WRITTEN QUESTION E-0347/04 by Glenys Kinnock (PSE) to the Commission. Use of ACT in treatment of malaria.
Date: 2004-02-11
Institutions: European Parliament, Provisional data
Subjects: aid policy, developing countries, infectious disease, medicinal product, pharmaceutical expenses, right to health, therapeutics

3.4.2004

EN

Official Journal of the European Union

C 84 E/777

Answer given by Ms Schreyer on behalf of the Commission

(29 March 2004)

Parmalat has received Community funding.

Since 1990 it has received, by way of expenditure directly managed by the Commission, payments
totalling EUR 2 278 448,00, broken down as follows:

Year/period

Amount

1990

1991-1998

1999-2003

733 747,76

677 636,24

867 064,00

Total

2 278 448,00

By way of indirect expenditure (under shared management), i.e. the award of Community aid financed or
co-financed by the European Agricultural Guidance and Guarantee Fund (EAGGF) under the common
agricultural policy, the attention of the Honourable Member is drawn to the following two remarks:

(cid:1) firstly, the agricultural aid payments financed by EAGGF, Guarantee Section are managed by the
Member States under the provisions of shared management. The accounting information concerning
these aid payments is held by the Member States and transmitted to the Commission in accordance
with Regulation (EC) No 2390/1999 (1) which, under Article 2(3), obliges the Commission to ensure
that the information received is kept confidential. The Commission is therefore unable to provide
details of the amounts received by Parmalat under EAGGF Guarantee;

(cid:1) secondly, Parmalat may also have been awarded aid under programmes co-financed by EAGGF
Guidance. Rural development measures assisted under EAGGF Guidance are incorporated in
operational programmes in accordance with the Objective 1 programming rules laid down in the
regulations on the Structural Funds (2).
In accordance with these regulations the programmes in
question do not contain financial information at the level of the final recipient of the aid. Article 18 of
Regulation (EC) No 438/2001 (3) concerning the management and control systems for assistance
granted under the Structural Funds lays down the form and content of the accounting information the
Member States must hold.

(1) Commission Regulation (EC) No 2390/1999 of 25 October 1999 laying down detailed rules of the application of
Regulation (EC) No 1663/95 as regards the form and content of the accounting information that the Member States
must hold at the disposal of the Commission for the purposes of the clearance of the EAGGF Guarantee Section
accounts, OJ L 295, 16.11.1999.

(2) Council Regulation (EC) No 1260/1999 of 21 June 1999 laying down general provisions on the Structural Funds,

OJ L 161, 26.6.1999.

(3) Commission Regulation (EC) No 438/2001 of 2 March 2001 laying down detailed rules for the implementation of
Council Regulation (EC) No 1260/1999 as regards the management and control systems for assistance granted
under the Structural Funds, OJ L 63, 3.3.2001.

(2004/C 84 E/0874)

WRITTEN QUESTION E-0347/04

by Glenys Kinnock (PSE) to the Commission

(11 February 2004)

Subject: Use of ACT in treatment of malaria

Would the Commission outline its position on the use of ACT (artemisinine combination)
treatment of malaria?

for the

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Official Journal of the European Union

EN

3.4.2004

Is the Commission aware that whilst ACT is the treatment recommended by the World Health
Organisation, there is a reluctance to introduce ACT combinations in countries with high resistance to
other drugs because of the costs involved?

How does the Commission propose to deal with this growing problem?

Answer given by Mr Nielson on behalf of the Commission

(18 March 2004)

The Commission is aware of the expansion of malaria strains resistant to anti-malarials, particularly
chloroquine and sulfadoxine-pirimethamine (SP). The World Health Organisation (WHO) issued malaria
treatment guidelines in January 2003 and November 2003 where they recommend five therapeutic
options, of which four are artemisine-combination therapies (ACT),
for regions with low levels of
resistance to these drugs, such as West Africa. While the recommendations rely on epidemiological,
parasitological and clinical criteria, there is no in-depth analysis of the costs involved and the capacities of
countries and the current international financial instruments to ensure a sustainable strategy. The specific
role of ACTs in all treatment levels, including frontline treatment, or referral levels, is not detailed either.

Malaria treatment strategies in countries are decisions that must be taken by each country after weighing
up the potential impact, the investments needed, their resources and capacities and the comparison with
other alternatives. Some countries outside West Africa, such as Mozambique, have decided on non-ACTs
strategies.

Within the framework policy of the ‘Programme for Action: Accelerated action on human immunodefi-
ciency virus/acquired immunodeficiency syndrome (HIV/AIDS), malaria and tuberculosis in the context of
poverty reduction’ (1), the Commission aims at reducing the burden of malaria though the three main
pillars of the programme, all related to malaria treatment.

