2017/2576(RSP) | [ParlTrack]

Citation 1

— having regard to the question to the Commission on HIV/AIDs, Tuberculosis and viral Hepatitis C (O-000000/2017 – B8- 0000/2017),

Amendment 10 #

Citation 10

— having regard to the Commission Communication of 22 November 2016, entitled “Next steps for a sustainable European future, encompassing the economic, social, environmental dimensions of sustainable development, as well as governance, within the EU and globally”3 , in which the European Commission states it will contribute by monitoring, reporting and reviewing progress towards Sustainable Development Goals in the EU context; _________________ 3 http://ec.europa.eu/europeaid/sites/devco/fi les/communication-next-steps-sustainable- europe-20161122_en.pdf

Amendment 11 #

Citation 11 a (new)

- having regard to the WHO Europe Action Plan for the health sector response to viral hepatitis in the WHO Europe region, whose overall goal is the elimination of viral hepatitis as a public health threat in the European Region by 2030, by reducing morbidity and mortality due to viral hepatitis and its complications, and ensuring equitable access to recommended prevention, testing, care and treatment services for all;

Amendment 12 #

Mireille D'ORNANO, Sylvie GODDYN, Jean-François JALKH

Citation 12 a (new)

- having regard to the European Parliament report of 2 March 2017 entitled 'Options for improving access to medicines' in which the Commission and the Member States are urged to adopt strategic plans to ensure access to life- saving medicines and to coordinate a plan to eradicate hepatitis C in the European Union by means of tools such as European joint procurement,

Amendment 13 #

Citation 12 a (new)

- having regard to the WHO Global Strategy for Women's, Children's and Adolescents' Health 2016-2030;

Amendment 14 #

Mireille D'ORNANO, Jean-François JALKH, Sylvie GODDYN

Citation 12 b (new)

- having regard to the WHO Global Health Sector Strategy on Sexually Transmitted Infections 2016-2021;

Amendment 15 #

Citation 16 a (new)

- Whereas the Dublin Declaration on Partnership to fight HIV/ Aids in Europe and Central Asia was significant in establishing a harmonised monitoring framework in the EU and neighbouring countries, which allows monitoring progress in the fight against HIV,

Amendment 16 #

Recital A a (new)

A a. Whereas it will be difficult for the European Commission to monitor progress towards the Sustainable Development Goals for viral hepatitis, as current surveillance data in Member States is frequently inadequate,

Amendment 17 #

Seb DANCE

Recital B

B. wWhereas there is strong evidence that ~~pre-exposure prophylaxis is effective~~ the use of antiretroviral treatment all but eliminates the risk of transmission where viral loads are reduced to undetectable levels. 1a _________________ 1a https://thin kpr~~eventing infection;~~ogress.org/massive-hiv- treatment-study-found-zero- transmissions-between-mixed-status- couples-73d4a497f77b

Amendment 18 #

Recital B

B. whereas there is strong evidence that pre-exposure prophylaxis is effective in preventing ~~infection~~cases of infection, although preventative prophylaxis does not prevent the rapid spread of the infection between MSM (men who have sex with men);

Amendment 19 #

Recital G

G. whereas Viral Hepatitis is one of G. the major public health threats globally affecting about 240 million people with chronic Hepatitis B4 and 150 million with chronic Hepatitis C, whereas within WHO European Region an estimated 13.3 million people live with chronic hepatitis B and an estimated 15 million people with hepatitis C, moreover Hepatitis B causes about 36 000 deaths and hepatitis C about 86 000 deaths per year in WHO European Member Stateshttp://www.euro.who.int/en/health- topics/communicable-diseases/hepatitis/data-and-statistics ; _________________ 4 Data regarding Europe: http://www.euro.who.int/__data/assets/pdf _file/0009/283356/fact-sheet-en- hepb.pdf?ua=1

Amendment 2 #

Citation 6 a (new)

- having regard to the WHO Global Health Sector Strategy on Viral Hepatitis 2016-2021 towards ending viral hepatitis, whose goal is to eliminate viral hepatitis as a major public health threat by 2030,

Amendment 20 #

Recital G a (new)

