(6 years ago)
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Lloyd Russell-Moyle (Brighton, Kemptown) (Lab/Co-op)
On 1 December 1988, we observed the first World AIDS Day. It was created as an international day to raise awareness of the AIDS pandemic caused by the spread of HIV and to mourn those who had died from the disease. In two days’ time, we mark its 30th anniversary, and this event gives us pause to reflect on how far we have come and to remember those we have lost.
Such events are also deeply personal to me, because next year I will be marking an anniversary of my own —10 years since I became HIV-positive. It has been a long journey from the fear of acceptance to today and, hopefully, advocacy, knowing that my treatment keeps me healthy and protects any partner that I may have.
When you are first diagnosed, you get that call from the clinic and they just say, “You need to come in.” They do not tell you the details, and you know immediately that something is wrong. All the different worst-case scenarios flash through your mind, and of course, being a sexually active young man, HIV is one of them. Going in, you kind of know that something is wrong and it might well be serious, but at the same time you are working out all the ways that this is just some joke, some technical error, some tiny thing they are going to tell you that you will be laughing about later. You try to imagine the ways you are going to get out of this, and then in that NHS room, with those cream carpets and the plastic seating we all know, they tell you, and it hits you like a wall. Although you have prepared yourself for it in your mind, nothing quite prepares you for when they say those words. I remember looking up at that ceiling—those false ceilings you get—and wishing that one of the tiles would rip away and it would suck me up, and that I would wake up and it would all be a dream and all be over.
But, of course, the reality is that that is not what happens. Instead, you walk out of that room and, even with all the greatest support and advice that they offer, you feel totally numb. You have a million things running through your mind and, at the same time, a sense of absolute nothingness.
I have decided to make this announcement and speech today, because earlier this year I was at an awards ceremony in Brighton. I had nominated Gary Pargeter, who for a number of years has been running a local club for people living with HIV called Lunch Positive. He had won the award and people were coming up to talk about how important the project was and how brave he had been to talk about his HIV status, and I felt like, “I am watching someone who has done inspiring work, and I am proud to have nominated him, but I have not told anyone else in this room that I am HIV positive, too.” Just like so many who attend Lunch Positive, I am lucky because the medication means I will not get sick and I cannot transmit HIV. I felt that if Gary and so many others can talk openly about it, then so should I.
The second reason I wanted to have this debate today is because we are genuinely on the cusp of eradicating new HIV transmissions in this country. Figures today show that we are already, in parts of this country, halting the rates of HIV diagnosis, but we are at a fork in the road and I worry that we might be starting to head in the wrong direction, with £700 million of cuts to public health having been made between 2014 and 2017. We are not investing in the universal roll-out of PrEP—Pre-exposure prophylaxis—the pill that prevents HIV. So it is important for me politically to speak out.
Finally, I wanted to be able to stand here in this place and say to those who are living with HIV that their status does not define them and we can be whoever we want to be, and to say to those who have not been tested, perhaps out of fear, that it is better to live in knowledge than to die in fear. HIV in this country is no longer the death sentence it once was. A recent study led by the University of Bristol found that due to the advances in HIV treatment, people living with HIV can expect to live a near normal life. The improvement in survival rates for people with HIV is one of the greatest success stories of recent times. What was once considered a terminal disease is now seen as a manageable condition. Yet this information has not changed the narrative, which is still, sadly, framed in those scare campaigns of the tombstones of the 1980s. So much of LGBT culture also is marked by this spectre of HIV, which has led to an incredible sense of fear about the disease.
In that hospital room, and in the days and weeks that followed, I had to come to terms with that fear myself. I am a HIV-positive man, but because I have been taking the right medication for several years I am what the NHS calls “HIV-positive undetectable”. That means not only can HIV not be detected in my system and so I do not get sick, but I cannot transmit HIV to someone else. As the virus lie undetectable and dormant in my body, my medication ensures that the virus does not reactivate, does not progress and cannot be passed on. That is why the NHS says “undetectable equals untransmittable”. UNAIDS highlights three large studies conducted between 2007 and 2016 of HIV transmissions among thousands of couples where one partner was positive and the other was negative. In those studies there was not a single case of sexual transmission of HIV from a positive undetectable person to a HIV-negative partner. It is safer to have sex with someone who is HIV-positive undetectable than with someone who does not know their status, because undetectable equals untransmittable.
