HIV Action Plan Annual Update 2022-23

Peter Gibson Excerpts

Tuesday 18th July 2023 Westminster Hall

[Peter Gibson (Darlington) (Con)]

It is a privilege to serve under your chairmanship, Dame Caroline. I congratulate my hon. Friend the Member for West Bromwich East (Nicola Richards) on leading this important and timely debate. As I remarked in Prime Minister’s questions in February, that month marked the 22nd anniversary of the death of a good friend of mine from AIDS-related complications. I am absolutely certain that had he been tested earlier and more regularly, he would have been given the right treatment and would still be alive today. It is because of people like him that this issue is so important to me.

I am entirely supportive of the Government’s commitment made in 2019 to end all new HIV transmissions in England by 2030. Although we have made some progress, we cannot be complacent. We should rightly celebrate the successes in improving HIV treatment, prevention, management and care. However, without testing we cannot treat, and without PrEP we cannot prevent further infection. It is great that HIV-positive people now experience a similar life expectancy to people without HIV, but we still have a lot of work to do. Although new HIV diagnoses have continued to fall, late diagnoses remain stubbornly high in England, and progress across the UK is not equitable.

There are three key areas where we need to seek more action: access to PrEP, more HIV testing and care for people living with HIV. As we have heard, access to PrEP remains limited. The HIV action plan included a commitment to develop a plan for PrEP access beyond sexual health services. However, more than a year on from that commitment, it is still not possible to access PrEP at a pharmacy or a GP surgery. May I ask the Minister why that is, and whether he will look urgently at this point? This is an easy win in our fight against HIV.

The HIV action plan included a £20 million investment in opt-out testing in emergency departments in areas classed as very high prevalence. As a result of additional hepatitis C funding, the whole of London was included and the programme became a combined one to tackle bloodborne viruses. The annual report includes the first year of data, and the results have been quite remarkable across London, Manchester, Blackpool and Brighton, as other speakers have highlighted. The figures demonstrate the huge success that opt-out testing has had in rooting out cases of bloodborne viruses—not just HIV, but hepatitis C and B.

In February, as a result of campaigning from many colleagues here and stakeholders across the country, the Public Health Minister committed to consider the case for expanding opt-out testing to all areas with a high HIV prevalence. Will he tell us the outcome of that review? When will opt-out testing be rolled out to high prevalence areas? People do not live their whole lives in fixed locations. Simply because someone now lives in an area that is not high prevalence does not mean that they did not once do so or have not visited such areas in the past.

Opt-out is a win-win: it is good for public health and the public purse. It is essential that we meet our target of ending all new HIV transmissions in England by 2030. We have made progress, but I fear that without renewed impetus, greater access to PrEP and an expansion of opt-out testing, we will miss the mark. Our internationally significant position on HIV is in no small part due to the zeal of giants in the field, such as Lord Fowler, and the efforts of the Terrence Higgins Trust. I ask the Minister to rekindle that zeal and energy, and ensure we take up this mantle and race towards a day when we have no new infections. It can be done.

--- Later in debate ---

[Neil O'Brien]

I am happy to look into that. We provided extra funding

in respect of mpox, but I will look into the issues the hon. Gentleman raised.

This debate is an opportunity to restate our joint commitment to tackling HIV and to reflect on the progress we have made since 2019, when the Government first announced our ambition to end new HIV transmissions, new AIDS diagnoses and new HIV-related deaths in England by 2030. As all Members know, 30 years ago AIDS was a fatal illness; today, when they are diagnosed early and have access to antiretrovirals, the majority of people with HIV in England can expect a near-normal life expectancy. People who are diagnosed with HIV can expect to receive HIV care that is world class, free and

open access.

We have come a long way. Despite the unprecedented and challenging backdrop of the covid pandemic, England has seen a 33% fall in new HIV diagnoses since 2019, and fewer than 4,500 people live with undiagnosed HIV. The vast majority of those diagnosed are on high-quality treatment and are now unable to pass on the virus—still not enough people know that. Our successes have been possible only through clear national leadership and strengthened partnership working.

I am incredibly grateful to Professor Kevin Fenton, the Government’s chief adviser on HIV, who chairs the HIV action plan implementation steering group, which has representation from the key partners involved in the delivery of the HIV action plan, including local government, the UK Health Security Agency, the NHS, professional bodies and our voluntary and community sector. The group has met quarterly throughout the year to monitor progress on our commitments and ensure that appropriate action is taken to help us to move forward on our objectives.

Within the steering group’s remit, we have established a community advisory group, comprising representatives from a wide range of community and voluntary groups, from which we have a lot to learn, and four task and finish groups to support PrEP access and equity, workforce, HIV control strategies in low-prevalence areas, and retention and engagement in HIV care. The groups provide vital, comprehensive and timely advice and help us to remain on track to meet our 2030 goal.

Many areas of the country have replicated the national action regionally by providing leadership and oversight of the work that is under way within local systems. For example, we have seen the development of regional HIV action plans in areas such as the south-west, multi-agency working groups in the midlands, and stocktakes of testing activity and action via sexual health networks in the south-east, the north-east and Yorkshire.

[Peter Gibson]

I am interested to hear the stories the Minister is telling about regional action plans; do they include opt-out testing?