G a. Whereas the Dublin Declaration on Partnership to fight HIV/ Aids in Europe and Central Asia was significant in establishing a harmonised monitoring framework in the EU and neighbouring countries, which allows monitoring progress in the fight against HIV,

Amendment 21 #

Recital G b (new)

G b. Whereas the Dublin Declaration on Partnership to fight HIV/ Aids in Europe and Central Asia was significant in establishing a harmonised monitoring framework in the EU and neighbouring countries, which allows monitoring progress in the fight against HIV;

Amendment 22 #

Recital G a (new)

G a. Whereas the WHO has identified injecting drug use as a major driver of the Hepatitis C epidemic in the European Region, with people who inject drugs (PWID) presenting the majority of new cases,

Amendment 23 #

Recital G a (new)

G a. whereas the WHO has identified injecting drug use as a major driver of the Hepatitis C epidemic in the European Region, with people who inject drugs (PWID) presenting the majority of new cases;

Amendment 24 #

Françoise GROSSETÊTE

Recital K a (new)

Ka. whereas the Dublin Declaration on Partnership to fight HIV/AIDS in Europe and Central Asia has been was crucial for the establishment of a harmonised system of surveillance making it possible to track progress in the fight against AIDS;

Amendment 25 #

Recital K a (new)

K a. whereas at the moment there is still an uneven approach at EU level on fighting viral hepatitis, some MS lack in having a national plan, while certain MS have made significant funding commitments and put in place strategies and developed national plans for a comprehensive response to the burden of viral hepatitis;

Amendment 26 #

Mireille D'ORNANO, Sylvie GODDYN, Jean-François JALKH

Recital K a (new)

Ka. whereas there are between 130 and 150 million people in the world with chronic hepatitis C virus infection and whereas approximately 700 000 people die every year from liver diseases related to hepatitis C;

Amendment 27 #

Recital K a (new)

Ka. whereas, while the incidence of HIV is increasing in the risk categories defined by the World Health Organisation, the general population of the European Union is being affected significantly by the growing incidence of sexually transmitted infections, 357 million persons being infected annually throughout the world by one of the four main treatable sexually transmitted diseases defined by the World Health Organisation; whereas , in addition, 18 % of women and 13 % of men in Western Europe are infected with the HSV-2 virus;

Amendment 28 #

Mireille D'ORNANO, Sylvie GODDYN, Jean-François JALKH

Recital K a (new)

K a. Whereas in 2014, 35 321 cases of hepatitis C were reported from 28 EU/EEA Member States, a crude rate of 8.8 cases per 100 000 population 2a. _________________ 2a Annual Epidemiological Report - ECDC. http://ecdc.europa.eu/en/healthtopics/hep atitis_C/Documents/aer2016/AER- hepatitis-C.pdf

Amendment 29 #

Recital K b (new)

Kb. whereas this higher incidence of sexually transmitted infections in the EU poses a major threat to public health due to the resulting complications, especially with regard to reproductive health and, in addition, such diseases place those affected at greater risk of HIV infection;

Amendment 3 #

Citation 6 a (new)

Amendment 30 #

Françoise GROSSETÊTE

Recital K b (new)

Kb. whereas it will be difficult for the European Commission to monitor progress in achieving the Sustainable Development Goals as regards viral hepatitis, given the frequent absence or inadequacy of surveillance data in the Member States;

Amendment 31 #

Mireille D'ORNANO, Sylvie GODDYN, Jean-François JALKH

Recital K b (new)

K b. Whereas between 2006 and 2014, the overall number of cases diagnosed and reported across all EU/EEA Member States increased by 28.7%, with most of this increase observed since 2010 3a. _________________ 3a Annual Epidemiological Report - ECDC. http://ecdc.europa.eu/en/healthtopics/hep atitis_C/Documents/aer2016/AER- hepatitis-C.pdf

Amendment 32 #

Recital K c (new)

Kc. whereas, for all the above reasons, measures to combat sexually transmitted infections are just as essential as those to combat HIV; whereas European and national programmes should be updated accordingly, particularly in the light of the recommendations of the World Health Organisation;

Amendment 33 #

Recital K c (new)

K c. Whereas the interpretation of hepatitis C data across countries is hampered by differences in surveillance systems, testing practices and programmes, and difficulties in defining the cases as acute or chronic 4a. _________________ 4a Annual Epidemiological Report - ECDC. http://ecdc.europa.eu/en/healthtopics/hep atitis_C/Documents/aer2016/AER- hepatitis-C.pdf

