The rapporteur welcomed the fact that the word ‘condom’ would henceforth be used in the wording of the draft Decision. Not wishing to offend, the Council had at first preferred the term ‘appropriate protection’. However, this description was less than satisfactory, mainly because it would permit all kinds of interpretations, especially those of the most conservative kind. A total of three of Parliament’s 18 amendments to the proposal were accepted as they were; 12 others were the subject of a satisfactory compromise and a further two were covered by comitology; the amendment relating to the safety of blood products had been covered by the Commission’s commitment to draw up a proposal on this subject. Mr MAMERE also pointed out that the budget allocation for this programme, while fairly large, was still relatively modest when seen against the scale of the problem. It was therefore important to make the best use of the available financial resources. Commissioner Flynn said that when implementing the programmes the Commission would do everything in its power to promote cooperation between the Member States. Finally, while he too recognised that the appropriations were modest when compared with the size of the problem, he stressed that it was important to derive the maximum level of benefits from them.

The Council took stock of progress, in the context of the codecision procedure with Parliament, on the proposals for decisions on the adoption of action plans or programmes of action in the fields of: - combating cancer; - health promotion, information, education and training; - the prevention of AIDS and certain other communicable diseases. Specifically, the Council was briefed on the informal talks that had taken place between Parliament, the Council and the Commission with a view to the meeting of the Conciliation Committee on the matter scheduled for 19 December 1995. It will be recalled that the Council adopted its common positions on the proposals in question at its meeting on 2 June 1995. In the meantime Parliament approved a number of amendments at second reading at the end of October. Some of those amendments concern the financial package for the programmes (for the ‘cancer’ plan, Parliament is proposing ECU 64 million instead of the ECU 59 million envisaged in the Council’s common position; for the ‘health promotion’ programme, Parliament is proposing ECU 35 million instead of ECU 30). Other Parliament amendments relate to the specifics of the programmes and to a number of general basic provisions.

The Council noted that it was unable to accept all the amendments approved by Parliament concerning the proposals for decisions adopting three action plans or programmes of action in the health field (combating cancer; health promotion, information, education and training; prevention of AIDS and certain other communicable diseases). It therefore decided to convene the Conciliation Committee on this matter in accordance with Article 189b of the Treaty.

The rapporteur, Mr MAMERE, explained that all of the amendments of the Committee of the Environment were important. In particular, Amendments Nos 1, 2, 3, 4, 6 and 7 sought to enhance the coordinating role of the European Union, and the Commission in particular. Amendments Nos 5 and 10 emphasised the essential role of non-governmental organisations and patients’ associations in assisting persons carrying the HIV virus and AIDS sufferers and in providing information. Amendment No 11 related to the measures required to ensure the reliability of blood products. Amendment No 13 proposed the establishment of a code of good conduct for clinical trials. Finally, Amendment No 12 underlined the vital importance of promoting the use of condoms and single-use syringes for drug addicts in fighting the spread of the disease. According to Mr Flynn, the Commission was prepared to take over the amendments that improved the text of the common position, including Amendments Nos 1, 2, 3, 4, 5, 6, 7, 10 and 13. Amendments Nos 12, 14 and 17 on the promotion and sale of condoms could be taken over in the form of a reference to this matter in the text of the programme. However, Amendments Nos 8 and 9, which provided for a mixed committee established by the Council to assist the Commission in implementing the programme could not be taken over for budgetary reasons. Amendment No 11, which laid down measures for the safety of blood and blood products would be better dealt with in other Community instruments. Finally, Amendments Nos 15, 16 and 18 were rejected because they were not relevant to this legislative field.

