The end of the HIV epidemic in the UK is within reach

Yet, the final yards are often the hardest when it comes to missions like this

The global battle against HIV and Aids has been being fought for seconds (Associated Press)

I was just nine years old on the very first World Aids Day on 1 December 1989. Like many children growing up in the 1980s, I didn't fully understand the devastating impact HIV was having on millions of lives.

A couple of years later I wrote for a school project of my hopes for the year 2020 – in which I listed “a world without Aids”.

So we are in 2020, and dealing with the consequences of another global pandemic, and and as we mark the 32nd World Aids Day, we may not have a world without Aids, but we are finally on the cusp of ending new HIV transmissions once and for all. 

Scientific advances in HIV treatment and prevention have been some of the biggest we’ve seen in modern medicine. An HIV diagnosis has gone from being a death sentence in the UK to be a manageable condition, with people living with HIV enjoying a normal life expectancy.

Even more remarkable, we can now say with absolute confidence that someone on effective HIV treatment cannot pass on the virus to their sexual partner: U=U. But the final yards are often the hardest.

Here, 106,000 people are living with HIV in the UK, with 94 per cent of people diagnosed and 92 per cent of those on effective treatment. In 2019 there was another drop in new diagnosis, with gay and bisexual men – who have been the most impacted by HIV throughout the epidemic – seeing rates plummet by nearly 50 per cent since 2014. But that same progress is not happening across other groups, with slower reductions among women (who make up a third of people living with HIV in the UK) and among BAME communities. 

Even more worryingly, more than four in ten people continue to receive their HIV diagnosis at a late stage. This means the virus may have done serious harm to a person's health, often because the opportunity to test earlier was missed. 

But it doesn't have to be this way. That’s why I welcome the publication of the HIV Commission’s roadmap to ending new HIV transmissions by 2030 – something the UK government has committed to. As a Welsh MP, I’m particularly proud of the leadership shown by the Welsh Government and my constituency colleague, and health minister, Vaughan Gething.

But the report makes clear that without a redoubling of efforts, at home (and abroad) we risk missing this once-in-a-generation opportunity to end the HIV epidemic.

HIV testing is crucial. There are still around 6,700 people living with HIV in the UK who are undiagnosed. Finding those people, ending chains of transmission, and getting them onto life-saving medication is critical. 

We need to change the narrative around testing, removing the fear that is often the biggest barrier. Whether it is normalising HIV testing throughout the NHS or getting people access to home sampling kits or home testing services, we must do more so everyone knows their HIV status.

But we also know year-on-year spending cuts to frontline sexual health services in England have resulted in clinics being overstretched.

We cannot escape the challenges Covid19 has brought. However, as our own recent report on HIV and Covid-19 makes clear, now is not the time for complacency on HIV and other crucial public health challenges we face.  
The inequalities we see tragically playing out in the Covid-19 pandemic have played out in the populations impacted by HIV for generations. The latest Public Health England shows nearly half (44 per cent) of new HIV diagnoses among heterosexuals in the UK are Black African men and women – totally disproportionate to their part of the overall British population.

Today is also a reminder that this is a global fight. Nearly 700,000 people died from an Aids-related illness in 2019, with over three in ten adults diagnosed with HIV still not able to access life-saving medication globally.  
Alongside other campaigners, I fought tooth and nail for the government to enshrine the 0.7 per cent of gross national income for overseas aid into law – a commitment that has seen us play a critical role for example in the UN Global Fund to tackle HIV, TB and Malaria.  


That commitment has now been wrongly slashed by the chancellor, Rishi Sunak, in a short-sighted and self-defeating move, which puts our crucial commitments to global public health in jeopardy, after decades of rare cross-party consensus. HIV, like Covid-19, has no respect for borders and nor should our mission to end the pandemic.

Here at home, the HIV Commission has provided us with a crucial roadmap to ending the domestic epidemic – something that was nothing more than an aspiration and dream just a few decades ago. We owe it to the millions of lives cut short here and elsewhere in the world to ensure we act on its recommendations.  
We know what we need to do. The clock is ticking. 

Stephen Doughty is chair of the All-Party Parliamentary Group on HIV & AIDS. He is also shadow minister for Africa (joint with Department for International Development) and Labour MP for Cardiff South and Penarth