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Volume 696: debated on Thursday 29 November 2007

asked Her Majesty’s Government:

What action they are taking to help in the world-wide fight against HIV/AIDS.

My Lords, DfID is the world’s second-largest donor in the fight against HIV/AIDS and has pledged to spend £1.5 billion on AIDS-related work in the three years to 2008. It recently made the first long-term commitment, to 2015, of £1 billion to the Global Fund. DfID promotes a comprehensive approach to tackling the epidemic, from prevention to access to treatment, from education to rights to health systems, and we prioritise women, children and other vulnerable groups.

My Lords, I pay tribute to the Government’s work overseas, but is the Minister aware that the position at home is not so good: that the number of people in the United Kingdom who are diagnosed each year with HIV has more than trebled since 1997; that the number of people living with HIV has reached a record total of 73,000; and that, rather than having the best record in western Europe, we now have one of the worst? Will the Government pledge on World AIDS Day on Saturday that, in renewing the battle against AIDS globally, they will renew it also at home?

My Lords, I am grateful to the noble Lord for asking us to mark the 20th World AIDS Day on Saturday. Yes, we will look at the new figures on the increasing prevalence of AIDS in the United Kingdom. I am sure that the Department of Health will have something to say about it.

My Lords, will the Minister congratulate the Royal College of Nursing, which last night launched a campaign, Think Positive, aiming to stop discrimination against people with HIV and AIDS? Will she encourage the worldwide treatment of HIV and tuberculosis together, as there has been a rise in the incidence of tuberculosis?

My Lords, indeed, I congratulate the Royal College of Nursing, particularly because we understand that stigma and discrimination are among the major obstacles to treating HIV and AIDS. I am pleased to announce that DfID will today publish guidance on best practice in dealing with stigma and discrimination for all its staff around the world and for those in the development community who are working on HIV/AIDS.

My Lords, does my noble friend agree that treatment of AIDS is much more than just supplying medicine, and that for both prevention and treatment it is essential to focus aid on the proper delivery of health services, particularly in rural areas?

My Lords, I totally agree with my noble friend. We have to be aware of the fact that for every new person put on ARV treatment, there are three or four new infections of HIV/AIDS. Therefore, we have to take a very comprehensive approach to prevention as well as the delivery of HIV/AIDS treatment. DfID’s focus has been very much on the creation of health systems in developing countries, a lot of the funding for which is not specifically earmarked to HIV/AIDS and not in the figures that I mentioned earlier. In particular, we look at the distribution of condoms, the availability of treatment for children and vulnerable groups, and gender issues, so we need to take a comprehensive approach.

My Lords, the Minister will have seen, as I have done, many children with HIV/AIDS. When will we see a significant improvement in the prevention of mother-to-child transmission? Will the Government’s new AIDS strategy, which they are working on at the moment, continue to earmark the treatment and care of children? There seem to be some doubts as to whether that will continue to be the case.

My Lords, I am happy to assure the noble Baroness that it is not the case that there will be any backing away from our commitment to children and women. I am conscious of the fact that we could be very effective in the prevention of mother-to-child transmission if we made the effort. Only 11 per cent of women receive treatment in order to prevent transmission to children. Of course, this is one of the major ways in which children get HIV/AIDS; in Africa, 90 per cent of children who have HIV/AIDS get it from mother-to-child transmission.

My Lords, is the Minister aware that yesterday the most reverend Primate the Archbishop of Canterbury said that churches need to be brave, imaginative and honest in the fight against the spread of HIV/AIDS? Does she agree with the most reverend Primate that Governments need to be challenged to work effectively with faith-based organisations on this issue?

My Lords, I completely agree with the most reverend Primate the Archbishop of Canterbury. I am pleased to say that DfID in particular is focusing on working with faith groups, which are, especially in Africa, one of the best delivery mechanisms for HIV/AIDS treatment.

My Lords, would the Minister agree that the virus in question is called the immunodeficiency virus and attacks the body’s immune system, and that because it does so it makes the development of a vaccine more difficult than in the case of many other infections? Nevertheless, what progress is being made in the development of a vaccine against this particular virus?

My Lords, no communicable disease has been eradicated without a vaccine, so we are completely aware of the need to focus on a vaccine. Unfortunately, I can say only that it remains a long-term goal; currently, 30 candidates are being trialled for vaccination and none of them looks immediately viable. We had a disappointment earlier in the year with the vaccine that was the most advanced. Nevertheless, DfID continues to fund and was the first government donor of the international AIDS vaccine initiative. Approximately $900 million are going into vaccine research this year.

My Lords, what progress has there been on research into microbicides that have been shown to be a barrier to the virus?

My Lords, microbicides are very important because of the feminisation of the virus. They could empower women and lead to a female-led solution, which may not be comprehensive but is part of a solution. Three first-generation products are currently on trial and we expect the results in 2009. There are two second-generation trials from which we shall receive data later, perhaps in 2010-11. However, we do not expect any products to be available on the market before 2010-11, if we are lucky.