Understanding that I was unable to transmit HIV sexually has been life-changing, too. I went from thinking that I would never have a HIV-negative partner, or that if I had sex with someone, I could pass this on, to knowing that I can live a normal life and that any partner I have is totally protected. I cannot transmit HIV to my sexual partner, I have a perfectly healthy life, so my announcement here today should go totally unnoticed—
Mr Tanmanjeet Singh Dhesi (Slough) (Lab)
My hon. Friend is being immensely courageous in what he is doing today. I, for one, am sure that his bravery will reduce the stigma and the fear of so many living in our country and beyond.
Lloyd Russell-Moyle
I thank my hon. Friend for that. He is right to say that my name will help those people, and it might appear in tomorrow’s newspapers as a result of my being the first MP to declare themselves HIV-positive in this Chamber and the second, after only Chris Smith, to openly live with HIV as an MP.
Karen Lee (Lincoln) (Lab)
I just want to say what a typical gesture of my hon. Friend this is and how proud of him we all are.
Lloyd Russell-Moyle
Perhaps foolishly, to gauge what the public reaction might be like, I went on social media to read some of the comments on recent HIV news stories. One does not have to scroll down far to find comments like:
“Anyone with HIV who has sex should be tried for murder”,
or
“fags getting what they deserve”,
or “disgusting lifestyle choice”. Now, most of the people behind such comments will be homophobes who are weaponising HIV to attack LGBT people. If it was not HIV, they would find something else, because they are haters and they are not pleasant people.
But HIV stigma is not just a symptom of homophobes. Even the most well-meaning people can perpetuate HIV stigma. It takes many shapes. It can be believing that HIV and AIDS are always associated with a death sentence. It can be thinking that HIV is transmitted only through sex. It is thinking that HIV infections are the result of some personal or moral fault. It can be believing inaccurate information about how HIV is transmitted, which in turn creates irrational behaviour and misconceptions about personal risk.
Before I was diagnosed, I myself perpetuated some of those stigmas, so it is not without judgment that I ask people to reflect; it is a genuine ask that we begin to think, talk and act differently when it comes to HIV. That is even harder when there is a taboo about talking about sex, which means that stigma is often compounded, thereby creating a more risky environment because people do not seek the treatment that they need.
The Sussex Beacon in my constituency is one of only two residential care facilities in the country for people living with HIV. It originally started as a hospice in the 1990s, when three to four people died there each week. Fortunately, end-of-life care is now a rare occurrence at the Beacon, and today most of its support services are utilised by people with HIV from marginalised groups who face a big stigma. Older people diagnosed late, women, black and ethnic minorities—all these groups are disproportionately affected by stigma and rely on the good work of the Sussex Beacon and other charities like it. But their funding is being reduced.
Yesterday, I was lucky enough to get a photo with Stiggy the Stigmasaurus at the Martin Fisher Foundation, as part of the foundation’s campaign to make HIV stigma history. I hope that Members who could not be there yesterday will be able to join me in that pledge going forward. Stigma causes a treatable disease to become life-threatening, because of the impact on an individual’s mental health and their access to medication. No person diagnosed with HIV today should feel any less able than anyone else to thrive and enjoy life because of their status.
Stigma is not just a UK problem; it is a global one. Fifteen years ago, 200,000 people around the world were receiving treatment for HIV. Today, the number is 22 million, but we still have 15 million more who need access to regular medicine.
Jim Shannon (Strangford) (DUP)
First, may I thank the hon. Gentleman for bringing his personal story to the House today? I mean that very much. I also wish him continued good health and that he continues to prosper, as he quite clearly is doing.
I mentioned to him before the debate that I wanted to intervene, and I wish to bring to his attention the Elim church in my constituency. The church has an HIV programme in Swaziland, which has the highest levels of HIV in the world. Every year, the children from a choir group come over. Every one of them is HIV-positive, but every one of them is surviving today because of the medication that is available. If the medication is there, we can do lots of things, save lives and give opportunity. Among many churches and individuals around the world, there is a lot of good will to help.
Lloyd Russell-Moyle
That is quite right.
We are making progress on treatment, but when it comes to stigma we still have so much further to go. Last week, I was in Kenya with the International Development Committee and met a HIV-positive mother of eight children from the Democratic Republic of the Congo. Although she was on medication, she had suffered such abuse that she was forced to flee the DRC and now lives in a refugee camp. Because of the prejudice and violence that she faced as a result of her status, she was forced to leave without her children, and she knows not of their future.
