Why look at Europe?
NAT’s aim is to work on policies which affect people with, or at risk of, HIV in the United Kingdom, but it is not possible to address the UK epidemic adequately without also considering the wider epidemic across the European region. One reason for this is that free movement of people across the European Union (EU) requires an EU-wide response to the epidemic. But in addition, a wide range of EU law can have an impact on people with HIV in the UK. For example, the discrimination law of EU member states has to comply with relevant EU directives. Moreover, almost all countries in the European region (both those inside and those outside the EU) have treaty obligations to abide by the European Convention on Human Rights (ECHR).
When we discuss the European region we refer to the region as defined by the World Health Organisation (WHO), consisting of 53 countries.
The HIV epidemic in Europe
HIV is a significant public health challenge across the European region but the nature of the epidemic varies significantly between countries and sub-regions. Injecting drug use is the major route for HIV transmission in Eastern Europe and has been very significant in some countries of southern Europe. In Western Europe and increasingly in some countries of Central Europe men who have sex with men are the key group amongst whom infections are occurring. There are also a considerable number of HIV diagnoses in Western Europe occurring amongst people who have migrated from high prevalence countries, in particular sub-Saharan Africa.
Data and information on the European HIV epidemic can be found on the website of the European Centre for Disease Prevention and Control (ECDC)
AIDS Action Europe
AIDS Action Europe is a partnership of more than 230 AIDS-related voluntary organisations from 44 European and Central Asian countries. Its mission is to unite civil society to work towards a more effective response to the HIV epidemic in Europe. AAE strives for better protection of human rights and universal access to prevention, treatment, care and support. AAE also works towards a reduction of health inequalities in Europe focusing on key vulnerable populations in Central and Eastern Europe and Central Asia.
Key activities include a clearing house for key HIV documents of interest from across Europe and support for capacity building of civil society in Eastern Europe. AAE is also one of the key civil society partners of the European Commission in its work on HIV, along with the European AIDS Treatment Group (EATG).
NAT was one of the founding members of AAE and NAT’s Director of Policy and Campaigns is a member of the AAE Steering Committee.
More information on AIDS Action Europe and its current work, including how to join if you are an HIV support organisation, can be found at AIDS Action Europe.
HIV and the European Union
HIV is considered an important public health issue by the EU. The European Commission agreed in 2009 its second ‘Communication’ on ‘Combating HIV/AIDS in the European Union and neighbouring countries, 2009-2013’. The Communication sets out the key analysis and priorities at the European level in addressing HIV across the EU and also includes an Action Plan.
Priorities for 2009 to 2013 are: HIV prevention; most at risk groups – in particular MSM, injecting drug users and migrants from high prevalence countries; and countries with significant HIV epidemics in Eastern Europe (both within the EU and amongst neighbouring countries). There is also a continuing emphasis on human rights, universal access to prevention, treatment and care, and on political leadership.
In addition to the Communication, the other key document at the European policy level is the ‘Dublin Declaration’ on ‘Partnership to fight HIV/AIDS in Europe and Central Asia’. This emerged from the Dublin Ministerial Conference in February 2004 and remains the most important political commitment by European governments to tackling HIV. ECDC is now tasked with monitoring country progress in implementation of the Dublin Declaration commitments.
Since 2004 the Dublin Declaration has been supplemented by declarations in Vilnius and Bremen. Both can be seen on the Commission HIV webpage. The Commission has established some forums both to provide advice to the Commission on HIV and also to facilitate exchanges of information and best practice between countries. The HIV/AIDS Thinktank is a forum to exchange information between the Commission, the Member States, Candidate and EEA countries (Lichtenstein, Iceland and Norway). Members include senior government officials from individual countries charged with oversight of the national response to HIV.
The HIV/AIDS Civil Society Forum (CSF) is an informal advisory body established in 2005 by the European Commission to facilitate the participation of NGOs and networks in the development of European HIV policy. The CSF has had an important influence and input in the development of the new Communication, and is also a forum where important regional issues can be discussed and information shared, for example on the campaign against HIV-related travel restrictions or on progress towards universal access in Europe.
NAT takes a leading role in the CSF, with its Director of Policy and Campaigns as one of the two CSF co-Chairs. More information on the membership and work of the CSF can be found here on the AIDS Action Europe website.
For more information from the European Commission on its work on HIV go to the European Commission Website.
NAT has led on a number of Europe-wide initiatives:
NAT welcomes MEP vote which safeguards HIV home testing
On 22 October the European Parliament voted against controversial amendments that sought to restrict access to self testing kits, including HIV home testing kits, in Europe.
HIV home testing will become legal in the UK in 2014, providing a regulated, safe and accurate testing option for those unable or unwilling to test in a healthcare setting. However, amendments to the regulation on in vitro diagnostic medical devices wanted to restrict home testing, allowing kits to be supplied on medical prescription only and requiring people to undergo counselling by a medical practitioner before using these tests.
NAT's and the Terrence Higgins Trust's briefing paper to MEPs argued that this was not necessary and would undermine efforts to bring down high rates of UK undiagnosed HIV (24%), late diagnosis (47%) and prevent further infections.
We welcome MEPs' rejection of the amendments and their support for our campaign.
NAT calls for EU-wide discrimination ban
NAT is calling for equal protection from discrimination for people living with HIV across Europe. The European Union is currently considering a proposed 'Equal Treatment Directive' (com/2008/0426final) which would, if agreed, extend protections for disabled people beyond employment to provision of good services.
NAT, along with AIDS Action Europe, the European AIDS Treatment Group and EU HIV/AIDS Civil Society Forum, are campaigning to ensure the EU's definition of disability includes all people living with HIV. All people with HIV in the UK are protected from discrimination in law because they are deemed to have a disability, but such protection is not available, or not as clearly, in every other EU country. People with HIV should enjoy the same level of legal protection wherever they are in the EU.
Without HIV being included in the Directive, member states are free to either protect or not protect people from HIV related discrimination from the point of diagnosis.
As a result of this campaign, the European Parliament in its report on the Commission's draft Directive of 2 April 2009 (P6-TA(2009)0211), recommended an Amendment (17) which would ensure the description of disability includes people with HIV. The draft Directive must now be considered and agreed by the Council of Ministers.
NAT and HIV organisations across Europe have signed a petition, calling on the European Union to take action and ensure the Directive includes HIV under the definition of disability in order to outlaw discrimination for PLWH across Europe. Read the petition here.
The petition is also available here in Russian.
Find out here why all people with HIV should be protected under the disability provisions of EU anti-discrimination law
If your organisation would like to add its name to the petition then please email email@example.com.
Legislation and Judicial Systems in relation to HIV and AIDS
The need for EU-wide protection from discrimination for people with HIV was a key recommendation of the expert seminar organised by NAT in 2007, in partnership with AIDS Action Europe, on 'Legislation and Judicial Systems in relation to HIV and AIDS'. The seminar was part of a wider project called ‘European Partners in Action on AIDS’ funded by the European Commission.
The NAT/AAE seminar on ‘Legislation and Judicial Systems in relation to HIV and AIDS’ involved a pre-seminar survey of legal issues across the European region, followed by a seminar which drew wide and expert participation. The seminar report identified 53 recommendations for action on a range of issues including discrimination law, confidentiality rights, rights of migrants, prisoners and drug users, NGOs’ legal status in court proceedings, financial services and the capacity of the legal system to deal fairly with HIV issues.
Read the pre-seminar report Legislative and Judicial Systems in Relation to HIV - Results of a European Survey.
Read the final seminar report Legislative and Judicial Systems in Relation to HIV - Report of a Seminar April 2007.