Pavel TELI?KA Member of the European CommissionHIV/AIDS : 20 years on; Have we really stopped caring ? Ministerial Conference “HIV/AIDS and Europe: New Challenges New opportunities”Vilnius, 17 September 2004

Friday, September 17 2004, 10:34


Pavel TELICKA

Member of the European Commission
HIV/AIDS : 20 years on; Have we really stopped caring ?

Ministerial Conference "HIV/AIDS and Europe: New Challenges New opportunities"
Vilnius, 17 September 2004

Prime Minister Brazauskas,

Minister Olekas,

Excellencies, Ladies and Gentlemen,

Prime Minister Brazauskas has eloquently set out the reasons why we are here today and the challenges we are facing.

This is the second major Ministerial conference this year, following the successful event hosted under the Irish Presidency, in February. We therefore do not need to repeat the conclusions adopted in the Dublin declaration which provides a starting point for our work.

My focus today is on how we can move the process forward and now we can ensure that the political commitments already given are turned into concrete results.

HIV/AIDS is the silent plague of our times. It knows no boundaries and is the thief of time and peoples. It is gradually removing nations from the map and erasing generations of the young from history.

In Europe, we seem to have become comfortable with the perception that it is preventable and treatable.

I hope that today, we recognise that within Europe, a false sense of security has developed.

This is despite the epidemiological trends which are alarming. Many EU Member States are reporting a significant increase in newly diagnosed infections and, according to latest statistics, around 600 000 people are living with HIV and AIDS within the EU.

The situation in the Member States of the Union is diverse. In the Baltic States the rates of new HIV infections have risen dramatically, particularly among young people: up to 80 percent of people with HIV are under 25 years of age.

Regional disparities clearly exist.. However, even in those countries and regions which to date have been largely spared from HIV/AIDS, high levels of drug use and of unprotected sexual behaviour are the forerunners of emerging epidemics.

Moreover, we face a rising epidemic in our neighbouring countries. Some have the highest rates of new infections in the world - Africa included.

In Eastern Europe and Central Asia, approximately 2 million people are living with HIV and AIDS. In Russia and in the Ukraine, one adult in every hundred is infected - a fifty fold increase in 10 years. At these levels of infection, the virus is spreading throughout the population and is more difficult to follow and prevent.

Tackling the epidemic is our common task. I do not make a distinction between those countries in or outside the European Union. Working together provides a real opportunity to pool expertise and knowledge across the continent to identify the best tools for prevention, support, treatment and care. Needs and requirements have to be defined at local level as a basis for comprehensive national programmes. This will ensure sustainability and avoid fragmented projects.

So how can we be successful in tackling HIV/AIDS?

First, we need to invest in education and information. HIV/AIDS is linked with stigma and discrimination, and is often met with suspicion and ignorance. Awareness and evidence-based information are prerequisites for effective and successful responses to HIV/AIDS. Governments have to accept that they have a problem.

While prevention measures need to address the population as a whole, targeted actions are required to reach those groups of society who are especially vulnerable. This includes, in particular, ensuring access to health and social services for injecting drug users.

Here I would like to call on EU Member States to ensure full and rapid implementation of the Council Recommendation on the prevention and reduction of health-related harm associated with drug dependence.

Second, we need to ensure that people living with HIV/AIDS have access to treatment, care, and support. This includes having trained personnel available for voluntary counselling and testing and monitoring treatment.

Third, decisions on public health have to be based on evidence. Therefore surveillance is vital to provide reliable and timely information so we can anticipate the size and nature of the epidemic and trends over time. Unfortunately, even within the European Union the surveillance systems vary from country to country and the resources to ensure a consistent collection are limited.

Finally, the importance of creating partnerships and of advocacy cannot be overemphasised. From the very beginning of the epidemic, community based organisations have been leaders in activism, advocacy, empowerment, and providing services. In those countries where combating HIV/AIDS has been a success, the role of non-governmental organisations and more generally civil society has been crucial. We have to ensure that the voice of organisations representing HIV/AIDS patients are not just heard but involved in policy development.

