New approach needed to stop HIV

Guaranteed public health funding is needed for the UK to reach a zero HIV infections target

Guaranteed public health funding is needed for the UK to reach a zero HIV infections target

Jason Warriner, left, demonstrating an HIV test. Picture: David Gee

World AIDS Day, held on 1 December each year, has marked its 30th anniversary. Over that time the world of HIV has changed in so many ways, yet we are still facing the challenge of eradicating the virus.

Someone living with HIV and accessing care and treatment today is looking at a normal life expectancy. In comparison with the start of the epidemic in the 1980s, when so many young men were dying of a virus that could not be treated, it sometimes feels as if we are talking about a different illness.

HIV medicines have changed lives, and we now know that if a person is receiving effective treatment they cannot pass the virus on.

Even though we do not have a cure for HIV we are in a position to reduce and stop new infections and end the epidemic. To achieve this, global collaboration is required alongside commitments from governments in all countries to work together and eradicate the virus.

Bold commitment

Earlier this year, health secretary Matt Hancock addressed the AIDSfree Cities Global Forum in London, pledging to end new HIV transmission in England by 2030. This bold government commitment to become one of the first countries to reach the United Nations’ zero infections target is ambitious and requires continuous commitment to become a reality.

The Department of Health and Social Care has confirmed that an expert group will be established to develop an action plan over the course of this year.

HIV charities have welcomed this pledge, acknowledging that the UK is meeting the UNAIDS 90-90-90 targets ahead of the 2020 deadline. The targets are 90% of people living with HIV diagnosed, 90% of those on treatment and 90% of these having an undetectable viral load. The UK currently stands at 92%, 98% and 97% respectively.

Invest to save

At a time when sexual health services are struggling to meet demand due to underinvestment and funding cuts to public health budgets, this announcement highlights the need for improved and sustained investment. Nurses are working in services that are experiencing cuts, increased waiting times and shortages of experienced and skilled staff. A valued and well-resourced workforce is vital to providing high-quality care and accessible services.

The government wants to achieve the UN target in the next 11 years, yet there is a planned £85 million reduction in the public health grant to local authorities in England for the next financial year.

For this ambitious target to be achieved we need the government to commit to investing in public health with guaranteed funding. When I talk about public health one of the terms that I often use is ‘invest to save’, and that certainly applies here.

UK-wide approach

Invest in sexual health and HIV services now, prevent new HIV infections and save money by people not needing to access specialist services in the future. We need investment in prevention, testing and treatment services.

Limits on access to the HIV prevention drugs known as pre-exposure prophylaxis (PrEP) need to end immediately. Currently, people who are unable to access PrEP are becoming infected with HIV. This is wrong, and the government urgently needs to address this issue in England.

It is essential that people living with HIV are involved in the development of the action plan and that it connects with local and national polices for the NHS, local authorities and public health.

To end the epidemic let us have a UK-wide approach, all four countries of the UK working together to achieve this goal and demonstrate that by working together we can locally, nationally and globally stop HIV.

Jason Warriner is chair of the RCN public health forum



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