 McWail Big, roedd y cyflau gyda'r agusag yr oedyn nhw. Gweithio'r newid yma i'ch fawr i gain iawn a gael i'ch bynnag i'ch amser yn gwneud i'ch gael i gael i'ch bynnag i'ch mewn gwneud i'ch gael i'ch gael i'ch bynnag i'ch bynnag i'ch wynt ag greu rhywun dros 12 munud. Mae'r gweithio'r gwawr i'ch gael i'ch gael i'ch bynnag i'ch gael i'ch wyf yma i'ch gael i'ch bynnag i'ch gael i'ch gael i'ch bynnag i'ch bynnag i'ch bynnag i'ch of mixed emotions. First and foremost, it's a time to remember and to pay tribute to over 40 million people who have died of HIV and AIDS-related illnesses across the globe. We've become used to quoting fatality statistics and case numbers, especially over the last few years, and we've heard over and over that those numbers are not just numbers and that each represents a real person. Nonetheless, I will make that point again today. That is over 40 million people who didn't have the chance to reach their full potential, who left behind friends and families, and who all too often had to battle stigma and prejudice on top of a deadly virus. Those people must never be forgotten, and in paying tribute to them, I hope we focus not on their deaths but on the lives that they led, and on the courage that so many of them showed in fighting for a better future, even if they knew that they would never see it. As we remember and as part of our tribute to them, we should acknowledge that astounding progress has been made in diagnosing and treating HIV and that that better future has at least in part become a reality. 40 years ago, an HIV diagnosis was effectively a death sentence. Today it means daily medication or receiving an injection every two months. People with the virus are now able to live long, happy and healthy lives without even the fear of passing on the virus if they remain on effective treatment. To be clear, and this is not to downplay an HIV diagnosis, it can still have an adverse physical and mental health impact on an individual and it requires lifelong interventions to manage, but it is largely a chronic illness now, not the killer at once was, and that is in stark contrast to the outlook when I was an undergraduate pharmacist in the early 1990s. In Scotland, we have been working hard to prevent infection and to ensure that those living with HIV receive the treatment that they need. The number of new diagnoses in Scotland has been falling since 2017, and in 2018 we met the United Nations 90-90-90 goals. That is 90 per cent of people living with HIV know their HIV status, 90 per cent of people with diagnosed HIV receive sustained anti-retroviral therapy and 90 per cent of people receiving anti-retroviral therapy have viral suppression. All of this is hugely encouraging, but we cannot and must not think that the job of tackling this virus is done. We must instead set our sights on stopping HIV transmission, and while it may seem inconceivable to anyone old enough to remember the horror at the height of the HIV pandemic, that goal is absolutely possible. Of course, possible does not mean inevitable, it will require hard dedicated work. We need to test more people, we need to work harder to find and connect with those people who are at risk, and we need to do all that in the most challenging circumstances that our health service has ever faced. None of it can happen without a clear plan. That is why, two years ago, the Scottish Government commissioned a proposal on how Scotland could become one of the first countries in the world to eliminate HIV transmission by 2030. In practice, that means zero people contracting HIV in Scotland. Today, the Scottish Government welcomes that proposal, which was developed by the HIV transmission elimination oversight group. As an aside, I am told that other longer names for that group were available. Before I go further, I want to extend my warmest thanks to Professor Rack Nandrani, who so ably chaired that group. I know that it was no small feat to assemble the clinical third sector and academic expertise needed to develop the plan, and I am also grateful to all those who made the time to participate. The proposal is wide-ranging, and all those who worked on it should be absolutely proud of its ambition. Time today does not allow me to do justice to the care and consideration that has gone into it, and I urge everyone in the chamber to read it for themselves. Crucially, it has three high-level goals. Firstly, to prevent people from acquiring HIV regardless of age, sex, gender identity, sexual orientation, race, ethnicity, religion, deprivation or disability status. Secondly, to find people living with HIV, some of whom are still undiagnosed and support them into HIV care and treatment. Thirdly, to help reduce the stigma that makes some people less likely to access HIV prevention, testing and treatment services. I am wholeheartedly in favour of reaching those goals, as I am absolutely sure is everyone involved in HIV care or prevention. However, the plan acknowledges that these are only achievable if organisations come together to make it happen—what it calls a whole system and a whole society approach. That in itself is often easier on paper than in practice. The scale of the effort required is demonstrated by the 22 recommendations that the plan set out, covering testing, education, prevention, contact tracing and HIV care. It would be unwise in the extreme for me to pretend that all of those can be achieved immediately. However, the plan itself recognises the complexity of the task and recommends an interim target on our journey towards transmission elimination. That interim target is that Scotland achieves and maintains the United Nations 95-95-95 goals by 2025. I am pleased to announce this Government's commitment to that target. 95 per cent of individuals with HIV have been diagnosed, 95 per cent of those diagnosed are on treatment and 95 per cent of those on treatment have a suppressed viral load. I will also take this opportunity to accept another of the recommendations within the proposal that an implementation group is established to carry on the work that is needed to ensure that we reach our targets. The group will provide dedicated focus and accountability, while also ensuring that the proposal is taken forward in a careful, considered way that recognises the challenges that are currently facing our health services and our third sector. That is vital work. I am delighted to announce today that Professor Nicola Steedman, the Scottish Government's deputy chief medical officer and Dr Dan Clutterbuck, the clinical lead for HIV at the Chammer Centre, have agreed to chair the group. Those are clinicians with huge experience in the field and I am profoundly grateful that they will be taking this task on. It will be for the group to develop a work programme, and I do not want to pre-empt that. However, I have two further announcements today that I hope will demonstrate the Scottish Government's commitment to transmission elimination. The first is that we will be funding a marketing campaign in recognition that increasing education and reducing stigma is a key pillar of the proposal. That campaign will be developed by a range of partners, including third sector, academia, public health experts and those with lived experience of HIV. I expect to see its first outputs in the spring. I have heard often that the alarming and intentionally fear-driven campaigns of the 1980s have left a damaging legacy of stereotypes and misconceptions, and a campaign to address these is overdue, and I am very pleased to be able to commit to that today. The second announcement is that we will provide funding for a pilot of e-prep clinics. In 2017, Scotland was one of the first countries in the world to introduce an HIV pre-exposure prophylaxis service, offering free preventative medication to those who were deemed at the highest risk of acquiring HIV. To date, more than 6,500 people have had pre-expositions prescribed at least once, and we have seen a significant reduction in new diagnosis of HIV amongst gay and bisexual men in the four years since it was launched. Has there been an improvement in the number of women coming forward to access pre-exposure prophylaxis? One of the things that we are keen to do in an early action to support elimination efforts is to widen eligibility guidance so that anyone who is at risk can access pre-exposure prophylaxis and work to develop and roll out that guidance is well under way. That is very welcome news, but expanding that eligibility also puts additional pressure on already stretched service, which I have alluded to in the Conservative amendment. We cannot address that overnight, but we know that there is huge potential for those who are able to largely manage their own care to request pre-op online and to carry out necessary tests in their own homes. Doing so could improve access to pre-op for those living in remote or rural areas, while also freeing up clinical capacity for those who might have more complex needs or require more support. I have to stress that this is only a pilot and, even if successful, it cannot be a panacea, but it is an exciting development. If we can make it work in the long term, it has enormous potential to reduce inequalities, which I think is what my colleague was alluding to, to widen access and to lessen the burden on NHS services. I hope that what I have set out today conveys the genuine ambition that this Government has to ending HIV transmission in Scotland by 2030. In doing so, I have tried to explain how challenging it will be. In case I fail to do so, I will say bluntly that the challenge is considerable. However, I also know that the reward of success is greater. The prize here is huge. As I said at the start, it is measurable and life-saved. It is improved health and it is overcoming the scourge of a stigma that has endured for too long. Today, I pledge this Government's support for that. It is the greatest tribute that we can offer to all of those that we have lost. I move the nation in motion in my name. I remind all members seeking to speak in a debate to please ensure that they have pressed the request to speak buttons. I now call on Jamie