HEALTH

1. Policy Background
2. Useful Documents
3. Links

1. Policy Background

The EU is a major international donor to Health, AIDS and Population interventions in developing countries. Since 1990, the EU has provided around € 4.2 billion, through a variety of complementary financing mechanisms, to health-related interventions in more than 100 developing countries world-wide. To date EU support for health issues has strengthened systems, services and access to medicines. EU support has also led to improvements in pharmaceutical procurement, distribution and management as part of wider efforts to reform health systems.

The EU's most recent development policy guidelines aim to reduce poverty through a coherent set of actions on humanitarian, development and research issues, with health clearly identified as a priority sector for support. Such interventions as those described above acknowledge the important links between the health of a population and development. They are an integral part of the EU's response to the global challenge of poverty eradication.

EU support for health programmes in developing countries operates on regional, national and local levels and gives priority to strengthening health service infrastructures and systems, to institutional development and towards a greater integration of cross-sectoral themes. These include sexual and reproductive health issues; sexually transmitted diseases (in particular HIV/AIDS); and working to accelerate global action against the HIV/AIDS, malaria and tuberculosis.

Current objectives:
Key objectives of current EU strategy are:

· Protect the most vulnerable from poverty caused by illness, the spread and consequences of HIV/AIDS and high fertility;
· Increase the quality, efficiency, equity and sustainability of, and participation in, health systems.

The health services of many poor countries are in crisis. Lack of funding, combined with ineffective training and migration of health service workers towards better prospects in more affluent countries, has created a desperate situation of withering services at a time of increasing demand and expectation, caused not least by the AIDS pandemic.

As a result many poor countries are now redefining their health policies and systems, moving towards sector-wide approaches within broad policy frameworks and establishing longer-term partnerships with donors. While this may pay dividends it is inevitably a long-term process requiring both knowledge generation and capacity building.

The EU broadly supports this approach but meanwhile EU recognises the urgent need to address an accelerated response to the increasing impact of the major communicable diseases (HIV/AIDS, malaria, tuberculosis) in the developing world.

To this end the EU convened a high level meeting in September 2000, with the World Health Organisation and the Joint United Nations Programme on HIV/AIDS to produce a new policy framework that utilised the EU's comparative advantages to complement existing initiatives and which attempted to bring greater coherence to the different branches of EU policymaking.

In February 2001 this new policy framework was approved as a programme for action to fight these three diseases. Accelerated Action On HIV/AIDS, Malaria And Tuberculosis In The Context Of Poverty Reduction develops EU policy and establishes a broad and coherent Community response for the period 2001-2006.

This initiative was reinforced at the EU/US summit in Göteburg in June 2001,when the EU and the US agreed two major initiatives: to establish a global fund to fight communicable diseases; and, secondly, to work with the pharmaceutical industry and with affected countries to obtain the widest possible provision of affordable medicines.

New health policy orientations are due to be adopted by the European Commission in the Spring of 2002. They are part of the continuing process of alignment of Community policies particularly in relation to development. They will be discussed by the Development Council in May.

2. Useful Documents

A. Overview of the EC's Health, AIDS and Population Policies
(1990-1999)

Health: Key policy document: Commission Communication - COM(94)77 (1994) Strategic priorities:
· to ensure that the health dimension is taken more fully into account in development policies, particularly in structural adjustment programmes;
· to help correct structural imbalances in health systems, by directing action to basic services;
· to facilitate institutional reform by building capacity at central level and supporting decentralisation;
· to help countries develop systems to measure and mobilise resources more efficiently. More…..

B. Programme For Action: Accelerated Action On Hiv/Aids, Malaria And Tuberculosis In The Context Of Poverty Reduction Commission Of The European Communities: Brussels, 21.2.2001

EXECUTIVE SUMMARY (The full document can be read at:
http://europa.eu.int/eur-lex/en/com/cnc/2001/com2001_0096en01.pdf )

This Commission's Programme for Action develops the policy framework presented in the September 2000 Communication on 'Accelerated Action targeted at major communicable diseases within the context of poverty reduction.'(COM(2000) 585 of 20.9.2000).

It establishes a broad and coherent Community response, over the period 2001-2006, to the global emergency caused by the three major communicable diseases, HIV/AIDS, malaria and tuberculosis, which most affect the poorest populations and which undermine global health. The Programme, as part of an expanded global effort, targets actions to increase the impact of existing interventions, the affordability of key pharmaceuticals, and research and development of specific global public goods to confront these diseases in developing countries. More…

C. Health Care for All: Speech By Mr Poul Nielson, EU Commissioner for Development and Humanitarian Aid, Antwerp 25 - 26 October 2001

Over the past two days many speakers have described the very real problems faced by those who are striving to improve the health of poor people. A common theme has been how to deliver more effective and better quality health services to the population, often with limited resources. The major communicable diseases are high on the agenda. We can sense a tension between those who promote a systematic approach through improving health services and those who propose accelerated and targeted action against the major causes of illness and death. I hope by the afternoon of day two we collectively recognise that we do not need one or other approach. We need more of both- working together to maximum benefit. More…

D. A New Framework For Action Against The Major Communicable
Diseases Within The Context Of Poverty Reduction. Speech By Mr Poul Nielson, EU Commissioner for Development and Humanitarian Aid To The ACP-EU Joint Parliamentary Assembly, Brussels, 12 October 2000

The Commission is contributing to the fight against HIV/AIDS through various instruments including the budget, the EDF and budget lines. We fund both targeted actions and wider health systems development. From 1990-1999 we committed 4.2 billion euro to health, AIDS and population interventions; in 1998 alone, the figure was over 700 million euro. Health has risen from 1% to 8% of total EC assistance over the past decade. Since 1990 more than 300 million euro has been provided specifically for HIV/AIDS interventions around the world. More…

E. The Role of Health: Poul Nielson, European Commissioner for Development Co-operation and Humanitarian Aid: Speech to the Thematic Session on Enhancing Productive Capacity, 3rd UN Conference on Least Developed Countries, Brussels, 16 May 2001

The Commission has recently adopted a comprehensive Programme for Action on communicable diseases with special emphasis on HIV/AIDS, malaria and tuberculosis. These three diseases, which particularly affect the poorest, will require a new approach if we are to reduce their impact. This Programme for Action was strongly endorsed by the General Affairs Council of 14 May. The Programme sets out, in my view, our best possible response to combine different approaches which target the impact of existing interventions, the affordability of medicines and the need for research and development of global public goods such as AIDS and malaria vaccines. Prevention remains at the forefront of our efforts, we clearly recognise that we must find ways to increase access to effective treatments. However we should not lose sight of the fact that, in the case of AIDS, even if anti-retroviral drugs were to be provided free, there remain significant obstacles to overcome in getting effective care to those in need. More…

3. Links

UNAIDS www.unaids.org
World Health Organisation www.who.org
EuropaWorld Health Pages
Médecins Sans Frontières www.msf.org
EU Commission DG External Relations http://europa.eu.int/comm/dgs/external_relations/index_en.htm
EU Commission DG Development and Humanitarian Affairs
http://europa.eu.int/comm/dgs/development/index_en.htm