October 4, 2018
WEAK SIGNALS OF POLITICAL COMMITMENT
Civil society has long been calling on the European Commission to take a leading role in the response to HIV/AIDS, tuberculosis (TB) and viral hepatitis in the EU by putting in place political strategies to effectively combat the three epidemics within the wider European region. In 2017, the European Parliament, in turn, has given a strong signal to the European Commission by calling it to step up its response to the HIV/AIDS, TB and hepatitis epidemics and develop a comprehensive and integrated policy framework to fight the three diseases with a regional approach, given the cross-border nature of the epidemics.
This summer the European Commission published a Staff Working Document on “combating HIV/AIDS, viral hepatitis B and C and tuberculosis in the EU and neighboring countries”. In the document, the Commission takes stock of EU contributions to tackling the three diseases across several policy areas, and presents the instruments and good practices developed under EU-funded projects. The document shows that the EU has been instrumental in setting policy measures and developing good practices for targeted interventions for tackling HIV/AIDS, TB and viral hepatitis.
By publishing a Staff Working Document, the lowest level policy document on the European Commission’s initiative’s scale, the Commission gives a clear sign that it does not intend to take political commitment and develop further policy for tackling the three diseases in the European region. By limiting itself to a Staff Working Document, which does not have any political power and is only an inventory of actions, the Commission is ignoring the calls for stronger political leadership to address the epidemics.
As members of the EU Civil Society Forum on HIV/AIDS, TB and viral hepatitis, we believe that the EU can and must do more.
EPIDEMICS ON THE RISE
The three diseases continue to take more lives and cripple the health and well-being of EU citizens and citizens of the immediate neighborhood.
Between 2010 and 2016, there was a 60% increase in the number of new HIV infections within the wider European region, the only region in the world where the rate of new HIV infections continues to rise. TB under its resistant forms continues to account for a quarter of all antimicrobial resistance deaths. By 2050, an additional 2.59 million lives could be lost through drug-resistant TB alone in the EU. The WHO estimates that there are 14 million people affected by hepatitis C across WHO European Region with some 6 million living in the Union alone.
DECREASING FUNDING
Despite this, the EU funding dedicated to actions on three diseases has been gradually decreasing: while in the first EU Health Programme (2000-2006) the share for the three diseases was EUR 19 million, in the second Porgramme (2007-2013) it shrank to EUR 15.6 million. In the 3rd Health Programme (2014-2020) it stands at EUR 11.6 million only, mostly for prevention, harm reduction and other activities for vulnerable groups affected by HIV, TB and viral hepatitis.
The epidemiological situation shows that TB, HIV and viral hepatitis pose the greatest risks for vulnerable and marginalized groups (mostly migrants, sex workers, prisoners, people who inject drugs, LGBTI groups). While across Europe, most vulnerable populations are left behind. They are facing stigma and discrimination and there is limited national political leadership and investments to address their health needs. The social dimension of the diseases is a major factor affecting the ability to tackle them as epidemics and to eliminate them in the EU and in the neighboring countries. Efforts to reach out to vulnerable groups are crucial, and funding for these interventions should be scaled up, not decreased as is currently the case.
LIP SERVICE TO THE SDGs?
In 2016 the EU made a political commitment to support Member States in reaching the Sustainable Development Goals (SDGs) by complementing Member States’ actions on HIV/AIDS, viral hepatitis and TB through legislation and other initiatives.
The Commission Staff Working Document on Combating HIV/AIDS, TB and viral hepatitis in the European Union and neighbouring countries recognizes that significant scale up efforts are needed for the EU to meet the targets for TB, HIV and viral hepatitis set in the SDG. The document shows that several Member States are facing major challenges in meeting internationally agreed targets.
Despite this reality, the EU shows lack of ambition and political leadership in the SDGs implementation. A recent European Parliament briefing on SDGs implementation at EU level concluded that the EU has been focused on technical aspects of implementation (such as indicators) rather than sectoral mainstreaming at political level, with no concrete sectoral goals and actions for achieving SDGs.
We believe that the SDG 3 targets for TB, HIV and hepatitis should be the driving force behind the EU’s policy in these areas with a concrete political road map on how to achieve the targets. The EU should develop a longer term vision and reorient EU budget contributions towards the achievement of SDG 3 for the three diseases, if it’s serious about fulfilling its commitment to achieve the SDGs targets and end TB, AIDS and combat hepatitis by 2030.
HEALTH IN THE EU POST 2020
In the next EU multi-annual budget (2021-2027) the EC has proposed to reduce its health budget to EUR 413 million (8% cut in health funding compared to the 2014-2020 period) and a downgrade of the EU Health Programme into a Health Strand of the enlarged European Social Fund (ESF+).
While merging health with other social areas might be a positive move and create additional synergies between health and social issues, this should not undermine the EU’s leadership on health, and raises a question whether there will be a Health Commissioner in the next legislative cycle, further to Brexit.
Contact info: Marine Ejuryan, Global Health Advocates, mejuryan@ghadvocates.org
EU Civil Society Forum on HIV/AIDS, tuberculosis and viral hepatitis is an informal advisory body established by the European Commission DG SANTE to facilitate the participation of HIV/AIDS, viral hepatitis and tuberculosis NGOs and networks in European policy development and programme implementation.
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