Presentation notes: Priorities in Europe
Presentation given by Lynette Lowndes, Head of the Europe Department, at the 4th Conference of the Red Cross and Red Crescent Societies held in Berlin, 14-19 April, 2002
14 April 2002



The RC/RC, at the national as well as the international level, is affected by the changes that have taken place over the last decade and is responding to these changes by adapting its priorities and focus.

In 2000, the United Nations adopted its millennium declaration and the Millennium Development Goals, including the commitment to combat HIV/AIDS and other diseases, including the goal of reversing the spread of HIV/AIDS, and addressing a range of cross cutting issues that are intimately related to the causes of migration and the vulnerabilities associated with this.

In the same year, the International Federation's own strategy for the new decade began to be implemented, a strategy developed largely in response to phenomena similar to those which gave rise to the Millennium Development Goals.

With this as part of the background, RC/RC in Europe met for the European Regional Conference in Berlin in April 2002 hosted by the German Red Cross to determine priorities for the next four years
They took some bold decisions based on current needs, on the action plan and national pledges from the International Conference of Red Cross and Red Crescent 1999, as well as on the outcomes of their own sub-regional meetings since the last European Conference in Copenhagen in 1998.

Following extensive preparations, European RC/RC Societies identified population movement issues and public health as their two most pressing and immediate concerns. These are the ones addressed today and are presented in the Berlin Charter itself 11.

RC/RC in Europe see a need to bring attention to "people living in the shadows" - in the European context people being discriminated /excluded are one of the most vulnerable groups:

People excluded from community and governmental programs because they are considered irregular migrants;

People excluded from access to health and care programs because they are drug users, sex workers, prisoners, or for other reasons.

For RC/RC it is a duty to act and speak for the most vulnerable, whoever or wherever they are.

This is always a challenge, but even more so when the people are on the fringes of society or in the shadows - but it is a challenge that the RC/RC must accept.

In 1999, in final goal 3.1 of the International Plan of Action adopted by States and National Societies, states committed themselves to strengthen their co-operation with their National Societies to provide improved health and social services for vulnerable groups in their communities.

This is the core of the Berlin Conference's call on states to recognise the obligations to protect basic human rights of all people within the territories of the state

Health
The two main challenges in Europe are HIV/AIDS and TB. The International Federation works, globally, to follow up on the commitments made, and the directions given, in the declaration of commitment on HIV/AIDS adopted by the UN General Assembly at its twenty-sixth special session, and the implementation of which was recommitted to at the World Summit on Sustainable Development in Johannesburg.

In Europe, RC/RC faced with long term public health crises - HIV/AIDS and TB - need to act - but their action can only be complementary - states are responsible for public health.

TB - Introduction:
TB is a new re-emerging disease, attacking the poor and the most vulnerable, people living with HIV/AIDS.
Multi resistant TB is caused by insufficient TB treatment.
Each year more people are dying in TB. In Eastern Europe TB deaths are increasing after almost 40 years of decline.

RC/RC - TB Action:
Prevention - health information
Ensuring compliance to sufficient TB treatment and support who "dots" approach.

New focus on prisons: in Russia TB incidence is 40 times higher in prisons than outside. RC is working with this in the prisons in Russian and the Caucasus already.

New focus on released prisoners e.g.. In Russia one third of TB infected prisoners discontinue their treatment when they are released.

HIV/AIDS - Introduction:
Eastern Europe and Central Asia are experiencing the fastest growing HIV/AIDS epidemic in the world. It is an explosive epidemic situation.
Preventive methods are crucial. The main risk group is indictable drug users, which is the majority of people living with HIV/AIDS in the former Soviet Union. The sexual spread of infection from this group to the general population is now a major source of concern.

The incidence of HIV/AIDS in Europe cannot be ignored. It threatens human security at all levels, and poses a threat to the peace and security of the region.

RC/RC HIV/AIDS Action:
A three part approach: prevention; access to care, treatment and support; and action to reduce HIV/AIDS related stigma and discrimination - with culturally sensitive and appropriate means
Harm reduction: concentrating on reducing risk from drug use - while this does not seek to change the actual behaviour that leads to drug use, it is clear from the experience of countries where it is employed that it has a rapid and very substantial impact on the spread of the epidemic.

Harm reduction includes needle exchange, substitute drugs and adequate social support for drug users.

Behaviour is just as important. Drug users are frequently young people so the importance of youth peer education is an important part of RC/RC programming.

Example Latvia:
Latvia has the third highest number of HIV cases in Europe (after Russia and Estonia).
Latvia RC:
Works closely with young people in their HIV peer education programmes.
Has an interactive website where people living with HIV/AIDS can talk anonymously to each other and ask questions of specialists.
Started needle exchange in Riga in 1997, outreach programme in 1999. In 2002 they expanded to 8 municipalities. Average of 200 new clients every months.

Health Advocacy:
To be able to meet the public health crisis:
Bring sensitive and caring attention to excluded HIV risks groups, drug users, sex workers, and TB infected prisoners - people living in the shadows
Stop discrimination and stigmatisation against people living with HIV/AIDS and TB.
Basic Human Rights merge with the basic national need to accelerate work to halt the spread of the pandemic

Health Challenges:
Harm reduction is either not addressed systematically or is still illegal in many countries - but to halt the HIV/AIDS pandemic it is essential.

