REPORT FROM THE COMMISSION TO THE COUNCIL AND THE EUROPEAN PARLIAMENT ON THE IMPLEMENTATION OF THE "EUROPE AGAINST AIDS" - ACTION PLAN 1994-1995
Date: 1997-01-15
Institutions: European Commission
Subjects: AIDS, action programme, disease prevention, public awareness campaign, public health

COMMISSION OF THE EUROPEAN COMMUNITIES 

Brussels,  15.01.1997 
COM(96) 720 final 

REPORT FROM THE COMMISSION TO THE COUNCIL 
AND THE EUROPEAN PARLIAMENT 

ON 

THE IMPLEMENTATION  OF THE 

"EUROPE AGAINST AIDS" 

ACTION PLAN  1994-1995 

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  plan  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.  Pending the adoption of the Community programme on the prevention of AIDS 
and  certain  communicable  diseases  (1996-2000)  proposed  by  the  Commission  on 
9 November  19944,  the  European  Parliament  and  the  Council  adopted  a  Decision  on 
19 June  1995 intended to extend the "Europe against AIDS" programme5 for a period of 
two years until  31 December  1995. 

In  accordance  with  Article  3  (2)  of  European  Parliament  and  Council  Decision  No 
1729/95/EC, the aim of this report, which takes up again and complements certain points 
of the  1994 implementation  report6,  is to  give an account  of the  implementation  of the 
"Europe against AIDS" action plan  1994-1995. 

II. 

IMPLEMENTATION  OF  THE  "EUROPE  AGAINST  AIDS"  ACTION 
PLAN  1994-1995 

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. 
COM (94) 413 final of 9 November 1994. 
Decision No  1729/95/EC, OJ L 168,  18.07.1995, p. 1. 
COM (95) 521 final of 7 November 1995. 

The  second  criterion  is  whether  the  project  offers  a  "Community  added  value",  in 
contrast  to  a purely  national  or  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,  or pilot  projects, 
and not to  subsidise ongoing basic services. 

Lastly,  the  final  criterion  relates to  financial  matters. The Commission provides  some 
financial  support for projects in accordance with the principle of shared costs, but cannot 
finance  them  fully  as a general rule. 

2. 

The Advisory  Committee 

As  required  by  Decision  No  1729/95/EC,  the  Commission  was  assisted  in  the 
implementation of the programme by an Advisory Committee comprising representatives 
of the  Member  States. This Committee met twice in  1994 (in February  and  September) 
and  three  times  in  1995  (in  February,  April  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  I) 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. 

After  consulting  the  members  of  the  Advisory  Committee,  the  Commission  decided 
whether to fund  or to reject  each  project. 

3. 

Calls  for  proposals  published  in  the  Official  Journal  of  the  European 
Communities 

European Parliament and Council Decision No  1729/95/EC on the extension until the end 
of  1995  of  the  1991-1993  action  plan  adopted  as  part  of  the  "Europe  against  AIDS"7 
programme  was  only  adopted  on  19 June  1995. Being  authorised  only  to  fund  ad  hoc 
measures  in  1994, the Commission published a call  for  proposals containing  the Annex 
to the proposal  for  a Decision8. 

Similarly,  the  Commission  published  a  call  for  proposals  in  April  19959  concerning 
projects  relating to the prevention  of HIV/AIDS. 

In  addition,  the  Commission  issued  a  restricted  invitation  to  tender  based  on  a  call  in 
199210 for  the  expression of  interest  in the evaluation  and  dissemination  of  information 
resulting  from  the  implementation  of  the  programme.  The  Advisory  Committee  on 
Procurements  and  Contracts, however,  deemed the number  of bidders to be  insufficient 
and therefore  issued an unfavourable  opinion  on this restricted  invitation to tender. 

4. 

Overview  of projects  supported  under the  1994-1995 action  plan 

These  projects  were  selected  on  the  basis  of  applications  to  the  Commission  by 
organisations  engaged  in work on the prevention  of HIV/AIDS. 

During the  implementation  of the  1994-1995  action plan,  a total  of  134 projects  (59  in 
1994  and  75  in  1995) received  financial  support  from  the  Commission.  These  various 
projects  are distributed  among the different  areas of activity  as  follows: 

Knowledge, attitudes and behaviour of 
the  general  public  and  certain  target 
groups;  information  and  awareness-
raising  campaigns  for  the  public  and 
these groups 

Measures  for  children  and  young 
people 

Prevention  of  HIV 
among  particular  groups  and 
particular  settings 

transmission 
in 

33  projects 

19 projects 

29  projects 

Social  and  psychological 

support 

19 projects 

COM (93) 453 final. 
No 94/C  108/08, OJ C  108, 16 April  1994, p. 19. 
No 95/C  82/09, OJ C 82, 4 April  1995, p. 9. 
No 92/C  181/08, OJ C  181, 17 July  1992, p. 15. 

Gathering 

data 

on  HIV/AIDS 

19 projects 

against 
Combating  discrimination 
people with HIV and AIDS and those 
close to them 

5 projects 

Altogether,  these  projects  represented  a  total  Community  contribution  of  ECU  17.7 
million (ECU 9.0 million in 1994 and ECU 8.7 million in 1995). The average Community 
contribution  per  project  funded  was  ECU  132  000,  with  a  rate  of  funding  generally 
between  50  and  70%.  By  way  of  comparison,  the  "Europe  against  AIDS"  action  plan 
Î 991-1993  supported  150 projects  with  total  funding  of  ECU  12.36  million,  giving  an 
average  Community  contribution  of ECU  82 400 per  project. 

III.  WORK  CARRIED  OUT  UNDER  EACH  AREA  OF  ACTIVITY  OF  THE 

ACTION  PLAN 

The  various  actions  are  classed  in  accordance  with  the  areas  of  activity  set  out  in  the 
Annex to European Parliament and Council Decision No  1729/95/EC. As these areas are 
interdependent,  some projects  have aspects which relate to a number  of areas. A project 
is therefore  classified  by  taking the predominant  aspect  into account  (Annex II  contains 
a  summary table). 

AREA OF ACTIVITY  1:  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 are key elements 
in any prevention  strategy. Also, precise information  is a prerequisite in order to be able 
to affect  behaviour  and  thus combat  discrimination. 

The Commission funded  33 projects  in this area: 

- 

- 

A Franco-Belgian  information  and  awareness-raising  campaign  was carried  out, 
aimed  at  populations  of  non-European  extraction  through  the  dissemination  of 
information  material translated into ten non-European languages: video cassettes, 
information  brochures, posters and discussions. 

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 
carried  out.  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  various  national  Parliaments  were  invited  to  a 
European  conference  organised  for  them,  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 following  a similar experiment in France, 
with  the  aim  of  making  information  accessible  to  all  levels  of  the  population. 
More  than  1 000  exhibition  kits  and  information  brochures  were  distributed  in 
towns,  youth  organisations, 
local  authorities  and  educational  and  health 
organisations.  The  advantage  of the exhibition  is 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 duplication of effort  within the European Community. The Commission 
accordingly  subsidised three analytical projects at Community  level.  The first was 
aimed  at  the  general  public,  the  second  at  target  groups  such  as  women, 
homosexuals,  young  people  and  ethnic  minorities  and the  third  at travellers  and 
tourists.  Three  universities  therefore  concentrated  on  collecting  and  examining 
studies already carried out in the 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,  so  that  the  possibility  of  carrying  out 
coordinated  measures  at Community  level  could  be  determined. 

The  Commission  supported  a project  involving  four  Member  States  intended  to 
verify  the  impact  of  information  on  changes  in  the  knowledge,  attitudes  and 
behaviour  of  the  groups  involved  and  to  propose  a  teaching  model  aimed  in 
particular  at  primary  prevention.  The  role  of  social  and  cultural  values  and 
standards, and of  socio-cognitive  factors  associated with  information  processing, 
in  mediating  between  the  information  given  to  individuals  and  any  changes  in 
attitudes  and behaviour  was  analysed  in this  context. 

