Westminster Hall Debate on HIV/Aids

Speech by Jo Swinson MP on Thu 11th May 2006

Last week, the nation was shocked by the revelation that 10 new cases of HIV had been discovered in the space of a single month in St. Ives, Cornwall. Headlines grew more hysterical as the story unfolded of a single perpetrator who had, perhaps knowingly, spread the infection through the small town. An expert team of medics was sent directly, a helpline was set up, two new testing clinics were established and my hon. Friend the Member for St. Ives (Andrew George) issued a call for calm. My thoughts are with those 10 people and their families, whose anxiety must be unbearable.

However, it is not to belittle their suffering to say that that is the reality every single day for many families throughout the world. In the UK, about 19 people are infected with HIV every day. As my hon. Friend the Member for Edinburgh, West (John Barrett) said, that is still far too much, and it is worrying indeed if the trend of recent years has been an increasing infection rate. Perhaps the safe sex messages that were so strongly accepted in the 1980s and early 1990s are losing some of their resonance.

We are, of course, concerned about cases in the UK, but compare 19 a day with the figure for Africa, which is 8,800. Even taking into account the huge difference in population size, there is a clear disparity. Per capita, if the UK's infection rate was the same as Africa's, every day in our country almost 600 people would be contracting HIV. That would be a major public health emergency. We would be dealing with it at the highest levels of Government. However, in Africa and in many other places in the world there is a much greater problem.

Botswana has one of the highest HIV rates; 37 per cent. of the adult population is HIV-positive. For those people there will be no crack team of medics, no special clinic, no helpline, and their contraction of HIV is by no means headline news. The sad fact is that for many communities in Botswana and across the world HIV is part of the daily reality. Having contracted the infection, the 10 people in St. Ives can expect an average of £15,000 a year to be spent on their care. In Africa, the average per person is £7.

The Government's commitment to funding antiretroviral drugs must be commended, and the Minister and the Secretary of State are to be congratulated on their work in pushing this issue up the agenda. The UK is the world's second biggest bilateral donor on HIV and AIDS. In 2004, DFID said that over the next three years the UK would spend at least £1.5 billion on AIDS-related work. However, it is already clear that that is not enough. In June 2005, UNAIDS and the World Health Organisation estimated that 6.5 million people in developing countries needed immediate antiretroviral treatment, and of those only 15 per cent. were receiving it. While the Government's commitment to aid is substantial, it is still out of balance with their spending on war; the £1.5 billion pledged to aid is dwarfed in comparison with the £3 billion already spent on the war in Iraq, and that figure is likely to rise to £5 billion by the end of the year. Our country must redress the balance of our spending on war and aid. Thirty years late, we are yet to meet the UN target of increasing international aid to 0.7 per cent. of gross national product, although I welcome the Government's commitment to meeting that in the coming years.

Furthermore, in the developing world war and health are inextricably linked. Aid to alleviate poverty and to improve health is an essential safeguard against the escalation of violence. Nowhere is this link between violence and the deterioration of health resources more glaring than in the Democratic Republic of the Congo, where easily preventable diseases are rampant because the war has destroyed hospitals and other areas of health infrastructure. The most recent report of the International Rescue Committee aid agency found that 1,000 people are dying every day from conditions such as malaria and malnutrition—basic, easily preventable diseases. When one adds HIV and AIDS to the situation, it is easy to see why the health services get stretched to the point where they cannot cope. In the DRC, there are 1.1 million HIV-positive people, which is about 4.5 per cent. of the population.

The report says that the international humanitarian aid to the DRC has been "abysmal" compared with the response to other disasters. In 2003, for example, Iraq received aid worth the equivalent of £75 per person and the DRC received the equivalent of £1.70 per person. There are some excellent aid projects under way to support the testing and treatment of HIV in the DRC, especially the work of the United States Department of Health and Human Sciences, with its Centres for Disease Control and Prevention global AIDS programme, but these projects need more attention from the UK Government. Several Members have spoken about the availability of antiretrovirals in the fight against AIDS. That is partly to do with health and the infrastructure in developing countries, but it is also partly to do with simply access to drugs and being able to afford them.

Unfortunately, the financial barriers faced by developing countries are not always simple. The issue that I believe currently needs most attention is TRIPs—the trade-related aspects of intellectual property rights—which is dealt with in paragraph 12 of the Select Committee's report. Protection must be in place to exempt areas that impact on the millennium development goals and global disease control. The current provisions have proved inadequate; we all remember the furore in 2001, when 39 major pharmaceutical companies tried to prosecute the South African Government for passing a law that allowed easy production and importation of generic HIV drugs. There was a good ending to that incident. Following immense pressure from the South African Government, the European Parliament and, not least, 300,000 people from more than 130 countries who signed a petition, the pharmaceutical companies were forced to back down.

I strongly support the Committee's recommendation that the WTO must be persuaded to undertake a review of the implementation of TRIPS, and that DFID should continue to work to build the capacity of developing countries to use TRIPS safeguards, like compulsory licences and Government-use provisions, to facilitate the production and export of affordable medicines, particularly second-line ARVs, which are increasingly important, especially as the disease becomes more resistant and the first-line ARVs become increasingly ineffective. It is perhaps a sign of the difficulty that developing countries have working within the TRIPS provisions that no compulsory licences have been issued.

I am deeply concerned about the future of the agreement that keeps sub-Saharan African countries immune from TRIPS-plus agreements with the United States. Those laws go beyond the requirements of TRIPS to protect intellectual property and are often drawn up as part of bilateral trade agreements with the US, usually involving the US promising better trade and investment to a particular country in exchange for it introducing legislation to protect US intellectual property rights. That may mean restrictions on compulsory licences or parallel importing, and it could mean the extension of patents beyond the standard 20 years suggested by TRIPS.

An Executive order signed by President Bill Clinton in 2000 barred the US Government from asking southern African nations to sign such agreements. President Bush endorsed that when he came to office in 2001, but there is a danger that his Administration, faced with the fact that many generic plants now operate in Africa, will not keep their promise. If the UK Government wish to stand by the promises made at Gleneagles, I urge them to make it clear that such a possibility is intolerable.

We are all aware of the extent of the HIV/AIDS problem. I welcome the Select Committee's excellent report and the spotlight that it is putting on the issue. The Government have made good progress, which is to be commended. I hope that Ministers will take on board the strength of interest that Members of this House and the wider public have in the issue. It is incredibly important that it is given a high priority within Government.