Legal provisions of SWD(2014)106 - Action Plan on HIV/AIDS in the EU and neighbouring countries: 2014-2016 - Main contents

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dossier	SWD(2014)106 - Action Plan on HIV/AIDS in the EU and neighbouring countries: 2014-2016.
document	SWD(2014)106
date	March 14, 2014

EUROPEAN COMMISSION

Brussels, 14.3.2014 SWD(2014) 106 final

COMMISSION STAFF WORKING DOCUMENT

Action Plan on HIV/AIDS in the EU and neighbouring countries:

2014-2016

EN

EN

COMMISSION STAFF WORKING DOCUMENT Action Plan on HIV/AIDS in the EU and neighbouring countries:

2014-2016

Contents

1. ) HIV/AIDS in the EU and neighbouring countries.........................................................................2

2. ) Commission Communication combating HIV/AIDS and action plan............................................2

3. ) Achievements of the EU policy framework on HIV/AIDS and the need for an increased focus ....3

4. ) Prolonging the Action Plan on HIV/AIDS....................................................................................4

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1. ) HIV/AIDS in the EU and neighbouring countries

HIV infection remains of major public health importance in the EU and neighbouring countries. Contrary to the global trend, which shows an overall decline in new infections, the number of newly reported HIV cases in Europe is increasing. In 2012, more than 131.000 new HIV infections were reported in Europe and Central Asia, an 8% increase from 2011¹. A total of 29.000 cases were reported in the European Union and European Economic Area (EU/EEA) a 1% increase from 2011 and 102.000 cases from countries in Eastern Europe and Central Asia (a 9% increase from 2011).

The main HIV transmission mechanisms differ depending on the region. In the EU/EEA HIV is predominantly transmitted among men who have sex with men (MSM). HIV transmission through heterosexual contacts plays also an important role. In neighbouring countries the main transmission modes are heterosexual contacts, followed by injecting drug use (IDU). Besides MSM and IDUs other vulnerable groups at high risk of acquiring HIV infections include migrants and mobile populations, sex workers and prisoners.

Early diagnosis followed by counselling and treatment as well as preventive strategies play a crucial role in reducing the spread of the disease. Recent evidence suggests that early treatment has significant effects in terms of reducing the risk of further transmission as well as reducing the morbidity and mortality related to HIV/ADDS. However, in the EU/EEA 49% of people living with HIV/ADDS are diagnosed late in the course of the infection and the percentage is even higher in Eastern Europe and Central Asia. In addition, significant gaps in coverage of prevention measures and access to antiretroviral therapy remain in some eastern European countries. In several countries the high number of HIV/AIDS co-infections, such as tuberculosis, viral hepatitis, and sexually transmitted diseases other than HIV/AIDS are another serious concern.

2. ) Commission Communication combating HIV/AIDS and action plan

The Commission Communication on combating HIV/ADDS in the European Union and neighbouring countries, 2009-2013 ² provides a policy instrument to complement national policies on HIV/ADDS on European level and has been the basis for EU action since 2009. The overall objectives of the Communication are: (i) to contribute to reducing new HIV infections across all European countries by 2013, (ii) to improve access to prevention, treatment, care and support and (iii) improving the quality of life of people living with, affected by or most vulnerable to HIV/ADDS in the European Union and neighbouring countries.

The Communication is complemented by an operational action plan that contains 50 actions, which are structured in the following six key issue areas: (1) Politics, policies and involvement of civil society, wider society and stakeholders, (2) Prevention, (3) Priority regions, (4) Priority groups, (5) Improving the knowledge, (6) Monitoring and evaluation.

The action plan presented an initial set of actions arising from consultation with Commission services and external stakeholders, to be further developed along the lines of the political

¹ European Centre for Disease Prevention and Control/WHO Regional Office for Europe. HIV/AIDS surveillance in Europe 2012. Stockholm; 2013

² COM(2009) 569 final

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actions presented in the Communication in cooperation with the HIV/ADDS Think Tank, the Civil Society Forum and external stakeholders.

Funding for the implementation of the Communication and action plan is provided through a range of mechanisms and instruments. These include the EU Health Programme, the EU Framework Programme for Research and Innovation, the Global Fund to Fight AIDS, Tuberculosis and Malaria, to which the EU is a major contributor, as well as EU Structural Funds, the Development Cooperation Instrument and the European Neighbourhood and Partnership Instrument.

