Michael Danby (Melbourne Ports, Australian Labor Party) Share this | Link to this | Hansard source

I rise in support of this motion to mark World AIDS Day. This year is the 20th anniversary of the first World AIDS Day, which originated from the 1988 world summit of ministers of health on programs for AIDS prevention. Australia’s representative at that meeting was Dr Neal Blewett, Minister for Health in the Hawke government and the minister who laid the foundations of Australia’s response to the HIV-AIDS epidemic.

World AIDS Day provides us with an opportunity to reflect on the development of the global fight against HIV-AIDS. The red ribbon, which many members are wearing today, is the symbol of World AIDS Day. This year’s World AIDS Day’s theme is: ‘Stop AIDS—keep the promise, lead, empower, deliver’. This theme is a timely reminder to us as law makers of our obligation to provide leadership in the fight against HIV-AIDS. Over the past 25 years in Australia we have pioneered the model of the three-sided coalition—a coalition of government, the medical profession and the affected communities. That strategy has proved remarkably successful, but it depends on us as law-makers maintaining our commitment.

It is hard to believe that it is a quarter of a century since AIDS first arrived in Australia. I have lived all my life in St Kilda, in the Elwood area, that part of Melbourne which has a strong gay community. I well remember in the early years of the epidemic the effect this disease had on them, a disease that has spread all over the world. I remember the fear that was aroused by the sudden appearance of this mysterious and fatal disease amongst gay men in the early 1980s. I remember the hysterical attacks on the gay community by some parts of the media and by some politicians.

I also remember the immediate efforts of the affected communities to get together, to organise themselves, to take action to prevent a further spread of AIDS and to support, in particular, those affected by it. I could go on for hours about the way the gay community in Melbourne has supported people who have been so affected. It is very moving. In July 1983 the Victorian AIDS Council was formed and for the last 25 years it has provided inspirational leadership for the Victorian gay community and many other people affected by the epidemic.

Over the past 25 years Australia has mounted one of the world’s most effective responses to the AIDS epidemic. We have had 10,000 AIDS cases and 6,700 deaths. That is a terrible toll, but it is far less than it would have been if effective action in the area of prevention had not been taken, both by affected communities and by Australian governments. It is far less, on a per capita basis, than in almost any other country.

When we look around the world we see in other countries close to us, such as Papua New Guinea and, unfortunately, South Africa and indeed throughout most of the continent of Africa, an unwillingness to take the kinds of measures that Australia has taken over the last 25 years. As stated in the motion, approximately half a million children and approximately 33 million people are living with AIDS or HIV. Particularly in Africa there is the tragedy of orphans who have had both parents die from the epidemic.

As an Australian parliamentarian, I am very proud to have visited Thailand recently to see the work of two devoted Australian doctors who are working on a nutrition project with the Thai Red Cross. Nutrition can affect the health and recovery—indeed, the physical existence—of people suffering from HIV-AIDS if they make sure they are nourished in the correct way. These two Australian doctors have been over in Bangkok. One has been there for 10 years and the other for five. That is the kind of spirit that has made Australia’s contribution to the fight against HIV-AIDS renowned around the world.

But in Australia we cannot be complacent. Complacency leads to new HIV infections and more AIDS diagnoses. Over the past 20 years, all Australian governments have pursued a bipartisan HIV-AIDS program. The current program, begun in 2005 under the previous government, is being continued by this government with an annual budget of $28 million. I commend all of those in the community sector— (Time expired)

Kay Hull (Riverina, National Party) Share this | Link to this | Hansard source

In speaking to this motion, I congratulate the member for putting this forward on World AIDS Day. I will be quoting extensively from a document from the National Association of People with AIDS. It says:

• A decade of treatment optimism and declines in HIV/AIDS mortality and morbidity have changed the expectations of many PLWHA about their lives and future. Many people with HIV/AIDS now expect that they should be able to live as close as possible to a normal life—with longer term goals and expectations replacing short-term ones based around survival.

There are going to be enormous pressures placed on clinical services. The document says:

• HIV clinical management and ARV prescribing have evolved to encompass a mix of specialist and generalist services, with hospital based physicians, sexual health physicians and general practitioners involved to varying degrees.
• Currently there are 19 ARV drugs available in five different classes.

