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Senator Singh's HIV address

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08 Sep 2017

I rise to speak on the fact that we are at a critical moment in our collective response to the HIV epidemic in Australia. During the 1980s, as many would remember, Australia was leading the world in containing HIV. But, 30 years later, our nation has arrived at a fundamental inflection point, as Bill Paterson from the National Association of People with HIV Australia called it, where we have the opportunity to once again lead the world in treating HIV and ending its transmission.

The tool to help us become leaders lies in a key report that was recently presented to the Parliamentary Liaison Group on HIV/AIDS, Blood Borne Viruses and Sexually Transmitted Diseases — a group that I have the honour of deputy chairing with our chair, Senator Dean Smith. I'd like to acknowledge the ongoing and tireless work that Senator Dean Smith does in this space of addressing the issues of HIV/AIDS in Australia.

Last month, AFAO, the Australian Federation of AIDS Organisations, launched its HIV blueprint, while just yesterday ViiV Healthcare Australia launched its white paper on critical steps towards addressing HIV in Australia. According to Michael Grant from ViiV Australia, Australia has the potential to fully address the impact of the virus on people living with HIV and a realistic opportunity to be the first among nations to virtually end transmission.

It is so important and so critical for us to be a leader. I am so wanting Australia to step up to the mark and do this, like we did in the 1980s, because many of the same barriers that fuelled the epidemic over the past 30 years are still in existence today. These barriers must be broken down to properly tackle this disease.

There are solutions, but they require us to focus on key affected populations and build evermore robust partnerships between policymakers and the people on the frontline. These include critical researchers like Professor Darryl O'Donnell and his team from the AFAO ; our inspirational leaders like Dr Fraser Drummond, the medical director of ViiV Healthcare Australia, who started caring for HIV patients in 1996; people like Brent Allan, of Living Positive Victoria, who has lived with HIV for 18 years and is an incredible advocate for dealing with HIV; people like Bill Paterson, from the National Association of People with HIV Australia, who developed the inpatient AIDS unit at St Vincent's Hospital in Sydney; and also people like Associate Professor Mark Bloch, president-elect of the Australasian Society for HIV, Viral Hepatitis and Sexual Health Medicine. All of these people are inspirational leaders, who spoke yesterday at ViiV Healthcare's event here in Parliament House on the issues of HIV in launching ViiV Healthcare's report, which I really see as a tool for Australia to be a leader if we are going to end this disease.

The solutions, unfortunately, took a recent hit when the Pharmaceutical Benefits Advisory Committee deferred its decision on a possible listing on the PBS of pre-exposure prophylaxis, or what we all know as PrEP. This leaves the cost of treatment as the unresolved issue in the path to list PrEP on the PBS . PrEP is widely considered a game changer, with the potential to end new HIV transmissions. Indeed, the AFAO believes it will be integral to reaching the goal of no new HIV cases by 2020.

When we talk about goals, we have to remember that, if we are really going to meet these kinds of goals, we have to better understand and support the needs of people living with HIV and support Australia in hopefully surpassing the UNAIDS 90-90-90 goals — that is, 90 percent of people with HIV will be diagnosed, 90 percent of those diagnosed will be on antiretroviral therapy, and 90 percent of those on ART will have an undetected viral load. This is an opportunity for Australia to lead and surpass those UN goals.

However, even though PrEP is widely considered a game changer, the PBAC found that PrEP ‘appeared to be effective in reducing the transmission of HIV but, unfortunately, access to this treatment is determined by access to state and territory trial programs leaving some outside the trial location' — like my home state of Tasmania — which means people are locked out of accessing the drug. The federal government, I believe, must step up and make sure that Australians who need this treatment have access to it. PrEP is the game changer. It is going to make Australia the world leader that we once were in the 1980s, and lead to the end of HIV transmission. But we need it to be available to everyone throughout the country.

Circumstances like this make it all the more important that we in this place remain united in our support for those who are working to reduce the prevalence of HIV/AIDS and assist the development of the 8th National HIV Strategy, and work towards that zero transmission by 2020. The work that ViiV Healthcare Australia has done in their report will be a key contribution to that 8th National HIV Strategy, because their report findings say it all.

They made 10 recommendations to address findings in five key areas: testing, treatment, stigma and discrimination, biomedical prevention and the importance of partnership. As Michael Grant pointed out yesterday, stigma and discrimination is a key factor touching most aspects of the HIV challenge. ViiV's research found that this still continues to be, after all of these years — 30 years— the major issue for people living with HIV, or at risk of HIV. It stops or delays those people from seeking diagnosis and from seeking treatment and ongoing care.

We have to end this stigma and this discrimination against people with HIV. Why? Because people still fear judgement. Over three-quarters of those surveyed by ViiV said they felt they had to hide their HIV status at least some of the time. Stigma, combined with a lack of knowledge, can lead to late diagnoses, which increases the risk of poorer health outcomes and onward transmission. To put that into perspective, in 2015 29 percent of people acquiring HIV were diagnosed late. This report highlights the need for equitable access to diagnosis, treatment and care, and focuses on the remaining unintended and, in some cases, systematic barriers to treatment and care, such as lack of health literacy, disparity between the states and territories, Medicare ineligibility, and a lack of access to specialised care.

These reports, both the AFAO blueprint and ViiV Healthcare's report have come at such an important time, as the federal government commences its consultation around Australia's 8th National HIV Strategy. Successive governments have provided bipartisan support for people at risk of or living with HIV, and a standalone, nationally coordinated and collaborative approach to the response must be this parliament's priority.

This is above politics. Labor is unstinting in our support to end the transmission of HIV/AIDS and the discrimination that diagnosis can bring. In 2015, we amended our national platform to acknowledge the importance of renewing efforts to reduce the spread of HIV/AIDS. When it comes to prophylaxis treatments like PrEP, Labor is committed to cooperation. In March, Labor wrote to the Prime Minister asking him to negotiate a way forward, and offering our bipartisan support on a range of measures to ensure those at risk of contracting HIV have access to the protection this drug affords. The capacity to end HIV transmission is within our reach, and Australia will lead the world in ending HIV transmission. That is my hope.