01 December 2011
Minister of State Alan Duncan speaks at The Beginning of the End of AIDS? event hosted by the All Party Parliamentary Group on HIV and AIDS and the UK Consortium on AIDS and International Development
Thank you. First of all I would like to thank the All Party Parliamentary Group on HIV and AIDS and the UK Consortium on AIDS and International Development for inviting me to make some short remarks and for organising this event to mark World AIDS Day 2011. Today we remember the millions of people who have lost their lives to AIDS, to those living with HIV now and we pay tribute to people from all levels of society, who have fought relentlessly for action against the epidemic.
The APPG plays an invaluable role in the UK’s response to the epidemic by bringing together members of parliament across the political spectrum and working with our strong civil society network to sustain UK taxpayers’ support for tackling AIDS. They hold us to account for what we promise to deliver. I would also like to commend Stop AIDS’ continued efforts to raise awareness on HIV issues.
Today, 30 years on from when AIDS was first diagnosed, we are working towards realizing the idea of “Getting to Zero”. Zero New HIV Infections, Zero Discrimination and Zero AIDS Related Deaths.
Never before have we been in a realistic position to seriously articulate and work towards this ambition:
Let me say at the outset that the Coalition Government remains 100% committed to this agenda. And, we have new priorities as well – such as our new strategic vision for women and girls. We confirmed our commitment in our recently published position paper on HIV. And we renewed our commitment to increase coverage of life saving treatment to reach 15 million people with HIV by 2015 alongside the global community at the UN General Assembly in June.
But despite these commitments and unprecedented efforts over the past decade, the current pace of change is not likely to achieve universal access to prevention, treatment, care and support.
Although transmission rates have reduced or stabilised in some countries, they are on the increase in others. Vulnerable communities, men who have sex with men, sex workers, prisoners and injecting drug users are still marginalized and often excluded from prevention, treatment and care services. Currently, around 8 million who could benefit from HIV treatment do not receive it.
Women continue to bare a disproportionate burden of illness and care responsibilities. The impact of the epidemic, on individuals, families and communities is enormous. Many adults and children living with and affected by HIV still struggle to get the quality care that they need, when and where they need it, be it in the home, hospital, village or health centre.
We need to look at new and innovative approaches to get to zero new infections, zero AIDS deaths and zero stigma and discrimination. I want to outline 3 important ways we can work towards this.
Firstly, in a difficult global financial climate, we need to ensure our HIV investments are effective and efficient. We need to show that we’re spending tax payers money on the right things and in ways that deliver maximum value for money. Every penny of every pound needs to make a positive difference.
The strategic investment framework (SIF) is a very useful approach to thinking through how we could optimize HIV responses. It is an approach to help partners involved in implementation focus and prioritise their efforts among the most affected populations in order to achieve the greatest impact. The SIF is a departure from previous plans because it suggests that up-front investment in a closely defined range of interventions will mean we reach the peak earlier and then see a drop in the epidemic. So up-front investment is justified by the decline in investment needs in later years.
And it places community mobilisation and community-led service delivery at the heart of the response. Communities affected by the epidemic need to be involved in the solutions.
More work is needed to spell out what this approach will mean in particular countries. That is why we are now engaging with UNAIDS to see how DFID can collaborate in taking forward this work and encourage countries to start managing their investments (and those of donors) more effectively and efficiently in order to reach this critical ‘tipping point’ in the epidemic.
Secondly, we need to drive more innovation of products and delivery models so that affordable access to quality assured treatment continues to save lives.
The UK will support innovation in a number of ways. Through our long-term commitment to UNITAID, we will support their engagement with markets to drive down the costs of antiretroviral therapy, including supporting the establishment of the Medicines Patent Pool. We work closely with originator pharmaceutical companies to ensure the benefits of innovation are made more widely available. And we work with generic companies through our funding to the Clinton Health Access Initiative to support, among other things, price reductions.
UK support of this kind has already led to the significant price reduction of one first-line AIDS drug. We calculate the cost savings, made as a result of the UK’s investment alone will enable an additional 500,000 people to access treatment.
Our research investments also drive innovation and over the next 4 years, research and evidence will increase to 3% of our total DFID budget, about a third of which will be focused on health. This will include:
Thirdly, we need to seek new approaches to optimise linkages and integration with other sectors which are critical in ensuring a comprehensive approach. Our broader investment in women and girls, including for reproductive, maternal and newborn health, education and social protection, will contribute to the HIV response. It is not just biomedical interventions which matter. We must ensure a comprehensive approach which also addresses structural and social barriers to confronting the epidemic and changing risky behaviour.
We need to improve integration at the level of service delivery so that clients are better provided for. This means making a number of different services available ‘under one roof’, without compromising quality of care. For example, we have seen successes in integrating the prevention of mother to child transmission of HIV within antenatal and delivery care. This can reduce the risk of a child being born with the virus to less than 5%—and just as importantly, keeps their mothers alive to raise them and their siblings.
We need integrated approaches to ensure HIV-TB co-infection is diagnosed and treated. Our support to TB Alert programmes in Zambia and India, through the civil society challenge fund, specifically targets this issue.
And we must not neglect care and support. Adults and children affected or living with HIV need to access services that include: clinical and psychosocial support, protection of social, economic and human rights, as well as action on stigma and discrimination.
Finally, we need sustainable resources for achieving results. Despite the challenging global financial climate, the UK government remains committed to reaching the target for 0.7% of GNP committed to overseas development aid from 2013. We urge other countries also to meet their commitments.
Our support to the Global Fund to fight AIDS, TB and Malaria is the principal mechanism the UK uses to finance our contribution to HIV and TB. In the face of the current financial shortfall being experienced by the Global Fund, the UK only last week brought forward a further £128 million for the Fund.
The UK has committed up to £1 billion from 2008 – 2015 to the Global Fund. Our current support to the Global Fund will enable 37,000 HIV-positive women to prevent transmission to their babies. And it will also enable 268,000 people to secure life-saving treatment. We intend to increase our commitment if there is the right kind of response to the recommendations made in the High Level Panel Report. The UK will also encourage other partners to meet their commitments.The UK also continues to work through our country and regional programmes to ensure that evidence is translated into best practice and results on the ground.
Through this support the UK will:
So, with a focus on greater effectiveness, efficiency, innovation and integration, alongside the resources needed to deliver results, I believe as a global community we are at an exciting moment in the response to HIV and AIDS. It is not an exaggeration to say that there is light at the end of the tunnel for the first time in three decades. So today, lets stand in solidarity with people living with HIV and together restate our commitment to ‘Getting to Zero’ - Zero New HIV Infections, Zero Discrimination and Zero AIDS Related Deaths.
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