HIV and AIDS

Debate between Pamela Nash and Peter Bottomley

Tuesday 10th December 2013 Westminster Hall

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

It is a pleasure to open this debate and to see you in the Chair, Mr Dobbin. I thank Mr Speaker for granting us the debate and my colleagues for attending this morning. Many of them have shown great support to the all-party group on HIV and AIDS, which I have chaired for two and a half years.

I am happy to see my hon. Friend the Member for Wirral South (Alison McGovern), in her newish role as shadow International Development Minister. I am also happy to see the Minister in attendance this morning; she has a strong personal commitment to the HIV response and has demonstrated that throughout her time at DFID. She has championed both the Global Fund to Fight AIDS, Tuberculosis and Malaria and UNAIDS, overseeing a significant increase in funding to both, which the all-party group has been delighted to see.

Today’s debate is timely, not just because we recently commemorated world AIDS day, but because today is international human rights day. As we mourn Nelson Mandela, we remember him as one of the great advocates of the AIDS response. He summed up the challenges very aptly when he said:

“AIDS is no longer just a disease; it is a human rights issue.”

The universal declaration of human rights states:

“Everyone has the right to a standard of living adequate for the health and well-being of himself…including…medical care”.

The virus has so far infected 58 million people, become the sixth biggest killer in the world and left 1.6 million people dead in the past year alone. However, it is not just the scale of the epidemic that makes it a human rights issue. It is a human rights issue because its effect on a country is dependent on that country’s wealth, and an individual’s social status still determines their risk of being infected and their ability to access treatment if they are.

HIV is the sixth biggest cause of death in the world, but it is the second biggest in low-income countries and does not even feature in the top 10 causes of death in high-income countries. The 1.6 million people did not die of AIDS last year because treatment does not exist; they died because the medicines were too expensive for them to buy, or because the stigma was too much for them to seek help in time. AIDS and poverty are now mutually reinforcing negative forces in many developing countries. We are 30 years into the epidemic, and AIDS is sadly still a major health and human rights issue, despite the leaps and bounds in progress we have made on prevention, testing and treatment.

One of the main barriers to fighting the epidemic, which stubbornly remains, is stigma. Last year, I took part in a Voluntary Service Overseas placement in Kenya to help parliamentarians and civil society there to strengthen their own all-party group on HIV and AIDS in the Kenyan Parliament. As part of that, I was lucky to work closely with Llina Kilimo MP, a much respected politician and campaigner on HIV and women’s rights. I remember her telling me that no one dies of AIDS. I was confused for a few seconds, but then realised that she meant that no one talks about dying of AIDS. When someone dies of AIDS in Kenya, the family will usually announce the cause of death as the secondary illness that was brought on by AIDS. Owing to the stigma attached, they keep their status quiet.

The best known example of that comes from Nelson Mandela’s own family. When his daughter-in-law passed away at the age of just 46, it was announced that she had died of pneumonia. It was not until her husband, Mandela’s son, died just a couple of years later that Mandela took the brave decision to announce to the world that his son had died of AIDS. In the midst of huge personal tragedy, burying his own son, he decided to use the occasion to show leadership on an issue that he feared would destabilise his country and damage the progress he had made in South Africa. He said at the time:

“That is why I have announced that my son has died of AIDS…Let us give publicity to HIV/AIDS and not hide it, because the only way to make it appear like a normal illness like TB, like cancer, is always to come out and say somebody has died because of HIV/AIDS, and people will stop regarding it as something extraordinary for which people go to hell and not to heaven.”

Mandela had already established his well known campaign 46664—named after his prisoner number on Robben island—a couple of years before he knew of his son’s HIV status. The campaign aimed to raise not just money but awareness, to get people talking about HIV and AIDS and to attempt to alleviate the stigma that too often stops people from seeking the treatment they need. Although there has been progress since Mandela’s landmark press conference in his garden following his son’s death in 2005, I fear that the stigma attached to HIV still prevails in Africa and across the world.

Mandela’s great work is not over. People are still dying from a preventable disease, and there are still 16 million people living with HIV without access to the treatment they require. We know that women, children and socially excluded groups are the people most affected by HIV, but one of the reasons for that is that they are least likely to have a political voice and are therefore not paid enough attention.

That might seem an odd statement, given the attention paid to the issue on world AIDS day recently, and the fact that many non-governmental organisations and some of the biggest ever global campaigns and organisations now provide treatment. However, we are fighting a losing battle for the political will to end AIDS in some of the countries most at risk, because of the stigma attached—not to being HIV-positive, but to talking about the matter at all.

The project in Kenya that I have mentioned was a follow-up to one carried out by my predecessor as chair of the all-party group, David Cairns, in Kenya two years previously. He helped the National Empowerment Network of People living with HIV/AIDS in Kenya— an umbrella organisation for HIV support groups—to set up an all-party group on HIV with Kenyan parliamentarians. However, that all-party group had not quite taken off.

When I was asked to go, I was concerned about the impact I could make; if David could not make a difference and set that group up, I did not see how I could. Surely, in a country as badly affected by HIV as Kenya, MPs would be falling over themselves to join a group that campaigned on it; it must be one of the biggest issues for their constituents. However, I found that HIV was not far up the political agenda—even just before the general election, when I was there.

What I am saying is not a criticism of the Kenyan Government, who have in many ways been at the forefront of the AIDS response, but politicians were not discussing HIV as a major issue for Kenya or talking about the next steps of their response to it as part of the general election campaign. With a few notable and brave exceptions, candidates and politicians told me privately that they did not feel they could speak about HIV. They were worried that the sensitive issues of HIV prevention would put voters off. A couple said that they were worried that voters would think that they were HIV-positive, and that that would damage their chances of being elected.

[Sir Peter Bottomley (Worthing West) (Con)]

In South Africa, when senior judge Edwin Cameron said he was living with HIV/AIDS, it became possible for a number of people in representative positions to be rather more open. There are also HIV choirs in townships around Cape Town. Those developments show that a way is beginning to be found of getting what everyone knows into the open. If things are brought out from behind the curtain, it is easier for people to take the action that will reduce the spread of HIV/AIDS, and there can be greater acceptance of people with the condition.

[Pamela Nash]

I completely agree. The problem is not unique to Kenya. In fact, I spoke at last year’s international AIDS conference in Washington, where I shared a platform with Ryuhei Kawada, who is a member of the Japanese House of Councillors. I believe that he is the first politician elected while openly being HIV-positive; I know that some have revealed their status later, but he was elected having already revealed his status. At last year’s event, he spoke passionately about his hope that he would be the first of many and that others would follow in his footsteps to try to relieve the stigma around HIV. It is clear that we need more public figures to reveal their status, but it is a big ask.

Let me be clear that the news is not all bad. I did not come here to spread doom and gloom. Truly excellent progress has been made in the global fight against HIV. I do not want to bore or bamboozle Westminster Hall with stats, but four recent figures from UNAIDS highlight the success so far. There has been a 33% decrease in new HIV infections since 2001, a 29% decrease in AIDs-related deaths since 2005, a 52% decrease in new HIV infections among children since 2001 and a fortyfold increase in access to antiretroviral therapy between 2002 and 2012. That last figure, in particular, is astonishing and shows just how far we have come. Such achievements should be applauded.