Ausführliche Sitzungsberichte

Montag, 17. Mai 2021 - Brüssel

23. Beschleunigung der Fortschritte und Bekämpfung von Ungleichheiten bei der Beseitigung von Aids als Bedrohung der öffentlichen Gesundheit bis 2030 (Aussprache)

  Presidente. – Segue-se o debate sobre a pergunta oral à Comissão do Deputado Tomas Tobé, em nome da Comissão do Desenvolvimento, sobre acelerar os progressos e combater as desigualdades a fim de erradicar a SIDA, enquanto ameaça para a saúde pública, até 2030 [2021/2604(RSP)] - (O-000027/2021 - B9-0015/21).

  Tomas Tobé, author. – Mr President, as Chair of the Development Committee, let me start by thanking Charles Goerens from Renew, who took the political initiative in our Committee, and also give my thanks to the whole Committee for supporting this and making sure that we could move quickly.

I think that today’s debate is very important, as it provides a timely opportunity to make a contribution ahead of the UN High Level Meeting on AIDS. It is a historic moment for AIDS response, as this year marks 40 years since the emergence of the first cases of HIV and 25 years since the creation of UNAIDS.

In 2019, 38 million people were living with HIV and approximately 12 million people did not have access to life-saving treatment. In 2019 there were also 1.77 million new infections, and 700 000 people died of AIDS-related causes globally. These data show that HIV and AIDS remains a global crisis. In 2020, targets set by the 2016 Political Declaration were missed by a huge margin, and due to the COVID-19 pandemic, many people have had no HIV or AIDS treatment, as HIV services have been severely disrupted. The COVID crisis has reversed the efforts made in fighting HIV and has also exposed social inequalities and health system weaknesses. It is therefore crucial that we use this opportunity of this upcoming high-level meeting to review progress and challenges, to make commitments, to accelerate action if we are to beat the disease by 2030.

In preparation for this important High Level Meeting, we would like to address three questions to the Commission. Firstly, how will the Commission ensure that the EU contributes to the adoption of forward-looking and ambitious commitments in the 2021 Political Declaration on HIV/AIDS? Secondly, what steps will the Commission take to accelerate efforts to end AIDS and support partner countries’ efforts to build resilient health and community systems? Thirdly, what will the Commission do to address inequalities fuelling the HIV epidemic at country level?

In the accompanying resolution, we also underline that the global AIDS response requires a multi-sectoral approach and multi-level cooperation. We state the need for partner countries to build strong and resilient health systems and for more EU funding to be devoted to global health and the fight against HIV. COVID-19 has also shown that countries need to invest in pandemic preparedness and responses. Evidence has also shown that progress in the fight against HIV is possible when human rights-based approaches are adopted and when services are responsive to the needs of key populations and other priority populations facing challenges in accessing HIV services.

We should use the implementation of the EU Human Rights Action Plan and Gender Action Plan III to address the fight against stigma and discrimination, criminalisation of same-sex relations and other punitive and discriminatory laws, as well as access to comprehensive sexuality education. I also believe that there is a need for renewed EU commitment to the global HIV response, with more determination, accountability and resources. For me it is abundantly clear that what we need to do is to increase our efforts and that the EU has a leading role to play.

  Janez Lenarčič, Member of the Commission. – Mr President, honourable Members of Parliament, thank you for this opportunity to discuss this important issue. The debate is very timely, as was said by the author himself, in view of the decision of the UN General Assembly to convene a high-level meeting on HIV and AIDS in June.

As the world tackles the COVID pandemic, the devastating AIDS global pandemic continues. While the world focuses on overcoming the direct impact of COVID and laying the ground for recovery, the secondary health impacts, the disruptions to essential health services, including with respect to HIV, hepatitis, tuberculosis and malaria, are deeply concerning.

We all know that HIV is fuelled by inequalities and that it disproportionately affects vulnerable and marginalised populations. Worsening inequalities increase the spread of HIV as do armed conflicts and natural disasters. We need to work collectively to ensure that our response to the COVID pandemic tackles these inequalities, preserve the gains achieved during the last decade and secures access for key populations to the essential services.