Greene to speak too and to move amendment 7025.2. I thank the minister for her opening comments. I will reflect on some of those in my speech today. Members might recall last year that I brought to the chamber members' business to celebrate or commemorate Mark World's aidesday. I am pleased that we are having a Government business that gives us a frank and fulsome opportunity to debate some of those issues. In fact, my first debate on the subject was as far back as 2016, after I was first elected when Kezia Dugdale brought a very similar member's debate to the chamber. I was pleased to participate. I read through some of my historic speeches that I have given in this chamber on the subject that I spoke in 2016 and 2018 last year. I read through some of those speeches with a slight glint of intrigue, a little bit of sadness but also a little bit of hope as well. I will come on to that today in my comments. That first speech in 2016, just a few short months into my new political life, I used phrases like chem sex and Jim Bunny's steroid users, a little risky perhaps, it certainly raised the eyebrows of the official report and the broadcast people in the booths. Do you know what if we can't be frank and honest with each other in this chamber on a subject like this and what's the point of having a debate about it in the first place? We should never be afraid to challenge ourselves or the wider world. In 2018, of course, in the debate that we had in this chamber, the introduction of the EU equals EU phrase came into political discourse. I remember recounting the horrors of the 1980s and some of the anecdotes that I had heard and personally affected me to be quite frank. Last year, of course, members might recall, I opened up can of worms on my take on the anniversary of the passing of Freddie Mercury. Of course, we were discussing the very topical TV show, It's a Sin, which I have to say I still haven't watched to the end. I struggled how to go about today's speech to say something different because this is a subject that is traditionally statistically very heavy and statistics, of course, are important. We heard a lot of them already. Behind stats are people, as the minister rightly pointed out. The situation in Scotland and across the UK is markedly better than it was 2016, 10 years ago, 20 years ago. Our collective ambition, and it is a collective ambition, to eliminate new HIV infections by 2030 is not just an admirable one, it is an achievable one. I am not one often to praise the Scottish Government standing at this podium, but the universal introduction of the availability of PrEP is exactly the sort of game-changing policy that we needed and has made such a difference because it has a very direct and immediate effect. Within the first four years of it being rolled out in Scotland, we saw a 43 per cent drop in HIV diagnoses in men attending sexual health clinics. Just one second. I will come on to the point that that rise in demand has also meant a huge rise in pressure on health services. That was true in 2018. I said it then, it was true last year and it is still true today, which is the whole point of my amendment today, which I do hope that members are willing to support. I am happy to give way. Alex Cole-Hamilton I am very grateful to Jamie Greene for giving way, and I commend him on his extra remarks. He always speaks so well on this subject as he does on so many. Does he agree with me that the delays caused by the pressure that he describes around accessing PrEP are causing potentially illness to spread, but also that the areas by which PrEP can be accessed are limited and that we should consider expanding those, particularly for people who live outside of major metropolitan areas? Jamie Greene You have pre-empted the next page of my speech. That is exactly the point that I want to make. I support calls made by many organisations, including Terence Higgins Trust, Waverlycarch, Heavy Scotland and many others, to expand access to treatment and services, especially in rural, remote and island communities. I cannot imagine that unenvywll position of having to approach your local GP, who is probably a family friend or a neighbour, and trying to explain to them what an earth prep is or what it is for or why you think that you need it because you think that you are a high-risk person, and saying all of that without sounding promiscuous or foolish. That is not a position I envy, but it is, I am afraid, the position that many Scots are in today. For example, if you study at St Andrews, you have to travel to Glenrothys for sexual health services. How is that going to help to increase testing and access to treatment? We do not all have the luxury or the pleasure of popping along to Chalmers or Sandiford. We are the brilliant staff there who will treat you with respect, with kindness, often a bit of humour as well. I have absolutely no qualms in telling the chamber how saunter off there for my regular check-ups, even if I do get the odd knowing glance from the patrons sitting next to me in the waiting room. Of course, if you do not want to do that, you can do much of this at home. Free HIV and STD kits are available. They are easy to use and they are free on demand. A few years ago, I actually ordered one during Covid. In the absence of being able to attend clinics, I made a video of myself taking a home test and I chucked a video on Instagram. I absolutely warmed my heart when a few days later I got an email from somebody to thank me for the video because it had encouraged him to do the same. I do not know the outcome of that test but I can only imagine that it was an important test to him. That is because we have to destigmatise things like this. Knowing your status—we spoke about this before—is the first and most vital way to defeating this virus. When in doubt, test, it really is that simple. If you are afraid to go for one, if you are afraid of the test or afraid of the outcome, then talk to someone. Talk to me. Talk to any of us. I will happily come with you, drop me an email and we will go along together, because testing is vital. Of course, that U equals U campaign lives on today because we all know that undetectable means untransmitable. In this debate, we spoke many times about stigma. It is getting better. The fact that we talk so freely and open in our national parliament about this issue means that we are addressing the issue of stigma. Of course, Governments can make moves to address that. For example, the recent lifting of the ban of HIV-positive individuals on medication and those on PrEP can now serve in the military. We had the landmark grilling on the issue of the blanket ban on gay men and bisexual men donating blood. I do not think that we went far enough, but we certainly made progress. However, that 2030 goal will not be achievable unless we defeat the disease called stigma. Not just the disease called stigma but that other one that I have frankly spoken about in this place, the disease of bigotry, which often fuels it. It has been 30 odd years since the Don't Die of Ignorance campaign. The question is, why has there not been a campaign since then, a national campaign that is? We have made progress, but we cannot defeat this virus at home unless we are equally defeating it abroad. I want to raise a very specific issue with your permission, Deputy Presiding Officer, if I have time. My concern is that, although the worldwide trend is of a 32 per cent reduction in new HIV transmissions between 2010 and 2021 welcome reduction, in the Middle East and North Africa there has been a rise of 33 per cent. We spoke for the last couple of weeks very publicly about LGBT rights in Qatar, for example, given the media attention on that, but no-one is really questioning the reality. I am sure that there are people out there who are afraid to go for a test and afraid to seek treatment out of fear of retribution, prosecution or even fear for their life. Political, religious and societal persecution remains and it is fuelling a rise in HIV transmissions in that part of the world. Given that there is so much media attention on it, perhaps we should use that opportunity to focus on that. This is not just a job for Governments, NGOs and charities. The third sector has all got a role to play in this. I have countless examples, if I had the time, I would share all good stuff and all welcome, but I finished where I started and that is right back here at home. In Scotland, we will not meet our 2030 target if we do not properly fund and resource local sexual health services. I welcome the announcement today on a public awareness campaign. I look forward to more detail of what that might look like and how much it might cost. Let's get back on track with reliable data. It's very hard to source data about the subject at the moment, which is why I support Labour's calls for annual reporting. Of course, I know times are tough, I know money is tight, but we've come a long, long way on this. It is now is not the time to take your foot off the pedal. That progress cannot and should not be in vain. I hope that one day, maybe even before I leave this place, we no longer need to have this debate on this day in this chamber. We don't need to have it because we've eliminated new transmissions. We've met our target. I think that we can do it. I really think that we can, and I hope that we can. I move the amendment in my name, Presiding Officer. Thank you, Mr Greene. I now call on Paul O'Kane to speak to you and to move amendment 7025.1 around six minutes, please, Mr O'Kane. Thank you, Deputy Presiding Officer, and I'm pleased and proud to have the opportunity to open this debate on behalf of the Scottish Labour Party, as we mark World AIDS Day 2022. It is genuinely a pleasure to follow the minister, who I know is very personally committed in this area, but also Jamie Greene, who I think has always spoke with an openness and a frankness, but also an integrity. It is good to hear his lived experience. I'm obviously younger than him, so it's always good to listen to him talk, but I genuinely think that what he says is important, particularly in the sense of sexual health clinics, and