Friday, September 02, 2011

UK HIV Response "Woefully Inadequate"

A report published yesterday by the HIV and AIDS in the UK Select Committee of the House of Lords has described the priority given to preventing HIV and AIDS in Britain as “woefully inadequate”. While nearly three quarters of a billion pounds is spent each year on HIV treatment, only a third of that is spent on prevention. In the last decade, the UK has trebled the number of people on anti-retroviral therapy for HIV (ART), while we face the number of people living with HIV topping the 100,000 mark in the next year if current trends continue – 25% of whom do not even know their diagnosis. And people unaware of their HIV status risk infecting others and worsening their own health.
While the scale of this problem has made headlines today, the underlying issue should come as no real surprise. As far back as 2006, while attending a function for UK civil society delegates to the UN High Level Meeting on AIDS in New York I was told by a Department of Health Civil Servant that the UK did not need a separate HIV prevention strategy any more, as it was all adequately dealt with by the UK’s sexual health strategy. Ignoring the fact that the most successful work has been done amongst drug users using needle exchanges, the astounding level of complacency this statement reveals is born out by not only today’s figures, but that the UK continues to have some of the highest STD and teenage pregnancy rates in Western Europe. If we cannot even tackle sexual health adequately, no wonder we are not tackling HIV!
In fact, the most worrying finding is that, a generation on from the start of the AIDS pandemic, the British population is more ignorant than ever about HIV, its effects routes of transmission and prevention.
While the British government has been applauded for its funding of HIV treatment and prevention work in the developing world, we remain shockingly inadequate (and even complacent) on the domestic front. Likewise, the global church has responded constructively to HIV in many parts of the world, especially sub-Saharan Africa, but the British church remains largely ignorant and unengaged with HIV as in issue in the UK. It is time for a change in our attitudes.
Well done to Lord Fowler (the originator of the ‘Don’t Die of Ignorance’ campaign in the eighties that many now credit with playing a significant part in saving the UK from a major HIV epidemic in the nineties) and his committee for reminding us the AIDS has not gone away, and getting it back in the headlines.

this post originally appeared on the blog of the Christian Medical Fellowship at

Saturday, April 02, 2011

Missing Midwives Costs Mothers’ Lives

On 1 April UNICEF and the Royal College of Midwives launched a campaign to find the missing midwives.  UNICEF’s recent research suggests that globally we need 350,000 midwives, and that this shortage of skilled birth attendants means as few as 6% of women in some developing countries have access to skilled birth attendants. This means that there are as many 1,000 women and 2,000 children dying daily, many of whose lives could be saved if a trained midwife was in attendance.

350,000 seems a remarkably small number and an achievable target. However, when you consider that the UK is also short of midwives, perhaps it is not a surprise that this gap has not been as easy to bridge as it at first seems.  As birth rates rise in the UK, we seem to be training fewer midwives.  Most midwives I know work in understaffed, over stressed units, and yet still manage to deliver a generally high standard of care that ensures that not only are the vast majority of British babies delivered safely, they are also delivered in a way that makes for a meaningful and happy experience for the mother.  One wonders for how much longer however, as we fail to train new midwives and support effectively those already working in the profession. As DFID gets behind the UNICEF campaign, it is worrying that other parts of the national and devolved governments are at best playing catch up and at worst reducing the numbers of midwives in this country!

However, in many parts of the world, there is no such provision.  Partly this is an issue of poverty, and partly a mixture of cultural and political values that do not prioritise motherhood or the life and health of women and children. As we highlighted in the CMF submission to DFID’s maternal health strategy consultation, it is only by addressing these issues, as well as the provision of trained midwives, obstetricians, appropriate medical supply chains etc, that we can turn around the gross inequality in maternal health and survival around the globe.

It is ironic, on Mother’s Day, to consider a world that really does not value mothers and motherhood. We live in a culture that here in the UK has such a disordered sense of human value that it does not train enough midwives, but prioritises free prescription of abortefactive post coital conception. In the process we are failing to address the deeper issues of fractured relationship and disordered sexuality that leads us to have one of the highest teen pregnancy rates in the Western world.  And as MPs seek to increase the amount of information, counselling and professional support being provided to women seeking an abortion, they are attacked for trying to harm women.  In other parts of the world a man will let his wife die rather than incur the cost of getting her to a hospital – other wives are always available, while his government will not put any money into training midwive who could have helpe her deliver her child more safely at home.  It is a sobering thought, as we celebrate our mothers this Sunday.  We need to do more than give a few gifts to say thanks to our mothers; we need to take action  seek to see motherhood properly supported around the world, and here at home.

To sign the UNICEF petition to UK Development Secretary to support the global drive for more midwives click here


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