Accelerated action targeted at major communicable diseases within the context of poverty reduction

1) OBJECTIVE

To create a policy framework to guide the EC towards coherent, global and accelerated action as part of the efforts to improve the standard of health amongst the world's poorest people with a view to tackling the three major communicable diseases holding up development: HIV/AIDS, malaria and tuberculosis.

2) COMMUNITY MEASURE

Communication from the Commission of 20 September 2000 to the Council and the European Parliament on accelerated action targeted at major communicable diseases within the context of poverty reduction.

3) CONTENT

Context

It is well known that improved health has been a determining factor in the rapid economic growth of many parts of the world during the 20th century. Effective education and public health systems are essential prerequisites for poverty reduction and development.

Communicable diseases, notably HIV/AIDS, malaria and tuberculosis, continue to slow down human development. Globally, these three diseases kill more than five million people a year, and communicable diseases account for 60% of morbidity in developing countries.

It has not been possible to prevent the spread of these diseases. On the contrary there has been an upsurge. Despite the fact that it has been possible to diagnose and treat tuberculosis for more than 50 years it remains a leading killer, and it has started to reappear in areas where it had previously been halted or eradicated (e.g. Eastern Europe).

It is possible to improve the health of the poorest people by targeting investment at communicable diseases, in particular HIV/AIDS, malaria and tuberculosis.

The Community has been granting aid to this field for some considerable time. Since 1990, 3.4 billion invested in Health, AIDS and Population (HAP) programmes has benefited more than 100 developing countries. The programme on HIV/AIDS in developing countries started in 1987. The EU contributes 65% of total global aid to Health, AIDS and Population.

However, the fight against communicable diseases has become a global emergency requiring a new policy framework. The aim of the European Community's new development programme is to reduce poverty. One of the priority areas for EC development aid is support for macroeconomic policies in developing countries, with an explicit link to poverty reduction strategies, in particular sectoral programmes in social areas such as health.

Objectives and actions The objectives and actions of the new policy framework are intended to supplement rather than replace existing activities. They comprise a set of interdependent and mutually supportive measures. The communication establishes a framework for assistance with three core areas:

Optimising the impact of existing assistance in the context of Community development cooperation

Although there are detection and/or treatment methods for these diseases, they are all too often ineffective. The aims in this core area include:

• continuing focus on prevention;
• encouraging developing countries to establish coordinated and coherent health policies targeting the principal communicable diseases;
• improving supply methods and quality assurance in health products, such as condoms, mosquito bednets, etc.;
• increasing targeted aid through innovative partnerships which are not limited to the traditional health sector (e.g. partnerships with civil society organisations or with the private sector).

Making essential medicines more affordable through a comprehensive global approach

The price of essential medicines and basic proprietary medicinal products needed to prevent and treat the three principal communicable diseases is one of the major obstacles to improved health and access to healthcare for the poorest people in developing countries. Most medicines are produced and patented in industrialised countries and thus remain unaffordable for the poor. A comprehensive synergistic approach to this problem is essential.

EC activities in this field will be based on guidelines reflecting the need to:

• increase current EC aid in order to consolidate national policies and practices regarding pharmaceutical products, with the ultimate aim of improving quality assurance, distribution etc.;
• review the prices of essential medicines for these three principal communicable diseases, as well as the impact in terms of import duties and taxes;
• apply a system of tiered pricing, allowing manufacturers to offer the lowest possible prices to the poorest countries without jeopardising their profits in developed countries;
• sign voluntary licensing agreements to facilitate local production of medicines and ensure that developing countries benefit from technology transfer;
• increase capacities for local production of generic medicines through the development of laboratories and cooperation between laboratories, research centres and the pharmaceutical industry, leading to effective competition on national markets;
• exploiting the flexibility provided for under the TRIPS Agreement to obtain compulsory licences for resolving public health problems or coping with crises.

Investing in research and development of global public goods used in the fight against the three diseases

The last core area tackles the long-term problem by aiming to overcome obstacles to investment in research and development. Three complementary strategies are envisaged:

• boosting the amounts and the effectiveness of public investment, particularly by increasing support for research in developing countries in the context of the European Research Area;
• development of an incentive package for private investment (e.g. venture capital encouragement, purchasing funds etc.);
• participation in a global partnership to ensure that better account is taken of the needs of developing countries over the next ten years. The aim is to improve the present ratio of 10% investment in 90% of the global burden of disease. The target ratio is 20/80%.

International perspective To achieve success, a global, international approach is required. This policy framework is the Community's first response to the recommendations of the G8 summit in Okinawa in July 2000, and is part of the international action targeted at communicable diseases, notably HIV/AIDS, malaria and tuberculosis in developing countries.

Poverty reduction through improved health will likewise require cooperation between all international players, i.e. institutions such as the EC, UN and WHO, as well as NGOs and the private sector.

Last updated: 12.10.2001