The European Commission is only one part of the co-ordinated response that is required. But we do intend to play a full role.

In the Commission document adopted last week we have outlined a first set of concrete measures we intend to take over the next eighteen months. I will highlight some areas, which I feel are of particular importance:

  • In December, we will launch a debate among all interested parties on the scope of an EU-wide umbrella information campaign;
  • On drug dependence we will review together with the Member States the state of implementation of the 2003 Council Recommendation;
  • This autumn, we will convene a meeting of industry and government representatives to explore options to support access to affordable anti-retroviral treatment;
  • Before the end of the year, we will hold a workshop among Member States, surveillance networks, WHO, UNAIDS, and interested neighbouring countries to review HIV/AIDS surveillance and its development.
  • This November, we are willing to host informal discussions among interested parties in the EU's neighbouring countries.

If we are honest with ourselves, these points still leave aside a number of the most sensitive questions that will have to be addressed if we are to be seen to take this issue seriously.

I want to address three issues today; funding, access to cheaper drugs and harm prevention programmes.

Let us be clear: the challenge we face is not without costs. Adequate funding is an essential component of any effective response to the spread of HIV/AIDS.

The European Community has programmed through the different instruments more than 1.2 billion Euros for the global fight against HIV/AIDS - together with malaria and TB - for 2003 to 2006. We have also invested heavily into research on HIV/AIDS and will continue to do so.

Our past experience has shown that new approaches and instruments in external aid lead to a shift from individual projects towards more global sector approaches.

The key concrete measures required are:

  • A real dialogue at country level involving representatives of all stakeholders
  • A national strategy with a clear work programme and mid term expenditure plan
  • Information dissemination towards politicians, the media, health and education professionals and the general population
  • Proper feedback and follow-up

A whole series of organisations provide funding - not always in a co-ordinated approach. I am therefore happy to see so many representatives of our international partner organisations present here today.

In most new EU Member States, the structural funds could provide support to developing health and social infrastructure. We are willing to look at how this can be further pursued.

In neighbouring countries, the Community has provided considerable financial support to the fight against HIV/AIDS through TACIS and other programmes. My question is whether there is a neighbouring country that will take the challenge to have all partners working together with government on the concrete measures including capacity building and a co-ordinated HIV/AIDS strategy?

Prevention remains the key to tackling this epidemic. But we must also ensure that doctors are not forced to choose on whether to treat a patient based on the cost of drugs. At present the cost of antiretroviral treatment is roughly 15, 000 EUR per patient per year.

While we can call for industry to provide cheaper anti-retrovirus drugs, we must also recognise their concerns about diversion of discounted medicines elsewhere in Europe. I take note of the importance for industry of finding appropriate solutions in the framework of the G10 process. We must learn to work with, rather than against, industry in this area. I welcome the engagement of the European industries in this regard.

Drugs dependence in general is a political hot potato. For some societies this issue is extremely difficult. However, we must acknowledge the overwhelming evidence of highly effective, safe and cost effective harm reduction strategies to reduce the negative health and social consequences of drug injection.

Drug substitution treatment, availability of sterile injecting equipment and its safe disposal, and factual information about drug use are all issues that will have to be discussed by Ministers.

More generally, we need to deliver the message that people are living today with HIV/AIDS which means that we need to offer them a life that includes work, care and a purpose to carry on. We are not talking here about simple statistics but people's lives. Infected people must be seen as part of the solution, not part of the problem.

Ladies and Gentlemen, action against HIV/AIDS will only be successful if we all work together to build an effective partnership to tackle the threat of the epidemic. My immediate task is to ensure that this Ministerial conference has the follow-up it deserves in the Barroso Commission. I will pay particular attention to ensuring a smooth transition to my successor, Commissioner Kyprianou. Responsibility, in my view, has many components and begins with our personal commitment and leadership to make this issue a priority. Some Governments are simply not doing enough. We now have a duty to ensure the action required is taken.

Thank you.