Amendment 34 #

Paragraph 1

1. Calls on the Commission and the Member States to develop a comprehensive EU Policy Framework addressing HIV/AIDS, Tuberculosis and viral Hepatitis C, bearing in mind the different situation and specific challenges of EU Member States and their neighbouring countries where the burden of HIV and MDR-TB is highest;

Amendment 35 #

Paragraph 1

1. Calls on the Commission and the Member States to develop a comprehensive EU Policy Framework addressing HIV/AIDS, Tuberculosis and Viral Hepatitis C, bearing in mind the different situation and specific challenges of EU Member States and their neighbouring countries where the burden of HIV and MDR-TB is highest;

Amendment 36 #

Mireille D'ORNANO, Sylvie GODDYN, Jean-François JALKH

Paragraph 3

3. Calls on the Commission and the Member States to strengthen work with communities and vulnerable people through multi-sectoral cooperation, with the inclusion of non-governmental organizations, especially local civil society institutions, as well as the provision of services to vulnerable and affected populations;

Amendment 37 #

Paragraph 3 a (new)

3a. Calls on the Commission to publish a conclusive study on the prevalence of the three diseases in question among migrants;

Amendment 38 #

Paragraph 4

4. Calls on the Commission and the Council to play a strong political role in the dialogue with neighbouring countries in Eastern Europe and Central Asia, ensuring that plans for sustainable transition to domestic funding are in place, so that Viral Hepatitis, HIV and TB programmes will be effective, continued and scaled up after the withdrawal of international donors’ support and to continue to work closely with those countries in ensuring they take the responsibility and ownership of Viral Hepatitis, HIV and TB responses;

Amendment 39 #

Paragraph 4

4. Calls on the Commission and the Council to play a strong political role in the dialogue with neighbouring countries in Eastern Europe and Central Asia, ensuring that plans for sustainable transition to domestic funding are in place, so that HIV, viral Hepatitis and TB programmes will be effective, continued and scaled up after the withdrawal of international donors’' support and to continue to work closely with those countries in ensuring they take the responsibility and ownership of HIV, viral hepatitis and TB responses;

Amendment 4 #

Citation 11 a (new)

- having regard to the first Global Health Sector Strategy on viral hepatitis 2016-2021 which, adopted by the World Health Assembly in May 2016, emphasises the crucial role of universal health coverage and whose goals are aligned with the Sustainable Development Goals, namely to reduce new cases by 90%, and mortality by 65%, by 2030, and ultimately to eliminate viral hepatitis as a public health threat,

Amendment 40 #

Paragraph 4

4. Calls on the Commission and the Council to ~~play a strong political role in the~~step up dialogue with neighbouring countries in Eastern Europe and Central Asia~~, ensuring that plans for~~ in order to achieve a sustainable transition to domestic funding ~~are in place~~, so that HIV and TB programmes ~~will b~~are effective~~, continued and scaled up after~~ and so that the withdrawal of international donors’ support does not cause them to cease their activities, and to continue to work closely with those countries ~~in ensuring~~, so as to ensure that they take ~~the~~ responsibility ~~and ownership of~~for tackling HIV and TB ~~responses~~;

Amendment 41 #

Françoise GROSSETÊTE

Paragraph 4 – point 1 (new)

(1) Calls on the Commission to discuss with the Member States the possibility of updating the Dublin Declaration in order to include viral hepatitis and tuberculosis, in addition to HIV/AIDS;

Amendment 42 #

Paragraph 4 a (new)

4 a. calls on the European Commission to discuss with Member States and future Council Presidencies the possibility of updating the Dublin Declaration to include HIV, Viral Hepatitis and TB on an equal footing;

Amendment 43 #

Paragraph 4 a (new)

4 a. Calls on the European Commission to discuss with Member States and future Council Presidencies the possibility of updating the Dublin Declaration to include HIV, viral Hepatitis and TB on an equal footing;

Amendment 44 #

Mireille D'ORNANO, Sylvie GODDYN, Jean-François JALKH

Paragraph 4 a (new)

