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Development Policy Health & Poverty Reduction in Developing Countries MOTION
FOR A RESOLUTION European Parliament
resolution on the Commission communication on Health and Poverty Reduction
in Developing Countries (COM(2002) 129 - C5-0334/2002 - 2002/2178(COS)) - having regard to the Commission communication (COM(2002) 129 - C5-0334/2002), - having regard to Article 152 and Articles 177 to 181 of the Treaty establishing the European Community, - having regard to the ACP-EC Partnership Agreement signed in Cotonou on 23 June 2000(1), - having regard to the Policy Statement on the EC Development Cooperation (April 2000), - having regard to its resolution of 1 March 2001 on the European Community's Development Policy(2), - having regard to its resolution of 15 March 2001 on access to medicines for AIDS patients in the Third World(3), - having regard to its resolution of 4 October 2001 on accelerated action targeted at major communicable diseases within the context of poverty reduction(4), - having regard to the resolution adopted by the ACP-EU Joint Parliamentary Assembly in Cape Town on 21 March 2002 on health issues, young people, the elderly and people living with disabilities(5), - having regard to its position of 30 January 2003 on the proposal for a regulation on aid for poverty diseases (HIV/AIDS, malaria and tuberculosis) in developing countries(6), - having regard to the Rome Declaration on Hunger adopted by the World Food Day Colloquium (October 1982), - having regard to the United Nations Convention on the Rights of the Child, - having regard to the Rio Declaration on Environment and Development adopted by the United Nations Conference on Environment and Development (14 June 1992), - having regard to the Protocol on Water and Health to the 1992 UNECE Convention on the Protection and Use of Transboundary Watercourses and International Lakes (Water Convention), - having regard to the Millennium Development Goals (MDG) adopted at the Millennium Summit of the United Nations (6-8 September 2000), - having regard to the Monterrey Consensus of the United Nations International Conference on Financing for Development (22 March 2002), - having regard to the Johannesburg Declaration on Sustainable Development adopted by the United Nations World Summit on Sustainable Development (4 September 2002), - having regard to the resolution of the Council and Representatives of the Governments of the Member States on Health and Poverty of 3 May 2002, - having regard to Rule 47(1) of its Rules of Procedure, - having regard to the report of the Committee on Development and Cooperation and the opinion of the Committee on Women's Rights and Equal Opportunities (A5-0217/2003), A. whereas health is a basic human right recognised in Article 25(1) of the Universal Declaration of Human Rights, B. whereas there can be no sustainable economic and social development without good health; and in developing countries, disease, disorder and disability continue to limit individual and collective human development, C. whereas health and the need to improve health outcomes for the poor feature prominently in the Millennium Development Goals (MDGs), D. whereas the achievement of the Programme of Action of the International Conference on Population and Development (ICPD) is vital in realising the MDGs, E. whereas the European Community is committed to greater support for improved health under the new ACP-EU Partnership Agreement and in its Policy Statement on Development Policy, F. whereas the resolution on the general budget for 2003 emphasised the need to increase EU interventions in basic health, building on the agreement to ensure a minimum 35% allocation to social spending, Health and poverty 1. Welcomes the Commission's Communication setting out a framework policy for health aid in developing countries; 2. Believes that the focus on reducing poverty is correct, but, as well as the focus on the three poverty diseases, believes it is important to support other areas of healthcare such as action to combat diarrhoeal diseases, which in particular kill hundreds of thousands of children, and also to the problems linked to areas such as mental and physical disorder; 3. Given that 3 million people die every year from water-borne diseases, calls on the Commission and the Member States to raise their contributions towards meeting the MDG target 10 of halving by 2015 the proportion of people without sustainable access to safe drinking water; 4. Emphasises that there are a number of other debilitating diseases and calls on the Commission and the Member States to make an impact in such areas as dysentery, cholera, river blindness, meningitis, epilepsy, diabetes, asthma, typhoid, hepatitis, polio, lymphatic filariasis, diphtheria, pertussis, measles, mumps, tetanus, haemophilus influenzae, pneumococcus, rotavirus and yellow fever; 5. Believes that the strategy for effective investment in health is as important as the total spending available, notes the dramatic improvements that have taken place where national immunisation programmes have focused on comprehensive local implementation, and believes that extensive vaccination campaigns against common diseases are therefore vital; 6. Underlines that better basic health and education can lead to better individual and family health, more effective use of health services and improved family planning and a reduction in sexually transmitted diseases, which means that poverty reduction must be given pride of place amongst all development policy measures; 7. Stresses that the fight against poverty involves access to education, training and the new information technologies, as well as access to property and saving and credit mechanisms, and