The  Commission  supported  a  project  which  utilised  extensive  statistical  and 
interview  data  derived  from  a  major  multi-country  study  on  "Managing  AIDS" 
supported by the WHO European Centre. The findings of this study have practical 
implications for better ways of managing and preventing AIDS, but their  diffusion 
will  not  produce  sufficient  motivation  to  change  policy  and  behaviour.  This 
project therefore  proposed a motivational  change method in each of four  Member 
States  (Belgium,  Italy,  Netherlands  and  Portugal)  to  work  through  the  major 
findings.  It  will  permit  the  enhancement  of  interactive  learning  between  the 
organisations  and  the  initiation  of  an  accurate  evaluation  of  past  successes  and 
failures,  leading  to  new  action-oriented  policies. 

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.  The  results  of  this  work  were 
published  internationally. 

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. 

In  dealing  with  AIDS,  doctors  and  health  care  systems  are  faced  with  social, 
ethical  and  political  problems.  Similarly,  governments  must  organise  and  bring 
about  international  solidarity.  In  order  to  analyse  the  correlations  between  the 
epidemiology  of  AIDS,  social  phenomena  and  population  movements,  an 
international  interdisciplinary  conference  was  held  under  the  auspices  of  the 
Commission.  This  took  place  in  Paris  on  17 and  18 October  1995  and  provided 
non-specialists, political  decision-makers  and journalists with  information  on  the 
impact  of  AIDS  on  society  and on  demographics. 

A conference  on the subject "Nurses and AIDS" was organised under Commission 
auspices in Barcelona from  24 to 27 November  1995.  The aim of this  conference 
was to  meet the  need  felt  by  nurses to  exchange  information  and experience  and 
to  reduce  their  feeling  of  vulnerability  in relation  to  HIV/AIDS. 

The Commission provided financial  support for a project to translate the brochure 
"AIDS:  the  facts,  the  hopes" into  all  the  languages  of  the  Community,  adapting 
these  translations  to  the  specific  realities  of  each  Member  State. 

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.  An analysis  and  comparison  of  labour  and  social  protection 
legislation  in  these  two  countries  with  regard  to  workers  with  HIV/AIDS  was 
carried  out.  Recommendations  were  formulated  for  the  European  Trade  Union 
Confederation. 

The  sexual  behaviour  of  and knowledge  of AIDS  among  a representative  sample 
of female  university students in Greece were analysed in cooperation with various 
European  partners.  Their perception  of  the  obstacles  to  and advantages  of  using 
condoms  were  examined. 

The "Europe Against AIDS" summer campaign, which the Commission supported 
in  1994  and  1995,  was  aimed  at  improving  AIDS  prevention  among  young 
holidaymakers  and  tourists  through  use  of  the  media  (posters  in  stations  and 
airports,  press  advertisements,  particularly  in  youth  magazines,  television  and 
radio advertising and distribution of T-shirts and stickers) and in conjunction  with 
national  AIDS agencies and youth networks in the majority of Member States and 
some  non-member  countries  (use  of  "Europe  Against  AIDS"  images  in  the 
communications  media of tourist bodies such as youth hostels and camp sites and 
in magazines for members of,  for example, the Youth Card and Interrail schemes). 
The  messages  and  logos  used  were  identical  in  all  participating  countries. 

An information  campaign aimed at young people was organised in  1994 and  1995 
through  the  cooperation  of  300  radio  stations  in  various  Member  States.  This 
provided  an  opportunity  to  reach  young  people  through  advertisements,  news 
bulletins,  personal  testimonies,  discussions  and  interviews.  Provision  was  also 
made  for  link-ups  between  the  stations  and off-the-air  measures  such  as the  free 
distribution  of condoms,  information  packs  specially  designed  for young  tourists, 
tape compilations of the above-mentioned radio programmes and lists of telephone 
helpline  numbers. 

Better than any other medium,  local radio often  reaches excluded or marginalised 
groups  in  urban  and  rural  areas  throughout  Europe.  The  Commission  therefore 
supported  the  establishment  of  a monthly  European-scale  radio  broadcast  aimed 
at  these  groups.  Seven  Member  States  were  involved  in  this  measure,  the  main 
objective  of  which  was  to  provide  information  on  high-risk  behaviour,  methods 
of  transmitting  the  disease,  associations  and  institutions,  the  most  effective 
preventive  measures,  etc.  This  was  done  by  means  of  examples  from  each 
Member  State of the European Community, through the European network of the 
World  Association  of  Local  Radio  Stations  (AM ARC-Europe). 

In  order  to  make  ethnic  minorities  in  four  Member  States  more  aware  of  the 
problem  of  HIV/AIDS,  the  Commission  assisted  with  a  project  using  radio 
programmes  and  helplines  for  transmitting  information  in  the  various  languages 
of  the  groups  concerned. 

The  Commission  supported  a  three-day  event  (TRANSMISSION  '96)  aimed  at 
developing  strategies for using new information technologies  in AIDS prevention. 
The main aim was to encourage people working in the prevention and/or treatment 
of  HIV/AIDS  to  understand  and use  these  technologies. 

In order to  promote  cinema  and video  as  means  of  providing  information  on the 
HIV/AIDS  epidemic,  the  Commission  supported  the  second  International  Film 
Festival  on  HIV  and AIDS,  held  in Paris  from  4  to  9  April  1995. 

- 

There  is  a  need  to  collect  more  information  than  currently  exists  about  how 
Community citizens regard their own health status and the health systems of their 
Member  States,  as  well  as  their  perception  of  priorities  in  health.  Such 
information  can  play  a  valuable  role  in  supporting  health  programmes  at 
Community  level  and  in  enabling  Member  States  to  plan  and  evaluate  their 
policies and priorities and make comparisons with those of other Member States. 
The problem of HIV/AIDS infection has been a regular subject of Eurobarometer 
surveys since  1989. These have examined three main parameters: the attitudes of 
Europeans  to  HIV/AIDS  infection;  their  attitudes  to  the  measures  to  be  taken; 
knowledge and proximity of the phenomenon. A Eurobarometer  survey on blood 
safety,  blood  transfusion  and  HIV/AIDS  was  carried  out  at  the  request  of  the 
Council of Health Ministers in April-May  1994. In  1995, the Commission carried 
out a Eurobarometer survey on "Europeans and public health" containing a chapter 
on  HIV/AIDS.  This  survey  provided  an  up-to-date  picture  of  the  opinions  of 
European citizens, while also analysing trends over a six-year period.  It was also 
the first Eurobarometer  survey on this subject  in the new Member  States. 

AREA OF ACTIVITY 2:  Measures  for children  and young  people 

Obviously, young people  are a primary  target  group for  the information,  education  and 
prevention  measures  implemented  in  the  context  of  the  "Europe  against  AIDS" 
programme. 

In this area of activity, the Commission contributed  to nineteen  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  led to the drawing up of a European consensus document with regard 
to HIV/AIDS prevention  in schools. 

A joint prevention programme was set up in Spain and Portugal  aimed primarily 
at schoolchildren aged  13-14 (approximately  100 000). The interesting feature  of 
this  project  is  that  it  involved  cooperation  by  teachers  and  parents.  One  of  the 
fundamental  aspects was  to  combat  discrimination  against  infected  people,  and 
particularly  HIV-positive  children  in  schools.  Under  the  project,  educational 
material  was widely  distributed  in the two countries  concerned. 

The  Commission  funded  a  week  of  HIV/AIDS  prevention  measures  ::  .1 region 
of  France  between  27  November  and  1  December  1995.  This  campaign  was 
organised  with  a  view  to  informing  and  making  young  people  awa  e  of  the 
problem  of  AIDS  (means  of  transmission,  protection,  etc)  and  overci. iiing  the 
taboos  surrounding  the  disease  in  order  to  be  able  to  talk  about  the  problem  of 
AIDS  in  a  spirit  of  frank  discussion  based  on  the  principle  of  tolerance.  Two 
similar  measures were also carried  out  in the  United  Kingdom  and  in  Germany. 
The United Kingdom  project was aimed at young people in schools and  involved 
the use by the pupils themselves of audio-visual technologies. The German project 
was  intended  specifically  for  young  people  (in  or  out  of  school)  in  the  region 
bordering  on  Belgium, and took  into account the specific  cultural  characteristics 
of that  region. 