That would be 19 in 2005, so there are probably more now. It goes on:

The new drug pipeline contains 15 new drugs which look promising. There are a host of others in very early development. Within another 5 years there may be some 30 ARV drugs available in six different classes.

• It is a major challenge for physicians and GPs working in HIV/AIDS to keep up to date with new drugs and new scientific knowledge and incorporate this into management of their patients. This applies even to the most experienced HIV clinicians.

…            …            …

• Keeping up to date with developments in HIV treatment and care is a considerable task. Time involved in reading journals, attending scientific conferences, training courses sponsored by ASHM, pharmaceutical industry educational events, also impacts on general practice remuneration for training, even when certain sponsorships are provided. For practices with small HIV caseloads, the motivation and/or opportunity to acquire and put all this information into practical use is obviously very limited.

This applies specifically and particularly in rural and regional areas, where the spread of HIV-AIDS has taken place with very few practitioners to deal with it. The document goes on:

There are difficulties in recruiting new GPs to become ARV prescribers, even among high HIV caseload practices.

So what chance do we have in many of our rural and regional areas? The paper continues:

• In the current complex environment, management of HIV disease and ARV treatment requires not only substantial knowledge, but also an active PLWHA—

that is, people living with HIV-AIDS—

caseload. It is not in the best interests of PLWHA to have complex decisions about their HIV care and treatment made in low HIV caseload medical facilities, be they general practices, sexual health clinics or hospitals.

It is so important that formal linkages be established between rural and regional practitioners to form pathways to our accredited practitioners. The paper goes on:

Training and accreditation requirements for current ARV prescribers should be upgraded, in light of complexity.

As part of upgrading training requirements, maybe consideration should be given to introducing a minimum HIV caseload level for ARV prescribing accreditation and then clear pathways set so that other, smaller caseload GPs and practitioners have a clear pathway to get them to the latest in treatments and the most important services and support networks available.

These issues have been raised by NAPWA for many years and there is an enormous paper on this. I think it is time that, in the review stage of the current domestic strategy that I believe will report back in January, we determine pathways forward to ensure that models of care for HIV-AIDS sufferers are included in a new strategy to reflect the new and emerging drugs, treatments and issues involved with HIV-AIDS sufferers living longer and more productive lives, thus causing in many new areas that need to be identified and addressed. I thank NAPWA for their dedication to all of those people who are living with HIV-AIDS and commend their work to the minister.

Annette Ellis (Canberra, Australian Labor Party) Share this | Link to this | Hansard source

I rise to speak in the House today on the 20th anniversary of the first commemoration of World AIDS Day. World AIDS Day plays an important role in society. It helps raise awareness worldwide about AIDS issues and the need to support and understand the situation faced by many people who are afflicted with the disease. Although Australia has one of the lowest rates of diagnoses in the developed world, there is a disturbing trend in that the overall number of diagnoses in Australia has increased from 718 in 1999 to more than 1,000 in 2007. This statistic reminds us that we must remain vigilant.

I want to take this opportunity to talk about HIV-AIDS in the Canberra community and about the AIDS Action Council of the ACT and the very important work that it does to support people living with HIV-AIDS in the local community. Every year, 10 Canberrans are diagnosed with HIV. When compared to over 1,000 in Australia and the many thousands worldwide, this appears to be a very small number. However, as the General Manager of the ACT AIDS Action Council, Mr Andrew Burry, said at the weekend, ‘It is 10 too many.’ We must do all we can to stop the spread of HIV-AIDS, and the ACT AIDS Action Council certainly plays an important role in the local community. It provides many services including testing, education, client support, counselling, advocacy and organisational development. They work cooperatively in the community with various stakeholders including the YWCA and SCOPE Youth Service, the Youth Coalition of the ACT, Junction Youth Health Service, Barnados, the Belconnen and Woden youth services, Canberra Sexual Health Centre, ACT Division of General Practice, ACT Health, ACT Queer, and the new Canberra Transgender Network, just to name a few.

