Global Fund to Fight AIDS, TB and Malaria

Mike Freer Excerpts

Tuesday 12th January 2016 Westminster Hall

[Mike Freer (Finchley and Golders Green) (Con)]

The latest figures released by UNAIDS show that nearly 16 million people now access antiretroviral therapies—ARTs—compared with fewer than 1 million just 10 years ago. In 2014, there were 2 million new HIV infections, compared with 3.4 million in 2001. That shows progress, but about 22 million people living with HIV still do not access ARTs and an incredible 19 million are simply unaware of their status.

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, to bend the curve of the epidemic towards manageable levels. The joint United Nations programme has accepted and released 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. The challenge of achieving universal access, however, remains ahead of us.

Affordable first-line treatments are available in low-income countries in the form of generic drugs, but those drugs are denied to middle-income countries—MICs. MICs are excluded from licensing deals and are forced to buy drugs at inflated prices, making second and third-line ARTs prohibitively expensive. It is estimated that, by 2020, only 13% of those living with HIV will be found in low-income countries. We will be leaving the rest behind. If international donors, including the UK, continue to scale back bilateral overseas development aid for MICs, we will leave the bulk of people infected with HIV with reduced access to treatment, as the countries we were aiding choose not to fill the gap because the groups that are left vulnerable are either marginalised or criminalised. We are leaving those people high and dry.

Multilaterals such as the Global Fund must be allowed to provide critical bridging finance for MICs. We cannot simply pull out and leave Governments to fill the gap when we know they will not do so. As countries transition into the middle-income category, we know that we will withdraw, but we must put some form of package in place to support the transition; otherwise we will not be supporting a successful response to the HIV epidemic.

The UK has championed the inclusion of the principle of “no one left behind”, but we are leaving people behind because of our focus on middle-income countries stepping up to the plate—something they are not doing. We have the influence and the money. When we withdraw—for the perfectly legitimate reasons of trying to persuade middle income countries to bridge that gap and step up—we need to ensure that we provide support. Simply withdrawing leaves too many people vulnerable and exposed. I hope the Minister will commit to looking at providing technical support before funding is withdrawn to ensure that programmes do not collapse after withdrawal and that illegal or marginalised groups are not simply left to their own devices.