The  Commission  helped  to  carry  out  a  training  project  for  an  HIV/AIDS 
prevention  network  in  two  Member  States (Spain  and  Portugal)  aimed  at} oung 
people  and  involving  conscientious  objectors.  The  aim  was  to  contribute  to  the 
dissemination of knowledge on HIV/AIDS, to increase the awareness of the group 
vulnerable  to  infection  and  to change  attitudes  and  sexual  behaviour. 

The  Commission  supported  a  Spanish  project  aimed  at developing  and  testing a 
model for  intervention and formulating  specific recommendations for  introducing 
measures aimed  at young  people  not  in schools. 

A conference  was held in Denmark in the spring of  1994 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 
and  widespread  impact  in all  Member  States, as approximately  6 million  young 
Scouts and Guides were directly or indirectly involved.  This event was supported 
by the  "Europe  against  AIDS" programme  in  1994 and  1995. 

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. 

10 

- 

- 

The  Commission  supported  an  action  and  analysis  project  carried  out  in  three 
Member  States  (France,  Belgium  and  Luxembourg)  relating  to  images  of  AIDS 
among  young  people  in  difficulties,  based  on  a  series  of  photographs.  This  in-
depth survey  into images of the HIV-positive  state and of the disease is likely  to 
provide better  working  tools and to develop preventive  strategies better  suited to 
this target  group. 

Finally,  two  projects  aimed  specifically  at  young  people  and  using  theatrical 
techniques  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.  The  Commission  ensured  that  all 
activities  in this area  were  carried  out  in  cooperation  with  the  European  "AIDS 
and  Youth"  Information  Centre established  under the  1991-1993  action  plan. 

AREA OF  ACTIVITY 3:  Prevention  of  HIV  transmission  among  particular 

groups  and  in  particular  settings 

Under  this area of  activity,  the Commission supported  twenty-nine  projects: 

Travel and tourism 
- 

A programme was established to prevent HIV/AIDS transmission, aimed at young 
European tourists visiting Greece. The project was implemented with Commission 
support and in partnership with two other Member States. Following consultation 
with  key  people  in  the  tourism  sector  on  how  to  achieve  the  objectives,  a 
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 importance of HIV/AIDS prevention measures targeted at migrant groups and 
support services for migrants infected  with the virus has been recognised on many 
occasions.  The  "AIDS  and  Mobility"  network,  with  the  support  of  the 
Commission,  continued  to  act  as  coordinator  between  the  various  European 
organisations  working  in  the  field  of  HIV/AIDS  prevention  among  migrant 
groups, ethnic  minorities  and travellers. In particular,  these activities  include the 
provision  of  documentation  services  such as databases, educational  material  and 
information  on the various projects  carried  out  in this area,  as well  as organising 
seminars dealing  with  the  interaction  between  AIDS  and  migratory  movements. 

11 

- 

In cooperation with this network, a major  meeting was organised  bringing 
together the coordinators of national  programmes to combat AIDS on the 
one hand and, on the other, representatives of ethnic minority organisations 
which are also fighting  this scourge. The aim of this meeting  was to gain 
an  understanding  of  the  problems  and  specific  requirements  of  ethnic 
minorities with regard to health and HIV/AIDS and to permit an exchange 
of  ideas which might  lead to the development  of  national  strategies more 
suited to  the  specific  needs of the  groups  involved. 

The Commission also considered it worthwhile subsidising a project aimed 
in  particular  at  monitoring  and  evaluating  services  provided  to  Irish 
migrants travelling between Ireland and the United Kingdom. This project 
was also  incorporated  into the  "AIDS and  Mobility"  network. 

A  German  institute  undertook  an  analysis  of  the  typical  problems  r^Lting  to 
HIV/AIDS/STDs  in  the  external  border  regions  of  the  European  Community. 
Given  the high degree of movement of people, these regions present a particular 
problem  with  regard  to  HIV/AIDS/STD  prevention.  The  main  aims  of  this 
measure  were to develop  specific  preventive  methods  adapted  to the situation  in 
these  regions  and  to  identify  the  measures  to  be  taken.  This  work  will  help  in 
establishing  a  European  network  devoted  to  the  problem. 

In  Galicia  (Spain)  and  in  northern  Portugal  approximately  9%  of  people  with 
AIDS are seamen. Studies show a high prevalence of HIV infection  in this group 
and,  especially,  a  lack  of preventive  measures. For  this  reason,  the  Commission 
considered it worthwhile supporting a pilot project  in Spain and Portugal  in order 
to  determine  the  attitudes  and  behaviour  of  the  groups  of  seamen  concerned  in 
relation to HIV/AIDS and to sexually transmitted diseases and to reduce the risks 
of  HIV/AIDS  transmission. 

Prisons 

Having  identified  a higher  rate  of  HIV  infection  among  reoffenders  in  a French 
prison,  it  was  assumed  that  infection  had  occurred  during  previous  periods  of 
imprisonment. In the absence of data for  Europe, it was necessary to evaluate the 
risks of  infection  in prison  in order  to draw  up specific  prevention  policies. The 
Commission  supported  a  pilot  study  project  carried  out  by  a  French  institution, 
which  enabled  it to: 

estimate  the  prevalence  of  high-risk  practices  and  of  certain  socio-
demographic and psychosocial determining factors among prisoners before 
and  during  imprisonment; 

- 

document the rate of infection during imprisonment and compare high-risk 
practices  among  prisoners in the  light  of  the concept  of  reoffending. 

12 

The  results  of  this  experiment  will  provide  a  basis  for  similar  studies  in  other 
Member  States  and  for  drawing  up preventive  policies. 

In this context,  and thanks to the efforts  of the Commission, France and Germany 
cooperated on a feasibility  study into the establishment of a European network  for 
the  prevention  of  HIV  infection  in  prisons.  Six  Member  States  are  currently 
involved  in  this  network,  with  the  aim  of  developing  common  tools  for 
epidemiological  surveillance, observation of high-risk behaviour in prisons and the 
development  of joint  primary  prevention  strategies  in  the  European  Union. 

Intravenous  drug  users 

- 

- 

In  order  to  measure  the  effectiveness  of  their  policies  on  public  health  and  the 
prevention  of AIDS  and drug abuse, a number of  European cities  felt  the need to 
establish  a  register  of  drug  users  taken  into  care,  particularly  those  following  a 
methadone  treatment  programme.  This  trend  towards  the  quantitative  and 
qualitative  growth  of  registers,  however,  runs  the  risk  of  infringing  individuals' 
privacy  by exceeding  established legal  standards. For this reason, the Commission 
supported a programme aimed on the one hand at promoting the development and 
adaptation  of  local  HIV/AIDS  prevention  policies  among  drug  users and,  on  the 
other,  at identifying  new  common  guidelines  to enable  registers to  continue  to be 
drawn  up  while  respecting  individual  rights. 

A  university  in  the  United  Kingdom  carried  out  a  project  in  that  country  and  in 
Germany  analysing  risk  factors  in HIV  infection  among  female  intravenous drug 
users.  As  part  of  this  measure,  HIV  prevalance  and  high-risk  behaviour  among 
these  women  were  examined,  as  were  their  knowledge  and  attitudes  with regard 
to health. Their experiences in relation to preventive measures were than analysed. 
This  project  should  make  it  possible  to  introduce  appropriate  HIV/AIDS 
prevention  programmes  and define  general  social  policies  with  regard to  women 
drug  users.  Finally,  the  various  results  and  conclusions  of  this  measure  were 
compared with data gathered through similar measures in  Spain.  France and Italy 
under  the  1991-1993  plan. 

Women exposed  to particular  risk  of  HIV  contamination 

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  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 

13 

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. 

