Katie Allen (Higgins, Liberal Party) Share this | Link to this | Hansard source

I move:

That this House:

(1) notes that:

(a) Australia is continuing to display international leadership on the issue of HIV/AIDS by co-facilitating the 2021 United Nations General Assembly High-Level Meeting on HIV and AIDS;

(b) this meeting took place from 8 to 10 June and covered the progress which had been made in reducing the impact of HIV since the last High-Level Meeting in 2016;

(c) the High-Level Meeting coincides with a meeting of public health and political leaders in Australia on 17 June to discuss Agenda 2025: Ending HIV transmission in Australia;

(d) testing and treatment services combined with successful leadership from governments and civil society mean that progression from HIV to AIDS is now relatively rare in Australia;

(e) action is still needed to address rising HIV transmission among First Nations, trans and gender diverse people, and other emerging high-risk population groups;

(f) gay and bisexual men continue to bear the burden of Australia's HIV epidemic and ongoing health education among this population group is needed; and

(g) further bipartisan political action and leadership is required to meet our national target of ending HIV transmission in Australia; and

(2) recognises and acknowledges the:

(a) Agenda 2025: Ending HIV transmission in Australia strategy outlines the commitments needed to make Australia one of the first countries to eliminate HIV;

(b) journey that people have made through their diagnosis, treatment and experiences of living with HIV;

(c) tremendous efforts of peer educators, healthcare professionals, researchers and scientists in developing treatment and prevention regimes that have improved the lives of people living with HIV;

(d) success of a bipartisan approach in Australia's health response; and

(e) tireless community advocates, civil society organisations and support groups that actively tackle stigma associated with HIV.

I proudly rise to move this motion to help destigmatise HIV/AIDS and raise awareness of the efforts Australia is making to end HIV transmission. Many people may be unaware that Australia is actually leading the way on ending HIV, not just locally but internationally. As a result of our leadership we were privileged to be asked to co-facilitate the 2021 United Nations General Assembly High-Level Meeting on AIDS in New York in June earlier this year. In fact, in 2019 we became one of only a handful of countries to achieve the 2020 HIV elimination targets set out by UNAIDS.

The meeting welcomed the recent scientific evidence that sexual transmission of HIV between adult couples does not occur when the HIV-positive partner is on effective and sustained antiretroviral treatment. The report also noted that, thanks to the increased access to antiretroviral therapy, more people are living longer with HIV. Decades of research and committed health care mean HIV/AIDS no longer is the death sentence it once was. I remember witnessing, as a young medical student, the introduction of this scourge to the world and how frightening it was not just for people in the community but even for medical practitioners. We've come a long way since the early eighties when this was an unknown epidemic.

The UN high-level meeting coincided with a meeting of public health and political leaders in Australia in June this year to discuss Agenda 2025: Ending HIV Transmission in Australia. This national strategy outlines the commitments needed to make Australia one of the first countries to eliminate HIV transmission. It's a fully costed plan which draws upon evidence based research and is backed by top researchers, leaders and clinicians in Australia's community-led HIV response. With additional investment and renewed policy settings, HIV transmission within Australia could be ended by as early as 2025. That's within the next term of government. Such an outcome provides much-needed hope and leadership that the world is on track to end AIDS by 2030. This is momentous, and we are so close. It has not been an easy journey but it is thanks to the tremendous efforts of so many—peer educators, healthcare professionals, researchers and scientists. All have worked tirelessly to improve the lives of people living with HIV. All are providing hope that AIDS elimination is just around the corner.

We know that here in Australia testing and treatment services combined with successful leadership from governments and civil society mean that progression from HIV to AIDS is now relatively rare. But there is still more to do to end transmission. HIV transmission among First Nations, trans and gender diverse people and other, emerging high-risk population groups does remain problematic. Gay and bisexual men continue to bear the burden of Australia's HIV epidemic, and ongoing health education among this population group remains a priority.

My electorate of Higgins is vibrant and diverse, and it has a large, thriving LGBTIQ+ community. I'm proud of the work my community does to ensure that stigma around HIV is diminished and that access to medicines is widened. I'm proud to be a member of Liberal Pride. Higgins is also home to world-leading HIV/AIDS research at the Burnet Institute and Alfred Health, and great advocacy groups like Thorn Harbour Health. My community campaigned, and is proud that the Commonwealth moved, to list pre-exposure prophylaxis, commonly known as PrEP, on the PBS, making it affordable and therefore more accessible—accessible by all, no matter what your means.

