Terri Butler (Griffith, Australian Labor Party) Share this | Link to this | Hansard source

I move:

That this House

(1) notes that:

(a) 1 December marks World AIDS Day, which is held every year to raise awareness about the issues concerning HIV and AIDS, and is a day for people to show their support for people living with HIV and to commemorate people who have died; and

(b) the theme for World AIDS Day this year is 'HIV is still here—and it's on the move';

(2) acknowledges the roles played by people living with HIV and their friends, family, supporters, AIDS activists and researchers, past and present, in making living with HIV possible; and

(3) will support actions to reduce stigma and prevent new HIV transmissions, and work towards a cure.

The 1st of December marks World AIDS Day. It is held every year to raise awareness of the issues in relation to HIV and AIDS. It is a day for people to show their support for those living with HIV and also to remember those who have died. It is always important to acknowledge that there have been many, many terrible tragedies across decades from those who have died from this terrible disease and to acknowledge all of those people and their families in anticipation of World AIDS Day.

The theme for this year is 'HIV is still here, and it's on the move', because the prevalence of HIV and AIDS is something that is continuing to be a really important problem for our society both here in Australia and internationally. I think that, given the amount of time that has elapsed since HIV and AIDS first came to the nation's attention and since the campaigns of the 1980s, sometimes it is possible for us to forget just how significant and how ongoing this crisis is in Australia and across the world. The Australian Federation of AIDS Organisations advises that, by the end of 2015, 36.7 million people across the world were estimated to be living with HIV, with 46 per cent of them being on life-saving antiretroviral treatment, which certainly would not have been the case a long time ago.

In 2015, there were 2.1 million people who became newly infected with HIV, down from 3.1 million in 2000; 17 million had access to HIV treatments, up from 7.5 million in 2010 and 15 million in 2014; and 1.1 million people died of AIDS-related causes in that year, a fall of 43 per cent in annual deaths since 2003. These are encouraging statistics, but the number of people affected is still too high. It is worth noting, given some of the conceptions about this particular disease, that adolescent girls and young women aged 15-24 accounted for 20 per cent of new infections among adults globally in 2015, although they comprise only 11 per cent of the population. This is a very multifaceted challenge for the world to face and, here in Australia, it is something that we continue to face together.

I wanted to acknowledge and pay tribute to the Australian Federation of AIDS Organisations and to thank Darryl O'Donnell, who joined the federation from ACON earlier this year. That organisation is a federation of AIDS organisations. The AIDS organisations in this country have been doing such a fantastic job of not just cutting down the stigma around HIV and AIDS but also making sure that people have access to life-saving medication like the retroviral medication I mentioned earlier. I know that, most importantly, they are looking for ways to prevent people from contracting the disease in the future. They are looking at ways we can make medicine for people with HIV and AIDS something that is a feature of the past—if we could get rid of AIDS like we have with polio, for example, what a wonderful world it would be.

One important measure in the fight for prevention of HIV and AIDS is pre-exposure prophylaxis, and I know that everyone in this House and in the other place will join me in encouraging the government to continue to work towards listing PrEP on the Pharmaceutical Benefits Scheme. It is really important that, where we can help with prevention of the contraction of HIV, we do seek to help with prevention of the contraction of HIV. It is something that I know many, many people will be campaigning for.

My friend Phil Carswell, who I mentioned in, I think, last year's World AIDS Day motion or possibly the year before, is a founding member of the Victorian AIDS Council. He recently travelled to Canberra—a little bit later than he had anticipated doing so—to give a speech about the history of AIDS activism and responses to HIV and AIDS in this country since those fairly notorious grim reaper ads of the 1980s. I particularly want to pay tribute to him. He is not as young as he once was—and he will not mind me saying that—but is continuing to work very hard in the campaign to assist in breaking down stigma, to ensure that people get the treatment they need and to build on the efforts towards prevention, which are so important.

