WRITTEN QUESTION E-0739/03 by Erik Meijer (GUE/NGL) to the Commission. Increasing spread of AIDS in countries with a low standard of living through poor medical practice for injections and blood transfusions.
Date: 2003-03-11
Institutions: European Parliament, Provisional data
Subjects: AIDS, Central and Eastern European countries, aid policy, blood transfusion, epidemiology, health aid, health statistics

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process, and thus help to ensure democratic developments in Guinea-Bissau? What other measures does
the Commission intend to take, either on its own or in cooperation with other countries and international
organisations, with a view to promoting Guinea-Bissau’s return to democratic normality?

Answer given by Mr Nielson on behalf of the Commission

(9 April 2003)

Within the context of its political dialogue with the authorities of Guinea- Bissau, the Commission closely
follows, in a permanent and regular way, the on-going deterioration of the situation as described by the
Honourable Member. A political dialogue encompassing a regular assessment of developments concerning
respect for human rights is provided for in article 8 of the Cotonou Agreement.

The Commission is willing to consider requests for financial support to the electoral process.

The Commission will continue to participate in a political dialogue with the authorities of Guinea-Bissau,
which may be intensified depending on the evolution of the situation.

(2004/C 33 E/071)

WRITTEN QUESTION E-0739/03

by Erik Meijer (GUE/NGL) to the Commission

(11 March 2003)

Subject: Increasing spread of AIDS in countries with a low standard of living through poor medical

practice for injections and blood transfusions

Is the Commission aware of the article published in the February 2003 issue of the International
1.
Journal of STD and AIDS, a medical
in which David
Gisselquist, John Potterat and others say that the spread of AIDS in Africa differs significantly from the
spread of sexually transmitted diseases, that there is also a high incidence of AIDS in children between five
and 10 years old whose mothers are not infected, and that AIDS occurs remarkably frequently in
population groups with the highest level of education and health care?

journal covering sexually transmitted diseases,

2.
Does the Commission agree with the authors of the article referred to in paragraph 1 that poor
practice in blood transfusions and injections rather than sexual promiscuity may be contributing to the
further spread of HIV/AIDS?

3.
Does the Commission have comparable data from the applicant countries where, as a result of
relative isolation, the spread of HIV/AIDS initially lagged behind that in Western Europe, but where there
has subsequently been a sharp increase ever since cuts in the spending required to ensure good medical
care or restrictions on access to health care for lower income groups as a result of the collapse of national
health insurance systems for all?

4.
To what extent is the EU involved in programmes in non-member countries to combat HIV/AIDS
which have so far focused exclusively on sexually transmitted diseases and paid virtually no attention to
poor practice and other shortcomings in medical treatment?

5. What can the Commission to do to ensure that the real causes of the rapid spread of HIV/AIDS
throughout the world are better understood and that any changes required in methods of combating this
disease are introduced as soon as possible?

Source: Netherlands newspaper, De Volkskrant, 25 February 2003.

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Answer given by Mr Nielson on behalf of the Commission

(16 April 2003)

The Commission does not agree with the conclusion of a series of articles that appeared in the March
2003 issue of the International Journal of sexually transmitted diseases (STD) and acquired immunodefi-
ciency syndrome (AIDS) that ‘health care exposures caused more human immunodeficiency virus (HIV)
than sexual transmission’ (in Africa). Rather, the Commission concurs with the main conclusion of a recent
World Health Organisation (WHO) and UNAIDS expert consultation on this subject that ‘unsafe sexual
practices continue to be responsible for the overwhelming majority of infections’ with HIV in Africa (1).

The Commission is of the opinion that the purported high incidence of HIV infection found in children
aged 5-10 years highlighted by Gisselquist and his collaborators was spurious, being caused by high rates
of false positive HIV test results. This was due to the lack of accurate and valid assays in sub-Saharan
Africa during the mid-1980s. Where children are subject to accurate and rigorous diagnostic testing, HIV
infection has not been found in the absence of maternal HIV infection (cid:1) except when the child has
received a contaminated blood transfusion or has been breast fed by a HIV+ wet nurse. While the articles
referred to findings of a statistical relationship between HIV infection and higher socio-economic status,
this is not necessarily evidence against sexual transmission (cid:1) as the authors themselves acknowledge.

This research, which is based on old data sets and outdated methods, is simply not consistent with the
modern epidemiological picture of HIV infection in Africa, where infection rates are very low in children
but then rise steeply with the onset of adulthood. The Commission is concerned that the publicity
surrounding publication of these papers may cause undue alarm and might discourage parents from taking
their children for routine immunisations and other health care. Furthermore, there is a risk that it could
undermine current activities aimed at prevention of HIV transmission by promoting safe sex practices.

