Testing times

Ray Collins

Ray Collins on the danger of Britain losing its pre-eminent position in the world fight against HIV

In Britain, we can be proud of our response to HIV. Our strategic approach has resulted in some of the best treatment and care in the world. It also led to the setting up of a strong legal framework against discrimination. It made real impacts on mother-to-child transmission and on infections amongst injecting drug users.

At a time when an increasing proportion of decisions are to be taken locally it is even more important that we have an overall national approach. We must also remember that people living with HIV still face exceptional levels of stigma and discrimination, including when using public services. Levels of poverty and unemployment remain high. Many also face a variety of associated health problems, including mental and physical illnesses. 

A real concern, despite signing up to the principle of a cross departmental strategy at the 2011 UN General Assembly, is that the Coalition government has yet to publish one for England. In the Lords today, I will press ministers on their plans. 

It’s just possible that reference will be made to the imminent government sexual health policy document suggesting that it covers all departments, and not just the Department of Health. Unless however, it thoroughly addresses the high rates of unemployment amongst people with HIV, how we meet their social care needs, drug policy and HIV transmission amongst people who inject drugs, it will not pass the UN test of what constitutes a multi-sectoral strategy. Our country will then be in danger of losing its pre-eminent position in the world fight against HIV.

In the Lords there is a fantastic cross-party coalition led by Lord Fowler and Baroness Gould, whose Select Committee Report has done so much to raise awareness about HIV. They reported that in Britain this year there will be 100,000 people living with HIV, with the even more frightening fact that a quarter remain unaware of their infection. That’s 25,000 people not aware of the risks to themselves or others.

At the end of last year I raised the standards of care for people living with HIV, published by the British HIV Association. It stressed the need to raise awareness about testing because late presentation of HIV continues to carry significant risks of morbidity and mortality, reduced life expectancy, and increased rates of hospitalisation. Undiagnosed, untreated and the more advanced stages of HIV infection facilitate onward transmission, compromising both individual well-being and the wider public health. 

At the time, the Minister, Earl Howe was very enthused by the successful National HIV Testing Week; but there are still serious issues around late diagnosis, and a failure to commission HIV testing in primary care. With an abysmally low level of testing in GP surgeries – even in high prevalence areas – the government must now make testing a specific area of priority for Public Health England. 

Lord Ray Collins of Highbury is Shadow Minister for International Development in the Lords, and also a member of the Shadow Health team

Published 15th January 2013


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