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)"
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| Legal base | — |
| Document originated | 27 April 2005
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| Deposited in Parliament | 17 May 2005
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| Department | International Development
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| Basis of consideration | EM of 19 May 2005
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| Previous Committee Report | None; but see HC 42-xxxvii (2003-04), para 5 (17 November 2004) and HC 38-iii (2004-05), para 13 (12 January 2005)
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| Discussed in Council | 23-24 May GAERC
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| Committee's assessment | Politically important
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| Committee's decision | Section 1.260 Cleared, but relevant to any debate on the EU contribution to the Global Fund on HIV/Aids, Tuberculosis and Malaria
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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.
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