HIV Action Plan Annual Update 2022-23

David Mundell Excerpts

Tuesday 18th July 2023 Westminster Hall

[David Mundell (Dumfriesshire, Clydesdale and Tweeddale) (Con)]

It really is a great pleasure to serve under your chairmanship, Dame Caroline. I am grateful to my hon. Friend the Member for West Bromwich East (Nicola Richards) for securing this timely debate and for her thoughtful contribution, which laid out the principal issues. I am also grateful to my right hon. Friend the Member for Romsey and Southampton North (Caroline Nokes) for making sure that the full gamut of issues was covered, because sometimes it is possible for the perception to be that this is just an issue about gay men, and it is not. The hon. Member for Vauxhall (Florence Eshalomi), who, along with me and others, is a co-chair of the all-party parliamentary group on HIV and AIDS, made it absolutely clear that this is a wider issue than for just that one group.

As the HIV action plan has put in print, we have already reached the UN’s 95-95-95 target and are hopefully within touching distance of ending new transmissions by 2030. If that can be achieved, we should be clear that it is a milestone, equivalent to the eradication of polio in past years. I believe it is also a tangible example of British leadership in health and a testament to consistent and concerted efforts, which have produced incremental gains, giant leaps and, ultimately, a pathway that others have followed. As we have heard, however, we are not there yet.

The HIV action plan makes it clear that the goal will not be reached without PrEP. We know that PrEP works, with new transmissions of HIV dropping by over a third from 2019, but a recent survey by Prepster, the National AIDS Trust, the Terrence Higgins Trust, Sophia Forum and One Voice Network found that many people end up being diagnosed with HIV while waiting for PrEP. We need to close the gap between awareness of risk, accessing services and receiving PrEP, and I absolutely agree with the hon. Member for Brighton, Kemptown (Lloyd Russell-Moyle) about the availability of PrEP. I could sit down after this speech, go on my phone and order PrEP to be delivered to me from India in the next few days, but I could not go to a pharmacy in the centre of London or, indeed, in my own constituency to receive that. Not only is that discriminatory, in the sense that people who can afford to buy it or access online services have an advantage; as the hon. Member suggested, it is putting the risk ahead of the reality that people are already accessing it. It is far better to get it from a pharmacy than from an Indian or other overseas supplier.

Our targets on new transmissions will not be reached if we have not identified those who are living with HIV, and we have heard Members speak about that. Many of these issues are devolved in relation to Scotland, but one thing that I would like to see there is a properly funded national testing week. To maximise its impact, it should work in tandem with that which already takes place in England, because having a UK-wide event—with a focus on national television, in the national media and on social media—is a much better way to draw attention to the issue. We have heard from my right hon. Friend the Member for Romsey and Southampton North; like her, I can confirm that even someone like me can use a test kit. I am grateful—this will interest the hon. Member for Vauxhall—that the funding is at least better now in Vauxhall, because people used to have to phone up at 3 am to get the kit. If someone tried to phone at about 9 am, all the kits for that day had been distributed, but now people seem to be able to get them 24 hours a day. Virtually anyone can use such a kit effectively.

As the action plan identifies, reaching those who do not know that they are living with HIV will mean targeting hard-to-reach parts of our society, and those who either do not see themselves at risk or ignore the risk because of stigma. Opt-out testing has proven to be a success in that regard, and it is also cost-effective. When I was in South Africa, I had the opportunity to hear directly from medical professionals that opt-out testing, where it applies, has had a remarkable effect on the identification of cases in women. There are issues with support and treatment, but in terms of identification of cases, South Africa demonstrates that opt-out testing has a proven record. We should not prevaricate before rolling out opt-out testing beyond the areas already identified. Agencies and charities are champing at the bit to partner the Government to do just that.

The position of no new transmissions is almost tangible, but, as with the progress we have already made, it will not come without consistent and concerted action. Like the hon. Member for Vauxhall, I commend the all-party parliamentary group on HIV and AIDS, and the Members across both Houses who are part of it, for the continued commitment to action. As the hon. Lady did, I vouch that the group will continue to work with any charity, trust, health board or Government to get our country to the position of no new transitions and to highlight the issue globally.