HIV

Debate between Pamela Nash and Mike Weatherley

Tuesday 29th November 2011 Westminster Hall

[Pamela Nash (Airdrie and Shotts) (Lab)]

I am grateful to have secured this debate during the week in which world AIDS day is marked. The HIV virus was discovered 30 years ago, since when it has claimed the lives of more than 30 million people throughout the world, including 20,000 in the UK. Over the past 20 years, we have seen remarkable progress in the medication available to people living with HIV, including today’s welcome approval of a drug that will provide triple antiretroviral therapy in a single tablet taken once a day. That does not, however, diminish the fact that there is still no vaccine or cure for HIV, and more efforts must be made to prevent the transmission of the virus.

Let me take this opportunity to pay tribute to my predecessor as chair of the all-party group on HIV and AIDS, the late David Cairns. One year ago in this Chamber, he spoke on this topic with eloquence and passion, and he consistently spoke out against the stigma and discrimination faced by people living with HIV both in the UK and overseas. I am glad that his work continues in the all-party group and through the David Cairns Foundation set up in his name, which was launched last week.

The House of Lords Committee on HIV and AIDS, led by the vice-chair of the all-party group and former Health Minister, Lord Fowler, recently published a report on HIV in the UK. Lord Fowler has done much to champion the cause over his long and distinguished career, and I believe that many owe their lives to the work he carried out as HIV began to take hold in the United Kingdom. The needle exchange programme that he introduced is a good example of that work, and it changed the course of the epidemic, particularly in Edinburgh and the rest of Scotland. In September this year, the Committee concluded that the Government’s current policies on tackling HIV in the UK are “woefully inadequate.” I will focus on some of the report’s recommendations, and I look forward to the Minister setting out the Government’s response to that report.

I will start with some startling headline figures. Some 30 years after the virus was discovered, almost 100,000 people in the UK live with HIV. Newly diagnosed cases of HIV among young people have risen by 48% over the past decade, and it is estimated that about a quarter of those living with HIV in the UK do not know that they have the virus. Half of all cases of HIV in the UK are diagnosed late, meaning a greater cost to public health and the public purse. HIV is spreading for many reasons, but principally because of high levels of undiagnosed HIV, too few people with HIV receiving stable treatment, persistent risk-taking behaviour, and a lack of HIV awareness. That is set against a dangerous backdrop of inconsistent sex and relationships education in our schools and beyond.

Early diagnosis of HIV for one person can obviously translate into prevention of the disease for their future sexual partners. People diagnosed with HIV are far less likely to pass the virus to others, as they can take steps to prevent transmission such as using a condom. Once diagnosed, people can receive HIV treatment that dramatically reduces levels of the virus in the body, so that the risk of transmission can be reduced to almost zero. This year I was surprised by the results of a remarkable clinical trial in South Africa that proved that putting people on medication for HIV can reduce the risk of transmission by an enormous 96%. That has extraordinary ramifications for efforts to tackle the HIV epidemic around the world and makes the need for the early diagnosis of HIV all the more pressing.

It is estimated that 51% of all people with HIV in the UK have undetectable levels of the virus. That is great news, although the UK should aim to increase that percentage to at least 65% over the next four years.

[Mike Weatherley (Hove) (Con)]

I congratulate the hon. Lady on securing this important debate. Does she agree with the recent remarks made by the US Secretary of State, Hillary Clinton, who said that an “AIDS-free generation” should be a policy priority for all Governments, including that of the UK?

[Pamela Nash]

I completely agree with the Secretary of State’s remarks. I raised the issue during Deputy Prime Minister’s questions last week. I hope that the coalition will take that aim on board and that it will be raised by the Prime Minister. The all-party group on HIV and AIDS is a member of the “Halve It” coalition that campaigns for levels of late-diagnosed and undiagnosed HIV to be halved in five years through more testing. That will help to stop the spread of HIV, improve health outcomes for those living with the virus, and in the long term save the Government money.

Patients and doctors have a large role to play. A study of people of sub-Saharan African origin in the UK who were diagnosed late with HIV found that three quarters had visited a doctor in the year preceding their diagnosis. Doctors and patients must be more aware of the primary infection symptoms of HIV. Incentivising HIV testing, particularly in areas with a high prevalence of HIV, is vital to ensure that people are diagnosed in time. One powerful incentive would be to ensure the inclusion of the late HIV diagnosis indicator in the Government’s revised public health outcomes framework. We have heard several times that a decision on that will be made later in the year. Will the Minister assure hon. Members that that indicator will be included, or at least say when the Department will reach a final decision?

As I understand it, the Department is investigating the possibility of legalising home-testing kits. I look forward to the outcome of that investigation. It is clear from the House of Lords report that home-testing kits ordered from overseas, usually over the internet, are already in use in the UK. If legalised, that practice could be regulated and allow people to test themselves securely and safely in their own home, again producing savings for public health and the public purse.

How else can we prevent the transmission of the HIV virus? The House of Lords report stated:

“More resources must be provided at national and local levels… The current levels of investment in national HIV prevention programmes are insufficient to provide the level of intervention required.”

Hon. Members may be surprised to learn that the Department of Health currently spends just £2.9 million a year on two national HIV prevention programmes for gay men and black Africans. That compares with an enormous £762 million spent on treatment. Preventing one infection avoids lifetime treatment costs for HIV of between £280,000 and £360,000, but as local service cuts kick in throughout the country, HIV prevention programmes are being reduced.

Under the new NHS structure, local HIV prevention work, campaigns and testing will be commissioned by local authorities, leading—we hope—to additional national campaigns, but I am concerned about the possible fragmentation and subsequent prioritisation of prevention work between HIV treatment that is commissioned nationally by the commissioning board, prevention and testing work commissioned by local authorities, and national campaigns overseen by Public Health England. Within local authorities, HIV prevention work is likely to face strong competition for funding within constrained budgets. A fragmented health care system will not deliver the results that we desperately need, or enable us to make headway against the rising tide of new HIV infections. We do not want a postcode lottery, or for sexual health services to be sidelined because of local sensitivities.