Asked by
To ask Her Majesty’s Government what progress they have made
towards ending HIV transmissions by 2030.
The Parliamentary Under-Secretary of State, Department of Health
and Social Care
() (Con)
My Lords, the Government remain fully committed to achieving zero
new HIV transmissions in England by 2030. This is why we endorsed
the HIV Commission, which was established by the Terrence Higgins
Trust, the National AIDS Trust and the Elton John AIDS Foundation,
and we welcome its report, published today. I reassure noble Lords
that we will consider all the recommendations carefully, including
an interim milestone of an 80% reduction in new HIV transmissions
by 2025, and how we can expand testing. We will use the insights of
the report to shape our upcoming sexual and reproductive health
strategy and HIV plan.
(LD)
I thank the Minister for that reply. I am very proud to a member of
the party which, before anybody else, advocated that there be
services for people with HIV and AIDS, and we will be there until
this report is fully implemented and the fight against AIDS is won.
Will the Government move to introduce a system of opt-out testing
so that all people, including men and women from black and minority
ethnic communities, can know their status, and we can get sooner to
the point where they can get treatment and stop transmission?
(Con)
The noble Baroness refers to one of the most interesting of the
recommendations of the commission’s report. I took a briefing from
the commission yesterday; members made that point very clearly, and
their arguments were extremely persuasive. We have learned a lot
during the Covid pandemic about opt-out testing; I completely
understand the value of it, and I will take that recommendation to
the department to look at it very closely.
(Con)
My Lords, I pay tribute to the long-standing work of the Lord
Speaker on HIV and AIDS. I have campaigned beside him in South
Africa and have seen the passion with which he devoted himself to
this role over many years.
Does my noble friend the Minister agree that the HIV Commission’s
recommendation for a plan that the Government should commit
themselves to is a wise one which they should adopt? After all,
it is D minus 10 now—10 years before AIDS should be beaten,
according to the SDG. We have the tools, now we need to implement
them.
(Con)
I reiterate the tribute of my noble friend to the Lord Speaker.
Over three decades, he has campaigned tirelessly on these issues,
and was instrumental as Secretary of State for Health and Social
Security in launching the ground-breaking “Don’t Die of
Ignorance” campaign, which made an indelible mark—its impact is
remembered today. The tenacity that he has shown in making
evidence-based decisions in the fight against HIV is a model for
us today.
My noble friend makes a very valid point on the need for a plan.
We will issue a sexual health and an AIDS plan in short order;
they have been delayed by Covid. He reminds us that it is D minus
10, a goal that we take extremely seriously.
(Lab)
We know that stigma, even fear, can often prevent people going
for tests. What does the Minister think we can do to improve the
uptake of testing, particularly from those who are at the highest
risk of contracting HIV? What does he think we can do to improve
the training of those who provide testing to make sure that in
future people are more likely to take tests?
(Con)
My Lords, we have made great progress in the area of tests,
hitting the UNAIDS 90-90-90 target for the third consecutive
year, with 94% of those living with HIV diagnosed, 98% of those
diagnosed getting treatment and 97% of those undergoing treatment
having an undetectable viral load. The noble Baroness is entirely
right: one of the greatest challenges is those who are not tested
because they do not know that they should be tested. Part of that
is stigma and part of it is encouraging people to step up to get
tested. That is the focus of the recommendations in the HIV
Commission’s report, which we take very seriously. It has clear
recommendations on marketing, which we will be looking at very
carefully.
(LD)
The Global Fund to Fight AIDS, Tuberculosis and Malaria warns
that additional support is badly needed to prevent a reversal in
“hard-won gains”. Will we, as a lead funder, join Germany, Italy,
Canada and South Africa to increase our contribution to the fund
as a matter of urgency? A Written Answer will suffice if that is
not in the Minister’s briefing notes.
(Con)
The noble Baroness makes a very good point. The UK Government
will continue to be a world leader in our HIV response through
our considerable investment in the Global Fund to Fight AIDS,
Tuberculosis and Malaria as well as through supporting the Robert
Carr Fund to advocate for the rights and needs of the most
marginalised groups, such as LGBTQ people and sex workers. In
relation to reassurance on the point she asks about, I cannot
provide that from the Dispatch Box, but I reassure her that our
commitment to these international causes remains robust.
(Lab)
My Lords, this is a global fight, and, as the noble Lord
mentioned, this target is for the SDGs that apply throughout. If
we are to meet the global agenda of no new transmissions of HIV
by 2030, how will the Government work with all major funders, as
he mentioned, to collectively invest the £36.49 billion needed
for HIV programming for key populations over the next decade?
(Con)
My Lords, I have already precisely outlined some of our
commitments to international funding. Two other areas where we
contribute are, first, through our example: by marching
resolutely towards the zero transmissions target, we set an
important global example, which should not be underestimated. The
second is the contribution of our science community, which has
been profound and has contributed huge medical insights to the
scientific progress on antiviral drugs and in the fight against
AIDS.
(Con) [V]
Does my noble friend agree that one of the biggest barriers to
meeting the 2030 target is the stubbornly high rate of late
diagnosis, which not only has serious repercussions for the
individuals concerned but contributes significantly to health
inequality? Does he support the following recommendation in the
HIV Commission’s report:
“Every late diagnosis must be viewed as a serious incident
requiring investigation … and a report produced to drive change
in local health systems”?
(Con)
My Lords, I noticed the recommendation that every late diagnosis
should be regarded as a major contagion, reported and followed up
by an authority such as PHE. This is something for PHE to
consider for itself, but I will certainly write to it to raise
the recommendation and ask it to respond to me.
(Lab)
My Lords, the doubling of mother-to-child transmissions around
the world is just one of the implications of this year of
instability in health services around the world caused by the
Covid-19 pandemic. In my experience around the world, one of the
greatest fears of those living with HIV is instability, whether
that is caused by climate change, conflict or pandemics. What are
the Government going to achieve by cutting £4 billion in overseas
development assistance when these great crises need so much
attention at this time?
(Con)
The noble Lord speaks with great humanity and compassion, but I
perhaps need to give a bit of perspective. I am not sure if our
UK aid budget is enough to solve all the problems that he
describes. The UK remains extremely committed to international
aid. In the Covid epidemic and recession, we have reduced our
commitment in a small way and have promised to revisit it at a
later date. That commitment is very clear, and we will do that in
due time.
(LD) [V]
My Lords, cuts to local authority public health budgets of some
£700 million in real terms over the last five years have led to
sexual health budgets being cut by 25% in this period. The King’s
Fund has estimated that restoring spending to the former level
“would require additional investment of £1 billion.”
Given the Government’s commitment to zero new HIV transmissions
by 2030, will the Minister tell the House what plans they have to
increase investment in HIV preventive services delivered by local
authorities? Can the Minister also confirm that there will still
be national funding for a prevention programme?
(Con)
The Covid epidemic has disrupted things, but I reassure the noble
Baroness that in the spending review 2020 we have confirmed that
the public health grant will be maintained into next year,
enabling local authorities to meet pressures and continue to
deliver important public services. DHSC will confirm final
allocations in the coming week, including the position on HIV
PrEP. I reassure the noble Baroness that PrEP has proved to be an
enormously valuable contribution to our fight against
transmissions, and we continue to back it.
