World AIDS Day 2017

Paul Williams Excerpts

Tuesday 5th December 2017 Westminster Hall

[Dr Paul Williams (Stockton South) (Lab)]

It is a pleasure to serve under your chairmanship, Mr Hollobone. I congratulate my hon. Friend the Member for Cardiff South and Penarth (Stephen Doughty) on securing this debate.

Ten years ago on World AIDS Day, I was leading an HIV/AIDS programme on the edge of the Bwindi Impenetrable Forest on the border of Uganda and the Democratic Republic of the Congo. I started the clinic out of a shipping container, supported by a team of local health workers. It was baking hot and packed full of people desperate for care, in a place where all most people knew about HIV was encapsulated by the name that they used—akakoko ka silimu, translated as “the little insects that make you lose weight”. I saw too many people who did not know what was happening to them until they started coughing up blood from HIV or gave birth to a child who mysteriously died a few months later.

Within a couple of years, more than 2,000 people were getting treatment. Mother-to-child transmission had dropped from 30% to 1%. Every school child understood the basics about HIV and stigma was lifted by brave people, who were proudly positive. Yes, it was the drugs, and huge credit must go to President George Bush and the President’s Emergency Plan for AIDS Relief for making massive financial contributions at the right time to HIV/AIDS care but, more importantly, it was about the health system and the people delivering care.

In a part of the world where, on any given day, half of all health workers in Government facilities are absent, and where drug supplies rarely find their way to the front line, it is a huge leadership challenge to have happy, paid and competent health workers in the same place as needy patients, and with the drugs they need to help them.

I contacted a friend working in the field in Africa over the weekend. She told me that we are still a long way off where we need to be. She said that men are still not coming forward to test, that

“we don’t have enough drugs for everyone and are challenged by low stocks of ARVs”

and that adherence to treatment regimes is still a challenge. With the end of the HIV epidemic within our sights, now is not the time to disinvest—but disinvestment is exactly what we are starting to see, with a decline in funding between 2012 and 2015, from £416 million a year to £324 million a year, and a massive drop in funding for civil society organisations through the Robert Carr civil society Networks Fund.

I have two asks of the Minister. First, it would be really helpful to understand what the Department for International Development’s HIV/AIDS strategy is. We are currently investing more than £300 million a year of public money into HIV/AIDS, but without seeing that strategy, it is hard to communicate priorities or measure impact.

My second request is for reconsideration of the amount of financial investment. In many ways, the 20 million people currently on treatment, who were referred to by my hon. Friend the Member for Cardiff South and Penarth, are the easiest-to-reach people. In healthcare, we need to spend more, not less, to reach the most disadvantaged. There are still 15 million people who either do not know their status or are not on treatment. In order to reach them, we need to invest more to engage them. If we do reach them, we have the potential for an amazing prize—the end of HIV as a global public health problem.