it's why we on these benches will support the Conservative amendment today. Today we remember those who have lost their lives from AIDS. We stand in solidarity with those living with HIV AIDS, and we commit to redoubling our efforts to eliminate HIV transmission, not only here in Scotland, but across the world, because we all stand on the shoulders of those who have gone before. As so often said on World AIDS Day, we remember the dead and we continue to fight for the living. We know that it is estimated that there are almost 7,000 people in Scotland living with HIV, and in recent years we have made steady progress, with 92 per cent of people living with HIV in Scotland being diagnosed, 90 per cent of people attending specialist services and 95 per cent of people accessing treatment, reporting and undetectable viral load. However, we cannot be satisfied with improvements because, although always welcome and every step we take is welcome, it is not job complete. It is very much still a work in progress, and I think that we all recognise that today in the chamber and want to redouble our efforts to move forward. As we have already heard, there has not been enough work done to widen access for PrEP to all the areas of Scotland, and that often results in sometimes a postcode lottery for treatment and access to things like testing and drugs. I think that there is a particular issue in remote and rural communities, where people living with HIV may be eligible for treatment but are simply unable to access PrEP because of their postcode. We heard some of the challenges that exist in Jamie Greene's contribution as well. I am pleased to hear that the minister intends to take forward a pilot to address some of those issues. I hope that she will look at rurality in terms of that pilot and see how we can quickly get more people to be able to access services online. In terms of education, there is clearly still stigma associated with a diagnosis of HIV, but at present we must do more to tackle outdated and very often homophobic myths, which I think continue to pull out the discourse in this space and have done over many, many decades. Although we are far on from those darkest of days, it is clear that this discrimination persists. I welcome the minister's commitment to a large campaign to address those issues in the public discourse. I look forward to receiving more information on that and, hopefully, to making a contribution as to how we shape and take that forward. In Scotland, there are certain groups of people who are more at risk, including gay and bisexual men, people who inject drugs and people who come from certain minority ethnic groups. It would be utterly wrong if we continued to allow a stereotype to persist that HIV can only affect certain groups of people. We need to continue to acknowledge that it can and can affect anyone. I think that that is clearly borne out in the most recent statistics, which shows that in 2019 of the 176th new diagnosis of HIV, the likelihood of contracting HIV for men who have sex with men was only marginally higher than heterosexual transmission rates, with 37 per cent of new diagnosis being among men who have sex with men and 32 per cent being in heterosexual relationships. I heard that referred to by Jamie Greene, and I think that that is an important point. It is critical to remember that it was only last year that changes to blood donation rules allowed gay and bisexual men to give blood, which began to rectify an outdated and deeply homophobic practice, which was the product of the moral panic around homosexuality and the HIV epidemic of the 1980s. Earlier this year, I was proud as Scottish Labour's first openly gay male MSP to give blood for the first time since I was 17, because it is undoubtedly the case that that historic change in the law has helped to tackle stigma related to HIV AIDS, and it is clear that we need to do more in that space to continue that work. I know that there is a consensus in this chamber to eradicate HIV transmissions by 2030. To achieve the same, we must have important interim markers to allow us to assess progress on the journey to elimination by 2030. That is why our amendment calls for the Government to outline clearer timescales as we work to eliminate HIV. I think that we can learn from other Governments in this regard. We know that there are plans elsewhere. In Wales, for example, the HIV action plan from 2023 to 2026 has, as an interim marker, put down some quite clear actions in terms of eliminating new HIV infections and improving quality of life and stigma. I welcome the commitment that the minister has made today, because it is very helpful to all of us in this chamber in terms of the scrutiny of this work, getting it right and moving it forward, that we have the opportunity to look at how the concrete actions are going to follow through and indeed how a lot of this work can be mainstreamed into the HIV elimination plan, because we know that it is not enough to just focus one day a year on these issues. It has to be something that we do weekend and week out and day in and day out, and it should be a public health priority for the Government, for this Parliament, for our local authorities and for all of us. I welcome the minister's commitments also to set up the group that will look at implementation. I think that that is very welcome. Again, we will want to use our time in this Parliament in order to scrutinise that work. That is why, in our amendment, we have called for that regular reporting to this Parliament, so that we can all have our say on those issues. In concluding, on this World AIDS Day, we must commit to moving the debate beyond good sentiment and warm words and focus on having clarity to deliver tangible actions on how we will eliminate HIV transmission in Scotland by the end of the decade, which we can do, and we will do. I move the amendment in my name. Thank you, Mr O'Kane. I now call on Alex Cole-Hamilton, around six minutes please, Mr Cole-Hamilton. Thank you very much indeed, Deputy Presiding Officer. It gives me great pride to rise from my party in this debate. It is a great debate. I am grateful to Marie Todd for bringing it to the chamber today. I get to hear these amazing speeches from the likes of Jamie Greene and Paul Cain and the minister himself. I think that people speak with real passion. They speak from experience, and we can learn a lot, but, more importantly, it brings us together as a chamber, as the debate did in large part last night, on the 16 days of activism. Around the world every year, thousands of people are still dying of this terrible condition. It has not gone away. Last year alone, 650,000 people died from age-related illness, particularly in the areas of poverty in our world. It is a massive global health inequality that, while there is life-saving and life-enhancing therapies available, for all too many sufferers, they are not available. Some 1.5 million are becoming newly affected with HIV last year as well. We have heard that desperate statistic, that cruel symmetry of the past 40 years and the 40 million lives lost and million lives for every single year that this disease has been manifest in our population. Today, Deputy Presiding Officer, we remember them. It is also incumbent upon us to recognise the toll that HIV and AIDS still take on those currently living with it, both around the world and here in Scotland. The threat of complacency looms ever-present when it comes to this issue. Scotland has made great progress. Do not get me wrong. We have made great progress in fighting the epidemic, and we should rightly be proud of the role that we have all played in acting as a global leader in ending transmission. As we have heard several times, and I salute the Government for this, that Scotland was one of the first countries in the world to make life-saving HIV medication prep widely accessible. It is absolutely vital in terms of allowing people to protect themselves from transmission. It is rightly that we acknowledge that process, but we should not become complacent in so doing. Two years ago, the Scottish Government committed to ending all new HIV infection in Scotland by 2030. While that was a welcome commitment today, Scotland risks being left behind in other areas of the UK in driving the change that is needed to meet that target. In August last year, or rather this year, Scottish Liberal Democrat research revealed that patients in Lothian are being forced to wait more than eight months for access to prep. That is just not good enough. We know that this medication is almost 100 per cent effective in preventing the passage of HIV. It plays a huge important role in eliminating transmission in Scotland, and in long waits for treatment, we risk an increase in transmission in the spread of disease. This year, patients have had to wait up to 260 days to receive medication, with all patients now waiting a minimum of 90 days in Lothian. In 2018, I asked the First Minister why Lothian had the longest wait in the country for prep, and she promised to work with NHS Lothian to deliver the drug more quickly. Four years later, and not only is NHS Lothian still struggling to meet demand, delivery is now even slower. I will take intervention from Jamie Greene. Just returning the favour, Mr Cole-Hamilton, but I wondered if we might hear, hopefully, in summing up from the Government benches more about the pilot scheme, that it might not just be rural and island communities, but suburban and urban communities as well, where there is a very hefty waiting time to get appointments and to seek treatment, or to get renewed treatment and testing. I hope that the pilot will include people in cities, not just outside of them as well. Alex Cole-Hamilton, give you the time back. As my intervention showed Jamie Greene's next page in his speech, so too his intervention shows the chamber the next page in mine. We must compare notes before speaking in the future. I think that his point is well made, Deputy Presiding Officer. I think that this is a postcode lottery in some cases, that is actually where you are, particularly if you are in areas of rurality. Let us