Select Committee on International Development Appendices to the Minutes of Evidence


ATTACHMENT

CASE STUDY: EC HEALTH, HIV/AIDS AND POPULATION PROGRAMMES

  The EC's Health, HIV/AIDS and population programmes (HAPs) are one example of effective development despite scarce human resources. When Dr Lieve Fransen joined the Commission in 1987 the Community's "social focus" was so weak it was almost invisible. Since the establishment of the Health Unit in DG Development, commitments have risen from an annual average of 35 million euro for the 1986-90 period to 170 million euro for 1991-95, rising again to 273 million euro for 1996-98. Aid to HAP activities has grown from barely 1 per cent of EC aid in 1986 to more than 8 per cent of the total, compared to an OECD average of 5.5 per cent in 1998. In 1999 the European Community committed around 700 million euro in total to health, AIDS and population, making it the second largest donor behind the World Bank. The EC now supports health-related programmes in more than 70 countries around the world.

  HAP assistance has moved away from an initial focus on curative medicine and health infrastructure to support for basic health services, developing fully fledged HIV/AIDS and reproductive health population programmes and supporting health sector reforms.

  Recently the EC has begun to adopt more collaborative, innovative partnerships with country governments. As part of this approach, efforts have been made to involve the private sector in the fight against HIV/AIDS.

  The Community also supports research on health problems in developing countries, including active collaboration between scientists from the European Institutions and developing countries. This approach allows European scientists to better understand the health problems faced by developing countries, and gives scientists from those countries access to high level research of particular relevance to their countries.

  The EC HIV/AIDS programme has emphasised a broad developmental focus since the early 1990s, and has supported the development of innovative multi-sectoral strategies, which now provide the basis for wider national and international initiatives in developing countries.

  HIV/AIDS was defined by the EC as a multi-sectoral issue from the outset. Over the last decade this has resulted in the involvement of mining, transport, education, and agricultural sectors in recognition of the fact that many sectors of the economies of developing countries have an important role to play in the prevention of HIV transmission. Correspondingly a set of tools for multi-sectoral planning were developed and reinforced by workshops and training. This in turn resulted in EC-funded projects for industries such as transport adopting EU guidelines on HIV/AIDS.

  A significant step forward in the strengthening and facilitation of multi-sectoral programmes was the EU-SADC HIV/AIDS regional conference held in Malawi in 1996, which brought together the regions key policy makers and other key actors involved in different sectors at a regional and national level in South Africa. Themes for discussion at the conference ranged from education to tourism. The conference was ground breaking as it involved all those involved in the fight against HIV/AIDS. The Malawi 1996 Conference Plan of Action was adopted by the SADC Council of Ministers in 1997, and led to a specific programme of financial assistance from the EU. An additional 5 million euro was recently announced by Commissioner Poul Nielson for the SADC HIV/AIDS Regional Action Programme. Action includes the implementation of the SADC code on HIV/AIDS and Employment, which provides a basis for dealing with the problem in the work place, in all sectors of the economy.

  Actions by civil society and non-governmental organisations have been an important aspect of EU multi-sectoral and development policy initiatives. EU assistance to legal NGOs in India and other countries have had a significant impact on the formulation of non-discriminatory policies on HIV/AIDS, as well as providing important legal assistance to people living with HIV/AIDS.

  The EU has also been active in working with other world donors. One outcome was a publication produced by the World Bank, UNAIDS and EU, which has now been adopted as the foundation for the World Banks strategy paper on HIV/AIDS.

  The EC has also been instrumental in facilitating better links between Member States in their approaches to HIV/AIDS in developing countries. A recent meeting of population experts in Brussels concluded that EU Member States programmes were increasingly cohesive in their strategies, no longer viewing HIV/AIDS as an issue for action by health services alone but as part of an integrated, multi-sectoral and development approach.

  Whilst the SCR has improved the state of disbursements relative to commitments it has deprived DG Development of much needed human resources. Staff were moved elsewhere and not replaced. Doctor Fransen heads a team of 5 dealing with health, population, gender, and HIV/AIDS projects world-wide. When asked why she stays in the Commission, instead of trying to work on these subjects elsewhere, she told me; "I am still convinced Europe has a major role to play and is a major donor. We have money, instruments, some good people and the expectations of the countries we have been working with. We do well by bringing the best out of bilateral donors and we can be stronger on influencing the different scenes. We do not do that enough at the moment but I think we can."


 
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