I also have a range of wonderful organisations in my home state of Queensland. For example, I recently had the benefit of, alongside Tanya Plibersek, the Deputy Leader of the Opposition, visiting the Queensland AIDS Council, and I wanted to thank them. They did an amazing job at the pride fair this year of putting a lot of information out and reaching out to people—those with HIV and without HIV—in relation to this terrible disease, and I thank them for their work as well.

Rob Mitchell (McEwen, Australian Labor Party) Share this | Link to this | Hansard source

Is the motion seconded?

Anthony Albanese (Grayndler, Australian Labor Party, Shadow Minister for Infrastructure and Transport) Share this | Link to this | Hansard source

I second the motion and reserve my right to speak.

Andrew Laming (Bowman, Liberal Party) Share this | Link to this | Hansard source

The first World AIDS Day was back in 1988, and it was 1984 when I first turned up as a first-year medical student and the world was grappling with this new viral infection of which we knew very little. It was, at that time, HTLV-1 and -2, and we could not really see where this was going to head. But here we are, 30 years later, with 35 million people living with HIV, and about the same number having passed away due to HIV since the first cases were recorded.

Back in the eighties, there was great uncertainty and incredible fear. There was First World HIV and there was developing world HIV, and for some time we almost thought that they were completely different conditions, until we better understood the pathophysiology. Then, when I was an eye surgeon, in 1996, one of my major jobs in a major Sydney hospital was to treat CMV retinopathy, which was almost exclusively, at that time, due to HIV. So, as a medical student, I saw that this exploding area of HIV, then known as AIDS, was going to become a major job for clinicians of my generation. And it is only now—since, as we once said, we 'scienced the heck out of it'—that we can finally say that most people will live with and not die from AIDS. And that has been an incredible scientific and technological achievement.

Of course, the numbers are still very stark if you go to sub-Saharan Africa, where two-thirds of the world's cases still exist, and the great challenge there is to get people on treatment. So I do commend the 90-90-90 goals that have been set as part of World AIDS Day, and those are that: we know about at least 90 per cent of all infections; 90 per cent of those we know about are able to access ART, the appropriate therapy; and, for those on therapy, 90 per cent carry zero or near-zero low viral loads. Now, 90-90-90 sounds really good, until you do the multiplication and find what that really means is that only 72 per cent of people living with HIV are actually appropriately treated under ART. So it is still a very, very distant goal, particularly in parts of remote and sub-Saharan Africa.

To improve that, we have done things in different parts of the world. The most important things, I think, were major deals done, driven by Jeffrey Sachs, Michael Kremer and others out of Harvard, to set up a global fund, first of all, to provide a pull mechanism to fund the cures, but then—as it became pretty obvious that the cures were there and we simply needed to strike agreements—to make sure that these expensive drugs were available in countries where HIV was endemic. And, while we saw some potential risks—that these drugs, sold for one price in a developed economy, and provided virtually for free by beneficent pharmaceutical manufacturers, created some tensions where some of these products could be siphoned away and sold on the black market—that ended up being an incredibly minor challenge, compared to the overwhelming benefit of making sure that these drugs were available.

Closer to home, right here in Australia, we have seen an absolute focus on approving these drugs as soon as they have been appropriately assessed by international agencies and then by the TGA. We took away, as a government, the CD4 count requirement which said that, until you had a particular blood test result, you could not access the treatment. We realised that that was just delaying treatment. And what this is about is early identification and treatment.

The last national HIV strategy is coming to its conclusion, and we are talking about where we go from here. So, to remind ourselves of those facts: there were still, around the world, 2.1 million new cases last year, and 150,000 of those were children; and we know that the number of people receiving ART has gone up from 7½ million to closer to 17 million in the last 10 years, but that is still only halfway to where we would like to be.

