WRITTEN QUESTION E-1010/00

by Cristiana Muscardini (UEN) to the Commission

(31 March 2000)

Subject: Measures to combat the AIDS epidemic in Africa

The statistics on the spread of AIDS in Africa and its devastating consequences in sub-Saharan Africa are striking. Of 33,6 million AIDS sufferers worldwide, 23,3 million are to be found in this region. The disease has already killed 13,7 million persons in Africa (ten times more than warfare in the region) and has left 10 million children orphaned, a figure that will rise to 13 million by the end of 2000.

After the remarks by the United Nations Secretary-General that AIDS is the African plague of the 21st century and that we must take immediate preventive action, produce low-cost drugs and distribute them as a matter of the utmost priority, the United Nations Security Council allocated a further 100 million dollars to the fight against AIDS.

1. What was the European Union's contribution to this?

2. What countries are to be targeted by this aid?

3. Are there any instruments to monitor the management and efficiency of this aid?

4. Given the scale of the tragedy in sub-Saharan Africa, would it not be more appropriate to concentrate efforts in that region?

5. Is the European Union cooperating with other international organisations to systematically coordinate the fight against AIDS in Africa?

Answer given by Mr Nielson on behalf of the Commission

(12 May 2000)

The Commission is extremely concerned by the tragic dimension the human immunodeficiency virus-acquired immune deficiency syndrome (HIV-AIDS) epidemic is taking in Africa and, over recent years, has been very active in developing strong partnerships with the most affected countries through two major instruments. Under programmes financed through the European development fund (EDF) actions targeted at HIV-AIDS for 1999/2000 represent 30 million. EDF programmes also include support to the development of health systems based on the reasoning that long-term success in prevention and care for HIV-AIDS also needs to be rooted in multi-sectoral approaches. In 1999, 16,5 million were committed to HIV-AIDS intervention through the special HIV-AIDS/population budget line of which more than 50 % were allocated to Africa. For the year 2000, 20 million will be allocated for actions related to the overall improvement of access to sexual and reproductive health services, the prevention of mother-to-child HIV transmission, the development of affordable ways to increase access to essential care for people living with HIV-AIDS and sexually transmitted diseases, the understanding of the key economic and public health issues related to a potential AIDS vaccine and the development of sector strategies to make microbicidal products available to the most vulnerable women in developing countries.

In addition, for the year 2000, the Commission has acknowledged the United Nations appeal for Partnership for Africa aiming at an increased political leadership and mobilisation for an expanded response to HIV-AIDS in Africa and has signed a 20 million agreement with African, Caribbean and Pacific (ACP) countries for specific interventions in the sector.

The Commission allocates the major part of its resources to Africa but in line with other partners, shares the view that prevention in countries at a pre-epidemic stage such as Asian or Latin America countries remains essential for a world-wide impact on the spread of the disease.

The aid provided by the Commission is regularly monitored. Two major evaluations were already carried out in 1993 and 1997. A third exercise was started in 1999 aiming at reviewing all health sector activities.

The Commission works in very close collaboration with United Nations partners, particularly with the joint and co-sponsored United Nations programme on HIV/AIDS (UNAIDS) and the World Health organisation (WHO) but also with the United States Agency for International development (USAID) and the World Bank. The Commission is involved with all international partners in the major debates relating to access to drugs in the wider scope of the Trade related aspects of intellectual property rights (TRIPS) agreement and through negotiations with the pharmaceutical industry.

The communication to the Parliament and the Council(1) entitled For increased solidarity to confront HIV-AIDS in developing countries emphasises the Commission's commitment to strengthening co-operation with all public and private actors of the sector, to improving access to care and developing new mechanisms for increased financial solidarity.

In recent years, the Commission has been able to organise and fund very significant research under its framework programme on the subject including the most recent study showing progression of HIV in groups of very young women in East Africa. Vaccine research efforts have been very substantially upgraded as well, with the launch of the beginning of this year of a HIV vaccine cluster representing a multi-partner effort in the Community worth some 20 million. An extensive trial on

Community developed microbicides as an additional female-controlled way to prevent HIV transmission and further research on how to organise control of tuberculosis, the first cause of mortality associated to AIDS, are under way. The Commission intends to upgrade its research efforts substantially in the next future.

(1) COM(98) 407.