calls on the European Community to develop specific measures directed at women in these areas, particularly as part of its cooperation and development policy; calls on the Commission to take positive action against trade and trafficking in human organs; 8. Asks the Commission to foster the involvement of local populations, and in particular that of women, in order to bring about substantial changes in the field of health, with a view to establishing fora that are open to everyone regardless of their race, religion or gender, thereby enabling an indigenous health system to be developed without imposing the model used in developed countries; certain cultural traditions, or ones relating to religious beliefs, exclude women from access to sexual and reproductive health services; 9. Asks the Commission to support the initiatives aimed at reinforcing the role of primary health care, which is the only means of extending complete health to the very poor; points out that there is also a need to ensure universal access to health care and to guarantee access to adequate sexual and reproductive health services and the access of local populations to medicines, and to support the strengthening of public health systems, the development of healthcare skills and the promotion of research; 10. Notes that HIV/AIDS affects the very sector of the population that is able to work, and calls for increased support for the Global Fund to fight AIDS, Tuberculosis and Malaria (GFATM); 11. Stresses the urgency of promoting access to medicines for all and recognises that there is a need to encourage pharmaceutical producers to make available pharmaceutical products at affordable prices in increased volumes by ensuring that such products remain on the market; 12. Believes that palliative care has received inadequate attention in areas where HIV/AIDS is rampant; urges that, in its community non-hospice form, it should be enabled to play its low-cost part in caring for those with life-limiting diseases, such as HIV/AIDS, tuberculosis and cancer, and that treatment should also be authorised, under medical supervision, using painkillers such as morphine, which are otherwise considered as narcotics and the use of which is legally restricted; 13. Notes that mental disorders such as depression are accelerating significantly, but that mental health services in developing countries are often poor or non-existent and that, for individuals, the burden of the disorder is often compounded by stigmatisation by their local society; calls on the Commission and the Member States to place greater emphasis on mental health; 14. Notes the inadequate access to services for, and discrimination against, many people living with disabilities and calls on the EC and the Member States to help ensure good health and social care, including access to medical devices and rehabilitation services for people with disabilities, and to encourage education and training programmes that combat discrimination; 15. Notes the high rate of maternal and infant mortality; stresses the importance of universal access to reproductive health care services such as family planning, safe motherhood services, prevention, detection and treatment of sexually transmitted infections, including HIV/AIDS, and of access to infant health services including childhood vaccination; also notes the totally inadequate quality of sex education, particularly for young people, and in particular its failure to convey to boys and young men a change in cultural attitudes which would lead them to refrain from engaging in behaviour detrimental to the health and dignity of women; 16. Believes that bona fide traditional medicine and treatments can play a beneficial role in addressing health needs in developing countries when traditional healers and Western medical practitioners work in cooperation; 17. Notes that more than one third of all pregnancies are unwanted or ill-timed, due to lack of access to contraceptives and contraceptive failure: notes that millions of unsafe abortions are administered every year, killing nearly 80 000 women and causing hundreds of thousands of disabilities, which could, however, be prevented via adequate sexual and reproductive health education and care programmes; 18. Notes the large number of households relying on biomass fuels for cooking and heating without proper ventilation, exposing people to high levels of indoor air pollution, and calls for support for a shift from biofuels in the long term and improved cooking stoves equipped with flues or hoods in the interim; believes that measures to raise awareness of environmental protection are vital in order to curb the damaging use of wood and the deforestation this entails, and to encourage people to use solar power; 19. Notes the need to combat pollution, deforestation, desertification and industrial development given that they have a detrimental impact on health, especially through the impact on water supply and untreated waste and sewage; Investing in health 20. Notes that the Monterrey commitments fall short of the funds needed to meet the MDG of halving world poverty, of which women and children are particular victims, by 2015; notes that, according to the Commission on Macroeconomics and Health, an additional USD 31 billion of aid for the health sector is required; 21. Welcomes the African governments' initiative (Abuja 2001) to commit 15% of national budgets to health; notes, however, that the governments of developing countries spend on average less than 15% of their national budgets on basic social services whereas many poor or heavily indebted countries spend over 20% of their annual budgets on debt servicing; 22. Draws attention to the EUR 10 billion not spent by the European Development Fund and calls on