remember that if you live in a small community, that access to intimate medical care of this kind can be very difficult, because everybody knows everybody else in small communities, but they may not know everything about your lifestyle and you may want to keep it that way. So we need to find ways around that, we need to find ways of making this far more accessible. The Scottish Government must ensure that every health authority has the right staff support and the resources that are necessary to eliminate HIV transmission through preventative remedies like this from square one. It is also vital that we acknowledge those living with HIV. I think that Jamie Greene was right to call it the disease of stigma. It is a disease. Stigma blights so many aspects of our life, it blights so many people who are vulnerable in so many ways, but in HIV I think that it is still one of the worst. It is discrimination, it is judgment based on their personal lives, their personal choices. In a 2019 poll by the Terence Higgins Trust found that public attitudes HIV still remain largely outdated and out of step with scientific progress. What we know about transmissibility, non-detectable viral load, but yet almost half of respondents would say that they would feel uncomfortable kissing somebody who is HIV positive despite there being no risk of transmission from that person. Prejudice leaves many people with HIV feeling marginalised and excluded. From their communities, they can even have a negative impact on job opportunities. Stigma also fuels the transmission of HIV, as we have heard several times today, by acting as a disincentive for people to seek testing and by extension treatment. I am very grateful to Alex Cole-Hamilton for taking intervention on that point. Does he agree with me that there is great hope in the proposed advertising campaign from the government to try and attack this stigma and right at its root and move us away from those horrible images that people still talk about of falling tombstones? We have moved on and so must the thinking. I am very grateful to Martin Whitfield for that intervention. I am delighted that the Scottish Government intends to take that back to the public. In large part, there is some total of what people know about HIV AIDS of younger generations that may have been gleaned from that excellent channel for drama It's a Sin. Again, Martin Whitfield is right. Things have moved on. It is not a death sentence that it was in the 1980s. There are therapies and treatments that we need to bring out into the light to let people understand their risks because people may not believe that they are actually in a susceptible group or an at-risk group and are therefore all the more exposed because of it. I absolutely agree with Martin Whitfield. We can't be complacent about this because those living with HIV can't afford us to be complacent. We must redouble our efforts and we must work towards a Scotland entirely free of HIV stigma with zero new HIV transmissions or death from AIDS related illness. The technology that we have, the medical care that we have available, should make that a material possibility. To that end, there is more that the Government should be doing. It should establish a national HIV testing week for Scotland, something that is already in place in England and Wales. I wonder if the minister might address that specifically in her summing up. Work must also be done to significantly broaden access of wrap, as Jamie Greene and I have discussed in both of our interventions, making it far more accessible beyond specialist sexual health clinics, which can be difficult for some populations to access. It should be rolled out in GP clinics, community pharmacies, maternity and reproductive health services because, let us not forget, Deputy Presiding Officer, the increase among women. Presiding Officer, I will close with the words of HIV activist Alex Garner, who said, I choose to be open about who I am because I understand that, affirmatively, declaring who I am to the world where we continue to be marginalised and dehumanised is a powerful term of resistance. We now move to the open debate. I call first Emma Roddick to be followed by Brian Whittle for around six minutes. Thank you, Presiding Officer. I first want to thank all the MSPs who turned up for the photo call that I was honoured to be able to sponsor earlier today to show support for Terence Higgins Trust, Waverly Care and National AIDS Trust, and for Scotland's goal of eliminating new HIV transmissions by 2030 and, of course, to everyone who is wearing their red ribbons today. Today, more than 40 years since the first cases were reported, is a very important one in the journey to eliminating HIV in Scotland. I will not be alone in noting the significance of the Scottish Government's commitment to interim 95 targets and to some other recommendations in the HIV transmission elimination proposal. Being a member of the LGBTQI community and working closely with others who campaign on issues important to us, I have heard some horrendous heartbreaking stories from around the world in the 80s. I have watched documentaries and dramas from that time with horror and a miserable fascination. Pop culture often plays a very important role in raising awareness of social issues, particularly in cases like this where younger people may not have a good awareness of what happened during the AIDS epidemic. Russell T. Davis is a sin, a short TV series set during the epidemic, which was mentioned earlier by my LGBTI CPG co-convener Jamie Greene, who I also think did a fantastic job in demonstrating how we can all play a part in destigmatising HIV. It is a great example of a drama that is accessible, has clear messages but is also based on real experiences and true stories of what people went through and the stigma that they faced from friends, family and society. Russell T. Davis himself has said that he is very aware that younger generations are growing up not knowing anything about this period. We have to remember those stories. We have to be aware of the same patterns emerging. We have to help young people with HIV or still suffering the stigma that our whole community faces understand where that comes from, to arm them to challenge it but also help them to know that they are not alone and that it is not them who are wrong. Earlier this year I heard some of the incredibly stigmatising media commentary from the AIDS epidemic and the kind of sentiments that were explored through characters in its sin echoed in stories about monkeypox. What were meant to be dramatised public reactions could be seen again almost word for word in tweets and Facebook comments under those stories. Yet again people in the LGBTQI community were seen as disgusting, dangerous, risky, something to be avoided or someone you shouldn't touch. Too many people still believe the harmful misinformation that was spread before we understood what HIV and AIDS are and too many don't know the difference not just between HIV and AIDS but between the HIV of reality and the HIV of scare stories. Science has brought us a long, long way since the AIDS to a point where it is completely possible for us now with existing therapies and preventative measures to not just prevent AIDS but to stop new cases of HIV. PrEP alone is almost 100 per cent effective at preventing transmission and HIV positive people are living into old age with effective management of the virus. Most people with HIV in Scotland are now over 50. It is not a death sentence, you can have a normal lifespan and live a healthy life. But society still has work to do to catch up with that medical potential. I try not in contributions to make speeches that are too heavy on stats and reading out facts and numbers as if they are going to go into people's heads but I am going to read three out here because they are incredibly important. Almost half of people surveyed in a Terence Higgins Trust poll said that they would be afraid to kiss someone who is HIV positive. There is no risk there but that means someone who is HIV positive might have half the chance of just being kissed as someone else. That goes up to 64 per cent, almost two thirds, when it comes to people not being willing to have sex with someone who is on effective treatment for their HIV, preventing them from passing on the virus. Most people with HIV will tell you that they face stigma because of their diagnosis. Terence Higgins Trust again revealed data this morning to mark World AIDS Day that showed 74 per cent, nearly three quarters, of people with HIV say that they have experienced stigma or discrimination because of it. The stigma and the lack of understanding of just how far we have come not only means that people are suffering from that stigma and discrimination but that those at risk are missing out on the very thing that could prevent them ever catching HIV. The high uptake of PrEP amongst gay and bisexual men has seen a significant drop in transmissions amongst that group but not so much in others because 97 per cent of those accessing the drug through NHS Scotland are gay or bisexual men. We need to increase awareness of PrEP in other groups and I was glad to hear the minister talk about expanding eligibility and access. I know that many cis women, trans people and non-binary people at risk of contracting HIV are completely unaware that PrEP is readily available to them and for those medically transitioning that it does not interact with their hormone therapies. We also know that black African women are more at risk and not taking up PrEP, so ladies and embies please look into PrEP if you are high risk and protect yourself. There are many places that you can go to get advice about preventing HIV and to be tested quickly and easily. Waverly Care operates throughout Scotland, including in the Highlands and Islands, offering free testing at regular drop-in clinics. Highlands sexual health also offer this testing service and advice in Skye, Wick, Avymor and other locations, as does Nordhaven and Orkney, best at the Balfour. I know that the minister, as a Highlands MSP who has previously represented the region herself, will, as