After  evaluating  the  results  obtained  in  the  first  phase,  funded  in  1993,  the 
Commission  considered  it  necessary  to  renew  support  for  the  EUROPAP 
(European  network  for  the  prevention  of  AIDS  among  prostitutes)  project.  This 
second  phase  was  used to: 

- 

- 

develop  and  extend  preventive  measures  among  prostitutes  in  eleven 
Member  States,  taking  account  of  the  conclusions  and results  of  the first 
phase; 
develop  models  of  good  practice  for  the  prevention  of  HIV  and  sexually 
transmitted  diseases,  as  well  as  access  to  support  services  for  prostitutes; 
strengthen  the  international  network  of  those  involved  in  the  prevention 
field  and help  with the  training  of  social  workers; 
exchange  material  on  health  education  through  the  establishment  of  a 
library  centralising  all  existing  material  on  HIV  prevention  and 
prostitution. 

In  order  to  obtain  maximum  benefit  from  HIV  and  STD  prevention  measures 
intended  for  migrant  prostitutes,  as  well  as  from  contacts  established  with  the 
medical  services  of  the  countries  concerned,  the  Commission  also  considered  it 
necessary  to  repeat  the  TAMPEP  project,  first  funded  in  1993.  One  of  the  main 
aims  is  to  encourage  the  use  and  dissemination  of  the  TAMPEP  method  of 
prevention among health services and to enable those persons interested to obtain 
information  and  training  within  the  organisations  involved  in  carrying  out  the 
project. 

The Commission provided financial  support for the development of a pilot project 
on the prevention and detection of HIV/AIDS among female prostitutes in the city 
of  Valencia,  with  the  aim  of  reducing  the  incidence  of  sexually  transmitted 
diseases  and  HIV/AIDS  infection  among  prostitutes,  in  particular  by  organising 
optional  screening  tests and by  providing  assistance to  women  infected  with the 
HIV  virus  by  providing  counselling  adapted  to  their  situation.  Exchanges  of 
information  arising  from  this  pilot  experiment  with  other  organisations  in  the 
European  Community  working  in  the  same  area  have  taken  place,  particularly 
with  organisations  involved  in  the  working  party  established  by  the  European 
Commission. 

Two  primary  prevention  projects  aimed  at  women  were  implemented  with 
Commission  support,  one  in  the  border  region  of  Germany,  France  and 
Luxembourg  (Saar-Lor-Lux),  and  the  other  in  the  United  Kingdom  and  the 
Netherlands.  With  regard  to  the  first  project,  several  categories  of  women  were 
approached  (women  with  an  HIV-positive,  bisexual,  intravenous  drug-using 
partner or women drug users, prostitutes, women who change partners  frequently, 
etc).  The  second  project  was  aimed  more  specifically  at  lesbian  or  bisexual 
women. 

14 

Vertical HIV transmission from mother to child 

- 

The  Commission  supported a comparative  analysis of  antenatal  HIV  screening 
carried  out  in  various European  centres.  This  required,  in particular,  a  survey 
relating to the psychological  barriers and difficulties  encountered  among health 
professionals  and pregnant  women  in relation  to  screening,  and an analysis  of 
existing training programmes in the field of obstetrics dealing with the subject of 
HIV/AIDS. 

Other populations 

A Danish prevention project aimed at homosexuals visiting Spanish tourist sites 
was carried out with Commission support. To this end, volunteers were specially 
trained in cooperation with the authorities and local organisations combating aids. 
The activities, which included the distribution of material relating to prevention 
and information, as well  as diseussions, also involved the managers and staff of 
leisure facilities in the areas concerned. 

- 

A primary prevention project aimed at young male prostitutes was implemented 
with  Commission  support  in  the  border  region  of  Germany,  France  and 
Luxembourg (Saar-Lor-Lux). 

Safety of blood and blood products 

- 

- 

The  continuation  of  efforts  aimed  at  promoting  European  Community  self-
sufficiency  in  blood  is  specifically  mentioned  in  the  Decision  extending  the 
"Europe against AIDS" programme. Accordingly, two analyses carried out in the 
Netherlands received Commission support in 1994. 

The Commission also supported a project in  1995 to examine  issues relevant to 
the  inspection  and  accreditation  of  blood  transfusion  establishments;  this  was 
carried out under the coordination of a Greek university. 

AREA OF ACTIVITY 4:  Social and psychological  support 

The Commission supported nineteen 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. 
Furthermore,  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. 

15 

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  from the public and the groups involved.  In this context, a project for 
an  electronic  system  was  launched  for  dissemination  and  exchanges  between 
information  and  documentation  centres. 

The  programme  also  supported  a conference  held  in  Copenhagen  from  15  to  19 
August  1995  on  the  subject  of  AIDS  and  social  work,  bringing  together  social 
workers, non-governmental  organisations, representatives of European authorities 
and  the  press.  The  conference  provided  an  opportunity  to  discuss  and  develop 
methods,  strategies,  models  and  recommendations  relating  to  social  work  in  the 
context  of  HIV/AIDS.  It also  provided  an opportunity  to examine  the  possibility 
of  establishing  a network  of  social  workers  and other  interested parties. 

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.  An  analysis  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  people,  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  of  information  and  comparisons  with  other  Member  States. 

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.  In addition,  a support measure  aimed  specifically  at women  with HIV 
was  carried  out  in  Germany,  Belgium  and the Netherlands. 

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,  made  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. 

16 

The  Commission also encouraged a pilot project  in the  Valence  region  for the 
reintegration  of  young  HIV-positive  people  or  AIDS  patients  into  social  and 
working  life,  enabling  them  to  confiront  social,  emotional,  economic  and 
educational  prejudices.  To  this  end,  courses  and workshops  were  organised  to 
provide them with psychological support and encourage their personal expression, 
creativity and autonomy. 

A  pilot project to assist and support those  with HIV  or AIDS  was  set up with 
Commission support. This measure, established in the Athens region, was aimed 
particularly  at,  on  the  one  hand,  people  who  were  unemployed  or  had  few 
resources  as  a  result  of  their  HIV  infection  and,  on  the  other,  at  families 
financially  dependent on the income  of an infected  person.  As  a result of  this 
project, cooperation between various organisations working on AIDS in different 
fields was reinforced through exchanges of information and experience. 

The  Commission  contributed  to  a project  aimed  at  collecting  information  and 
describing  the  medical  and  social  services  available  to  families  affected  and 
children infected  with HIV/AIDS. This measure was carried out in ten Member 
States.  In order  to  carry  out  this  work,  the  extent  of  the  problem  of  families 
affected  by HIV/AIDS was estimated and the socio-demographic origins thereof 
was studied. Subsequently, the medical  services provided  for these families and 
their interaction with the services offered by non-governmental organisations were 
described. The aim of this measure was to provide comprehensive information on 
those services best suited to the needs of families. 

Along the same lines, an Italian institution collected information on the activities 
and functions of non-hospital services and structures for HIV carriers, in order to 
disseminate this information  at European level.  This information  may  be useful 
for  various  categories of  people,  particularly  those  affected  by  HIV/AIDS  and 
their families or health professionals. 

The programme funded a project relating to the quality of assistance and support 
services in Europe. A comparison was made of the organisation of these services 
in  the  various  Member  States.  A  survey  was  carried  out  with  the  aim  of 
identifying  more  closely  and  understanding  the  needs  of  people  with  AIDS, 
Finally, recommendations for good practice were drawn up. 

Lastly, the Commission supported a project with the main aim of: 

- 

- 

improving the quality of assistance given to children with HIV and to their 
families, by the practical adaptation of current health and social assistance 
schemes to the needs of the children and their families; 

integrating 
organisations helping infected children. 

the  activities  of  governmental  and  non-governmental 

17 

The  Commission made  efforts  to coordinate  measures by the bodies  responsible 
for  the  four  projects  referred  to  above,  particularly  with  the  activities  of  the 
European  Forum  for  HIV-positive  children,  established  under  the  1991-1993 
action plan. 

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,  collection  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  prevention 
activities. 