3.) Achievements of the EU policy framework on HIV/AIDS and the need for an increased focus

Prime responsibility for protecting and improving the health of their citizens rests with the EU Member States and the neighbouring countries. However, Article 168 of the Treaty on the Functioning of the European Union explicitly acknowledges that Union action shall complement national policies, and shall be directed towards improving public health, preventing physical and mental illness and diseases, and obviating sources of danger to physical and mental health. As HIV/AIDS is a communicable disease it needs to be addressed by coordinating the efforts of national governments.

Upon request of the European Commission, the European Centre for Disease Prevention and Control (ECDC) prepared a monitoring report on the implementation of the Commission Communication and Action Plan for combating HIV/AIDS in 2013³. The report highlights several achievements of the EU policy framework. For instance the Communication was identified as an important tool for galvanizing political leadership, which was instrumental in keeping HIV/AIDS on the agenda and has been used by civil society to frame debate at regional and national levels. The Think Tank and Civil Society Forum proved to be valuable platforms for policy dialogue and exchange of information and experience, and helped to promote Europe-wide action and effective communication.

Financial inputs to support the objectives of the Communication and action plan are considered to amount to approximately EUR 57.5 million annually. This funding contributed to the development of new treatments and prevention technologies through the EU Framework Programme for Research and Innovation, and supported the scaling up of HIV-related services in the most affected Member States, neighbourhood countries and the Russian Federation via Commission funding to the Global Fund. The EU Health Programme helped to strengthen national HIV responses focusing on populations most at risk, such as targeted prevention services and development of better approaches to service delivery for these population groups. Substantial improvements were also achieved in relation to epidemiological surveillance of HIV/AIDS and TB co-infection, and data reporting rates could be significantly enhanced. In Eastern Europe and Russia capacity building of non-state actors in the field of HIV has been supported through the Development Cooperation Instrument.

Furthermore, the report identifies additional areas requiring continued attention and areas where progress has been less pronounced. Amongst others these include: keeping HIV/AIDS

³ European Centre for Disease Prevention and Control. Monitoring implementation of the European Commission Communication and Action Plan for combating HIV/AIDS in the EU and neighbouring countries, 2009-2013. Final report Stockholm, 2013.

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visibly high on the political agenda, tackling discrimination in relation to HIV/AIDS, achieving universal access to voluntary testing, treatment and care, implementation of harm reduction measures, and strengthening of behavioural surveillance. In May 2013 the high-level meeting on HIV and Human Rights 'Right to health, right to life', which was jointly organised by the European Commission and UNAIDS recognized the need for a continued and renewed commitment by the European Commission to keep HIV/ADDS high on the political agenda. The meeting also identified important areas addressed in the Communication and the action plan, which require further attention, and pointed towards new developments, which may warrant consideration in the future. Building on these findings, the HIV/ADDS Civil Society Forum stressed the importance of continued attention to certain critical aspects of HIV/AIDS policies and advocated the need for further action on HIV/AIDS.

This Staff Working Document prolongs the action plan thus providing continuity in EU Action beyond 2013. An independent external evaluation of the Communication and action plan is on-going, and due to be concluded in spring 2014. The results will contribute to the consideration of options for a possible future EU policy framework on HIV/AIDS.

4.) Prolonging the Action Plan on HIV/AIDS

A consultation process was carried out from August to November 2013, involving Commission services, the HIV/AIDS Think Tank, the Civil Society Forum, as well as WHO and UNAIDS. The suggestions and comments of most respondents converged around several key issues, which could be clustered into two groups.

Some issues and actions which are already addressed in the action plan require in particular continued and/or increased focus and attention in order to reach the objectives of the Communication. These include continued political leadership, addressing stigma and discrimination, treatment as prevention, as well as continued and improved attention to co-infections.

The Communication explicitly mentions political leadership as an important asset in the fight against HIV/AIDS. Political leadership helps to keep HIV/AIDS high on the political agenda, and has assisted civil society to frame debate at regional and national levels. Particularly political support at national and regional level should be further encouraged, for instance through existing policy dialogues between the EU (European Commission) and neighbouring countries.

