Gareth Thomas MP

From Harrow, For Harrow.

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Westminster Hall Debate on HIV

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Hansard record from Gareth’s contribution to a Westminster Hall debate on HIV, 15th April 2016

It is a pleasure to serve under your chairmanship for the first time, Ms Buck, and to follow the hon. Member for Finchley and Golders Green (Mike Freer), who gave a measured and constructive speech. I will try to continue that tone.

This debate is a timely opportunity to ask whether the Secretary of State and her ministerial colleagues have, perhaps inadvertently, downgraded the Department’s work on HIV and AIDS. Ministers rarely mention HIV and AIDS unless pushed. There is—granted, my exploration of DFID’s website was only cursory—no record of a serious ministerial speech on this issue unprompted by Parliament for a very long time. There is no sign of a push to signal Britain’s continued interest in the major international efforts to tackle the factors that still drive the spread of HIV and AIDS. Given the urgency of the investment that is needed if we are to achieve the 90-90-90 targets, which the hon. Gentleman spoke about, it is disappointing that the Secretary of State does not appear—unless the Minister has news for us—to have a major plan to do the advocacy work that is needed at an international level.

The 10 countries that had the most people living with HIV in 2014—the last year for which figures are available—are South Africa, Nigeria, Zimbabwe, Mozambique, Uganda, Tanzania, Kenya, Zambia, Malawi and Ethiopia. They are all countries in which DFID has a significant bilateral programme or with which our Government have a long history and good connections. Britain’s continued influence with the countries that have the most people living with HIV is unlike that of any other country in the G7 or globally. It is therefore all the more important that Britain continues to show leadership on this issue.

Similarly, the slightly different list of the countries with the highest incidence of HIV among adults, as opposed to the general population, comprises countries with which Britain has a close relationship at Government level or, with one exception, where DFID has significant programmes. Again, that highlights the importance of Britain’s role in galvanising further investment in antiretroviral programmes and in championing the legal and cultural changes that are necessary to improve the response to HIV and AIDS.

The Department’s work focusing on girls and women is important and very welcome, and it is strongly supported on both sides of the House and among the non-governmental organisation community. I commend the Secretary of State for that work. However, I continue to be surprised by the apparent lack of interest in the impact on women and girls of being HIV positive. HIV and AIDS continue to be the biggest single killer of women of reproductive age globally. Despite that fact, the impact of HIV on women as a priority group is not frequently discussed or reflected in ministerial policy.

Absolutely. Britain’s international leadership on this issue is important because one of the things that we, as a country, should be championing is the cultural change that is needed in countries so that, as the hon. Lady says, women and girls become more active decision makers. At the moment, in too many cases, they are not. I gently bring her back to the important point she made about the strong support given by Britain to the global fund. I welcome that investment, but it is not enough to outsource leadership on HIV and AIDS from ministerial offices to the global fund. Political change is needed in countries as much as investment in health services, with which the fund helps. I fear that that is the important missing link in Britain’s response at the moment.

On 16 March, at International Development questions, I asked the Secretary of State specifically whether her Department’s spending on HIV and AIDS would be rising or falling over the comprehensive spending review period. In her reply, she said that the Department was planning shortly to publish the results of its bilateral aid review. Will the Minister set out for us whether he expects bilateral HIV-specific programmes to be rising, when up to now they have been in decline?

I am told by some of the NGOs that follow the Department’s work on HIV and AIDS closely that no mention of any such work seems to be in the aid strategy published by the Department last November. It would be good to hear from the Minister why that omission has happened. Furthermore, the sexual and reproductive health team, which has responsibility for HIV and AIDS work—certainly on the basis of ministerial answers to written questions—appears to be prioritising a series of other issues. They are very important issues, granted, but they are issues other than HIV and AIDS. Again, it would be good if the Minister explained that choice to downgrade the work on HIV and AIDS by the sexual and reproductive health team in DFID. 

I come back to the first intervention that I made on the hon. Member for Finchley and Golders Green. He mentioned the Durban meeting, but I gently suggest that the UN General Assembly’s high-level meeting on ending AIDS, which is to take place in New York in June, is equally important. That is surely the perfect opportunity for the Secretary of State to set out Britain’s continuing commitment to and willingness to play a significant leadership role in tackling AIDS.

In addition, Britain could ask the new Commonwealth secretary-general to prioritise a discussion of the work needed in Commonwealth countries to tackle the HIV and AIDS epidemic. Foreign Office ambassadors and senior staff could perfectly reasonably be tasked to talk to senior figures about what more might be done in countries with particular challenges in tackling AIDS.

The hon. Lady is absolutely right. A series of factors drive the spread of HIV and AIDS. A health response is needed—we have rightly talked about the need to invest more in antiretroviral AIDS therapy and to improve health services more generally. A series of cultural practices need challenging and gender empowerment issues need addressing. 

The only way that such things can happen is if political leaders are willing to step up to the mark. The challenge needs to come from a country such as Britain that has shown great leadership on the issue in the past; we will work with and support them, but we want things to change. I hope that the Minister will reassure me that the Secretary of State is willing to show that kind of leadership in future.

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