Mid-Term Assessment of the EU Drugs Strategy 2013–2020 and Final Evaluation of the Action Plan on Drugs 2013–2016

Final Report

Emilie Balbirnie, Matthew Davies, Emma Disley, Cristina Gonzalez Monsalve, Stephen Hartka, Stijn Hoorens, Kristy Kruithof, Martin Sacher, Jirka Taylor

RAND Health Quarterly, 2018; 7(2):4

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Abstract

The aim of the EU Drugs Strategy 2013–2020 is to contribute to a reduction in drug demand and drug supply within the EU. The Strategy has so far been implemented by an Action Plan covering the period 2013–2016. This article sets out the findings of an evaluation that assesses the degree of implementation of the Strategy and the Action Plan in terms of outputs and, where possible, impacts. It looks at the extent to which the objectives of the Strategy have been achieved. The evaluation aims to provide evidence to support the European Commission's decision about whether to propose a new Action Plan for the period 2017–2020 and, if so, what changes would be needed compared to the current plan. Through applying a mixed-methods approach, the evaluation examined the effectiveness, efficiency, relevance and coherence of the actions undertaken on the basis of the EU Drugs Strategy and the Action Plan, as well as their EU added value. The evaluation makes 20 recommendations, addressed to the European Commission, Member States, the European Council and other stakeholders. The key recommendation for the Commission is that a new Action Plan should be implemented for the period 2017–2020. This should be an updated version of the current Action Plan, rather than taking a new approach or introducing more new actions.

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The EU Drugs Strategy and Action Plan

The aim of the EU Drugs Strategy 2013–2020 is to contribute to a reduction in drug demand and drug supply within the EU. It is divided into two policy areas of demand reduction and supply reduction and has three cross-cutting themes of coordination, international cooperation, and information, research and evaluation.

Its five overarching objectives are to contribute to a measurable reduction of the demand for drugs, to contribute to a disruption of the illicit drugs market and a measurable reduction of the availability of illicit drugs, to encourage coordination and strengthen cooperation in relation to drug policy (within the EU and internationally), and to contribute to better dissemination of monitoring, research and evaluation. The Strategy sets out 15 specific objectives (three in relation to each overarching objective) that are implemented by an Action Plan that has 54 actions and covers the period 2013–2016.

The Aims and Scope of the Evaluation

This evaluation assesses the degree of implementation of the EU Drugs Strategy 2013–2020 and the Action Plan 2013–2016 in terms of outputs and, to the extent possible, impacts. It looks at the extent to which the objectives of the EU Drugs Strategy have been achieved, highlighting the areas where progress has been made and those where progress is lagging. In addition, the evaluation aims to provide evidence to support the Commission's decision about whether to propose a new Action Plan for the period 2017–2020, and if so, what changes would be needed compared to the current plan.

In accordance with the Better Regulation guidelines, the evaluation addresses 13 research questions that relate to the criteria of effectiveness, efficiency, relevance and coherence of the EU Drugs Strategy and the Action Plan as well as their EU added value. The evaluation addresses all parts of the Strategy; the two policy areas (or “pillars”) of drug demand and drug supply reduction, and the three cross-cutting themes of coordination, international cooperation, and information, research, monitoring and evaluation.

This summary describes how the data were collected for the evaluation (and the limitations to those data), sets out the main findings in relation to each of the 13 research questions and presents some cross-cutting conclusions which highlight key messages from across the evaluation criteria. Lastly, it lists the 20 recommendations made by the evaluation.

Data Collection Approach

This study has applied a mixed-methods approach in order to address the evaluation questions and ensure that all relevant stakeholders have been consulted. The approach included an extensive review of relevant EU and Member State data and documents relating to drug markets, trends and Member States' drugs strategies; over 90 interviews (by telephone and in person) to gather input from representatives from all EU Member States, European institutions, EU agencies, third countries and other stakeholders; an online survey of European External Action Service (EEAS) representatives in third countries; an online public consultation; and a roundtable discussion with representatives from civil society organisations.