Under  this area  of  activity,  the  Commission supported  19 projects: 

It continued to assist the European Centre for the Epidemiological  Monitoring of 
AIDS in  1994 and  1995. The main aim of this project  is to maintain and develop 
the  European  surveillance  system  for  AIDS  and  HIV  infection.  The  system 
enables  national  surveillance  data  to  be  collected,  analysed,  interpreted  and 
disseminated at Union level and for each Member State. The secondary  objectives 
developed  on  the  basis  of  the  programme  include  an  evaluation  of  surveillance 
methods,  determination  of  the  incubation  period  and  of  life  expectancy  with 
AIDS,  analysis  of  epidemiological  trends  and  forecasting,  together  with  an 
analysis of diseases whose epidemiological  characteristics are associated with the 
HIV  epidemic  (tuberculosis, hepatitis, sexually  transmitted  diseases). During  the 
period  covered  by  the programme,  the  Centre  developed: 

- 
- 

- 
- 

- 

- 

an analysis of the  incidence  of AIDS  by year  of birth; 
surveillance  of  perinatal  HIV  infection  (children  infected  by  their 
mothers); 
analysis of factors associated with various pathologies indicative of AIDS; 
an analysis of the association between the incidence of AIDS and  HIV in 
the  various  countries  on  the  one  hand  and,  on  the  other,  factors  such  as 
sexual  behaviour,  behaviour  in  relation  to  drug  abuse,  prevention 
programmes,  the  demographic  structure  of  the  population,  the  socio 
economic  level  of the countries, etc.; 
an  estimate  of  the  incidence  of  HIV  on  the  basis  of  repeated  data  for 
seroprevalence  among pregnant  women,  obtained  through  non-correlated 
anonymous  surveys,  and  data  on  fertility  broken  down  by  the  women's 
age; 
an analysis of  survival among AIDS patients; 

18 

- 

- 

an evaluation of the impact of the dissemination of methods of preventing 
Pneumocystis carinii; 
a geographical data system which would enable an improvement in graphic 
representation and spatio-temporal  analysis of data. 

The European Centre also received financial  support from the Commission for a 
feasibility  study aimed at drawing up a development  plan for the publication  of 
a bilingual  (French-English) European bulletin on surveillance of  communicable 
diseases, including AIDS. 

The  Institute for Hygiene  and Epidemiology  in Brussels carried out an analysis 
of  the  collection  of  data  relating  to  the  demand  for  HIV  tests  and  other 
consultations of  general  practitioners  relating  to  HIV/AIDS  in cooperation  with 
five  countries  involved  in  a  sentinel  network.  This  institute  also  carried  out a 
survey of HIV/AIDS  counselling  by general practitioners. 

The Public Health Laboratory Service Board of London conducted an enquiry in 
order to advise the Commission on the feasibility of setting up an epidemiological 
network  for  the  surveillance  of  communicable  diseases  in  the  European 
Community  and  to  provide  expert  advice  on  the  surveillance  priorities  and 
functions,  such as the development  of  electronic  exchange  of  information.  This 
enquiry also led to the elaboration of a Communicable Diseases Charter (including 
AIDS)  at Community level. 

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  aim  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. 

The  Commission  contributed  to the  realisation of  a project  aimed  at setting up 
guidelines  for  control  and  management  of  hepatitis  C.  This  project  is  broadly 
based on epidemiology  and on focusing  on host factors as predictors of  disease 
outcome. 

19 

Three  universities  (in  Greece,  Belgium  and the  United  Kingdom)  analysed the 
costs  engendered  by  HIV/AIDS  for  the  health  and  social  services  ;n  Member 
States, and analysed ways of controlling them using methods common to all these 
countries; the aim 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  for  the 
training of nursing auxiliaries dealing with the risk of HIV infection among drug 
users. This  is now being published internationally.  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  deals 
specifically  with  HIV  infection  and  its  interaction  with  tuberculosis,  making  it 
possible  to  cover  shortcomings  in  information  about  and  prevention  of  these 
associated diseases. This multidisciplinary approach, overcoming barriers between 
countries  and  disciplines,  met  with  a  favourable  response  both  from  the 
international bodies involved in combating these two epidemics and from doctors 
in  the  countries  concerned.  For  this  reason,  the  Commission  considered  it 
worthwhile  continuing this measure in  1995. 

The Commission also continued to provide support for a Belgian project  on the 
training  of  health  professionals  in  1994  and  1995.  The  aim  was  to  improve 
communication  between doctors and patients affected  by HIV/AIDS and reduce 
discrimination against those with HIV or AIDS. To this end, health professionals 
underwent training to enable them to improve their communication techniques. In 
the  light  of  the  results  obtained,  this  training  was  evaluated,  adapted  and 
disseminated in nine Member States. 

The  Commission  funded  a project  carried  out  by  a  group  of  United  Kingdom 
universities to evaluate the training given to people working in the field of AIDS. 
Two  similar  measures  were  carried  out  by  Spanish  institutes,  relating  to  the 
training of people working for non-governmental organisations active in the  field 
of AIDS (in cooperation with the United Kingdom group referred to above) on the 
one hand and in the field of drug prevention on the other. 

An international seminar was held under the auspices of the Commission, dealing 
with  methodological  aspects and  scientific  priorities  in  relation  to  the  study  of 
asymptomatic  patients  (long-term  HIV-positive  patients  showing  no  apparent 
clinical  or  immunological  progression).  The  results  of  this  activity  led  to  the 
publication of recommendations  for rationalising  research strategies on the non-
progression of HIV  infection. 

20 

AREA  OF ACTIVITY  6:  Combating discrimination against people with HIV and 

AIDS  and those  close to them 

The  Commission supported five projects  under this area of  activity: 

- 

- 

An  analysis  of  the  status  of  implementation  of  the  Council  Resolution  of 
22 December  1989  . 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 United  Kingdom  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/AIDS 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.  Another  project  attempting  to  identify  existing  barriers  in  alUhe 
Member  States  to  the  adoption  of  anti-discrimination  measures  was  supported, 
with  particular  reference  to  employment,  insurance,  housing,  education  and  the 
health  system  The  second  objective  was  to  encourage  the  application  of  these 
measures  in the  Member  States. 

The  Commission  assisted  with  the  carrying  out  of  a  project  analysing  the 
consequences  of  discrimination  against  people  with  HIV/AIDS  in  relation  to 
access to public health services, and examining access to legal services in the field 
of  discrimination.  This  analysis  was  carried  out  in  six  Member  States.  The 
particular  aim  of  this  project  was  to  develop  models  of  good  practice  and  to 
identify  strategies and  policies  in a European  context. 

AREA OF ACTIVITY  7:  Coordination  with  other  programmes  dealing  with 

HIV/AIDS 

In  order  to  ensure  coordination  of  the  different  Community  programmes  and  policies 
relating  directly  or  indirectly  to the  prevention  of  HIV transmission  and  the  combating 
of AIDS, the Commission established an Interservice Group on AIDS, bringing  together 
on a regular  basis the various Directorates-General  involved.  This group met 4 times in 
1994  and  1995.  These  meetings  make  it  possible  to  exchange  information  at  regular 
intervals  on the  implementation  of the programmes concerned,  on measures  in progress 
and  on  initiatives  being  prepared  in  the  main  areas:  public  health,  prevention  and 
education,  research,  the  pharmaceuticals  industry,  cooperation  with  the  developing 
countries, etc. 

OJ C  10,  16.1.1990,  p. 3. 

21 

The  Commission  took  an  active  part  in  the  International  Conference  on  AIDS  held  in 
August  1994 in Yokohama. A preparatory  conference  was organised  in order to present 
the different  Community  programmes  and  certain  other projects.  The  Commission was 
also represented by a stand in the exhibition hall. 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. 

At  the  end  of  1995, arrangements  were  also  made  for  the  Commission  to  play  a  very 
active  part  in  the  International  Conference  on  AIDS  to  be  held  in  Vancouver  in  July 
1996: 

- 

- 

direct  participation  by  Commission  representatives  in  the  organisation  of  the 
conference  and  in the sessions; 
a  stand  setting  out  the  activities  and  achievements  of the  European  Community 
in combating  HIV/AIDS; 
a preparatory conference  on "Public health - AIDS" in the European Community. 