One issue requiring greater attention is the need to address stigma and discrimination, including legal barriers that impede measures to fight HIV/AIDS. Given the limited EU competence in this field the Commission will work closely with civil society and Member States to achieve progress. In organising the high level meeting on HIV and Human Rights, as well as the workshop on 'Improving Access and Combating Discrimination in Healthcare with a focus on vulnerable groups'⁴, the Commission is already taking action. Building on these events a high-level meeting on access and antidiscrimination in health entitled 'Health in Europe - making it fairer' is scheduled to take place in March 2014.

HIV/AIDS co-infections such as tuberculosis (TB) and viral hepatitis are amid the leading causes of death for people living with HIV, particularly among drug users. For instance HIV is a major risk factor for developing TB, and TB is responsible for more than a quarter of

⁴ Within the Framework of the European Health Forum Gastein 2013

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deaths among people living with HIV.⁵ Particularly in Eastern European countries efforts need to be continued to increase integrated prevention and treatment measures such as access to harm reduction methods, and antiretroviral treatment, particularly in prisons.

An increasing body of evidence confirms that treatment is effective in preventing HIV transmission, particularly in relation to heterosexual transmission⁶. This underlines not only the need for the strategic use of treatment, but also further increases the importance of early and increased testing particularly amongst high risk groups. These changes are for instance reflected in the consolidated WHO guidelines on the use of antiretroviral drugs for treating and preventing HIV infection, which were released in June 2013, and should inform practice in Member States and neighbouring countries.

Finally, there is the need to stay aligned with regional action frameworks to facilitate synergies and maximise impact. For instance in 2011 WHO endorsed its European Action Plan for HIV/AIDS, 2012-2015, and currently the Global Fund is developing a Strategy on HIV/AIDS for Eastern Europe and Central Asia.

The consultation process also identified a number of other issues such as the need to provide targeted support to additional populations at risk, the development of integrated strategies to address HIV/AIDS and other sexually transmitted diseases, or the need to consider addressing other co-morbidities, in addition to TB and Hepatitis. These issues require further reflection and monitoring and will be further considered in discussions on a future EU policy framework on HIV/AIDS.

Financing of specific actions contained in this action plan will be subject to final approval of the Health Programme 2014-2020, and implementing decisions within the annual work plans. As such, the prolongation will not have any budgetary impact. The research objectives of the action plan will also be funded through the next EU programme for research and innovation, Horizon 2020, which was formally adopted in November 2013.

This table below presents the action plan arising from consultations with Commission services and external stakeholders. Actions are designed alongside the political actions of the Commission communication on combating HIV/AIDS in the European Union and the neighbouring countries, 2009-2013, and should contribute to achieving the envisaged targets. The action plan was originally developed in 2009. The below table maintains the original structure since it was acknowledged by many stakeholders that the majority of actions are still valid and relevant. Besides the key issue areas outlined in section 4 of this paper further changes were introduced mainly to specify and provide precision in terms of indicators and expected results. This action plan may need to be further developed and updated in cooperation with relevant stakeholders and in line with the results of the external evaluation of the Commission Communication on combating HIV/AIDS.

The geographical scope of the action plan includes EU Member States, EEA/EFTA countries and neighbouring countries, namely the EU Enlargement countries, the European Neighbourhood Policy (ENP) countries, in particular the Eastern ones bordering the EU, as well as the Russian Federation.

⁵ World Health Organization. European Action Plan for HIV/AIDS 2012-2015, Copenhagen 2011.

⁶ Cohen MS, Smith MK, Muessig KE, et. al. Antiretroviral treatment of HIV-1 prevents transmission of HIV-1: where do we go from here? The Lancet, published online October 21, 2013 http://www.melancet.com/journals/lancet/article/PnS0140-6736%2813%2961998-4/fulltext

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European Union Action Plan on HIV/AIDS: prolongation 2014-2016