I do, be keen to make sure that rural and island residents can and know how to access sexual health clinics. I hope that the marketing campaign that she mentioned in her speech will reach our constituents, as well as those in urban areas. I would like to start with an apology for needing to leave before closing speeches. I would like to take an interest as well as a doctor and that is going to be quite obvious given what I say next. Human immunodeficiency virus, HIV, is actually a group of viruses called retroviruses and they destroy a certain type of white cell in our bodies, the CD4T cells. Common symptoms include malaise, myalgia, which is a muscle ache, headaches, diarrhea, neuralgia, which is pain across nerves and rash. It is important that we try to test people at this stage because finding out early means early treatment. After this phase, people become asymptomatic, which means that they have no symptoms and this phase can last for years and eventually this leads to AIDS. AIDS is an acquired immunodeficiency syndrome. AIDS is actually a term that covers a range of infections and illnesses that result from a weakened immune system, but we do not ever need to reach AIDS. Those of us from a certain vintage will still remember one of the most petrifying health campaigns ever. In 1986, John Hertz's voice and menacing do not die of ignorance television ads, featuring a huge granite tombstone or a crass warning the public of a newly deadly virus that anyone can catch from sex with an infected person. I remember that ad. I was six at the time and it was terrifying. I still remember that black tombstone coming down, but I suspect that was the point of them. The hard-hitting ads did not exactly put people off having sex with new partners, but it did have a significant impact in trying to change behaviour, particularly encouraging people to use protection and to get tested. The campaign's key messages were clear and stark. If you ignore AIDS, it could be the death of you. Every household in Britain received a leaflet with a warning. Anyone can get it, gay or straight, male or female. Already 30,000 people are affected. In those days of posted letters, and I'm sure most of us in the chamber remember that, the royal male marked on the loops with don't die of ignorance. Back then, there was little knowledge of this disease and no drugs to treat it with. The predicted death toll was terrifying. The UK government was told that it could be millions and millions. Hospital wards could be filling up with dying young men. I'm very grateful to Dr Gilhani for giving way. He describes a terrifying time. I remember that myself. The stigma was legion around that time. There was a massive surge of infections in the 80s, but so, too, there was a surge in co-infections that people who had blood-borne viruses were contracting sometimes multiple different lifelong viruses at the same time. Does he agree with me that the work that we need to continue to do to tackle HIV and transmission in this country needs to be coupled with work on things like hapsies so that those communities who work co-infected are helped as well? I very much do agree with you. We need to work hard at eliminating hepatitis C, and that's something that we spoke about last time in one of the debates. Back then, there was little sympathy for gay men. A common and unjust view was that anyone with HIV had brought it upon themselves and should be left to their own fate—the stigma, the prejudice, the discrimination. HIV and AIDS was known as the gay plague. When I was at med school in the 2000s, we were taught about the devastating diagnosis of HIV. The fact was drummed into us before testing. We had to counsel our patient. We had to talk about the implications of a positive diagnosis and get explicit informed consent, because it could affect their health insurance, their life insurance, their travel insurance—just to name a few financial things. In London, in the early Nauties, people were still dying of AIDS. Later, as orthopedics registrar in Birmingham, although infection controls were robust, there was still the perceived additional threat of occupational transmission from HIV-positive patients. Just look at how far we have come. HIV is still a lifelong infection but can be managed successfully by antiretroviral therapies or ART. There is no vaccine or cure for HIV, but taking daily tablets, the virus will not replicate and progress to AIDS. We now even have drugs to reduce the likelihood of becoming infected. For those who think they have been exposed to the virus, we have prepped. For those who are HIV-negative but are in high risk HIV infection groups, we have the pre-exposure prophylaxis medicine, which reduces this risk significantly. 30 years ago, HIV-AIDS was a death sentence. Now, the medical profession considers HIV as a chronic disease. In fact, the prognosis and life expectancy for a person living with HIV is better than someone living with type 2 diabetes. Living well with HIV usually involves taking a tablet per day, and that does not give you a reduction in your life expectancy. Despite how well you can control type 2 diabetes, there is a progressive disease and it is life-limiting, with the need to increase pharmacological therapies over time. It is estimated that 500 Scots are likely to be unaware that they are living with HIV. There is evidence that some people are still being diagnosed at a very late stage. On this world age day, while there is so much welcome regard, our knowledge of this disease and the advancement in the disease treatment and management, there is still so much to do. The goal is to eliminate AIDS and have zero transmission of HIV by 2030. Testing is key. Well-functioning sexual health services are vital to this, but too many people are going undiagnosed, and that does not have to happen. Thank you very much, Dr Gilhane. I now call Joe Fitzpatrick to be followed by Claire Baker around six minutes. I want to start by remembering all those who have lost their lives to HIV and AIDS. Too many lives lost too early. There have never been more people living with HIV in Tayside than there are now. We see new diagnoses every year, but thanks to modern treatment, as we have heard from Dr Gilhane, HIV-related deaths are rare. People living with HIV continue, however, to experience disproportionate stigma and discrimination, which impacts on willingness to test for HIV or engage with treatment and prevention interventions. Ultimately, stigma fuels the on-going HIV epidemic in Tayside in Scotland and around the globe. Stigma has been a major feature in many of the contributions today, and I will come back to it to discuss stigma later in my speech. I recently attended an event at Discovery Point in Dundee to hear more about plans to make Dundee a fast-track city. Fast-track cities is a global initiative that unites local leaders and organisations with the common goal of ending the HIV epidemic by building on and strengthening HIV programmes to accelerate a locally co-ordinated response that reflects specific local needs. Committing to fast-track cities seeks to unite local leaders in Dundee and Tayside and link them to that network of like-minded leaders across the globe. Fast-track cities initiative supports technical support, including data and systems, opportunities to share best practice via connections with other fast-track cities, capacity building support and solutions for funding and resource mobilisation. With the support of fast-track cities, Scotland is on track to meet the UN AIDS target of elimination HIV by 2030. Tayside was the first region in the world to effectively eliminate hepatitis C in 2019, 11 years before the World Health Organization's 2030 target. There is a determination to also be the first to eliminate HIV transmission. I want to highlight the work of the Tayside sexual and reproductive health services, including Dr Sarah Allstaff, consultant GUM physician and clinical lead for HIV. I know that Dr Allstaff and her team worked tirelessly during the Covid-19 pandemic to support people living with HIV. The Covid-19 pandemic had a unique effect on people living with HIV, often bringing back memories of stigma, contagion and contamination. I know that the work of fast-track cities stalled during the Covid-19 pandemic, so I am pleased that, certainly in Dundee, that work is now progressing once more at pace. I also commend the work of Waverley Care and the Terence Higgin Trust. Waverley Care is leading on reducing new HIV and hepatitis C infections and getting people diagnosed, tackling health inequalities, promoting good sexual health and, crucially, challenging that stigma. Terence Higgin's trust, as members will know, has been supporting people living with HIV since the early 1980s, since those horrible ads that others have talked about. The trust provides testing services for HIV and other sexually transmitted infections and helps service users to achieve good sexual health. The Terence Higgin Trust also highlights issues with stigma surrounding HIV. The trust advises that stigma is often borne out of fear and can take many forms, including hostility, physical or verbal abuse and someone being avoided or excluded from activities that they used to take part in. My colleague reiterated some of the other impacts of stigma on people living with HIV. Although we all hope that, one day, there will be a cure for HIV, the actions that we are taking right now mean that Scotland is on course to be one of the first countries in the world to eliminate transmission of HIV. In the meantime, it is crucial that we do everything that we can to tackle that stigma, which is a remaining barrier. Stigma is the recurring theme of my speech and other speeches today. HIV does not discriminate as we have already heard and neither should we or anyone else. Members across the chamber supported the Terence Higgin's Trust's Can't Pass It On campaign, and I want to take this opportunity to again highlight the key message that people on effective HIV treatment cannot pass on the virus. 