Recently the council worked on the corrections-health services plan for the new Alexander Maconochie Centre—the first correctional facility in the ACT. The council worked with the ACT Community Coalition on Corrections and with other agencies to support a proposed needle and syringe program, and with the ACT Hepatitis Resource Centre to develop proposals for development and health promotion programs for staff and residents. This year the council has relaunched a rejuvenated volunteer program. It focuses on best practice, professional development, clearly defined roles and improved communication channels. It also releases a newsletter that gives a voice to other community members and publicises gay, lesbian and transgender sporting groups in the ACT community.

The council is also involved in the international candlelight memorial. The 25th memorial was held on Sunday, 18 May this year. It involved a prayer service held at the All Saints Anglican Church in Ainslie, followed by a second service at the National Museum of Australia in Acton. The theme of the service this year was to remember not only people infected with HIV-AIDS, but also the much wider group of people such as family and friends who are also affected. This year the ACT AIDS Action Council is asking people to focus on the large number of people—around 65,000—who are suffering from HIV-AIDS in Papua New Guinea, our nearest neighbour.

Worldwide, the spread of HIV-AIDS continues to be a major problem. Approximately 33 million are infected, and it kills many millions of people each year, not to mention over half a million children. This truly is a tragic statistic. Australia is committed to help fighting the spread of this infection overseas by spending $1 billion in the 10-year period between 2000 and 2010—and I note that is across two governments. Australia’s commitment includes spending $178 million over the four-year period between 2007 and 2010 in Papua New Guinea; $100 million over eight years, from 2008 to 2015, in Indonesia to combat HIV, focusing on capacity building, prevention and care; $135 million over three years on the Global Fund to fight AIDS, Tuberculosis and Malaria; and up to $59 million to support a program across South-East Asia that will concentrate on harm reduction among injecting drug users to prevent the spread of HIV around those communities.

In the few seconds I have left, I want to reflect also on the role that our previous minister Neal Blewett took back in the eighties, when he bravely stepped forward with a radical plan which had bipartisan support and which the public really was very worried about—but without that I do not know that we would be where we are today. The other thing I want to reflect on is young Eve van Grafhorst. There was an article in the paper about this little girl at the weekend, and I read it with great remembrance. In 1985, having been diagnosed with HIV, the little one was shunned by her community here in Australia and her family ended up living in New Zealand. Thank goodness we have come a long way from the days when we did that sort of thing to a person suffering from HIV.

Steve Irons (Swan, Liberal Party) Share this | Link to this | Hansard source

I rise this evening to discuss World AIDS Day. Today marks the 20th anniversary of World AIDS Day. It is now viewed as one of the most successful commemorative days internationally, with more than 190 countries, including Australia, acknowledging this initiative. World AIDS Day is an international health initiative aiming to raise awareness of acquired immunodeficiency syndrome, AIDS, caused by the spread of HIV. This initiative was originated in 1988 by the World Health Organisation and has developed over time. It has continued to be a necessity due to the high prevalence of HIV and AIDS. In 2007 it was calculated that 33 million people were living with HIV, with 2.7 million newly affected. The AIDS disease has killed 25 million people worldwide since 1981. The campaign follows annual themes under the wider theme of, ‘Stop AIDS—keep the promise,’ which is active until 2010. This year’s theme is continued from 2007, focusing on leadership as its main objective. Self-responsibility and activism are also clear themes for the initiative.

World AIDS Day recognises that it is necessary to not only aid and assist the most crippled countries but also prevent the increase of AIDS in countries with lower prevalence rates. The number of people living with HIV has risen from approximately eight million in 1990 to 33 million in 2007 and is currently on the rise, according to a report published by UNAIDS and the WHO. Fifty per cent of those living with HIV-AIDS are women. It is concerning that young people under 25 account for half of the world’s new HIV infections, highlighting the need for continual education to prevent the conditions and support those who have contracted HIV-AIDS. It is not uncommon for those suffering from HIV or AIDS to be subjected to much social scrutiny in many different cultures due to the lack of understanding of how the infection is contracted and the historical stigma attached to it. To reduce this stigma and scrutiny, the stereotype of an HIV-AIDS carrier needs to be broken down. Often, to break down a stereotype that results in discrimination, a greater understanding of the infection is needed, and this can be achieved through increased education. This is where days like today are important in continually encouraging education.

