Brussels, 30 November 2012
Q&A: The Fight Against HIV/AIDS by the EU
What are the latest figures on HIV/AIDS in the EU and neighbouring countries?
Today, on the eve of World AIDS Day, the European Centre for Disease Prevention and Control (ECDC) and the World Health Organisation Regional Office for Europe (WHO Euro) have released their joint report "HIV/AIDS Surveillance in Europe 2011", with the latest data on HIV/AIDS cases in the EU and neighbouring countries.
In 2011, there were more than 28,000 new HIV infections reported in EU and EEA countries. HIV epidemics were concentrated among key populations: men who have sex with men (Western Europe), people who inject drugs (Eastern Europe) and people originating from countries with generalised HIV epidemics. In addition, HIV infection rates are still expanding in Eastern neighbouring countries.
Overall, the new surveillance data demonstrates no decline in HIV transmissions. While the number of new infections has remained stable in the European Union - between 27000 and 29000 new HIV cases per year in 2006-2011 - the total number of people living with HIV is increasing across Europe. The most recent increase of HIV among people who inject drugs illustrates that even low numbers of HIV infections can rapidly evolve into an outbreak when public health interventions are insufficient.
What is the situation regarding HIV/AIDS in the world?
Sub-Saharan Africa is the region most affected by the disease and is home to 69% of all people living with HIV worldwide and 91% of all new infections among children. AIDS is the leading cause of death in sub-Saharan Africa and the fourth-leading cause of death worldwide.
Since the beginning of the epidemic, more than 60 million people worldwide have been infected with HIV and more than 30 million people have died from AIDS. Today, more than 34 million people are living with HIV/AIDS.
More than eight million people in low and middle income countries receive life-saving antiretroviral treatment, but another seven million people still do not have access to this. Globally in low and middle income countries, 54% of people in need benefitted from antiretroviral therapy in 2011, including 56% in Sub-Saharan Africa.
The most recent figures of UNAIDS (the joint United Nations Programme on HIV/AIDS) reveal that in 2011 about 7,000 people were infected by HIV infections each day, out of which 800 were children under the age of 15 years. The vast majority of infected people – about 97% - live in low and middle income countries.
Despite an overall decrease in the number of new infections, the total number of people living with HIV worldwide continues to grow (partly due to increased survival because of increased coverage with anti-retroviral treatment).
How is the European Commission involved in the fight against HIV/AIDS?
A number of policies and funds contribute to fighting HIV/AID, on a complementary fashion.
Development policy and funding
The Commission - in cooperation with partner countries all over the world- increasingly channels funds through budget support to strengthen third countries' health systems. This use of funds is regarded as particularly efficient. In the discussions with partner countries, the Commission advocates for the implementation of programmes that have already proved successful. Protection of mother to child transmission and condom promotion and distribution are two examples of evidence-based programmes.
The European Commission is also a founding member of the Global Fund to Fight AIDS, Tuberculosis and Malaria (GFATM), and has been providing strong political and financial support to the fund since 2002. EU Member States and the European Commission have provided more than $11 billion between 2001 and 2011 to the GFATM, which equals 52% of the GFATM resources. Around 4 million people with HIV have received life-saving antiretroviral (ARV) treatment through Global Fund support. So far, the Commission's contribution to the fund exceeded€1 billion. This support is complemented by additional funding of around €250 to various social organisations, during the last decade.
Health policy, agencies and funding
Specialised Agencies such as the European Centre for Diseases Prevention and Control (ECDC) and the European Monitoring Centre for Drugs and Drug Addiction (EMCDDA) act in support of Member States towards efficient surveillance and better prevention and preparedness strategies.
The 2009 Commission Communication "on combating HIV/AIDS in the EU and neighbouring countries" and its action plan set out EU action to address the HIV challenge with a focus on effective prevention, priority groups and priority regions, in particular Eastern Europe. Activities are being implemented in cooperation with Member States, Civil Society, UN organisations and EU agencies.
The HIV/AIDS Think Tank (national authorities from EU Member States, neighbouring countries and international organisations) and the HIV/AIDS Civil Society Forum (NGOs and networks from all over Europe), bring together national authorities, academia, International organisations and Civil Society to implement EU HIV action plan.
A series of actions and projects are co-funded through the Health Programme fostering cooperation among Member States and enhancing the exchange of good practise. One example is the SIALON I project concluded in 2010 which has gathered data on the prevalence of HIV among men having sex with men, their risk patterns and the availability of access to voluntary counselling and testing. This generated reliable data to help design targeted prevention policies. Its follow up, the on-going SIALON II project, is helping to promote combined and targeted prevention complemented by surveillance among men having sex with men. Another example is the BORDERNETwork project 2010-2012, based in Germany, which focuses on prevention, treatment and care of vulnerable groups, such as migrants, sex workers and ethnic minorities, in the border regions of central, eastern and south-eastern Europe.
In the context of the Seventh Framework Programme for Research and Innovation more than €121 million were spent on research for therapeutic and preventive approaches for HIV so far, and under the European and Developing Countries Clinical Trials Partnership (EDCTP) €118 million were invested in clinical studies on new or improved medical interventions
The EU supports a flexible use of TRIPS (Agreement on Trade Related Aspects of Intellectual Property Rights, 1991, WTO) provisions, to allow low-income countries to procure lifesaving generic medicines (produced under compulsory licences) from third countries. The EU has consistently led efforts to widen access to vital medicines in developing countries and to strike a balance between intellectual property rights of pharmaceutical companies and the need to ensure that medicines are available for poor countries facing public health crises.
What are the main challenges remaining in Europe?
Firstly, in several European regions there remains a shortfall in structures, means and/or access to HIV prevention, testing and treatment. Secondly, the expanding HIV epidemic in neighbouring countries is very worrying and needs to be curtailed. Finally, there is still stigma and discrimination in Europe directed at people living with HIV/AIDS, which drives people away from seeking help and care, fuelling an increase in HIV transmission. To address this issue, the Commission is organising a conference on "HIV/AIDS and human rights" in May 2013, in cooperation with UNAIDS and with support of members of the European Parliament.
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