The rapporteur, Mr MAMERE(ARE, F), feared that there was a risk of overloading the 1995-1999 programme on the prevention of AIDS (with an allocation of ECU 50 million) by extending it to other communicable diseases. He opposed any form of discrimination against persons carrying the HIV virus or suffering from AIDS. He regretted that infection through blood transfusions was not included in the Commission proposal. It was vital to adopt strict rules on the selection of donors and on transfusions. He was in favour of allowing NGOs, and particularly patients’ associations, to participate in the programme. He also believed that it was essential to establish at Community level a warning and rapid information system for public authorities and medical and scientific bodies, based on a network of epidemiologists. Commissioner FLYNN stated: - that of the 66 amendments, he could take over 36 in full or in part; - that he could not take over: a) Amendments Nos 1, 17, 21, 22, 29, 30, 45, 49, 51, 52, 55 and 63, which included the amendments providing for maximum safety of blood products (Amendments Nos 45 and 63) as this should be covered by other Community programmes; b) Amendments Nos 34, 36, 44 (on voluntary screening), 62 and 66, the latter having been tabled by the Greens with a view to abolishing the Russian law on HIV testing for foreigners entering Russia for a stay longer than three months, as they were outside the scope of the programme; c) Amendments Nos 5, 12, 20, 26, 36, 46 to 48, 53, 57 and 59, notably concerning cooperation and coordination with the national authorities, as they would limit the scope of the initial proposal. In light of these statements made before the beginning of the debate, the rapporteur added that it was likely that conciliation would be required, particularly if the amendments on transparency, the utilisation of condoms and the fight against discrimination were not taken over by the Commission.

In its Opinion the Committee suggested that this proposal should be part of a comprehensive public health programme (in accordance with Article 129 of the Treaty on European Union) with the aim of coordinating the various specific programmes and ensuring greater consistency between them. It also called for a management committee to be set up, rather than an advisory committee, and stressed that the management committee should include representatives of regional and local authorities. To this end, it urged the Commission to give greater encouragement to the Member States to set up national coordination committees with all the interested partners (including regional ones). The Committee also put forward specific comments on the measures to be implemented: it called for the role of schools to be strengthened, better prevention of AIDS transmission among groups at risk, safer blood transfusions, and social and psychological support for people with HIV. The Committee drew particular attention to discrimination against people with AIDS and recommended that measures be put in place to combat such discrimination.

The Committee called for the required distinction to be made between action on AIDS and action in connection with other infectious diseases. In the case of AIDS, there were a number of specific features (absence of vaccines, problems of confidentiality of screening results, etc.), but the Community was now able to draw on a solid wealth of experience that would enable progress to be made. With other infectious diseases, however, European-level coordination was already in place. It would therefore be the task of the new programme to improve and develop such coordination, pinpointing centres of excellence that were able to perform functions similar to those of the European Centre for the Epidemiological Monitoring of AIDS in Paris. Responsibility for circulating information undoubtedly lay in the hands of the national authorities but certain initiatives supported by the Community had proved to be valuable, for example the drawing-up of inventories of existing actions such as the directory of activities carried out by non-governmental organisations in the European Union in the field of AIDS prevention and assistance. The ESC therefore called upon the Commission to speedily prepare and distribute an information booklet in all languages of the European Union and of principal ethnic minorities in order to facilitate access to Community schemes by all interested organisations and associations. With regard to the ‘safety of blood and blood products’, mentioned in points 109 and 110 of the Communication and discussed in points 3.3.3. to 3.3.10. of ESC Opinion 228/94, the ESC reiterated that self-sufficiency was not in itself synonymous with safety. It was pleased that this subject was dealt with in a separate Commission Communication [(1) Doc. COM(94)652 final]. The conclusions to be drawn from an examination of this separate Communication should be translated into specific measures and incorporated in the present programme. The ESC asked to be consulted on this in due course. At the present time Member States already operated an informal network of coordination whenever there was a health emergency, but if such emergencies were to be tackled with greater efficiency a European rapid intervention unit needed to be set up under the programme. Finally, the ESC recommended that the intermediate status report to be forwarded to it should carefully evaluate the feasibility of linking HIV/AIDS and other infectious diseases within the same programme.