HIV and AIDS

Alison McGovern Excerpts

Tuesday 10th December 2013 Westminster Hall

[Alison McGovern (Wirral South) (Lab)]

It is a great pleasure to serve under your chairmanship again, Mr Dobbin. I join other hon. Members in paying tribute to my hon. Friend the Member for Airdrie and Shotts (Pamela Nash)—not just for securing this debate, but for the excellent work that she has done as chair of the all-party HIV and AIDS group, one of the most active and effective groups in this place. She should be proud of that work, and her constituents should be proud of her.

I also pay tribute to all the other hon. Members who have spoken for their balanced and careful reflections. I know that the hon. Member for Stafford (Jeremy Lefroy) has had to head off to the International Development Committee, where he will no doubt do his good work in the effective way that I have witnessed at first hand. I will just note that he mentioned health systems, quite rightly. Those are a very important issue and I caveat whatever I say with my hope that the Minister will listen to her hon. Friend in that regard.

My hon. Friend the Member for Newcastle upon Tyne North (Catherine McKinnell) and the hon. Members for Strangford (Jim Shannon) and for Foyle (Mark Durkan) also raised serious and important points. Each of them reflected on different aspects of the issue, whether it was the shift in focus from both low and middle-income countries or the range of drugs available now and the importance of taking the widest possible look at that. They all reflected a sense of progress, but also the driving sense that there is still much more to do. I am sure the Minister would agree.

Given the scale of the global crisis that HIV/AIDS represents, it is vital that we continually examine the effectiveness of the action being taken, at home and abroad, both to ensure that there is treatment for those who need it and to slow and halt the spread of the disease. However, as other hon. Members have mentioned, today’s debate feels especially timely, for two reasons. First, and I suspect that my hon. Friend the Member for Airdrie and Shotts had this in mind when she applied for the debate, last week we marked world AIDS day, when we remember the 35 million people who have died from HIV/AIDS since the start of the epidemic; when we stand with those who live with the disease; and when we re-pledge our determination to end this scourge.

Secondly, today is the day when the world is coming together to remember the life of Nelson Mandela, so this debate seems particularly appropriate. Nelson Mandela had a particularly interesting interpretation of the word “retirement”. During his retirement, he campaigned tirelessly to stem the tide of HIV/AIDS, which he saw destroying lives and communities in his own country. On world AIDS day in 2000, he described it in this way:

“Our country is facing a disaster of immeasurable proportions from HIV/AIDS. We are facing a silent and invisible enemy that is threatening the very fabric of our society.”

Mandela fought against the prevailing attitudes and the stigma attached to HIV/AIDS, which resisted calls to fund antiretroviral drugs or to educate people on the need for safer sexual practices. He saw that HIV/AIDS was not only shortening lives and destroying families; the economic impact was also consigning many more people to poverty than would otherwise have been the case. The hollowing out of a generation placed a brake on economic development that could have reached across the country in the post-apartheid years.

South Africa continues to be haunted by AIDS, but thanks to Mandela and others who fought alongside him, things are slowly—albeit too slowly—starting to get better. Strikingly, earlier this year, Dr Olive Shisana, head of the South African Human Sciences Research Council, said that for the first time

“the glass is half full”.

There has been a dramatic increase in the numbers of people in South Africa receiving antiretroviral treatment, up to 2 million in 2012, and for the first time there has been a decline in the prevalence of HIV among 15 to 24-year-olds. That story—that there is progress, but still a long way to go—is also the story of HIV/AIDS across the world. Bill Clinton adopted the Churchillian phrase

“we are at the end of the beginning”

to describe the current situation.

There is good news. In most regions, the number of people newly infected with HIV is falling. Globally, it was down 33% in the period from 2001 to 2012. The millennium development goal of halting and reversing the growth of HIV has been achieved and in just one year, between 2011 and 2012, the numbers accessing treatment grew by 1.6 million, as has been mentioned. It is right to pay tribute to the communities, NGOs and politicians who have fought so hard to achieve that historic turnaround.

However, those glimmers of hope must not blind us to the continued severity of the situation and the requirement to do far more. Every year, 2.3 million people are newly infected with HIV, and of those, more than 1.6 million are in sub-Saharan Africa. Seven million people still lack access to antiretroviral therapy for HIV. Marginalised groups continue to be particularly prone to infection and to have lower levels of access to treatment. That includes women and girls. The reversal of the growth in new infections could be fragile. In particular, many nations in south-east and south Asia are seeing increases in the numbers of new infections.

Britain has a strong history of leading the fight against HIV/AIDS. Under the last Labour Government, we became the second largest bilateral donor in the fight against the disease and introduced long-term funding to strengthen health systems and services. I am pleased that, broadly, that legacy has been continued under the current Government and I welcome the additional £5 million of funding each year for UNAIDS—the joint UN programme on HIV/AIDS—that the Minister announced in the run-up to world AIDS day. However, I would like to conclude by asking the hon. Lady a few questions that I hope she can address in her winding-up speech.

Millennium development goal 6 has been an important spur in pushing for progress on HIV/AIDS and in that respect has been perhaps one of the more successful goals. What replaces the MDGs post-2015 could be vital in solidifying progress. Will the Minister update us on the Government’s view as to what form the next goal on HIV/AIDS should take?

The countries in which progress towards reducing HIV infections is weakest, or in which there is a deterioration, include nations for which DFID decided in its bilateral aid review to end programmes. They include India, Cambodia, Vietnam and Russia. Without reopening those questions or getting into the rights and wrongs of those decisions, will the Minister set out what work is ongoing to help middle-income countries and others in which the bilateral programme is ending to tackle HIV/AIDS, such as expert support from Britain?

Importantly, we know that one of the most effective safeguards against all forms of disease, in terms of both prevention and cure, is universal healthcare, free at the point of use. That is particularly true in the case of HIV/AIDS: community health advice and support can be an excellent means of preventing new infections. Will the Minister set out for the record DFID’s position on providing bilateral support for health care systems in which user charges are levied and what specific work is being done to ensure that HIV treatments are available free of charge in the nations with which DFID has a bilateral relationship?

As a number of hon. Members have noted, the Government’s review of their position paper on HIV/AIDS is limited, missing a number of key issues, including access to medicines. Can the Minister assure us that such issues will be dealt with as part of the review and, given that the consultation on the review ended nearly five months ago, tell us when she expects the outcome of the consultation to be published?

On global health fund replenishment, the UK pledged £1 billion, but in fact replenishment required $15 billion and it reached only $12 billion in the talks last week. What discussions are DFID Ministers having with other Governments to ensure that the global health fund reaches its $15 billion target?

Having set out those questions for the Minister, I will conclude by thanking most sincerely all hon. Members who have taken part in this important debate, which has shown once again, if it were in any doubt, this House’s commitment to ending the scourge of HIV/AIDS.