As some of you are all too aware, COVID changed our lives in many ways. Australians delayed health check-ups and stopped taking vital medicines. This can be seen in delayed preventative health checks, even with PrEP. We know, unfortunately, that 42 per cent of gay and bisexual men stopped taking PrEP during a short period of time early in the COVID crisis. We know this has been reversed, which is wonderful. But we need to remain vigilant. We want people to go out and make sure they take up their healthcare checks and their preventative healthcare checks. We all have a responsibility to educate others about HIV, to remove the stigma, because, when we work together, we can help end HIV transmission here in Australia and around the world.

Mike Freelander (Macarthur, Australian Labor Party) Share this | Link to this | Hansard source

Is the motion seconded?

Angie Bell (Moncrieff, Liberal National Party) Share this | Link to this | Hansard source

I second the motion and reserve my right to speak.

Ged Kearney (Cooper, Australian Labor Party, Shadow Assistant Minister for Health and Ageing) Share this | Link to this | Hansard source

I'm pleased today to speak on this motion moved by the member for Higgins. It is vital that members in this place continue to talk about HIV until its transmission is ended in Australia and around the world. I've been lucky enough to work with the team from the Australian Federation of AIDS Organisations, or the AFAO, in looking at what can be done to reach this goal.

Australia has a proud history of strong, bipartisan action on HIV. The HIV crisis was an horrific time for all of us in Australia, but, of course, most particularly for our gay and bisexual communities. I know as someone who was a nurse during this time just how bad it was—the confusion, the hysteria caused by the media, which fuelled terrible instances of homophobia and violence. I remember the isolation felt by so many of my patients during that time. The lack of understanding and the fear from healthcare staff furthered that isolation. For far too many people with HIV, nursing and health staff were the only people in the room at the end of their lives.

But then we saw the wonderful mobilisation of the LGBTIQ+ community. Community and political activists pulled together and demanded action. They demanded an end to the vilification and homophobia, and they worked with health professionals and governments to make a change—to act on the epidemic in ways that were appropriate and effective. And it worked. Government came together with the community and took decisive action. There are wonderful stories of the bipartisanship shown at this time. Under the Hawke government, which was in power through the crisis, the then Labor health minister, Neal Blewitt, set up a bipartisan committee to ensure unity on the response to the crisis. Imagine that. During such an important time for Australia, on such a vital health issue, which had divided much of the Australian community, there was political unity. This is a story all of us in this place can learn a lot from, and it should inspire the way we approach HIV policy into the future, because, while Australia has seen incredible success in its approaches to stemming HIV transmission, we aren't there yet.

I spoke earlier of my work with the AFAO. Their plan, Agenda 2025, which is mentioned in this motion, outlines steps that can be taken to eliminate transmission of HIV in Australia by 2025. I applaud them for this work. What their plan shows clearly is there's still work to be done. We know that, here in Australia, gay and bisexual men remain the key population where HIV transmission is occurring.

We are at the pointy end of the fight against HIV. That stubborn amount of transmission that requires that bit more innovation to get to it is our last piece of the puzzle. But, at their core, the same answers we found during the crisis in the eighties will be the answers to ending HIV transmission in Australia once and for all: access and information. This includes access to preventative measures, detection services and effective treatments, and information on how transmission works and how to access prevention and treatment measures—information that is culturally appropriate and accessible to all.

Over the last few decades, we have seen innovative prevention and treatment strategies come online. PrEP has changed the game on the transmission of HIV, and effective HIV treatments mean those who are diagnosed can go on to lead healthy, full lives and many can reach the point of having undetectable levels of HIV. These medications and treatments are incredible. If we utilise the technology we have before us now and invest in the technology which is still coming online, we can end HIV transmission here and go on to ending it around the world. We just need to invest in informing people and giving them fair and equitable access.

I look forward to continuing to work with AFAO on their plan and to hearing more about how we can reach this huge milestone. I encourage everybody, especially those opposite, to learn from our past, from the incredible bipartisan efforts of the Hawke Labor government, on this important issue. There's no reason at all that we can't come together again—why we can't sit down as one, in a true bipartisan nature, and discuss this issue end to end—to stop HIV transmission once and for all. My door is always open if you'd like to discuss it, and I know there wouldn't be a member on this side of the House that would close a door to such a process.

Angie Bell (Moncrieff, Liberal National Party) Share this | Link to this | Hansard source

I'd firstly like to thank the member for Higgins for bringing this motion before the chamber to be highlighted for those living with HIV/AIDS in Australia. Her proactive approach to representing her electorate, the broader community and the medical profession is evident through her output of work and her continued dedication to deliver better medical outcomes for all Australians, as a government member.

