Written by Nicole Scholz.
Every year, 1 December marks World AIDS Day, proclaimed by the United Nations (UN) in 1988 and aimed mainly at raising awareness. This year’s specific theme, ‘Communities make a difference’, draws attention to the crucial role of community health workers and communities of people living with HIV, highlighting their contribution to ending the epidemic. World AIDS Day also offers an opportunity to take stock of progress, globally and in the EU.
HIV/AIDS: BackgroundInfection with human immunodeficiency virus (HIV) causes a person’s immune system to deteriorate, making them vulnerable to often life-threatening opportunistic infections. Acquired immunodeficiency syndrome (AIDS) is the most advanced stage of HIV infection. Although HIV/AIDS does not yet have a cure, it is treatable and preventable. HIV medicines (antiretroviral therapy) can slow progression of the virus in the body to a near halt and reduce the risk of transmission. Measures such as practising safer sex or using sterile needles help to avoid HIV infection and prevent AIDS. As an additional prevention method, HIV-negative people at a high risk of infection can use pre-exposure prophylaxis (PrEP), which involves taking a specific combination of HIV medicines daily. PrEP effectively prevents infection and has the potential to help reverse the increase in new HIV infections. HIV has claimed more than 32 million lives since the beginning of the epidemic some 35 years ago, and continues to be a major global public health issue. Considerable advances have been made, however, and HIV infection has become a manageable chronic health condition. People living with HIV can expect to live a normal lifespan.
Facts and figures from EuropeDespite the progress made – the number of AIDS cases and AIDS-related deaths has declined steadily in Europe since the 1990s – HIV transmission remains a problem in the EU and its neighbouring countries (i.e. the World Health Organization (WHO) European Region, spanning Europe and central Asia). According to the 2018 joint report by the European Centre for Disease Prevention and Control (ECDC) and the WHO Regional Office for Europe, the rates and overall numbers of people diagnosed with HIV are highest in the east of the region, lower in the west and in the EU/European Economic Area (EEA), and lowest in the centre.
Estimated new HIV infections and reported new HIV diagnoses in the EU/EEA and WHO European Region, 2008-2017, and target for 2020
The report’s data show that in 2017, 25 353 people were diagnosed with HIV, in 30 of the 31 EU/EEA countries. The rate of new HIV diagnoses was higher among men than women. Sex between men remained the predominant mode of HIV transmission, accounting for 38 % of all new diagnoses. Heterosexual contact was the second most common transmission mode among people newly diagnosed (33 %, equally divided between men and women). Transmission due to injecting drug use accounted for 4 % of HIV diagnoses. 41 % of people diagnosed in the EU/EEA were migrants. The overall EU/EEA trend in reported HIV diagnoses appeared to have declined slightly over the last decade, but contrasting trends were seen at national level: while some countries reported a decline in HIV diagnoses, rates had more than doubled in others.
United Nations-led global efforts to end AIDSEnding the AIDS epidemic by 2030 counts among the targets under Goal 3 (target 3) of the sustainable development goals (SDGs), adopted by the UN in September 2015. UNAIDS, the joint UN programme on HIV/AIDS, is leading global efforts. Recent UNAIDS statistics show that there were an estimated 37.9 million people living with HIV in 2018. Of those, 23.3 million were accessing antiretroviral therapy, up from 7.7 million in 2010. Around 1.7 million were newly infected with HIV, compared with 2.9 million in 1997 – a 40 % decrease. In 2018, around 700 000 people died from AIDS-related illnesses worldwide, compared with 1.7 million in 2004. With increasing access to HIV prevention, diagnosis, treatment and care, AIDS-related deaths have been reduced by more than 56 % since the peak in 2004. As the WHO points out, although the coverage of services has been steadily increasing, not everyone is able to access HIV testing, treatment and care. Some key populations (men who have sex with men; people who inject drugs; prisoners; sex workers and their clients; and transgender people) are more at risk of HIV, but have less access to care (the ‘PrEP gap‘). In 2018, these population groups accounted for an estimated 54 % of new HIV infections globally (and 88 % in western and central Europe).
On World AIDS Day 2019, the WHO’s five main messages to global decision-makers are:
Whereas the Member States have the main responsibility for health, the EU complements national action. EU HIV/AIDS policy focuses on prevention and on supporting people living with the disease. The 2009 Commission communication on combating HIV/AIDS identified policies to help reduce the number of new infections and to improve quality of life for those living with the disease. An action plan on HIV/AIDS in the EU and neighbouring countries, introduced in 2014 to support the implementation of the communication, ended in 2016 and has not been renewed. The Commission’s 2018 staff working document on combatting HIV/AIDS, viral hepatitis and tuberculosis (TB) in the EU and neighbouring countries gives an overview of policy initiatives to help Member States achieve SDG 3. The EU has invested significantly in HIV/AIDS research over the years, and is financing projects under Horizon 2020. One example is EHVA, a platform for the development of prophylactic and therapeutic HIV vaccines. HIV/AIDS-related projects funded under the EU health programme (2014-2020) include the joint action on integrating prevention, testing and linkage to care strategies for HIV, viral hepatitis, TB and sexually transmitted diseases in Europe (INTEGRATE). At the August 2019 G7 summit in Biarritz, the Commission pledged €550 million to The Global Fund against AIDS, TB and malaria, which new Health Commissioner Stella Kyriakides intends to translate into action. At her hearing, she committed to ensure access to innovation and medicines for people with TB, HIV/AIDS and hepatitis.
