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Baroness Masham of Ilton: My Lords, before the Minister leaves education, can he say whether the core curriculum is part of the strategy?

Lord Hunt of Kings Heath: My Lords, that is an important point. It leads me on to the issue of stigma to which the noble Baroness, Lady Masham, and my noble friend Lady Rendell particularly referred. There is no doubt that children, families and individuals are often faced with the considerable extra burden of stigma, discrimination and social isolation. That can occur not only within the communities where they live, but also in the wider social context. Clearly, our nationally-funded health promotion work aims to overcome that by providing clear information on how HIV is and is not transmitted. Some of the public mass media campaigns have helped to contribute to a more tolerant social climate. But I accept that there is room for improvement. As I said earlier, the health promotion issues will be an important component part of the strategy.

That leads me on to the issue of education. The noble Baroness will know that sex education is a compulsory component of the core curriculum in secondary schools. But the specific content of that sex education by a school is the responsibility of the school governors in association with teachers and parents. It may involve issues surrounding HIV/AIDS, but also it may not. I said earlier that one of the important components of the strategy has to be the contribution other government departments can make. I hope that as a result of the strategy we will be enabled to have discussions with the Department for Education and Employment. But, of course, what can be done has to rest in the law and the regulations applying to sex education. I very much share the noble Baroness's concern in this area.

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My noble friend Lord Winston and, indeed, the noble Lord, Lord McColl, graphically described some of the challenges faced by other countries. I was very struck by what both noble Lords had to say. If my noble friend wishes to provide me with information regarding the letter that has not received a reply, I shall certainly do my best to ensure that it does receive a response.

In responding to this particular point, I think it would be helpful if I described the communique issued by the Commonwealth Heads of Government meeting on the area of HIV/AIDS. This was an important communique, which viewed HIV/AIDS as a global emergency with heads of government personally pledged to lead the fight against it. The communique emphasised measures, especially preventive measures, and urged that greater priority be given to vaccine prevention. In addition, and in line with that, we have confirmed our grant of £14 million over five years to the International Aids Vaccine Initiative.

Moreover, DfID is giving priority to sexually transmitted infection prevention for all through essential information services, care and commodities. I was glad to hear the remarks made by the noble Lord, Lord McColl, about the support that DfID has been able to give to Mildmay. I am very encouraged by that. Clearly, if there are other ways in which we can support international efforts, we would very much want to do so.

The noble Baroness, Lady Masham, asked about blood testing and the differences between the United Kingdom and the United States. Perhaps I may tell her that the National Blood Authority is actively assessing several methods of advanced testing to continue to ensure a safe blood supply. However, I shall be happy to write to the noble Baroness with further details on that matter.

The noble Earl, Lord Baldwin, raised the issue of whether more effort should be placed on looking for less toxic complementary medicine alternatives and stressed the fact that many long-term survivors of HIV/AIDS are using this approach. I am advised that there are two groups of HIV/AIDS patients who are often described as "long-term survivors". First, about 5 per cent to 8 per cent of HIV infected individuals are long-term, non-progressors who survive for at least 10 years after infection. They are either asymptomatic or have mild symptoms. I am advised that there is most likely a genetic factor at play here, such as not carrying the genes which code for HIV cell receptors.

Secondly, patients who survive two years or more after an AIDS diagnosis are referred to as "long-term AIDS survivors". With the widespread use of combination theories, as other noble Lords have suggested, the survival time increases. I accept that many HIV/AIDS patients have found complementary therapies helpful. I give way to the noble Earl.

Earl Baldwin of Bewdley: My Lords, I am grateful to the noble Lord. I should just like to point out that some survivors of a frank AIDS diagnosis have been

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around for five years or more, which is some time longer than the combination therapies have actually been in existence.

Lord Hunt of Kings Heath: My Lords, I do not seek to say that the answer I am giving is a definitive and complete response to the points raised by the noble Earl. I am merely suggesting that certain factors need to be taken into account. The noble Earl and I have debated previously the issue of the Department of Health's research programme. The noble Earl will know that there is a procedure under which applications for research are considered and that the R&D programme does fund a number of research projects in relation to the use of complementary medicine.