Information gathered from these sources was analysed to produce a “traffic light” assessment of the implementation of the Action Plan and synthesised to answer the evaluation questions. On the whole the research team believes that the evaluation presents a coherent and robust set of answers to the evaluation questions. However, some limitations to the evaluation methods stem from data availability constraints. These include limited availability of baseline measures against which to compare changes in key outcomes over the period covered by the Drugs Strategy, the limited availability of systematically collected data relevant to the measurement of some indicators included in the Action Plan, and a time lag in the availability of statistics that cover the whole of the period of the current Strategy (much of the epidemiological data and data about treatment programmes and prevention measures only cover the period up to 2013). There were also limitations to the representativeness of the respondents to the public consultation, and very few data available about national expenditure on drug policy.

To address these limitations the evaluation collected the best possible statistical data available (in terms of its relevance and timeliness, drawing in particular on data provided by the European Monitoring Centre for Drugs and Drug Addiction (EMCDDA) and Europol to inform the evaluation), and interpreted this in light of the extensive qualitative data collected. Using evidence from different sources in this way provided opportunities to validate the information and build up a picture of the weight of evidence.

The evaluation approach was based on the recognition that it is very difficult to attribute observed trends and developments in the drugs situation to the Drugs Strategy and Action Plan. Similarly, the shape of Member State drug policy is driven by a range of national, EU-level and international factors. The aim of the evaluation was to understand the contribution that the Strategy and Action Plan made to developments in drug policy, in combination with other factors. Trends in the drug supply and demand situation provided an important context for the assessment of this contribution. However, the conclusions from the evaluation in relation to questions about the impact of the Drugs Strategy are necessarily tentative.

The evaluation's main conclusions over the five evaluation criteria are presented below.

The Effectiveness of the EU Drugs Strategy and Action Plan

To what extent have the objectives and actions of the EU Action Plan on Drugs 2013–2016 been implemented?

The evaluation found that, overall, the majority of the actions in the Action Plan have been implemented and considerable progress has been made with regard to the 15 objectives. Eight out of 15 objectives were assessed as completed or on target in terms of implementation, with the remaining seven assessed as “in progress, but behind plan.” The pillars of the drugs strategy focusing on coordination and information, research, monitoring and evaluation had relatively high proportions of actions on track or completed, while least progress in implementation had been made under the international cooperation and demand reduction pillars.

What have been the results of the actions implemented in relation to the specific objectives of the EU Drugs Strategy and Action Plan? To what extent have the objectives of the Strategy been achieved and what have been the impacts of the Strategy and Action Plan?

With regard to the results and achievements of the EU Drugs Strategy and Action Plan, the following key developments in each policy area were identified:

  • Drug demand reduction: Overall, available data suggest a mixed picture, with the current Strategy and Action Plan coinciding with both improvements and some trends which suggest a worsening situation. The Strategy and Action Plan have coincided with some positive demand-side trends: the prevalence of recorded high-risk opioid use has stabilised and in some countries decreased, and the prevalence of infectious diseases has been decreasing, overall, since 2013. At the same time, there are more worrying trends: there appears to have been an increase in drug-related deaths since 2013, with no recorded decrease in the use of drugs. In relation to treatment availability the picture is positive: data from the EMCDDA indicate that more than half of problem drug users have access to treatment and that there are a range of treatment programmes available. Similarly, the availability of prevention measures has remained stable or improved over 2013–2014 and most Member States reported running awareness-raising initiatives. In relation to treatment uptake, the number of people entering treatment has remained stable since 2013, when the current Drugs Strategy was adopted, but there has been a decrease in the number of first-time users seeking treatment.
  • Drug supply reduction: In recent years there have been no signs of a reduction in the supply of drugs. The number of recorded seizures of illicit drugs did not change substantially in 2014 (the latest year for which data are available) compared to 2013, but the volume of drugs seized increased. The price and purity indicators reported in 2014 are generally similar to those from 2013, and the overall number of drug-related offences has continued an upward trend. Law enforcement cooperation in relation to tackling the supply of drugs is extensive in the EU, and evidence suggests it has increased.
  • Coordination: The evaluation found that drug policy is increasingly coordinated at both EU and international levels, in line with the objectives of the EU Drugs Strategy. Stakeholders valued the ability of the EU to speak ‘with one voice’ in international fora, particularly evidenced in the relatively swift preparation and adoption of EU Common Position in preparation for the UN General Assembly Special Session (UNGASS) in 2016.
  • International cooperation: In addition to contributing to the ability of the EU to speak “with one voice” in international fora, a number of other measures in the field of international cooperation included in the Drugs Strategy and Action Plan have been implemented as planned. EU-funded projects aiming to reduce the supply of drugs (such as the Cocaine and Heroin Route Programmes and the Cooperation Programme on Drugs Policies—COPOLAD) have been implemented and resulted in significant activities in a number of third countries. There is no evidence that activities undertaken as part of these projects (or as a result of the EU Drugs Strategy or Action Plan) have affected the international supply of drugs. The current Strategy has coincided with some diverging trends in drug production and trafficking. For example, global production of heroin fell in 2014, but in the same year global production of cocaine rose by 38%. However, EU-funded projects continue to be key structures under which EU international cooperation in relation to drugs is undertaken and as part of which long-term relationships are maintained with third countries.
  • Information, research, monitoring and evaluation: There has been progress in relation to a number of activities included in the Action Plan which aim to improve research and knowledge about drugs. For example, the EMCDDA and its network of Reitox focal points have made a significant contribution to better understanding all aspects of the drugs situation in the EU and trends in drug markets, as called for in the Action Plan. Similarly, Europol and the European Union Agency for Law Enforcement Training (CEPOL) have contributed to maintaining networking and cooperation within and across the EU's knowledge infrastructure. The EU has also funded significant research projects in the drugs field. A particular challenge in relation to evaluation is the still limited understanding of the impact of law enforcement efforts on drug markets, a situation that persists despite ongoing work on, and progress in, developing supply-side indicators and continuing investment in monitoring and intelligence.