20 years' worth of evidence proves definitively that people living with HIV with an undetectable viral load cannot transmit HIV sexually. As Jamie Greene and others said in their contributions, undetectable equals untransmittable. The message behind that phrase is worth repeating. People on effective HIV treatment cannot pass on the virus. I am delighted that Dundee is to become a fast track city and I am confident that we can learn from the on-going fantastic works in other cities across Scotland and around the world. On World AIDS Day 2020, I stated that the goal of eliminating HIV transmission was in sight. Two years on, I believe that remains the case, but let me be clear, irrespective of the progress that we have made in recent years. As the minister said in her opening, elimination is not inevitable, but it is achievable. By working together, Scotland can, and I believe that it will, eliminate HIV transmission by 2030. The minister's three significant announcements today will support that ambition. I call Claire Baker to be followed by Evelyn Tweeden in around a generous six minutes. It is four decades on from the first diagnosed cases of HIV, and World AIDS Day provides an important opportunity to stand with those living with those affected by HIV today and to remember the millions of lives that have been lost to HIV and AIDS. Here in Scotland, as we have heard this afternoon, we have made huge advances in that time, including being one of the first countries to make PrEP widely accessible, but we know that more concerted and continued action is needed if the goal of zero new transmissions by 2030 is to be met. While we welcome the progress being made in the fight against HIV, there remains challenges that must be addressed both holistically and specifically if we are to succeed. With cross-party backing for plans to end new HIV cases within the decade, the challenge for the Scottish Government is determining the route to get there. Our amendment today calls for a commitment to annual reporting to Parliament on progress, but we also need to see action such as a more proactive approach to HIV testing, wider access to PrEP, public education and work to address HIV stigma and HIV health inequalities, particularly among people who are intravenous drug users. It is vital that the Scottish Government's drug strategy takes into account the risk of HIV transmission among populations who inject drugs in Scotland. Data on routes of transmission for first diagnosis of HIV recorded in 2020 shows that 17 per cent were linked to people who inject drugs. Of those living with HIV up to December 2019, the route of transmission linked to people who inject drugs was 9 per cent. When we think about the risks of drug use, transmission of HIV and other blood-borne viruses must be part of that discussion, so we can address it within the broader action that is being taken. Alex Cole-Hamilton is very grateful to Clare Baker for giving way on that point. She makes a very compelling argument about the link between intravenous drug use and HIV transmission. Does she agree with me that we saw an HIV outbreak in Glasgow when services were cut to ADPs or that funding was cut to ADPs? That underscores why we need to fund, adequately fund, on-the-ground drug services in our country. Clare Baker. Thank you. That is an excellent point. It is a point that I made in last week's debate that we had on stigma within the drug strategy. Was it not me that you were indicating too bad? No, sorry. It is a point that I made last week that we need to make sure that community, although we have centralised our drug and addiction services, that leads to good medical outcomes. There needs to be more locally delivered provision, because that is where people look to access their provision, and I argued around more provision within GP services. Back to the issue of drug-related deaths. When we look at our record on drug-related deaths, we should also look at the number of individual lives lost that were related to HIV and hepatitis C. The NRS drug-related death publication for 2021 shows that, between 2010 and 2021, there were 413 deaths resulting from hepatitis C or HIV, which are not included within the definition of drug misuse deaths, but may be associated with present or past drug use. Harm reduction measures have a key role to play in reducing HIV and other blood-borne viruses, with effective delivery of the mat standards important in ensuring this. Standard 4 in the mat standards includes provision related to access to harm reduction services at the point of mat delivery, including injecting risk assessments and BBV testing. Service providers will be required to have a procedure in place to offer testing for HIV and other BBVs, but, as we know, implementation of mat standards has slipped, with full implementation of standard 4 only in place in ADPs areas where the pro-guess report was carried out. Full delivery of the standard 4 would only happen if the service is properly developed and funded, and they must meet the target of delivery by next April. We talk about safer drug consumption facilities, primarily in terms of preventing overdoses, but they reduce the risk of HIV and hepatitis C by providing people with a safe space to inject and reduce needle-sharing. Although we still await for facilities to be operation in Scotland, and I understand that a submission has been made to the crime office for a facility in Glasgow, but it is disappointing that, three years after the declaration of a public health emergency, we still do not have a pilot facility up and running in Scotland. The joining up of policy and service delivery is vital in our fight to eradicate HIV transmission. We have seen the benefits of collaborative working to prevent blood-borne viruses among people who inject drugs that are carried out by public health Scotland, recognising that people who inject drugs are disproportionately affected by BBVs, and the challenges of tailoring interventions to reduce the health inequalities faced by this group. Public Health Scotland worked with NHS boards, third sector organisations and other key partners to design and implement monitoring and evaluation initiatives. The Needle Exchange Surveillance Initiative, supported by the Scottish Government, is an example of data gathering to support better intervention and is the kind of action that we need to see more of. So last week, as I said, I spoke in the debate on stigma and the importance of addressing stigma within drugs policy, and this too is vital to today's debate. Knowledge and understanding of HIV among the public is still too low and much more needs to be done to end stigma and discrimination around HIV. There hasn't been a major public information campaign about HIV since the 1980s don't die of ignorance messages, and data released this summer by the Tenzingens Trust showed that public attitudes for many are still tied to this campaign, particularly among older people. I welcome the minister's announcement this afternoon about an upcoming campaign. With others, I would like to see more detail on that, but it's positive that a campaign is forthcoming, because just 38 per cent of those surveys knew that people living with HIV on effective treatment cannot pass on to partners. The same survey found that just 30 per cent of respondents who would be comfortable dating someone living with HIV and on effective treatment. So there remains a disconnect between knowledge about HIV transmission and the impact on how people living with HIV are perceived and treated, and the Government does have a role to play in addressing that. So a new campaign should help address stigma by informing the public about the realities of HIV, encourage more people to get tested and provide better support for those living with HIV. So if we are to successfully end HIV transmission in Scotland, we cannot do so by thinking about an isolation. For individuals who inject drugs, the risks of harm are interlinked and need to be addressed by looking at them holistically. The implementation of the MAT standards can help play a key role in ensuring that several providers are able to engage with at-risk groups, but we have also waited too long for this to take effect. Improving public information is essential to reducing stigma, and working collaboratively at a coffee agency will help to reduce the inequality and provision of support and reach those groups that too often can be missed. I apologise to the chamber for my lateness today. It felt like a death sentence. The words of my constituent who supported his partner through an HIV diagnosis in the 90s. The diagnosis was kept under wraps amidst a great deal of discrimination. Thankfully, my constituent was keen to highlight the enormous progress that has been made since his partner's diagnosis, with many public figures now openly sharing their status as HIV positive. Today, on World AIDS Day, we remember the millions of lives lost globally to HIV and AIDS. It is also an opportunity to stand in solidarity with those living with HIV and reflect on the progress made. In 2018, Scotland met United's 1990 target, with 91 per cent of people living with HIV diagnosed, 98 per cent of them accessing treatment, and 94 per cent of them with an undetectable viral load. I apologise for some of the statistics that we have already talked about today, but they are important. Once again, the Scottish Government is showing an ambitious approach to tackling health issues, and I welcome the Scottish Government's announcements today. Treatments for HIV are now very effective and free HIV testing is available in the NHS to anyone. Pre-exposure prophylaxis, or PREP, as we have already heard, is a medication for people who do not have HIV, which is almost 100 per cent effective in preventing transmission. I commend the Scottish Government for making PREP available in the NHS. It is the first nation in the UK and one of the first in the world to do so. However, social attitudes, as we have heard in the chamber today, lag behind medical advances. Misconceptions of HIV risk are still around. In 2020, HIV Scotland found that 31 per cent of Scots believe that they are not the type of person who can get infected with HIV. Only 17 per cent believe that