This is why the Commission welcomes the new global AIDS strategy for 2021-2026, sharing many of its priorities, not least the focus on tackling inequalities, gender equality and human rights. Putting people at the centre, involving communities and ensuring that we learn from COVID, in particular to build sustainable health systems is fundamental. This is why we welcome the broad principles, reiterated commitments and strong calls contained in the resolution tabled today.

The European Union is actively involved in the negotiation of an ambitious and progressive new political declaration for the upcoming high-level meeting on HIV-AIDS. As with previous United Nations political declarations, the most sensitive issues will require delicate negotiations.

On behalf of the European Union, the Commission is recommending the inclusion, not only of new prevention, testing and treatment targets, but also of specific targets related to stigma, discrimination and human rights. I am convinced that the fight against HIV is closely linked to breaking down barriers, including working on legal issues ensuring equitable access of key populations to services and treatments and strengthening the overall health systems, accompanied by an enabling environment for sustainable financial resources, notably domestic.

The response to the HIV pandemic also requires further focus on adolescent girls and young women. Our new Gender Action Plan 3, puts the fight against gender inequality at the centre of our action. The Commission is a long-standing supporter of the fight against HIV. We are a major contributor to the global fund with EUR 550 million for the period 2020-2022 and we attach high importance to fighting HIV-AIDS globally. Our more recent support to the work of the act accelerator, notably its cross-cutting health system connector, is paramount to mitigating the indirect effects of the COVID pandemic and to strengthening the preparedness and response to current and future pandemics, and this includes HIV-AIDS.

The upcoming high-level meeting provides an important opportunity to remobilise the international community with respect to the fight against HIV-AIDS, and you can count on the EU’s engagement.

  Frances Fitzgerald, on behalf of the PPE Group. – Mr President, in the midst of this current pandemic, I’m reminded of another epidemic, the HIV-AIDS epidemic back in the 1980s. Back then, so many suffered such unnecessary stigma, uncertainty, pain and death. Thankfully, things are now brighter for those living with HIV. Men and women can be confident in the medical knowledge and the drug therapies available, and that the social stigma that the disease once carried is now decreasing, and of course we need to shift our focus to living well with HIV as it is now considered a disease which can be managed. People living with HIV are beginning to age and their health needs should be supported.

However, we do have an ongoing crisis, and there remain huge challenges, unnecessary deaths and infections. The incidence of HIV has been increasing in Ireland and elsewhere since 2011, despite greater public awareness and access to preventative treatments and policy commitments. Therefore, there is a responsibility on us as policymakers to ensure there is a framework in place. There can be a new impetus and a proper strategy politically. We can engage with relevant stakeholders – advocacy bodies, academia, infectious diseases experts, people living with HIV and the pharmaceutical industry – to finally end AIDS as a public health threat by 2030.

  Pierfrancesco Majorino, a nome del gruppo S&D. – Signor Presidente, onorevoli colleghi, l'AIDS è una malattia terribile, uscita dalle nostre agende, spessissimo dimenticata ma assolutamente presente nella vita reale.

Il quadro, già ricordato dall'onorevole Tobé, è drammatico: nel 2019 le persone affette da HIV erano 38 milioni: di queste 12 milioni non avevano accesso alla terapia retrovirale salvavita. Il numero dei morti è stato di 700 000. L'Africa subsahariana continua a essere la regione più colpita, con il 57 % di tutte le nuove infezioni da HIV e l'84 % delle infezioni da HIV nei bambini.

Serve che la prossima Assemblea generale delle Nazioni Unite assuma un forte e rinnovato impegno globale per debellare questa malattia, come diceva già il Commissario. Si devono garantire quelle cure che sono troppo spesso bloccate dalle logiche del profitto.

Serve anche un'attenzione forte per garantire il diritto alla sessualità e per contrastare la discriminazione, la criminalizzazione delle persone omosessuali e transessuali, delle diseguaglianze di genere: ancora oggi, siamo di fronte, in alcune aree del mondo a una ghettizzazione che favorisce la malattia.

  Charles Goerens, au nom du groupe Renew. – Monsieur le Président, le contexte de la pandémie de COVID-19 risque de dévier notre regard d’un autre fléau, vieux de 40 ans: le SIDA. De ce point de vue, la tenue de la réunion de haut niveau des Nations unies, prévue du 7 au 10 juin 2021, tombe à point.