Jeremy Corbyn (Islington North) (Lab)
I thank my hon. Friend for giving way. He is making an absolutely brilliant and historic speech. I am very grateful that he mentioned my good friend, Chris Smith, who very bravely told the world in 1984 that he was gay and proud of it, and we are proud of Chris for doing that. I am also pleased that my hon. Friend has brought up the international context, where there are appalling levels of prejudice and abuse against HIV-positive people and against the LGBT community of many countries around the world. We just need to send out a message from this House of Commons that this country has changed its attitudes. We have done a great deal medically to help people. We need to ensure that the rest of the world understands that we can do the same in every other country. We have to close our minds to prejudice and open up our minds to human rights and justice for people all across the globe.
Lloyd Russell-Moyle
I thank my right hon. Friend for his intervention, and I totally agree with him. There are some countries in the world I may now struggle to travel to because of this announcement. It is important that we continue to make international efforts. I do not have time to talk about all the international aspects here. I commend the work of the HIV/AIDS Alliance and plan to come back to this House in future months to talk about its ENDAIDS 2030 Festival, which is really important.
Turning back to the UK, it is the case not just that HIV is treatable, but that it is preventable with one tablet a day. A person can prevent themselves from contracting HIV with pre-exposure prophylaxis. PrEP is revolutionising the fight against HIV transmissions. It has an almost 100% success rate, a higher rate than condoms, in the prevention of HIV, and it is just one pill. We expect this pill to be soon available as a generic drug and, according to the NHS’s own analysis, it could save the health service £1 billion in preventing HIV transmissions for future generations. Astoundingly, however, the only way to access PrEP in England is through a limited trial. This is not a medical trial—those have been done and approved. This is not about financing—we know the cost. This trial, as far as I can see, is about delaying the roll-out of PrEP in England because someone meddling in the Ministry thinks that they know better than doctors when it comes to people’s health. It seems to me that this trial is more concerned about what a person does between the sheets than the health of the nation. Despite being just one year into this three-year trial, 3,000 additional places have already had to be added, and it looks like the 13,000 places will run out early next year. England now lags behind all the other nations in the UK as the only country with capped PrEP access on the NHS. There are two years to go until this trial ends, yet people cannot get immediate access to PrEP, with many clinics now having long waiting lists, and some completely full.
We know that there are cases of young men who have sought out this prevention pill and have been turned away because the clinics cannot accommodate them, and they have subsequently become HIV-positive. Those men now have to live with HIV and everything associated with it because of the misguided morality of this decision. Let us make no mistake: these are not isolated cases. The longer this Government wait to roll out PrEP properly, the more people will be diagnosed.
Will the Minister intervene to ensure that PrEP is made routinely available on the NHS in England—just like his Government have already done with Northern Ireland with direct rule, just like the Scottish Government have done, and just like a Labour Government have done in Wales? Failing that, will he at least uncap the trial to ensure that those trying to access the drug can do so? Will he reverse public health cuts, including those in sexual health, so that the Government meet demand, including that of people affected by HIV, otherwise we seriously risk undoing the really good progress that we have all made?
Just today, the latest Public Health England statistics show that the UK has met its UN AIDS target of 90-90-90, ahead of 2020, which was the date. This is amazing progress, with 92% of people living with HIV diagnosed, 98% on treatment and 97% with undetectable viral load, meaning that they cannot pass it on.
At the Terrence Higgins Trust World AIDS Day reception earlier this week, I am told that the Minister hinted that the Government were considering bolstering their ambition on HIV to committing to reaching zero new HIV transmissions by 2030. In the light of today’s statistics, now is the time to seize that opportunity of reaching zero new HIV infections and be a true global leader. Can the Minister provide details of how the UK Government plan to end HIV infections and what timescale they will commit to?
At present, one young person every day is still diagnosed with HIV and young people continue to suffer some of the worst sexual health outcomes. We cannot be complicit on this. Will the Minister agree to work with the Department for Education to ensure that relationship and sex education guidance has a strong focus on not only HIV prevention, but anti-HIV stigma? Will the Minister also liaise with Department for International Development colleagues to ensure that research funding is increased so that we can make huge gains in scientific breakthroughs to eradicate this disease globally?
In two days’ time, on World AIDS Day, I will stand with my community to mourn the losses of those who have died of AIDS. I will do so at the Brighton AIDS memorial—the only such dedicated public memorial in the country. I will stand there in the knowledge that I will live a life that so many could not. I am able to do that because of the people who have come before me: the people who have fought and lost their lives, and the people who stood up and had their lives changed. We owe it to these people to beat the disease—something we have the power to do. I hope that future generations will look at HIV in the same way that we look at smallpox and polio, as diseases that were once killers but can now be eradicated.
