HIV Australia | Vol. 8 No. 2 | July 2010

PROFESSOR MICHAEL KIDD speaks at the launch of the new National HIV Strategy about the newly announced strategies to manage HIV and other BBVs in Australia.

On 28 May 2010, Parliamentary Secretary for Health, The Hon Mark Butler MP, launched the 6th National HIV Strategy and the 2nd National STI Strategy at AFAO’s National Symposium on Prevention in Sydney. The Strategies represent major advances in national coordination and accountability, and a return to strong national leadership.

Following is the paper delivered by Professor Michael Kidd AM, Chair of the Ministerial Advisory Committee on Blood Borne Viruses and Sexually Transmissible Infections. Michael Kidd is also Executive Dean of the Faculty of Health Sciences at Flinders University.

It is appropriate that this launch is taking place at this national symposium on the prevention of HIV and other blood borne viruses (BBVs) and sexually transmissible infections (STIs) because prevention has always been at the heart of Australia’s effective national response to HIV and it must remain so.

In March 2009, our Health Minister, The Hon Nicola Roxon MP, established her Ministerial Advisory Committee on Blood Borne Viruses and Sexually Transmissible Infections, affectionately known as MACBBVS. AFAO President, Dr Graham Brown, and NAPWA President, Robert Mitchell, are among the 18 members of MACBBVS who ensure that HIV prevention and treatment and care issues are high on our committee’s agenda.

Last year, our Health Minister set her advisory committee two challenges: to lead the development of the new set of national strategies based on lessons learned about what did and did not work during the life of the last set of national strategies, and to re-engage the partnership approach which has been fundamental to this nation’s effective response to the HIV epidemic, including involving each of the jurisdictions.

We now have five new linked national strategies:

• 6th National HIV Strategy

• 2nd National STI Strategy

• 3rd National Aboriginal and Torres Strait Islander Sexually Transmissible Infections and Blood Borne Viruses Strategy

• 3rd National Hepatitis C Strategy, and

• 1st National Hepatitis B Strategy.

This set of five strategies was endorsed by all our health ministers – Federal, State and Territory – at a meeting last month. While we may not see all our governments agreeing on all aspects of our national health reform agenda, it is significant that every single health minister was willing to sign up to this new set of strategies and, in so doing, commit their health services to meet the targets for prevention, treatment and care set out in each strategy.

Each of the new strategies contains a set of objectives and indicators against which the Commonwealth and each State and Territory will report each year. That will allow us all to closely monitor progress in reducing rates of infection with HIV and other BBVs and STIs, while at the same time ensuring equity of access to treatment and care for all people in this nation.

The principles of our national strategies are based on applying what we know works well, to all people in this country, with a focus on:

• prevention and education of both the general population and priority populations

• ensuring community empowerment and partnership

• ensuring equity of access to treatment and care

• ensuring we do not tolerate stigma and discrimination

• building our workforce capacity and providing training and support, and

• continuing Australia’s international leadership in research and surveillance.

One of the commonest questions I have been asked since being appointed Chair of MACBBVS, is whether HIV is still a problem. The answer of course is ‘yes’. Despite the success of Australia’s globally recognised response, in 2008 there were more than 17,000 people living with HIV in this country.

In 2008, 995 people were newly diagnosed with HIV. In 2008, 69%of new diagnoses were among men who have sex with men, and rates were rising. We are also seeing a rise in new infections among people travelling and working in high prevalence countries, among members of some culturally and linguistically diverse communities, and among injecting drug users in some Aboriginal and Torres Strait Islander communities.

The goal of the new National HIV Strategy is to reduce transmission of HIV, reduce the morbidity and mortality caused by HIV, and minimise the personal and social impact of HIV. This can be achieved by a reinvigoration of prevention efforts, strengthening of the partnership, addressing key workforce development, and renewing our focus on human-rights-based approaches.

One of the other questions I am asked, only by men and never by women, is ‘what’s chlamydia?’. The answer is that chlamydia is the most frequently reported notifiable infection in Australia, with 60,000 cases reported in 2008, and a doubling of the rate of reported infection from 2004 to 2008 for both women and men.

The greatest number of infections is in the 20 to 29 year age group, which is a grave concern because it indicates that our messages on the prevention of STIs are failing to reach many of the people most at risk. The new National STI Strategy has a strong focus on prevention, and a focus on the need to increase rates of testing and treatment.

The third and final question that I am often asked is, ‘does syphilis still exist in Australia?’. And of course the answer is ‘yes. It does’. In 2008, there were 1,300 cases diagnosed. 14% of those cases were in Aboriginal and Torres Strait Islander people, which includes cases of children being born with congenital syphilis and cases of people who had developed serious long term neurological and cardiovascular disease from undiagnosed and untreated syphilis. The new strategies aim to work towards elimination of infectious syphilis in Aboriginal and Torres Strait Islander communities.

MACBBVS worked with the Australian Government Department of Health and Ageing and each of the States and Territories and key community-based organisations, consumers, clinicians and researchers on the development of the new set of national strategies for BBVs and STIs, working with a team of talented writers led by Levinia Crooks from the Australasian Society for HIV Medicine (ASHM).

I thank everyone who has been involved in the development of the new set of strategies. Now that the strategies are in place, we all face the far more important work of implementing them and making a difference. I am looking forward to continuing to work with you all.

Professor Michael Kidd AM, is the Chair of the Ministerial Advisory Committee on Blood Borne Viruses and Sexually Transmissible Infections. and the Executive Dean of the Faculty of Health Sciences at Flinders University.

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