ISSUE	ACTION Bold = increased focus Normal = continued actions	PARTNERS INVOLVED IN REALISATION Bold = leading entities Italics = associated entities	TIME	INDICATOR(S)	EXPECTED RESULTS
1. Politics, policies and involvement of civil society, wider society and stakeholders
HIV/AIDS as an issue requiring political attention	Promote HIV/AIDS and co-infections as public health and social concern Keep the topic on the political agenda particularly in countries with concentrated epidemics Use World AIDS day to raise awareness of the public and policy makers	Commission Member States Neighbouring countries Civil Society International organisations	Ongoing -2016	Inclusion of HIV/AIDS cooperation in bilateral cooperation agreements and/or actions plans between the EU/Commission and neighbouring countries National Composite Policy Index Existence of one national HIV/AIDS plan, including surveillance monitoring and evaluation	Better use of existing policy dialogue mechanisms to promote effective political leadership particularly in countries with concentrated epidemics Better public awareness on HIV/AIDS Political support for the implementation of cost-effective, and evidence based measures to combat HIV/AIDS HIV is mainstreamed in EU policies
	Regular HIV/AIDS Think Tank and Civil Society Forum meetings including linkage to relevant other EU civil society fora	Commission Member States and neighbouring countries Civil Society International organisations	Ongoing -2016	Number of meetings Dissemination and implementation of results from meetings Actions agreed and implemented	Know-how transfer Effective cooperation between all key players Joint actions carried out
	Address HIV/AIDS and Human Rights: Tackle stigma, discrimination, and legal barriers in relation to HIV status, ensuring equal access and quality of	Member States and neighbouring countries Civil Society *Commission*	Ongoing-2016	Level of discrimination in relation to HIV status, i.e. as monitored by the stigma index Monitoring of national policies and legislation in place (related to	Integrated antidiscrimination policies applied in EU and neighbouring states, Prohibition of discrimination in relation to HIV status in national legislation

	prevention,			HIV-specific	Better quality of life
	testing and			discrimination of	of people living with
	treatment			People living with	HIV/AIDS
				HIV and key
				populations)	Promotion of a
					public health
				Number of actions	approach (as an
				and measures	alternative to
				taken to protect	criminalization) in
				fundamental rights	managing
				including expected	behaviours that put
				results of initiatives	people at risk of HIV
				supported at	acquisition
				international level
					Better awareness of
					legal aspects of
					discrimination
					among Member
					States and
					integrated anti-
					discrimination
					policies with a
					particular focus on
					legislative solutions
					and their correct
					implementation
HIV/AIDS	Development,	Member States	Ongoing	National European	Scaling up of
policies and	budgeting	and	-2016	and international	development and
strategies	implementation,	neighbouring		AIDS spending by	effective
	monitoring and	countries		categories and	implementation of
	evaluation of	ECDC		financing sources	innovative HIV/AIDS
	targeted ,				policies at regional,
	regional, national	Civil Society		Number of	national and sub-
	and supranational			explicit	national level
	HIV/AIDS and co-	International		HIV/AIDS policies	leading to a
	infection policies	organisations		in place, scale and	reduction of HIV
				quality of	transmission
				implementation
				Sustainability of
				funding for HIV
				and co-infection
				programmes
Civil society	Support of civil	National	Ongoing	NGOs and	Larger number of
	society through	authorities in the	-2016	vulnerable groups	effective NGOs in
	funding and legal	EU and		actively involved in	EU Member States
	support at EU and	neighbouring		planning, policy	and neighbouring
	national levels in	countries		formulation,	countries
	the EU and			budgeting,
	neighbouring	Commission		monitoring	Higher degree of
	countries			&evaluation of HIV	NGO participation in
		Other		activities at EU,	decision making
	Involve and	stakeholders		national and
	consult civil			subnational levels
	society including
	people living with			Number of NGOs
	HIV/AIDS and			which have access
	other vulnerable			to specific funding
	groups in			instruments (as a
	development and			result of their

	implementation of			participation in
	HIV policies			competitive calls for funding)
	Ensure
	sustainable			Percentage of
	funding			NGOs with
	opportunities for			projected income
	NGOs in relevant			for the next 2/3/5
	EU instruments			years
The private	Intensify	Business &	Ongoing	Number of	Successful
sector	cooperation with the private sector	Industry	-2016	partnerships programmes	partnership projects
	and invite all	National		between	Solidarity with
	relevant	authorities		stakeholders	people living with
	stakeholders to				HIV
	develop and	Commission		Number of ARV
	implement			price rebate	Affordable and
	initiatives	Civil Society		agreements	accessible HIV
	addressing				prevention
	HIV/AIDS				measures including
	including in the				condoms
	workplace				Affordable and fair
	Work with				ARV prices
	pharmaceutical
	industry to				Early treatment and
	improve access				care, better
	and availability of				treatment coverage,
	HIV/AIDS				improved health
	treatment across				status of people
	the EU and				living with HIV
	neighbouring
	countries				Development of new business models to facilitate development and access to testing and treatment for HIV and co-infections

