HIV and AIDS

Lord Black of Brentwood Excerpts

Monday 18th January 2016 Lords Chamber

[Lord Black of Brentwood (Con)]

My Lords, I join others in congratulating the noble Baroness, Lady Barker, on securing the debate, which is quite literally about life and death, and therefore one of the most important subjects with which this House can deal. The report is extremely compelling and I support without hesitation its recommendations, particularly on the issue of paediatric treatments, which the noble Baroness mentioned briefly. There is something horribly cruel about babies and infants being infected with HIV, which is compounded by the poor levels of care available. The figures from the WHO and UNICEF, which show that by 2020 some 1.9 million children will require HIV treatment, are heart-breaking. The chances of even a majority of them getting such treatment are slender, but, as UNAIDS makes clear:

“Without treatment, about one third of children living with HIV die by their first birthday”.

New energy and focus need to be brought to bear on this issue, and policy and programming given the same priority as the key populations.

The point I want to highlight is one already raised by my noble friend Lord Fowler and the noble Lord, Lord Cashman, and which we have debated with great passion on a number of occasions in this House: the link between the criminalisation of homosexuality and the spread of HIV. I promise noble Lords that the three of us have not colluded on our homework, but I hope that the message is clear. For, with the best will in the world, HIV treatments, when they are available, are of use only if people are prepared to come forward, get tested and then take the drugs. But in far too many parts of the world—the majority of them, as we have heard, shamefully in the Commonwealth—criminalisation and stigma, which my noble friend talked so powerfully about, mean that HIV spreads more quickly, that safe sex practices never take root because there is no education on the subject, that prevention programmes simply do not exist, that people at risk do not get a test, and that the treatments central to this report are therefore simply not an option.

The evidence is overwhelming, as the Human Dignity Trust and others have documented in compelling work on the subject. The most telling statistic comes from UNAIDS, which found that HIV prevalence among men who have sex with men rises from one in 15 in Caribbean countries where homosexuality is not criminalised to one in four where it is. In countries where homosexuality is unlawful, the risks for the entire community are heightened because trans women and men who have sex with men have concurrent relationships with men and women, with fatal consequences, as the noble Baroness, Lady Gould, said in such a compelling way.

As I have said before on this issue, criminalisation kills. We have heard about the sterling and extraordinarily courageous work of the noble Lord in the mid-1980s, when the phrase that very much came to the fore was, “AIDS: Don’t die of ignorance”. Now it would be “AIDS: criminalisation kills”, so, “AIDS: Don’t die of criminalisation”, might be a better way of looking at it. Whether or not there is widespread access to effective treatments, the HIV/AIDS crisis can never be brought under control and the dream of an AIDS-free world by 2030, which the noble Baroness, Lady Barker, talked about, will remain impossible while consensual same-sex relationships remain criminal in so many parts of the globe.

That has massive implications for public policy and for the brilliant work going on in the area of treatment. The UK is quite rightly investing millions of pounds in managing and ameliorating the HIV/AIDS crisis in the developing world, yet we are still prepared to accept the criminalisation fuelling it. While criminalisation exists, much of this money, invested with the best of intent, is being wasted. Policy needs to be joined up. That needs to start with our leadership role in the Commonwealth since 40 of its 53 members criminalise, in a most shameful breach of human rights. Some 60% of all people with HIV currently live in the Commonwealth, yet it is still a subject which, I say with some irony, dare not speak its name. At a presentation entitled “Getting to Zero” at the Commonwealth Secretariat on World AIDS Day in December, there was not a single mention of the link between criminalisation and HIV, despite the overwhelming empirical evidence, nor even mention of men who have sex with men and trans women as high-risk groups. Progress will never be made while the Commonwealth has its head in the sand, yet until progress is made on this front important issues surrounding access to treatment are, in so many parts of the world, largely academic.

In commending this report, which contains so many vital recommendations that need to be acted on, please let us continue to remember, as we have heard from so many speakers today, that one of the most basic points about why HIV continues to spread and why treatment will never be as effective as it can be is down to criminalisation of gay men and women. Action on treatment will never be sufficient on its own until we make progress on that agenda too.