Minister for Health and Aged Care speech - 30 November 2023

Read the transcript of Minister Butler's speech at the World AIDS Day Parliamentary Breakfast.

The Hon Mark Butler MP
Minister for Health and Aged Care

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It's a great pleasure to be here. I'm here with the Assistant Minister for Health Ged Kearney who played a great role in the work that I'm pleased to announce today. 

This is such an important event for our parliament and a really terrific way to end a sitting year. It reflects the best of bipartisanship and not just for coming together for our own country, but as Penny and Simon have said, the recognition that we play a leadership role in the region and in the world and have for many, many years around this issue.

It is primarily an opportunity to come and remember the loss of as many as 40 million people around the world and 10,000 Australians. To mourn that loss and to reflect not just on the loss but the grief, distress, stigma and trauma that accompanied that particularly in the earliest days of the epidemic. A loss and trauma that continues today. 

As I talk about our ambitions for virtual elimination of HIV in this country we also recognise that there are around 30,000 Australians living with HIV today. Virtual elimination of new infections in no way diminishes the challenges that they live every day and every year. 

It has been an extraordinary driver of grief and loss in this country, but we can also as Penny and Simon said, be so proud of our response as a country over those 40 years. It has been a credit to our country and a source of real inspiration I know around the world. 

To my mind, our response has consistently rested on three pillars. In no particular order of importance, bipartisanship has been so critical. It's easy to understate the achievement of people like Neal Blewett and Peter Baume in those earliest years in coming together across the aisle and resisting the division and stigma which is such a part of politics today, but was then as well. That bipartisanship is reflected in this breakfast each and every year and I know is something that both of the major parties are still very committed to - and we're joined in that by some of the minor parties and crossbench. 

The second pillar was comprehensiveness. That is still a feature of the response today, but it was so important back then dealing with some of the really tricky issues around condom distribution, needle exchange programs. In particular, needle exchange programs were so important in minimizing the infection rates in this country compared to a country like the United States. Comprehensiveness is right at the heart of the work that I'm really pleased to announce today. 

But the most important pillar, the thing that really marks our country out is that it was a community-led response. From the get-go people like Neal Blewett, Peter Baume and others across the Parliament, talked to the community and co-designed the response with community. Health Equity Matters or AFAO as we used to know it, NAPWHA, so many others, the clinicians through ASHM, the Scarlet Alliance and many others have played such an important role coming up here or down the hill, as it was in the early days, and helping politicians find the best response. Helping bureaucrats find the best response. That still is a core feature of the epidemic response today and one that's not only important for an HIV response, but one as Darryl and his colleagues know we tapped into immediately when Mpox became a real challenge for countries around the world. Our ability to tap into those networks and that capability from day one meant that we were able to get that issue under control in Australia very, very quickly indeed. 

Louise mentioned the scientific conference, which I had the great pleasure of speaking at. The conference I understand has five takeouts every time it comes together. One of the takeouts was the virtual elimination of HIV in inner Sydney. As we know, if there was an epicentre of the epidemic in Australia, it was inner Sydney. A community that bore more of the brunt of the epidemic particularly in those early years than any other community in the country. For the whole world the virtual elimination of HIV in that part of Australia is a beacon. It really is a beacon for the rest of the world and should be for us as well. 

There are still several hundred HIV infections and notifications in Australia every year. While we along with the world, as Senator Wong mentioned, saw a drop off over the last couple of years we don't yet know how much of that was COVID induced and how much of that will bounce back. We're already seeing some early indications of bounce back, unfortunately. the challenges are not gone but the important thing to note is they are in harder to reach communities, those new infections. There's a different population, in different parts of our community that account for large numbers of those several hundred new notifications that we're still challenging. 

AFAO, NAPWHA and others in the community, in the face of all that have brought a new level of ambition to this place over the last couple of years. An ambition to virtually eliminate HIV infections in this country by the end of this decade. It's an ambition that we have grabbed with both hands and decided to work with community on achieving as a country. 

This is important for Australia. This would be an extraordinary thing for us to achieve in the fifth decade of this epidemic. The message, I think, from the conference in Brisbane is if we can't do it, probably no country can. There is a degree to which the rest of the world looks to Australia for hope and for inspiration, and to some degree for direction for our experience that extraordinary cooperation between government, the community and clinicians to show the best options for virtual elimination. 

It's not just an ambition I was keen to take up for our own country. It's one that we increasingly recognised as our responsibility to the rest of the world to do everything we can to achieve it because if we can't, through the best of our efforts, no country will. And this epidemic will be with us for even more decades than it has been. 

I was really pleased to be able to pull together the Taskforce and Chair it directly myself with Ged, Louise and Dean a part of that as well. I think reflecting the strong connections between government and the parliament but also across the two major parties. But more importantly than the four of us we had terrific representation from the community. I can't go through all of those representatives, there was a good number of them. We had a number of meetings over the course of this year, since I announced the Taskforce at the last breakfast. They went for several hours, we were presented lots of data, lots of terrific ideas by some of the smartest epidemiologists in this area. I think we've come up with a really good report and today I'll be releasing the report. It will guide the Government's response to the challenge that Health Equity Matters, NAPWHA and others have set us as a government and us as a parliament to achieve that virtual elimination by the end of this decade. It’s a comprehensively report that has recommendations that cross the health portfolio but raise some issues around immigration given the population that is accounting for a large number of our new notifications, but also some challenges around decriminalisation in association with ongoing stigma that are important at the state and territory level. As you would expect it covers access to PrEP, access to treatment, and some of the new testing opportunities that we have before us right now. I'm sure these 25 recommendations are going to be a really important source of debate and discussion over the course of the coming months as the Government starts to frame its response to it. 

I really want to thank Darrell and Aaron and all of the members of the community who participated in this Taskforce and had faith in a process that we decided to set up to develop this response together. I really hope that the work that we do in response to it is a tribute and a credit to all of those who have suffered and struggled through an epidemic that has been with us for more than 40 years. Thank you very much.

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