Les progrès réalisés avant tout lors des 20 dernières années sont considérables, notamment pour ce qui est de l’accès aux antirétroviraux. Néanmoins, l’éradication du VIH/SIDA risque de rester illusoire si nous n’y prenons garde. Si nous voulons rendre irréversible la tendance vers la contamination zéro, la communauté internationale doit donner une réponse globale structurée.

Si la détermination de l’Union européenne a été décisive pour engranger des résultats encourageants, celle-ci doit garder le cap et doper les structures existantes, au niveau tant de la production pharmaceutique que des transferts de capacité vers les pays en développement et des efforts pédagogiques indispensables à l’endiguement de la pandémie.

La Commission joue un rôle central dans la fédération de toutes les forces engagées dans la lutte contre le SIDA. Parmi ses partenaires, il y a lieu de citer les institutions internationales, le monde associatif, qui a joué un rôle pionnier en la matière, ainsi que le Fonds mondial de lutte contre le SIDA, la malaria et la tuberculose, qui est devenu entre-temps l’acteur central par excellence. C’est grâce à ce dernier qu’ont été mises en place des structures différenciées, à même de répondre aux besoins des malades dans tous les pays en développement.

Conscient que la Commission va marquer de son empreinte la réunion de New York, le Parlement européen l’encourage à persévérer dans cette voie. Si ces résultats escomptés pour la fin 2030 nous tiennent à cœur, il ne nous reste plus que neuf ans pour agir.

  Tilly Metz, au nom du groupe Verts/ALE. – Monsieur le Président, Monsieur le Commissaire, en 2019, sur les 38 millions de personnes ayant le SIDA, 12 millions n’avaient pas accès aux traitements adéquats, et plus d’un tiers des nouveaux infectés sont des jeunes entre 15 et 27 ans. C’est pourquoi nous demandons, en Europe et partout dans le monde, un soutien inconditionnel aux associations qui œuvrent pour sensibiliser à la prévention du SIDA ainsi qu’au personnel de santé pour soigner les personnes atteintes du SIDA, et une aide ciblée aux populations vulnérables, notamment en Afrique subsaharienne.

Pouvoir vivre en bonne santé est un droit et l’on ne devrait pas pouvoir faire du commerce sur le dos des pandémies. Pour combattre le SIDA partout et pour garantir une accessibilité aux médicaments pour toutes et tous, une levée des droits de propriété intellectuelle est indispensable. Pour le SIDA, nous devons la maintenir; pour la COVID-19, nous devons l’instaurer.

  Beata Kempa, w imieniu grupy ECR. – Panie Przewodniczący! Panie Komisarzu! Panie Przewodniczący komisji DEVE! Mimo wielu lat badań i milionów wydanych środków oraz tysięcy zaangażowanych osób, akcji informacyjnych, szkoleń lekarzy, wirus AIDS jest wciąż groźnym zagrożeniem dla świata. Obecnie na świecie żyje 38 mln osób z potwierdzonym zakażeniem, a wirus pochłonął już 78 mln istnień ludzkich. Co prawda w ostatnich latach udało się spowolnić jego rozprzestrzenianie, ale wciąż brakuje skutecznego leku pozwalającego na całkowite pozbycie się wirusa, a także szczepionki dającej dożywotnią ochronę. Szczególnie narażeni na zakażenia są mieszkańcy krajów rozwijających się w Afryce, Azji, Ameryce Południowej, ale nie możemy też zapominać o mieszkańcach Rosji i Ukrainy, gdzie wciąż notowana jest bardzo duża ilość zakażeń, co wiąże się z brakiem skutecznej opieki oraz dostępem do testów. To tam powinniśmy też kierować nasze wysiłki. Potrzebujemy wielosektorowej i globalnej odpowiedzi na ten światowy kryzys: z jednej strony – kampanii informacyjnej, a z drugiej – odpowiedniego wsparcia i dzielenia się istniejącymi lekami pomagającymi chorym w nierównej walce. Wirus HIV nie zna granic, tak jak i walka z nim nie zna i nie powinna znać granic. To właśnie na tym froncie Unia Europejska może pokazać swoją siłę i skuteczność i zwiększyć inwestycje w ramach UNAIDS, Globalnego Funduszu na Rzecz Walki z AIDS Gruźlicą i Malarią. Większe środki to istotna szansa na wynalezienie leku i – jeśli to możliwe – na wynalezienie szczepionki. Pandemia COVID-19 pokazała, że w stanach wyjątkowego zagrożenia możemy działać szybko i skutecznie. Dziś warto iść tą drogą, aby przynieść tak oczekiwaną zmianę.