But, most importantly, we have worked really hard on maternal to child transmission. Around the world, there are 1.8 million children who have HIV through no fault other than they were born to a parent who was a carrier of HIV. In Australia, we have seen that number fall precipitously. Around the world we have now seen a halving, since 2010, of maternal to child transmission, and that in itself is a major victory because, when you talk about maternal to child transmission, you are talking about someone living for the full period of their life carrying this disease, which is an incredible burden.

In closing, this is a victory of science and technology. Never had the world got together, I do not think, save for forms of influenza and epidemics, to be so singularly focused on finding a cure, and, for a decade, there was very, very little hope that that would be possible, and it injected huge amounts of community fear, uncertainty, stigma and discrimination. Thankfully, we are past that. Thankfully, now, we have got these numbers down. I think, without being too self congratulatory, developed economies found solutions for developing economies, like we have often failed to do in other areas. So, on World AIDS Day, I salute every clinician and researcher involved in that victory.

Anthony Albanese (Grayndler, Australian Labor Party, Shadow Minister for Infrastructure and Transport) Share this | Link to this | Hansard source

I rise to support the motion from my friend the member for Griffith, acknowledging that this week we will hold, on Thursday, World AIDS Day, and the theme this year is: HIV is still here and it is on the move. World AIDS Day has been held every year since 1988. More than 36 million people around the world are living with HIV.

The first recorded case of HIV AIDS in Australia was in Sydney in October 1982, and the first Australian death from AIDS occurred in July 1983. Between 1984 and mid-1985, there was a 540 per cent increase in HIV infections. And there was no cure. Labor health minister Neal Blewett, with the support of the then opposition, deserves incredible praise for embarking on a world-leading, pioneering and brave campaign to promote a safe-sex message. A television advertisement showing the Grim Reaper knocking people down like pins in a bowling alley was first screened on 5 April 1987 and kicked off efforts to provide the public with reliable information on preventing HIV and AIDS.

The success of the campaign can be judged by the reduction in the rate of infections. New diagnoses of HIV—according to the Australian Federation of Aids Organisations, based in my electorate in Newtown—have stabilised at just over 1,000 per year in the last three years. HIV diagnosis among Aboriginal and Torres Strait Islanders, however, has been increasing over the last five years. Ninety per cent of people living with HIV are men.

The stabilisation follows a concerted effort to increase the scope and regularity of HIV testing. The key is awareness. Pre-exposure prophylaxis has revolutionised HIV prevention. Through its use—along with rapid HIV testing, treatment as prevention, condoms and lube, and supportive attitudes and laws—the situation in Australia has stabilised. What is more, highly effective treatment for those with HIV means that deaths in Australia are now rare.

Unfortunately, people are still dying, including my dear friend and the first out MP in Australia, Paul O'Grady, who passed away in recent times after a very long illness. When he contracted HIV he resigned from the New South Wales parliament because he was not expected to live very much longer. He of course lived for decades longer as a result of the effort of science in prolonging people's lives and providing that treatment.

Internationally, there remains a massive challenge. In our region of the Asia-Pacific, 180,000 cases of AIDS and 1.2 million cases of HIV are reported each year. The Australian government has committed $220 million over three years towards the Global Fund to Fight AIDS, Tuberculosis and Malaria. This fund operates in 120 countries and is estimated to have saved 20 million lives since 2002. Australia should play a leading role in our region in tackling HIV, and this of course should be a bipartisan effort.

I want to today pay tribute to those people who in the early years had the courage to come out and say that they were HIV positive, sometimes attracting criticism and very personal derision as a result of the courageous stance that they took. Many of those people are no longer around. But, as a result of that many—hundreds of thousands—of lives here in Australia have been saved. The courage and vision that the former Labor government showed—and also it must be said the fact that the opposition of the time was prepared to support that leadership from Neal Blewett has made a real difference in our society. It is another reason why we need to be open about these issues, how we need to as a community do whatever we can to ensure that in future years we do not actually have a theme of 'HIV is still here and it is on the move'; but that we can celebrate that HIV is in the past.