IV. 

THE  FIGHT  AGAINST  AIDS  IN  THE  CONTEXT  OF  OTHER 
COMMUNITY  POLICIES 

1. 

Research 

Medical  research  at EU  level  aims at: 

- 
- 
- 

- 

- 

pooling  of data; 
avoiding  duplication  of  efforts; 
standardisation  of methods and reagents; 
better  selection of cohorts  for  clinical trials; 
bringing  together  complementary  skills in multi-faceted  projects; 
improving  training possibilities for  young  researchers in specialised fields; 
improved  exploitation  of the results in the public health  industry; 
creating  better  access to research  results for  all parts of Europe; 
establishment  of  European  shared  facilities  for  animal  experimentation  in  order 
to reduce  the overall  number  of animals used  in experimentation; 
increased  cost-effectiveness. 

Ever since  1983, only two years after the first case of AIDS was diagnosed, the European 
Commission has taken an active role in the fight against the AIDS epidemic. Funding of 
research  on  AIDS  began  in  1987  under  the  Fourth  Medical  and  Health  Research 
Programme. The ambitions of the programme as well as the budget available have been 
significantly  increased  over  the years. A total  of  38 projects  including  several  hundred 
research teams were  funded  under  the BIOMED  1 programme  (1990-1994).  Within the 
framework  of  the  BIOMED  2 programme  (1994-1998),  13 AIDS-related  projects  were 
initiated  in response to the First Call in  1995-1996. The current  Second  Call will add to 
this number. 

22 

The projects  are all closely  related to the three main priorities of the programme: 

- 
- 

- 

development  of  safe  and effective  vaccines against HIV  infection; 
development  of  therapeutic  agents  suppressing  progression  of  the  disease  in 
infected  individuals; 
research on the epidemiology  of the virus in Europe. 

Under  the  INCO  international  cooperation  programme,  and  its  section  concerned  with 
research into health in the developing countries, the Commission is supporting a number 
of  important  projects  involving  cooperation  between  European  and  African  research 
teams. 

One of these multilateral projects, also supported by DG VIII, has become widely known 
as  the  Mwanza  study;  here,  in  Tanzania,  it  was  shown  that  HIV  transmission  could 
effectively  be halved in a population receiving screening and treatment for STDs, the key 
role  of  which  in  the  transmission  of  HIV  had  been  highlighted  in  earlier  projects 
supported  in Zaïre and,  subsequently, in Kenya. 

A project  aimed at defining  criteria for qualifying  for  STD services, in order to establish 
the maximum  level of efficiency,  is under way  in the Mwanza region,  following  up the 
first study. 

The first call for proposals also made it possible to select joint research projects  into the 
dissemination of HIV sub-types in Africa  and their significance,  particularly  with a view 
to developing  vaccines. 

The Commission is also supporting a large-scale project in cooperation with, in particular, 
UNAIDS  on the differential  distribution  of HIV  in  Africa. 

2, 

The policy  of the Community  with  regard  to AIDS  in  developing  COUP'HPS 

In  1994 and  1995 the Commission continued  its activities in connection with HIV/AiDS 
in developing  countries. 

In a communication  to the  Council and  the European  Parliament'2,  the  Commission set 
out  its  priorities  in  terms  of  policy  principles,  strategies  and  actions  with  reg^d  to 
HÎV/AIDS  in  developing  countries. On  this basis, the  Council  adopted  a  Resolution  m 
May  1994 approving the  guidelines proposed  by the Commission. The Commissi-™ has 
also  prepared  a  legal  basis  for  the  use  of  the  AIDS  budget  line,  This  basis  is  under 
discussion in Parliament  and the Council. 

COM 193) 479 final  of  7  Jutuuy  1994. 

23 

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  and  actions  to  minimise  sexual  and  perinatal 
transmission of HIV/AIDS  and to prevent discrimination; 

breaking the "poverty-instability-HIV/AIDSM cycle by paying particular attention 
to population groups in risk environments (refugees, migrants, etc.); 

strengthening  the  healthcare  and  social  sectors  to  enable  them  to  bear  the 
increasing burdens associated with the spread of the epidemic and its prevention; 

supporting governments in assessing and planning for the impact of the epidemic 
on the various economic  sectors and social  groups ; 

developing  scientific  knowledge  of  the  epidemic,  its  impact  and  the  possible 
interventions  and responses, with the aim of improving the quality thereof. 

In general, the Commission is meeting regularly with experts from the Member States and 
a study on operational coordination on HIV/AIDS at headquarters and country level was 
launched. 

The Commission published  an information  brochure  on the  HIV/AIDS  programme  for 
developing  countries as well  as two books on safe blood in developing  countries: "Safe 
blood in developing countries: Principles and organisation" - ISBN 92-827-5279-8; and 
"Safe blood in developing countries: The lessons from Uganda" - ISBN 92-827-5281-X. 

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  the  rapid  and  simultaneous  dissemination  throughout  the 
Community  of  medicinal  products  for  AIDS  patients.  The  second  relates  to  measures 
taken to ensure, as far as possible, that medicinal products derived from human blood or 
plasma are free  of the virus. 

1. 

Medicinal  products for AIDS patients 

Until  recently,  the  pharmaceutical  approach  for  patients  with  AIDS  and  associated 
conditions was to use viral reverse transcriptase products which prevent replication of the 
virus. Three medicinal products of this type were authorised: zidovudine, ralcitabine and 
didanosine. 

The advent of protease inhibitors, which inhibit the enzyme which breaks down protein, 
represented a different  approach, and the clinical  benefit  to patients looks promising. A 
number of  companies have submitted applications for this type of medicinal  product to 
the European Agency  for the Evaluation of Medicinal  Products (EMEA). 

24 

These  applications  will  benefit  from  the  newly  introduced  centralised  procedure, 
providing access to the entire Community market. Following the scientific opinion of the 
EMEA, the Commission takes a decision which is valid for the whole Community. 

Medicinal products for AIDS are considered a priority for the EMEA and the Committee 
for Proprietary Medicinal  Products, which is the scientific  committee that evaluates the 
application and prepares the opimon. 

2. 

Safety  of blood products 

Council  Directive  89/3 81/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  has  been 
recommended that manufacturers of blood products test plasma pools for a series of viral 
markers, including the HIV-1 and HIV-2 antibodies. 

V. 

EVALUATION 

Ex-ante  evaluation of proposals: 

Ex-ante evaluation of proposals submitted for funding under the programme was carried 
out  in consultation  with  the programme  committee.  In this  context,  care  was taken to 
select projects likely to contribute to achieving the objectives and activities set out in the 
1994-1995  action plan. The objectives of the programme as set out in the Decision of 4 
June  1991 are as follows: 

to develop exchanges of information and experience; 
to promote cooperation and coordination of national activities; 
to encourage Community activities. 

One of the three main criteria for ex-ante evaluation is the Community or transnational 
dimension  of  the  project.  Applying  this  criterion  made  it  possible  to  select  proposals 
likely to contribute to the overall objectives of the programme. 

25 

With regard to the implementation of the activities set out in the programme (detailed in 
the Annex to the Decision of  19 June  1995), the first criterion for ex-ante evaluation of 
proposals was aimed  specifically  at selecting  projects which  contributed directly  to the 
carrying out of the activities set out in the Decision. 

In general,  the  result of  ex-ante  evaluation  was that only  between  one  quarter and one 
third of  the proposals submitted to the Commission were adopted. 

In addition, it should be noted that, between the 1991-1993 action plan and its 1994-1995 
extension phase, the average financial  significance  of projects increased in parallel with 
the strengthening  of their transnational dimension. 

Monitoring of projects: 

The contract terms relating to projects funded under the programme stipulate one or more 
interim  reports and a final report on the execution  of the project.  Examination  of these 
reports  by  the  Commission  makes  it  possible  to  verify  that  the  work  set  out  in  the 
contract  has  been  properly  carried  out;  if  necessary,  the  Commission  can  request 
adjustments.  Verification  of  the work is a precondition  for payment of the Community 
contribution. 