LGBT people often talk about coming out as something that you constantly have to do to new neighbours, friends and work colleagues. You could say the same about your HIV status. I have spent many nervous moments deciding whether to tell new friends and acquaintances about my status. The lump forms in your throat and your heart flutters, and you finally kind of blurt it out and hopefully move on. Well, Mr Deputy Speaker, I would like to thank you for giving me this platform to do just that. I thank my friends, family and colleagues for supporting me. I also thank the Terrence Higgins Trust for all its work and the support it has given me in preparing for this debate.
We have the ability to end new HIV transmissions, as well as to end stigma and discrimination—not only here, but globally. I hope we can all make that our mission. [Applause.]
Mr Deputy Speaker (Sir Lindsay Hoyle)
We should not clap in the House, but I understand why people have. That was a very brave and moving speech, which will give hope to a lot of people around the world. I should also say that I broke with convention today by allowing an Opposition Front-Bench Member to speak in the Adjournment debate. Please be reassured that this is not the norm; it is a one-off.
Stephen Doughty (Cardiff South and Penarth) (Lab/Co-op)
As chair of the all-party group on HIV and AIDS, may I first offer a whole hearted tribute to the bravery, courage and example of my hon. Friend the Member for Brighton, Kemptown (Lloyd Russell-Moyle)? He has not only shared with us his own very personal experiences in such a clear and honest way that will have an impact in this country and globally; he has also—I would expect nothing less from him—not shied away from the fact that HIV is political. He has mentioned many of the issues still faced by those living with HIV in this country and around the globe, including stigma, discrimination and a lack of access to services. If any message goes out from here today, it should be that we need to continue the fight and end this by 2030, and we can end it. After the example that my hon. Friend has shown today, I am all the more confident that we will do so.
I also pay tribute to my hon. Friend on behalf of other vice-chairs who wanted to be here but could not—Baroness Barker, Lord Black, and my hon. Friend the Member for Stockton South (Dr Williams)—and who are incredibly proud of what he has done today.
As my hon. Friend said, the situation has dramatically transformed since the first World Aids Day 30 years ago. I remember coming to these issues while working in the international development sector for World Vision, Oxfam and others, and I look back at some of the horrific statistics, particularly on young people orphaned or made vulnerable, on those living with HIV and on those dying from AIDS. We saw this as an unreachable mountain that could not be overcome. The progress that has been made over the past 15 years is remarkable, but we must not have a slipping back in that progress.
Patrick Grady (Glasgow North) (SNP)
I would like to express, on my own behalf and that of my SNP colleagues who cannot be here, our commendation for the incredibly powerful and moving testimony that the hon. Member for Brighton, Kemptown (Lloyd Russell-Moyle) has given. The hon. Member for Cardiff South and Penarth (Stephen Doughty) is absolutely correct that that speech will be heard not just here, and not just across this country, but around the world. It provides an opportunity to tackle the stigma that is still associated with HIV in so many parts of the world and that prevents people seeking the treatment, or even the diagnosis, that they need, despite all the opportunities and all the funding that is provided. There has to be a change of mindset as well. So we are thoroughly behind what we are hearing today.
Stephen Doughty
I thank the hon. Gentleman for his intervention and completely agree with what he has said.
As my hon. Friend said, access to antiretroviral treatments has revolutionised both treatment and prevention. That has enabled many HIV-positive people to achieve viral suppression where the level of HIV in the blood is so low that it is undetectable and, crucially—we have to emphasise this—untransmittable to others. U=U—undetectable equals untransmittable—is one of the messages that must ring loud and clear from his speech and from this House. It has transformed the medical understanding of HIV from a fatal and emergency disease to one that is chronic and manageable, and where people can live long, happy, healthy lives.
But we must recognise the challenges that exist, particularly internationally, among the world’s 36.9 million people living with HIV. That is still a huge figure. One in four remain unaware of their HIV status. Among those who have tested HIV-positive, 21% globally do not have access to treatment and, of those who have access to antiretroviral treatment, 19% have not yet achieved viral suppression.
