Employ what works to avoid an AIDS disaster
"Medium term forecasts for HIV in Eastern Europe are catastrophic: the USA National Intelligence Council predicts that 6-11% of Russian adults will be HIV positive by the end of the decade. UNAIDS says about 1% of the adult population is already HIV positive in Ukraine, Russia and Estonia. Some applicant countries are facing exponential growth in infection rates.
This recent explosion of the HIV epidemic is related mostly to intravenous drug use - so we know how to fight it. Harm reduction projects for drug users, which include needle exchange, community based outreach and peer-support, distribution of methadone and other replacement therapies, have proven repeatedly to be hugely efficient in reducing HIV and hepatitis C infections. Our challenge is to make sure that these strategies are urgently put in place both in applicant countries and in Russia, Ukraine and other eastern European and central Asian countries. Only with massive and urgent action from the European Union, along with other national and international agencies, can we succeed against this epidemic by 2008."
Arnaud WASSON-SIMON, Coordinator of a "best practices" project in Central and Eastern Europe (www.integration-project.org), AIDES (French Community-based NGO against HIV/AIDS).
Resolve the nursing crisis
"If you want to develop and implement robust policies to improve health in Europe, you need an effective, motivated and appropriately trained health workforce. We are now struggling through not only a European but an emerging worldwide shortage of nurses.
There are two major challenges which the EU health programme could help address:
the lack of reliable comparable data on flows of health professionals within Europe and in and out of Europe. This information could greatly improve workforce and health planning
the need to identify and spread good practice on ethical recruitment and employment across Europe, and to secure political commitment to implementing it in the present Member States and the accession countries."
Susan Williams, European Officer, Royal College of Nursing UK.
Include NGOs in developing "best practices"
"In terms of the implementation strategies, we would like to see recognition of the importance of including governmental and non-governmental organisations for the development of best practices. In many countries, governments and NGOs are working together or the non-governmental sector takes up what the governmental level is not willing or daring to tackle. This is particularly the case in the area of sexual and reproductive health where in some countries the economic situation does not allow sufficient government input or where governments have a problem in dealing with this type of sensitive issue or where governments do not yet understand the concept of sexual and reproductive rights but are rather concerned with declining birth rates."
Vicky Claeys, IPPF European Network, Reaction to the Concept Papers in the Implementation of the EU Health Strategy, 30 April 2002.
Benefit from the Public Health Series
Many EPHA members say they would like to see more EU health reports made available. Those produced so far have proved key for promoting EU involvement in public health. They include Report of the Scientific Steering Committee on BSE, European Union health policy on the even of the millennium, Health care systems in the EU: A comparative study. In particular, where translation is available, the material is used to promote networking in good practice in local languages. Citizens, local government and not-for-profit groups need communication about EU programmes and about the existence and development of local public health policies and actions. New additions to the series could be developed with the expertise of not-for-profit associations and groups. For example, one new addition might address sexual and reproductive health.
Urgent issues
Funding - not only is overall funding for health projects low in the new Public Health Programme but no core (or operational) funding is available for health NGO networks. This is despite the fact that such facilities are available for many other areas of civil society, such as environmental NGOs, youth, disabled and women’s organizations, consumer bodies and so on.
Weak structures - the European Health Forum has been set up to involve the voluntary sector in policy development. However, it has no funds and no mechanism for dialogue in the sense that participants are not asked for comments relating to the legislative process. EPHA members have also expressed their concerns about the lack of transparency surrounding the membership selection criteria and the lack of participation in drawing up agendas.
Transparency in the NGO sector - citizens’ organisations can play a key role in countering the effects of vested interests. However, this depends on their independence. Transparency is a vital issue. A process needs to be set up to ensure transparency and maintain credibility so that opportunities for civil dialogue are meaningful.