Australia continues to be a world leader in the elimination of HIV and, in 2019, it became one of only a handful of countries to achieve the 2020 HIV elimination targets set by UNAIDS. Overall, HIV transmissions continue their long-term trend of decreasing in Australia. In 2019, 90 per cent of the 29,045 people suspected to be living with HIV in Australia had been tested and diagnosed with HIV. Of those diagnosed, 91 per cent were on treatment, and, of those on treatment, 97 per cent had an undetectable viral load, which is great news for all Australians and for those who are suffering from this disease.

The Australian government continues to work towards the important goal of eliminating HIV altogether in Australia and of supporting international efforts to do just that. In my own electorate, researchers at the Menzies Health Institute Queensland, located within the Griffith University Southport campus in my electorate—my alma mater—have developed a novel anti-HIV protein which suppressed HIV levels in the bone marrow, spleens and brains of mice and prevented the virus from replicating in those areas. The federal government announced in 2019 a significant investment in the Australian HIV response by way of a funding boost of $45.4 million over four years. Griffith University on the Gold Coast has received more than $3 million in funding for health and science initiatives.

Under the Morrison government, Australia has beat the 2020 HIV elimination targets set by UNAIDS, and we are confident in Australia's progress to achieve the 2025 UNAIDS targets. These are ambitious targets, and we still have work to do in this area. The government continues to support efforts to eliminate HIV and to support people living with HIV, working closely with the sector. In February 2021 this year, the TGA registered the first prolonged-release injectable HIV treatment for use in Australia. Injectable HIV treatments have several benefits for the patient, including removing the need for daily tablets. Under the Morrison government, Australians are able to access affordable HIV prevention medication and protect themselves and others from possible transmission. We're committed to supporting all Australians—including those at higher risk of HIV, the LGBTIQ community—to ensure their safety and prosperity so they can live free and long lives. In addition, pre-exposure prophylaxis was listed on the Pharmaceutical Benefits Scheme on 1 April 2018. As at March this year, 44,798 people had been dispensed PBS-subsidised PrEP. The number of HIV notifications in Australian-born men with male-to-male sex as an exposure risk has decreased since this PBS listing, which is great news again. This has been attributed to the introduction of PrEP on the PBS. So it's going in the right direction; it's going down.

As we approach World AIDS Day, on 1 December this year, it's important to acknowledge the efforts of those working in this sector and ensure that we all remain committed to supporting the elimination of HIV and AIDS in Australia. Agenda 2025 was launched on 17 June 2021 at Parliament House in Canberra. It will cost $53 million per annum and proposes a range of activities for community campaigns, peer education, and HIV stigma education and media programs. Campaigns and peer education support the implementation of the National Blood-Borne Viruses and Sexually Transmissible Infections Research Strategy. Australia is working towards achieving the targets that I outlined. In 2019, 90 per cent of the 29,045 people living with HIV had been diagnosed. As I said, of those, 91 per cent were on treatment. Of those, 97 per cent had an undetectable viral load. We're certainly making headway with HIV-AIDS in Australia, and I commend the Australian government for the work that we are doing to eliminate it across our great nation.

Mike Freelander (Macarthur, Australian Labor Party) Share this | Link to this | Hansard source

I thank the member for Higgins for her motion. This is a very important one, and it again demonstrates that we work best when we all work together. I'm going to demonstrate my age a little bit here. I was a registrar, and then a very young consultant, at the beginning of the AIDS epidemic in Australia. I remember how frightened we all were. Then we didn't call it HIV, because the virus hadn't been identified. We called it 'acquired immunodeficiency syndrome'. I remember when we had the first child with AIDS at the children's hospital, and a very good consultant, Dr Kamath, who was a gastroenterologist, was asked to see this child in intensive care. He said, 'The symptoms are very similar to something I've just read about that is happening in the United States.' In fact, this child did have full-blown AIDS and had returned from the United States. The child ultimately succumbed to AIDS, as did, I believe, his parents. That was the beginning of the AIDS epidemic. I think people do not quite understand how frightened we all were about this. We were frightened because, at that stage in the United States, many people were dying. There was vertical spread from mother to infant. We were very frightened that it would get into our disadvantaged groups such as our Indigenous population—and there was absolutely no treatment. We were seeing children dying from this disease. I, for one, cared for a little girl called Eve van Grafhorst, who ultimately developed AIDS from a blood transfusion given to her as a premature infant. We saw the terrible way she was ostracised and her family was treated. It really was a very frightening time for all of us. I remember speaking to my immunologist friend, then working at Liverpool in south-west Sydney, and he was very scared about transmission among intravenous-drug-using people, and we were very frightened about what that was going to mean in our communities.