Ex-post evaluation of measures  undertaken: 

Projects funded under the 1995 budget will, technically speaking, not be completed either 
administratively  or financially  until  the end of  1996 or, in some cases, until  some time 
during the first half of  1997. 

At the time  this  report was drawn up, it was therefore  not possible to have an ex-post 
evaluation of the effectiveness  of measures undertaken under the  1994-1995  action plan. 
To this end, the Commission intends to carry out an independent overall evaluation of the 
effectiveness  of the measures undertaken once all activities have been completed. 

VI.  CONCLUSION 

During the  implementation  of the  "Europe against AIDS" action plan  1994-1995, three 
areas of activity under the programme (Nos  1, 3 and 5) accounted between them for over 
70% of the appropriations allocated and nearly two thirds of all projects. 

The  area  of  activity  relating  to  "attitudes  and  behaviour:  information  and  awareness-
raising  for  the  public"  accounted  for  25%  of  projects  (20%  of  appropriations).  This 
allocation of resources is justified  if the vital importance of informing the public and the 
need to be aware of and bring about improvements in attitudes and behaviour as part of 
a global  prevention strategy are taken into account. 

26 

Activities relating to the  "prevention of HIV transmission among particular groups and 
in  particular  settings"  represented  22%  of  all  projects  (26%  of  the  budget).  The 
importance  attached  to  preventive  measures  aimed  specifically  at  these  groups  and 
settings should be seen in connection with epidemiological data and their development 
during 1993-1995, as well as the analysis of methods of transmission (drug injection, also 
in relation to certain settings such as prostitution, prison, male homosexual relations, etc.). 

In  the  area  of  "epidemiological  surveillance  of  HIV/AIDS  and  related  fields",  the 
programme  also provided  significant  support: 22% of  all projects (26% of the budget), 
reflecting  the over-riding  need for reliable epidemiological  data at European level. This 
trend was emphasised in  1996 with the implementation  of  the new programme  for the 
prevention of AIDS and certain communicable diseases (1996-2000). In this connection, 
there will be a case for measuring the effect of the development of surveillance measures 
for other communicable diseases at European level with regard to resources still available 
for HIV-AIDS prevention measures in the context of a total annual budget which remains 
relatively  constant. 

The relative  importance  accorded to these areas of  activity  under the  1994-1995 action 
plan will of course be extended into the new programme on the prevention of AIDS and 
certain other communicable diseases (1996 to 2000) adopted on 29  March  1996 by the 
European Parliament and the Council13, the four aims of which are: 

- 
- 

- 
- 

surveillance  and monitoring of HIV/AIDS and other communicable diseases; 
combating  transmission  of  HIV  and  other  sexually  transmitted  diseases,  with 
particular regard to high-risk environments and behaviour; 
information,  education and training; 
support for persons with HIV/AIDS and combating discrimination. 

At  the  end  of  the  1994-1995  "Europe  Against  AIDS"  programme,  it  is  possible  to 
determine some of the main characteristics relating to the aims of the programme. 

Firstly,  the  1994-1995  action  plan  aroused  great  interest  among  the  various  people 
involved  in  AIDS  prevention  in  Europe,  judging  by  the  number  of  requests  for 
information  and the number of projects submitted to the Commission. 

The  "Europe against AIDS" action plan thus made  it possible to  identify  and mobilise 
those  most  involved  in AIDS  prevention  who  were  likely  to  cooperate  at  Community 
level,  for  example  universities,  research  institutes,  non-governmental  organisations 
(NGOs), national prevention or health education agencies, etc. 

As  far as possible, the Commission encouraged  full  participation by all  Member States 
in  the  activities  of  the  programme.  For  some  of  them,  particularly  the  new  Member 
States, no national bodies received a grant in  1995. However, it should be noted that, in 
each  of  these  Member  States,  organisations  or  institutions  took  part  in  projects  or 
activities under the programme as associated partners (see diagrams in Annex  III C). 

Decision  647/96/EC,  OJ L 95,  16 April  1996,  p.  16. 

27 

Finally,  one  aspect  which  deserves  particular  mention  is  the  progressive  affirmation  of 
the  Community  or  transnational  dimension,  and  the  fact  that  European  cooperation 
networks  have  been  established  around  specific  topics  relating  to  prevention.  The  new 
Community  action programme (1996-2000) can thus count on the support of  cooperation 
networks  in  areas  such as: 

AIDS  prevention  in relation  to  prostitution; 
AIDS  prevention  in prisons; 
migrants  and  AIDS; 
AIDS  prevention  and  cross-border  problems,  etc. 

The rapid developments currently under way in terms of therapies and antiviral  medicinal 
products,  given  broad  coverage  at  the  International  Conference  on  AIDS  held  in 
Vancouver  in July  1996,  have  pushed  back  the  boundaries  of  knowledge  of  this  disease 
and  opened  up  the  possibility  of  remission  in  the  longer  term.  It  would  certainly  be 
wrong,  however,  to  relax  the  efforts  so  far  made  with  regard  to  prevention  at  both 
national  and  Community  level. 

The first and only  real  bulwark against the scourge of HIV/AIDS  is still, more than ever, 
prevention  through  information,  education,  the  use  of  condoms  and  solidarity  with  the 
people  affected. 

28 

ANNEX 1 

PROJECT EVALUATION CHART 

CATEGORY 

A 

B 

C 

D 

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 

» 

DISTRIBUTION  OF NUMBER OF PROJECTS AND TOTAL AMOUNTS COMMITTED  PER AREA OF ACTIVITY IN 1994 

"EUROPE  AGAINST AIDS" ACTION  PLAN  1994-1995 

ANNEX  IIA 

AREA OF  A&HWTY 

TOTAL AMOUNT 
COMMITTED PER AREA OF 
ACTIVITY IN ECU 

F f R C ^ T A GE  OF BUDGET 
COMMITTED PER AREA OF 
ACTIVITY 

NUMBER OF PROJECTS PER 
AREA OF  A C T I VE 

V 

INFORMATION,  ATTITUDES 
AND BEHAVIOUR 
MEASURES FOR CHILDREN 
AND YOUNG PEOPLE 
PREVENTION OF HIV 
TRANSMISSION 
SOCIAL AND 
PSYCHOLOGICAL  SUPPORT 
GATHERING DATA ON 
HIV/AIDS 
COMBATING 
DISCRIMINATION 
COORDINATION WITH 
OTHER PROGRAMMES 
TOTAL 

1 

1 633 810 

1454 214 

810414 

662 447 

3 716 175 

301 422 

420 654 
8999136 

18,16% 

16,16% 

9,01% 

7,36% 

41,29% 

3,35% 

4,67% 
100,00% 

12 

9 

7 

9 

14 

2 

6 

••^.^:•>^=:  » - / f ^ ^ :-

DISTRIBUTION OF NUMBER OF PROJECTS AND TOTAL AMOUNTS COMMITTED PER AREA OF ACTIVITY IN 1995 

"EUROPE AGAINST AIDS" ACTION PLAN  1994-1995 

ANNEX II B 

AMAOFi^rrivny 

TQTALAMOUNT 
COMMITTED PER AREA OF 
ACTIVITY IN ECU 

PERCENTAGE OF BUDGET : 
COMMITTED PER AREA OF 
ACTIVITY 

INFORMATION,  ATTITUDES 
AND BEHAVIOUR 
MEASURES FOR CHILDREN 
AND YOUNG PEOPLE 
PREVENTION OF HIV 
TRANSMISSION 
SOCIAL AND 
PSYCHOLOGICAL SUPPORT 
GATHERING DATA ON 
HIV/AIDS 
COMBATING 
DISCRIMINATION 
COORDINATION WITH 
OTHER PROGRAMMES 
TOTAL 

1 906 027 

432 649 

3 695 192 

771 056 

985 326 

714 446 

151 768 
8 656 464 

22,02% 

5,00% 

42,69% 

8,91% 

11,38% 

8,25% 

21 

10 

22 

10 

5 

3 

1,75% 
100,00% 

••'.' •"' 