The Efficiency of the EU Drugs Strategy and Action Plan

To what extent have the Strategy and Action Plan had an impact on Member States' budgetary resources?

The assessment of efficiency was particularly affected by the lack of available data. No systematic or comparable information is available regarding the budgets for drug-related activities at Member State level. Spending at a national level does not appear to be in influenced directly by the need to implement the EU Drugs Strategy and Action Plan, because priority is placed on the implementation of national objectives (most of which align with the Strategy). There appears to have been a reduction in the budget allocated to drug-related issues within a majority of Member States during the period of the current Strategy, due in part to the economic crisis and, in some instances, decisions to prioritise spending on policy areas other than drugs. This has impacted on the implementation of several actions. Even in a climate of financial austerity, however, Member States have in some cases been able to implement national programmes that are in line with the Action Plan.

Were sufficient resources allocated throughout the years 2013–2016 to fulfil the objectives of the EU Strategy and Action Plan?

Overall, resources were considered to be sufficient for the EU Strategy and Action Plan, particularly with regard to drug demand and supply. Not surprisingly, stakeholders indicated that increasing resources would ensure better implementation of the actions in the Action Plan. Evidence on EU-funded projects and programmes demonstrated that drug-related expenditure at the EU level contributed to the implementation of the actions in the Action Plan.

Will additional resources be necessary for the remaining years of the EU Drugs Strategy? If yes, where should these additional resources come from?

The evaluation found that the level of resources available was, overall, considered to be sufficient, though the effectiveness of drug demand and supply reduction policies could be improved by increasing resources at the Member State level. Views on the areas where additional funding should be provided differed, depending on stakeholders' interests.

The Relevance of the EU Drugs Strategy and Action Plan

To what extent has the EU Drugs Strategy been relevant in view of EU needs?

The evaluation found that the EU Drugs Strategy and Action Plan were considered to be relevant to problems identified at the EU and national level at the time of their adoption.

Concerning demand reduction, the EU Strategy and Action Plan address the need for information-sharing at the EU level to support the evidence-base underpinning demand-side policies. At the national level, it was confirmed that the Action Plan was relevant to the need to continue to provide and expand a range of demand reduction activities. With regard to supply reduction, the priorities and actions set out in the Strategy and Action Plan were considered to be highly relevant. This view particularly related to their general focus on law enforcement and judicial cooperation and to responding to challenges related to the emergence, use and rapid distribution of New Psychoactive Substances (NPS) and the diversion of precursors (EU level), and their alignment with the diverse needs of Member States (national level). Similarly, the cross-cutting pillars were also considered to be highly relevant to needs at the EU level. In particular, the Strategy and Action Plan were seen as relevant to the need to improve international cooperation and as a guide for work with third countries. At the national level, the coordination pillar was relevant to the need recognised by national stakeholders to improve within-country coordination. Furthermore, with regard to the overall relevance of the Action Plan, the evaluation found that, while the Action Plan can be characterised as slightly more streamlined than its predecessors (it has fewer actions), its relevance and that of the Strategy can largely be attributed to their broad scope.

