In just a few weeks, hundreds of new MPs will be arriving in Westminster. They will have a historic opportunity to be the generation of parliamentarians that ends the HIV epidemic in England.  

All the major political parties standing candidates in England have now published their manifestos for the general election. The Conservative, Labour and Green manifestos commit to action that could enable us to end new HIV cases by 2030. Whoever forms the next government will need to act fast to meet this ambitious goal. We are clear what a new HIV Action Plan needs to include: increasing HIV testing, expanding PrEP access and ensuring everyone living with HIV gets the care they need.

A new HIV Action Plan for England will be the cornerstone of our efforts for the next five years. The government’s current plan expires in 2025 - and we’re not on track to meet the necessary target of reducing new transmissions by 80% within 12 months. Labour’s manifesto commits to commissioning a new HIV Action Plan in pursuit of ending new HIV cases by 2030. That’s exactly what’s needed. Keir Starmer laid this out in more detail on World AIDS Day last year when he said that Labour would start developing a new HIV Action Plan within 100 days of taking office. That plan will need to be bold and ambitious if we are to meet our target by the end of the decade.

To get there, we must find every one of the 4,500 people estimated to be living with undiagnosed HIV in England, 5,150 UK-wide. In the last two years, we’ve proved how best to do this: test, test, test. A&Es in London, Brighton, Blackpool and Manchester have done more than two million HIV tests since April 2022 as part of the government’s opt-out testing programme. This type of routine testing – of everyone who has their blood taken – has diagnosed people at a speed and on a scale not seen before.  More than 1,300 people have been found with HIV and more than 5,000 with HIV, Hep B and C combined. Thanks to our supporters, last year we won the case for this type of testing in all areas with a high HIV prevalence, so now another 47 hospitals are contributing to over 4 million HIV tests a year. The funding for this programme is facing a cliff edge in April 2025. That’s why the Conservative manifesto commitment to fund the expansion of opt-out HIV testing is incredibly welcome. This will need to happen quickly for the programme to continue uninterrupted.

The success of this flagship programme has exposed a bigger challenge: the number of people living with diagnosed HIV but not accessing life-saving treatment. It’s estimated as many as 14,000 people in England, 963 in Scotland, have not been to their HIV clinic in more than 15 months – a quiet crisis that will jeopardise our chance to meet the 2030 goal and is causing serious ill health for many living with HIV. Alarmingly, more people are now being admitted to hospitals in London because they weren’t accessing HIV care than because they didn’t know they were living with the virus.

Turning that around starts with acknowledging the scale of the problem. We must change how we report progress against UNAIDS 90-90-90 targets, to properly capture that cohort who are not getting the treatment they require. An ‘HIV Retention England’ programme must follow. A funded, national effort to find and re-engage every person lost to HIV care across the country is what’s needed. Now.

We must make sure that the game-changing drug PrEP is reaching its full potential. A plan for PrEP access beyond sexual health services was promised in the last HIV Action Plan, but it’s yet to be delivered. This commitment must not be lost in a new plan - we’ve got to make PrEP available in pharmacies, online and in GP services. This should enable access for those not benefiting, but also relieve pressure on sexual health services, where the average waiting time for PrEP is an unacceptable 12 weeks. It’s great that the Green Party manifesto commits to this, and to the vital renewal of opt-out HIV testing programmes in A&Es.

Restoring public health funding will also be vital to relieving this strain so that sexual health services can be there for everyone who needs them. It’s not just PrEP access that has suffered as a result of the 40% real-terms cut to sexual health funding, it’s also testing and care. While STI rates soar, more than half of clinics can’t offer appointments to people without symptoms and there’s no postal STI/HIV testing service in 30% of rural England. The Liberal Democrats and the Green Party have committed to an increase in the public health grant in their manifestos, which would be a crucial step to turning around these trends.

There is lots to celebrate in the commitments made on HIV and public health this week, but there is no room for complacency. At Terrence Higgins Trust, with our partners from across the HIV sector, we’ve published our own manifesto for the election, with six clear calls for action. It shows over 20 charities and doctors’ groups in agreement on what is needed to end new HIV cases. We are ready to support any new government of any party to make that happen.

It’s going to be up to all of us. So whether it’s through writing to your parliamentary candidate or donating to support our work, please stand with us on this next phase of the journey.

Let’s make this the parliament that we end new HIV cases for good.