here - United Kingdom Parliament

303WH
HIV
1 DECEMBER 2010
HIV
304WH
[David Cairns]
breastfeeding are making an enormous difference.
However, almost 500,000 babies born in Africa every
year are HIV-positive. That is completely preventable—
entirely avoidable. If pregnant women are tested and
put on ARVs, they do not need to pass on the virus. It is
one of the great scandals of our age that something that
is solvable—we have solved it here—could be solved
throughout the world with the correct financial support
and the political will, but it has not been.
Mr Thomas: Is not one of the conclusions that can be
drawn from the comments made by the hon. Member
for Cardiff Central (Jenny Willott), as well as from my
hon. Friend’s point about mother-to-child transmission,
that we need to ensure that the Department of Health
and DFID work closely together so that the lessons of
success in dealing with HIV in this country can be
properly worked into our development policy abroad?
Is it not therefore a concern that DFID’s HIV/AIDS
team seems to have shrunk very small—if indeed
any cadre of skills in this area is left in the Department
at all?
David Cairns: I am grateful to my hon. Friend. He
has far greater knowledge of these matters from within
DFID than I have. If what he says is true, clearly it is a
very worrying development. I was fortunate enough to
meet some members of the HIV/AIDS team in DFID a
few weeks ago. Whether or not the team is smaller than
it used to be, it is certainly very committed. I also met
some DFID workers when I was in Kenya a few months
ago, and they are doing a tremendous job.
It is to the credit of the Government that they have
protected the international development budget, but of
course there will be reprioritising within that budget.
Part of what we are doing as an all-party group is
ensuring that these issues are not lost in the reprioritisation.
This is what people find very frustrating about the
international dimension of this issue. Enormous progress
has been made and the tide is beginning to turn. If we
withdrew funding or support or lost the political will at
this stage, it would be a disaster and a tragedy, not least
because in five years’ time we would have to return to
the matter, because we could not let the number of
deaths and new infections let rip as we saw happen in
the 1980s and 1990s.
Mr Thomas: Will the all-party group, as part of its
thinking about the Government’s multilateral aid review,
also consider funding for the new UN women’s agency?
I ask that in the context of the comments from a
previous UN Secretary-General, who said that AIDS in
many parts of the developing world has an increasingly
female face and that we need to ensure that we continue
to champion efforts to tackle issues relating to gender
equality—for many reasons, of course, but in particular
to help with the fight against AIDS.
David Cairns: My hon. Friend makes an excellent
point. The new agency has real potential to make a
difference. We are all relieved that some of the world’s
appalling, oppressive, anti-women regimes that were
muscling in have been set to one side, which will allow
the agency to focus on the issues that he mentioned.
A saying that we hear over and again now in Africa is
that the face of the epidemic is female. That is not just
because of mother-to-child transmissions, but because
of the disempowerment of women and the limiting of
women’s ability to make choices about their own sexual
and reproductive health. Of course, that is not the case
solely in Africa; it is the case elsewhere in the world as
well. However, it is a particularly pressing problem in
Africa and one that we must not lose sight of.
I was talking about the need to ensure that people
who are HIV-positive know that they are HIV-positive.
That is why the all-party group is pleased to support the
Halve It campaign, which is composed of many agencies,
clinicians and groups advocating on behalf of people
with HIV. It is campaigning to halve the number of late
diagnoses by 2015. That is an ambitious target, but the
document sets out steps that can be taken to meet it,
and I would be grateful for the Minister’s comments on
them.
Yesterday, I was pleased that when I urged the Secretary
of State for Health, while he was making his statement
on the public health White Paper in the House, to look
at the Halve It campaign, he gave an undertaking to do
so and see whether it could form part of the HIV and
sexual health strategy. I would be grateful if the Minister
confirmed that she will look at the campaign’s document,
particularly at the steps that can be taken to halve the
numbers of late diagnoses and of those living with
undiagnosed HIV by 2015.
I shall press on because I know other hon. Members
are keen to take part and I want to hear the Minister’s
reply. Once a person is diagnosed––I shall speak about
some of the hurdles in a moment––the virus changes
from being in its potentially lethal undiagnosed state,
which poses a wide public health risk due to how it can
be transmitted, to being a more normal—I use that
word advisedly—long-term managed condition. That
brings different challenges with it.
One thing that we are looking for in the detail of the
NHS restructuring plan is how people will access services
in the long-term managed phase of the condition. Who
will commission those services, particularly in lowprevalence
areas? Until those questions are answered,
there will be uncertainty in the community. I want the
Minister to answer specifically the question of who will
commission HIV services in the new restructured NHS.
Will it always be the GP? Is the GP the best placed
person to do so? Do GPs have the time and the expertise,
particularly in low-prevalence areas? I am sure that GPs
in much of London, Brighton, Manchester or Glasgow
have the necessary expertise because they have the caseload,
but in other areas that might not be the case. Is a
one-size-fits-all approach across the NHS the right
solution or is something a little more granulated necessary
to deal with the full complexity of the issue?
We have to face up to the fact that a lot of people who
are HIV-positive simply do not want to access services
through their local GP. Whether it is wise or unwise, it is
understandable in some areas, particularly in smaller
towns or villages, where everyone knows everyone else,
and you know who works in your GP’s surgery and they
know everybody and everything about you. Under those
circumstances and given that the stigma prevails, and
the myths, misunderstandings and prejudice that people
with HIV face, it is understandable that there are those
who will not want their status to be known in their own