medication can prevent HIV infection. If Scotland is to reach zero transmission by 2030, outdated myths need to be overcome. I welcome the minister's comments on a new awareness campaign. Since PREP has become more widely available, the demographics of new diagnosis have shifted. Those being diagnosed are more likely to be women, black African and have acquired HIV outside of Scotland. However, from July 2017 to June 2019, less than 1 per cent prescribed for PREP were women and only 0.4 per cent identified as African or African Scottish, despite this being a group. Black African and Caribbean women living in the UK report low levels of knowledge around the benefits and effectiveness of PREP. That results in low take-up and little change in rates of diagnosis. That study also highlighted the importance of peer networks for information on sexual health for that group. In a 2021 study, HIV positive asylum seekers and migrants in Scotland reported feeling stigmatised by public health services. However, they described overwhelmingly positive experiences with dedicated services such as the African health project at Waverley Care. I look forward to hearing how the Government will support people of colour, migrants and asylum seekers through diagnosis, treatment and prevention. Scotland has been able to show that PREP has and can continue to have a powerful population level effectiveness. On World AIDS Day, I am so happy to hear the positive progress that we are making and to hear my fellow parliamentarians speak about their own experiences. We have moved on so much from the dark days of the 80s, the adverts with foreboding music showing tombstones that I remember as a teenager and the fear that everyone felt. Scotland is already well on the way to zero transmissions by 2030, and I welcome the Scottish Government's announcements today. I now call Gillian Mackay to be followed by Brian Whittle for a generous six minutes. I would like to begin by expressing my condolences to everyone who has lost someone they love to AIDS. I also want to give my thanks to all the activists who have led and who continue to lead the fight for better treatment, diagnosis and understanding of HIV and AIDS. We would not be where we are today without their efforts, often made at great personal cost. Huge medical advancements have been made in the decades since HIV was first discovered, and it is now a very treatable disease. However, access to diagnosis and treatment is still not equitable both globally and in Scotland. Inequality drives risk and creates barriers to diagnosis and treatment across the world. 70 per cent of new HIV infections are among people who are marginalised and often criminalised. According to the World Health Organization, division, disparity and disregard for human rights are among the failures that allowed HIV to become and remain a global health crisis. We cannot make those same mistakes. We can only end HIV transmission by scaling up HIV services, removing structural barriers and tackling stigma and discrimination worldwide. Those structural barriers are evident in Scotland. To take an example, the current HIV outbreak in Glasgow is closely linked to widening health and social inequalities that are faced by people who inject drugs, including poverty and deprivation. Analysis of the outbreak by Public Health Scotland found that none of the deaths associated with the outbreak were from an AIDS-related illness. However, people who inject drugs face a range of inequalities that increase their risk of HIV infection and their rate of mortality, such as homelessness and poor access to healthcare. Those factors interact in complex ways, presenting significant barriers that prevent people from staying well. The Scottish Greens believe that action to address underlying health inequalities will help to reduce drug-related deaths, as well as related harms such as HIV infection. Alongside tackling underlying inequalities, we also need to ensure that it is as easy as possible to test for HIV. Vulnerable people who may be at increased risk can be labelled as difficult to reach, but, in reality, testing is not always accessible. Early diagnosis is crucial to ensuring that people with HIV can live the healthiest lives possible. However, according to the most recent statistics from Waverley Care, three out of every 10 HIV cases are being diagnosed late. The analysis states that access to HIV testing can be impacted by structural barriers, such as capacity, time constraints, lack of knowledge about how to obtain a test, low-perceived risk of HIV infection, as well as fear of a positive test result or issues around disclosure. I thank the member for taking my intervention. Does the member think that there may be some merit or benefit to, for example, an idea proposed in a national HIV testing week, with a huge country-wide roll-out of mobile testing, home testing and clinic testing in one specific identified week, that might find some of those 500 undiagnosed people that would go a long, long way to reduce cases in Scotland? I absolutely agree with the member. I would challenge everybody that if that does become a thing that we in this chamber are the ones that make sure that everybody sees that we get tested to and break down some of that stigma. I am aware that, although not directly related, the current protests outside abortion clinics, which are often on the same sites as sexual health clinics, are putting people off getting tested for fear of being recognised. However, I would like to echo Jamie Greene's calls to get tested, or if you are frightened, could I join him in offering to go with those who are concerned? Additionally, people who live in rural or remote areas of Scotland may be discouraged from getting tested, as it can be difficult to maintain anonymity in rural communities where simply accessing HIV testing services may expose HIV status. It can also be costly to travel to get tested if facilities are located far away. If we are to improve care for people with HIV and achieve zero transmissions by 2030, we need to ensure that everyone who has contracted HIV is tested and diagnosed. Initiatives such as the HIV self-sampling test will play an important part, but we must explore other options to widen access. The Terence Higgins Trust is advocating for expanded, opt-out HIV testing in healthcare settings, and the HIV commission's flagship recommendation is that opt-out rather than opt-in HIV testing must become routine across healthcare settings, starting with areas of high prevalence. I was pleased to see the Government's commitment in the ending HIV transmission by 2030, but around the world we have already seen the difference opt-out testing can make. In around the year 2000, opt-out HIV testing was implemented in maternity services with a take-up of more than 99 per cent. That innovation has become mainstream and has eliminated transitions of HIV from mother to baby. Subsequently, the National Institute for Health and Care Excellence published guidance in 2016, which stated that in areas of high and extremely high prevalence, it recommended HIV testing on admission to hospital, including emergency departments to everyone who has not previously been diagnosed with HIV and who is undergoing blood tests for another reason. According to the Terence Higgins Trust, the initial findings of the three months of opt-out testing in England found that 102 people have been newly diagnosed with HIV and 60 people have been reconnected to an HIV clinic. There have also been 328 new hepatitis B diagnoses, as well as 137 new hepatitis C diagnoses. Pilosing a similar approach in Scotland could be a vital way of ensuring that no one is left behind in Scotland's response to HIV. Along with improving access to testing, we must continue to tackle stigmas that we have heard from across the chamber this afternoon. It still prevents a very real barrier to diagnosis and treatment. People receiving antiretroviral medication can reach an undetectable viral load, which means that they cannot pass on HIV to anyone else within six months of beginning treatment, and that is incredible progress. However, knowledge of HIV has not kept up with medical advancements. At the risk of being booed by colleagues, I do not remember the do not die in ignorance campaign. I was not born until the early 90s, but I grew up in a time when there were many myths about HIV, several of which persist today. That is why it is so important that we raise awareness of improved treatments and what having an undetectable viral load actually means. The Terence Higgins Trust cannot pass it on campaign aims to spread this simple message. Someone living with HIV and on effective treatment cannot pass it on. Raising awareness of this reduces the stigma around HIV and is a positive message that encourages people with HIV to stay on treatment to keep both themselves and their sexual partners healthy. The more people who test and start effective treatment, the fewer HIV transmissions will happen. To conclude, I would like to welcome all the interventions that the minister has announced today and look forward to seeing the impact that they have. World AIDS Day is an important reminder that HIV has not gone away. An estimated 38.4 million people live with HIV and each year in the UK over 4,139 people are diagnosed with the disease. Access to diagnosis and treatment is not equitable and stigma is still a reality in many people's lives. We must continue to widen access to diagnosis and treatment, increase awareness, fight prejudice and improve education. I am going to check standing orders to see what it says about gratuitously flaunting youth, but there you go. I am going to call Brian Whittle to be followed by Richard Leonard at a generous six minutes. I promise I will not fall into that category. I am delighted to once again be speaking in this debate and to follow some really excellent contributions to this debate. I am just struck by how far we have actually come. I am going to show my age. I am remembering those who have actually changed the conversation around AIDS and HIV and those who have helped to reduce stigma. I am going to