World AIDS Day Guest Post: A global strategy for health

by Ben Simms is Director of STOPAIDS and writes here in his personal capacity as an LCID Member

Today is World AIDS Day, an opportunity to remember the 1.5 million people who died of AIDS in 2013, and the 39 million who have died in the last 30 years.

World AIDS Day is also an opportunity to remind ourselves of one of Labour’s proudest moments in government. Ten years ago, as Labour were planning the 2005 G8 Summit in Scotland, AIDS related deaths were at their peak, with 2.4 million people dying in 2005 alone. Just 700,000 people were accessing treatment.

Ten years on, 13.6 million people are alive today thanks in large part to the commitment to deliver Universal Access made at Gleneagles.

With renewed leadership, financial and political commitment, a further 21 million lives could be saved by 2030. And if we achieve that we will be looking at the end of AIDS as a public health threat.

This is surely a prize worth having, and a success story worthy of silencing even the most diehard critics of overseas development.

The response to AIDS is a story that resonates naturally with Labour as the party that founded the NHS, went on to put global health at the centre of an independent Department of International Development, and is now setting its sights firmly on Universal Health Coverage for people of all nations.

To achieve this goal Labour must take the initiative and drive the discourse on international development at the General Election. Ending AIDS will require ongoing UK investment, but UK leadership must go beyond aid. We will need to overcome the structural and systemic barriers which impact on the health and wealth of developing countries. To achieve this, three lessons (at least) need to be learnt from the past decade responding to HIV and AIDS.

First, Labour need to look at access to medicines. Between 2000 and 2011, the total cost of treating someone living with HIV has fallen from $10,000+ a year, to just $350 a year. Not because of the goodwill of pharmaceutical companies, but because, in defiance of them, we have seen the growth of competition from manufacturers of generic medicines. Labour must take a strong stand against initiatives such as the Trans-Atlantic Trade and Investment Partnership and other trade agreements that pose a threat to future access to medicines in Europe and the developing world.

Intrinsically related to this, as the current outbreak of Ebola reminds us, we need to prioritise non-commercial funding of R&D for diseases of the poor. Until we do people will continue to die in their millions from diseases we could cure, but choose not to.

Compulsory reading this World AIDS Day will be the ‘Access Denied’ report launched today by Pamela Nash MP as Chair of the APPG on HIV and AIDS. The report highlights multiple access to medicine challenges facing the next wave of the AIDS response.

Second, Labour needs to define and measure its commitment to Universal Health Coverage in ways that ensure every person has access to quality healthcare. We have learnt from 30 years of responding to HIV and AIDS, that having a fully staffed clinic and a well-stocked pharmacy mean nothing if you are a gay man, transgender woman, sex worker or drug user and are prevented from accessing services because of fear, stigma or persecution. This World AIDS Day, we should turn out thoughts to Uganda in particular, where its parliament are on the cusp of re-introducing an Anti-Homosexuality Bill that would make it illegal to run an LGBTI-sensitive health service.

Third, if we are serious about wanting countries to develop and fund a greater proportion of their own healthcare, Labour needs to be serious about addressing the underlying drivers of global poverty and inequality. Our development policy must reflect the complexity of the modern world – where inequality within countries is greater than between. There is a need to build a new model of responsible capitalism to replace that which has savaged the developing world and resulted in the greater flow of resources from south to north – for example through corporate tax evasion and the flow of health workers.

All of the above will require Labour to adopt a strategy for global health in government. But it must be a strategy built on the lessons of how we have responded to HIV and AIDS, one that embraces a vision of overseas development which never forgets the impact of effectively targeted funding, but also remembers the foundations of a better society are social justice and human rights.

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