Ms Catherine King (Ballarat, Australian Labor Party, Shadow Minister for Health) Share this | Link to this | Hansard source

It is a privilege to follow both the member for Griffith and the member for Grayndler on this important matter. I rise to speak in support of the member for Griffith's motion on World AIDS Day, which is Thursday of this week, a health issue which has wide-reaching impacts across all of our constituencies.

World AIDS Day is a good opportunity to both reflect on the significant progress we have made in fighting AIDS in our community, and to reaffirm our commitment to the challenges ahead. Certainly, developments in treating HIV have been a public health triumph. From the first Australian AIDS death in 1983 until the present day, where living with HIV is no longer a death sentence but is managed as a chronic disease, Australia has been at the front line of treatment.

Over the last 30 years the development of retrovirals, combined in this country with our world-class universal health care system, Medicare, and our Pharmaceutical Benefits Scheme have meant the vast majority of Australians with HIV have been able to access the health care they need to ensure they will not go on to develop AIDS. We have also led the world internationally in trying to make sure that these retrovirals are available in developing countries.

We are at a stage where most people who now contract HIV in this country will be able to successfully manage their condition and remain relatively healthy for the rest of their lives. And advancements in treatment are continuing. One factor which will play a significant role in the fight against HIV is pre-exposure prophylaxis medicine, PrEP, which experts have called a 'game changer'. Trials of PrEP have shown it is highly effective at stopping the transmission of HIV, and that it will play an important part in supporting Australia to reach the goal of virtually eliminating HIV transmissions by 2020. I commend the number of state governments who are trialling PrEP and making PrEP available. We hope that it will eventually be available on the pharmaceutical benefits schedule.

But, while we mark the progress we have made in fighting HIV/AIDS in Australia, more than ever we cannot afford to be complacent. According to the most recent statistics, there are approximately 27,150 people living with HIV in Australia. It is estimated that 12 per cent of these people are unaware of their HIV positive status. While the rate of notifications per 100 people diagnosed and living with HIV has declined by 25 per cent in the past ten years in Australia, progress has flat-lined over the past three years. Significantly, the HIV diagnosis rate in Aboriginal and Torres Strait Islander people has increased in the past five years.

We cannot afford any sign of complacency. Many Australians are of the impression that the great success we have had in dramatically reducing the numbers of Australians with HIV means that HIV-AIDS was no longer the threat it had once been. This is simply not the case. Australians must continue to be made aware that HIV remains a very serious threat and that the transmission of HIV can only be halted by safe sex practices and through harm minimisation with intravenous drug users. We still need to work very significantly with Aboriginal and Torres Strait Islander communities as a population to get the rates down there and we are working on the evidence for that.

As well as awareness of how at-risk groups can minimise their risk of acquisition, we must also promote awareness of how to support individuals living with, or affected by, HIV/AIDS. Confronting discrimination and promoting acceptance should be an essential part of community conversations about HIV/AIDS. Challenging the stigma around the disease is a critical part of promoting awareness and making sure people not only feel empowered to tackle the disease if they are infected, but to take steps to protect themselves from transmission in the first place.

Finally, I would like to acknowledge the work of researchers, AIDS activists, friends, family and supporters, as well as people living with HIV, in building a community in which HIV is now a disease people can live with. We know it has been the community working on prevention, hand in hand with government, community organisations and HIV-infected people, that has underpinned the success here in Australia, and that must continue to be the case. Again, I am always disappointed that we have seen many of the HIV-AIDS organisations defunded under this government. I would caution very strongly that the government, if it is going to continue to get infection rates down, needs to continue to engage with the sector. That funding needs to be restored or they need to work with the community to see how they can continue the very important services they provide today.