I want to turn briefly to some of the key challenges that we face in the UK, which my hon. Friend laid out. Forty-one per cent. of people are still diagnosed late and one in eight people living with HIV do not know their status. In October, we held an event here where we heard from a lady who preferred not to use her real name who had been diagnosed with HIV in her late 50s. She had been left with lifelong physical complications and, tragically, suffered a mental health breakdown because of the extreme stress caused by the diagnosis, the lack of support, the fear, the stigma and the discrimination that she thought she would experience. Holding back tears, she told that room full of strangers that she had been unable to share her HIV status with her friends or family. That shows the courage of the example set by my hon. Friend today. Unfortunately, there are still many people out there, including many I know, who would not have the confidence to do this or even to share their status in private circumstances. We have to turn that around and end the stigma and discrimination.
I absolutely endorse what my hon. Friend said about PrEP. It is simply extraordinary that we are still waiting for the English NHS to make this routinely available. People have told me this week that they want to access PrEP and cannot do so. That simply cannot be the right way forward, from a purely public health point of view, from a rights point of view, and from a cost point of view. In all respects, it is wrong. I hope that the Minister can give us some positive news on that and that we will see the progress that we have seen in the other nations. I pay tribute, as my hon. Friend did, to our Labour Health Secretary in Wales who has shown quite a lot of political and practical leadership, as a Minister, on this issue.
I was disappointed when we had the Department of Health and Social Care prevention strategy last month. there is much in there for us all to agree with, while it failed to mention sexual health at all. That was a huge disappointment because there is a huge amount in the strategy that very much applies to the agenda that we have been talking about today. I hope that the Minister can explain what the Department is going to do to ensure sexual health and HIV prevention are at the heart of that prevention strategy for the NHS overall. I also emphasise what my hon. Friend said about demand for sexual health services rising and the challenges facing particular communities, whether the BME community, the LGBT community, young people, sex workers or injecting drug users. Sometimes we shy away from talking about unfashionable and difficult topics in this House, but we need to have honest and frank conversations if we are going to end HIV and AIDS in this country.
Globally, there are still 15 million people who are not accessing treatment because of inadequate health systems and funding, discriminatory laws, stigma and discrimination, and colonial-era laws that ensure that people do not get the treatment they need. The UK needs to lead the way in ending HIV stigma for good and supporting these programmes through the work of the Department for International Development.
I pay tribute to the Minister of State, Department for International Development, the right hon. Member for North East Bedfordshire (Alistair Burt), who announced at the AIDS conference in Amsterdam an increase in funding for the Robert Carr Fund, for which so many of us have campaigned, and support for civil society organisations to support key populations.
It was inspiring yesterday to hear from not only a young female AIDS activist from Zimbabwe called Audrey, but two former Presidents—the former President of Botswana, Festus Mogae, and the former President of Mozambique, Joaquim Chissano. President Mogae spoke to us in a way that I did not expect. He spoke about all the things that we know we need to do to tackle HIV, but he stood up as a former African leader and said, “We need to address the needs of the LGBT population, the needs of the trans population, the needs of sex workers and the needs of injecting drug users.” That sent an incredibly strong signal to leaders across Africa and the world that we must talk about these issues and take action on them, and I hope the UK will continue to provide that crucial support.
I pay tribute again to my hon. Friend the Member for Brighton, Kemptown for his courage and bravery and the message that it sends. I hope the Minister will have some hopeful words for us about the situation in the UK. I want to end by thanking all the organisations that do so much to support our APPG’s work, including the Terrence Higgins Trust, the National AIDS Trust, the International HIV/AIDS Alliance, STOPAIDS, Youth Stop AIDS, the British Association for Sexual Health and HIV and so many more. I thank all the organisations that are active in our communities and, I am sorry to say, are filling the gaps left by cuts to provision. They are out there making the case, supporting people living with HIV and taking us all down the road to ending this epidemic by 2030.
Emma Dent Coad (Kensington) (Lab)
I would like to commend all those who have spoken, and particularly my hon. Friend the Member for Brighton, Kemptown (Lloyd Russell-Moyle) for his bravery in speaking out in this place. I am sure his speech will be heard around the country.
As a graduate of the 1980s London club scene, I know that I had a narrow escape from contracting HIV. I remember the stories in the early ’80s coming from San Francisco about people dying from minor ailments such as flu. It was originally thought to be something to do with taking too much amyl nitrite, or poppers. Eventually the virus was identified, but it was too late for some. Quite a few of my friends became ill, and we had many funerals in the mid-‘80s.
I remember the London Lighthouse project opening just down the road from my house, and Diana, Princess of Wales, came to open it. She did a huge amount to disperse the stigma. We will never forget the photograph of her holding hands with an HIV/AIDS sufferer, which made people think again about how we contract AIDS and showed pure compassion for people who were ill.