It is a well-recognised fact that Third World countries, in particular in Africa, are the most highly affected by the AIDS pandemic. Sub-Saharan Africa has the highest total of people living with HIV or AIDS, totalling 22 million in the 2007 statistics. In saying that, I say that it is important to talk about our own HIV-AIDS issues here in Australia. By the end of 2007, Australians living with HIV accumulated to a total of 16,692. Although the AIDS incidence in Australia, much as in Canada and the UK, is much less than in non-developed countries, it is still on the rise. AIDS causes much destruction not only to the sufferer but also to their family and friends. Australia has experienced 6,709 deaths caused by AIDS. Australia is using the slogan: ‘Enjoy life. Take control. Stop HIV-AIDS.’ This theme empowers people to be responsible and make decisions to maximise their control of the outcome.

Australians, like people in many industrial countries, view the HIV-AIDS problem as something specific to Third World countries such as in Africa, where its prevalence is highest. Within Australia, it is necessary to note that there are varying incidences within the different states and capitals. In proportion to the population size, New South Wales has the highest incidence of HIV diagnosis—214 people per 100,000. Victoria is the second highest, with a rate of 110.4, and the Australian Capital Territory incidence is also quite high, with a total of 87.1. Rates in Queensland at 73.4, the Northern Territory at 72.9, Western Australia at 69.1 and South Australia at 66 were similar. In contrast, Tasmania has the lowest rate of HIV diagnosis—24.1. These figures highlight which areas of Australia and the world are affected by AIDS.

On World AIDS Day I think it is appropriate to talk about the significant cut in Papua New Guinea’s 2009 AIDS budget. A report from AusAID highlighted that two per cent of PNG’s population is infected with HIV-AIDS. An Age article today stated that there are relevant fears that by 2025 more than 50,000 people will be infected with HIV in the region. The Papua New Guinea government has cut the budget by 25.1 million kina, which is equivalent to A$15 million. This cut will not affect the Australian funding given to tackle the AIDS epidemic, with a sum of $100 million expected to change hands over the five-year program—although, due to the current economic situation, the funding package is now reduced by 30 per cent.

In concluding, I say that it is important that the topic of current and future challenges be brought up. It is necessary to highlight that there is a lack of adequate treatment in poor countries, along with the unlikelihood of finding a vaccine at any time soon. Medication used to manage HIV in Africa is not affordable or readily available for those infected. It is not surprising that AIDS orphans in Africa number 11.6 million.

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

I rise to support the motion moved by the member for Melbourne Ports. I would also like to commend the member for Swan for his contribution. He is always a fair-minded person and it was great to hear his words on this important topic.

Like many people and parliamentarians throughout Australia, I am today wearing a red ribbon. I thought about wearing the rainbow ribbon today. I phoned my brother Nicholas for a bit of advice and he said that with my poor taste in clothes the rainbow ribbon would be more appropriate because it would go with everything. Leaving aside his cruel but accurate advice, I deferred to the simple red because, 20 years on, all informed Australians understand that acknowledging HIV-AIDS is not about the homosexual community; instead, it is about commemorating, supporting and understanding all people with HIV-AIDS. It is a disease that strikes irrespective of our sexuality or faith or beliefs.

When I first learned about HIV-AIDS it did put the fear of death into me. The Grim Reaper campaign, with the bowling ball, was an incredibly effective advertising strategy. To quote Elvis Costello, ‘Death wears a big hat.’ And so our Death, or the Grim Reaper from the 1980s, with a bowling ball and no regard for child protection conventions, remains to this day an iconic image for me and for many people my age or older. Since 1981, around 7,000 people in Australia have died from AIDS related illnesses. I knew just one of the 6,767. Many people here tonight would know of others. Certainly people in my family know too many more.

The Hawke-Keating government’s attentiveness to the disease when it first came to our shores meant that there was a relatively low incidence of seroconversion. Thankfully, the Howard government—I will give them credit—continued to perform great work in this area also. I especially acknowledge the Leader of the Opposition for the great work that he and his wife, Lucy, have done in this area over the years. Unfortunately, we can contrast this bipartisan support and approach with Ronald Reagan’s approach. He was a President who could not even bring himself to say the word ‘AIDS’. I do not wish to speak ill of the dead, but he was a disgrace to former union leaders. Who knows how many lives were ruined or lost because of Ronald Reagan’s prejudices and ignorance?

