In this horrible year, it has been really tempting to despair. From Syria and ISIS to Brexit and Trump, it sometimes feels like we're being tugged together over a cliff. But when I feel that sense of bleakness coming, and I want to give up, I remember something that happened to me, a long time ago now. I want to share it with you, as a small candle in the darkness of 2016.
HIV no longer has to prevent people living normal, happy and long lives - but we know that it does. There is still no cure, and without treatment, people will die. Meanwhile HIV services are being cut, stigma is rife, and we're now facing the first generation of people to grow old with HIV. We can't stop now - it's not over. On World AIDS Day at Terrence Higgins Trust, we're still fighting, still caring and still wearing our red ribbons with pride. It may be just one day out of 365 - but thank goodness we've got that one day.
A long-term condition framework for understanding HIV is not yet fully embedded within the thinking of the general public, the media, politicians - or our NHS. The framing of HIV as a long-term condition has not replaced the dominant image of HIV as a serious, communicable disease, which is ultimately fatal but for the constant innovation of medical science.
There's been jubilation in the HIV community about our landmark win this week. The Court of Appeal upheld the High Court's judgment that NHS England has the legal power to pay for PrEP, an HIV prevention drug. But what does this actually mean? Will PrEP now be available in sexual health clinics for those at risk of HIV?
Pre Exposure Prophylaxis, or PrEP, is nothing short of a game-changer for HIV - a HIV drug taken by HIV negative people to stop infection. This is something I could only dream about twenty years ago. If used alongside condoms, regular testing and treatment, it could be the vital piece of the puzzle to help end the HIV epidemic here in the UK for good.
Today is 19 years we are together. This is also the year I turn fifty. My life has been defined by you, there is no denying it. You have pushed me in so many directions. The highest and the lowest. I never felt so lonely and damaged like 19 years ago. But today you connect me to an amazing community of people that in spite of fear, suffering, illness and stigma, have risen, resisted and flourished.
PrEP is exciting, new, and currently, unique. It is not a vaccine, although it has a similar impact. We can draw comparisons to statins, in terms of preventing illness, or contraception, in terms of preventing unwanted consequences of sex. But actually, there is nothing quite like it. It is the definition of healthcare innovation. The NHS should be falling over itself to get the benefits, which makes today's response all the more regrettable.
This admirable pledge, which comes with a promise to 'leave no-one behind', will remain no more than a slogan. People who use drugs are being left behind and only a major injection of political courage, backed up by a redirection of the necessary resources away from drug control and into harm reduction, will change this.
What I have seen in the last few days in Lesotho gives me huge confidence that we will rise to this challenge. Seeing young people who have so little, yet who work so hard to support their friends and educate their families about HIV, continues to inspire all of us at Sentebale. They are why I care so much about this fight. I hope that their stories of courage, and not just the huge problems they face, can inspire all of you as well. What I believe is that we cannot beat HIV without giving young people in every country the voice they deserve. Without education and without empowerment, HIV will win.
Too many members of the gay community, with our hard-won marriages, our adopted kids, our newfound respectability, regard the guys who haven't yet got there as traitors. Letting down the side. Tainting the gay brand. Doing what the homophobes accuse us of. Let's not be Pharisees. Let's welcome our gay brothers into the fold and protect them from what is still the most serious consequence of sexual risk. Let us save them from HIV. Let us offer them PrEP.
I met Sebenele, a bright 14 year-old boy with a big smile, this week during a visit to Swaziland to see how my fund is helping UNICEF to support and protect children living with HIV. Swaziland has the highest rate of HIV infection in the world. Twenty-four per cent of children here have lost one or both parents to AIDS and many are themselves now living with HIV. I thought about my own children and how in many ways the things Sebenele enjoys are the same things they do. Yet he told me how he is struggling to continue to take his antiretroviral medicine, which is vital to ensure he stays healthy, because he can't keep the pills down without any food.
At the last High Level Meeting on Ending AIDS in 2011, the coalition government sent a delegation led by Minister Stephan O'Brien. But sadly, this time round, no minister from the UK Government will attend. In addition, the Department for International Development (DFID), the lead department for this UN meeting, is not planning to send a senior member of staff either. In the context of a meeting that is expected to be well attended by ministers and even presidents from some countries, this sends a bad message about the importance the UK places on a successful High Level Meeting.
As duty bearers of human rights, it is the responsibility of states to ensure that their citizens are able to realise their rights. The High Level Panel's recommendations are set to come out in June and will be addressed to heads of state. It is yet to be known whether these recommendations will have an accountability mechanism attached to them so it may well fall to civil society to hold governments to account.