The European Parliament, in its 2017 resolution on HIV/AIDS, TB and viral hepatitis, urges the Commission and Member States to develop a comprehensive EU policy framework to address the three diseases. It advocates for the EU to play a strong role in dialogue with neighbouring countries in eastern Europe and central Asia. On HIV/AIDS, in particular, it calls on the Commission and the Member States to facilitate treatment, including for the most vulnerable groups, and to work on combating the stigma associated with HIV infection.
Download this At a glance note on ‘World Aids Day 2019’ in PDF.
Written by Marie Lecerf,
On 3 December each year, the European Commission, together with the European Disability Forum, organises a conference to mark the European Day of Persons with Disabilities, and 2019 marks the 27th anniversary of this day. The conference brings together decision-makers, people with and without disabilities, experts, the media and other stakeholders. Alongside and in support of national policies, the European Union (EU) has introduced a series of initiatives, programmes and strategies to improve the situation of disabled people over a number of decades.
Statistics – Disability in the European UnionAccording to the latest available data, in 2012, there were at least 70 million people aged 15 years and over with disabilities in the European Union (EU-27), corresponding to 17.6 % of the population aged 15 years and over. This share is likely to increase with an ageing population, given that people are more prone to develop disabilities with age.
First steps – ‘Equality of opportunity for people with disabilities’In 1996, the European Commission published a communication entitled ‘Equality of Opportunity for People with Disabilities – A New European Community Disability Strategy’. Later on, an action programme to combat discrimination (2001-2006) was adopted to stimulate the introduction of specific measures to tackle discrimination. As an additional step, in May 2001, the European Commissioner for Social Affairs called on the European Council to dedicate the year 2003 to disabled people.
Legal basis – including disability in EU charters and treatiesAs the EU paid closer attention to the situation of disabled people, the question of the legal basis on which it would introduce a genuine EU disability policy became increasingly important.
The European treaties enshrine the rights of persons with disabilities since 1997.. Article 19 of the Treaty on the Functioning of the European Union (TFEU, ex-Article 13 TEC) sets out that ‘in defining and implementing its policies and activities, the Union shall aim to combat discrimination based on sex, racial or ethnic origin, religion or belief, disability, age or sexual orientation’.
Moreover, Article 26 of the Charter of Fundamental Rights of the European Union, proclaimed in Nice in December 2000, is dedicated to the professional and social integration of persons with disabilities. Having come into effect in 2009, the Treaty of Lisbon attributed the same legal value to the Charter as to the Treaties.
International dimension – the Convention on the Rights of Persons with DisabilitiesThe United Nations Convention on the Rights of Persons with Disabilities (UNCRPD) was adopted on 13 December 2006. The convention is the first international legally binding instrument, which sets minimum standards for rights for people with disabilities and the first human rights convention to which the EU became a party.
By ratifying the UNCRPD in 2010, the EU associated itself with the efforts agreed at international level to guarantee the fundamental rights of disabled people. The measures taken in the Member States to guarantee compliance with the Charter must be guided by the need to enable disabled people to lead a normal life and be socially integrated on an equal level with others.
A strategy – the European Disability Strategy 2010-2020To continue its activities, the EU published a new ‘European Disability Strategy 2010-2020′ to enable disabled people to enjoy their rights in full and to participate in society and the economy on an equal footing with others. It draws on the UNCRPD and complements the Europe 2020 Strategy and the Charter of Fundamental Rights of the EU. The action plan covers eight areas: accessibility, participation, equality, employment, education, social protection and inclusion, health and external actions.
More and more EU initiatives and actions – assisting people with disabilitiesThe Disability Intergroup of the European Parliament is an informal grouping of Members of the European Parliament who are interested in promoting disability policy. Established in 1980, it is one of the oldest and largest intergroups in the European Parliament.
The Intergroup has been a key player in advocating for and advancing the rights of persons with disabilities in the EU. This new legislature provides an opportunity for the Intergroup to maintain its instrumental position on the adoption of legislation favourable to persons with disabilities.
Further informationInformation on disability is available in various European Parliament Think Tank publications. Further details concerning people with disabilities are available on the webpage of the European Union Agency for Fundamental Rights and on the What Europe does for me website.