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HIV: Global Response and Young People

Volume 787: debated on Thursday 30 November 2017


Asked by

To ask Her Majesty’s Government how they will support young people as partners, leaders, and advocates within the global response to HIV.

My Lords, ending AIDS as a public health threat by 2030 is a UK priority. We are the second-largest international funder of HIV prevention, treatment and care. Much progress has been made, but AIDS remains a leading killer of adolescents globally. To change this, we must work together with young people to help them take informed choices to protect themselves from infection.

My Lords, I welcome the Government’s commitment, but one thing that concerns me is that no mention is made of HIV in DfID’s youth agenda, which was published in 2015 and promotes youth as being the agents for change in the heart of development. HIV affects young people disproportionately. Does the Minister accept that, by including it in the agenda and recognising HIV as a youth issue, young people could be supported to lead HIV programming and to be effective advocates in stopping the spread of HIV? One thing that DfID could do would be to include a young delegate in the delegation to the international AIDS conference in Amsterdam next July, but certainly prioritising it among young people is key.

That seems a very good suggestion. I am happy to take it away and look at the possibility of sending a young delegate to the AIDS conference next year. I think that we could do more in this area. Above the youth strategy, we have the HIV/AIDS strategy, which cuts across all these issues. The noble Lord is absolutely right to remind us about the effects of AIDS. It is the biggest killer of young girls in sub-Saharan Africa and 80% of all new infections among adolescents occur in young girls. Education, the involvement of peer groups, overcoming stigma and making sure that people have access to the right sexual and reproductive health advice are all very important, and I am very happy to take away the noble Lord’s suggestion and look at it again.

My Lords, the latest figures from the WHO show an increase in new infections in Europe. In Africa, the number of new infections is declining far too slowly. Does the Minister agree that prevention is better than cure and that investment in vaccines and other prevention tools must continue?

As the noble Baroness will know, we are the second-largest contributor to the Global Fund, with a commitment of £1.1 billion. She is also absolutely right to say that the fastest growth areas in terms of new infections are eastern Europe and central Asia. Following a significant decline in infection rates in the early part of this century, we have found that those rates have plateaued out, with around 2 million new infections last year. That is way too high and is way short of the objectives that we all signed up to in SDG 3, which includes achieving the eradication of AIDS as a public health threat by 2030.

My Lords, I know the Minister has been in Africa quite recently. Can he say which countries are most successful in reducing the infection rate? Is Uganda still in that position?

Of the 15 countries which are at the highest risk, it is correct that 10 are in sub-Saharan Africa. Regarding those which have been most effective, there has been a combination of two things. First, there is a need to remove the stigma: in far too many countries, same-sex relationships are criminalised; there is a stigma attached to talking openly about sexual relations; and therefore, particularly among young people, that is not conducive to reducing infection levels. Secondly, there is the question of healthcare systems. We are working with many countries in sub-Saharan Africa to address those issues.

My Lords, what action is taken with immigrants to the UK, including refugees and asylum seekers, to make them aware of the facilities available and that they are able to access them just like anyone else?

My Lords, I am sure that is happening as a matter of course through our health service, which has been pioneering responses to and treatments of this epidemic throughout the world. I am sure that will continue and impact other people as well. At the same time, we are also working with organisations such as the Robert Carr civil society Networks Fund to get non-government organisations better joined up and advocating to reduce the threat and tackle the epidemic.

My Lords, will the Minister pay a visit to Scotland and discuss with the Scottish Executive—the Scottish Government—the Scottish Parliament, voluntary organisations in Scotland and his own staff at East Kilbride, where about 40% of DfID’s staff are based, what they can do to help fight AIDS, both at home and abroad? That would be particularly appropriate because, as well as World AIDS day, this is also St Andrew’s Day.

The noble Lord provides me with an opportunity to pay tribute to our staff in East Kilbride on St Andrew’s Day for the incredible work they do in tackling poverty around the world from there. I am happy to visit East Kilbride, as I do often, and have discussions to explore opportunities to reduce this epidemic.

My Lords, my noble friend will not be aware but a couple of years ago I went to Lusaka and visited a male prison where AIDS was in an incremental state. Does he accept that overcrowding in prisons is one of the causes, and one of the solutions, to reducing AIDS among men?

By making sure that people are educated and aware, there are many ways in which infection can be prevented—and prevention is far better than cure in virtually every circumstance. We are looking for opportunities to provide better education and sexual and reproductive advice to inmates as well as the wider population.

My Lords, DfID should be congratulated on the work it has done with marginal groups. Does the Minister acknowledge that in too many countries, because drug abuse, sex between men and sex trafficking are criminal, many Governments refuse to engage with those sectors, and yet they are the drivers of AIDS? Will DfID keep up its good work in that sector?

There are 72 countries around the world which criminalise same-sex relationships, eight of which have the death penalty. Therefore, having an open conversation about how to address these issues is very difficult in those circumstances. Sadly, 36 of those countries are also members of the Commonwealth. The Prime Minister has said that we will be taking the opportunity at the Commonwealth Heads of Government Meeting to raise those issues in that summit to ensure that there is change.