Is the EU Drugs Strategy relevant in view of current needs?

The evaluation found that the EU Drugs Strategy and Action Plan continue to address current problems in relation to drugs policy at the EU and national level. The evaluation could not identify areas that were no longer considered relevant. In many respects, the Strategy and Action Plan were conceived as a comprehensive “wish list,” rather than as a selective strategy focused on achieving a set of prioritised objectives within a given time span. As such, there is no widespread desire among stakeholders to decrease the number of objectives and actions in the Strategy and Action Plan. Stakeholders identified areas where greater focus could be placed moving forward (e.g. the adoption of legislation relating to NPS) or where new priorities could be considered (e.g. the fostering of a closer link between drug demand policy and overall social policy in Member States).

Some stakeholders also suggested a more fundamental change; that a future EU Drugs Strategy should be part of a pan-addiction strategy covering licit and illicit substances and addictive behaviours.

The Coherence of the EU Drugs Strategy and Action Plan

To what extent are the EU Drugs Strategy and Action Plan coherent with other EU policies, as well as with Member States' drugs policies?

The evaluation concluded that, overall, the EU Drugs Strategy and Action Plan are aligned with the objectives set out in other relevant EU and Member State policies and strategies. In the field of internal security, however, the evaluation found that greater coherence and coordination could be achieved with regard to the working groups within the Council. Better cooperation between the Horizontal Drugs Group of the Council of the European Union (HDG) and the Standing Committee on Operational Cooperation on Internal Security (COSI) would help to ensure that the HDG can fulfil its role of monitoring the implementation of the EU Drugs Strategy and ensuring coherence between demand and supply reduction activities. Furthermore, although the EU Drugs Strategy is aligned with the fundamental objective of fostering good health, it does not take into account key aspects of the EU Health Strategy (e.g. the ageing population and emergency preparedness measures for drug-related epidemics). The EU Drugs Strategy and Action Plan are generally highly aligned with national strategies, action plans and other key policy documents.

To what extent are the EU Drugs Strategy and Action Plan coherent with the developments in international fora and with EU external action?

A key international actor in relation to global drugs policy is the UN, the strategic priorities of which have become increasingly aligned with the EU approach—a process in which the EU has played a role. More broadly, strategies elaborated by organisations such as the Organization of American States (OAS), the Association of Southeast Asian Nations (ASEAN) and the African Union (AU) follow a similar approach to the EU Drugs Strategy (based on demand and supply reduction pillars and cross-cutting actions such as awareness raising, cooperation and monitoring and research). However, the EU Strategy and Action Plan appear to be more advanced in terms of adopting a balanced health- and evidence-based approach.

To what extent is EU cooperation with third countries and international organisations coherent with the objectives of the EU Drugs Strategy?

The approach set out in the EU Drug Strategy and Action Plan has been integrated by the EU into its dialogue with third countries and regions. Particular priority is given to technical assistance projects in acceding and potential candidate countries. In line with the Strategy and Action Plan, the EU and its Member States also provide support and assistance to a wide range of drug-related initiatives in Latin America, the Caribbean and West Africa along the cocaine trafficking route, and in Afghanistan and Central Asia along the heroin route. This ‘drugs route’ approach has helped the EU to be particularly successful in dealing with the interplay between the drugs issues and organised crime. It was also found that the EU has generally maintained strong support for a balanced approach between supply and demand reduction measures.

Finally, EU cooperation with international organisations has been conducted in line with the EU Drugs Strategy and Action Plan. Since 2013, the EU has decisively contributed to shaping the international drugs policy agenda.

The Added Value of the EU Drugs Strategy and Action Plan

What is the additional value resulting from the EU Drugs Strategy and Action Plan, compared to what could be achieved by Member States at national and/or regional level?

The Strategy and Action Plan provide added value to individual Member States (and other non-State actors) and their strategies by establishing a common EU-wide strategic framework and by institutionalising a process of consensus-building for increasingly complex and international issues. Moreover, the Strategy and Action Plan appear to add most value in newer Member States, which in the main did not have pre-existing, developed drugs policies prior to their EU accession. Beyond the EU, the Strategy and Action Plan add considerable value in terms of enhancing the voice of the EU in international fora and in relation to third countries. They provide an important source of guidance for candidate countries, and a framework for bilateral cooperation with third countries.