  Miguel Urbán Crespo, en nombre del Grupo The Left. – Señor presidente, hoy en día, una de cada tres personas infectadas por el sida no tiene acceso a medicamentos retrovirales.

Como muchas otras enfermedades, el sida suele ser consecuencia y acelerador de desigualdades económicas, sociales y sanitarias. Con el coronavirus, los efectos devastadores del sida han aumentado, pero también han quedado invisibilizados. El mundo está lleno de crisis olvidadas; evitemos que esta sea una de ellas.

Frente a retos globales como una pandemia, solo hay una respuesta efectiva: sanidad pública universal. El acceso a la salud es un derecho humano fundamental; la vacunación y los medicamentos deben ser considerados como bienes públicos globales.

El mercado se ha mostrado incapaz de afrontar estos desafíos mundiales. No hay sitio para la iniciativa privada cuando está en juego la vida de millones y millones de personas. Hay que liberar las patentes y poner los derechos de todas y de todos por delante de los intereses privados. No nos cansaremos de repetir que nuestras vidas valen mucho más que los beneficios de un puñado de farmacéuticas.

  Marlene Mortler (PPE). – Sehr geehrter Herr Präsident, Herr Kommissar, liebe Kolleginnen und Kollegen! Nur wer sich schätzt, der schützt sich. Das gilt für jeden Einzelnen. Uns muss nicht jeder Lebensstil entsprechen, aber am Ende steht der Erfolg. Und wenn es Mittel und Wege gibt, um Krankheiten zu verhindern und Todeszahlen massiv zu senken, dann müssen wir diese Wege weltweit nutzen.

Auch in Europa haben wir noch gewaltige Unterschiede. Das heißt auch mal, altes Denken aufzubrechen, um neue Wege zu gehen. Als ehemalige Suchtbeauftragte der deutschen Bundesregierung wurde mir schnell bewusst, dass die Substitutionstherapie, zum Beispiel mit Methadon, immer besser als purer Heroinkonsum ist. So ist es bei AIDS: Wir haben Medikamente, Tests – wir müssen sie nur konsequent anwenden.

Jeder Mensch ist gleich viel wert und hat die gleiche Würde. Dieses ist der Schlüssel, um HIV global einzudämmen. Jahrzehntelange Erfahrungen und Erkenntnisse aus der HIV—Bekämpfung zeigen, dass Ungleichheiten – einschließlich bei der Gleichstellung der Geschlechter –, Stigmatisierung, Diskriminierung und fehlende Einrichtungen lokaler öffentlicher Gesundheitsdienste Fortschritte bei der Beendigung von AIDS verhindern.

Selbst in den Ländern, die die sogenannten 90-90-90-Behandlungsziele erreicht haben, werden immer noch zu viele Menschen zurückgelassen. Es ist deshalb von großer Bedeutung, diverse Ungleichheiten anzugehen, Synergien zwischen struktureller Prävention und Behandlung voll auszuschöpfen. Vierzig Jahre nach dem ersten Bericht über AIDS und HIV muss die Beendigung spätestens bis 2030 gelingen. Danke deshalb, Tomas, danke allen Initiatoren.

  Marc Angel (S&D). – Mr President, we Socialists and Democrats welcome the UNAIDS global strategy ending inequalities, ending HIV/AIDS. This new approach under the leadership of UNAIDS Executive Director Winnie Byanyima underlines the synergies and the links between HIV/AIDS and the 17 Sustainable Development Goals.

To win the battle against AIDS we need progress in almost all 17 SDGs. As a parliamentarian but also an activist since the 1980s, and a UNAIDS champion, I remind that we must not forget key populations and vulnerable populations such as prisoners, drug users, sex workers, men having sex with men, transgender persons, young women and girls, and victims of sexual abuse. We need to tackle key populations and their specific challenges. For this, we need to call on all stakeholders worldwide to step up their efforts to encourage governments to recognise and reach out to all key populations in full respect of human rights and dignity.

