Select Committee on European Scrutiny First Report


36 EU Programme for Action on HIV/AIDS, malaria and tuberculosis

(26527)

8689/05

COM(05) 179

Commission Communication: "A European Programme for Action to Confront HIV/AIDS, Malaria and Tuberculosis through External Action (2007-2011)"

Legal base
Document originated27 April 2005
Deposited in Parliament17 May 2005
DepartmentInternational Development
Basis of considerationEM of 19 May 2005
Previous Committee ReportNone; but see HC 42-xxxvii (2003-04), para 5 (17 November 2004) and HC 38-iii (2004-05), para 13 (12 January 2005)
Discussed in Council23-24 May GAERC
Committee's assessmentPolitically important
Committee's decisionSection 1.260  Cleared, but relevant to any debate on the EU contribution to the Global Fund on HIV/Aids, Tuberculosis and Malaria

Background

Section 1.261  36.1 In October 2004, the European Commission (EC) issued a Communication entitled "A Coherent European Policy Framework for External Action to confront HIV/AIDS, Malaria and Tuberculosis (TB)".[143] It was based on a progress report on the "EC Programme for Action: Accelerated action on HIV/AIDS, malaria and tuberculosis in the context of poverty reduction", which highlighted key results and areas for further action.[144] The Council reached general conclusions on 23 November 2004, welcoming the policy framework, urging the Commission and the EU Member States to enhance their cooperation to confront the three diseases and asking the Commission to present a Programme for Action (PFA).[145]

The Commission Communication

Section 1.262  36.2 This Communication sets out a PFA covering the period 2007 to 2011. The broader context is set out in paragraph 3 of this Report, in which we consider the Commission's separate Communication on the EU's contribution to replenishment of the Global Fund for HIV/AIDS, TB and Malaria (GFATM).[146]

Section 1.263  36.3 The PFA proposes collective EU action to support country-led programmes and action at global level where there is added value from EU involvement. The focus is on developing and middle-income countries. A major objective is to scale up those interventions that have shown results, with the EU aiming at a contribution that helps to fill the financing gap for the three diseases and reflects Europe's weight and importance as an international partner in development. It highlights the need for further funding by both public and private sectors to meet projected resource gaps. The paper uses the GFATM estimates of the resource gap: US $14.9 billion by 2007 — US $11.5 billion for HIV/AIDS, US $2.6 billion for malaria, and US $0.8 billion for TB.

Section 1.264  36.4 The Communication says EU actions at country level should focus on support for country-led, participatory strategies, with specific actions including:

·  Political and policy dialogue to support country-led strategies: such as political dialogue between the EU and other countries on key issues relating to leadership and governance (e.g. women and children's rights, orphans and vulnerable groups); preparation of a "toolkit" for EC Delegations; sharing EU and regional expertise; and promoting health and disease prevention amongst EC staff;

·  Building the capacity of national health and social systems including: promoting more public expenditure on health; strengthening national research capacity through the European and Developing Countries Clinical Trials Partnership; improving capacity to develop pharmaceutical policy, including sound procurement policies; assisting implementation of international agreements and initiatives; "mainstreaming" strategies for poverty diseases into humanitarian programmes; and analysing the impact of the three diseases on human security;

·  Financial resources to confront poverty diseases: The EU will help countries finance a package of cost-effective interventions (i.e. insecticide-treated bed nets, contraceptives, voluntary counselling and testing and antiretroviral drugs). The Commission will support further action linking national policy commitments to the Millennium Development Goals more closely with financing decisions.

Section 1.265  36.5 Selected areas for action at global level include:

·  Affordable and safe pharmaceutical products: The EC will promote price transparency on pharmaceutical products and commodities, and uphold the principles reflected in the 2001 Doha Declaration on Trade-Related Intellectual Property Rights and Public Health.

·  Regulatory capacity and prequalification: The EC will support development of the capacity of bodies to perform scientific regulation of pharmaceutical products; the establishment of regional networks of regulatory consultants; and the World Health Organisation (WHO) in its efforts to expand the coverage and range of products.

·  Addressing the human resource crisis for health providers: the EC will support both regional and local efforts in formulating a response, including the development of national plans for human resources. To mitigate the impact of brain drain from countries with human resource problems, the EC will also support incentives for health workers to remain in or return to developing countries or regions. By 2006, the Commission will produce a strategy paper that will include discussion of a European Code for ethical recruitment practice, drawing upon experience in EU Member States with voluntary codes; compensation for partner countries (e.g. through taxation by the EU Member States on recruitment) to make up for the recruitment of trained nationals from countries with a human resource crisis; and a Declaration of Global Solidarity on key principles and objectives for supporting action on human resources in the health crisis.

·  New tools and interventions: the EC will support research and development on new tools and interventions such as vaccines, drugs, microbicides[147] and diagnostic tools. Actions would involve research collaboration with developing countries, better pan-European cooperation and support for public/private partnerships. The EU will undertake studies to establish a priority list of "pull incentives" to engage private industry in research and development on new tools and interventions

·  Strengthened partnerships: the EC will engage a wide group of partners, including those affected by the three diseases and the private sector, through the EC Stakeholder Forum and regional consultations. The EC will collaborate with and support key organisations and global initiatives including WHO, UNAIDS, United Nations Population Fund, International Labour Organisation and UNICEF, assessing the relative merits as regards making EU action more effective and efficient, whether the benefits for the EU outweigh the inputs, whether the EC as an organisation offers the partner specific comparative advantages and what the position of EU Member States is towards the potential partner.