What do we do:
Start where it is legal
Publicise the statistics
Advocate for change
Co-operation with other organisations: UNAIDS, Open Society Institute, GNP+.
Prisons are "virtual banks" for TB, if this is not addressed TB will continue to spread

HIV/AIDS, an acknowledged threat to international peace and security - is a component in the International Federation's concept of the human security debate now gathering force around the world.
How will this be addressed in New York in the coming years? Germany and Spain, the next elected members of the Security Council from Europe, have the opportunity to join with permanent members France and the United Kingdom to take European Red Cross thinking into the heart of the issue.

Population movement, Migration
Significantly increased migration in Europe is a fact of life, and welcomed by employers already suffering serious labour shortages.
The question is how population movement should happen. The RC/RC starting point is that migration should not be organised by criminals, but it should take place within fair, transparent and humanely planned and managed migration policies. Walls, "filters" and similar controls have always failed in the past, and are doing so again now.

People move for many personal reasons, but at the root of all their choices are similar ambitions - to escape from violations of civil and political rights, or from the nonavailability of economic, social or cultural rights. It is illusory to try to draw distinctions between the sources of fear when deciding how to treat a migrant.

RC/RC Migration Actions:
RC/RC confronted with the crisis and forced to act. The nature of the crisis brings the need for action to the doorstep of the local or national RC office, for this is where the people are, and they, rightly, see the RC/RC emblem as the neutral, impartial and humane symbol of the help and protection they need.

What are we engaged in: humanitarian response, protection, integration and advocacy.

Vulnerable asylum seeks and migrants in detention. Federation/ICRC and RC/RC Societies identifying suitable interventions: visits, humanitarian assistance

Action based on vulnerability and need, not on legal status.
RC/RC Societies are based in countries, being countries of origin, transit and/or destination for migrants, asylum seekers and refugees. This provides the opportunity for co-operation in order to improve protection.

The European National RC/RC Societies ask governments to accept our place in national dialogue aimed at addressing this vulnerability. And to establish full dialogue on the most appropriate ways of addressing that vulnerability.

Example: Belgium
Unaccompanied children
A common phenomenon, up to 100.000 unaccompanied children totally in European Union today, often as a result of the actions of traffickers and desperate parents.

The Belgium tracing services help establish the identities of the children and from that the services they need to reduce their vulnerability.

The respect of the police and the interior ministries for this RC/RC action is vital - confidentiality is an essential element to successful tracing and protection for the child.

Example Ukraine:
Very complex situation, Ukraine is:
Receiving asylum seekers/refugees.
A source of migrants and a lucrative area for criminals engaged in trafficking.
A transit country for irregular migrants and for refugees.
Welcoming the return of persons formally deported persons in earlier times (Crimean Tatars deported during 50's)

Ukrainian RC:
Supporting asylum seekers and refugees suffering from TB - food and hygiene kits, awareness and DOTS.
Supporting irregular migrants in detention centres - food, medicine and other material support.
Supporting asylum seekers in centre in Odessa - social assistance, integration activities (courses, etc.).
Supporting formally displaced persons - minor repairs, visiting nurses

Migration Advocacy:
To ensure humanitarian treatment, with a special focus on the vulnerable
Bring attention to irregular migrants forced underground
Fight discrimination, racism and xenophobia

Challenges:
To have a clear understanding from governments that a RC Society's obligation is based on our principle of impartiality, give support all vulnerable groups - that our assistance to irregular migrants is a humanitarian obligation and can not be permitted to strain relations with governments.

EU enlargement will create new borders, new bordering states will carry heavy load without resources or preparedness, e.g. Ukraine. How can states help to prepare for this change.

Detention - RC can ensure that vulnerabilities are assessed. Rights are respected, this role must be respected by states.

The way ahead
This presentation has outlined the challenges the RC/RC in Europe see before it. It is, however, beyond the capacity of one organisation or government to handle. It can only be achieved through partnership with the civil society, with governments and with other national and international humanitarian and technical organisations, including with the United Nations Office of the High Commissioner for Human Rights (UNHCHR), the International Labour Organisation (ILO), the International Organisation for Migration (IOM), the Organisation for Security and Co-operation in Europe (OSCE), the World Health Organisation (WHO), the Joint United Nations Programme on HIV/AIDS (UNAIDS), the United Nations Development Programme (UNDP), and other regional and sub-regional organisations as well as non-governmental organisations.

The regional conferences, an example of which was Berlin, is the visible part of an ongoing consultation process which involves not only national societies, but National Societies and their respective governments, intergovernmental organisations and representatives of international bodies.

As one statutory conference feeds in to another - from Berlin we take the message to Manila, a policy development process moves forward on its way to the International Conference of the Red Cross and the Red Crescent Movement, where the issues that were discussed will be put on the table where you - States party to the Geneva Conventions - will be asked to debate and decide on them. This is what will happen at the next International Conference in Geneva in 2003, where we look forward to seeing you, and to engage with you in developing the humanitarian agenda of the Red Cross and Red Crescent.

The International Federation will move from this session of the UN General Assembly through a sequence of other international meetings, including the various functional commissions of ECOSOC and ECOSOC itself in preparation for the next International Conference of the Movement.

We will maintain close consultation with your delegations at these meetings, and our member National Societies will bring issues forward with your Foreign Ministries in your capitals.

We ask that you take this message back to your capitals, so that we can be prepared together for the challenging tasks that await us in December 2003.