2. Prevention
Targeted and	Identify	National /	Ongoing	Percentage of	Most at risk and
combination	prevention needs	Regional	-2016	most at risk groups	general populations,
prevention	and integrated	authorities		reached with HIV-	and particularly
and	strategies based			prevention	young people better
treatment	on current	Civil Society		programmes	informed about HIV
	evidence and best				prevention
	practice targeted	Commission		Number of health	measures
	to sub-national			facilities that
	realities	ECDC		provide HIV testing	Reduction of new
				and counselling	HIV infections
	Targeted		2014-	services
	integrated		2016		Access to
	prevention and				comprehensive and
	treatment to			Funding level of	integrated
	most at risk			integrated	prevention, and
	groups			prevention and	early testing
	(including sex			treatment	services and
	workers and			strategies for HIV-	commodities for
	prisoners) as			AIDS and co-	most at risk
	central focus of			infections including	populations
	national HIV-			proportion of	including sex
	AIDS and STI			funding targeting	workers and
	strategies		Ongoing	most at risk groups	prisoners
			-2016	done in
	Improve			collaboration with
	exchange of best			civil society
	practice,			organisations
	information and
	education on HIV			Number of national
	and HIV			policy documents
	prevention and			and guidelines in
	treatment			which treatment as
				prevention is
				mentioned.
HIV	Apply evidence	ECDC,	Ongoing	Precise,	Improved
transmission	based knowledge		-2016	geographically	understanding of
and risk	from behavioural	EMCDDA		distinct	behavioural
behaviour	research in order			disaggregated	parameters
	to develop	Academia		data and resulting	contributing to the
	effective			policies	epidemic
	measures leading	*Civil Society*
	to reduced risk			Number of	Adaptation of
	behaviour	Commission		developed	policies and
				guidelines and	prevention
	Support the		2014-	measures leading	measures
	enhancing of		2016	to reduced risk
	treatment			behaviour and	Reduction of new
	literacy			increased	HIV cases in most at
				treatment uptake	risk populations
				and adherence.
				Percentage of
				health care
				facilities providing
				basic-level HIV
				testing and
				HIV/AIDS clinical
				management

Education	Better	Member States	Ongoing-	Number of	Reduced incidence
	awareness on		2016	awareness raising	of HIV and sexually
	sexual and	International		actions carried out	transmitted
	reproductive	Organisations			infections in
	health				particular among
		Civil Society			young people
		Commission			Less stigma and
					discrimination of
					groups at risk of HIV
					and sexually
					transmitted
					infections
3. Priority regions and settings
Eastern	Reach universal	National	Ongoing	Domestic and	More people under
European	access to	authorities	-2016	international	treatment, decline of
Member	voluntary testing,			HIV/AIDS	AIDS related deaths
States,	treatment and	Civil society		spending
Enlargement,	care			(including harm	Reduction of HIV
ENP		Regional (Health)		reduction	and co-infections
countries and	Introduction and	Networks (i.e.		measures) by	infection rate among
the Russian	implementation of	Northern		categories,	injecting drug users
Federation	effective harm	Dimension		financing source,
	reduction	Partnership in		and allocation to	Better health status
	measures for	Public Health and		priority groups.	of IDUs and
	prevention of HIV	Social Wellbeing)			prisoners and their
	and co-infections			Number of basic	partners
		Commission		activities and
	Prevention and			programmes in	Decreased HIV and
	integrated HIV,			place, scale and	co-infections
	and co-infections			quality of	incidence in prisons
	treatment,			implementation,
	including in			synergies
	prisons and other			developed and
	particular settings,			critical enablers
	using innovative			funded
	strategies to
	reach target			Coverage of
	groups,			integrated
	particularly MSM,			prevention and
	IDUs and Sex			treatment services
	Workers			in prisons
				Provision of
				integrated HIV and
				co-infections
				services
Enlargement,	Promote	Commission	Ongoing	HIV/AIDS and co-	Improved national
ENP	Cooperation on		-2016	infections as an	HIV/AIDS and co-
countries and	HIV/AIDS and co-	Member States		agenda point in	infections plans for
the Russian	infections	and		regular health	prevention,
Federation	between the	neighbouring		policy dialogues	treatment, care and
	EU, and	countries		with relevant	support
	neighbouring			Enlargement,
	countries through	WHO		ENP countries,	Effective
	established policy			and the Russian	implementation of
	dialogue	UNAIDS		Federation	antidiscrimination
	mechanisms				policies
		ECDC		Alignment of
	Invitation and			actions with

