My Lords, according to the UNAIDS Gap report published in July 2014, globally it is estimated that 2.1 million men, women and children became newly infected with HIV in 2013, which is down from 3.4 million in 2001. It is estimated that 35 million people are now living with HIV.
My Lords, is not the worst feature of that figure of 35 million people living with HIV around the world that half of them are undiagnosed, and the principal reason is that people are prevented coming forward for testing because of the prejudice and fear that surrounds this area? As we approach World AIDS Day in about a week’s time, will the Government renew their efforts to persuade a change of policy in the 80 countries around the world, several of which are in the Commonwealth, where homosexuality is still a criminal offence?
I start by paying tribute to my noble friend for his outstanding work in this field, and not least for his new book, which I have been reading with great interest, AIDS: Don’t Die of Prejudice. He makes a very strong case not only for action in the United Kingdom—which, of course, he led on, and which I hope he will agree we have maintained—but for very active work overseas. It is by being inclusive, not stigmatising, and by making sure that prevention, treatment and care are all taken forward for everybody that we will indeed turn this around.
Is the Minister aware that many people suffering with HIV are in fact addicted to drugs and that it is the interpretation of the UN conventions that is failing HIV patients and also failing the rest of the world? As 5.5 billion people do not have access to essential pain-relieving medicines, will the Minister support the guidance being prepared by the All-Party Parliamentary Group for Drug Policy Reform, which we are doing in conjunction with the Mexican, Colombian and Guatemalan Governments? Will she support that guidance on the reinterpretation of the UN conventions?
The noble Baroness is right to associate this with the use of drugs, and she will also know that in those countries that have addressed needle use HIV has been reduced—for example, in the United Kingdom it is minimal. We realise the significance of this challenge worldwide, particularly, for example, in eastern Europe. I will look closely at what she has suggested.
My Lords, while HIV is clearly a health issue, does the Minister agree that in many countries gender inequalities remain the driving force behind this epidemic? Studies have shown that women and girls experience violence and are, therefore, at increased risk from HIV and live lives full of threat. Does the Minister agree that the needs and rights of women and girls are not being adequately addressed in response to HIV, and will DfID call for an in-country response to HIV, which includes, as the UN has requested, the creation of specific budgets intended to cater for the specific needs of women and girls?
The noble Baroness is quite right to associate this with violence against women and girls and the inequality of women and girls. She will know that the infection rate among young women is twice as high as that for young men, for the very reasons she has given. It is absolutely fundamental to our approach to address that inequality and try to combat violence against women and girls.
My Lords, an increasing number of people with HIV, although very poor and marginalised in their own communities, live in middle-income countries. To date, DfID’s grant support has been crucially important to the HIV prevention and treatment programmes in those countries. What will happen when the funding ceases in 2015?
My noble friend is probably aware that we are a major donor to the Global Fund, which works internationally in middle and low-income countries. She is right that our bilateral programmes focus on the poorest countries, but through our enormous contribution to the Global Fund—we are the second largest international donor in this area—we are supporting those with HIV in middle-income countries.
Like the noble Lord opposite, I had an extremely instructive visit to the IAVI lab at Imperial College. He will have noted, as I did, the challenge of trying to find a vaccine for HIV because of the difficulty with the way the virus mutates. This is in contrast, for example, with seeking to find a vaccine for Ebola. We continue to emphasise the need for research in this area, but it is immensely challenging.
My Lords, does my noble friend agree that, when the Global Fund launched its great campaign to get antiretroviral drugs out to AIDS sufferers all over the world, it missed an opportunity to ensure that there were simple primary care health systems set up on the back of the campaign, and people in Africa are suffering from that now?
The noble Baroness is right in her analysis of what happened in the first instance. Because HIV was such a major catastrophe, it was targeted separately from the health systems. However, the lesson was quickly learned that these needed to be integrated. Our emphasis now is absolutely that this needs to be integrated with the health systems in the relevant countries, and this has benefits across the board.