HIV and AIDS

Debate between Pamela Nash and Annette Brooke

Tuesday 10th December 2013 Westminster Hall

[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.

[Annette Brooke (Mid Dorset and North Poole) (LD)]

I congratulate the hon. Lady on securing this debate and on all her work. It is so important to keep ensuring that HIV is a priority in the world. Does she agree that, when countries have a high incidence of co-infection, it is important to have joint programmes to control TB and HIV/AIDS?

[Pamela Nash]

I completely agree. I believe that colleagues will touch on that subject today, so I will not go into much depth, but it is something that my all-party group has worked on along with the all-party group on global tuberculosis. I hope that the hon. Lady will join in with such campaigns in future.

We cannot get carried away with progress, however. Many good news stories exist, but we have not yet reached our goal of ending the epidemic, the very nature of which means that we must continually work to eradicate HIV; if we do not, all our efforts will be overturned as it spreads further and further.

I am delighted that the Government have increased funding to the key multilateral organisations that fight AIDS. I congratulate the Minister on her role in achieving that, but I must highlight a few areas where the Government could and should be doing more. Strategies to combat the HIV epidemic are intrinsically linked to each country’s human rights environment.

Young people aged between 15 and 24 account for 45% of all new infections, according to the United Nations Commission on Human Rights. Two recent studies of women in Uganda and South Africa found that those who had experienced intimate partner violence were 50% more likely to have acquired HIV than those who had not experienced such violence. A study conducted in Malawi by the Salamander Trust, which works closely with the all-party group, revealed that women living with HIV were terrified that they would face violence if they told their partner or family about their status. Men who have sex with men are also particularly vulnerable, partly because of punitive laws in many countries.

Likewise, failure to provide access to education and information about HIV and AIDS treatment and care and support services further fuels the epidemic. I know that the Minister agrees that those elements are essential components of an effective response, but what does the Department for International Development plan to do specifically to ensure that human rights are at the heart of the HIV response?

One way is to invest in grass-roots community groups. One organisation that is particularly in my and others’ hearts is Sexual Minorities Uganda—SMUG. Members will remember the tragic murder of its leader, David Kato, in 2011. David Cairns met David Kato during a visit to Uganda, and I remember him being deeply pained at his death.

To honour both the memory of David Cairns and the heroic bravery of David Kato in his fight against prejudice, the David Cairns Foundation donated a staggering £10,000 to SMUG to help to establish Uganda’s first health care clinic specifically for the LGBT community in Kampala. It is projects such as that that will sustain the AIDS response in a country where homosexuality is criminalised. The most vulnerable populations need a place to get tested and treated without fear of imprisonment or death.

I was pleased to see that DFID will be giving £4 million to the Robert Carr Fund for Civil Society Networks, a vital organisation that reaches global and regional civil society networks. Although such funding is, of course, positive and given that civil society activism will be the backbone of the sustainable response to HIV/AIDS, will DFID be doing more for grass-roots organisations?

I am cutting my speech short as I was not expecting such an attendance this morning and a few hon. Members want to speak, but I want briefly to discuss carers. HIV affects the human rights of not only those living with it, but also those who care for the ill and the orphaned. That effect impacts disproportionately on the poorest and most vulnerable in society. In 2005, Nelson Mandela said:

“Women don’t only bear the burden of HIV infection, they also bear the burden of HIV care. Grandmothers are looking after their children. Women are caring for their dying husbands. Children are looking after dying parents and surviving siblings.”

In sub-Saharan Africa, an estimated 90% of care for people living with HIV is done in the home by family or community-based carers. Voluntary Service Overseas highlights that inequality between women and men continues to fuel the pandemic. What is DFID doing to encourage the Governments with whom it works in partnership to adopt policies that recognise the contribution of home-based carers affected by HIV/AIDS?

I want to touch on harm reduction. I do not have the time to go into it in much depth, but I want to mention the upcoming United Nations General Assembly special session on drugs in 2016. Concerns have been raised with me that harm reduction practices for injecting drug users could be affected by the special session. The UK has historically shown great leadership in harm reduction over the years and in reducing the impact of HIV on injecting drug users. Would DFID therefore consider calling for a cross-Whitehall working group in the lead up to the 2016 special session, to ensure that the UK maintains its strong leadership on harm reduction policies across the world and that nothing happens to jeopardise it?

Before I conclude, I want to touch on a future challenge for the global response to HIV—access to medicines. I was pleased that DFID carried out a review of its position paper on HIV and AIDS. The review is more than twice the size of the original paper and is testament to the Minister’s and the Department’s commitment to the issue. I remain concerned, however, that it is missing some key elements.

I am particularly concerned about access to antiretroviral treatment. Those who have been here longer than me will know that that was a focus of the all-party group long before I became an MP, with the group conducting an inquiry in 2009 resulting in a report titled “The Treatment Timebomb”. The report effectively laid out the case that people living with HIV are now living longer—thankfully—but that the cost of treatment will therefore continue to rise to levels unaffordable for many unless something is done to ensure that intellectual property rights and patents do not infringe on a person’s right to health.

I appreciate that that presents a complex challenge to Governments throughout the world. DFID’s review mentions the challenge, but the little attention given does not reflect the magnitude of the issue. Without affordable medicines, the AIDS response could not have existed and most certainly would not be sustainable in future. Will the Minister tell us what steps DFID will be taking to tackle this fundamental human rights issue of access to medicines for HIV patients? Has she had discussions with other Departments that might have influence?

Rhetoric on HIV in recent years has spoken much of the end of AIDS being within our grasp—we have the means to do it. However, although it is true that we can now prevent people from being infected and that we can treat people living with HIV so that in practice they live a full life span, we are a long way off achieving the end of AIDS.

Recently, I spoke at the annual general meeting of Stop AIDS, which is a fantastic organisation working to secure the global response to HIV and AIDS. At the AGM, the non-governmental organisation ONE reported that we are getting close to a tipping point in the epidemic, which it defined as the total number of people newly infected by HIV being equal to, and eventually lower than, the number of HIV-positive people newly put on ARVs. That is truly excellent news, which demonstrates that we are on the right track to end AIDS, although we cannot be complacent.

We are still off track on some key millennium development goals for treatment and prevention. Funding is insufficient to control and ultimately defeat the disease. Much work remains to be done and, as we approach a new global architecture in the post-MDG framework, it is vital that that is recognised by the UK and other countries that lead the way in development.

To conclude, I reiterate that HIV is not only a medical issue, but a social and a human rights one. It is one of our key human rights concerns today. I look forward to hearing the contributions of my colleagues and the Minister’s response.