HIV Action Plan Annual Update 2022-23

(Limited Text - Ministerial Extracts only)

Tuesday 18th July 2023 Westminster Hall

[The Parliamentary Under-Secretary of State for Health and Social Care (Neil O'Brien)]

I pay tribute to my hon. Friend the Member for West Bromwich East (Nicola Richards) and to all other hon. Members present. A number of them have played leading roles in campaigning on this issue.

This afternoon, we have had an excellent debate, hearing important contributions about particular aspects of the challenge: my right hon. Friend the Member for Romsey and Southampton North (Caroline Nokes) on the dimension for women; the hon. Member for Brighton, Kemptown (Lloyd Russell-Moyle) on the opportunities for home testing; and the hon. Member for Vauxhall (Florence Eshalomi) on the importance to her constituency. We heard about the inspirational work of centres such as 56 Dean Street from my hon. Friend the Member for Cities of London and Westminster (Nickie Aiken) and about the searing personal experience of friends and families of people suffering and dying of this terrible disease from my hon. Friend the Member for Darlington (Peter Gibson).

[Andy Slaughter (Hammersmith) (Lab)]

I apologise, as I have not been present for the whole debate. May I mention one other clinic, 10 Hammersmith Broadway? I visited it recently and was hugely impressed by the staff and their partners in the community, such as the Terrence Higgins Trust. It is clear, however, that they are under increasing stress. The problem is that it only takes an emergency like the outbreak of mpox, or STIs going up, and routine services such as providing PrEP go on to the back foot. Will the Minister look at that, particularly in high-prevalence areas, because the limited cost is not worth the great risk involved?

[Neil O'Brien]

I am happy to look into that. We provided extra funding

in respect of mpox, but I will look into the issues the hon. Gentleman raised.

This debate is an opportunity to restate our joint commitment to tackling HIV and to reflect on the progress we have made since 2019, when the Government first announced our ambition to end new HIV transmissions, new AIDS diagnoses and new HIV-related deaths in England by 2030. As all Members know, 30 years ago AIDS was a fatal illness; today, when they are diagnosed early and have access to antiretrovirals, the majority of people with HIV in England can expect a near-normal life expectancy. People who are diagnosed with HIV can expect to receive HIV care that is world class, free and

open access.

We have come a long way. Despite the unprecedented and challenging backdrop of the covid pandemic, England has seen a 33% fall in new HIV diagnoses since 2019, and fewer than 4,500 people live with undiagnosed HIV. The vast majority of those diagnosed are on high-quality treatment and are now unable to pass on the virus—still not enough people know that. Our successes have been possible only through clear national leadership and strengthened partnership working.

I am incredibly grateful to Professor Kevin Fenton, the Government’s chief adviser on HIV, who chairs the HIV action plan implementation steering group, which has representation from the key partners involved in the delivery of the HIV action plan, including local government, the UK Health Security Agency, the NHS, professional bodies and our voluntary and community sector. The group has met quarterly throughout the year to monitor progress on our commitments and ensure that appropriate action is taken to help us to move forward on our objectives.

Within the steering group’s remit, we have established a community advisory group, comprising representatives from a wide range of community and voluntary groups, from which we have a lot to learn, and four task and finish groups to support PrEP access and equity, workforce, HIV control strategies in low-prevalence areas, and retention and engagement in HIV care. The groups provide vital, comprehensive and timely advice and help us to remain on track to meet our 2030 goal.

Many areas of the country have replicated the national action regionally by providing leadership and oversight of the work that is under way within local systems. For example, we have seen the development of regional HIV action plans in areas such as the south-west, multi-agency working groups in the midlands, and stocktakes of testing activity and action via sexual health networks in the south-east, the north-east and Yorkshire.

[Peter Gibson]

I am interested to hear the stories the Minister is telling about regional action plans; do they include opt-out testing?

--- Later in debate ---

[Neil O’Brien]

I will come on to opt-out testing in a moment.

