Public health: prevention of AIDS and other communicable diseases, Community action programme 1996-2000

A. THE REPORT The Committee has adopted the report of Mr. Noel MAMERE (ARE, F) on the Commission proposal for a EP and Council decision adopting a programme of Community action on the prevention of aids and certain other communicable diseases within the framework for action in the field of public health. The programme of Community action has as its objectives: to undertake action against the spread of AIDS with the health and social resources which are available, in other words information and prevention; and to ensure that every effort is made to limit the effects of the epidemic, in particular by combatting all forms of discrimination against AIDS sufferers or HIV-positive persons and, where possible, improving the living conditions of those affected (including those in a terminal condition) and those close to them. Rapporteur MAMERE, followed by the Committee yesterday, welcomed the intentions and objectives of the proposal for a decision. He feels nonetheless obliged to pose a number of questions on matters which he believes to be of major importance, to express a number of anxieties and to make various comments. Firstly, he feared that there is a risk of overloading this action programme (with an allocation of 50 mecu for 4 years) by covering other communicable diseases than AIDS, and thus failing to concentrate on the fundamental point, which is to combat the spread of AIDS. It thus appears necessary to "recentre" the programme of action against AIDS. This entails reaffirming from the outset that the basic objective is to limit the spread of AIDS and that all means available must be deployed to keep this scourge in check. Secondly, it is vital to stress the principle of combating all forms of discrimination. The EU must undertake action to support all actions and initiatives aimed at combating discrimination of whatever kind affecting AIDS sufferers or persons carrying the HIV virus. Mr. MAMERE felt that "the programme does no more than invoke this ethical principle in a half-hearted fashion, despite the current attempts in Member States to impose forms of legal discrimination such as compulsory testing. The Union must commit itself unequivocally to defending human rights in the context of anti-AIDS action. Thirdly, the rapporteur wants the programme to be open to participation by NGO's, especially patients' associations. The rapporteur deplored that the possible infection by blood transfusion is not raised in the proposal. It is therefore vital to adopt strict rules on donor selection, screening and transfusion practice. He concluded that the experience of so devastating an infectious disease as AIDS should force a lesson on us, which the Commission seems not to have taken sufficient note of in its proposal. The sudden appearance and rapid spread of AIDS took everyone by surprise: this applies as much to the medical and scientific communities as to national health authorities worldwide. This painful experience holds a lesson for the future: it is essential to establish, at Community level, a warning system with provision for rapid information. This would ensure that the public authorities and the medical and scientific committees were not totally without resources vis-a-vis the appearance of a new disease. Such a warning and information system should obviously be based on a Union-wide network of epidemiologists, which should be created as a matter of urgency. This will require the development of specific training programmes in the EU's universities and schools of medicine. B. THE AMENDMENTS Rapporteur MAMERE had tabled 45 amendments. The most important he saw carried are: a. Amendment 26 : The Commission should enhance coordination between national epidemiological monitoring centres, and create a Community network of epidemiologists with a view to identifying common tools and methods and increasing the capacity of responding in a coordinated fashion to the development of communicable diseases: b. Amendment 30 : There should be a coordination of studies and information on problems related to groups at risk (drug users, sex workers, homo- and bisexuals), risk situations, with a view to adapting preventive measures to different groups and circumstances and reducing the spread of AIDS; - promotion of exchanges of experience and support for preventive measures such as the unrestricted sale of condoms of good quality with instructions; - distribution of single-use sterile syringes; - development of methadone substitution treatment programmes. c. Amendment 31 : The Commission should take the necessary measures at EU level to ensure maximum safety of blood products; self-sufficiency in blood, tightening of rules and selection procedures for donors and screening, and the drawing up of a code of conduct for blood transfusions; d. Amendment 39 : At EU level, a warning system should be created with arrangements for the rapid exchange of information in case of epidemic outbreaks or the appearance of a new communicable disease, to be based on: - compatibility as between Member States' systems for the surveillance of communicable diseases; - interconnection of the Member States surveillance systems; - aid for the creation of such systems in Member States where they do not exist at present; - definition of a joint strategy for epidemiological intervention. �