§ Mr. DicksTo ask the Secretary of State for Health how much money has been spent in the last 10 years by her Department or via other bodies or organisations of public awareness campaigns and research on (i) AIDS, (ii) leukaemia in children and (iii) spina bifida.
§ Mr. SackvilleFor details of expenditure on AIDS public awareness campaigns and research, I refer my hon. Friend to the replies I gave to my hon. Friend the Member for Coventry, South-West (Mr. Butcher) on 26 April at columns280–81.
Comparable information on the amount spent related to children with leukaemia is not available centrally.
So far as spina bifida is concerned, an expert advisory group report on "Folic Acid and the Prevention of Neural Tube Defects" was launched in December 1992. This publication cost £21,400 to produce and its distribution to the national health service cost in excess of £50,000. A follow-up public information campaign in the current financial year is being planned. Research into spina bifida is undertaken by the Medical Research Council which receives its grant in aid from the office of my rright hon. Friend the Chancellor of the Duchy of Lancaster.
§ Mr. DicksTo ask the Secretary of State for Health how much public money has been spent by her Department or via other bodies or organisations in connection with the AIDS disease since 1986; and how many cases of AIDS have become known since that time.
§ Mr. SackvilleThe cumulative total of Government funding for HIV/AIDS for the financial years 1986–87 to 1992–93 is £886,304,000. This includes money made available for medical treatment and care, training of health and social care workers, infection control, surveillance, protection of the blood supply, HIV testing and counselling, funding of voluntary sector projects, local authority support services, research, and public education and prevention campaigns. This figure does not include spending by other Government Departments on HIV and 447W AIDS work connected with their own spheres of interest. Information about total expenditure from nongovernmental sources is not available centrally.
A total of 7,083 cases of AIDS and 16,164 cases of HIV have been reported since 1986.
§ Mr. DicksTo ask the Secretary of State for Health how many research programmes examining the HIV/ AIDS virus have been funded either directly or indirectly from public expenditure over the past 10 years.
§ Mr. SackvilleThe main agency through which the Government support medical research is the Medical Research Council which receives grant-in-aid from the office of my right hon. Friend the Chancellor of the Duchy of Lancaster for a directed programme of AIDS research covering vaccine development and to improve our understanding of the natural history of the virus. Between 1986–87 and 1992–93, a total of £66,170,000 was made available to fund the programme.
§ Mr. DicksTo ask the Secretary of State for Health what evidence she has as to the relative degree of risk to(a) heterosexuals and (b) homosexuals of contracting AIDS.
§ Mr. SackvilleHIV, the virus which causes AIDS, is primarily transmitted by unprotected sexual intercourse between men or between men and women, where one person is infected. The relative risk of acquiring HIV depends on the frequency and type of sexual activity, prevalence of infection and other factors such as the presence of ulcerative genital diseases.
In general, the individual risk of acquiring infection through unprotected sex between men is at present likely to be far greater than it is for unprotected sex between men and women. This largely reflects the fact that homosexual and bisexual males still account for the greatest number of reports of both HIV and AIDS. However, whilst the numbers of those infected heterosexually are smaller, the fastest rate of growth in HIV reports is now seen in this group.
§ Mr. DicksTo ask the Secretary of State for Health what percentage of known AIDS cases have been among homosexuals and drug users; and what percentage of such cases have come from within the heterosexual community over the past 10 years.
§ Mr. SackvilleA total of 7,331 cases of AIDS had been reported in the United Kingdom up to 31 March 1993.
AIDS in England and Wales—Reported and projected Table 1 1987 1988 1989 1990 1991 1992 1993 Cox 800 1,250 1,800 2,350 2,950 3,600 — Day — — 856 1,040 1,280 1,600 2,160 Reported 624 819 907 998 1,276 1,420 — 448W
Table 2 1989 1990 1991 1992 Total AIDS Day 1,070 1,300 1,600 2,000 Total AIDS outcome 1,160 1,410 1,530 1,975 Heterosexual AIDS Day 55 115 225 420 Heterosexual AIDS outcome 90 145 220 320 Seventy-five per cent. of cases are attributed to infection transmitted through sex between men; 5 per cent. of cases attributed to infection transmitted through injecting drug misuse; and 2 per cent. of cases have been reported in homosexual or bisexual men who were also drug misusers. Ten per cent. of cases are attributed to infection transmitted through sex between men and women.
§ Mr. DicksTo ask the Secretary of State for Health (1) if she will provide details of the annual forecasts of the number of people likely to contract AIDS and the actual number of cases notified;
(2) how accurate the forecast made in 1986 by her Department as to the number of heterosexuals expected to contract AIDS over the next 10 years has so far proved to be; and what assessment has been made of the reasons for divergence of outturn figures from the forecast.
§ Mr. SackvilleThe Government have consistently sought to minimise the uncertainty surrounding the HIV/AIDS epidemic by providing for high quality HIV surveillance which has informed forecasting work and enabled its accuracy to be monitored.
Two Official Reports have been published on projections for AIDS cases in England and Wales. The Cox report was published in 1988 on projections from 1987 up to the end of 1992. The projections were not subdivided by exposure categories. The Cox report was superseded, in January 1990, by the Day report which provided projections up to end of 1993. Copies of both reports are available in the Library.
The reports provide a range of estimates. Table I gives recommended planning estimates from each report for annual total number of AIDS diagnoses, without adjustment for under-reporting, plus the total numbers of AIDS cases reported in each year. However, there is a delay between diagnosis and report so that reporting figures for any one year are not directly comparable to figures for diagnosis. Table 2 gives the Day recommended estimates for total and heterosexual contact AIDS cases, allowing for under-reporting—outcome—plus a projection of the actual numbers of diagnoses allowing for reporting delay.
The uncertainty of the Cox projections was inevitable because of the lack of relevant data available in the very early stages of any new infectious disease epidemic. The shortfall of AIDS cases compared to Cox's estimates is also attributable to modification of high-risk behaviour among homosexual men in the mid-1980s.
§ Mr. DicksTo ask the Secretary of State for Health what assessment she has made of the available evidence on the effectiveness of research and awareness campaigns on AIDS; what plans she has to reduce expenditure by her Department on such campaigns; and if she will make a statement.
§ Mr. SackvilleResults from a range of surveys, including research and evaluation on the Health 449W Education Authority's public education campaigns demonstrate significant and sustained levels of public awareness and knowledge about HIV and AIDS.
Expenditure on such campaigns is subject to careful scrutiny and funding will be made available as necessary to meet the Government's objectives. More information about public education and awareness is set out in the White Paper "The Health of the Nation: A Strategy for Health in England", Cm 1986, a copy of which is available in the Library.