I was careful, but before I had my children, I had an HIV test. The results took an agonising two weeks. I was fine. I know that people diagnosed with HIV now live long and healthy lives with the treatment currently available, but I hear anecdotally that, because of that, some people are not being sufficiently careful with their health. Two weeks ago, I took the test again in my local hospital, having been asked to do so as part of the campaign. It now takes two minutes—you get the result immediately. Nobody needs to risk contracting HIV, but if anybody does, I recommend that they spend those two minutes to save their lives and those of their loved ones.
Thangam Debbonaire (Bristol West) (Lab)
I want to add my support for the campaign that my hon. Friend mentioned. I too did that. I think those working for the Terrence Higgins Trust referred to it as “pricking the finger”, or some quite naughty expression, when it suggested that I could show that it is not that difficult and does not take that long, and there is counselling and support around it. I recommend that any Member who has not already taken the plunge does so and shows HIV/AIDS the finger. I thank her for raising that.
Emma Dent Coad
Absolutely. I recommend that everybody does so. It literally takes two minutes.
I would like to finish by saying that, as regards ending the stigma, my hon. Friend the Member for Brighton, Kemptown has made a very powerful statement. This is your Diana moment.
The Parliamentary Under-Secretary of State for Health and Social Care (Steve Brine)
That was an unexpected but lovely thing for the hon. Member for Kensington (Emma Dent Coad) to say at the end of her speech. I believe “Give HIV the finger” is the expression that the hon. Member for Bristol West (Thangam Debbonaire) was looking for. Wow! Madam Deputy Speaker, you have just taken over in the Chair, and you have missed a treat. I suggest that you watch it back later. Let me, as it says in my brief, congratulate the hon. Member for Brighton, Kemptown (Lloyd Russell-Moyle) on securing the debate. Obviously, I share his passion for the topic, but I did not know what he was going to say until we spoke just before the debate, and even then I did not know how he was going to say it and the extent to which he was going to put so much of the personal into it.
The turnout of the hon. Gentleman’s friends and colleagues around him for his speech was a testament to its power and to how much they obviously think of him. Clapping is not right in the Chamber, but even I did clap after his speech. I do not like to clap in the Chamber or in church, but I have done one of them. The look on his face when his colleagues were all standing up and clapping him was wonderful. If I had thought to do so, I would have stood up and taken a photo for him, because it will be a nice moment for him. [Interruption.] No, Madam Deputy Speaker, you are not at all happy about that. I have gone too far. Edit that bit out, Hansard.
It was an incredible speech and it was a very brave thing to do. Following the debate that had just taken place on education—we were here for the winding-up speeches—which got a little political at times, the Adjournment debate has once again shown that it is Parliament’s best kept secret. It is where all the good things go on, and this was certainly a good thing.
As the hon. Gentleman reminded us, World AIDS Day is 30 years old this year. We had a wonderful reception in Speaker’s House on Tuesday night, with the Terrence Higgins Trust, and some really good friends were there. It is the second time I have done that now. As I said then, this week and Saturday will be about remembering loved ones who lost their challenge against and their battle to HIV. However, it will be a celebration, as he said. I note that he said that he will be at the Brighton AIDS memorial at the weekend, and I wish him well with that, as I do everybody who will be with him from his constituency and, I am sure, from much further afield. This is also a chance to say to say how much has changed since the late ’80s.
Eddie Hughes (Walsall North) (Con)
I just want to say briefly how fortunate I feel I am to have been walking past the Chamber, seen that there was this debate and taken the opportunity to come in. My first wife was a nurse, and I remember when she came home from work—I think 27 years ago—having just treated her first AIDS case, and we were both scared. Since then, the treatment of it and the understanding and appreciation of it in society have changed so dramatically. I realise now, having heard the speech of the hon. Member for Brighton, Kemptown (Lloyd Russell-Moyle), that there is still some way to go for those who are hesitant about telling new friends and acquaintances, but it felt like a genuine privilege to have been here to hear him speak, so I thank him very much.
Steve Brine
I thank my hon. Friend for his intervention.
As I was saying, much has changed since the late ’80s: health needs are different; we have better drugs and better diagnostic tools; and, as has been said, attitudes towards HIV and AIDS are totally different and totally transformed.