Amendment 45 #

Paragraph 5

5. Stresses that HIV remains the communicable disease carrying greatest social stigma which can impact gravely individual’s quality of life, despite the significant improvement in antiretroviral treatment and additional care intended to alleviate the adverse side effects of antiretroviral treatment, for example, and that almost 30 000 newly diagnosed HIV infections were reported by the 31 EU/EEA countries in 2015, with no clear signs of an overall decrease;

Amendment 46 #

Mireille D'ORNANO, Sylvie GODDYN, Jean-François JALKH

Paragraph 6

6. Calls on the Commission and the Member States to facilitate full access to innovative treatments ~~also~~, particularly including post-exposure prophylaxis for the most vulnerable groups ~~and to work on~~, thus also doing more to combat~~ting~~ the social stigma associated with HIV infection and unscientific popular myths about it;

Amendment 47 #

Paragraph 6 a (new)

6a. Stresses that awareness campaigns designed to remove the social stigma suffered by HIV carriers should not in any way negate or detract from their moral, ethical and possibly legal responsibility to ensure that third parties are informed of the theoretical risk of HIV infection and protected against it, especially those engaged in sexual relations, but also certain health- care professionals providing medical services possibly exposing them to this theoretical risk;

Amendment 48 #

Mireille D'ORNANO, Sylvie GODDYN, Jean-François JALKH

Paragraph 6 b (new)

6b. Stresses that HIV continues to be a chronic disease not definitively curable by any treatment apart from antiretroviral treatment, with possibly major side- effects; observes that, in addition, positive HIV screening may, for all the above reasons, have a great psychological impact on the individual concerned and that, as a result, intentional exposure of others to the risk of HIV infection and failure of the carrier to inform them in advance may, under the national law of the Member State concerned, constitute a criminal offence;

Amendment 49 #

Nicola CAPUTO, Claudiu Ciprian TĂNĂSESCU

Paragraph 7

7. Underlines that in the EU/EEA, sexual intercourse is still the main reported HIV transmission mode, followed by drug use injection, and highlights the vulnerability of women and children to the infection; stresses the necessity of taking into due account the voluntary HIV transmission (a.k.a. 'bug-chasing') as a statistically marginal but culturally relevant phenomenon;

Amendment 5 #

Citation 7 a (new)

- having regard to the WHO Global Health Sector Strategy on Viral Hepatitis 2016-2021 towards ending viral hepatitis, whose goal is to eliminate it's major public health threat by 2030;

Amendment 50 #

Paragraph 7

7. Underlines that in the EU/EEA, sexual intercourse between men and heterosexuals is still the main reported HIV transmission mode, followed by drug use injection, and highlights the vulnerability of women and children to the infection;

Amendment 51 #

Mireille D'ORNANO, Sylvie GODDYN, Jean-François JALKH

Paragraph 7

Amendment 52 #

Paragraph 7 a (new)

7a. Stresses the fact that for social as well as physiological reasons, women are particularly at risk from sexually transmitted infections, as well as making up a growing proportion of those newly infected with HIV, especially in Sub- Saharan Africa, where twice as many young women as men in the same age group are infected with HIV;

Amendment 53 #

Mireille D'ORNANO, Sylvie GODDYN, Jean-François JALKH

Paragraph 7 b (new)

7b. Stresses that women are frequently forced or induced to accept sexual relations placing them at risk of sexually transmitted infections, including HIV, especially where no suitable precautions are taken; observes that policies seeking the empowerment of women should also address sexual health by raising awareness among women regarding the heightened risk of sexually transmitted diseases and infections, including HIV;

Amendment 54 #

Mireille D'ORNANO, Sylvie GODDYN, Jean-François JALKH

Paragraph 8

8. Calls on the ~~Commission and Council~~Member States not only to increase investment in research to achieve effective cures and to develop new tools as well as innovative and patient- centred approaches to fighting these diseases, but also to ensure availability ~~and affordability~~ of these tools and to more effectively address co- infections in particular tuberculosis and viral hepatitis B and C and their complications;

Amendment 55 #

Paragraph 9 a (new)

9a. Stresses that prevention should focus on dangerous sexual and other practices ;

Amendment 56 #

Mireille D'ORNANO, Sylvie GODDYN, Jean-François JALKH

Paragraph 9 b (new)