involvement of			international
neighbouring			organizations
countries in HIV			working on HIV-
related meetings			AIDS to generate
at EU level			synergies and
			maximize impact
Monitoring and		2014-
reporting		2016	Number of
progress in			Enlargement and
implementation			ENP annual
of HIV-related			progress reports
actions agreed			addressing
in bilateral			HIV/AIDS and co-
cooperation			infections
agreements
and/or Action
Plans between
the EU and
neighbouring
countries
Strengthen the	ECDC, WHO-	Ongoing	Increased	Better surveillance,
surveillance by	Euro, EMCDDA,	-2016	interaction with	monitoring and
stepping up			and involvement of	evaluation
cooperation	Surveillance		Enlargement and
between the	institutions in		ENP countries in	Improved integrated
ECDC, WHO-	Neighbouring		ECDC HIV/AIDS	HIV policies and
Euro, EMCDDA	countries and		and co-infection	programmes in the
and surveillance	Russian		programmes	EU and
authorities in	Federation			neighbouring
Enlargement and				countries
ENP countries	Commission
and Russian
Federation	ENP partners
	Member States
	Civil society
Exchange	Health	Ongoing	Number of	Better trained clinical
programmes	Professional	-2016	exchange	and social staff and
between Member	associations		programmes	NGOs
States and
neighbouring	Member States
countries for
training of medical	Neighbouring
and social and	countries
NGO staff
	Civil Society
	Industry

4. Priority groups
Men having	Intensify the	Civil Society	Ongoing-	HIV incidence and	Adaptation in risk
sex	promotion of safer		2016	prevalence	behaviour
with men	sex behaviour among MSM	*Member States*		among MSM	Reduction in HIV
	Information on	*Neighbouring*		Changes	transmission among
	HIV prevention	*countries*		(increase/decreas	MSM
	integrated in			e) in rates of
	sexual and	Commission		unsafe sex	Less stigma and
	reproductive			practices amongst	discrimination
	health education	ECDC		MSM
	and health care				Better knowledge on
	services				sexual and reproductive health
	Intensify	Member	Ongoing	Rate of late	Decrease of late
	implementation of	States	-2016	diagnoses among	diagnoses, timely
	voluntary			MSM	start of treatment
	counselling and	Neighbouring
	testing programs	countries		HIV testing rates	Reduction in HIV
	(VCT) among			among MSM	transmission among
	MSM	Health			MSM
	and other most at	Professional		Rate of unknown
	risk groups at	Associations		HIV status
	healthcare, and	and community
	community based	based		Percentage of
	facilities, ensuring	organisations		MSM who
	effective link to			received an HIV
	treatment and	Commission		test in the last 12
	care	Civil Society		months and who know their results
	Increase
	innovative testing			Percentage of
	strategies			MSM reached
	including outreach			with HIV
	and peer support			programmes
	to ensure access
	to voluntary
	counselling and
	testing to most at
	risk groups
Injecting drug	Implementation of	Member States	Ongoing	Coverage of harm	Decreased HIV
users (IDUs)	risk and harm		-2016	reduction	incidence among
	reduction	Neighbouring		programmes,	people who inject
	measures to IDUs	countries		including syringe	drugs
	and their partners			exchange and
	for prevention and	Civil Society		clean needles	Better access for
	treatment of HIV,				IDUs to harm
	co-infections and	Commission		Coverage of drug	reduction measures,
	drug dependency			substitution, HIV	including clean
	in the community	ECDC		and co-infections	syringes and needles
	and prisons			treatment programmes Percentage of IDUs reached with HIV	Availability of specific, effective prevention programmes for IDUs and their

