In the media
Call for evidence for APPG inquiry on key populations and women and girls in middle-income and transitioning countries
The All-Party Parliamentary Group on HIV & AIDS recognises that a high proportion of people living with HIV live in middle-income countries (MICs) and the vast majority are projected to do so by 2020, coinciding with the UNAIDS 90-90-90 target deadline. In many middle-income countries, key populations and women and girls are disproportionately affected by HIV and AIDS, yet the Group has heard concerns from civil society that key populations and women and girls are being left behind by services as donor governments withdraw from middle-income countries. In the context of changing aid relationships between donor governments and MICs, the APPG is interested in how DFID and other UK Government departments are working with, and influencing, other stakeholders (Global Fund, private sector, other governments and philanthropic foundations) to ensure that all those most at risk have access to appropriate services to ensure countries are equipped to meet the UNAIDS 90-90-90 target.
1. What are the major barriers to access to services for key populations and women and girls in middle-income countries? Are there particular countries where these barriers are most acute? Is it possible to characterise these countries? How is DFID helping key populations to overcome these barriers?
2. What are the differences between the following types of countries in terms of the donor support available for their HIV and AIDS responses?:
a) Lower-income vs lower-middle income countries
b) Lower-middle-income countries and upper-middle income countries
3. What is the value of continued UK leadership in multilateral organisations?
4. In 2016, the UK Government recently announced a £1.1bn commitment to the Global Fund to fight HIV and AIDS, TB and malaria. What other forms of investment and support would best complement this investment? What aspects fall outside the remit of the Global Fund, particularly for key populations and women & girls?
5. DFID’s ‘Leave No One Behind’ approach mentions women and girls and LGBT groups. How can the UK Government implement the ‘Leave No One Behind’ approach and SDG 10 in relation to key populations in middle-income and transitioning countries?
6. What has been the impact of withdrawal of bilateral and multilateral aid in middle-income countries? How did donors ensure that gains made through their investment were sustained? Where possible, please highlight both examples of best practice and challenges either from the UK Government or other donors.
7. What steps could be taken by the UK Government to ensure that as UK aid relationships change, key populations and women and girls continue to have access to HIV treatment and services? How can measures be put in place to achieve the highest standard of accessibility and services while ensuring public funds are most effectively spent?
8. How effective has the process of integrating HIV and AIDS into other programmes (such as SRHR and health-systems strengthening) been? What are the criteria for when HIV should be integrated and when it should not be integrated?
9. How has the UK Government planned for and implemented withdrawal of bilateral and multilateral aid in middle-income and/or transitioning countries to sustain the gains made? What documents are used to inform/guide this process?
10. How will Brexit impact on the UK’s obligations and participation under EU joint action programmes and existing programming for HIV and AIDS both in the immediate EU neighbourhood and globally?
11. Given the US is a key player in overall global ODA spend, how should the UK Government use its influence to ensure continued engagement of senior ODA donors?
12. What role can be played by Government departments other than DFID to ensure that key populations and women and girls in middle-income countries continue to have access to HIV services?
13. Please share any other relevant information.
Deadline for submissions is Thursday 25 May 2017 at 17.30
• The submission should be in Word format emailed to email@example.com
• It should be clearly stated who the submission is from, i.e. whether from yourself in a personal capacity or sent on behalf of an organisation;
• Your submission should comprise a single document attachment to the email;
• It should begin with a summary in bullet point form;
• It should have numbered paragraphs;
• It should be no longer than 4000 words;
• It should include case studies where possible
• Please only answer the questions which you feel are relevant to you or your organisation, do not feel you have to answer all of the questions;
• Please use the question headings and numbers to organise your response.
Written evidence may be referenced in the final report. If you wish for your evidence to be anonymous please make this clear.
Submissions should be emailed to the group’s Policy Advisor, Tom Addison at: firstname.lastname@example.org . If you have any queries about the report or require further information please contact Tom at the email address above.
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A joint meeting with the WHO, STOPAIDS and Equal InternationalWednesday 5th April 201714.00-16.00
STOPAIDS in partnership with the World Health Organization, Equal International and the APPG on HIV & AIDS invite you to a briefing from WHO on HIV Drug Resistance between 14.00 and 16.00 in the Jubilee Room, Palace of Westminster.
Since the last WHO HIV drug resistance (HIVDR) global report in 2012 an increased number of reports from low and middle income countries have shown elevated levels of HIVDR to first line ART. Levels of HIVDR prior to treatment initiation reached 6.8% in 2010, but more recent representative samples show levels of resistance prior to treatment initiation at or above 10%.