The Commission is trying to increase the impact of interventions. To this end, the Commission has
speeded up and increased the support to malaria programmes. Overall, the Commission has programmed
EUR 1,1 billion to fight these diseases in the period 2003-2006, some 25 % of the interventions targeting
malaria. This includes the Commission contribution to the Global Fund (EUR 460 million for 2001-2006),
where USD 30 millions have already been committed for the purchase of ACTs in the three first proposal
rounds. The Commission has also programmed support under the thematic budget line on poverty
diseases, to initiatives introducing malaria combination therapies,
including ACTs. But the bulk of the
Commission support for countries to progress towards health-related Millennium Development Goals
(MDGs) (cid:1) including the 6th MDG related to malaria is through sector and, progressively, general budget
support. The capacity of any country to decide on the inclusion of the most effective treatment options
will be related to their financial capacities and it is here where the Commission tries to direct the lion’s
share of its support.

The Commission continues to be active in promoting the reduction of prices of essential medicines such as
ACTs, through advocacy and legal support (such as the regulation to prevent re-importation of tiered-
priced medicines) of tiered pricing, the use of Trade Related Intellectual Property Rights (TRIPS) provisions
and the promotion of local production of ACTs. In this regard, the Commission is in the process of
reviewing initiatives aiming at local production of quality and affordable ACTs, submitted following a call
for proposals launched in 2003.

The Commission has also programmed significant research resources to develop more effective medicines
and vaccines for HIV/AIDS, malaria and tuberculosis. This includes support, in partnership with developing
countries of basic research and phase I trials (EUR 200 million) and clinical trials (under the European
Development Clinical Trials Programme (EDCTP): EUR 200 million from the Commission and
EUR 200 million from Member States). Through this integrated approach the Commission aims at
alleviating the burden of malaria and its effects on poverty in developing countries.

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Official Journal of the European Union

C 84 E/779

Whilst the Commission supports, in principle, WHO recommended therapeutic protocols for malaria or
other diseases in developing countries, it holds the clear view that decisions on such strategies have to be
made by the country concerned based on local conditions.

(1) COM(2003) 93 final.

(2004/C 84 E/0875)

WRITTEN QUESTION E-0350/04

by Roberta Angelilli (UEN) to the Commission

(12 February 2004)

Subject: Travel agencies: repercussions of the Alitalia crisis on employment

The crisis affecting Alitalia is likely to damage other sectors connected with air transport, in particular
travel agencies.

The industrial restructuring plan under discussion at present envisages drastic cuts in the commission paid
to agencies (cid:1) from 7 % to 1 % on the sale of international tickets and from 3 % to 1 % on the sale of
domestic tickets.

As reported by the national representatives of associations of travel agents, these decisions may lead to the
closure of hundreds of agencies. This means that more than 10 000 jobs, about four times as many jobs as
those threatened in Alitalia, are at risk.

Furthermore the cuts, which would result in a rise in air fares, would have other repercussions on
consumers. The end user would have the practical problem of obtaining tickets, because agencies are
obliged to refuse to provide a service which has become too expensive.

It should also be noted that operators in the sector were informed of these decisions, unprecedented in
Europe, only 60 days in advance.

In view of the serious consequences such a move would have on employment and bearing in mind that
travel agencies are the main channel for air-ticket sales, since they manage 91 % of ticket turnover, and
hence a crisis in the sector would impact not only on Alitalia, worsening its already precarious position,
but also on all other European airlines, can the Commission say:

1. whether the European Union has the power to intervene in the matter, in accordance with policies to

safeguard employment or by virtue of any other relevant competence;

2. how it views the matter as a whole?

(2004/C 84 E/0876)

WRITTEN QUESTION E-0351/04

by Roberta Angelilli (UEN) to the Commission

(12 February 2004)

Subject: Travel agencies: serious difficulties for operators and customers

Travel agencies are currently experiencing serious difficulties as a result of the crisis in the tourism sector,
which suffered a recession as a result of the attacks on the Twin Towers in 2001, fears of the spread of
infectious diseases, price increases linked to the introduction of the euro and fears of air disasters and wars.
The situation is now becoming worse because many European airlines have decided to substantially cut the
commission paid to agencies, in order to reduce their debts and meet the needs of the market. The recent
crisis affecting Alitalia, which led to it to take such a decision, was only the latest in a series of events
which continue to have an impact on other operators in the sector. Air France, Iberia, Lufthansa, Tyrolean
and British Airways have also already announced drastic cuts in commission. In order not to lose their