Bill Speech: Public Health and Wellbeing Amendment Bill 2019
Ms SPENCE (Yuroke) (16:03:02): I am very pleased to rise today to add my contribution on the Public Health and Wellbeing Amendment Bill 2019. The objective of this bill, as we have heard from previous speakers, is to reduce stigma and discrimination and to expand the availability of HIV testing by removing special requirements on medical practitioners. The bill does this by amending the Public Health and Wellbeing Act 2008 to reduce barriers to HIV testing for Victorians. This 2008 act singles out HIV testing for special requirements. Section 131 of that act makes it mandatory for a registered medical practitioner to ensure a person is given prescribed information before they carry out or authorise a test for HIV or any other prescribed disease. Section 132 requires a registered medical practitioner or prescribed class of person to ensure that prescribed information is given to a person before advising them of the results of the HIV test if they are positive. This bill will repeal the sections of the 2008 act which set out these requirements, and it does so for two important reasons. Firstly, these sections are not necessary as they are now covered by the more appropriate National HIV Testing Policy that was introduced in 2011. That policy sets out the framework for providing quality testing, which is subject to annual review by an expert committee, and outlines key principles which guide HIV screening and diagnostic testing in Australia. These principles include ensuring that testing is conducted ethically, that it is voluntary and that it is performed with the informed consent of and is beneficial to the person being tested. The policy also provides for an understanding of HIV infection in the population and provides a measurement against which to evaluate national strategy goals. The removal of the current requirements will also benefit the community through the reduction of barriers to HIV testing and will support greater access to rapidly evolving testing approaches. One example of this is the recent approval of HIV home testing kits by the Therapeutic Goods Administration. The current requirements in the 2008 act for HIV testing are inconsistent with the ease of home testing. The unnecessary complexity is not only confusing but effectively locks Victorians out of the advances that are being made by medical research. Removing the current requirements from the principal act will harmonise Australian policy, as currently Victoria is the only jurisdiction in Australia to impose these additional requirements on HIV testing. The second important reason for amending the 2008 act is that those provisions, as well as increasing the difficulties in expanding testing availability, also contribute to structural stigma and discrimination. By singling out HIV for special requirements, the provisions have contributed to a stigmatised view of the virus. Barriers to increasing HIV testing include concerns about stigma and discrimination in health settings, difficulty in getting an appointment at high caseload HIV clinics, lack of access to easily accessible local testing and even not knowing where to get tested. These changes will address the structural stigma associated with HIV and normalise regular screening for the virus, as well as remove a barrier to the expansion of cost-effective, peer-led testing models, particularly in rural and regional Victoria. In doing this the bill supports the government’s commitment to targeting zero stigma and discrimination for people living with HIV as provided in the Victorian HIV Strategy 2017–2020. This strategy was released by this government in 2017, and it provides the road map for achieving our bold vision of the virtual elimination of new HIV transmissions in Victoria by 2020 and eliminating HIV stigma and discrimination. The amendments in this bill align with and aim to assist in achieving the priority actions in this HIV strategy. As important as this strategy is, it is by no means the first action taken by this government to minimise HIV, to support those living with HIV and to reduce stigma and discrimination. In 2015 the Andrews Labor government joined with the City of Melbourne to become the first Australian Fast-Track City, committing the city to reaching the joint United Nations targets on reducing HIV and stigma and discrimination. This puts us on the world stage with other Fast-Track Cities partners, such as UNAIDS, UN-Habitat, the International Association of Providers of AIDS Care and the city of Paris. And as a Fast-Track City we committed to meeting the joint United Nations goal of 90-90-90 by 2020, where 90 per cent of all people living with HIV will know their HIV status, 90 per cent of all people with a diagnosed HIV infection will receive sustained antiretroviral therapy and 90 per cent of all people receiving that therapy will have viral suppression with an undetectable viral load. It really is a testament to our great state that Victoria and the City of Melbourne are on track to achieve the 2020 target, and we are among the most successful Fast-Track Cities participants to date, along with Amsterdam, San Francisco and Denver. Currently 89 per cent of people living with HIV are diagnosed; of these, 95 per cent are on treatments and 94 per cent of those on treatment have achieved an undetectable viral load. I am very pleased that given this success the government has committed to a higher target of 95-95-95 by 2030. In addition to our government’s support, these goals would not be possible without the many support services in the community who assist those with HIV and other bloodborne viruses. The value of these services cannot be underestimated, and there are many—Living Positive Victoria, Positive Women Victoria, PrEP’D for Change, PrEPaccessNow, the Victorian AIDS Council, the Melbourne Sexual Health Centre, the Multicultural Health & Support Service, the David Williams Fund, Generation Y Guys and Pronto!, just to name a few—and not to forget those services in our hospitals, healthcare services and research institutes that do an enormous amount of work. I also became familiar with the work of TasCAHRD in Tasmania through my friend Dez, who passed away in 2016. Dez was a long-time board member and former vice-president of TasCAHRD, the Tasmanian Council on AIDS, Hepatitis and Related Diseases. While working towards the elimination of bloodborne viruses and the related stigma and discrimination, TasCAHRD also provides services to promote the health and wellbeing of people living with, who are affected by or who are at risk of HIV and hepatitis. For me, I knew to expect the annual call-up to assist with red ribbon sales during AIDS Awareness Week to support the Andrew Shaw Foundation. Andrew Shaw was a young Tasmanian man who died of an AIDS-related disease in 1987. In his memory his family established the foundation, which offers financial assistance to people living with or directly affected by HIV or AIDS and who are experiencing economic hardship. Not only did my friend Dez generously give his time to TasCAHRD and to the Andrew Shaw Foundation but he was also a beneficiary of the support that was provided to him, and I know he was incredibly grateful for that—just as I know that the many Victorians with or at risk of bloodborne viruses who are supported by the range of important support groups here in Victoria would be immensely grateful for the support that they also receive. While we have all these terrific support services in place, it is obviously important that the government also supports HIV prevention and testing and striving for a reduction in stigma and discrimination, and I am very proud that the Andrews Labor government is doing just that. The amendments to the Public Health and Wellbeing Act 2008 in this bill are only a small change, but they will make a huge difference when it comes to reducing stigma attached to HIV. I am very pleased that this bill builds upon the previous and ongoing initiatives of this government in regard to HIV prevention and testing and reducing stigma and discrimination. I am very pleased that the opposition are supporting this bill. This bill provides another very welcome step forward, and I commend the bill to the house.