HIVDR hinders viral suppression, and modelling estimates suggest that when pre-treatment drug resistance is above 10% in sub-Saharan African Fast-Track countries, 480,000 new HIV infections, an excess of 890,000 deaths and US$6.5 billion additional ART costs could be attributable to HIVDR between 2015-2030.
At this event the World Health Organisation (WHO) will present the most recent modelling regarding HIVDR, the implications of growing rates of HIVDR for the global HIV response, and present efforts the WHO is leading to respond, monitor and prevent HIVDR worldwide, including the development of the first Global Action Plan (GAP) on HIVDR which will be launched at the IAS Conference in July 2017. The WHO contextualises its work regarding HIVDR in terms of its HIV, anti-microbial resistance and broader health programmes.
Spaces are limited so if you would like to attend please RSVP to email@example.com.
Government announces new measures to piece together HIV care in light of APPG debate on The HIV Puzzle
Today, the Minister for Public Health, Nicola Blackwood MP, announced a series of measures including the extension of the public health ring-fence until 2019 in response to the All-Party Parliamentary Group on HIV & AIDS’ report The HIV Puzzle: Piecing together HIV care since the Health and Social Care Act.
Chair of the APPG on HIV & AIDS, Mike Freer MP, held a Westminster Hall Debate today on the APPG’s report The HIV Puzzle on HIV care and treatment.
The aim of the report was to inform the debate around HIV policies and provide insight into the way in which HIV and sexual health services are delivered in England in light of changes to commissioning brought about by the Health & Social Care Act 2012.
The APPG launched its inquiry over a year ago to investigate the impact of the Health & Social Care Act since its implementation in 2012 and as part of its call for evidence heard from people living with HIV, clinicians, advocacy groups, local authorities and public health in Manchester, Wales and Scotland.
Among the recommendations drawn from the evidence provided to the group were calls on the Government to:
- Ensure HIV prevention and testing remain appropriately commissioned to prevent new infections
- Clarify commissioning responsibility for HIV support services
- Encourage Public Health England to mandate local authorities, CCGs and NHS England to provide clear and consistent advice across all providers
- Give more clarity on NHS England's responsibility for commissioning pre-exposure prophylaxis and the upcoming 2017/18 clinical trial.
In response to the debate, the Minister announced that the ringfence around public health budget has now been extended by a further year until 2019. The Public Health Minister also recognised that work needed to be done on improving commissioning of HIV services and announced a PHE action plan to support commissioning with pilots to address fragmentation.
Commenting on the debate Mr Freer said: “It really is positive to learn the Government are putting in place a number of measures that had been recommended by the APPG. The announcements made by the Minister today represent significant developments which will be welcomed by the Group and other campaigners who have worked tireless on this.”
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APPG welcomes NAT to Parliament to launch its reports on HIV support services and commissioning across the UK
Today, Baroness Barker, Vice-Chair of the All-Party Parliamentary Group on HIV & AIDS, hosted the launch of two reports by the National AIDS Trust (NAT) on HIV support services. The first report outlined the continued value of support services with the second report contextualising this need with data on local authority and clinical commissioning groups (CCGs) spend in 2015/16 and 2016/17. The launch of the reports was accompanied by testimony from people living with HIV about the significance of support services in helping at different stages in their care.
Why we need support services outlined the variety of HIV-specific and generic support services that are required to ensure that people living with HIV are empowered to live healthy and secure lives. The report found that majority of people living with HIV use support services, with about a third of people living with HIV accessing services in any one year. HIV support services – the state of the nation outlines the reported expenditure by the different commissioning bodies in England, Wales, Scotland and Northern Ireland. The report found significant variation in investment across the four nations, reflecting differences in overall population density and HIV prevalence but concluded that all four nations have uncertainties around commissioning responsibilities and roles to varying degrees.
Speaking at the launch of the reports, Baroness Barker noted; ‘what we have heard today is the sometimes life-saving impact that support services can have – not just in helping people adhere to treatments but ensuring that they have access to up-to-date advice about a variety of issues affecting people living with HIV including employment issues, relationship and disclosure support to help them live healthy lives’.
Electronic copies of the reports can be found at http://www.nat.org.uk/publications
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Mike Freer, Chair of the All-Party Parliamentary Group on HIV & AIDS has secured a debate in Westminster Hall debate to discuss the findings and recommendations of the Group's 2016 report 'The HIV Puzzle'.
The report, driven by evidence presented from charities, civil society groups and pharmaceutical industry, notes significant upheaval to HIV and sexual health services since the Health and Social Care Act 2012 was implemented. Many identified 'fragmentation' of the service, characterised by a split in commissioning responsibilities between NHS England, Clinical Commissioning Groups (CCGs) and local authorities. The lack of a 'lead commissioner' or other mechanisms such as an up to date service specification is leading to widely diverging standards in care across the country.
