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HIV Action Plan

Volume 815: debated on Monday 18 October 2021


Asked by

To ask Her Majesty’s Government what funding they will provide to support the new HIV Action Plan to end new HIV transmissions in England; and whether this will be included in the upcoming Comprehensive Spending Review.

My Lords, I beg leave to ask the Question standing in my name on the Order Paper. In doing so, I record that I am a member of the APPG on HIV/AIDS and a patron of the Terrence Higgins Trust.

The Government remain committed to reaching zero new HIV transmissions in England by 2030, and we continue to make good progress towards this target. In September, the Government committed £36 billion over the next three years for the NHS and social care, but decisions on future funding for non-NHS and social care budgets, including for the new HIV action plan, are being taken as part of the comprehensive spending review.

I thank the Minister for his Answer. He hits the nail right on the head. He will be aware of concerns by NGOs, the Elton John AIDS Foundation, the National AIDS Trust and the Terrence Higgins Trust that the Government will back down on their financial commitments on HIV/AIDS. We need greater commitment to ending transmissions now, not less. Will the Minister therefore ensure that the Government keep their commitments, made at the height of the Covid pandemic in December 2020, by the Chancellor, to end new HIV/AIDS transmissions by 2030? Will he further commit to implement opt-out HIV testing in high incidence areas in England?

I start by paying tribute to the noble Lord, Lord Cashman. We served in the European Parliament together for many years, where he was always a champion of LGBTQ+ issues and made sure that people were aware of the issue of tackling HIV. Funding for HIV treatment and care services is provided by NHS England and NHS Improvement through specialised commissioning. HIV testing and prevention is funded by local government through the ring-fenced public health grant. In March 2020, the Government announced that the HIV prevention drug PrEP would be routinely available across England. The public health grant in 2021-22 includes £23 million to cover local authority costs of routine commissioning, in addition to the £11 million made available in 2021. I give the noble Lord that statement.

Is not one of the chief challenges for the Government to combat the stigma and prejudice that still surround HIV and AIDS? Is it not therefore important that there should be a strong public education campaign, run by the Government, to improve public understanding and dispel the myths? Surely, countering stigma must be a key to ending the HIV epidemic.

As noble Lords will have seen, there is agreement with the noble Lord’s point. As part of the Government’s commitment to reaching zero new HIV transmissions in England by 2030, the department is currently developing a new sexual and reproductive health strategy and an HIV action plan. Officials will continue to engage in discussions with the Department for Education during the development of these publications to relate them to how HIV is covered in the statutory curriculum in schools and as part of the intimate and sexual relationships lessons under personal health and social education.

My Lords, HIV can affect anyone, as we know. Despite the success in combating it, further reducing the number of people who remain undiagnosed with HIV will become very challenging unless testing uptake is improved, as my noble friend Lord Cashman said. This is particularly the case for heterosexuals who do not consider themselves at risk of HIV. What assessment has the Minister made of why people who visit a sexual health clinic may leave without testing for HIV? Will he make it a priority to ensure that all those attending sexual health clinics are offered, and encouraged to accept, an HIV test?

I am afraid I do not have a detailed answer to the question from the noble Baroness, but I commit to write to her.

My Lords, the Minister was right to highlight the fact that sexual health funding comes from public health budgets through local authorities. The Terrence Higgins Trust and British Association for Sexual Health and HIV report from 2019 showed that five years of cuts to public health and sexual health funding have had a direct impact on access to sexual health services. So can I push the Minister to confirm that there will be a real-terms cash increase, to fully fund the HIV action plan, to local authorities’ public health budgets for the next three years?

I thank the noble Baroness for her question. The department is currently developing a new sexual and reproductive health strategy and an HIV action plan, as she referred to. We plan to publish the HIV action plan later this year to coincide with World AIDS Day on 1 December. The action plan will set out clear actions to achieve the interim target of reaching an 80% reduction in HIV transmissions in England by 2025. Publication of the detailed sexual and reproductive health strategy will follow shortly afterwards.

Do the Government accept that their forthcoming action plan should have four key features: the expansion of testing; greater support for those living with HIV; increased funding for HIV prevention; and new national prevention programmes? Will the Government provide sufficient resources to achieve all four aims and so enhance their reputation as a global leader in combating HIV?

I thank my noble friend for his question. The four features he referred to are aligned with the independent HIV Commission’s recommendations. The Government have welcomed the HIV Commission’s report and are currently considering its recommendations to inform the development of the forthcoming HIV action plan. Our specific decisions regarding resources for the HIV action plan are being taken as part of the ongoing comprehensive spending review.

My Lords, over a year and a half ago, Jo Churchill, the previous Parliamentary Under-Secretary of State for Health, said that the Government were seriously considering access to pre-exposure prophylaxis for HIV in community pharmacies and GP practices. Will the Minister say when this will happen, and, if he cannot, what is holding this up?

As the noble Lord says, in March 2020 the Government announced that the HIV prevention drug PrEP would be routinely available across England in 2020-21. It is now routinely available in specialist sexual services throughout the country. The settings in which PrEP could be made available outside these health services, such as pharmacies, will be considered as part of the ongoing work on the development of the sexual and reproductive health strategy and the HIV action plan. We plan to publish the HIV action plan later this year to coincide with World AIDS Day on 1 December, and the sexual and reproductive health strategy shortly thereafter.

My Lords, I welcome the Minister to the fight against HIV/AIDS. Will he agree with me that NHS England, public health, local authorities and voluntary organisations should work together to fight against HIV infection so that it does not become fragmented? Because of the coronavirus infection, many people think that HIV/AIDS has gone away: it has not.

I thank the noble Baroness for reminding us that HIV has not gone away. This is why the Government have an action plan. All noble Lords will agree on how important it is to tackle HIV and to raise awareness. The Government hope, in their plan and strategy, to be able to do this as soon as possible, and we remain committed to the goals previously set out.