HIV Treatment: Low and Middle- income Countries

Russell Brown Excerpts

Wednesday 11th March 2015 Westminster Hall

[Mr Russell Brown (Dumfries and Galloway) (Lab)]

I thank my hon. Friend the Member for Airdrie and Shotts (Pamela Nash) not only for calling the debate, but for her leadership of the all-party group on HIV and AIDS since she took over as chair after the tragic loss of our parliamentary colleague David Cairns, who passed away suddenly.

I have been a member of the all-party group since I came into Parliament almost 18 years ago. The leadership of my hon. Friend and the previous leadership of David Cairns have backed up a robust group of individuals who have worked long and hard in Parliament on the problem of HIV and AIDS. I have not visited some of the many places that my hon. Friend has visited, but a few years ago I visited Ukraine courtesy of UNICEF UK. I was asked to go there because I am also joint chair of the all-party group on street children.

UNICEF UK looked at what was happening in Ukraine. Children sleeping rough on the streets were taking drugs intravenously, with many then finding that they had become HIV-positive. That brings us back to the point about stigma and discrimination. Many of those young people were living in fear, because if they presented for a medical, and it was discovered they were carrying the infection, they would be reported to the authorities—the police. They were in a real dilemma: they understood something was medically wrong, but should they go for the medical, given the consequences?

I and the UNICEF UK person who went with me to Ukraine, along with a couple of people working on behalf of UNICEF in Ukraine, visited the British ambassador, and I have to say that I was bitterly disappointed. I came away from the meeting thinking, “I sincerely hope that that individual has arrived here only in the last couple of days,” because he had no perception of the problems on the ground or of what people were experiencing. I also met one or two Ukraine Government officials, and it was anything but heartening to realise that what was happening was not an issue for them.

At that time, Ukraine was heavily dependent on global funding and support. Less than 12 months after I visited, that funding and support were taken away. Just because certain countries fall into the middle-income category, that does not mean they are handling some of these problems better. In my view—it is only my view, although one or two people did share it with me—Ukraine was on the verge of being a basket case in terms of dealing with HIV/AIDS, because there was no real support for people. That goes back to the issue of stigma and discrimination.

The all-party group’s report mentions paediatric treatment, which is lagging behind adult treatment in terms of access and research. Our report indicates that the market for paediatric treatments is, regrettably, a low-profit market, which reduces the incentive for research and development by private companies. There is a real lack of adequate treatment regimens for children, which often leads to adult treatments simply being broken up and given to children. It must be recognised that children are simply not being given the proper treatment and dosage on many occasions. Treatment regimens need to be tailored to individuals because children are not all the same weight or same height. We need to ensure that the correct dosage is given if we are truly looking for these young children to get proper treatment. If incorrect dosages or unsuitable adult treatments are administered, children’s treatment is unlikely to be as effective, which could lead to resistance and the need to switch to second or even third-line treatments.

Any of us, with any condition, would want to know that whatever we were prescribed would meet our needs as individuals. Of all the conditions that exist in the world, HIV/AIDS needs proper treatment. As a starting point, we need to encourage pharmaceutical companies to deliver more suitable dosages for children, because this problem has existed for far too long—indeed, it has existed since I joined the all-party group almost 18 years ago.

There is also a gap in early infant diagnostics, and there are insufficient opportunities for testing children. That results in children living with HIV not being identified and given treatment, or in those whose treatment is failing not having their problems addressed.

I do not want to say much more, because my hon. Friend the Member for Airdrie and Shotts and the hon. Member for Brighton, Kemptown (Simon Kirby) have covered a significant amount of the report. However, I want to put on record that, in taking evidence for the inquiry, we were assisted by colleagues from the other place, as my hon. Friend said. Their support and assistance are invaluable. The oldest soldiers in the all-party group are Lord Fowler, who has done so much in the Palace of Westminster over all these years, and Baroness Sue Masham, whom I met when I first joined the group. They are absolute stalwarts, and it is fitting that we recognise the work they have done and the way they have assisted in maintaining such a robust group. I hope it will continue after the election on 7 May.

Again, I thank my hon. Friend the Member for Airdrie and Shotts, as the chair, for pulling the report together and for securing the debate.