Speech at the 10th Anniversary of the African HIV Policy Network Event
Thursday, 23 November 2006




Let me first thank the African HIV Policy Network, Max Sesay and Neil Gerard MP for inviting me here tonight to highlight this issue at the 10th Anniversary of the African HIV Policy Network.

Any anniversary is a time to reflect on where we have been, and where we are going. With HIV there has been a great deal of progress – better treatment, improved education, political will and public understanding. But we all know that there is still a great deal of work to do.

For most of the history of the first twenty or so years of the HIV crisis, we in the Western World and in the black community thought of HIV as a disease ‘other people’ suffered from. We saw it, like much of the rest of the population, as a disease that only affected the gay community.

And at Government level, this meant that after the initial universal public health campaigns of the 1980s, most of the public health resources were directed towards preventing and treating HIV, and Aids related illnesses, in the gay community.

In effect, this placed most of the treatment in large teaching hospitals, in our major urban centres. And through a dedicated combination of charities and government working together, we worked hard to educate and inform a community - changing practices and saving lives.

Later, as the scale of the crisis in Africa became abundantly clear, HIV again began to rise up the political agenda; but this time it was an issue for the International Development community. Like many others, and especially as a member of the Government, and later as a trustee of Action Aid, I worked to ensure that this issue was taken seriously.

Here as a Government, we have been leading the world in taking action and committing resources. We can all be proud of the successes in this area - increased spending and access to treatment and antiretroviral drugs in Africa.

The UK alone has pledged to provide £1.5 billion for HIV and AIDS treatment, education, and research between 2005 and 2008. This includes £150 million for orphans and vulnerable children.

However, there is, let us be honest, a sense of this being ‘someone else’s problem’. And amongst the people in the UK, let’s be frank, HIV has sometimes not been taken seriously enough.

It has taken the hard work of organizations like the African HIV Policy Network to start making serious inroads into our community - educating and informing them and the wider community about these issues.

Tonight, I’m here to add my voice - saying that we can no longer ignore the issue of HIV in our communities, regardless of heritage. This issue cannot be treated as someone else’s problem, or wholly be solved by waiting for someone else to come in and deal with it.

We must all take ownership of this issue for our own health – and that of our communities, especially if we are to lobby opinion makers for the resources we need to successfully tackle HIV.

Like many of the other great struggles in our history: Be it the civil rights movement, the campaign against Apartheid, or the make poverty history campaign - We know that to succeed and bring about change, we must take ownership of the issue and lead on it.

We know the strengths of our communities, and we know their weaknesses. We know the issues, the cultural sensitivities and the challenges, but we also know some of the solutions.

It is going to take the dedicated and sustained leadership from us as politicians, health professionals, faith leaders and members of the community to combat the stigma of HIV, which in turn is fuelling the epidemic.

If we look back at where the gay community has been, it took a lot of time and perseverance for the stigma of HIV to be addressed. It took courage from within the community, to tackle the prejudice from without and the rejection from within.

We as public figures have a catalysing role to help and lead our community - helping people not to look upon HIV as a curse.

We must have the courage to make it clear both to them and the wider community that to stigmatize and reject someone because of their HIV status is fundamentally wrong.

We must shatter the illusions held by some - that if we ostracize people with HIV, rejecting them as latter day lepers, that some how the disease will go away or be expelled from our communities.

This mistaken belief is corrosive and fuelled often by cultural prejudice creating a climate of fear - where lack of knowledge, education and information is increasing the damage done by the epidemic.

If we allow our communities to be dominated by views like this, it will drive the illness underground and marginalise people living with HIV. In turn they will find it harder to access the support and treatment they need, feeding the climate of fear and ignorance.

Instead, I want to offer an alternative vision of how we as a community can take a lead on this issue, changing and challenging public perceptions of HIV. This vision should not be one of victim hood, it should be about empowerment – not using the language of fear, but the language of hope.

The African Community has many of the qualities and resources that if harnessed in this fight can be used to tackle this crisis.

Africans in Britain benefit often from extended family networks, strong community links, dedicated faith leaders, well educated opinion formers and a history of political action.

But we should not fall into the trap of saying, “now over to you”.

Because I also know that like the other politicians here; we have our role to play. Government has to ensure that health and education services are responsive to these new challenges. That‘s why I’m pleased the Department of Health is funding the African HIV Policy Network.