It was only when two people—Neal Blewett, the Minister for Health, and Peter Baume, the shadow minister for health—came together and agreed to work together in a completely apolitical, bipartisan way that we were able to work towards Australia becoming the leading nation in the world in combating this scourge of AIDS, ultimately found to be HIV. Even today, when I was speaking to a younger member of my staff, he didn't know what the word 'AIDS' meant, and this was something that could've taken over our community. Yet, by working together, we managed to get on top of the epidemic and reach a point where, now, Australia leads the world.

The PrEP, pre-exposure prophylaxis, treatment, which was trialled initially by the New South Wales Liberal government, has been a fantastic effort. Now available around Australia, it has led to much-decreased rates of transmission. We now have intravenous preparations, which are a very effective way of providing treatment without the need to use prolonged oral treatments. We are now able to provide this in a non-judgemental, non-partisan way throughout Australia, which has been dramatic. We are now seeking to be able to eradicate HIV by human-to-human transmission from Australia. It is an achievable fact that many years ago we believed would never be possible.

We still have areas of need. We still have disadvantaged populations. We still have populations in countries around us, such as Papua New Guinea and some of the Pacific islands, where it is still a huge risk and a huge problem. I want to pay tribute to AFAO and the organisations that are part of it and the work they have done to develop a very non-judgemental, apolitical way of approaching HIV in Australia as we look towards eradicating it and being one of the first countries in the world to be able to do that. That's a tribute to politicians on both sides and to people in the community, in the LGBTI community and in the medical community who have worked towards this aim.

John Alexander (Bennelong, Liberal Party) Share this | Link to this | Hansard source

I thank the member for Higgins for bringing forward this debate today. I speak about medical marvels a lot in this chamber. Representing the innovation capital of Australia makes that an easy thing to do. Local companies are vaccinating us against COVID and other diseases, curing heart conditions and consigning many deadly diseases to history. It's an incredibly exciting time to be alive, and it's the best part of Australia to represent.

One of the areas we have had stupendous improvements in is the area of AIDS. Not long ago HIV/AIDS was terrifying. It seemed to strike without warning, taking healthy young people rapidly. There was no cure. The grim reaper ads are still a vivid reminder of the fear of those days. It was all the more shocking because its victims—young people, healthy people, people with their whole lives ahead of them—were taken by this insidious disease. Everybody knew someone who was affected. Tackling this disease took incredible resources, vigilance and teamwork. By working together, the world dragged this disease into the light. In 30 years it has gone from a disease that people will die from to one you might die with in many years time.

Looking at where we were with it in the eighties, it is miraculous that we have come this far this quickly. Now, in Australia, we have the results to show for all our hard work. Overall HIV transmissions continue their long-term trend of decrease in Australia. In 2019, 90 per cent of the 29,045 people suspected to be living with HIV in Australia have been tested and diagnosed with HIV. Of those diagnosed, 91 per cent were on treatment and, of those on treatment, 97 per cent had an undetectable viral load.

Because working on this requires a global push, the UN has become involved and set ambitious targets to fight HIV. They have created a high-level task force which has set the following targets to reduce annual new HIV infections to under 370,000 and annual AIDS related deaths to under 250,000 by 2025, ending paediatric AIDS and eliminating all forms of AIDS related stigma and discrimination and to achieve the 95-95-95 testing, treatment and viral suppression targets within all demographic groups and geographic settings.

I'm proud to say Australia continues to be a world leader in the elimination of HIV. Australia has achieved the 2020 HIV limitation targets set by UNAIDS and we are working hard to meet the 2025 UNAIDS targets. These are ambitious targets, and we still have work to do in this area. In particular, the overall reduction of HIV has not been seen in many Aboriginal and Torres Strait Islander people, and for overseas-born gay and bisexual men there was a three per cent increase in HIV notification. The government continues to support efforts to eliminate HIV and to support people living with HIV and working closely with the sector.

Australia's role in this global push is highly commendable. This year Australia, together with Namibia, cofacilitated the United Nations meeting and we have been strong in ensuring that critical issues like comprehensive education of sexual and reproductive health and rights for adolescents and young people are addressed. We have got there through hard work and diligence but also through technology and testing, and tracing and treatment medications have all been game changers over the past two decades.

