Just a few weeks ago David Cameron and other MPs sat in the House of Commons and wore red World AIDS Day ribbons for a community they clearly don’t understand.
“The ribbon is the universal symbol of HIV awareness and it was good to see so many MPs showing solidarity with people who live with HIV in the UK and around the world,” said Cameron in his statement on December 1st. “Whilst the overall number of new diagnoses last year was down slightly on 2010, there was an increase amongst men who have sex with men. And a quarter of people living with HIV don’t know they have it. I am absolutely clear that there can be no complacency in our fight against HIV and AIDS.”
Cameron concluded by saying how the red ribbon is about more than showing solidarity with those living with HIV in the UK and abroad.
“It should also be a spur to increase testing and a symbol of our commitment to carrying on work to reduce infection levels whilst tackling the stigma, discrimination and prejudice often associated with HIV and sexual health.”
But we’ve heard it all before. Politicians deliver compassionate messages one day and deliver crushing blows the next. Despite more and more young people being diagnosed HIV positive because of a lack of information about the issue, the government has announced that there will be devastating cuts to the national HIV prevention programme in England.
Funding will be halved for the year commencing April 2015 and there is, as yet, no government commitment to fund further years of the programme. It seems like yet another complete refusal to believe that the most imperative is needed at ground-level.
“This is not the right time for the government to pare back spending on HIV prevention,” says Dr Rosemary Gillespie, Chief Executive at Terrence Higgins Trust. “In recent years, we have made good progress in driving down rates of undiagnosed and late-diagnosed HIV. However, tens of thousands of people with HIV across England are still undiagnosed and at increased risk of passing the virus on unwittingly. We have not yet reached the tipping point in our fight against the epidemic, and halving government spending on HIV prevention now would be a regressive step that risks undermining the headway we have made.”
The government’s ill-considered decision is in direct contradiction to Simon Stevens’ ‘ NHS Five Year Forward View‘, released in October. “The future health of millions of children, the sustainability of the NHS, and the economic prosperity of Britain all now depend on a radical upgrade in prevention and public health,” he wrote. “Twelve years ago, Derek Wanless’ health review warned that unless the country took prevention seriously we would be faced with a sharply rising burden of avoidable illness. That warning has not been heeded – and the NHS is on the hook for the consequences.”
Stevens’ report has been immensely influential and all the main political parties have expressed their support for its vision for the future of the NHS. It is striking that, within weeks of the government stating its support for the health vision of this publication, they are expressly contradicting one if its key tenets – the absolute centrality of prevention if we are to regain control of NHS finances.
“We have not yet reached the tipping point in our fight against the epidemic, and halving government spending on HIV prevention now would be a regressive step that risks undermining the headway we have made” – Dr Rosemary Gillespie, Chief Executive, Terrence Higgins Trust
In 2004 there were 38,117 people with diagnosed HIV living in England. In 2013, that figure had risen to 74,760. Meanwhile, funding for HIV prevention work has drastically declined during that same period while transmission rates soared. Rather than increasing its efforts to tackle the spread of HIV and the existing stigma, the government’s response is to further squeeze the sector of its resources.
What’s more shocking still is how the government cuts affect two specific minority communities. The national HIV prevention programme focuses on two groups – men who have sex with men, and black African men and women. Yusef Azad of National AIDS Trust agrees that the government is ignoring the needs of these communities.
“HIV is a health inequalities issue, since it disproportionately affects these minorities. Were British-born heterosexuals seeing the same percentages getting HIV as gay men and Africans there would be immense efforts by government to address the problem. When gay men and Africans experience such a public health crisis the response is to reduce further already inadequate funding.”
What this farce highlights is that the government, yet again, is looking for short-term gain at long-term sacrifice. Save money today, but let’s not think about the consequences of tomorrow. Azad agrees. “All governments pay lip-service to this principle and to the fact prevention is cost-effective and often cost-saving. It is only in a time of budgetary pressure that we learn whether they really mean it.
Preventing just one HIV transmission saves the public purse £360,777, according to recent modelling. The national prevention programme pays for itself many times over. “This cut will not save £1 million, says Azad. “It will mean spending many millions in preventable treatment costs.”