Last week I visited the HIV unit in the North Middlesex Hospital and I saw there the excellent work being done. The HIV unit at the hospital is at the forefront of outreach work engaging with the African Community and their needs.

Firstly, the unit is close to where people live – essential if we are to demystify the disease and its treatment. This is also vital given that some of our communities are amongst the most deprived in the Britain - we can’t for instance expect them to travel all over the country for medical care - it must be easily accessible and close to where people live.

Secondly, the team also explained to me how we have to have a holistic approach to treatment – dealing with some of the social issues and poverty that propagate the disease, and also the consequences of racism and other pressures.

Staff there are also strongly pushing the message that HIV need not be a death sentence, but only of course if treatment is started early.

However, as we know, this relies on people testing early as well as receiving proper treatment, care and support to live with the disease.

And the figures on this are stark – a third of people in the UK with HIV don’t know they are infected – and it is these people that are likely to go on and develop Aids and suffer from Aids related illnesses.

Unfortunately, this group is also likely to be made up of far too many Africans and other BME groups, as unlike the gay community they are not in the habit of regularly testing. And 73% of new cases of HIV in the UK are likely to have been acquired abroad.

Too often I am told that, either through nervousness or ignorance, many in the African Community are only having their HIV status identified when they present themselves to our acute services, totally unaware of their status.

This means individuals are arriving in our hospitals with other conditions, and diseases such as pneumonia or TB. Only later are they having their HIV status detected, placing themselves at greater risk and adding to the stress of any diagnosis on themselves and their family.

As I said before, the services I saw at the North Mid were excellent: a specialized ward with dedicated and passionate staff. As it is my local hospital, I will do what I can to support their work and I hope that this localized model can be sustained.

If we are to change attitudes to testing, as we must, then we need to also ensure we have testing services easily accessible to the community. This is a wider issue, as anyone who has been to a GUM clinic recently will know.

For communities that fear testing, this adds to their difficulties - meaning that even if you have an individual keen to test, the resources and facilities may not be available to them to easily access. I know we in Government are looking at this, and we continue to make GUM facilities a spending priority.

However, it is only through education, changing attitudes and informing people that we can encourage people to test in the first place.

And the community must also be ready to play its part. We must alter perceptions of testing so that is accepted and seen as routine, not stigmatizing those taking a test, what ever the result may later be.

Obviously, statistics that show that HIV is being contracted abroad raise challenges for all of us. And here we must be clear, and not allow the debate to be dominated by a narrow right wing agenda.

I am clear that we are not taking about widespread health tourism. I see many people in my advice surgeries, who I do my best to support through the immigration process.

Some have HIV, and although now they may want to stay in the UK to secure the best treatment, this wasn’t their motivation for coming here. Rather, most immigrants arrived here as asylum seekers fleeing persecution, or as people hoping for a better life, to study or work.

This perhaps means that we need to look again at how we treat people that are here with HIV and have immigration problems. Of course, we have to have controls on access to NHS services; but we need to be careful and check regulations are not too prescriptive, damaging other public health priorities.

There is a vast difference between someone travelling to the UK with full knowledge of an existing medical condition – deliberately seeking treatment; and someone who has come here with no knowledge of their HIV status, and who now finds themselves in fear of being returned to Africa, where although treatment options are now improving, they may face an uncertain future.

I’d like to finish tonight by saying that despite these challenges, I’m hopeful – holding events like this is important. But it is through the work of organizations like the African HIV Policy Network and the Terrence Higgins Trust, supported by Government and health professionals that we can really start to change the situation.

As in other communities that have faced and met this challenge - HIV need no longer be a killer. If we can connect with the community; if we can demystify, destigmatize and re-educate; together we can beat the ignorance and intolerance that fuels the taboos around HIV, and leaves people scared of coming forward.

It is after all the illness which is the problem, not the person living with the illness.

I know everyone in this room is committed to this cause, and I am doubly committed - not only as a black politician, but also as a representative of one of the largest African communities in the country.

But it will require courage. Courage in our communities to challenge long held views; and courage to face prejudice from the outside.

It requires a willingness to reach out to communities scared of being stigmatized as a whole - either for cultural reasons, or perhaps because they are not used to engaging and talking about issues like sex education and the role of women.

This must be a sustained crusade, and we must use every mechanism at our disposal - not just our health service, but our faith groups, the media and popular culture to get the message across - changing attitudes and saving lives.

Thank you.

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