				programmes	partners
Migrants and	Targeted	Migrants and	Ongoing	Number of	Better information of
mobile	prevention	ethnic minorities	-2016	programmes and	migrants on risk
populations⁷	measures and	organisations		policies	prevention, HIV/AIDS
	access to			developed and	and treatment, care
	services and	National		implemented	and support
	treatment for	authorities
	migrants, and			Coverage of	Improved access and
	mobile	Commission		prevention	information on rights
	populations			services and	and possibilities for
		Civil society		treatment for	migrants and mobile
	Sustain and		2014-	migrants,	population
	promote testing		2016	including
	and treatment			undocumented
				migrants, and
				mobile
				populations
	Abolish HIV	National	Ongoing	Number of	Non-discrimination of
	associated travel	authorities	-2016	countries/regions	migrants and mobile
	and residence			with restrictions	populations with
	restrictions				regard to HIV status
5. Improving the knowledge
Research	Promote research	Commission	Ongoing-	Projects and	Moving towards a
	for the		2016	programmes	cure and
	development of	Member States		funded	development of new
	new, or better				or better diagnostic
	prevention,	Industry			and preventive tools
	diagnostic and				and treatment
	treatment	Research			options
	solutions for HIV,	institutions
	co-infections and
	co-morbidity	Public health
		Institutions
		Civil Society
	In depth analysis	ECDC	2014-	Studies, reports,	More adequate,
	of trends and		2016	recommendations	evidence based
	dynamics in	EMCDDA			prevention
	sexual and drug			Number of actions	programmes, in
	use related risk	Academia		funded under EU	particular for risk
	behaviour			programmes	populations
		Commission
	Ensure adequate
	allocation of	Member States
	funding for social
	and behavioural	Civil society

⁷ By 'migrants' we understand third-country nationals. By 'mobile populations' we understand EU citizens exercising their right to free movement. It also include ethnic minorities defined as, national minorities, in line with the Charter of Fundamental Rights prohibiting discrimination on any ground, such as sex, race, colour, ethnic or social origin, etc. http://ec.europa.eu/justice/fundamental-rights/minorities/index_en.htm.

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	research, socio-
	economic
	analysis
Health care	Improve	Health	Ongoing-	Broad application	Timely diagnosis and
	capacities and	professionals	2016	of international	more effective
	knowledge of	associations and		testing and	treatment solutions
	medical staff and	community		treatment
	community based	based		guidelines
	organisations with	organisations
	regards to
	HIV/AIDS and co-	Member States
	infections
	prevention,	WHO
	testing, treatment
	and care including	Academia
	larger
	dissemination of	Industry
	clinical best
	practice
Surveillance	Enhanced and	ECDC	Ongoing-	Comprehensive	Powerful
	integrated		2016	overview of	epidemiology
	surveillance of all	EMCDDA		HIV/AIDS and co-	resulting in
	relevant aspects			infections in the	comprehensive and
	on HIV/AIDS and	WHO		European region	evidence based
	CO	- infections			disaggregated	policies
	(including	Commission		data to identify
	strengthened bio-			epidemiology
	behavioural	Member States		including those
	surveillance)	and neighbouring		linked to
			countries		behavioural
					issues
			Civil society
6. Monitoring and
evaluation
Commitments of	Regular	ECDC	Ongoing	Progress reports	Realisation of
Dublin, Vilnius		monitoring		(Every 2		commitments
and Bremen		on scale and	WHO	years)
declarations		quality				Improved quality of
	of	Commission			life of people living
	implementatio				and affected by HIV
	n	UNAIDS
					Reduced incidence
		Civil Society
		Member
		States and
		neighbouring
		countries
Implementation	On-going	ECDC	Ongoing-	Progress reports	More effective
of this action		monitoring on		2016		policies, less new
plan		scale and	Commission			HIV infections, better
	quality of				medical, social and
	implementatio	Think Tank			legal conditions for
	n				people affected by
		HIV/AIDS Civil			HIV
		Society Forum