The hon. Member for Kensington mentioned Princess Diana—the original one, as opposed to the new one—and that incredible moment. I will repeat what I said the other night in Speaker’s House. I was in secondary school at that time, and I remember that powerful image being broadcast. I was only a teenager at the time, and little did I know that I would one day be the public health Minister talking about these issues. It was one of those images that is really seared into our national conscience. What a great loss that lady is to so many social causes, as well as of course to her family. It was an incredible image.
As the hon. Member for Brighton, Kemptown has said, today, it is not about dying of AIDS, but about living with HIV. I would go further, however, because it is about more than that, is it not? It is not really “living with”; it is just “living”. I am also very privileged to be the cancer Minister, and how many times cancer patients say to me—my shadow, the hon. Member for Washington and Sunderland West (Mrs Hodgson), knows this, because people very often used to say this to us when we ran the all-party group on breast cancer together—that, “I am not my cancer. It is just something that I do and something that I have as well.” Happily, HIV is now just part of the hon. Gentleman: I am sure he would rather it was not, but it is not just something he lives with; it is something that he lives.
A big public health display in the foyer of the Department of Health and Social Care currently shows all the different public health campaigns over the years. The terrifying tombstone image is obviously something that we have, rightly, moved on from, but it is still an incredible part of our public health campaign history. Back then, the Government made the bold move to run a major public information campaign on HIV—“Don’t die of ignorance”—and we piloted needle exchange schemes, introduced HIV testing and raised the prospect with the public. If we consider the HIV epidemic in this country, we can be proud of the record of Governments of all parties over many years.
As figures released today show, the UK has met the UNAIDS 90-90-90 target—yes!—and it is one of the first countries in the world to do so. Members from across the House are proud of that, and the latest report from Public Health England showed that in 2017 an estimated 92% of people living with HIV in the UK were diagnosed, 98% of those were on treatment and 97% of those on treatment were unable to pass on their infection. That is a major achievement that we should be proud of. More importantly, those who work in our health service and have done so for years—like the partner of my hon. Friend the Member for Walsall North (Eddie Hughes)—should be even more proud.
Prevention is one of my passions, and one of the Secretary of State’s priorities. We do not yet have a cure for HIV, which is why prevention is so important. Our efforts to prevent HIV and AIDS have been highly successful, and much has been said about the international dimension, which I will touch on. The UK is a world leader in efforts to end the AIDS epidemic, including through our major investment in the global fund. Our largest investments are through multilateral organisations such as the Global Fund to Fight AIDS, UNAIDS and Unitaid, given their greater reach and scale. I met Lelio from Unitaid at the G20 in Argentina last month, and it is doing such good things with the investment that we announced in Amsterdam, to which the hon. Member for Cardiff South and Penarth (Stephen Doughty) referred. I work closely with my hon. Friends in the Department for International Development and the Foreign Office, and these three Departments are very tight and work closely together on this issue.
Excellent initiatives such as the MenStar Coalition aim to get more young men tested and on to life-saving HIV treatment to protect them and their partners. There is the Elton John AIDS Foundation and other partners, and MenStar is rolling out a self-testing campaign in east Africa. The UK is the second largest donor to Unitaid—a charity that does so much work against stigma—and provides an annual contribution of around €60 million as part of our 20-year funding commitment.
There has been much talk about the domestic situation, and NHS England launched the world’s largest pre-exposure prophylaxis—PrEP—trial last year. To be honest, I had never heard of that until I became a health Minister—why would I have?—but once officials had explained it to me, it did not take me long to think that it sounded like a real no-brainer. I know that many people are eagerly awaiting the results of the trial. I am one of them, and my officials know of my impatience, which is legendary in our Department. It is crucial to have the right information to address the major questions and effectively implement the PrEP trial on a larger scale.
The point about savings was well made and not lost on me. I am not in a position to make a policy promise at the Dispatch Box today, but on the point about places made by the hon. Members for Brighton, Kemptown and for Cardiff South and Penarth, I say only that I am listening closely and they should continue those discussions with me—I know they will. The Department met members of the all-party group on HIV and AIDS to discuss these issues, and they should continue those discussions with me. We are listening. Many of the public health challenges we face today require different approaches and fresh thinking if we are to make progress. Indeed, in the past few years many innovative ways to tackle HIV have emerged, including HIV testing options such as self-sampling and home testing services, which I know are very popular.