Graham Perrett (Moreton, Australian Labor Party) Share this | Link to this | Hansard source

I support the motion moved by the member for Griffith. Acquired immune deficiency syndrome, or AIDS, has been called 'the epidemic of our time'. Since first being recognised in 1984, more than 35 million people have died from AIDS or HIV. It is one of the most destructive pandemics in world history. Since the first diagnosis of AIDS in Australia, in 1984, there have been more than 36,000 people diagnosed as HIV positive in Australia. It is estimated that more than 25,000 Australians are currently living with HIV. However, with the combination therapies now available, it is not the challenge that it once was.

AIDS initially appeared in the early 1980s as a trickle of cases and posed a dilemma for health workers, who did not understand it. By the mid-1980s the public was worked into a hysterical state. In Queensland, under the then Premier, Joh Bjelke-Petersen, the hysteria was arguably even worse. Recently released Queensland cabinet minutes from 1985 reveal the depth of misinformation and hatred for the LGBTIQ community at the time. Queensland's then welfare, youth and ethnic affairs minister, Geoff Muntz, said:

As a parent, I would have strong reservations about letting young people compete in a pool that was used for such a sick event as a gay swimming carnival.

Although the then Queensland health minister, Brian Austin, argued in cabinet to rescind the ban on condom-vending machines in Queensland, the Bjelke-Petersen cabinet rejected his arguments and the ban remained, notwithstanding the fact that the World Health Organization had recommended that the ban be lifted. Homosexual activity was a criminal offence in Queensland at the time under Bjelke-Petersen. It was not until 1990 and the first Labor government to be elected in Queensland for 32 years, with the great Wayne Goss as Premier, that homosexuality laws in Queensland were overturned. But in the 1980s police were regularly raiding venues in Brisbane and charging people for engaging in consensual homosexual acts.

With such an unenlightened government in Queensland in the 1980s, the community remained ill informed about AIDS, which promoted fear and encouraged discrimination towards the LGBTIQ community. The grim reaper advertising campaign contributed to that hysteria without providing any information about the disease itself. Although the larger community campaign was devoid of detail, targeted campaigns were being rolled out to the LGBTIQ community with much more detail and practical advice on how to stay safe. The larger community was further gripped with fear when several babies in Queensland died after receiving infected blood. The AIDS epidemic then became real to all Australians, not just the LGBTIQ community. Although Australia quickly set up screening procedures to ensure that blood transfusions were safe, the fear created by these infections quickly turned into anger. That anger, sadly, was directed at the LGBTIQ community, who were blamed for putting babies at risk. Adam Carr from the Victorian AIDS Action Committee delivered a speech at a public meeting in December 1984, just as the media was latching onto the story of the babies being infected. This is part of that speech:

Unscrupulous politicians, extreme right wing fringe groups, powerful religious bigots and a sensation-hungry media will combine to exploit public fear and to channel ignorance into bigotry and the search for a scapegoat, and we have no guarantee that even the most liberal-minded of governments will be able to resist this kind of pressure for long.

That was 32 years ago. I can relate to the frustration Adam Carr felt at the time.

Sadly, while the issues are different, the fear and division being inflamed by some politicians and elements in the media are the same today as they were in 1984. HIV is no longer the death sentence it was considered to be in the early 1980s. In Australia, more than 80 per cent of people living with HIV have access to antiretroviral treatment. Of these people, 92 per cent have an undetectable viral load. The targets set by the United Nations are that, by 2020, 90 per cent of people living with HIV will know their status, 90 per cent of people diagnosed with HIV will be receiving treatment and 90 per cent of people on treatment will have suppressed viral loads. We cannot be complacent about HIV and AIDS, but we have significantly improved the outlook for those living with it. We must keep up the awareness campaign to highlight the importance of safe sex.