The report highlights a number of key areas where civil society, Government and healthcare professionals can work with older people living with HIV to ensure they are supported physically and emotionally. These include:
• HIV support services aimed at people living with HIV aged 50 and over should carefully consider the diversity of needs of service users and consider tailoring different support packages to 50-60 year olds, 61-64 year olds and to individuals aged 65+
• RCGP should work with BHIVA, BASHH, HIV charities and people living with HIV to provide training and support to current GPs to increase their understanding of HIV and its interaction with ageing
• Social care providers should ensure continued professional development for staff around HIV, using key awareness days such as World AIDS Day and utilising local and national HIV organisations to ensure all activities are based on up-to-date evidence.
If you would like to contribute a brief for members contributing to the debate, please contact firstname.lastname@example.org
Secretary of State for International Development response to the International Development Committee's inquiry into DFID's work on HIV/AIDS
As part of its inquiry into DFID's work into HIV/AIDS, the International Development Committee wrote to the Secretary of State with questions based on the evidence it received during its oral evidence sessions in January 2017. Attached is the response from the Secretary of State, Priti Patel.
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Peers use debate on the UK’s upcoming role as chair of the Commonwealth to highlight the impact of inequality on meeting the United Nations Political Declaration on Ending AIDS
On 16 March 2017, during a debate on the UK’s future relationship with the Commonwealth, peers from across all parts of the chamber, highlighted the negative impact that criminalisation and discrimination on the grounds of sexual orientation can have on meeting the UN’s commitment to ending AIDS by 2030.
40 of the 77 states that criminalise same-sex relationships are in the Commonwealth, and these laws have an immediate impact on the ability of groups most disproportionately affected by HIV on the ability to seek advice, use prevention and access treatment and services.
Baroness Barker, Vice-chair of the APPG on HIV & AIDS noted the Academy of Science of South Africa findings that laws justified on the grounds that they improve public health have an ‘immediate and destructive impact’ not only on individual and public health but also crime, economic empowerment and the rule of law. This point was similarly reinforced by Lord Cashman and Lord Collins their contributions to the debate.
Beyond the immediate health impacts of same-sex relationship criminalisation, Lord McConnell and Lord Crisp both noted the detrimental economic effects that HIV and AIDS have had on some of the poorest countries in the world to encourage UK leadership in international development.
The full debate can be found here (https://hansard.parliament.uk/lords/2017-03-16/debates/E9678A92-E2C0-4FE...).
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Yesterday, the All Party Parliamentary Group on HIV & AIDS welcomed over 60 young campaigners from Dublin to Dundee, Brighton to Birmingham to Portcullis House as they urged the UK Government to keep their eye on the ball with the global HIV epidemic.
The 'It Aint’ Over campaign', led by Youth Stop AIDS and supported by Restless Development and Stop AIDS, have been on a month-long tour of the UK raising awareness of the renewed threats of the global HIV & AIDS epidemic. AIDS is now the second biggest killer of adolescents in the world - in 2000, it wasn’t even in the top ten.
The APPG event was attended by DFID Minister James Wharton, who accepted nine giant postcards from the campaigners - each containing messages of support for the It Ain’t Over campaign from every city visited by the UK-wide Speaker Tour.
The young campaigners are calling for a stocktake review of all of DFID’s work on HIV and urged the Government to “keep their eye on the ball” with a stunt outside Parliament. More detail of their campaign demands can be found on their website (http://youthstopaids.org/itaintover/)
Mike Freer MP, Chair of the APPG on HIV & AIDS, speaking after the event noted; ‘AIDS-related deaths are now the second highest killer of young people globally. This makes campaigns such as It Ain’t Over crucial both in terms of maintaining the focus of the Government on its work combatting HIV and AIDS and ensuring that young people are at the heart of developing sustainable solutions to help meet the UN’s target of eradicating AIDS by 2030.’
James Cole, Youth Stop AIDS National Coordinator, said; ‘We can beat AIDS, but It Ain’t Over. AIDS is now the second largest killer of young people in the world - in 2000 it wasn’t even in the top ten. After hearing about the experiences of young people living with HIV directly on our Speaker Tour, it’s great to see that so many young people from across the country have been inspired to take action today.’
Cat Currie, Campaign Manager at Restless Development, said; ‘Last year, as part of the Global Goals process, our world leaders made a commitment to end AIDS altogether by 2030. We’re using the power of young people’s voice to make sure those promises become a reality.’
