This Sunday, my community will silently march and light candles to remember those we have lost to the most catastrophic medical crisis faced by LGBT+ people across the globe.
It will be the thirty-first World AIDS Day, but the first to be commemorated during the campaign season of a UK general election. It is likely that this will mean that more politicians than ever before will be keen to use our day of mourning and anger as an opportunity to position themselves as the most progressive - but we need to remember exactly how their decisions have impacted, and continue to impact, those who are diagnosed as HIV positive.
Politicians failed our community in the 1980s. Even as evidence of the extent of the AIDS epidemic was emerging, Margaret Thatcher attempted to block crucial public health warnings because she feared for the impact that the proposed descriptions of ‘risky sex’ could have on the minds of young people. This ludicrous and dangerous intervention was also carried out by her Deputy Prime Minister, Willie Whitelaw, at the privy council committee coordinating the government response to AIDS. At this stage there had already been 196 victims, of whom 110 had died, and yet the government would still not treat the medical crisis with the seriousness and urgency it required.
But the government’s inaction on the AIDS crisis is not simply a thing of the past. The 2012 Health and Social Care Act received wide criticism from the healthcare sector and LGBT+ organisations for fragmenting HIV services, resulting in a treatment postcode lottery and making it unclear exactly whose responsibility it was to provide what.
The Act was also ambiguous when it came to assigning responsibility for the commissioning and distributing of PrEP, the life-changing HIV prevention drug that has been at the centre of AIDS activists’ demands in recent years. Although PrEP is currently being rolled out by NHS England, it is happening at a snail’s pace and with limited access, meanwhile private companies charge up to £55 for a month’s prescription. One study by AIDS Map even found that up to a quarter of people who want PrEP can’t currently get it.
On top of this, overall funding for sexual health services is falling every year - the local authority public health budget is being cut by £700 million in real terms between 2014/15 and 2019/20. These funding cuts have led to sexual health service budgets being cut by 25% in this time.
The implementation of austerity has had a disastrous impact on sexual health provisions and thus diagnosis rates in the UK, especially when the services are already patchily funded. As NHS provisions are cut short, LGBT+ and AIDS charities are filling the gaps. The Terrence Higgins Trust set up the Mags Portman fund for those unable to access the limited NHS PrEP supply or afford it themselves, meanwhile the LGBT Foundation provides STI testing outreach as well as peer-led support groups and vital social care such as counselling.
NHS privatisation has been a hot topic so far during the campaign season, with Boris Johnson saying that our NHS is “off the table” for post-Brexit trade negotiations while Channel 4’s Dispatches revealed “secret meetings” between senior civil servants and representatives of US pharmaceutical firms. At a time when we don’t know who will be Prime Minister in a month’s time, it’s impossible to guess what our NHS will look like in the future. But what is clear is that austerity is catastrophic for public sexual health.
The AIDS crisis has always been a political one, but this December that takes on a whole new meaning. As candidates make vague pledges around “better funding”, our community needs to push for specific promises to improve the lives of those living with HIV. We need everyone to vote for parties that will commit to providing greater funding for the NHS, to expand the provision of sexual health services, but also to invest in healthcare students to secure the pipeline of the future NHS workforce and ensure that all those in post-16 education can access healthcare they need. The National AIDS Trust has produced a handy tool you can use to write to the candidates in your constituency to ensure that HIV services are on the agenda of our next parliament.
Politicians can’t wear a red ribbon one day and slash local funding the next - they need to take a firm stance against welfare cuts in all their forms if they want to end AIDS once and for all. On December 12th, make sure you use your vote wisely - for those we have lost, but also for those we still fight for.