We are incredibly grateful for the work of the UK Health Security Agency, which is a world-class organisation that runs high-quality data-collection and surveillance systems to help us to better understand the scale of the challenge. In December 2022, the UKHSA published the first monitoring and evaluation report on the HIV action plan, which indicated that the achievement of our ambitious commitments, including the interim commitment to an 80% reduction in transmissions by 2025, is within our grasp, and we should be encouraged by the progress that has been made.

As various Members pointed out, progress in the UK is increasingly recognised internationally at different HIV global forums, such as the UNAIDS and WHO international boards. The proof of that is that the UK met the UNAIDS 95-95-95 targets for the second time in 2021: 95% of HIV-positive individuals were diagnosed; 99% of those diagnosed were receiving treatment; and 98% of those receiving treatment were being virally suppressed and unable to pass on the disease.

Transparency and accountability are a key cornerstone of our plan, which is why we also committed to update Parliament each year on the progress made towards our ambition to end new HIV transmissions. In particular, we are committed to ensure that underserved populations benefit equally from the improvements made in HIV outcomes, including by scaling up our prevention efforts and increasing access to PrEP. We have already invested £33 million to roll out PrEP across sexual health services over the past two years, and PrEP is now being commissioned as a routine service through the public health grant. However, we know that there is more to do to improve PrEP access and equity for key groups, and we are in the process of developing a road map based on the input of the PrEP task and finish group that I mentioned, to improve PrEP provision and help us to reach those who are under-represented in PrEP access.

The hon. Member for Brighton, Kemptown raised the issue of the blood test, which I will absolutely take away and look at. On the specific point about timing made by my hon. Friend the Member for Darlington (Peter Gibson) and by my right hon. Friend the Member for Dumfriesshire, Clydesdale and Tweeddale (David Mundell), the HIV plan implementation steering group is working to develop a road map based on the task and finish group’s recommendations, to help to guide our movement forward. Our work will be informed by the findings of research on the use of HIV PrEP commissioned by the English HIV and sexual health commissioners group. In particular, we want to understand the barriers for underserved groups that access PrEP and how they can be mitigated.

It is expected that the research will be published this month—of which there is, of course, not much left. Members will see that very shortly, because we know the urgency of this issue, and I have been struck by Members’ testimony today about what is happening in respect of private access and the need for people to access PrEP in a timely and smooth way.

A number of hon. and right hon. Members raised the issue of the opt-out testing programme. I have met some of the people who have already benefited from that incredible programme, which powerfully underlines its huge benefits. Preliminary results from the pilot are promising, and we are still considering the full evidence from the first year of the programme, alongside the data on progress towards our ambition of ending new transmissions. Through the HIV action plan, DHSE is investing £3.5 million in our national HIV prevention programme from 2021 to 2024, to raise awareness of ways to prevent the spread of HIV and other sexually transmitted infections among the most affected communities.

As part of that programme, we deliver National HIV Testing Week in partnership with the Terrence Higgins Trust. In 2023, it distributed almost 22,000 free HIV testing kits ordered by the public. The self-testing kits provide instant at-home results and are available for the very first time. A targeted summer campaign is currently being delivered through the brilliant work of our partners at the Terrence Higgins Trust. The campaign has been carefully developed and tailored through strong audience insight evaluation to help us reach those most at risk, and it aims to increase testing among key groups, particularly young people and people of African heritage. It also aims to promote awareness of good sexual health practices to prevent transmission of other sexually transmitted infections. To reassure my right hon. Friend the Member for Romsey and Southampton North, we are working with the Department for Education on its RHSE review, and have been doing so since March, so I absolutely recognise the importance of the point that she made.

Achieving our 2030 goal will require sustained commitment from many partners across the health system and beyond—in education, for example—and the HIV action plan describes the role that each partner will play in this vital endeavour. The success of recent years, and the scale of the task that remains, should give us the belief and the drive to go further in the years ahead. Let us continue working together to ensure that we are the generation that ends HIV once and for all.