Public Health and Wellbeing Amendment Bill 2019

May 27, 2019

I rise to make a contribution in relation to the Public Health and Wellbeing Amendment Bill 2019. This legislation is designed to bring Victoria into line with what is happening in other states in relation to requirements around HIV testing. As the previous speaker said, times have moved on since the first infectious cases of HIV were detected, and this bill is evidence of the changes that have taken place. Under current legislation HIV testing has a number of special requirements. For instance, it is mandatory for a registered medical practitioner to ensure that a person is given prescribed information before carrying out a test, and a registered practitioner must also give certain information to a person before advising them of the results of a positive test. The government has introduced this bill on the basis that these sections are no longer necessary as they are now covered by national testing policies. The National HIV Testing Policy, which was introduced in 2011 and endorsed by the commonwealth, sets out a framework for providing quality testing and is subject to annual review by an expert committee. The thinking behind this change is that the provisions contribute to the stigma and discrimination associated with HIV and impede the expansion of testing availability.

I understand that many of the stakeholders who were consulted identified the current requirements as being unnecessarily burdensome and stigmatising, so it is hoped that counselling services that were obviously there and required for medical practitioners are not reduced in the sense of people being able to get advice and counselling both before and after, but the bill does take away that requirement and effectively means that everyone with any sort of bloodborne disease will now be treated in the same way. Looking at the early years, the first diagnosis in Australia was in 1982, with the introduction of HIV testing in 1985 and the diagnosis of HIV disease in 1987. There were 2773 cases then, and they declined to their lowest level in 1999. I was old enough to be around when this epidemic commenced, and I recall news reports coming out of America at the time that were really quite frightening in some ways. Initially there was very little known about it. It was considered a disease of gay men. As time went on it became apparent that, particularly in the United States, the numbers were rising, and as early as 1983 Australia did identify its first case of HIV, so within a fairly short period of time it became apparent that governments needed to address this really important health issue.

There were fear campaigns around this being the pandemic that might be the pandemic to end many. In the United States a lot of the rhetoric was around the claim that this was the disease to punish deviant behaviour. This was the sort of tone that was out there in some places in the 1980s, and I think the seriousness of the way this disease was treated initially and the way it was looked at was very much exemplified by the Grim Reaper campaign. I read that in 1983 when Minister Blewett took up his position as the Minister for Health in the federal Parliament he had a folder with a huge number of health issues in it. The first related to the introduction of Medicare, which was to be the new national health program, but in among the papers was information about AIDS, and it was at a very early stage. As those years then moved on the government realised that they would have to address it, and this campaign was brought about by engaging an advertising agency in Sydney to have a think about how to deal with it. There is no doubt that that campaign was designed to scare the hell out of Australians. The campaign really divided thinking then in relation to what was the best way of going about bringing about change in relation to the activities that were identified as being some of the causes of AIDS. After the Grim Reaper campaign was rolled out there was much more of an emphasis on education—educating people about safe sex—and setting up needle exchanges, because that drug-related issue where AIDS was being transmitted through the sharing of needles and the like was also identified as a major cause of the spread of it. Australia in fact had some of the best needle exchange programs in the world at a very early stage. The intense education seemed to work, and as time has gone on we have seen more treatments become available for those who have been tested and shown to be positive for HIV.

The Joint United Nations Programme on HIV/AIDS declared in March 2019 that it was greatly encouraged by news that an HIV-positive man had been functionally cured of HIV when he was treated by specialists at University College London and Imperial College London. They had a very complex patient, and while they do not maintain that they have actually got the cure yet, through a number of processes they do regard that man as having been cured of that disease.

Across the world there are many who are infected. In 2017 there were 36.9 million people living with HIV and 1.8 million people became newly infected with the virus. In First World countries the opportunities for prevention and treatment are of course much greater. But as we know, in many Third Word countries, particularly in Africa, it has taken a terrible toll on those populations where access to resources has been very limited and governments have even denied that it is a disease that really exists. Where we go with the treatment of HIV will be of great interest to all of us. Will there be a vaccination that is developed or will there simply be medications that will ultimately lead to a cure? It inevitably led me to think about how incredible vaccination has been in our society, how by 1973 smallpox had effectively been wiped out through vaccination and how so many diseases which ran rampant across the world at times and killed large numbers of people are no longer the threat they are. So it is particularly concerning to me that we are now faced with populations of people who are opposed to and will not participate in vaccinating their children. Without that herd immunity that is required we place everyone at risk, and so many people in this day and age have not seen the effects of many of these diseases. I think I have said before in this place that my husband is an old paediatrician. He recalls treating babies with whooping cough who coughed themselves to death. Anyone who has seen or treated children with illnesses like that—children who die quickly and suddenly because there are simply no treatments available for them—would understand how important vaccination is.

I truly hope that with a disease such as AIDS and the opportunities that are now being looked into we can find a vaccination or indeed a cure for it. Attitudes have changed so much in my lifetime since that notion of deviancy and the like that was going around in America in the 1980s. We have moved on so much. We are such a kinder society. We are such a tolerant society in comparison to the way people thought back then. I just reflect on the fact that in Shepparton alone each year we have an OUTintheOPEN Festival. It has been a remarkable journey to see the way people have come along in a sense and understood the effects of discrimination and bias that were so deeply embedded in our communities. They are now much more willing to embrace, care for and accept the diversity that we have in our community. So there is hope, and there now seems to be the capacity to arrest HIV at all of its various stages. This bill ensures that testing will still take place, and that is important, but it also helps to remove the stigma associated with it.

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