the Commission to ensure that it is spent on the purposes for which it was budgeted, including health support; 23. Believes that there is a special need for investing in the health of displaced persons, refugees and victims of war and disaster to ensure that they have access to proper care and that this does not become an impossible burden on the health services of the receiving country; 24. Stresses the need for more effective and increased global investment in the development of new products, particularly vaccines, microbicides, vector control products and drugs, and emphasises the need for global collective action, coordination and financing to produce and develop - in sufficient quantities - specific global public goods, in particular those commodities, resources and services related to eradicating deadly communicable diseases, the benefits of which accrue to all people across borders, and the beneficial effects of which for an individual do not detract from the benefit to others; 25. Believes that there is a need for pharmaceutical companies to produce high quality compounds, for pharmacies to prescribe medicines responsibly, for individuals to adhere correctly to prescriptions and for drugs and vaccines already in production to be made more accessible, by supporting the full implementation of the Doha Declaration on public heath and notably by increasing international cooperation, and stresses the need for the EU to show responsibility and solidarity by giving strong support to existing initiatives such as the national multi-year immunisation plans funded and supervised by the Global Alliance for Vaccines and Immunisation (GAVI) and the Vaccine Fund; Improving effectiveness 26. Agrees with the Commission that there is a need for additional selective and targeted approaches to complement ongoing Community support aimed at strengthening health systems with a view to delivering services that benefit the poor; 27. Notes that donor-driven projects can absorb scarce human and financial resources, can have limited coverage and can set standards that cannot be sustained, and that heavy reliance on foreign technical assistance can hinder the development of local capacity; 28. Stresses the importance of expanding the range of expertise in the field and of stemming the drain of skills, especially medical skills, from the developing world to the developed world; 29. Stresses the need for further coordination within the EU, between missions in the respective developing countries and between the EU and other donors, both globally and locally, and welcomes moves by the Commission to strengthen cooperation with Member States and with NGOs, including WHO, UNAIDS, UNFPA, UNICEF, the World Bank, GFATM, GAVI, Stop TB, Roll Back Malaria, the International AIDS Vaccine Initiative and the International Partnership for Microbicides; 30. Highlights the positive role that civil society, including faith-based organisations, can play in public-private partnerships; 31. Emphasises the desirability of involving international and local NGOs and communities in the health sector, and in particular the provision of primary care and peripatetic services; 32. Calls on the Commission to ensure that health is not included within the scope of the General Agreement on Trade in Services (GATS) as a 'service' subject to free market sources and productivity criteria; 33. Points out to the Commission that the importance of women as primary health promoters should be highlighted and that a gender perspective therefore needs to be introduced into health policies, into the statistics and research relating to them and into education, environment, international trade, agriculture and immigration policies; 20% of the world's population are currently of child-bearing age, making it crucial for information to be provided on sexual and reproductive health and health services, such as family planning and safe motherhood services, so as to enable this section of the population to guard against unwanted pregnancies, clandestine abortion and sexually transmitted diseases such as HIV/AIDS; stresses that the numbers and rates of HIV infection among women and girls are rising compared to those of men; points out that in 1997, 41% of HIV-positive adults were women and girls, and yet today this group accounts for 50% of all people living with HIV or AIDS worldwide; also notes that in sub-Saharan Africa, the figure is 58%; 34. Calls on the Commission to pursue an active policy aimed at combating trade and trafficking in counterfeit, adulterated or out-of-date medicines and their transit through the territory of the European Union; 35. Asks the Commission to introduce the concept of food sovereignty(7) alongside that of food security, with food sovereignty meaning the right of peoples to frame their own sustainable policies and strategies for the production, distribution and consumption of food; Monitoring 36. Highlights the need for effective target setting and outcome measurements for individual projects and programmes; 37. Urges the use of specific indicators to assess the impact of EC assistance in terms of the various types of contribution; 38. Underlines the need to ensure that Country Strategy Papers reflect the basic principles of EC support for health in developing countries; 39. Considers that monitoring national budget allocations and health outcomes should form part of the Poverty Reduction Strategy Paper process; 40. Instructs its President to forward this resolution to the Council, the Commission, the World Health Organisation (WHO) and the ACP-EU Joint Parliamentary Assembly. -------------------------------------------------------------------------------- (1) OJ L 317, 15.12.2000,
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