(1 day, 17 hours ago)
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Lord Black of Brentwood
To ask His Majesty’s Government what progress they have made towards the target of ending new HIV transmissions in England by 2030.
Lord Black of Brentwood (Con)
My Lords, I beg leave to ask the Question standing in my name on the Order Paper and declare my interest as a trustee of the Terrence Higgins Trust.
Baroness in Waiting/Government Whip (Baroness Hyde of Bemerton) (Lab)
Provisional data released by UKHSA in May shows that steady progress has been made since the publication of the HIV action plan last year, with new HIV diagnoses continuing to fall. Compared with 2024, the provisional number of new HIV diagnoses among gay and bisexual men fell in 2025 by 7%. Over the same period, there was a 15% decline among heterosexual men and a 22% decline among heterosexual women.
Lord Black of Brentwood (Con)
My Lords, I applaud the Government’s commitment, which is strongly supported on these Benches, to end new HIV transmissions by 2030, which would make us the first country in the world to do so. I welcome significant new investment in HIV testing and care. However, to meet the ambitious 2030 target, do we not need to do more on prevention, which means widening access to PrEP? What are the Government doing to expand access to it, including online and through community pharmacies, so that everyone who would benefit from this game-changing medication has easy access to it?
Baroness Hyde of Bemerton (Lab)
I congratulate the noble Lord on his appointment as the incoming chair of the Terrence Higgins Trust and on all his excellent work in this area to date. The ring-fenced public health grant funds local authorities to provide open-access sexual health services, including PrEP. The grant rose to over £3.8 billion in 2025-26, the biggest real-terms increase for a decade. The HIV action plan is backed by over £170 million and includes action on innovative PrEP provision. Local authorities are responsible for commissioning services and are best placed to do so, and can use the NHS shared business services framework to procure both online and postal PrEP.
Lord Cashman (Non-Afl)
My Lords, I refer to my register of interests, particularly as a patron of the Terrence Higgins Trust. I congratulate the Government on their HIV Action Plan for England, 2025 to 2030—and previous Governments. This is an example of what we can achieve when we work together across the political spectrum. However, can the Minister say how we will connect with the 5,000 people who are currently living with diagnosed HIV but not accessing treatment? These people are at risk of becoming seriously ill—indeed, some already have. I look forward to the Minister’s reply on this urgent issue.
Baroness Hyde of Bemerton (Lab)
I pay tribute to the noble Lord, Lord Cashman, for all his work in this area. The HIV action plan committed £9 million over three years to establish that first retention and re-engagement initiative. It is a core part of the plan and is intended to support people diagnosed with HIV who, as the noble Lord said, are not currently retained in specialist care, and to help people re-engage where perhaps they have fallen out, and to restart effective treatment and achieve viral suppression. It will amplify existing work within local services and partner with the voluntary and community sector and industry to increase the number of patients who are re-engaged in their care. Detailed plans for that national retention and re-engagement initiative will be set out in due course.
Baroness Barker (LD)
The testing programme in A&E, which was initially funded by the Elton John AIDS Foundation, has been extraordinarily successful, finding all sorts of people, including an 86 year-old woman who was completely unaware of her status. Will the Government commit to continuing the funding after the initial period that has been agreed? Will they also look at how we can expand testing to areas other than high-incidence areas, as it is limited to at the moment?
Baroness Hyde of Bemerton (Lab)
The noble Baroness is right to draw attention to the success of opt-out testing. The Government are pleased that this continues to be a very important plank of HIV detection and future prevention. As with everything, we look forward to the 2027 spending review. I will write in more detail to the noble Baroness on the rest of her question.
Baroness Bottomley of Nettlestone (Con)
Has there not been an increase in incidence among Black African heterosexual men? The Minister gave the figures for the welcome decrease in HIV, but there have been increases. That speaks to the requirement for better education. It is 40 years since my noble friend Lord Fowler introduced the “Don’t Die of Ignorance” campaign. We all need to relearn the lessons and promote education and anti-stigma campaigns at every level.