Section 1.266  36.6 The PFA's next steps focus mainly on ways to ensure closer cooperation between EU Member States and the EC.

The Government's view

Section 1.267  36.7 In his Explanatory Memorandum of 19 May, the Parliamentary Under-Secretary of State at the Department for International Development (Mr Gareth Thomas) says that:

"Generally the PFA is welcomed. The UK supports EC efforts to present a coherent and comprehensive framework for tackling poverty diseases. The main strengths are:

·  Strong commitment to global partnerships including the Global Fund for AIDS, TB and Malaria;

·  Commitment to support country led, multisectoral approaches to tackling poverty diseases;

·  Continued commitment to sexual and reproductive health & rights and political commitment to orphans and vulnerable children;

·  Focus on low and middle income countries;

·  Links to Europe and Near Neighbourhood policies on AIDS;

·  Role of European research and development efforts Public/Private Partnerships in relation to new prevention technologies;

·  Role of EC in trade related issues.

"The Communication is weak on defining the EC's comparative advantage in this field. Also, in some areas there is a danger of the EC duplicating work better suited for others — notably the UN. There is no reference to the current UNAIDS-led Global Task Team to define the 'division of labour' among key players in the sector and little reference to the 'Three Ones Principle'. This is UNAIDS' approach to improving AIDS responses at country level, to help prioritise and improve coordination.[148]

"Generally, the UK believes that the EC's comparative advantage at country level is related to its direct budget support and support to sector wide approaches, including support of the 'Three Ones" rather than project focus. At global level the EC's comparative advantage lies primarily in its support of the GFATM, its aims to promote policy coherence and on research and trade issues.

"Reference to EU coordination in the PFA, other than political, is often ambiguous. We welcome EC efforts to coordinate across EU whilst guarding against Member States' autonomy.

"With regards to finances, the Communication does not make a clear link between strategic priorities and budget allocations. This is due to the pending agreement on new financial instruments for 2007. The UK support moves to more transparent funding arrangements for the three poverty diseases. We believe that the EU should continue to significantly increase funding for poverty diseases to fill the identified resource gaps.

"The UK believes that:

a.  Funding for low-income countries should be prioritised.

b.  Sexual and reproductive health and rights should be more prominent in the PFA with clear links to HIV/AIDS programs and with specific monitoring targets.

c.  The PFA should refer to wider resource needs rather than to the funding gap defined by the Global Fund to fight AIDS, TB and Malaria.

d.  With regards to research, the European and Developing Countries Clinical Trials Partnership (EDCTP) has performed poorly to date due to internal management and institutional issues. The EDCTP should support the clinical development of the most promising products available based on robust scientific assessment and will be guided by the needs of developing countries. We must ensure that EU's research programme (FP7) provide a significant contribution to research on poverty diseases.

e.  The discussion on human resource issues is welcome, notably the focus on country-led efforts. However, the UK questions the feasibility and desirability of establishing a compensation mechanism for countries particularly affected by brain drain.

f.  Country strategies on the three diseases should support government-led processes. The role of the UN family in supporting countries to lead the development of their own strategies should be fully recognised."

Section 1.268  36.8 Development of the PFA was based on a series of external consultations in late 2004 and early 2005, in which the UK participated. "Consultation with Member States on the tabled version of the PFA has been limited."

Section 1.269  36.9 On the financial aspects, the Minister says that allocations for the PFA will be established in discussions on the Financial Perspective for 2007-13, which is not yet finalised: "The UK wants an increase in EC funding for global poverty diseases (via the GFATM)."

Conclusion

Section 1.270  36.10 We generally share the Minister's assessment, and are accordingly pleased that the Conclusions adopted at the 24 May, six-monthly "development" General Affairs and External Relations Council, in welcoming the Communication, emphasised the importance of enhanced co-ordination and co-operation between the Commission and Member States and with the UN system and African partner organisations; of mainstreaming action against the three diseases into country poverty reduction strategies, based on broad-based local ownership; of increased, predictable and sustained funding for the Global Fund for HIV/AIDS, TB and Malaria (GFATM); and of a strong EU contribution to the UN Millennium Development Goals review summit in September (which we consider separately in paragraph 4 of this Report).

Section 1.271  36.11 We clear the document, but it is relevant to the debate on the GFATM, which we have recommended in paragraph 3 of this Report.


143   (26100) 14245/04; see HC 42-xxxvii (2003-04), para 5 (17 November 2004) and HC 38-iii (2004-05), para 13 (12 January 2005). Back

144   COM(04) 726 and SEC(04) 1326. Back

145   Council Conclusions of 23 November 2004 (15158/04). Back

146   The Global Fund to Fight AIDS, Tuberculosis and Malaria was created to increase dramatically resources to fight three of the world's most devastating diseases, and to direct those resources to areas of greatest need, through partnership between governments, civil society, the private sector and affected communities. Since 2001, the Global Fund has attracted US$4.7 billion in financing and has so far committed US $1.5 billion to support 154 programmes in 93 countries. Back

147   Agents that destroys microbes (such as an antiseptic).In this context, although not yet available, scientists are currently testing around 60 substances to see whether they help protect against HIV and/or other sexually transmitted infections.  Back

148   In April 2004, the international community endorsed the "Three Ones" principles, to achieve the most effective and efficient use of resources, and to ensure rapid action and results-based management: One agreed HIV/AIDS Action Framework that provides the basis for coordinating the work of all partners; One National AIDS Coordinating Authority, with a broad-based multisectoral mandate; One agreed country-level Monitoring and Evaluation System.  Back


 
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