9b. Underlines, in this regard, that the forms of prophylaxis generally presented quite rightly as providing reliable protection against HIV infection may not provide reliable protection against other sexually transmitted infections such as HPV or HSV-2 and that for that reason a comprehensive prevention programme necessarily entails general sexual health awareness;

Amendment 57 #

Paragraph 10

10. Calls on Member States, Commission and Council to continue supporting HIV/AIDS prevention and linkage to care through joint actions and projects under the EU Health Programme and to promote proven public health measures to prevent HIV, including comprehensive harm reduction services for people who use drugs, treatment as prevention, condom use, pre-exposure prophylaxis and effective education on sexual health ~~education~~and responsible sexual behaviour;

Amendment 58 #

Paragraph 10 a (new)

10a. Calls on the Member States to raise public awareness of the risks of HIV and encourage people infected with the virus to behave responsibly and inform their partners of the dangers of the infection, and to prevent the spread of the disease by abstaining from sex;

Amendment 59 #

Paragraph 11

11. Invites Member States to focus HIV testing services to reach ~~key~~ populations in those settings where HIV prevalence is highest, following WHO recommendations;

Amendment 6 #

Citation 6 a (new)

- having regard to the European Parliament's Written Declaration on Hepatitis C from 2007;

Amendment 60 #

Paragraph 12

12. Invites Member States to fight effectively against the sexually transmitted infections that increase the risks of contracting HIV;

Amendment 61 #

Mireille D'ORNANO, Sylvie GODDYN, Jean-François JALKH

Paragraph 13

13. Encourages Member States to ~~make~~ensure that HIV tests are available ~~free of charge~~, especially for vulnerable groups, ~~to ensure~~in order to establish procedures for early detection and to improve reporting of the number of infections, which is important for adequate information and warnings about the disease;

Amendment 62 #

Paragraph 13 a (new)

13a. Stresses that the generalised HIV screening carried out in most Member States in recent years is not necessarily effective, given that the incidence of HIV in the EU is much higher regarding the categories of those at risk defined by the World Health Organisation and can therefore result in disproportionate costs to the health systems of the Member States with no significant increase in positive screening rates;

Amendment 63 #

Mireille D'ORNANO, Sylvie GODDYN, Jean-François JALKH

Paragraph 13 b (new)

13b. Stresses that the early diagnosis of HIV must remain a key objective but that it is necessarily limited by the window period of the virus, during which the antibodies reach detectable levels, which may be up to six weeks or even three months and that during the primary infection period, the viral load is particularly great, resulting in a particularly high risk of contamination;

Amendment 64 #

Mireille D'ORNANO, Sylvie GODDYN, Jean-François JALKH

Paragraph 13 c (new)

13c. Stresses that the medical practitioners board must continue to be the final arbiter regarding the conduct of screening tests, including those carried out for the early diagnosis of infection, such as 'PCR' tests, which can be costly for Member States’ health systems;

Amendment 65 #

Mireille D'ORNANO, Sylvie GODDYN, Jean-François JALKH

Paragraph 13 d (new)

13d. Points out that, while certain tools, such as 'home' HIV screening tests, are useful, the advice and follow-up of medical professionals are still crucial for the HIV testing, in the light of not only their scientific knowledge of matters such as the window period but also their ability to to accompany the individual concerned, given the potentially major psychological impact of positive HIV screening ;

Amendment 66 #

Mireille D'ORNANO, Sylvie GODDYN, Jean-François JALKH

Paragraph 13 e (new)

13e. Stresses that the opinion of a medical practitioner must be the determining factor for the conduct of certain screening tests, including 'PCR' screening tests or post-exposure prophylaxis, which may also delay subsequent HIV identification and diagnosis;

Amendment 67 #

Mireille D'ORNANO, Sylvie GODDYN, Jean-François JALKH

Paragraph 13 f (new)

13f. Stresses that a medical practitioner must be able to refuse to conduct a screening test in certain cases, particularly if the applicant has not been exposed to an established risk of contamination or has already undergone a number of screening tests with consistent results and in accordance with the current health authority recommendations regarding the window period;

Amendment 68 #

Paragraph 15 a (new)

