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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Theresa May’s Brexit speech is Angela Merkel’s victory – here’s why

The Germans coined the word “merkeln to describe their Chancellor’s approach to negotiations. 

It is a measure of Britain’s weak position that Theresa May accepts Angela Merkel’s ultimatum even before the Brexit negotiations have formally started

The British Prime Minister blinked first when she presented her plan for Brexit Tuesday morning. After months of repeating the tautological mantra that “Brexit means Brexit”, she finally specified her position when she essentially proposed that Britain should leave the internal market for goods, services and people, which had been so championed by Margaret Thatcher in the 1980s. 

By accepting that the “UK will be outside” and that there can be “no half-way house”, Theresa May has essentially caved in before the negotiations have begun.

At her meeting with May in July last year, the German Chancellor stated her ultimatum that there could be no “Rosinenpickerei” – the German equivalent of cherry picking. Merkel stated that Britain was not free to choose. That is still her position.

Back then, May was still battling for access to the internal market. It is a measure of how much her position has weakened that the Prime Minister has been forced to accept that Britain will have to leave the single market.

For those who have followed Merkel in her eleven years as German Kanzlerin there is sense of déjà vu about all this.  In negotiations over the Greek debt in 2011 and in 2015, as well as in her negotiations with German banks, in the wake of the global clash in 2008, Merkel played a waiting game; she let others reveal their hands first. The Germans even coined the word "merkeln", to describe the Chancellor’s favoured approach to negotiations.

Unlike other politicians, Frau Merkel is known for her careful analysis, behind-the-scene diplomacy and her determination to pursue German interests. All these are evident in the Brexit negotiations even before they have started.

Much has been made of US President-Elect Donald Trump’s offer to do a trade deal with Britain “very quickly” (as well as bad-mouthing Merkel). In the greater scheme of things, such a deal – should it come – will amount to very little. The UK’s exports to the EU were valued at £223.3bn in 2015 – roughly five times as much as our exports to the United States. 

But more importantly, Britain’s main export is services. It constitutes 79 per cent of the economy, according to the Office of National Statistics. Without access to the single market for services, and without free movement of skilled workers, the financial sector will have a strong incentive to move to the European mainland.

This is Germany’s gain. There is a general consensus that many banks are ready to move if Britain quits the single market, and Frankfurt is an obvious destination.

In an election year, this is welcome news for Merkel. That the British Prime Minister voluntarily gives up the access to the internal market is a boon for the German Chancellor and solves several of her problems. 

May’s acceptance that Britain will not be in the single market shows that no country is able to secure a better deal outside the EU. This will deter other countries from following the UK’s example. 

Moreover, securing a deal that will make Frankfurt the financial centre in Europe will give Merkel a political boost, and will take focus away from other issues such as immigration.

Despite the rise of the far-right Alternative für Deutschland party, the largely proportional electoral system in Germany will all but guarantee that the current coalition government continues after the elections to the Bundestag in September.

Before the referendum in June last year, Brexiteers published a poster with the mildly xenophobic message "Halt ze German advance". By essentially caving in to Merkel’s demands before these have been expressly stated, Mrs May will strengthen Germany at Britain’s expense. 

Perhaps, the German word schadenfreude comes to mind?

Matthew Qvortrup is author of the book Angela Merkel: Europe’s Most Influential Leader published by Duckworth, and professor of applied political science at Coventry University.