4 

:y^'ifi^M^"-S;>i 

DISTRIBUTION  PER COUNTRY OF APPROPRIATIONS COMMITTED IN 1994 UNDER THE 1994-1995 ACTION PLAN 

ANNEX m  A 

COUNTRY 

B 
D 
DK 
E 
F 
GR 
I 
IRL 
L 
NL 
P 
UK 
T0TÀJ. 
SUPPLEMENTARY 
COMMITMENT FOR THE 
INTERNATIONAL 
CONFERENCE IN 
YOKOHAMA 
GRANDTOTAL 

NUMBER OF SUBSIDIES PER 
COUNTRY 
8 
1 
1 
3 
13 
6 
1 
3 
1 
4 
0 
17 
58 

1 
59 

£ 

AMOUNT GRANTED IN ECU 

PERCENTAGE OF BUDGET 
GRANTED PER COUNTRY 

3 396 928 
6 024 
93 663 
217 879 
1 592 269 
501 203 
214 000 
228 243 
292 232 
564 011 
0 
1 887 472 
8993924 

5 212 
8 999136 

37,70% 
0,10% 
1,00% 
2,40% 
17,70% 
5,60% 
2,50% 
2,40% 
3,20% 
6,30% 
0,00% 
21,00% 

y--^kj.ïïïÊ£&& 

0,10% 
W0»00% 

DISTRIBUTION PER COUNTRY OF APPROPRIATIONS COMMITTED IN 1995 UNDER TEE 1994-1995 ACTION PLAN 

ANNEX III B 

COUNTRY 

A 
B 
D 
DK 
E 
F 
GR 
I 
IRL 
L 
NL 
IP 
s 
|SF 
[UK 
ITOTAL 
(SUPPLEMENTARY 
[COMMITMENT FOR THE 
INTERNATIONAL 
[CONFERENCE IN 
[VANCOUVER 
K«MAJK8> 'TOTAL.-

NUMBER OF SUBSIDIES PER 
COUNTRY 
0 
16 
6 
2 
9 
13 
3 
2 
0 
0 
5 
1 
0 
0 
17 
74 

AMOUNT GRANTED IN ECU 

0 

1 765  158 
757 976 
148  163 
838 522 
2 004 868 
324 297 
257 980 
0 
0 
616 998 
77 809 
0 
0 
1 794 953 
8 586 724 

GRANTED PWgL COUNTRY 
0,00% 
20,00% 
8,80% 
1,70% 
9,70% 
23,20% 
3,70% 
3,00% 
0,00% 
0,00% 
7,10% 
0,90% 
0,00% 
0,00% 
20,70% 
9M8% 

1 
75 

99 740 
8 686 464 

1,20% 
^ y a M N M IH 

ANNEX IH C 

TRANSNATIONAL PARTNERSHD7S 
ESTABLISHED  UNDER 
THE ACTION PLAN IN  1995 

2ft 

PARTNERS FOR GERMANY  IN THE 6 PROJECTS LED  BY IT  WHICH  RECEIVED A GRANT 

PARTNERS  FOR BELGIUM  IN T HE  a  PROJECTS  LED BY IT WHICH  R E V I V ED  A  GRANT 

A 

B 

D 

DK 

E 

F 

GR 

I 

IRL 

L 

NL 

P 

S 

SF 

UK 

A 

B 

D 

DK 

E 

F 

GR 

I 

IRL 

L 

NL 

P 

S 

F- 

IK 

3> 

PARTNERS FOR DENMARK  IN THE 2 PROJECTS LED BY IT WHICH  RECEIVED A GRANT 

PARTNERS  FOR SPAIN  IN T HE 9  PROJECTS  L ED BY IT W H I CH  HF.CF.IMJ)  A 

CRAM 

5 

4 

3 

2 

0 

! 

,\ 

II 

r> 

DK 

E 

F 

GR 

I 

IRL 

L 

NI. 

P 

S 

SF 

UK 

A 

B 

D 

DK 

E 

1 

i 

NL 

P 

S 

1 1 "  1 

GR 

IRL 

F 

I. 

I 

I'AK  f M KS  FOR  F R A N CE  IN  T HE  13  I'KO.IF.CTS  LEI)  BY  IT  W H I CH  R E C E I V E !)  A  G R A NT 

PARTNERS  FOR  G R E E CE  IN  T HE  3  PROJECTS  LED  BY  IT  WHICH  RECEIVED  A  GRANT 

A 

B 

D 

DK 

E 

F 

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ANNEX IV 

EPIDEMIOLOGICAL DATA  1993-1995 

AIDS cases and rate  f incidence  per country and per year of diagnosis declared as at 31 December  1995, corrected for declaration deadlines 

CASES  DECLARED 
YEAR OF DIAGNOSIS 
1994 

-  •* 

* 1995 

1993 

CASES CORRECTED FOR DECLARATION DEADLINES {  . 
Î 

"  * 

_< 

* 

YEAROFPIAGISSfô 
l#M 

1995 

1993 

% 

Country 

Niimber 

Rate 

Number 

Rate 

Number 

Rate 

Number 

Rate 

Number 

Germany 
Austria 
Belgium 
Denmark 
Spain 
Finland 
France0 
Greece 
Ireland 
Italy 
Luxembourg 
Netherlands 
Portugal 
Sweden 
United 
Kingdom 

| 

1 766 
228 
245 
239 
5 172 
25 
5  383 
158 
69 
4 765 
20 
459 
498 
180 

21,8 
29,04 
24,4 
46,3 
103,9 
4,9 
91,1 
15,2 
19,6 
83,4 
50,6 
30,0 
50,6 
20,7 

1620 
161 
242 
234 
6 558 
44 
5 415 
192 
61 
5 405 
13 
450 
567 
180 

19,9 
20,3 
24,0 
45,2 
165,7 
8,7 
91,3 
18,4 
17,2 
94,6 
32,4 
29,2 
57,7 
20,6 

945 
161 
154 
201 
4 327 
36 
3 637 
156 
19i 
4 505 
15 
347 
395 
163 

11,6 
20,2 
15,2 
38,8 
109,2 
7 
61 
14,9 
5,3 
78,8 
36,9 
22,4 
40,2 
18,6 

1 816 
232 
248 
240 
5313 
25 
5 477 
165 
71 
4 828 
20 
461 
519 
181 

22,5 
29,5 
24,7 
46,5 
134,5 
4,9 
92,7 
15,9 
20,1 
84,5 
50,6 
30,2 
52,8 
20,8 

1 645 

28,4 

1565| 

26,9 

1 024 

17,6 

1 677 

29,0 

1 829 
171 
255 
239 
7 220 
44 
5 786 
228 
67 
5 650 
13 
460 
661 
183! 
! 
i 
1693; 

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22,5 
21,6 
25,3 
46,2 
182,5 
8,7 
97,5 
21,9 
18,9 
98,9 
32,4 
29,9 
67,2 
20,9 

Number 

Rate 

1 701 
202 
237 
233 
6 879 
39 
5 365 
239 
27 
6 079 
15 
474 
702 
191 

20,8 
25,4 
23,4 
45,0 
173,6 
7,6 
90,0 
22,9 
7,6 
106,3 
36,9 
30,6 
71,5 
21,8 

15 093 
1 551 
2 124 
1 872 
39 170 
230 
41948 
1422 
514 
33 701 
105 
3 979 
3 341 
1 356 

29,1 

1 429 

24,5 

12 437 

Per million inhabitants 

14 Includes 324 cases with no known date of diagnosis 
0  Includes the Overseas Departments: Guadeloupe, French Guyana, Martinique and Réunion 

Source: European Centre for the Epidemiological Monitoring of AIDS - Quarterly Report No 33-1995/4 

ISSN 0254-1475 

COM(96) 720  final 

DOCUMENTS 

EN 

05 

Catalogue number  :  CB-C0-96-732-EN-C 

ISBN  92-78-14124-0 

Office  for Official  Publications of the European Coinmunities 

L-2985 Luxembourg 

m