Bianca Jagger: The unacceptable face of our Aids policy at home

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The Independent Online

Gordon Brown, in his first message to the Labour Party conference as Prime Minister, went to great lengths to affirm the universality of human rights. "No injustice can last forever," he said. But while our attention is often drawn to human rights abuses in Burma, injustices in Darfur and HIV in Africa, it is easy to overlook our responsibility to end human rights abuses in our own country. And in the case of many migrants living with HIV in the UK, the Government seems to have forgotten to practice what it preaches.

Julia is pregnant and living with HIV. Drugs exist today that can prevent Julia passing the virus onto her unborn child. But Julia is unable to access these drugs, not because she is living in a developing country where HIV drugs are unavailable, but because she is one of many in a group ignored by the UK Government and by society; an asylum seeker whose request for sanctuary in the UK was refused, and who is now living in residency limbo.

Following an antenatal screen, Julia received a letter informing her that her residency status means she will not be provided free treatment for HIV and would have to pay thousands of pounds for the drugs needed. Julia disappeared from care, unable to afford the charges.

Julia's fate, and the fate of her child, was sealed not by outdated policy or a loophole in the system. Julia, and others like her, are denied treatment thanks to a new policy introduced by this Government in 2004, just one year before the UK's pledge of universal access to treatment for all by 2010.

Prior to 2004, NHS treatment of all kinds was available free of charge to anyone who could show that they had been in the UK for more than 12 months. Today, the new regulations mean some of the most vulnerable people living with HIV – refused asylum seekers and other undocumented migrants – cannot access free HIV treatment. These individuals legally are prohibited from working. As a result, they are often destitute – certainly unable to pay any bill for hospital care.

The tabloid press protests loudly about so-called "treatment tourism", but there is no evidence to show that this actually occurs. The evidence that does exist suggests that the majority of people who have claimed asylum and, are subsequently diagnosed with HIV, only receive their diagnosis after they have entered the UK and become ill, usually many months – if not years – later. People seek asylum because they face persecution in their own country, not to gain free treatment.

Every month HIV organisations including the National Aids Trust hear stories like Julia's, stories of pregnant mothers denied maternity care; of people co-infected with HIV and TB who discontinue their TB treatment so they can pay their HIV-related bills; of people either without legal residency or whose status is unclear being billed for thousands of pounds. Often destitute, those unable to pay such bills have had their treatment delayed, denied, interrupted or withdrawn. Many have been pursued aggressively by debt collectors. Furthermore, others have been mistakenly denied free treatment by NHS officials confused over their own regulations.

Unaffordable treatment is not accessible treatment – not only is the UK Government breaking its G8 promise, it is breaching basic human rights to life and healthcare.

And the consequences spread further than individuals' health. Without the prospect of access to treatment, people are deterred from having an HIV test. Undiagnosed infection is now fuelling the epidemic. Those untreated are significantly more infectious than those on treatment and, being unaware of their infection, will unwittingly put sexual partners at risk. Those sexual partners are likely to include others without residency; thus the cycle continues.

Eventually, of course, someone infected with HIV but undiagnosed will become seriously ill and arrive in Accident & Emergency departments, who pick up the bill. And a week in intensive care will wipe out the savings on a whole year's HIV treatment. Denying free treatment is a foolish and deadly false economy.

Gordon Brown must make good on the promises he has made with clear and unambiguous new legislation. He must set an example to other governments. He must not use "residency status" to get out of international obligations and human rights commitments. If the Government is serious about supporting global access to HIV drugs, it needs to begin by reassessing access to drugs in the UK.

I have signed the National Aids Trust campaign for free HIV treatment for all in the UK. I urge Gordon Brown to begin by doing the same.

The writer is chair of The World Future Council and founder of the Bianca Jagger Human Rights Foundation

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