HIV and AIDS

Lord Patten Excerpts

Monday 18th January 2016 Lords Chamber

[Lord Patten (Con)]

My Lords, of all the issues facing all those concerned with diminishing the spread of AIDS and HIV that are highlighted in this report, one of the most intractable and difficult to deal with is the damage inflicted by stigma. It is, of course, very easy to call for different ways of approaching the problem: more money, for example—the UK is showing a lead in this area, and we should be proud of that—or indeed, bashing the pharmaceutical industry for its charges. I would caution all to remember that these companies are not a public but a private good, however much their drugs may do public good in the end. It is shareholder funds, not government or charitable donations that make such wonderful ground-breaking research possible—going off from paid-for antiretrovirals and spinning off into generics—so we need to work with them, not against them, all the way.

Changing attitudes is just as difficult, expensive and long term as is the research that provides those new drugs and eventually their generic equivalents. This remains a huge challenge, particularly in reaching the poorest and most marginalised, leaving no one behind. Stigma stops people going for HIV tests in the first place, finding support without shame, telling their family and friends or taking the potentially life-saving drugs—all this from the apparent fear of being rejected by those you love the most, of losing your job, of abuse from your community and the rest.

I am told that we urgently need much more systematic stigma-reduction initiatives, particularly in Africa. Who told me this? Well, I listened during the debate on Syria—the one that bumped the noble Baroness’s debate seven weeks forward into a new year—to the most reverend Primate the Archbishop of Canterbury, on the need to do more to protect Christians and other minority non-Christian faith groups in the Near East, citing as his source the work done on the ground by his daughter. Borrowing from the episcopal book, and listening to what the most reverend Primate had to say, I hope that if it is all right for him it is all right for me to lean on briefings that I have had from my daughter who, ever since she came down from university, has worked with the Catholic Agency for Overseas Development. That organisation has been working flat out on trying to help on stigma reduction in Africa since the epidemic began. CAFOD and its partners, of all faiths and none, implement a broad range of HIV-related programmes from providing information on transmission, care, prevention, counselling and spiritual support to those of all faiths and none.

In three African countries—Kenya, Zambia and Ethiopia—back in 2010, CAFOD set up what I believe to be a brilliant and ground-breaking survey into the causes of stigma carried out by local people living with AIDS who, after proper training, asked people about stigma. Its findings were shared very widely. It revealed invaluable information about, say, differences between urban and rural communities or what drives some, rather than taking the antiretrovirals available, to spend what must be to them fabulous sums of money on traditional medicines and on the purveyors of traditional medicines. Our daughter has seen and heard much of the efficiency of this research-based evidence in visits to each of the three countries, going right up to the Eritrean border. She will be there again in March this year, listening and talking in particular to women—Muslim women as well as to Catholic women or those with no religion at all. The more the work of CAFOD and other organisations like it is successful in reducing stigma, the greater will be the parallel reduction in the spread of the epidemic.

Unless stigma is reduced, so that people living with and affected by HIV are helped with advice on how to live—and, most of all, simply how to take their antiretrovirals—then all the money spent and all the scientific advances that are made will be all the less effective. That is for certain. I hope that Her Majesty’s Government take stigma-reduction programmes very seriously indeed.