WHO have estimated that unsafe injection practices only account for about 2,5 % of HIV infections in
Africa. The Commission agrees that this is the best available estimate, but accepts that there is still need for
vigilance in monitoring the HIV/AIDS epidemic and for increased efforts to improve bio-safety in health
care systems. In addition to Community support for national blood safety programmes in several African
countries (including Malawi, Niger, Uganda, Zambia, and Zimbabwe) we will continue to work with
governments to improve health care practices and ensure adequate provision of sterile medical supplies.

The Commission policies and priorities on fighting the HIV/AIDS epidemic in developing countries are
enumerated in the Programme for Action on Accelerated action on HIV/AIDS, malaria and TB in the
context of poverty reduction adopted on 20 February 2001 (2). This was updated in the Commission’s
Communication to Council and Parliament dated 26 February 2003 (3).

According to available data, the prevalence of HIV infection is rising rapidly in Eastern Europe. In the
Caucasus and Central Asia, there is a great danger that the prevalence will soon increase to dangerous
levels. The TACIS Indicative programmes for 2002-2003 and 2004-2006 identify the measures the
Commission intends to undertake to assist partner governments in this region to prevent and fight HIV/
AIDS. Prevention and control of HIV/AIDS is a particularly high priority in its cooperation with Ukraine
and Russia, including the Kaliningrad enclave. In these areas, Community activities have a special focus on
the problem of HIV transmission through intravenous drug use and mother-to-child HIV transmission. For
example, in Russia, a new project to prevent and combat HIV/AIDS will be financed from the 2002 TACIS
national programme. This will support a comprehensive public awareness and information campaign
targeted at the population at large, with specific attention paid to the so-called ‘bridge population’ which
contributes to the spread of HIV/AIDS from the risk groups to the general population. In this case, the
main risk group consists of intravenous drug users, who may also be commercial sex workers, and the
‘bridge population’ is their sexual partners.

HIV prevalence in Accession Countries remains low. Data on HIV/AIDS in applicant countries are
collected by the EuroHIV project, funded by the Commission. They can be downloaded from http://
www.eurohiv.org/sida.htm. The reduction of the risk of HIV transmission by blood transfusion in the
Union is one of the main aims of Directive 2002/98/EC of the Parliament and of the Council of

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27 January 2003 setting standards of quality and safety for the collection, testing, processing, storage and
distribution of human blood and blood components and amending Directive 2001/83/EC (4), which will
have to be applied by the accession countries in the future. This Directive includes requirements for donor
deferral criteria, and HIV testing for each blood donation.

(1) http://www.who.int/mediacentre/statements/2003/statement5/en/.
(2) COM(2001) 96 final.
(3) COM(2003) 93 final.
(4) OJ L 33, 8.2.2003.

(2004/C 33 E/072)

WRITTEN QUESTION P-0743/03

by Helena Torres Marques (PSE) to the Commission

Subject: EU funds for the Caribbean tourism sector

(4 March 2003)

The European Community, its 15 Member States and the 77 ACP countries (Africa, Caribbean and Pacific)
are in the process of ratifying the Cotonou Agreement, signed in June 2000, providing a framework for
EU-ACP trade and cooperation for the next 20 years.

The cooperation aid with ACP countries is channelled through different instruments: Direct cooperation
aid through the ninth European Development Fund and loans through the European Investment Bank, as
well as various support facilities like the Centre for Development of Enterprise, Proinvest or the European
Business Assistance Scheme.

Some sub-regions in the ACP countries,
like the Caribbean islands, are fiercely competing with EU
destinations in the share of world tourism destinations. Does the European Commission have data on the
total amount of funds and financing made available by the EU to the Caribbean tourism sector? How
much of the money is available for private investments?

Answer given by Mr Nielson on behalf of the Commission

(26 March 2003)

The Commission, like many other donors, sees the tourism sector as a potential key player in achieving
poverty reduction, to the extent that it can contribute to economic growth and job creation.

The Commission is particularly keen on promoting sustainable tourism, supporting the setting up of
appropriate policy frameworks and setting standards, especially in the environmental field. It also wishes to
support representative national and regional associations, promote training and other business devel-
opment services to local small hotels and tourism related producers and service providers. In the past,
support has been provided to facilitate at tourism fairs, participation for local operators, which is no
longer envisaged. In specific cases, the preservation of historical monuments and the setting up of eco-
tourism projects has been ensured.

Overall, through the 7th and 8th European Development Fund (EDF), EUR 20,8 million has been approved
for regional tourism development programmes in the Caribbean.

The all African, Caribbean and Pacific States (ACP) programme Proinvest (8th EDF), which aims at
strengthening foreign direct investments in the ACP States and cooperation agreements, is also likely to be
active in the tourism sector in the Caribbean to support the setting up of partnership agreements between
local and European players.