15a. Points out that antimicrobial resistance is an increasingly serious medical challenge in the treatment of infections, including tuberculosis;

Amendment 69 #

Paragraph 16 a (new)

16a. Points out that two-thirds of the antibiotics produced globally are administered to animals, which leads to antimicrobial resistance, and that the reduction of chemical use in agriculture is fundamental to consumer health;

Amendment 7 #

Citation 9

— having regard to the outcome of the informal EU Health Ministers’' meeting held in Bratislava on 3-4 October 2016 where member States agreed on the support for the development of an integrated EU policy framework on HIV, tuberculosis and Hepatitis B and C,

Amendment 70 #

Mireille D'ORNANO, Sylvie GODDYN, Jean-François JALKH

Paragraph 17

17. Underlines that in order to improve TB prevention, detection and treatment adherence, ~~the European Commission and Member States need~~it would be advisable for the Member States, with the help of the Commission, to develop national tuberculosis programs ~~and~~, ensuring sufficient financial support to strengthen work with communities and vulnerable people through multi-sectoral cooperation, with the inclusion of non-governmental organizations especially in developing countries. ~~Also highlights that financial involvement of all actors in subsidizing treatment for tuberculosis is essential for continuity of TB care, because treatments can be prohibitive due to high costs;~~

Amendment 71 #

Paragraph 18 a (new)

18a. Calls on the Member States to consider extending vaccination coverage to tuberculosis, for example through the reintroduction of compulsory vaccination;

Amendment 72 #

Paragraph 19

19. Calls on the Commission and the Council to play a strong political role in ensuring that the link between Anti- Microbial Resistance (AMR) and MDR- TB is reflected in the outcome of the July 2017 G20 Summit in Germany as well as in the new EU Action Plan on AMR ~~that is set to be published in 2017~~, which must be published as soon as possible;

Amendment 73 #

Paragraph 19

19. Calls on the Commission and the Council to play a strong political role in ~~ensuring that~~making sure that account is taken of the link between Anti- Microbial Resistance (AMR) and MDR- TB ~~is reflected~~ in the outcome of the July 2017 G20 Summit in Germany as well as in the new EU Action Plan on AMR that is set to be published in 2017;

Amendment 74 #

Paragraph 20 a (new)

20a. Calls on the Commission and Member States to conduct research into the relationship between migration from particular third countries and tuberculosis in the European Union and to take account of this aspect in their policies;

Amendment 75 #

Paragraph 20 b (new)

20b. Urges the Commission and Member States, in addition to X-ray screening of migrants upon arrival if they come from highly endemic areas, to take other measures such as individual screening for latent tuberculosis infection, in order to prevent the spread of TB among asylum-seekers and at reception locations in the Union;

Amendment 76 #

Paragraph 21

21. Calls on the Commission, the Council and the Member States to strengthen ~~and formalize~~ regional collaboration on TB and MDR-TB at the highest political level across the different sectors and build partnerships with upcoming EU Presidencies to continue this work;

Amendment 77 #

Paragraph 22

22. Stresses that within the European Union the main route of ~~HCV~~Viral Hepatitis transmission is via injecting drug use as a result of sharing contaminated needles, due to the use of unsterile injecting drug equipment, stresses that hepatitis infection of healthcare workers due to needle stick injuries remains above average; stresses that the provision of harm reduction services, including OST and NSPs, is a critical viral hepatitis prevention strategy, including measures to overcome stigma and discrimination;stresses that anti-HCV and HbsAg tests are frequently not part of reimbursed health check-ups; highlights that more rarely, the virus can be transmitted sexually, or in health and cosmetic care settings due to inadequate infection control practices, or perinatally from an infected mother to the baby;

Amendment 78 #

Paragraph 23

23. Points out that around 30% of people with chronic hepatitis C suffer from liver damage and a small number of those develop cancer, and that Viral Hepatitis C is considered to be one of the leading causes of liver cancer and liver transplants in Europe; points out that the peak of the burden due to viral hepatitis-related complications such as primary liver cancer and transplants is yet to come;

