Britain's hidden Aids victims

Despite an improving global picture, in parts of this country we are losing the fight against HIV.

Ernest Nkrumah opens the door of his tiny flat with a blue tooth chip clipped to his chin, and a loud African shirt. His home is rammed with desks, computers and trailing wires. Posters of HIV and Aids line the walls alongside pictures of Barak Obama, Michael Jackson and Ghanaian flags. Nkrumah's humble home on the top floor of a Peckham estate is also his Foundation. His mouthpiece lets him take calls from patients at anytime.

I went to see Nkrumah today for World Aids Day. I came armed with positive facts. The latest UN report paints an optimistic picture, with new HIV infections at their lowest levels since 1997 across the globe. Meanwhile, the number of people dying from Aids related causes fell from 2.2 million in the mid-2000s to 1.8 million in 2010. It remains terrifyingly prevalent, but the tide is finally turning. We are all learning to address it.

So when Nkrumah started telling me about the devastating discrimination happening on my doorstep, I was shocked.

He spoke about a community where family, friends and faith leaders do not recognise the condition as anything other than a curse. A significant group, who still see HIV as a "dirty illness for dirty people"; a just punishment for inappropriate behaviour. NHS staff are still being refused entry to my local churches to offer tests, and banned from mentioning the disease in front of religious buildings. South London radio stations continue to pump out disrespect for sufferers in different languages, and free contraception is not taken up.

"People are living underground, they do not want to come forward," says Nkrumah, "It's like living below the radar."

These stories are backed up by the numbers. According to the National Aids Trust, some 12 per cent of all HIV sufferers in the country now live in Southwark, Lewisham and Lambeth -- a tiny corner of South East London. The prevalence of diagnosed HIV in my borough more than doubled between 1996 and 2003, and over 11 people in 1,000 now have it. While the world and the country is making progress, the fight against HIV in parts of our country remains dark, hidden and is getting worse.

These problems persist beneath sterile NHS clinics and rosy-cheeked health workers. Nkrumah told me about finding patients who have haven't been out for years, people whose self esteem has dropped so low they won't even bother taking medication. His self-help groups have to meet in anonymous locations and pretend not to know each other on the street.

Another Aids worker told me about students with the condition being segregated in class. One patient saw a friend delete their number from their mobile in front of their face when they found out. In such a hostile environment, Nkrumah's flat is the only place patients from some communities trust to find understanding.

Although some 50 per cent of the country's HIV patients are now found in London -- largely associated with the relatively high numbers of gay and African men -- other areas suffer pockets of disproportionate prevalence, too. Manchester, Salford, Leicester and Blackpool are some of the urban areas where prevalence persists above the national average.

Any sense that we are disconnected from this problem is an illusion. Most of us won't see or hear about these cases, but they are playing out on our streets. Stigma in any community means people are less likely to be tested, less likely to be treated and more likely to spread the condition. We pick up increased infections and NHS bills. We lose talent from early deaths.

So when news came through today that there are massive cuts to international Aids funding, we will be the ones who suffer. Over a quarter of my ward are black African or Caribbean, and those that were not born abroad still go back to visit. We cannot afford to be insular on this.

If you're worried that global Aids charities seem too distant and unaccountable, think about visiting Nkrumah and his flat. Read the "thank you" text messages he holds up proudly from patients, and listen to him constantly giving advice through a headset that he rarely switches off. Right now he's struggling to compete with bigger charities for smaller funding pots. If you want to help or need it yourself, think about giving him a call.

Click here to visit The Ernest Foundation website

Rowenna Davis is a journalist and author of Tangled up in Blue: Blue Labour and the Struggle for Labour's Soul, published by Ruskin Publishing at £8.99. She is also a Labour councillor.

Rowenna Davis is Labour PPC for Southampton Itchen and a councillor for Peckham

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There's nothing Luddite about banning zero-hours contracts

The TUC general secretary responds to the Taylor Review. 

Unions have been criticised over the past week for our lukewarm response to the Taylor Review. According to the report’s author we were wrong to expect “quick fixes”, when “gradual change” is the order of the day. “Why aren’t you celebrating the new ‘flexibility’ the gig economy has unleashed?” others have complained.

Our response to these arguments is clear. Unions are not Luddites, and we recognise that the world of work is changing. But to understand these changes, we need to recognise that we’ve seen shifts in the balance of power in the workplace that go well beyond the replacement of a paper schedule with an app.

Years of attacks on trade unions have reduced workers’ bargaining power. This is key to understanding today’s world of work. Economic theory says that the near full employment rates should enable workers to ask for higher pay – but we’re still in the middle of the longest pay squeeze for 150 years.

And while fears of mass unemployment didn’t materialise after the economic crisis, we saw working people increasingly forced to accept jobs with less security, be it zero-hours contracts, agency work, or low-paid self-employment.

The key test for us is not whether new laws respond to new technology. It’s whether they harness it to make the world of work better, and give working people the confidence they need to negotiate better rights.

Don’t get me wrong. Matthew Taylor’s review is not without merit. We support his call for the abolishment of the Swedish Derogation – a loophole that has allowed employers to get away with paying agency workers less, even when they are doing the same job as their permanent colleagues.

Guaranteeing all workers the right to sick pay would make a real difference, as would asking employers to pay a higher rate for non-contracted hours. Payment for when shifts are cancelled at the last minute, as is now increasingly the case in the United States, was a key ask in our submission to the review.

But where the report falls short is not taking power seriously. 

The proposed new "dependent contractor status" carries real risks of downgrading people’s ability to receive a fair day’s pay for a fair day’s work. Here new technology isn’t creating new risks – it’s exacerbating old ones that we have fought to eradicate.

It’s no surprise that we are nervous about the return of "piece rates" or payment for tasks completed, rather than hours worked. Our experience of these has been in sectors like contract cleaning and hotels, where they’re used to set unreasonable targets, and drive down pay. Forgive us for being sceptical about Uber’s record of following the letter of the law.

Taylor’s proposals on zero-hours contracts also miss the point. Those on zero hours contracts – working in low paid sectors like hospitality, caring, and retail - are dependent on their boss for the hours they need to pay their bills. A "right to request" guaranteed hours from an exploitative boss is no right at all for many workers. Those in insecure jobs are in constant fear of having their hours cut if they speak up at work. Will the "right to request" really change this?

Tilting the balance of power back towards workers is what the trade union movement exists for. But it’s also vital to delivering the better productivity and growth Britain so sorely needs.

There is plenty of evidence from across the UK and the wider world that workplaces with good terms and conditions, pay and worker voice are more productive. That’s why the OECD (hardly a left-wing mouth piece) has called for a new debate about how collective bargaining can deliver more equality, more inclusion and better jobs all round.

We know as a union movement that we have to up our game. And part of that thinking must include how trade unions can take advantage of new technologies to organise workers.

We are ready for this challenge. Our role isn’t to stop changes in technology. It’s to make sure technology is used to make working people’s lives better, and to make sure any gains are fairly shared.

Frances O'Grady is the General Secretary of the TUC.