECTED FOR DECLARATION 
DEADLINES 
YEAR OF DIAGNOSIS 
1992 
No 
171 
33 
3 
68 
34 
4 193 
0 
1 
1 
12 
4 
2 
9 
508 
51 
36 
388 
433 
28 Rate 
16.5 
3.2 
11.5 
19.4 
6.8 
73.4 
0.0 
0.4 
0.3 
30.8 
11.1 
0.5 
290.3 
33.5 
11.9 
0.9 
39.4 
18.7 
0.2 1993 
N6 
173 
33 
6 
70 
58 
4 780 
2 
3 
1 
20 
3 
0 
7 
462 
65 
67 
511 
429 
13 Rate 
16.7 
3.2 
22.8 
19.9 
11.0 
83.7 
0.1 
1.1 
0.3 
50.6 
8.3 
0.0 
225.8 
30.2 
15.1 
1.7 
51.9 
18.6 
0.1 1994 
No 
126 
24 
3 
47 
39 
5 479 
3 
2 
0 
13 
1 
0 
3 
427 
86 
79 
605 
451 
26 Rate 
12.1 
2.4 
11.3 
13.3 
7.1 
95.9 
0.2 
0.8 
0.0 
32.4 
2.7 
0.0 
96.8 
27.7 
19.9 
2.1 
61.5 
19.7 
0.2 t Cumul­
ative 
total 
1 031 
172 
35 
460 
337 
27 232 
5 
9 
5 
90 
30 
4 
33 
3 474 
463 
278 
2 552 
3 185 
168 
er 
Country 
•San Marino 
•Slovakia 
•Slovenia 
Spain 
Sweden 
Switzerland 
Tadjikistan 
Turkey 
•Ukraine 
United Kingdom 
•Uzbekistan 
§Yugoslavia CASES DECLARED 
YEAR OF DIAGNOSIS 
1989 
No 
1 
0 
7 
3 031 
131 
574 
0 
13 
1 
1 056 
0 
33 Rate 
43.5 
0.0 
3.7 
77.4 
15.4 
84.8 
0.0 
0.2 
0.0 
18.5 
0.0 
3.3 1990 
No 
0 
0 
2 
3 712 
128 
573 
0 
11 
1 
1 206 
0 
54 Rate 
0.0 
0.0 
1.0 
94.5 
15.0 
83.8 
0.0 
0.2 
0.0 
21.0 
0.0 
5.3 1991 
No 
0 
0 
7 
4 303 
139 
553 
0 
22 
4 
1 347 
0 
55 % 
0.0 
0.0 
3.6 
109.3 
16.2 
80.1 
0.0 
0.4 
0.1 
23.4 
0.0 
5.3 CASES CORRECTED FOR DECLARATION 
DEADLINES 
YEAR OF DIAGNOSIS 
1992 
No 
0 
3 
3 
4 857 
128 
677 
0 
27 
4 
1 525 
1 
86 Rate 
0.0 
0.6 
1.6 
123.1 
14.8 
97.0 
0.0 
0.5 
0.1 
26.4 
0.0 
8.2 1993 
No 
0 
1 
7 
5 579 
183 
620 
0 
30 
10 
1 680 
1 
60 Rate 
0.0 
0.2 
3.6 
141.2 
21.0 
87.9 
0.0 
0.5 
0.2 
29.0 
0.0 
5.6 1994 
No 
0 
3 
6 
8 012 
180 
591 
0 
34 
10 
1 729 
0 
50 Rate 
0.0 
0.6 
3.1 
202.5 
20.6 
82.9 
0.0 
0.6 
0.2 
29.8 
0.0 
4.6 t 
Cumul­
ative 
total 
1 
10 
37 
33 742 
1 167 
4 670 
0 
158 
32 
11 005 
2 
379 
Per million inhabitants 
Source of demographic data: 
World Population Prospects: The 1994 Revision (United Nations, New York) 
Includes 369 cases with no known date of diagnosis 
Not corrected (insufficient number of cases) 
Serbia and Montenegro 
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