here - United Kingdom Parliament

315WH
HIV
1 DECEMBER 2010
HIV
316WH
[Ms Diane Abbott]
When we look at some of the indices around HIV/AIDS,
we see that there has been an increase in HIV testing
among gay men. Testing rose from 58% in 1997 to 72%
in 2008. We have seen a plateau in new diagnoses
among gay men, and we now see a consistently high rate
of condom use among them—at least nine out of 10
now use condoms. The fact that we have seen such
progress is partly a tribute to the people who took up
the issue all those years ago. It is also a continuing
tribute to the communities, activists and health providers
who provide both care and commitment, and we need
to acknowledge that today in this debate.
However, there is still some way to go. How we go
forward on HIV/AIDS will be a test of the reorganisation
of both the NHS and public health that has been
announced in recent months. In principle, I do not
think that anyone in this Chamber is opposed to the
reorganisation, but it is just this sort of issue, which is
not consistent across the country, that is not necessarily
well represented in GPs’ lists and has different levels of
information across the country; there may not be as
much information in rural areas as there is in Brighton
and London. That will be a test of the reorganisation’s
effectiveness.
We know that AIDS can affect anyone, and that
apart from the gay community the largest community
affected by HIV/AIDS is that made up of black African
men and women; currently, 38% of new HIV diagnosis
is among that group. The stigma attached to HIV in
that community cannot be overstated, and it very much
hampers efforts to reach out to people and achieve early
diagnosis.
The problem among black African men and women—
and among other groups, as well—is that they present
late and are therefore diagnosed late. That not only
gives them a poor prognosis; it means that the cost of
treatment is much more expensive than it need be. That
is true of any individual or any group that presents late.
Another issue with black African men is that even
though they may be having sex with men, they refuse to
consider themselves as gay. They think that HIV is
something for the gay community and not for them, so
they end up presenting very late indeed. They are more
likely to be undiagnosed and to live in areas in which a
relatively high proportion of the population are not on
their GP’s list, so they are not really interacting with the
authorities.
I should like to use this debate to stress the importance
of educational and informative work generally and with
the black and African community in particular. We
must do more with the Churches, because that is probably
the most effective way to reach those groups. Any
Sunday morning, there will more people in African-led
churches in Hackney than at any political party meetings
for 12 months of the year.
We need to normalise testing and offer it in a much
wider range of settings—not just for black and African
men and women, but for the population as a whole. I
was routinely tested when I had my son 19 years ago
and thought nothing of it. We need to make testing
more routine so that people do not think, “If I go for
this test, it will badge me as someone at risk.” Universal
testing may well be a step too far, but we need to make
testing available in a wider range of contexts.
My hon. Friend the Member for Inverclyde said that
he did not want to talk about international issues, but
given that 38% of new HIV diagnosis is among black
African men and women, I do not apologise for raising
the issue of funds for the Global Fund to fight AIDS,
Tuberculosis and Malaria. I know that that is not a
matter for the Minister and I do not expect her to
respond on the specific point. None the less, will she
pass on to her colleagues the very concerning fact that
the global fund is £13 billion short of what it needs? If
the UK was to raise its pledged amount in line with
France and other western European countries, the fund
would be able to go to private sector donors such as the
Gates Foundation and reach the amount of money it
needs.
In that context, I should like to mention—again, I do
not expect the Minister to respond on this point—that
in the next few weeks we will have EU trade talks with
India in Brussels. There is a great concern that as a
consequence of the trade talks, India might not be able
to produce the cheap generic drugs that have played
such a huge role in the fight against AIDS in Africa.
That would be a blow not so much for Indian industry,
but for the millions of people in Africa who have
benefited from access to cheap generic drugs.
HIV/AIDS is no longer a death sentence, which is
good news. Thanks to new drugs, research and greater
understanding, people are now living with HIV. As one
of my hon. Friends said earlier, we have 65,390 people
in the community living with HIV. In fact, it is increasing
faster among the over-50s than among any other group,
which raises new issues that were not considered in the
era of the adverts with the crashing tombstones and the
voice from above.
My hon. Friend the Member for Ealing, Southall
(Mr Sharma) mentioned the issue of depression and
how that interconnects with sufferers of HIV/AIDS
and the support that they need in relation to that. There
are ongoing concerns about care and support that were
not an issue 20 years ago. If we are to offer sufferers
from HIV/AIDS equity of health care and, as far as
possible, a good quality of life, we must consider care
and support, within the new health service and local
authority structures, as we have not in the past.
As I said at the start of my remarks, the reorganisation
of the commissioning of health care and of the public
health service will be tested by this issue. Many ordinary
people on the ground will judge the reorganisation by
how issues such as this are dealt with. I stress, as my
hon. Friends have stressed, the importance of a national
strategy. We need to consider how it can go forward
under the new arrangements. Will the Minister tell us
who will be responsible for commissioning and funding
the information work that is needed now more than
ever—in particular, the specific education work that
goes into the communities that I have mentioned? Who
will be responsible for commissioning preventive work,
care, treatment and support? I will listen with interest to
the Minister’s responses to those questions.
I welcome the new public health arrangements in
principle. Public health has been a core activity of local
government since the 19th century and so, as a former
local councillor, I am glad that public health has “come
home” to local authorities. However, because I know