World AIDS Day

Baroness Winterton of Doncaster Excerpts

Thursday 1st December 2022 Commons Chamber

[Chris Clarkson (Heywood and Middleton) (Con)]

It is a pleasure to follow my hon. Friend the Member for West Bromwich East (Nicola Richards). I welcome this debate and I thank the hon. Member for Brighton, Kemptown (Lloyd Russell-Moyle) for bringing it to the House today. I also wish to praise him for his leadership in this area and for the work he has done to educate the public on the realities of people living with HIV. Unfortunately, there are still a lot of prejudices out there, and his speaking openly about his own experience as somebody living with HIV is incredibly powerful and important. When people see that their representatives are representative of society as a whole it makes a real difference. I will not speak at length, because we have heard a series of excellent speeches and I am going to use some of the same facts and figures that have been mentioned. However, I want to say how pleased I am that we are still having these debates, because this problem has not gone away.

The Government committed in December 2021 to achieve zero new HIV infections, HIV or AIDS-related deaths in England by 2030. That is an ambitious target, but I am sure everyone across this Chamber can agree it is essential. The framework for achieving that means ensuring equitable access to and uptake of HIV prevention programmes, scaling up testing in line with national guidelines, optimising rapid access to treatment and retention in care, improving the quality of life for people living with HIV and addressing the stigma surrounding infection and testing.

We must work to address the lazy stereotypes associated with HIV/AIDS, especially those surrounding the LGBT community. I am pleased to see that real progress is being made. The Government have provided £20 million to ensure that HIV opt-out testing is expanded to areas with a high prevalence, including Manchester, London, Blackpool—I pay tribute to my hon. Friend the Member for Blackpool South (Scott Benton) for his dogged determination in getting Blackpool included—and Brighton. That has helped to reduce diagnosis times and improve diagnosis rates.

In Rochdale borough, where my Heywood and Middleton constituency is located, 2.2 in every 1,000 adults are living with HIV. I would particularly like to thank the teams at Middleton health centre and Heywood clinic for their work in providing sexual health testing and support, and I hope we will be able to take advantage of opt-out testing too, as it is essential. The roll-out of opt-out testing saw 128 people newly diagnosed with HIV, 325 people newly diagnosed with hepatitis B, as has been mentioned, and 153 people newly diagnosed with hepatitis C. At a cost of just £2.2 million across 100 days, the opt-out testing paid for itself, saving the NHS an estimated £6 million to 9 million, through early diagnosis and treatment. Opt-out testing also goes some way to addressing health inequalities, with higher proportions of women and people from black African and black Caribbean backgrounds being diagnosed compared with the national average.

In March 2020, the Department of Health and Social Care provided £16 million in funding to local authorities to provide PrEP. I warmly welcome that, but barriers still exist. More than 57% of people waited more than 12 weeks to access PrEP and only 35% who attempted to access PrEP services were successful. It is essential that that changes. PrEP is a game changer for all of us. It is an essential tool if we are to end new infections by the next decade in the UK.

Of course, we know that this is not just a problem here at home. The truth is that covid-19 was the second pandemic of our lifetimes and we are still living through the first; this is a global matter. That is why I am proud that the UK provides funds to UNAIDS, the Robert Carr Fund and the Global Fund to Fight AIDS, Tuberculosis and Malaria. I will join the hon. Member for Brighton, Kemptown in saying that I would have liked to have seen the levels sustained, but my hon. Friend the Member for Totnes (Anthony Mangnall) made the important point that there are other things we can leverage as a country to help other countries in their fight against this disease. The UK is a co-founder of Global Fund and the third largest donor historically—my hon. Friend mentioned the figure of £4.4 billion in that regard—and the Foreign, Commonwealth and Development Office announced on 14 November that the UK will contribute a further £1 billion, so at least we are still in the fight. As with covid, the truth is that none of us is safe until all of us are safe, and we have a role to play in supporting those parts of the world less able to tackle HIV/AIDS than ourselves.

As we aim for our 2030 target, I would also like to draw the Government’s attention to the recommendations of the Terrence Higgins Trust and National AIDS Trust, which are calling for the expansion of opt-out testing to all areas of high prevalence—I cannot stress how important that is—the provision of PrEP to all who could benefit from it, which is very important, and a refocusing of sexual health services that have been displaced by the recent mpox outbreak.

There is a huge amount of work to do if we are to reach our 2030 target, and that will rely on adequate funding, access and information across society. It will need those of us in this place to speak openly and honestly about HIV/AIDS and to be collaborative, working across the piece. I am confident that we can get to that 2030 target and I will continue to support everyone working to that endeavour for as long as I have the privilege to be in this place.

[Madam Deputy Speaker (Dame Rosie Winterton)]

I call the SNP spokesperson.

[Steven Bonnar (Coatbridge, Chryston and Bellshill) (SNP)]

. I join all Members in commending the hon. Member for Brighton, Kemptown (Lloyd Russell-Moyle) for leading this debate and for informing us so well on a subject on which he is such a powerful crusader and advocate. I thank him and commend him for his contribution today.