Baroness Hyde of Bemerton (Lab)
Indeed, the Government are not complacent about those who are not captured within the very welcome statistics on new rates of transition and the overall incidence falling. The HIV action plan focuses on five key population groups to ensure that no one is left behind, and this includes ethnic minority and white GBMSM, Black African heterosexual men and women, and ethnic minority heterosexual adults. That is what the £4.8 million in the HIV Prevention England programme is for: to reduce the size of that undiagnosed population and to address some of the inequalities the noble Baroness raises.
Lord Doyle (Non-Afl)
My Lords, I thank my noble friend the Minister for reaffirming the Government’s commitment to ending new cases by 2030. This is an ambitious but essential goal for us to achieve. The action plan highlights the essential need to expand the amount of HIV testing, because we know that effective treatment is available once we have identified cases. What progress has been made on putting HIV testing on the NHS app? If the pilot is successful, will it be expanded?
Baroness Hyde of Bemerton (Lab)
I do not want to pre-empt the outcome of an ongoing pilot but, as set out in the HIV action plan, the Government are serious about achieving all of UNAIDS’ previous aims of 95-95-95 and UNAIDS’ 2030 plan. This means that we will pull every lever, including that which the noble Lord mentioned, if the evidence suggests that it is how we can finally eliminate HIV and AIDS from the UK.
Lord Kamall (Con)
My Lords, I too pay tribute to both the noble Lord, Lord Cashman, and my noble friend Lord Black for their persistence on this issue—for making sure that it does not go away and that we continue the conversation. We also welcome the Government’s commitment to the 2030 target, originally set in 2019 by our Conservative Government but also by other Governments around the world, which shows that it is not really a political issue at all; it goes across the whole spectrum. Can the Minister tell the House what interim annual milestones have been set between now and 2030 towards meeting that 2030 target?
Baroness Hyde of Bemerton (Lab)
As I am sure the noble Lord is aware, we have provisional figures for 2025 that we expect to be confirmed by the end of this year, probably within the next month. Each year, we will be looking and monitoring, making sure that we track progress, because we cannot expect just to rock up in 2030 with all our work done.
Baroness Bousted (Lab)
Does the Minister agree with me that, as research studies show, school-based sex education is strongly associated with reduced risky sexual behaviour? Will she join me in thanking teachers for looking after young people every day of their working lives and educating them about their sexual health?
Baroness Hyde of Bemerton (Lab)
Absolutely—as my noble friend says, schools are a key place for education and the Government are fully committed to the consistent, nationwide provision of healthy relationship and sex education. We are also working to bring forward a sexual and reproductive health framework; there will be guidance on that for schools, pulling together a range of existing initiatives, so that we can be reassured that the best quality information is available to all children and young people, in every school of the country.
Baroness Pidgeon (LD)
My Lords, according to the UKHSA, HIV testing in community settings fell by 33% between 2019 and 2024. Given the potential for community testing to reach people who might otherwise be missed, what are the Government doing to reverse this decline and expand access to testing closer to where people live?
Baroness Hyde of Bemerton (Lab)
There are many reasons for that decline, as I am sure the noble Baroness is aware. As we know, the Government are very committed to the devolution agenda and many of these services have long been commissioned through local authorities. It is about encouraging local authorities to focus on the granular detail, given the variation across the country, because they know their populations best and how to commission grass-roots services. Of course, the voluntary and community sector has a key role to play in ensuring that all the people who need to be reached are reached. We will continue with our devolution agenda and the ring-fenced public health fund for local authorities to ensure that every person, in every part of the country, is not left out from the possibility of diagnosis and treatment.
Baroness McIntosh of Hudnall (Lab)
My Lords, if the noble Lord, Lord Fowler, were here—we are sorry that he is not—he would very much want to ask my noble friend about any residual stigma that persists. This is particularly difficult in areas where testing does not reach quite as far as we would like. Can she tell the House what the Government are doing to address these persisting levels of stigma?
Baroness Hyde of Bemerton (Lab)
I thank my noble friend for that question. As I am sure noble Lords are aware, there were five key planks of the HIV action plan, the fourth of which was “thrive”. On my noble friend’s point, that was deliberately included to address stigma and improve the quality of life for people living with HIV. In the interests of time, I point noble Lords to the fourth priority of the HIV action plan.