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   At the ACP/EEC Joint Assembly meeting in Kampala, a Commission expert Dr.
   Lieve  FRANSEN,  presented  the current situation  of  its  AIDS  control
   programme, created in 1987.
   Manuel  MARIN,  Vice-President  of the Commission,  during  his  stay  in
   Kampala, donated blood at the Nakasero Blood Bank, founded by the E.C.
   Although  accurate  data  on the scale of the  AIDS  epidemic  are  still
   lacking,  there is nevertheless a consensus that the situation is  likely
   to deteriorate in the years to come.
   .  The  estimates  of  the number of people  currently  infected  are  10
      million worldwide and  more than 600,000 AIDS cases are reported now.
   .  Two  thirds  of people infected are between 20 and 45  years  old.  In
      several  countries  not  only urban areas but  also  rural  areas  are
      becoming highly infected.
   .  It is estimated that as many as 10 million new infections could  occur
      by  the  end  of the century, of which 90 percent  in  the  developing
      world.
   .  50%  of  these new infections are avoidable with  sustained,  vigorous
      efforts.
   The AIDS Control Programme of the Commission was created in July 1987  by
   Mr Natali for the benefit of all ACP countries (signatories of Lomé II).
   In  1988  a  parallel  programme was created  for  the  other  developing
   countries.  The initial budget was 35 million ECU for the benefit of  the
   ACP states, which has been totally committed. For the year 1991 an  extra
   of  4 million ECU was alocated, which has been pledged totally.  For  the
   parallel programme (not restricted to ACP countries), an annual budget of
   5 million ECU was made available.
                                     - 2 -
   In July 1987 the Commission set up within its own services a special task
   force  on AIDS  with public health experts, in order to examine,  process
   and  develop  requests for assistance from the ACP countries,  to  liaise
   with WHO and to manage the programme.
   Activities of the AIDS Control Programme of the Commission
   Since the inception of the progamme, it has focused on three intervention
   strategies (control of sexual transmission, of transmission via blood and
   of transmission from mother to child).
   For   control  of  sexual  transmission  the  programme   works   towards
   behavioural  change  where necessary, including  prevention  of  Sexually
   Transmitted Diseases in general.
   Prevention of bloodborne trasmission is done through screening of  donors
   and donor blood and through rationalised blood use policies.
   Prevention  of  perinatal  transmission is done  through  counselling  of
   seropositive women and making contraception available if necessary.
   In  countries  with a high prevalence of HIV, priority is given  to  safe
   blood programmes and alleviation of the impact of the disease.
   In countries with a relatively low prevalence, control of STD and  target
   education for youth and behavioural modification for core transmitters is
   given priority.
   Since  1990  another  aspect  has  been  included  into  the  programme's
   strategies:  caring  for the sick and their families,  to  alleviate  the
   impact on individuals and society (e.g. a rural development programme  in
   a region where a lot of orphans due to AIDS are living).
   Up to now, nearly all ACP countries requested repeatedly for support  and
   advice  from the AIDS  control programme. In total more than 90  projects
   were identified and developed. Another 50 requests are being dealt with.
   The  average budget for those projects is 300,000 ECU yearly and  a  mean
   duration of 3 years.
   In  37 countries projects are developed to prevent  sexual  transmission;
   this includes education.
   In   23  countries  projects  to  prevent  bloodborne  transmission   are
   developed.
   The  Commission  just started to support 2 programmes  to  alleviate  the
   impact of the disease.
   The  programme also supports training, operational research and  exchange
   of information and technology between ACP and EEC countries.
   Main obstacles encountered by the programme
   A strong political commitment, although improved in the last 2 years,  is
   not as yet apparent on all levels and in all sectors.
   Human  and financial resources are insufficient as compared to the  needs
   and requests.
                                     - 3 -
   Procedures  to deliver the programme  rapidly and efficiently are not  as
   yet  available  in  all  ACP  countries,  nor  in  all  the   responsible
   authorities in the Community.
   Decreasing  Health  and  Education  budgets in  the  ACP  countries  make
   implementation  and  integration of AIDS  control  activities  difficult,
   tedious and costly.
   There  is a growing sense of complacency in Europe, where spread  of  the
   disease  had  been proved to be avoidable, coupled with ignorance  of  or
   insensitivity to the scale of the problem in ACP countries.
   The impact of the programme
   After  3 years of activities it is very early to be able to evaluate  the
   impact  of  the  programme.  It is also  dificult  in  most  projects  to
   separately  evaluate  the impact of the Commission  activities  from  the
   total  and only the coordinated international effort in general  is  what
   counts.
   Some  data in Zaire, Uganda and Kenya demonstrate that  interventions  to
   achieve  risk-reducing behaviour among youth or various other  groups  of
   the  population  is having an effect and increase of incidence  is  lower
   than expected in those groups.
   Recommendations
   -  Increased  support should be given by the international  community  to
      the countries afflicted by AIDS.
   -  This  support should be sustained and planned for a longer  period  of
      time.
   -  A  better co-ordination between all parties and partners  involved  in
      managing  this support is needed (health, education,  legal,  ethical,
      social, development).
   -  New strategies should be developed to:
      . alleviate  the impact of the disease on the individual,  the  family
        and the society (this includes treatment of opportunistic infections
        and care for orphans).
      . effectively    change   high   risk   groups'   behaviour    without
        stigmatisation.
      . make  counselling, testing and contraception available  to  decrease
        transmission from women to newborn.
   -  Support regional exchanges and training programmes.
                                     - 4 -
   The Nakasero Blood Bank in Kampala
   Within  the Uganda AIDS  Control Programme, formed in 1987, the  European
   Comission  pledged  1.5 MECU for a safe blood programme  at  the  central
   blood  bank in Nakasero (Kampala). A further 789.000 ECU have  just  been
   committed this year, to extend the programme's activities to the whole of
   the country.
   The  Nakasero  Blood  Transfusion Services  started  operating  in  1988.
   15.000 usable  units  of blood per annum are now produced  (the  original
   target was 10.000 units by end 1990).
   The  efforts  of  the bank are concentrated  on  the  least  HIV-infested
   population  groups:  50%  of transfusions are to  children,  and  20%  to
   pregnant or delivering women.
   During his stay in Kampala for the ACP/EEC Joint Assembly meeting,  Vice-
   President  MARIN  visited  the Nakasero Blood Bank  on  February  27  and
   donated  blood. He expressed the Commission's support, and  his  personal
   attachment, to the AIDS control programme and to the task accomplished by
the Nakasero Blood Bank in particular.

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