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APPG on HIV & AIDS welcomes Government announcement to introduce statutory SRE in all schools in England and Wales
The All-Party Parliamentary Group on HIV & AIDS welcomes the Government’s amendment to the Children and Social Work Bill making relationships and sex education (RSE) a statutory requirement in all secondary schools. The APPG, working with its partners in civil society, supports the view that RSE is crucial in ensuring that young people are empowered with the knowledge and life skills they will need to develop healthy and supportive relationships and prevent the onward transmission of HIV and other sexually transmitted infections.
Speaking after the announcement, Mike Freer, Chair of the APPG on HIV & AIDS noted ‘statutory RSE in schools is long overdue and we are pleased that the Government has committed to doing more to support young people, growing up with 21st century challenges to safe and healthy relationships. The APPG looks forward to working alongside the Government to improve the quality and delivery of SRE and PSHE and ensure that guidance for schools is LGBT-inclusive and includes a significant focus on good sexual health.’
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National AIDS Trust (NAT)Tuesday 21th March 201714.00-16.00
Committee Room, House of Commons
A report launch and opportunity to explore:
• Why HIV support services matter;
• What current access to support people living with HIV have in the UK – with new and exclusive data presented by NAT; and
• What needs to be done to ensure that services necessary to good health outcomes are not lost.
Support services for people living with HIV are vital to HIV care. These specialist services, which cover a wide range of needs, are an essential, safe and understanding source of support – support which ultimately leads to better health outcomes. But, without a clear commissioning home for them since the introduction of the Health and Social Care Act 2012, austerity has led to significant cuts and sometimes total de-commissioning of these services.
‘The sad fact is that people [living with HIV] are being denied the right to vital services which could lead to a significant public health failure in the not so distant future.’ The HIV Puzzle, published by the APPG on HIV & AIDS December 2016.
Report launch: As part of this event NAT will launch two new reports on the evidence and policy base for providing support services and exclusive data on what HIV support services are actually being commissioned across the UK - based on over 250 Freedom of Information requests, this will be the first opportunity to see how access varies across the UK and to explore the implications of this.
Spaces are limited. To secure your place, please register for this event here (https://www.eventbrite.co.uk/e/putting-hiv-support-services-back-on-the-...)
Chair of the All-Party Parliamentary Group on HIV & AIDS seeks further Government engagement on HIV awareness as part of PSHE in schools
Today, Mike Freer MP, Chair of the All-Party Parliamentary Group on HIV & AIDS, spoke in the chamber about the need for greater awareness of HIV in the teaching of health and sex education to pupils. Mike noted the success of previous public health campaigns on HIV, notably the Don’t Die of Ignorance campaign of the 1980s, but highlighted that with 44% of new infections occurring in those aged between 18-34, many are unlikely to have seen the adverts and mass media campaigns of previous generations. He warned that this in turn, could give rise to the idea that if diagnosed with HIV, access to antiretrovirals will mean that ‘nothing will happen to them, or that if it does they do not have to worry, because there is a pill or because by the time it becomes a problem there will be a cure’. This attitude, he noted, risks a rise not only in new HIV infections but other STIs as well.
Mike also noted new ways that young people learn about sex and find sexual partners. He called upon schools to include peer education as a means of removing barriers to useful sex education and ensuring that safe sex messages are adopted by young people. In particular, Mike highlighted the work of Robbie Lawlor and Terrence Higgins Trust’s Positive Voices campaign in the UK, as well as the work of the Elizabeth Taylor AIDS Foundation Sex Squad in the US.
Also participating in the debate was Stephen Doughty MP, Vice-Chair of the APPG, who praised the work of Youth StopAIDS in raising HIV awareness not only in the UK but globally as well, setting an example for young people at home and abroad.
The Minister’s response recognised that HIV is a serious public health concern and that it is ‘crucial that we ingrain the safe sex message, particularly in young people’. The Minister also recognised the work of Public Health England and the Terrence Higgins Trust in ensuring that young people have access to information and testing related to sexual health and HIV. She also agreed to meet with the organisations mentioned by the Chair to hear more about the work they are doing.
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Tell us what you think!
What HIV policies would you prioritise in 2017?
Please take 5-10 minutes to fill in our short survey and inform the APPG's advocacy priorities for the coming year. APPG members will be meeting in February to finalise plans for the APPG's work programme for 2017 and would like your input. Please respond no later than 5pm on Friday 3rd February otherwise your feedback may not be taken into consideration.
The survey can be accessed by following this link (https://www.surveymonkey.co.uk/r/DJVQRJY)
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Tom Addison begins covering Susie Pelly's position as Policy Advisor to the APPG on HIV & AIDS as Susie begins her maternity leave.