Amendment 79 #

Paragraph 23

23. ~~Points out that around 30% of people with chronic hepatitis C suffer from liver damage and a small number of those develop cancer, and that Hepatitis C is considered to be one of~~Stresses that over 90 % of patients do not have any symptoms when they contract the disease with it usually being discovered by chance during analysis or when symptoms begin to appear owing to its having caused chronic hepatitis in 55 % to 85 % of cases, and that in these cases there is a 15 % to 30 % risk of liver cirrhosis after 20 years, this being in turn the ~~lead~~maing causes of ~~liver cancer and liver transplants in Europe~~hepatocellular carcinoma;

Amendment 8 #

Citation 9

— having regard to the outcome of the informal EU Health Ministers’ meeting held in Bratislava on 3-4 October 2016 where member States agreed on the support for the development of an integrated EU policy framework on HIV, tuberculosis and Viral Hepatitis C,

Amendment 80 #

Paragraph 23 a (new)

23a. Emphasises that in 75 % of cases of hepatocellular carcinoma, the patient presents with positive HCV serology;

Amendment 81 #

Paragraph 23 b (new)

23b. Emphasises that there is no standardised protocol in the Member States for hepatitis C screening and that data on numbers of people affected may be underestimated;

Amendment 82 #

Paragraph 23 c (new)

23c. Emphasises that in April 2016 the WHO updated its Guidelines on the screening, care and treatment of persons with chronic hepatitis C infection, and that these complement existing WHO guidance on preventing the transmission of bloodborne viruses, including HVC; points out that these Guidelines provide key recommendations in these areas and discuss considerations for implementation;

Amendment 83 #

Paragraph 24

24. Emphasizes that the HCV infection can be cured, especially if it is detected and treated with the appropriate antiviral drug combinations, in particular points out that antiviral treatment can now cure over 90% of persons with HCV infection; emphasizes that viral HBV is preventable through vaccine and can be controlled; however less than 50% of people with chronic viral hepatitis are only diagnosed after decades following their infection;;

Amendment 84 #

Paragraph 24

Amendment 85 #

Paragraph 24 – subparagraph 1 (new)

Calls on European Commission and Member States to ensure sustainable funding of viral national Hepatitis Elimination Plans, also making use of EU Structural Funds and other available EU funding;

Amendment 86 #

Paragraph 24 a (new)

24 a. calls on the European Commission, Council and Member States to put in place an EU-wide harmonsied infection surveillance programmes that can detect outbreaks of Viral Hepatitis, TB and HIV in a timely manner, assess trends in incidence, inform disease burden estimates and effectively track in "real time" the diagnosis, treatment and care cascade, including in specific vulnerable groups;

Amendment 87 #

Paragraph 24 a (new)

24 a. Calls on European Commission to lead discussions with Member States on how to best equip primary care professionals (such as inclusion of anti- HCV and HBsAg in health check-ups, anamnesis, follow up tests, referral pathways), with a view to increasing the diagnosis rate and ensuring guideline- conform care;

Amendment 88 #

Paragraph 24 a (new)

24a. Regrets that there is no vaccine available at present for hepatitis C, rendering primary and secondary prevention crucial; emphasises, however, that the specific characteristics of hepatitis C infection and the lack of screening protocols impede testing in many cases;

Amendment 89 #

Paragraph 24 b (new)

24 b. Calls on European Commission to lead discussions with Member States on how to best equip primary care professionals (such as inclusion of anti- HCV and HbsAg in health check-ups, anamnesis, follow up tests, referral pathways), with a view to increasing the diagnosis rate and ensuring guideline- conform care;

Amendment 9 #

Citation 10

— having regard to the Commission Communication of 22 November 2016, entitled “"Next steps for a sustainable European future, encompassing the economic, social, environmental dimensions of sustainable development, as well as governance, within the EU and globally~~”3 ,~~"3, in which the European Commission states it will contribute by monitoring, reporting and reviewing progress towards Sustainable Development Goals in an EU context. _________________ 3 http://ec.europa.eu/europeaid/sites/devco/fi les/communication-next-steps-sustainable- europe-20161122_en.pdf

Amendment 90 #

Paragraph 24 b (new)

24b. Calls on the Commission, under the direction of the ECDC, to launch a multidisciplinary plan, in coordination with the Member States, to eradicate hepatitis C in the EU by 2030 and which will standardise screening, testing and treatment protocols;

Amendment 91 #