Today, 1 December, is the annual World AIDS Day. From the inaugural World AIDS Day in 1988, the first ever global health day, until today, it has given an opportunity for people worldwide to unite in the fight against HIV, to show support for people living with HIV and to commemorate those who have, sadly, lost their lives as a result of AIDS-related illnesses. More than 105,000 people are living with HIV in the UK, and globally an estimated 38 million people have the virus. Despite the fact that the virus was only identified in 1984, more than 35 million people have died of HIV or AIDS-related illnesses, making it one of the most destructive pandemics ever known.

Each year in the UK more than 4,000 people are diagnosed with HIV. Many people do not know the facts about how to protect themselves and others, and stigma and discrimination remain a reality for so many people who are currently living with this condition. About 6,000 people in Scotland are living with AIDS, according to Health Protection Scotland data, and 98% of those attending HIV specialist treatment and care were receiving antiretroviral therapy—ART. In 95%, the virus cannot be detected in their blood, meaning they have an undetectable viral load and cannot transmit HIV. We know that many within our society are still largely unaware of the disease and the risks of it. A recent survey from the National AIDS Trust found that only 16% of people surveyed knew that if someone with HIV is on effective treatment, they cannot pass on HIV and can expect to live a long, happy, healthy and fulfilling life.

HIV continues to be a major public health crisis both in the UK and across the world, as we have heard today. Although we know that HIV disproportionately impacts segments of the LGBTQ+ community, the two issues should not be conflated; HIV is by no means confined to LGBTQ+ communities or certain black or ethnic minority communities. The fact is that anyone, regardless of sexual orientation, gender, age or any other factor, can acquire HIV or AIDS.

We in Scotland are extremely proud to be the first country in the UK to make PrEP available free of charge to those at a high risk of acquiring HIV. We have made huge progress in detecting and treating HIV, and people with the virus are able to live those long, happy and fulfilling lives. PrEP is free of charge from NHS Scotland for anyone who is more at risk of getting HIV. As we have heard from the hon. Member for Brighton, Kemptown, it is simply an oral medicine, in pill form, comprising two HIV antiretroviral drugs. It is prescribed to HIV-negative people at risk of becoming infected as part of a comprehensive approach to HIV prevention. We know that the drug is highly effective at stopping HIV from being passed on. In clinical trials, PrEP has been shown to reduce the risk of sexually transmitted HIV by between 75% and 86%, so it is hugely successful. Research lead by Glasgow Caledonian University’s Professor Claudia Estcourt shows there has been significant reduction in HIV infections since the implementation of the first PrEP programme in Scotland in July 2017, and that new diagnoses in Scotland have fallen by 20%.

The SNP Scottish Government will continue work to reduce the stigma of HIV, raise awareness of the condition and reduce its transmission. Support is being provided for new research on reducing transmission of the virus, and a separate working group will also look at the clinical utility of PrEP in Scotland.

The SNP Scottish Government have also provided £337,000 to develop a national online service for sexually transmitted infections and blood-borne viruses, which will allow people to request a test online and conduct that home self-sampling that we have heard about today from across the House. Every tool possible will be required in our fight against HIV/AIDS. These are all excellent tools and the Scottish Government remain committed to being on course to reach their target of eliminating HIV transmission in Scotland, and across the rest of the UK, by 2030.

As a fierce defender of minorities in this place, I must also mention the plain fact that many of those living across these nations with HIV are vulnerable. Some experience language, faith and cultural barriers associated with long-standing stigma, while others have complexities, such as mental health and societal issues, that impact their access to health and social care services, leading to poorer health outcomes. As we are all too aware, socio-economic inequalities drive health inequalities. Will the Minister outline the steps being taken by his Government to mitigate the impact of austerity and reduce inequality for all our minority communities?

The Government need to take an intersectional approach to healthcare—an approach that recognises that many people in the United Kingdom will face multiple and often overlapping disadvantages and barriers to accessing good healthcare, and sometimes, as we have heard, a postcode lottery.

Finally, on the matter of funding, the SNP is once again calling on the UK Government to reverse, in effect, the 83% cut to UNAIDS funding, which is a consequence of their decision to cut the aid budget from 0.7% to 0.5% of our GDP. On 31 Oct 2022, the UK Government missed the deadline to donate to the Global Fund to Fight AIDS, Tuberculosis and Malaria. At the time, Mike Podmore, UK Director at STOPAIDS, said:

“The UK is acting as an unreliable partner and preventing the Global Fund from communicating clearly to its grantees about what funding is now available for them to work with, creating uncertainty.”

The consequences of that action could be immeasurable when it comes to the number of lives affected. Although the UK did provide some funding, it was £400 million less than in 2019. Again, we in the SNP call on the UK Government to do the right thing. The aid budget must be restored to its 0.7% level, especially if the UK does not want to be known as an unreliable partner among its counterparts.

[Madam Deputy Speaker (Dame Rosie Winterton)]

I call the shadow Minister.