HIV and AIDS

Lord Collins of Highbury Excerpts

Monday 18th January 2016 Lords Chamber

[Lord Collins of Highbury (Lab)]

My Lords, I, too, thank the noble Baroness, Lady Barker, for initiating this debate. The APPG report demonstrated progress on access to anti-retroviral therapies. The latest figures released by UNAIDS show that nearly 16 million people now have access compared with fewer than 1 million just 10 years ago. However, 22 million people living with HIV still do not have access to ARTs and an incredible 19 million remain unaware of their status.

Since the report’s publication we have had DfID’s new development strategy and the Government’s strategic defence and security review, which alongside the Autumn Statement pledged significant new funding for global health. These strategies highlight the need for better integration between DfID and the FCO to address human rights abuses and, as noble Lords have pointed out, criminalisation of LGBT groups, which, as the noble Lord, Lord Fowler, said, contributes to access to treatment being denied. Can the Minister outline the process ensuring cross-Whitehall policy coherence so that development needs are not undermined by other political considerations?

SDG objective 3.3 is to end HIV/AIDS, TB and malaria by 2030, and 2016 marks the beginning of the next replenishment phase for the Global Fund. The Global Fund estimates that the combined external funding required to beat the three diseases in line with the SDGs will be $97 billion through to 2019. This will come from affected countries themselves and the countries contributing to the Global Fund, which will need some $13 billion over the period—slightly less than for the last replenishment period. As noble Lords have said, the UK has a proud record on the Global Fund, contributing up to £1 billion over the last replenishment period, making it the third largest contributor.

In addition to the Global Fund commitment, I welcome the Autumn Statement launching the £1 billion Ross fund with the Gates Foundation. The Opposition will hold the Government to account on how that co-operation is working in the months and years ahead. That £1 billion includes a £300 million package on malaria and £115 million to develop new drugs and insecticides for malaria and TB. I welcome that attention given to TB and malaria but, as noble Lords have indicated, the funds do not yet specifically cover new tools for HIV and AIDS, either for treatment or prevention. It is crucial that the Government recognise the importance of new and better tools to prevent and treat HIV to ensure that investments in eliminating the disease are ultimately sustainable and successful.

If the aim of ending AIDS as a public health threat by 2030 is to be achieved, the bulk of the progress must be made in the next five years, as we have heard. The joint UN programme has accepted fast-track targets. These are that 90% of people living with HIV know their status; 90% of those people are accessing treatment; and 90% of those on treatment are virally supressed. That would significantly reduce the number of onward transmissions. Achieving universal access, however, remains a challenge. As my noble friend Lord Cashman said, affordable first-line generic drug treatments are denied to middle-income countries, which are excluded from licensing deals and are forced to buy at inflated prices, making second and third-line ARTs prohibitively expensive. The Global Fund must be allowed to provide critical bridging finance for middle-income countries. We cannot simply pull out and leave Governments to fill the gap when we know that they will not. So will the Minister commit to looking at providing technical support before funding is withdrawn to ensure that programmes do not collapse after withdrawal?