World AIDS Day is an important part of this. Although by far the highest rate of transmission of HIV is through male homosexual activity, I stress that it can be transmitted by both homosexual and heterosexual activity. World AIDS Day is also a show of support for those in the community living with HIV, their friends and families and the many activists and researchers who have worked tirelessly to make it possible to live with HIV. I mention in particular the Bobby Goldsmith Foundation. It has been around since the 1980s. In fact, my brother was collecting for the foundation nearly 20 years ago when he met his partner, Michael—and they are still together.

Andrew Giles (Scullin, Australian Labor Party) Share this | Link to this | Hansard source

HIV is still here and it is on the move. This is, of course, the theme of this Thursday's World AIDS Day and it goes to the heart of this very important motion the member for Griffith has put before the House, which I am pleased to speak in support of. I was also very pleased to be in the chamber for the contribution of my friend the member for Moreton, who spoke very effectively and passionately about the challenges of overcoming discrimination, which has been at the heart of our successes as a country in overcoming many of the challenges posed by HIV/AIDS. I was also here for the contribution by the shadow minister for health, the member for Ballarat, who touched on the progress and cautioned about complacency, which I think really goes to the heart of where we sit today in Australia as well as looking more broadly to the challenges in the developing world posed by the continuing prevalence of HIV.

In this motion, there are a couple of elements that deserve to be drawn out. First is the question of awareness raising, noting that this is a very important week where we show our support for work that has been done and for people. We acknowledge that 36 million people have died around the world of complications relating to HIV and that there are a similar number today, tens of millions, who are living with HIV. We show our solidarity for all of those people and our support for them. We also acknowledge the extraordinary advances that have taken place—advances in treatment but also advances in public health and wider public policymaking. It is important that all of us in this debate touch upon the extraordinary contribution of then health minister Neal Blewett and, indeed, to acknowledge the bipartisanship that was shown at that time when this issue first came into Australian political life and the critical importance of that bold and entirely appropriate response. But, in acknowledging those actions and the advantages in treatment, there is a challenge that comes with it, and that challenge really comes to visibility because, of course, HIV still exists in Australia as it does in parts of the developing world, particularly Sub-Saharan Africa.

As well as HIV still existing, it is disappointing and disturbing but we have to face up to the fact that so do some of the stigmas, which the member for Moreton touched upon, going back to the eighties and nineties—some of them still persist. That is why this motion in this place is so important. That is why a bipartisan support of World AIDS Day is so important.

The member for Ballarat, again, said that there could be no room for complacency when we debate these issues. She dwelt on a couple of really important matters: firstly, that there are a very large number of Australia's who are unaware that they have HIV today; and, secondly, that rates are flatlining and increasing when it comes to the Aboriginal and Torres Strait Islander community. This is not over as a public health problem, and we need to continue with our efforts when it comes to our work in treatments and our work in education, particularly around safe sex and some of the drug availability questions and, as other speakers have touched upon, PrEP. These continue to be very important, if we are to not only reach our goals of ending transmission worldwide by 2020 but also enable all Australians presently living with HIV to live full lives and participate fully in society.

This motion importantly acknowledges the roles played by people living with HIV and their friends. I think it is important to stress in this place the courage shown by many people at times when it was difficult to do so. It was their courage that created the impetus for effective political and public policy action that has been so successful in Australia. I also acknowledge, as previous speakers have done, the work of researchers and some of the advocacy bodies. I join other speakers in expressing my concern about the defunding of some advocacy organisations at a juncture when there is no time for complacency. I also join the call at the end of this resolution that this House will support actions to reduce stigma, prevent new transmissions and work towards a cure.

As we come towards World AIDS Day, I show my support with members of this House and other places to enable all Australians with HIV to live full lives. I join colleagues in making a statement not only in solidarity for all those who have past and all those living with HIV but also to take every action I can against further transmission. I commend the motion to the House.

Ross Vasta (Bonner, Liberal Party) Share this | Link to this | Hansard source

The time allotted for this debate has expired. The debate is adjourned and the resumption of the debate will be made an order of the day for the next sitting.