For how long can we dodge the pandemic bullet?

Two MEPs discuss pandemics.

Georgs Andrejevs

Last year marked 25 years since the discovery of HIV (Human Immunodeficiency Virus). Since then, AIDS (Acquired Immunodeficiency Syndrome) - the last stage of a HIV infection - has killed more than 25 million people worldwide. According to the UNAIDS Epidemic Update for 2006, more than 39.5 million people were living with HIV and 4.3 million people were newly infected. The overwhelming majority of people infected are living in developing countries and thanks to the international community as well as to private foundations there seems to be some progress in improving the dire situation of people living in the most affected countries.

But being confronted with such dramatic data often leads us to overlook the increasingly worrying situation across the European Union where infection with HIV not only remains a serious health threat but where infection rates are actually rising again. The European Centre for Disease Prevention and Control (ECDC) estimates that 30% of people infected with HIV within the EU are unaware of their sero-status. The groups of people exposed to the highest risk of contracting HIV include injecting drug users (IDUs), men having sex with men, migrants and young people under the age of 25. Heterosexual intercourse with an infected partner is, however, the most likely way to contract HIV within the EU. This is especially the case among the migrant population in western and central Europe, whereas the high infection rate among IDUs is the reason for the rapid spread of HIV infection in many eastern European countries.

There are a multitude of factors which have contributed to the recent rise in new HIV infections within the Union, including the complacency about this disease among young people, an astonishing lack of knowledge among the general population about infection with HIV and a distressing and overall untrue belief that there is a cure for an HIV infection. There is not.

So, what is being done within the EU to counteract these developments?

An important first step is to show political leadership, make people aware of the magnitude of the problem, talk openly about how one can avoid infection and encourage people to get tested.

There are several initiatives which the EU is currently undertaking: the Commission can allocate resources to prevention measures within the framework of the public health action programme to combat HIV/AIDS; there are resources to allocate from the seventh framework programme on research and development for new drugs, vaccines and microbicides; in my report I asked the Commission to define rules for the possibility to use the structural funds and the social funds for HIV/AIDS related projects; and I am looking forward to the potential of the forthcoming innovative medicines initiative for the research and the development of new drugs.

There is still a lot of work to be done, on the European level as well as nationally and locally. Experience shows, and I want to use this opportunity to commend the exceptional work that has been done by various non-governmental organisations in this regard, that often the most effective and sustainable work is done on the ground. But I also firmly believe that there is a lot we can do at European level. One example is the decision by the German government to make HIV/AIDS one of the priorities of their EU presidency and to organize a high-level conference - ‘Responsibility and partnership - together against HIV/AIDS’ - in March in Bremen. Chancellor Angela Merkel, who delivered a very straightforward keynote speech on this occasion, also kept this topic high on the agenda of Germany’s G8 presidency.

Markos Kyprianou, European health commissioner, said it well during the debate in Parliament’s plenary on 24 April: "For us it [HIV/AIDS] is a very high priority. It is not just about a policy or a strategy. It is a question of moral obligation. I believe that the system as a whole has failed our citizens over the past 20 years and it is now time to resume our efforts and correct our mistakes." Where we, as a European Community, are still lacking is on our delivery on concrete promises. It is time to take action.

• Latvian Liberal Democrat (ALDE) MEP Georgs Andrejevs is a member of Parliament’s committee on the environment, public health and food safety anddrafted an own-initiative report on combating HIV/AIDS in the EU and neighbouring countries.

Adamos Adamou

The recent confirmation of person-to-person transmission of a strain of avian influenza A (HN51) in Northern Sumatra brings back to the agenda the issue of avian influenza and raises serious concerns about how well prepared Europe really is to deal with such a pandemic outbreak. Although the outbreak was contained by voluntary quarantine and rapid administration of antiviral medication, scientists admitted that the world had ‘dodged a bullet’ and ‘may not be so lucky next time’.

Influenza is a major threat to human as well as animal health. While concerns recently focus mainly on the danger of a ‘pandemic’ influenza outbreak that would rapidly spread around the world and kill millions of people, it is frequently forgotten that even during a ‘regular’ influenza season, the disease is responsible for as many as 300,000 human deaths worldwide.

Despite the fact that health-related issues do not belong to the competences of the Union, member states are insisting that the Commission take a more co-ordinating role amid the significant social stakes that are linked to an influenza pandemic outbreak. They seem to abide by the recommen-dations of the European Centre for Disease Prevention and Control (ECDC) and welcome the assessments of their national pandemic influenza preparedness plans undertaken jointly by the European Commission, ECDC and World Health Organization (Regional Office for Europe). It is obvious that member states and national governments dread the possibility of an influenza pandemic outbreak, given the significant social stakes that are linked to such a pandemic. The three influenza pandemics of the last century (in 1918, 1957 and 1968) killed millions of people and caused widespread disruption to the countries affected.

The crucial question is how well prepared Europe really is against pandemics? As a response to such concerns, the network on communicable diseases started work in 1999. It is built on work done with member states and consists of two pillars: surveillance and early warning. On the one hand the Commission has specified the list of communicable diseases (including pandemics) to be placed progressively under EU-wide surveillance and the criteria for their selection. The network’s main task is to monitor and track developments. Within that network disease-specific networks have been created.

On the other hand the second pillar of the network, that is an early warning and response system (EWRS), aims at alerting public health authorities in member states and the Commission on outbreaks with greater than national dimensions, so that co-ordinated EU action may be required.

To increase the comparability of the data from the different member states, definitions for reporting communicable diseases to the Community network have been laid down.

Moreover, according to recent information released by the European Commission, preliminary results of the first clinical trial of a novel avian ‘bird flu’ vaccine have shown that it is safe and well tolerated in healthy volunteers. Given that the original H7N1 virus is considered too dangerous in safety terms to work with, it was modified to make it safer, using a process called reverse genetics. The advantage of using this process is that the vaccine is produced in a cell line rather than the traditionally used eggs. This technology could complement current egg-based vaccine production capacity in case of pandemic influenza. The vaccine was developed by a team of European scientists and co-funded by the EU’s Research Framework Programme. It has also been announced that support for innovative scientific solutions in the fight against this deadly disease will continue, in particular by providing more than €27 million for 11 new collaborative projects.

A lot of preventative action is been undertaken at European level by the European Commission which is working closely together with the member states. The work done by European agencies in this respect should not be undermined; both the European Medicines Agency (EMEA) and ECDC are putting a lot of work in the co-ordination activities of the member states. As Research Commissioner Janez Potocnik said, "by working together, we can achieve so much more".

• Cypriot Socialist (PES) MEP Adamos Adamou is a member of Parliament’s committee on the environment, public health and food safety.

Two MEPs discuss pandemics.