Fast-Track London Will Only Work If We Keep Our Foot On The Accelerator

On 10 January the Mayor of London, Sadiq Khan, together with a Who’s Who in council politics, signed the Paris Declaration on Fast-Track Cities aiming to End the AIDS Epidemic.  In an event held at City Hall, the Mayor and representatives from NHS England, Public Health England and London Councils, all pledged support for the initiative.

Their ambition is a bold one. Firstly, to cut rates of new HIV infection in the capital and secondly, and in many ways more importantly, to eliminate the discrimination and stigma associated with the condition.

Signing such a declaration poses two key questions: firstly, is this important? And secondly, is it achievable? The answer, in short, is definitely and maybe.

For the British HIV Association (BHIVA) and many other campaigning organisations this really is an incredibly important and courageous statement for the Mayor to make.   It means he is putting the weight of City Hall behind the fight to halt the spread of HIV, and to end the discrimination and stigma associated with it.

He said: “As well as putting an end to new infections, I am clear that HIV-related stigma and discrimination must end too. Improving the quality of life and wellbeing of those living with HIV in London is a priority for me, which is why I’m proud to sign this commitment today.”

This is music to our ears this year, as he joins Prince Harry and Ms Markle in putting HIV back on the front pages.

The combination of political will, influence and celebrity they bring can do more than they can possibly imagine to improve the lives of people living with HIV and at the same time encourage and cajole those not yet testing regularly to test. And this is crucial if we are to prevent new infections.

The social media impact alone that these three individuals created helped to make 2017’s annual HIV testing week (November 18 to 24) the most widely tweeted #HIVtestweek ever. Hundreds of clinics and organisations took part, providing opportunities to test and promoting their HIV services, using customisable digital resources provided by HIV Prevention England.  This means that many more people found out their HIV status, were able to access life-saving antiretroviral medication, and ultimately not infect others.

So is it possible? Can we achieve all the goals outlined?  In London we have already achieved the UN’s 90:90:90 targets, that is that 90 per cent of people living with HIV know their status, 90 per cent of people with diagnosed HIV are on treatment, and 90 per cent of people have a suppressed viral load.   

It is clear to us as an organisation that the only way that London has achieved what it has to date is through the dedication and expertise of highly networked, world class sexual health and HIV services, dedicated charities focusing on peer support in the HIV community, and premier STI and HIV surveillance systems.  To achieve the rest of the Declaration’s aims – including eradicating discrimination and stigma – we need to build on these achievements.

So why is it so important that City Hall, London Councils, Public Health England and NHS England sign up to this important initiative right now?  This commitment comes at a time when sexual health services in London are going through the largest, and most radical, reorganisation in a decade.  Sexual health and public health budgets are being significantly cut – in some instances by up to 20 per cent.

Since 2013 HIV testing and the provision of sexual health services and sexual health promotion has been the responsibility of local councils.  This means that the very same individuals who have pledged to achieve the goals of the Fast-Track Cities initiative, who signed up to the Declaration on 10 January, have the power to actually influence its outcome.  

37 years after the emergence of the epidemic, for the first time an end to new HIV transmissions is beginning to look achievable.  With leadership, investment, political will, commitment and collaboration we may get there.  But we cannot afford to take our foot off the accelerator until we do.