We have come a long, long way on this front. But it's exciting to note that there are still improvements being made to these treatments. Just in February the Therapeutic Goods Administration registered the first prolonged release injectable HIV treatment for use in Australia. Injectable HIV treatments have several benefits for the patient, removing the need for daily tablets—the bright present leading to an even brighter future for everyone diagnosed with HIV.

I'm still amazed by the turnaround in fortunes for people with this condition. The defining feature of HIV in the eighties was fear and uncertainty. Now it's optimism. This change cannot be understated. It also shows that we can do whatever we set our minds to fixing when we work together towards a common goal. We're seeing it today with COVID as well. When we work together with focus, we can achieve anything that we set our minds to.

Sharon Claydon (Newcastle, Australian Labor Party) Share this | Link to this | Hansard source

I'm very pleased to rise to speak on this motion today moved by the member for Higgins, highlighting the vital role that Australia continues to play in the fight to combat HIV/AIDS. As you noted in your contributions, member for Macarthur, this year marks 40 years since the first reported case of HIV. As we look back over the last couple of decades, we can see how radical policy changes to our public health response has produced utterly extraordinary progress across the globe. According to the Global Fund 2021 Results Report, last year 27.5 million of the 37.7 million people living with HIV were on life-saving antiretroviral therapy globally. That is up from a very small by comparison 7.8 million people who were in that situation back in 2010. So, globally AIDS related deaths have fallen 47 per cent since 2010.

Whilst this milestone is absolutely worth celebrating, it is critical that we also acknowledge that we are facing a very new and sobering reality. COVID-19 is reversing many of the hard-fought gains in the fight against HIV and other blood-borne diseases like TB and malaria not just here in Australia but globally. Because of the disruptions and restrictions imposed as a result of COVID-19, communities at greater risk of HIV infection have been unable to access the tools and information needed to protect themselves. COVID-19 has disrupted the supply chains, limited access to prevention tools such as condoms, lubricants and ARVs. The number of people reached by HIV prevention programs and services declined by 11 per cent and programs aimed at reaching young people declined by 12 per cent. Above all the global pandemic has exacerbated inequalities that make people more susceptible to HIV, and to end HIV and to confront new threats like COVID-19 we must renew our commitment to vulnerable communities and ensure that no-one is left behind, regardless of where you live on this planet.

Since the beginning of the HIV-AIDS epidemic in the early 1980s there have been strong partnerships between governments and oppositions, with the affected communities, people living with HIV, researchers and the health profession always being at the heart of Australia's response. Those kinds of collaborative partnerships have always been strong in Australia. As a senior adviser to the then Australian health minister, Bill Bowtell played a very significant role in the development and the introduction of Medicare and our universal health system back in 1984. At the very same time he was overseeing an enormously successful and well regarded Australian response to HIV and AIDS. To this day Bill maintains a very close interest in the potential impact of the HIV-AIDS epidemic and other communicable diseases on the social, economic and political development of the Asia-Pacific region via his work now with the HIV-AIDS project at the Lowy Institute for international policy and he leads the Pacific Friends of the Global Fund.

Likewise, the work of the Kirby Institute at the University of New South Wales has been pivotal to Australia's most recent efforts to tackle HIV. In 2016 Professor Andrew Grulich and his team from the UNSW led the first large-scale trial of the groundbreaking HIV-prevention medication called PrEP. In recent years the PrEP pill has ushered in a sexual, social and political revolution amongst those most affected by HIV. It's contributed to the unprecedented reductions in new HIV infections, although, as the member for Bennelong noted, that is not the case in First Nations communities, and that remains a really huge issue for us and a gross inequality in this nation. But PrEP has the potential to significantly impact Australia's response to the HIV epidemic. It's an important new option in a suite of HIV strategies and responses to help end HIV transmission.

Certainly, in June this year the global community adopted new targets, through the political declaration at the UN, to get us back on track to stop an AIDS epidemic. The COVID-19 pandemic, as I mentioned, has had a catastrophic impact on the most vulnerable communities around the world and threatens to roll back progress on HIV, TB and malaria. As a global community we've got to unite to fight against them all. This is a time for us to step up and replenish the global fund. The government has done so in the past. I'm calling on them today to make sure that there is a generous replenishment in the global fund again.

Mike Freelander (Macarthur, Australian Labor Party) Share this | Link to this | Hansard source

The time allocated 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.

Sitting suspended from 13:13 to 16:0 3