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We know that sex between men accounts for 10 per cent. of global HIV infections, yet UNAIDS reports that fewer than one man in 20 who have sex with men can access the HIV-prevention services that they need. We know that in Ethiopia up to three quarters of female sex workers are infected with HIV, yet some donors debate whether it is right to give them condoms.
Some donors even place restrictions on working with them. That is not sensible if we want to defeat this epidemic.
Injecting drug use accounts for a third of new infections outside sub-Saharan Africa, particularly in eastern Europe. We know that harm-reduction programmes work—needle and syringe exchanges in particular—but less than 5 per cent. of drug users can access them. We have to put that right and ensure that people are not harassed when they are trying to use those services.
We know that condoms save lives, but they are in short supply. Since 2001, the UK has paid for more than 1 billion condoms. That amounts to the use of about 54,000 every hour, but in Africa there are still only enough to provide eight condoms for each man each year. There are 200 million couples with an unmet need for contraception. That is not good enough.
Therefore, improving services is crucial to achieving universal access. Supply is important, but so is demand. That is why tackling stigma and discrimination really is significant. Stigma and discrimination stop people accessing the services that they need and stop them coming forward for counselling, testing and treatment. If, as happens in Ukraine and Russia, police officers patrol needle exchange points and arrest people, surprise, surprise, drug users do not go to use them. Some women will not get tested because they are terrified that if their husband or family finds out, they will be thrown out of the family home.
What we do know is that where there is greater openness and honesty about HIV, progress happens. That is the case for Brazil, Thailand, parts of India and Malawi, but it is not straightforward, because in Lesotho although less than 10 per cent. of women in their late teens are infected, the figure for those in their early 20s rises to 40 per cent. We must keep on the case everywhere. As I said a moment ago, many women and girls do not have control over what happens to them. They need to be able to say, “If we’re going to have sex, you’ve got to use a condom.” Men and boys need to respect women’s decisions and to understand that no means no.
This is about changing culture and attitudes, and we can do that only if we are honest about the nature of the disease and what the problem is. Also, we must be honest about what works and in giving people the information and services that they need to protect themselves. Not all societies and not everybody finds it easy to do that, because some people feel very embarrassed and we are not always good at talking about sex. However, that is as nothing compared with the shame that we should feel about the huge daily death toll. The truth is, as our experience teaches us, that we can do something about it, and we have to do something about it.
I am really grateful to the hon. Member for Ribble Valley for giving us the chance to debate the progress that we have made and what we have yet to do. Now is a good time to show that we are serious about doing something on this issue.
Adjourned accordingly at twenty-nine minutes past Six o’clock.
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