HIV Commission

Debate between Steve Brine and Alison Thewliss

Tuesday 1st December 2020 Commons Chamber

[Steve Brine]

Yes. The faith element is very important. We have done very well on driving down the numbers, but we have to do even better, and it will get harder as we get closer to the goal. Reverend Steve Chalke, a Baptist minister and the founder of the Oasis Charitable Trust, was one of our commissioners. He provided a very important element and the hon. Gentleman’s point is very valid.

Why do I say that this is scientifically possible? A HIV diagnosis is a notification of a serious condition, but these days, thank goodness, it is not the death sentence it once was and many understand it to be. An end is therefore in sight. Treatment has come such a long way. People on the right treatment have their viral load suppressed, meaning that they cannot pass on HIV. That, frankly, was a game changer. Overwhelmingly, people in England and the UK now know their HIV status. Of the 106,000 people with HIV in our country today, 94% know they are HIV positive, 98% are on treatment, and nearly all are virally suppressed and therefore cannot pass it on.

In addition, we have a wonder drug, PrEP— pre-exposure prophylaxis—which is taken by people who are HIV negative. It stops transmission during sexual intercourse. The PrEP impact trial data comes out in the new year, but we know already that it is a massive success—I hope I am proved right in that assertion. The Secretary of State made the drug readily available, free on the NHS—that was important. That took a little longer than it might have done but, legal challenges notwithstanding, let us not dwell on old ground. Let us ensure that all communities that can benefit from it know about its virtues and its availability.

If we are to get the benefits of PrEP to all who need it, HIV testing is needed in GP surgeries, pharmacies—I refer the House to my entry in the Register of Members’ Financial Interests—termination clinics, gender clinics and much more besides. Then, PrEP prescribing powers need to be given to each of those bodies. Again, it can be done—we need the will to do it. I commend the PrEP Protects campaign, focusing on black African women and men. If we can get take-up in other communities as there has been with gay and bisexual men, we will be changing lives and saving money. So thank you to the Terrence Higgins Trust, the National AIDS Trust, I Want PrEP Now, who lobbied me heavily as a Minister, and PrEPster for their amazing campaigns on the issue.

[Alison Thewliss (Glasgow Central) (SNP)]

I thank the hon. Gentleman very much for giving way. Does he commend the efforts of community groups who are going out and selling that message to their own communities? Those who work for Waverley Care in Glasgow and the Hwupenyu Health and Wellbeing Project are making sure that the message gets out into the community.

[Steve Brine]

Absolutely. The big society groups have been so important to the work of the commission. We have heard from many of them and I know they are very important north of the border, so I thank the hon. Lady for putting them on the record.

With the cavalry—the science—in place and the policy agreed, we needed a practical plan. For 18 months, the commission met, listened, learned and deliberated. Its recommendations are clear and I will close with a few of them. The first benchmark is to get new instances and the number of people undiagnosed down by 80% by 2025. Most of those will be in communities we already work with to reduce HIV transmissions, but the last 20% most likely will not. They will be hard to find, but the rewards will be great.

Secondly, we want Ministers to report to Parliament annually on the 2025 target and the 2030 goal. This will focus minds and track progress. To make these kinds of advances, we need the promised HIV action plan in very short order.

Thirdly, HIV testing—this is the crucial bit—must become normalised in the system. No longer should 250,000 people go to a sexual health clinic and not be offered a test, but we must go so much further. When someone presents at A&E or registers with a GP and the NHS or whoever else is taking blood, an HIV test must be carried out—so not opt-in, but opt-out. The default assumption is that it will happen.

We know that that can happen. Maternity services have shown that it is possible. Midwives test pregnant women for HIV, in non-judgmental settings, and there is a 99% take-up and therefore near zero vertical transmission to newborn babies. It could be the same elsewhere if we get this right, but there are many challenges in doing that. The funding is with local government. The testing needs to happen in primary care as well as secondary, but it is all possible with political will. In short, it is a policy of test, test, test, and if ever there was a time when we can successfully land that message, it is surely at the end of this ghastly 2020.

Underneath these recommendations lies a 20-point action plan to bring all this to life. Rarely has a commission been presented with such an implementation-friendly set of actions. If the Government are minded—and they have one or two other things on their plate right now—they could do a lot worse than copy and paste our findings into the first draft of the aforementioned HIV action plan. Each action is assessed for its impact on health inequalities and its contribution to fighting stigma. It looks to everyone who is and could be affected by HIV, and that was important to us. We are not denying that some of this will require investment, but I think that it is investment worth making, because bluntly, it will change and save lives, and we have shown how to do that after the Government asked us to.

If the moral case does not persuade people listening to this debate, hard cash might. Modelling by the Elton John AIDS Foundation found that over £200,000 in future healthcare costs were saved per person who was diagnosed and linked into the right treatment and care, so, not unlike the dynamic we face in cancer care, early diagnosis is the magic key in HIV as well.

Finally, to the wider sector, I say this: I hope that we have done you proud in our work with the HIV Commission. You got us here. We now need to come together to get this done. To my colleagues in the House tonight and listening elsewhere who will join us in campaigning for exactly what we are asking, I say: many thanks in advance. We will be in contact.

We could end HIV transmission on our watch. How amazing would that be to that 12-year-old schoolboy and many others who saw that advert in 1986? Let us not pass up the opportunity and, with this man as Secretary of State, I do not think we will.