In relation to the High Court ruling mentioned by the noble Earl, I must tell him that we do not comment on individual cases. We were not party to the case brought by Camden Council social services. In such circumstances, local agencies decide how to respond to individual cases, taking all the facts of the case into account.

As far as concerns the article in the Lancet mentioned by the noble Earl on infant feeding and mother-to-child transmission, I know that that has caused much comment. I should point out that the article was a South African study, which suggested that exclusive breast-feeding carried a significantly lower risk of vertical transmission of HIV than a mixture of bottle/breast and bottle-only feeding. Previous results from South Africa indicated that the highest rate of HIV transmission was an exclusively breast-fed instance. My advice is that recent results certainly need careful assessment.

I listened with great interest to the comments of the noble Lord, Lord McColl, and the noble Baroness, Lady Masham, on the contribution of Mildmay. The noble Baroness is constantly inviting me to visit centres. Therefore, if the noble Lord, Lord McColl, is agreeable, I would be very pleased to do so in this case because, clearly, there is much to learn. I was especially taken by the noble Lord's remarks about caring not just for young carers but also for professional carers. As regards the NHS, we sometimes forget the pressures that are placed upon so many of our staff when they deal with such stressful and tense situations.

A number of questions were raised about our approach to prevent transmission in the first place. As the noble Baroness, Lady Masham, and my noble friend Lord Winston suggested, anti-retroviral drugs, delivery by caesarean section and avoiding breast-feeding all reduce the risk of mother-to-baby transmission. Together, their effect is to reduce the risk of transmission from 25 per cent to less than 5 per cent.

My noble friend Lord Winston asked about our ante-natal screening policy. The previous policy was to offer an HIV test only to pregnant women at high risk. The policy was clearly not working, as 70 per cent of HIV infected pregnant women were not identified. This meant that those women could not be offered measures to reduce the risk of their babies becoming

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infected; nor could they be offered advice about treatment for their own infection. The advantage of the new policy to offer an HIV test to all pregnant women means that all women are treated equally. As the noble Lord, Lord Clement-Jones, mentioned, we have set a national objective to reduce the number of babies born with HIV by 80 per cent by the year 2002.

In relation to resources, I should tell the noble Lord, Lord Clement-Jones, that we have allocated £233 million for the treatment and care of people with HIV/AIDS in England. Those allocations take into account the associated costs of the new combination therapies. However, I should also point out that we are currently considering the recommendations of the Stock-Take Group on the funding of HIV/AIDS treatment and care. We hope to make an announcement shortly in that regard.

Before I conclude, perhaps I may turn to a crucial point of importance regarding the support for young people as carers. During the past two years we have discussed on a number of occasions in this House the crucial importance of supporting carers. How much more important is it to support young children? The National Strategy for Carers aims to ensure that children whose relatives have specific needs arising out of disability, or health conditions, enjoy the same life chances as all other children in their locality in terms of education, welfare and development. This requires local authorities to identify children with additional family burdens, to raise awareness among professionals of the many sensitive issues around this area and to provide services that are geared to ensure that those children's education, general development and their life chances do not suffer.

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So we are developing--and have developed--a set of policies that we hope will tackle those issues. The Department for Education and Employment is working with the Carers National Association to identify good practice in existing young carers' projects in schools. We are also working to ensure that local authorities recognise the need to sustain and enhance the number of young carers' projects, and to ensure in particular that they have access to leisure and recreational activities. We also expect children's services plans to set out local support that ought to be available.

In addition, we are currently looking at ways in which we can improve awareness training about young carers for general practitioners. I very much take the point raised by one noble Lord earlier about the crucial importance of GPs, but how they cannot play that role if they do not have the right information. That applies not just to general practitioners but also to primary healthcare teams, social workers and teachers both at the time of their initial training and throughout their subsequent career development.

The clock ticks on. I am sure that I have spoken for far too long. If I have not replied to specific points--we shall read this debate carefully--I give an assurance to noble Lords that they will be fed into the strategy. The aim is to produce fairly soon some broad issues which will be followed by a more detailed consultation document.

I sum up. The Government fully recognise the issues and concerns which noble Lords have raised. I appreciate in particular the initiative of my noble friend Lady Massey in introducing this debate. She has done us a great service. We shall take on board the comments which have been made.

        House adjourned at ten minutes past eight o'clock.

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