WRITTEN QUESTION E-0633/98 by Maartje van Putten (PSE) to the Commission (9 March 1998)

Subject: Prevention of HIV/AIDS in the ACP countries and Central and Eastern Europe

Referring to the special hearing on HIV/AIDS prevention in Central and Eastern Europe hosted by the European Parliament's Development Committee, where it became obvious that the HIV/AIDS epidemic is in its 'nascent' stage and where it was noted that prevention measures are essential, can the Commission answer the following questions:

1. Given the fact that most countries in Central and Eastern Europe have been classified as being in the nascent stage of the HIV/AIDS epidemic as the rate of HIV infections, particularly among vulnerable groups such as street-children and injecting drug users, has increased dramatically since 1995 and given the Union's current focus on Central and Eastern Europe in view of 'enlargement', what measures are being taken to monitor the nascent HIV epidemic in the region? Are there any special EU policies and/or programmes in any Eastern European country which focus specifically on HIV/AIDS and what special attention is given to the vulnerable groups as mentioned? Should PHARE and TACIS be restructured to include the monitoring and prevention of HIV/AIDS?

2. With reference to the potential danger of an HIV/AIDS epidemic in Central and Eastern Europe and in the former Soviet Union highlighted at the special meeting on HIV/AIDS which took place at the European Parliament, what is the role of NGOs working in the region in HIV/AIDS prevention? How many of these NGOs receive EU funding? Where do these funds come from?

3. To continue its HIV/AIDS programme in developing countries the sum of ECU 20 million has been allocated under the 8th EDF for a five-year regional programme directed to all ACP countries. In what way are these funds going to be allocated and to which groups within the society, for instance street-children, women, etc.? What will the breakdown by region be? Will these funds be allocated directly to NGOs or through local governments?

Answer given by Mr Van den Broek on behalf of the Commission (8 April 1998)

The Commission is aware of the health situation in Central and Eastern Europe. In its opinions on the ability of the applicant countries to integrate into the Community, the Commission stressed the need for them all, apart from Slovenia, to reform their welfare systems, including their health systems, and to improve public health.

As part of the pre-accession strategy, the Phare programme is financing programmes to restructure health systems to make them viable, adequate to social needs and capable of dealing with the particular public health problems they face. These programmes are particularly aimed at developing primary health care, and take an integrated and very direct approach to preventing the spread, which can be avoided, of potentially epidemic diseases such as acquired immune deficiency syndrome (AIDS) and dealing appropriately with existing cases. Financing is also provided for applicant countries that wish to participate in the four Community health programmes, including the programme of Community action on the prevention of AIDS and certain other communicable diseases within the framework for action in the field of public health (1996 to 2000) introduced by Decision No 647/96/EC of the European Parliament and of the Council of 29 March 1996 ((OJ L 95, 16.4.1996. )). Provided the necessary legal bases are in place, these countries will also be able to participate in the planned network for the epidemiological surveillance of communicable diseases.

In addition, projects financed by the Phare and Tacis LIEN programme, open to initiatives from non-governmental organisations (NGOs), include projects involving AIDS prevention and treatment. For example, between 1995 and 1997 six NGOs received financing totalling almost ECU 1 million for projects specifically designed to combat AIDS in Poland, Romania and Albania.

The human immune deficiency virus/acquired immune deficiency syndrome (HIV/AIDS) programme in developing countries has several financial sources that can be used for its activities. The majority of the funds come from the national indicative programmes (NIP) of the African, Caribbean and Pacific (ACP) countries and the specific country or regional budgets for other developing countries.

The yearly AIDS budget, ECU 15 million, can also be used for innovative and pilot phase action in all developing countries. To finance regional actions, mainly in the field of capacity building, training, research and information exchange, ECU 20 million is to be allocated for the next five years for the 'all ACP' regional funds. Procedures for appropriation are ongoing.

Vulnerable groups are the main beneficiaries of this programme, as has been confirmed by the two evaluations made of the programme. The specific breakdown by region for the future allocation of the ECU 20 million cannot be specified for the moment. However governments, NGOs and the private sector are partners in the programme.

The programme of Community action on the prevention of AIDS and certain other communicable diseases within the framework for action in the field of public health was adopted by the Parliament and the Council in order to contain the spread of AIDS and reduce mortality and morbidity due to communicable diseases (Decision No 647/96/EC of the European Parliament and of the Council of 29 March 1996). This five-year programme (1996-2000) is open to participation by the associated countries of Central and Eastern Europe, in accordance with the conditions laid down in the additional protocols to the association agreements relating to participation in Community programmes. A draft association Council decision is being prepared on the participation of Hungary and Romania in the programme. Slovenia, Lithuania and Bulgaria have also expressed interest in participation, whilst Estonia and Poland are not interested. In order to monitor the HIV epidemic in Europe, the programme on the prevention of AIDS and other communicable diseases is supporting the activities of the European centre for the epidemiological surveillance of the AIDS epidemic and HIV infection. This system allows national surveillance data to be collected, analysed, interpreted and disseminated throughout Europe.