Would a new Action Plan for the period 2017–2020, as foreseen in the EU Drugs Strategy, be useful and necessary? If so, is there anything to be changed (beyond the actual actions) in the new Action Plan compared to the current one? What would be the most urgent issues to be tackled by the new Action Plan?

The evaluation found widespread agreement that there is a continued need for an Action Plan. An Action Plan was considered as a necessary operational translation of the EU Drugs Strategy since it allows for the community to set out more precise priorities and actions, as well as to assign responsibility and formulate specific and measurable indicators. The evaluation therefore recommends that the Commission should propose a new Action Plan for the period 2017–2020 in order to continue translating high-level objectives into concrete action. Very few stakeholders identified priorities that should no longer be included in the Action Plan. Instead they suggested continuing the emphasis on ongoing actions whilst further emphasising and developing certain priorities. The evaluation therefore recommends that the new Action Plan should be an updated version of the current one, rather than taking a new approach or introducing more actions.

Cross-Cutting Conclusions

Looking across the answers to the 13 evaluation questions the following key, cross-cutting messages emerge.

The EU Drugs Strategy's horizontal pillars (coordination, international cooperation and information, monitoring, research and evaluation) have important institutional-level impacts. The Strategy encourages coordination of law enforcement activities and in relation to how the EU and Member States interact with third countries and international organisations. It also champions the value of data collection and research. In these ways, the Strategy adds value to the individual activities of Member States.

The EU Drugs Strategy articulates a consensus among Member States as to the key features of effective drugs policy. This consensus has been built up since the adoption of the EU Strategy in 2013. All Member States have some form of drugs strategy and most strategies are coherent with the five-pillar structure of the EU Drugs Strategy. The EU Strategy encourages rather than drives change in national drugs policies, but remains relevant to Member States by providing a “wish list” of policy options that are considered as sensible, feasible and effective, and can guide new Member States and candidate countries that need to comply with the acquis.

The EU Drugs Strategy and Action Plan are comprehensive in identifying the relevant actors who play a role in a holistic and multidisciplinary approach to drug policy. There is a need to constantly review coordination mechanisms and processes to ensure that all relevant stakeholders are considered, and to keep pace with the ever-evolving institutional landscape and the changing nature of the drugs situation.

Overall, the evaluation finds that the EU Drugs Strategy covers the main issues that Member States want to tackle nationally across the five pillars, according to their national situation. There is appetite among all stakeholders for a new Action Plan to cover the period 2017–2020, and for that Action Plan to have a similar structure to the current one.

There are some issues on the horizon which might usefully be considered in the run-up to an EU Drugs Strategy for 2020 and beyond. These include changes in the types of NPS available, changing modes of trafficking drugs (including the Internet), the ongoing debates about cannabis reform, and a trend towards placing responses to drugs in the context of pan-addiction policies covering licit (such as tobacco, alcohol or prescription drugs) and illicit substances as well as non-drug-related addictive behaviours (such as gambling).

Recommendations

The evaluation makes 20 recommendations, addressed to the European Commission, Member States, the Council and other stakeholders.

The key recommendation for the Commission is that it should propose a new Action Plan for the period 2017–2020 in order to continue translating the objectives of Strategy into concrete operational steps and activities. It is further recommended that the new Action Plan should be an updated version of the current one, rather than taking a new approach or introducing many more actions.

Recommendations made by the evaluation:

  • Member States should focus on the design and implementation of evidence-based prevention and treatment programmes with the aim of addressing drug-related harms and decreasing the prevalence of drug use.
  • The next Action Plan should maintain the focus on improving the availability and quality of data about trends in use, the nature of drugs and the effectiveness of prevention and treatment. Key actors responsible for this are the EMCDDA and Member States.
  • There should be ongoing dialogue between the European Commission and the Council with civil society stakeholders to continue to involve them in the policymaking process.
  • There should be a continuation of efforts by Europol, Eurojust and the EMCDDA to enhance supply reduction activity indicators and data collection to inform those indicators. Data collection should be complemented with qualitative, contextual information to obtain a more comprehensive picture of the impact of supply reduction efforts.
  • A review of current coordination mechanisms between the HDG and the Standing Committee on Operational Cooperation on Internal Security (COSI) should be undertaken to identify opportunities for: the HDG to better monitor the implementation and impact of the supply reduction priorities of the Strategy; supply reduction activities as part of the Organised Crime Policy Cycle to be linked, when appropriate, to the objectives of the Strategy (and communicated accordingly); and synergies between supply reduction activities and other pillars of the Strategy to be identified. Greater communication between these working parties could be encouraged through: regular sharing by COSI of relevant reports with HDG on activities relating to the supply reduction priorities of Strategy and Action Plan (e.g. based on EMPACT reporting); regular (e.g. every six months) attendance by COSI (e.g. the COSI chair) at HDG meetings, in which, for example, a recurring agenda item on supply reduction is discussed, and vice versa. The European Commission could play a role in facilitating coordination, given its attendance at both the HDG and meetings related to the Organised Crime Policy Cycle.
  • The Commission should continue engaging with and providing support to the CSF, in particular in relation to its activities in countries with comparatively weaker civil society. Lessons from the evaluation of the Commission's Communication on Combatting HIV/AIDS in the EU1 showed that legitimacy conferred by EU institutions was one of the factors facilitating and strengthening the role of the HIV Civil Society Forum.
  • The Commission and Council should build on the momentum from the successful negotiation at UNGASS to continue to foster dialogue with the UN and identify opportunities for further dialogue through other international fora, in order to exert greater European influence on shared concerns in the area of the drugs phenomenon and to ensure coherence between the EU and international strategies in the coming years, and prepare for the 2019 Special Session.
  • Continue sustained work to promote the balanced approach in third countries. When the concept of harm reduction is not accepted by partners during negotiations and dialogues with third countries, the EU should strive as much as possible to ensure that practices and approaches encompassed under the concept are reflected.
  • The European Commission in partnership with the EEAS could take steps to increase and ensure a consistent level of knowledge among EU Delegations of the EU Drugs Strategy and Action Plan and provide guidance to EU Delegations as necessary. This could support the EU Delegations' role of analysing drug policy developments in third countries and reporting these developments back to the European Commission and EEAS.
  • The Commission should promote structured mechanisms to capture the impact of EU-funded projects. The results should be in turn used to inform the Annual Research Dialogue and the design of calls for research proposals.
  • The EMCDDA and Member States should ensure national and EU funding for the Reitox network is commensurate with the data and analytical outputs expected to be delivered by the network. Where it is not commensurate, formal prioritisation of monitoring and data collection activities may be necessary.
  • The five-pillar structure of the Strategy and Action Plan should be maintained to continue to address current needs.
  • The possibility of creating an EU pan-addiction strategy could be considered in the coming years, including both substances (illegal drugs, alcohol and tobacco, prescription medications, NPS) and behaviours (primarily gambling). A careful investigation should be conducted to consider: the advantages and disadvantages of such an approach; the extent to which there is support for this among stakeholders; and the key actors and institutions at the EU level with whom coordination would be needed to develop such a strategy.
  • A future Action Plan should continue to include actions to monitor NPS, to reduce demand for and supply of them, and to reduce harms associated with their consumption. A priority should be placed on adopting EU legislative measures to address the emergence, use and rapid spread of NPS as quickly as possible in 2016/7.
  • A future EU Action Plan should continue the focus on EU-level activities in relation to international cooperation.
  • The potential developments in cannabis policy, including decriminalisation and/or legalisation, as well as the potential consequences of this for other Member States and the EU should be considered, for example at the HDG meetings.
  • Coordination and cooperation should be enhanced at the EU level to ensure greater alignment between the objectives of the EU Drugs Strategy and the relevant objectives of the EU Health Strategy.
  • The ongoing dialogue with regions and third countries should be carried through into a future Strategy and Action Plan in order to ensure continued benefits resulting from these actions.
  • The Commission should propose a new Action Plan for the period 2017–2020 to continue to translate the Strategy into steps and activities that can be taken in relation to the drugs phenomenon.
  • The new Action Plan should be an updated version of the current Action Plan, rather than taking a new approach or introducing more actions.

The research described in this article was prepared for the European Commission Directorate-General for Migration and Home Affairs and conducted by RAND Europe.

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Note

  • 1 Hofman, J., Exley, J., Bienkowska-Gibbs, T. et al. (2014) Evaluation of the implementation of the Commission Communication “Combating HIV/AIDS in the European Union and the neighbouring countries, 2009–2013.” Santa Monica, CA: RAND Corporation.

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