There have been great innovations in HIV-AIDS medication over the last 20 years. Now this big disease with the little name is not the death sentence it once was—at least not in Western countries, where we have medication and resources to combat the ravages of the disease. But unfortunately there is still ignorance in some countries where the non-scientific approach of politicians and religious leaders is still killing people unnecessarily. In 2007, 72 per cent of AIDS related deaths in the world occurred in sub-Saharan Africa. Obviously, faith based treatments are not the answer. Instead we need to have real scientific approaches.

One of the dangers in the innovation and treatment that I referred to earlier is that there is no longer the same sort of fear—there is no Grim Reaper in everybody’s lounge room anymore—and this might make risk-taking behaviour more acceptable in some sections of the community in Australia. This means there is an even greater onus on the government to educate younger people to make sure that they do not engage in risk-taking behaviour. Especially at Schoolies Week and the like, people can become involved in all sorts of activities that might include risk-taking behaviour.

Last year in Australia there were 1,051 people diagnosed with HIV-AIDS. They joined a community that is way too large already. There are 16,700 people already living with HIV-AIDS. That is equivalent to a good sized town, and that is way too many people. Hopefully our community has stopped looking for the rainbow ribbon when it comes to talking about HIV-AIDS. That is from 20 years ago. We have moved on. We are much more inclusive and much more understanding about how we should approach these things. Obviously, we never need to have an approach similar to that of Ronald Reagan to drugs, when he said, ‘Just say no.’ That will not work. We need to be much more proactive. It is good to see a lot of community groups and churches being much more proactive in combating HIV-AIDS. I commend those opposite for the bipartisan support shown by them, especially by the opposition leader, on this important issue.

Stuart Robert (Fadden, Liberal Party) Share this | Link to this | Hansard source

Today marks the 20th anniversary of World AIDS Day. In 1988, the World Health Organisation declared the first World AIDS Day in an effort to raise public awareness about HIV-AIDS. It makes today an appropriate day to discuss in this place the future of Australia’s HIV-AIDS strategy, and I thank the member for Melbourne Ports for introducing this motion.

‘Enjoy life, take control, fight HIV-AIDS’ is the Australian theme for World AIDS Day. Recent studies indicate that HIV infection rates in Australia are gradually increasing. This fact on its own demonstrates that the Australian battle against HIV-AIDS infection is not won. We must continue to be vigilant in our response to this ongoing problem. It is easy to go from a small increase in infection rates to a more serious and widespread problem if governments and the community become complacent. It shows that HIV not only is a problem overseas but requires continuing action right here at home. The theme aims to send out the message that, if people take personal responsibility by being informed about how they can protect themselves and others, there is no reason why they cannot enjoy life and at the same time stop the spread of HIV-AIDS.

The National HIV/AIDS Strategy 2005-2008 identified five priority areas for action to be addressed over the life of the strategy. But the current strategy has expired. Whilst it continues to be funded, I understand it has been referred to an outside organisation for consideration and that a report regarding the future of our domestic HIV-AIDS strategy is due to be returned perhaps as late as March. I also understand the international strategy is now under consideration by the minister, and I eagerly await her response and an announcement regarding its future. I had hoped the announcement would have been made today. Indeed, the majority of new Australian cases of HIV-AIDS resulting from heterosexual contact have arisen through contact with a partner from a high-prevalence country—particularly sub-Saharan Africa or parts of South-East Asia—demonstrating the importance to Australia of a continuing international response.

An estimated 16½ thousand people in Australia were living with HIV at the end of 2007. From the start of the epidemic until the end of June 2007, there were 23,360 diagnoses of HIV—after adjustment for multiple reports—and 10,097 diagnoses of AIDS. Australia has recorded an unfortunate loss of 6,709 lives through AIDS. The AIDS incidence in Australia of 0.9 per 100,000 population is similar to that in the UK and Canada—at 1.4 and 0.8 respectively—though much lower than that in the United States, at 12.8. The annual number of HIV diagnoses in Australia peaked in 1987. There followed 12 years of decline, after which the rate of diagnoses grew again to reach 983 in 2007. The annual number of AIDS diagnoses in Australia peaked in 1994, with 953 cases, and then declined rapidly to 216 in 1999. The fall was largely due to the introduction of effective combination antiretroviral therapy, which delays progression from HIV infection to AIDS.