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APPG HIV/AIDS and Terrence Higgins Trust Panel EventMonday 23rd January 201718:00 – 19:30
Committee Room 6, House of Commons
Please join the All-Party Parliamentary Group on HIV and AIDS and Terrence Higgins Trust to launch a new report that explores what it means to grow older with HIV in the UK.
The report is based on research carried out by the Terrence Higgins Trust in partnership with peer researchers – older people themselves living with HIV. The report seeks to set out the needs and experiences of this first generation of people ageing with HIV, and the actions needed to ensure that their needs and concerns are fully addressed.
The event will be chaired by Mike Freer MP.
Please RSVP to Debbie Laycock on Debbie.Laycock@tht.org.ukEvent Taxonomy: ReportEvent2017
APPG: ‘People living with HIV are being denied the right to vital services which could lead to a significant public health failure in the not so distant future’
According to a report launched today by a group of cross-party Parliamentarians on HIV and AIDS, vital services for people living with HIV in the UK are under threat because of changes made under the Health and Social Care Act 2012.
The report ‘HIV Puzzle: piecing together HIV care since the Health and Social Care Act’ highlights that changes under the Health and Social Care Act have lead to a fragmentation of HIV services and care leading to:
- Major reductions by local authorities to HIV support services threatening to end this vital aspect of HIV care for good.
- NHS England failure to take responsibility for providing pioneering preventative treatment for HIV.
- Inefficiencies and uncertainty for HIV and sexual health services across the country.
The report recommends four vital changes that the Government should make to ensure this situation is addressed:
1. Clarify commissioning responsibility for HIV support services and ensure they are not summarily cut across the country.
2. Encourage Public Health England to urgently develop a whole-service specification for HIV and sexual health, bringing together the various strands of clinical guidance which already exist, to ensure there is clear, consistent advice available to local authorities, Clinical Commissioning Groups (CCGs) and NHS England.
3. NHS England needs to urgently acknowledge its responsibility for commissioning PrEP and assess it accordingly.
4. Ensure HIV prevention and testing are not neglected in the wake of decreased local authority budgets and devolved responsibility. Tackling late diagnosis is key to improving HIV outcomes.
Chair of the APPG on HIV and AIDS Mike Freer MP said.
“The Government needs to recognise when elements of legislation aren’t working and that is clearly the case with HIV.
What this report shows, is that devolution of sexual health and HIV services to local authorities has created a great deal of complexity for people living with HIV which must be addressed.
It is simply unfair and unwise to allow services for people living with HIV to suffer because of the shortcomings in the Health and Social Care Act.
The logic behind devolution of public health to local authorities was sound, but the Government must act where we see there are adverse consequences. HIV support services must continue to be funded, PrEP should not have been caught up in a legal battle and HIV testing, prevention and treatment must continue to be provided in the most efficient and effective way.”
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The report will be launched in Parliament on Monday 5th December 12pm-2pm
For more information contact: Susie Pelly
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On 2nd November Mike Freer MP chaired the launch of the HIV Prevention Innovation Fund. The fund is providing £600,000 to thirteen new innovative local HIV Prevention projects across England.
Speakers included, Public Health and Innovations Minister, Nicola Blackwood MP and the National Director of Health and Wellbeing at Public Health England, Professor Kevin Fenton.
On 29th June, young advocates living with HIV came to Parliament to meet with APPG members and discuss their views, concerns and experiences of how HIV impacts on their lives – whether that be in school, university or in the health system. Members of the APPG found the meeting extremely useful.
As replenishment of the Global Fund draws nearer the APPG has been working hard to increase awareness amongst Parliamentarians of the important work the Global Fund does. On 12th July the HIV/AIDS APPG joined with APPGs on TB and Malaria to host a reception with special guest speaker Annie Lennox. The event was a great opportunity to get the important message across that the UK needs to increase its contribution to the Global Fund.
On Wednesday 13th July the APPG held its annual AGM to re-elect officers. To make the most of the opportunity we also decided to hold a roundtable discussion on the recent High Level Meeting in New York with the outgoing Minister Baroness Verma, STOPAIDS, AIDS Alliance, Harm Reduction International and members of the APPG.
River Room, House of Lords
The Halve It World AIDS Day event and launch of the APPG on HIV & AIDS inquiry report ‘The HIV Puzzle: Piecing together HIV care since the Health and Social Care Act’
Between 12.00 and 2.00 pm on Monday, 5 December 2016, River Room, House of Lords By kind permission of the Lord Speaker. Strictly invitation only.Event Taxonomy: Events2016WAD