I would like to mention the HIV prevention innovation fund, which I am very proud of. Innovative community-led interventions have had a significant role to play in limiting the HIV epidemic in England, so we set up the HIV prevention innovation fund in 2015 to support voluntary sector organisations. The fund has supported many projects since it started. I announced them at an event here in the House last year—the hon. Member for Cardiff South and Penarth, who chairs the all-party group, was present. In 2017, we awarded just under £600,000 to 12 projects. I am very pleased to say that we are running the fund again this year. The principle of the fund is something we are carrying over into other areas of policy, because it has been so successful. I want to see us do more of that.
This year we celebrated the 70th birthday of the NHS. I have already mentioned the incredible staff who work across the service. England has an outstanding record of achievements in HIV treatment and care. I want to take this opportunity to recognise and thank everyone for doing that. Care for people with HIV is now highly effective, and increasing numbers of people are living with HIV into older age with normal life expectancy. Antiretroviral therapy has transformed the outlook for people living with HIV, from what used to be a tragic death sentence to a very manageable long-term condition, as we heard so eloquently this afternoon.
Our policy is to make sure that HIV testing is as accessible as possible, in particular to those at increased risk. It is therefore very important that testing is available in a range of clinical and community settings—hence why the innovation fund and its programmes are important. Over the years, local authorities, which are now public health authorities up and down the land, have introduced innovations and improvements of their own, in particular on testing. We know it is working. Testing activity at sexual health services, which we know are under great pressure—we do not deny that for one moment—continues to increase and HIV diagnoses have fallen. HIV testing in sexual health services has increased 15%, from 1.07 million tests in 2013 to 1.24 million in 2017. Most significantly, we have seen a 28% drop in new HIV diagnoses between 2015 and 2017. That is encouraging and good, but we must not be complacent. I assure the House that we are not complacent and we want to continue to maintain this progress.
The hon. Gentleman mentioned the prevention strategy. That was a very top line document. I had a meeting this afternoon to discuss the prevention Green Paper, which will follow next year. I can assure him that the long-term plan, which will follow before that, will absolutely have sexual health and HIV in it. I am being very ambitious with officials on that. I know that he will rightly hold us to account and I thank him for giving me a chance to say that.
I want to touch on education and awareness. Education around HIV and how it is transmitted remains absolutely critical, as the hon. Member for Brighton, Kemptown said in his opening remarks. I am pleased to say that schools will be required to teach relationship and sex education from September 2020. The Government announced that relatively recently. I have been very involved in that in relation to the cancer brief, because I am very keen for schools to responsibly teach cancer awareness to young people. At secondary schools, there will be clear and accurate teaching about sexual matters, including factual knowledge around sex, sexual health—including HIV—and sexuality. The schools Minister was sitting next to me throughout his speech. He wanted me to pass on his congratulations to the hon. Gentleman on his speech.
Testing is the only way to be certain of HIV status. Last week was National HIV Testing Week and the Secretary of State took part. This flagship campaign promotes regular testing among the most at-risk population groups and aims to reduce the rates of late diagnosis or of those remaining undiagnosed. Sadly, stigma remains a significant factor in why people do not test for HIV. I understand that. This can mean that HIV goes untreated and can then be transmitted. It is vital that we continue to break down the stigma, normalise testing and support those most at risk of infection.
I want to mention the “Can’t Pass It On” campaign. Whoever is doing the marketing for the Terrence Higgins Trust is doing a very good job—I know it works with a very good agency. As I said at the reception the other night, I was on the tube the other day with my daughter, who spotted some advertising or branding for testing week. She asked me what it was, because it caught her eye, and I was able to explain it to her. She is only 11. If more parents did that for their children and relatives, it would help to break down that stigma. The trust’s website has a very good page on the “Can’t Pass It On” campaign that includes different people’s stories, and I have a funny feeling that before we leave the Chamber, “Lloyd’s story” will be on it, with a clip from today in Parliament. I will certainly be clipping it off the Parliament TV website and tweeting it out through the Department of Health’s social media account.
In conclusion, I congratulate the hon. Gentleman again on introducing this timely and vital debate, and I wish him and everybody well for Saturday who will be marking World AIDS Day, whether they be remembering and celebrating private, not yet able to do so publicly, and those who, like him, are able to do so publicly. They are all part of the story, and our best wishes and love go to them all. We look forward to brighter futures in this policy area, as we work towards what I am determined will be zero stigma and zero transmissions.
Madam Deputy Speaker (Dame Eleanor Laing)
Would it not be wonderful if more people paid attention to the work done in the House in such debates—this excellent, positive, meaningful, emotive and successful debate this afternoon? If only.
Question put and agreed to.