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

Cameron in Nuneaton. Photo: Getty
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Why fewer of us want a long-term relationship ... with a political party

In 2015, 38 per cent of voters backed a different party to the one they supported in 2010. So what does the rise of swing voters mean for British politics?

For decades political parties have competed furiously for one of the great prizes of British politics: the affections of the swing voter. It wasn’t that long ago that there were relatively few political swingers: until the 1990s, fewer than a quarter of voters would switch parties from one election to the next.

Yet that once relatively rare breed is becoming increasingly common, which means party campaigners are going to have to come up with new tactical thinking. The British Election Study survey panels, conducted episodically over the last fifty years, are unique in that they are able to track the same voters from one election to the next, unlike more conventional opinion polls that only look at a snapshot of voters at a given time. Using these studies, you can identify the percentage of voters who switch their vote from one party to another between each pair of elections since 1966 when such data was first collected.

In 1966 only around 13 per cent of voters had changed their minds since the previous election in 1964. Since then, the proportion of swingers has been steadily increasing, and by 2015, 38 per cent of voters backed a different party to the one they supported in 2010.

The increase in swing voters is pretty consistent. The only exceptions are between February and October 1974, when (understandably) fewer voters changed their minds in eight months than switched in the preceding four years, and between 1997 and 2001, when the electoral dominance of New Labour under Tony Blair held back the tide for a time. These two exceptions aside, the increase has been constant election-on-election.

A lot of vote shifting can go on even between elections where the overall result remains stable. In 2001, for example, more people switched votes than in any election before 1997, with a surprising level of turmoil beneath the surface stability. While these largely cancelled out on that occasion, it set the stage for more dramatic changes in the parties’ votes later on.

So British voters now seem more likely than ever to jump from party to party. But who exactly are these swingers? Are they disillusioned former party loyalists? Or have British voters simply stopped getting into a serious relationship with the parties in the first place? We can get some insight into this using data from the yearly British Social Attitudes Survey, looking at the number of respondents who say that they do not identify with any of the political parties (party identifiers tend to switch much less often) when they are asked ‘Generally speaking, do you think of yourself as a supporter of any one political party?’ and then ‘Do you think of yourself as a little closer to one political party than to the others?’ if they say no to the first question. The graph below combines data from 1984 to 2013. Each line represents people who were born in a different year. Higher lines mean that there are more people who do not identify with a political party. So, for instance, voters born in 1955 started with very low levels of non-identification (22 per cent), which have gradually risen to 44 per cent in the latest survey. Most of the lines on the graph go up over time, which shows that almost all generations are falling out of love with the parties.

However, an acquired taste in swinging among the older generations is dwarfed by the promiscuous younger generations – shown by the dashed lines – most of whom never form an attachment to a party at all. Each generation in the data has been less committed to the parties than the previous generation was at the same age, with around 60 per cent of the youngest generation – those born since 1985 – expressing no attachment to any political party.

Since most of this change has been a generational shift, it may be a long road back for the parties. Loyalty to parties is often handed down in families, with children inheriting their parents’ commitment to a party. Now that this process has broken down, and younger generations have lost their attachment to parties, they may in turn pass on this political detachment to their children.

The majority of younger voters have simply never grown up with the idea of getting into a long-term relationship with a political party, so they may never settle down. Many Labour MPs were outraged when it turned out that lots of the new members who joined up to vote for Jeremy Corbyn had voted for the Green Party just a few months before, but this may simply reflect the political approach of a generation who see parties as needing to earn their vote each time rather than commanding lasting, even unconditional loyalty.

If Britain’s newfound taste for swinging isn’t going to disappear any time soon, what does it mean for party competition? In the past most people had settled partisan views, which seldom changed. General elections could be won by attracting the relatively small group of voters who hadn’t made up their minds and could very easily vote for either of the two main parties, so political parties based their strategies around mobilising their core voters and targeting the few waverers. While they worried about traditional loyalists not turning up to the polls, the parties could be assured of their supporters’ votes as long as they got them to the voting booth.

Nowadays, swing voters are no longer a small section of the electorate who are being pulled back and forth by the parties, but a substantial chunk of all voters. This helps to explain why politicians have been so surprised by the sudden rise of new parties competing for groups previously thought to be reliable supporters. The new parties that have entered British politics have also allowed voters to express their views on issues that don’t fall neatly into traditional left– right politics such as immigration (UKIP) or Scottish independence (the SNP). This in turn has posed a dilemma for the traditional parties, who are pulled in multiple directions trying to stop their voters being tempted away.

This may just be the start. If the number of swing voters stays this high, the parties will have to get used to defending themselves on multiple fronts.

This is an extract from More Sex, Lies and the Ballot Box, edited by Philip Cowley and Robert Ford.