This World AIDS Day theme is ‘End Inequalities. End AIDS. End Pandemics.’ Many who have supported their friends, lovers, family members and colleagues living with HIV have experienced and challenged the corrosive stigma that still exists against people living with HIV. This year marks 40 years since the first cases of AIDS were reported. Since that time, where investments have met ambition, there has been huge progress, particularly in expanding access to treatment. By June 2021, 28.2 million people had access to HIV treatment, up from 7.8 million in 2010, although progress has slowed considerably according to the Joint United Nations Programme on HIV/AIDS (UNAIDS).
“The red light is flashing. Progress against AIDS, which was already off track, is now under even greater strain as the COVID-19 crisis continues to rage, disrupting HIV prevention and treatment services, schooling, violence-prevention programmes and more. And make no mistake: AIDS remains a pandemic. To stop it we urgently need a bolder view of pandemic response that is capable of tackling the inequalities prolonging the AIDS pandemic. Many of these missing pieces to fight HIV are also allowing the COVID-19 pandemic to continue and leaving us dangerously unprepared for pandemics of the future,” says Winnie Byanyima, UNAIDS Executive Director.
In the UK the National AIDS Trust has said that we are at a crucial point in the fight against HIV.
It is now scientifically possible to end new cases of HIV by 2030. In January 2019, the UK government promised that it would meet this goal. The HIV Commission’s report has now provided a route map. After months of delay, the government is starting to draft its HIV action plan. NAT says: “We cannot afford to delay this any more.”
“Any HIV Action Plan is worthy of its name must genuinely start the process of ending new cases of HIV and support people to live well with HIV and AIDS.”
The Elton John AIDS Foundation has a project which operates across Lambeth, Southwark and Lewisham. This focuses on increasing HIV testing, and re-engaging with people who have stopped HIV treatment. It has helped provide additional HIV testing in University Hospital Lewisham A&E department, primary care settings, and in community organisations, as well as recall of those who are no longer in treatment. Some 115 Lewisham residents living with HIV have received treatment and care since the project started in November 2018.
I has campaigned with the NAT and local HIV organisations like Metro for many years. Earlier this year, I wrote to Matt Hancock who was then, Secretary of State for Health, about the need for action.Letter-to-Matt-Hancock-HIV-AIDS-2021-AH-headed
During the 1990s Lewisham did not have a specialist hospital based sexual health clinic. Following a successful campaign led by the voluntary sector, the local Community Health Council and LGBTQi+ groups a new clinic was opened at University Hospital Lewisham. The Alexis Clinic is much in demand as Lewisham’s centre for treating outpatients and inpatients with HIV in a confidential, comprehensive and patient-centred manner.
The Alexis Clinic provides a wide range of services for adults aged 16 and there are 850 registered patients. More than 50 per cent of them are heterosexual and most are of African origin. Many live on the poverty line and struggle with mental health problems. The Alexis Clinic say that the biggest challenge facing its clinical team is the issue of stigma.
The rates of HIV infection in Lewisham need to be seen in the context that the UK maintains the largest HIV epidemic in western Europe. Lewisham as a London borough has one of the highest HIV prevalence rates in the country, with 1,693 diagnosed.
Recently published research in Ireland around stigma and HIV, in the well respected National AIDS Manual, concluded that despite improved access to HIV treatment and prevention, the Irish HIV epidemic remains a significant public health concern, with annual increases in the number of infections. In 2019 the number of new diagnoses of 11 per 100,000 was much higher than the European average of 6.2. The rise in HIV infections coincided with significant health funding cuts since 2008. People living with HIV continue to feel stigmatised and this impacts upon health in varied ways, such as not seeking out healthcare services.
Perhaps, there needs to be some research into how the public discourse around HIV and the media coverage of it is having an impact on HIV treatment, care and prevention in the UK?
HIV and AIDS non governmental organisations promote the positive advances in medicine – and these are real and beneficial. However, there is still a question of whether we are reaching those who need support. As the researchers in Ireland put it: “Whose ‘health’ counts in a politics ‘that produce conditions of systematic negligence’, which disproportionately affect individuals with less access to power?”
To redress the balance, then access to advocacy and support service for individuals with HIV – and other conditions – needs to be prioritised.
This is one of the many reasons that Lewisham needs an independent disability advocacy service. Since the Lewisham Association of People with Disabilities closed its doors in Bellingham in December 2018 there is no organisation to advocate and represent those with disabilities in Lewisham and the small budget of around £50,000 remains unspent. Politics is about priorities and this must be one of them – without delay.
In advance of World AIDS Day on the 1st December 2021, I tabled a formal question at Lewisham Council. The latest statistics available and the text of the reply
Taking up the need to address the “Crisis in HIV and AIDS in the UK, London and Lewisham” and pointing out that Lambeth, Southwark and Lewisham all have high rates of HIV and AIDS, in fact among the highest in Europe, I urged Lewisham Council to do more work and to address the issue of racism that I raised on the floor of the Council Chamber last year 2020.
Cllr Chris Best, cabinet member for Adult Services said: “I am not proud of the statistics at all” and she agreed there was more that needed to be done.
The full exchange between can be viewed here
A report on transforming sexual and reproductive health for BAME communities in Lambeth Southwark and Lewisham published on 3rd November 2020 says:
“Mainstream services must look at the way racial and HIV discrimination intersects when caring for BAME service users, so they can provide efficient care for individuals who may be coping with social isolation, stigma from the community as well as racial discrimination: something that is not necessarily relevant to the rest of the HIV positive community.”
I have joined campaigners calling for more government action to end new cases of HIV in the UK by 2030. I say:
“There is a failure to act to end HIV. To end the prejudice, to end the stigma. In the Budget – earlier this year – the failure to allocate resources means that action is needed more urgently, if we are to put the country on course to end transmissions by the end of the decade. History will look kindly on those who show real leadership and financial commitment now. We need to fund the fight and take the decision to end new cases of HIV by 2030. We need real action now to end the colliding pandemics.”
Winnie Byanyima, Executive Director of UNAIDS said: “Ending inequalities to end AIDS is a political choice that requires bold policy reforms and requires money. We have reached a fork in the road. The choice for leaders to make is between bold action and half-measures.”
Cllr Alan Hall was a trustee of the London Lighthouse, the pioneering HIV and AIDS hospice and centre in London.