Lord Collins of Highbury stood up in the House of Lords on Tuesday and introduced a debate on how the Government has failed to deliver a much needed national HIV strategy. In doing so he raises the question, one the National AIDS Trust also wants answered, how serious is the Government about tackling HIV?
HIV remains one of the most serious infectious diseases we face. About 100,000 people are living with HIV in the UK, approximately one in twenty gay and bisexual men, and one in twenty African men and women. In London roughly one in 200 people have HIV. Whilst we have a strategy for conditions such as flu and autism, the national strategy for sexual health and HIV in England came to an end in 2010 and two years on, no replacement has been published.
In 2011 at the United Nations General Assembly the Government re-committed to having a cross-departmental, comprehensive HIV Strategy for England. They have so far failed to live up to this commitment.
What they have promised is a sexual health policy document (now long overdue). Once published this could well be very useful. However this document will only address HIV as a sexually transmitted disease. Whilst this is an important area - 95% of new infections are through sexual transmission - it is by no means the whole picture. The document will not address the risks from sharing injecting equipment. And a national strategy for HIV should look beyond sexual transmission of HIV and also address in detail issues facing people living with HIV as a long-term condition.
People with HIV still too often face stigma and discrimination (a third report discrimination, half of it in healthcare) - what are the Government's plans to address social attitudes to HIV, perhaps as they have recently done for mental health issues? We know many schoolchildren leave education with no information on HIV and HIV risk. There are people with HIV in prison or immigration detention who have their access to daily medication interrupted, with grave risks to their ongoing health. How can we get our detention system to be HIV-aware and competent?
Unemployment and poverty are disproportionately severe amongst people with HIV so what are the Government's plans to support people with HIV back into work or provide a dignified and secure life for those unable to do so? Social care and long-term condition management services are essential for many people with HIV in helping them maintain good health - a national strategy should explore how in a time of fewer resources we can nevertheless ensure these key preventive services are maintained and joined up with the HIV clinics.
What's striking on so many of these issues is that they are not simply responsibilities of the Department of Health - we need the Department for Education, the DWP, Communities and Local Government, the Ministry of Justice and Home Office, to name a few, engaged with clear commitments to act. At NAT we addressed these issues in 2011 our Shadow HIV Strategy for England: 'HIV - a strategy for success'.
Whilst it appears the Government recognises the need to address HIV and provide guidance, if HIV is addressed simply as an STI, with no broader strategic attention, the Government are in serious danger of letting down people with HIV.