To end AIDS by 2030 we need sustainable funding. I call on the Commission and all 27 Member States to invest in global health. Please support UNAIDS and the global fund and all projects strengthening community health workers and projects empowering women and girls through good access to education and teaching them about their sexual and reproductive rights.

It is possible to end HIV/AIDS by 2030 as a global health threat so let’s make it happen. Thank you to the rapporteur Tobé, and all those who worked on this fantastic resolution.

  Engin Eroglu (Renew). – Sehr geehrter Herr Präsident, sehr geehrter Herr Kommissar! Die AIDS-Pandemie steht seit vierzig Jahren im Blickpunkt der Öffentlichkeit. Wichtig ist, dass wir durch Aufklärung und durch Forschung Teilerfolge erzielen konnten. Gerade in den Industrieländern haben sich die Zahlen reduziert. Es gibt gute Medikamente, aber leider noch kein Heilmittel.

In den Entwicklungsländern und global sieht es aber ganz anders aus. Fakt ist, dass jährlich über einhunderttausend Kinder und Jugendliche an AIDS sterben: eine erschreckende Zahl, und das damit verbundene Leid der Eltern – unerträglich! Wir dürfen es nicht zulassen, Herr Kommissar, dass dieses unerträgliche Leid in unserem Jahrhundert zur Normalität wird. Wir haben bei COVID bewiesen, was wir machen können in kürzester Zeit.

Sehr geehrter Herr Kommissar, nehmen Sie diese gute Entschließung im Juni mit zu den UN, und beenden Sie das Leid mit all dem, was wir in Europa dazu beitragen können.

  Kateřina Konečná (The Left). – Vážený pane předsedající, pane komisaři, v rámci cíle udržitelného rozvoje číslo 3 jsme se zavázali, my všichni, ukončit AIDS jako hrozbu pro veřejné zdraví do roku 2030. Z jeho naplňování jak v Evropské unii, tak mimo ni je mi však velmi smutno.

Jak dlouho budeme ve výboru ENVI ještě volat po novém akčním plánu pro boj s HIV/AIDS v Evropské unii? Ne, pane komisaři, neděláte dost. My to chceme. Platnost toho starého totiž vypršela již před lety a stále se nic neděje. Komise nečiní. Takhle tu nemoc u nás ani do roku 2030 nevymýtíme, že? Bohužel stejně jako u rakoviny se nějak zapomnělo, že AIDS je tady stále s námi.

Dovolte mi připomenout, že boj proti patentům na život zachraňující léky začal Nelson Mandela právě během prvních let pandemie HIV v Africe. Tento boj nás naučil, že k ukončení jakékoliv pandemie je třeba dát přednost zdraví před ziskem. Naše nečinnost zabíjí. Členské státy a Komise se konečně musí chytnout za nos, přijít s novým akčním plánem a změnit svoji pozici vůči návrhu Indie a Jihoafrické republiky na WTO, jinak se tady znovu za pár let sejdeme a budeme hořekovat nad tím, že se nic neděje a situace je špatná.

  Sara Cerdas (S&D). – Senhor Presidente, Senhor Comissário, estamos esta noite a discutir um problema de saúde global que tem solução, mas não estamos a atuar corretamente de forma que o HIV-Sida seja eliminado.

Uma das missões da pandemia COVID-19 é que respondemos melhor se trabalharmos juntos e coordenados com uma visão global e estes bons exemplos devem ser seguidos para o combate ao HIV-Sida.

Para isso, temos de aumentar a literacia em saúde, melhorar os acessos aos serviços de testagem e rastreio, melhorar a acessibilidade aos medicamentos para tratamento, bem como para a prevenção, ao mesmo tempo que capacitamos os profissionais de saúde para melhor orientar para esta temática.

Temos que melhorar a acessibilidade a nível global, a um preço justo e de forma atempada, de forma a que não deixemos ninguém para trás.

