Lords Debate on AIDS, Tuberculosis and Malaria December 2014

To ask Her Majesty’s Government what action they are taking to support the Global Fund to Fight AIDS, Tuberculosis and Malaria.

My Lords, one of my major purposes in raising this short debate is to emphasise a crucial point about public health across the globe. Currently there is vast concern about Ebola, and rightly so. It must be met with all the resources at our disposal. But at the same time we must not forget the even greater challenge posed by the three diseases that the Global Fund was formed to fight—AIDS, TB and malaria.

The figures for deaths tell their own story. In 2013 an estimated 1.5 million people died from HIV/AIDS; 584,000 people died from malaria, and an additional 1.1 million people died from tuberculosis. The burden is heaviest in sub-Saharan Africa, where an estimated 90% of all malaria deaths occur, and—this is perhaps the most disgraceful statistic—in children under five. So, currently, three diseases account for more than 3 million deaths a year, to add to the mountainous totals over the past 25 years. AIDS is an example: the death toll so far is 35 million people. In addition, 36 million people are living with HIV, and in 2013 almost 200 million cases of malaria, and 9 million new tuberculosis cases, were detected.

Having said that, I do not want to downplay or understate the progress made, or the vast contribution that the Global Fund, and the President’s fund from the United States, have made. Without them the world would be in even greater crisis. The latest figures for the Global Fund show that 7.3 million people are on antiretroviral therapy for AIDS. It has tested and treated, or helped to test and treat, more than 12 million people for TB, and has distributed 450 million insecticide-treated nets to protect families against malaria. We have therefore made vast progress since those dismal and tragic days in the 1980s, when AIDS patients died and there was absolutely nothing we could do about it. I pay tribute to the clinicians, the nurses, the volunteers, and all those working for NGOs, throughout the world, who have made this progress possible.

Now we come to what is perhaps the most difficult challenge for any Government. In spite of the progress made, much more needs to be made, and it needs to be made urgently. As UNAIDS says in its latest report, only about three-fifths of countries have risk reduction programmes for sex workers, and 88 countries report that fewer than half of men who have sex with men know their HIV status. Most countries fail to provide drug substitution therapy, or access to sterile needles and syringes for people who inject drugs—even though that is something we started in this country back in the 1980s. Again, most disgracefully of all, antiretroviral treatment for children lags very substantially behind that for adults.?

Not all the steps to combat these factors imply increased financial help. If the 80 countries that currently—and disgracefully—criminalise homosexuality were to reform that policy, we would take a massive step forward and reduce one enormous barrier to testing and treatment around the world. There is no question but that that could have a profound effect. I very much hope that in this debate the Government will underline their determination and commitment to do as much as they can to persuade those countries to reform their legal processes.

Read the full debate on Hansard.