The number of AIDS diagnoses has since remained relatively stable. After the initial success in limiting the spread of AIDS, HIV infection rates began to rise again, though they remained low by global standards. After new reported cases dropped to 656 in 2000, the rate of HIV infection rose to 930 in 2005. Transmission continues to occur predominantly through sexual contact between men, in contrast to many high-prevalence countries where it is transmitted increasingly through heterosexual contact.

We cannot take our eyes off the ball when it comes to HIV-AIDS. The minister must be motivated to quickly outline Australia’s future strategy now. Time is of the essence. In this case, time will wait for no-one and no nation. Due to its strong years of bipartisan action, Australia has an excellent record in fighting growth in HIV infections. We cannot afford to lose this record, reputation or any more lives needlessly. I commend the member for Melbourne Ports for raising this important motion and I look to the minister to announce a strategy going forward.

Steve Georganas (Hindmarsh, Australian Labor Party) Share this | Link to this | Hansard source

I welcome this motion and thank and congratulate the member for Melbourne Ports for bringing such a critical issue to the parliament. It is significant because we should all be concerned about the global epidemic of HIV-AIDS. As we all know, today marks the 20th anniversary of World AIDS Day. According to a 2008 UN report on HIV-AIDS, globally there were an estimated 33 million people living with HIV in 2007. There were about 2.7 million new HIV infections and about two million AIDS related deaths in 2007. Sub-Saharan Africa remains the most seriously affected region, accounting for 67 per cent of all people living with HIV and for 72 per cent of AIDS deaths in 2007. The number of children living with HIV increased from an estimated 1.5 million in 2001 to about 2.5 million in 2007. Nearly 90 per cent of all HIV-positive children live in sub-Saharan Africa.

Australia’s nearest neighbours, Indonesia and Papua New Guinea, are also facing growing numbers of people with the disease. The spread of HIV is one of the biggest development challenges facing Papua New Guinea today. The Australian government is the lead donor supporting Papua New Guinea’s national HIV response. The emphasis of Australia’s strategy is to prevent the spread of HIV in the region. The strategy also provides for supporting treatment, care and ongoing support for people infected and affected by HIV. Between 1981 and 2007, 27,331 Australians were infected with HIV, 10,230 were diagnosed with AIDS and, sadly, 6,767 died from AIDS related illnesses. Among those 6,767, there were two people whom I knew personally. In 2007 it was estimated that 16,700 people were living with HIV-AIDS.

The number of new HIV diagnoses in Australia has increased each year, from 718 in 1999 to 1,051 in 2007. The number of new diagnoses each year is around 280. Australia was very quick to implement strategies—we all remember the grim reaper advertisements on TV—and this assisted to prevent the acquisition of HIV. The rate here is almost half that of the UK and 10 times lower than that of the US. In my home state of South Australia, 1,127 people have been diagnosed with HIV-AIDS.

In 1988, the World Health Organisation declared the first World AIDS Day in an effort to raise public awareness about HIV-AIDS issues. World AIDS Day is now recognised and observed by millions of people in more than 190 countries around the globe. The Australian theme for World AIDS Day 2008 is, as we heard earlier: ‘Enjoy life. Take control. Stop HIV-AIDS.’ It is an appeal for all people to take personal responsibility in the fight to stop the acquisition and spread of HIV-AIDS.

Recent studies indicate that HIV infection rates in Australia are gradually increasing. The Australian government developed a national HIV-AIDS strategy which identified five priority areas for action, to be addressed over the life of that strategy. The goal of this strategy was to reduce HIV transmission and to minimise the personal and social impacts of HIV-AIDS infection. One aim of this review is to uncover innovative ways to provide education, support and clinical services that will both decrease the spread of AIDS within Australia and improve access to care for people living with AIDS.

Alby Schultz (Hume, Liberal Party) Share this | Link to this | Hansard source

Order! 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.