  Alex Agius Saliba (S&D). – Sur President, il-pandemija affettwat il-ħajja ta' kull wieħed u waħda minna, iżda żgur li ħalliet impatt ferm aktar qawwi fuq dawk li diġà kienu jbatu minn kundizzjonijiet mediċi. Żgur li r-restrizzjonijiet ta' lockdowns kienu bżonjużi sabiex nipproteġu l-ħajja tan-nies però dawn l-istess restrizzjonijiet ħallew effetti devastanti fuq numru ta' pazjenti, fosthom dawk li jgħixu bl-AIDS u l-HIV, sabiex ikunu jistgħu jkomplu jieħdu, fost oħrajn, it-trattamenti tagħhom.

Xorta jibqa' l-fatt li, waqt il-pandemija, il-firxa tal-AIDS u l-HIV baqgħet sfida għaż-żgħażagħ u n-nisa, b'mod speċjali, f'diversi pajjiżi fost dawk l-anqas żviluppati. It-trattament universali għall-AIDS u l-HIV u kura ta' kwalità tista' ssalva l-ħajjiet ta' bosta. Tgħin sabiex tagħti ħajja kważi normali lill-pazjenti morda bl-HIV, filwaqt li tgħin ukoll sabiex inkomplu nrażżnu t-trażmissjonijiet.

Kulħadd għandu dritt għall-aqwa kwalità tas-saħħa u, kif ukoll, dritt li jgħix ħajtu b'dinjità. U għalhekk importanti li l-Ewropa trid taġixxi llum qabel għada sabiex tipprijoritizza l-ġlieda kontra l-HIV u l-AIDS; ġlieda li għandu jkollha l-ambizzjoni li telimina l-AIDS mil-lista ta' kriżijiet għas-saħħa pubblika sas-sena 2030.

  Janez Lenarčič, Member of the Commission. – Mr President, let me reiterate that the Commission has been a long-standing supporter of the fight against HIV and will remain on the frontline. The COVID-19 pandemic has taught us yet again the importance of multilateral partnerships in tackling global challenges. The world must draw lessons and be better prepared for future pandemics but also address ongoing global health challenges. The European Union is notably committed in this context to supporting the strengthening of health systems and universal health coverage everywhere.

And this will be at the heart of the Global Health Summit co-organised by the Commission later this week. We are very glad to be able to count on the support of this House for the next steps.

  Presidente. – Está encerrado o debate.

A votação realizar-se-á na quarta-feira.

Declarações escritas (artigo 171.º)

  Joanna Kopcińska (ECR), na piśmie. – Ogólna tendencja nowych zakażeń HIV wg. danych UNAIDS pokazuje, że epidemia HIV pozostaje światowym wyzwaniem z powodu problemów społecznych oraz braku dostępu do skutecznych narzędzi profilaktycznych. Nierówności, które napędzają epidemię HIV, zostały dodatkowo zaostrzone przez pandemię COVID-19. Cel strategii FastTrack polegający na zmniejszeniu liczby nowych zakażeń do poziomu około 200 tys. do roku 2030 oraz osiągnięcie zespolonego wyniku „90%–90%–90%”, zgodnie z którym prawie wszystkie osoby zakażone (90%) wiedzą o swoim zakażeniu, z czego 90% otrzymuje leczenie antyretrowirusowe i 90% z nich ma niewykrywaną, może być trudny do utrzymania w swoim globalnym założeniu w kontekście panującej pandemii COVID-19. Jakie kroki zamierza podjąć KE, aby przyspieszyć wysiłki na rzecz walki z AIDS – z jednej strony, zgodnie ze strategią FastTrack stworzoną przez UNAIDS, z drugiej strony przy konkretnym wsparciu wysiłków krajów członkowskich, we wsparciu ich własnych programów polityki zdrowotnej, budowania systemów opieki zdrowotnej oraz systemów niwelujących nierówności społeczne? Pamiętajmy, że celem strategii zwalczania epidemii HIV/AIDS i leczenia ARV jest nie tylko poprawa stanu zdrowia osób żyjących z HIV, ale również odbudowa ich sytemu odpornościowego, zmniejszenie ryzyka rozwoju AIDS, obniżenie poziomu zakaźności a przez to zmniejszenie ryzyka transmisji zakażenia na osoby niezakażone poprzez przerwanie transmisji w populacji.