mention Ferry Mercury. He was one of the first people to note that we found out that he had AIDS. The great American basketball player, Magic Johnson, who remained an elite sports condition, went to the Olympics as part of the American dream team. Sport and rock music, you know that I will always get that in whenever I can, but those people were heroes to so many and in the public eye and really brought the reality of AIDS to us. The Welsh rugby player, Gareth Thomas, who in 2019 announced he was HIV positive and it was a BBC documentary. Gareth Thomas, HIV and me aired shortly afterwards and he timed that announcement to coincide with his taking part in an Iron Man triathlon. It was carefully orchestrating media campaign to drive home a very simple message. HIV did not weaken him. He was in control. His life was not over. I don't know if we all remember when Princess Diana visited Terence Higgins trust and shock horror shook hands with people who were HIV positive. Those are the people that I think began to change the way in which we view HIV and started to tackle that stigma. Nicola Polychec served as chair of HIV Scotland in 2020, told of her experience as a woman living with HIV for most of her adult life. She reminds us that anyone can acquire an HIV infection. It's not limited to a subsection of people as we used to believe and as we used to be told. World AIDS Day was the first ever global health day and on 31 December 2021 a total of 6,415 people were living with HIV in Scotland. As my colleague Jamie Greene has spoken so eloquently on, I agree with his assertion that access to better sexual health services is vitally important in the fight against HIV, but so too is education and access to that public health service, such as drug and alcohol treatments. There are many people living with HIV who are not acknowledged in the public eye, such as those battling addiction or those who are homeless. Those populations can often be difficult to reach, resulting in substantial health inequalities. I'm proud to rock the ribbon as part of World AIDS Day 2022 campaign as an HIV ally this year to those who are often overlooked. We need to look at the public health programmes. The needle exchange programme in general funding for drug and alcohol partnership more generally is underfunded. Between June 2014 and December 2020 188 new diagnoses of HIV infection were detected among people who injected drugs in NHS Greater Glasgow and Clyde as part of an on-going outbreak. That was the largest HIV outbreak among people who injected drugs in the UK in more than 30 years. It is not a coincidence at that point that was a reduced needle exchange programme. Levels of reporting needle and syrin sharing in the past six months have increased from a low of 7 per cent in 2015-16 to 11 per cent in 2019-20, so we have to be cognisant of that and understand the part that the needle exchange programme will play in this. I welcome the fact that the number of AIDS diagnoses in Scotland is declining, and during 2021 a total of 218 reports of HIV diagnoses were recorded in Scotland compared to 326 reports in 2019. However, late diagnosis continues to persist and it is vitally important that we continue to educate and provide that outreach. Although the proportions of first ever diagnoses recorded as late have decreased in the past two years during the Covid-19 pandemic, there is evidence that some people are still being diagnosed at a very late stage of HIV infection. It is concerning that individuals diagnosed at a late or very late stage of infection have an eightfold risk of dying within one year of the diagnosis, and often the response to treatment and therapy is poor increasing concerns about quality of life during their last months. Testing remains a key public health priority for all risk groups to reduce the number of undiagnosed infections, identify individuals early in HIV infection when they can benefit from the most effective antiretroviral therapy and reduce the potential for onward transmission. Public Health Scotland notes that challenging during Covid-19 recovery is to re-establish and improve opportunities for testing in primary care settings and across all medical specialities in addition to home and self-testing options. I would further argue that raising public awareness is also important, as Jamie Greene made in his interventions, so that the public knows their risk factors and knows what help is available. I would like to say that in East Ayrshire there are 52 estimated cases in South Lanarkshire, there are 577 cases, but in Lanarkshire North Lanarkshire Council, South Lanarkshire Council, NHS Lanarkshire and Lanarkshire Bloodborne Viruses Network have created a partnership to address HIV and hepatitis, both of which I think we recognise we could eliminate. That joined up approach ensures that those services are accessible to the young and older like, as well as patients and medical providers. Research into pharma and treatments will obviously be extremely important. Prep is a drug taken by HIV-negative people before sex that reduces the risk of getting HIV. It continues to be a particularly effective prevention intervention, and the monthly average number of individuals who are accessing the service for the first prescription between July and December 2021 was the third-largest observed since the first year of the programme. However, on representation of some groups who may benefit from PrEP, for example women, must be tackled to ensure equality of access to the PrEP service. I will bring my comments to a close, Deputy Presiding Officer, just to once again be thankful for the opportunity to speak in this programme, in this particular debate, and of course there is an awful lot of work to do. If we have the will, we can eliminate this virus by the target of 2030. Thank you, Deputy Presiding Officer. Thank you very much, Mr Whithall. I now call Richard Leonard to be followed by Gillian Martin again in six minutes. Thank you, Deputy Presiding Officer. We have heard a lot in recent weeks in this Parliament about the founding principles of the NHS. We need to apply those founding principles of our national health service to the global community's fight against international and intergenerational pandemics. That means that we need to get medicines to people according to need, not according to wealth. That is what we need to do, to those who are ill, not those who can afford to pay, and it must be fully funded, paid out of general taxation, not to enhance the profit margin and the shareholder dividend, but to enhance universal life expectancy and the humanitarian dividend, because people must be the assets on our balance sheet. Those are the principles of an Iron Bevan. Those are the principles that we should stick to today. There is another principle, an article of faith, which guides me and many others, although I recognise it may be a minority view in this Parliament, which was best set out by Tom Mann, who a century ago wrote, no narrow nationalism can satisfy our people. Nothing short of cosmopolitanism can really satisfy a world citizen. The world is my country, is the declaration of every socialist, so I view the world crisis in AIDS as my crisis. I view it as all of our crisis, which is why we must all work to harness science, to get the most advanced, the most effective medicines without frontiers to those who need them, because the prevention and treatment of HIV-AIDS is a human rights issue. When private companies take over public health, profit becomes dominant over need, and you have a two-tier system, the corollary of the corruption of power, which we see with the super profits and racketeering of big pharma, is the corruption of powerlessness. We need more democracy in this global approach and organised peoples counterweight to the power of organised big business. Big businesses, like Gilead Sciences, last year, they generated $27 billion in turnover, settled a $1.25 billion patent infringement case with one of their main rivals, Vive Healthcare, majority-owned by GlaxoSmithKline, and still managed to pay its CEO and chairman, Daniel O'Day, over $19 million. Last year, the theme of World AIDS Day was end inequalities, end AIDS and pandemics. This year, the warning is to end dangerous inequalities, but we know that this lies at the root cause of a still rising number of cases in certain parts of the world. New infections are going up among women, among adolescent girls and young women especially. In sub-Saharan Africa, girls are three times more likely to acquire HIV than boys of the same age. I have to say to Conservative MSPs, this debate this afternoon is in the end about inequalities of wealth, but it is also about the inequalities of power as well, because what is happening out there globally is that, while people with wealth survive, people in poverty are dying. According to the United Nations last year, children accounted for only 4 per cent of all people living with HIV, but 15 per cent of all AIDS-related deaths. So the cuts to overseas AIDS, the cuts to organisations tackling AIDS globally, the cuts to the global fund to fight AIDS beg these questions on World AIDS Day 2022. Where is our sense of injustice? Where is our moral outrage? Where is our adherence to a civilised code of human rights, led alone of children's rights in this? UNA's Executive Director, Winnie Beyan-Yama, is absolutely right to say this week, and I quote her, what world leaders need to do is crystal clear in one word, equalise. Equalise access to rights, equalise access to services, equalise access to best science and medicine. Equalising will not only help the marginalised, it will help everyone. If all right-minded people challenge prejudice and stigma head-on, take action so that there is no place for the profit motive and the shareholder dividend in this humanitarian quest. Recognise that silence is a vice and show real international leadership, then there is hope for a better future. We can break the link between corporate power and global poverty. We can end not only the dangerous inequalities but the very pandemic itself. That is the task facing us in this generation. We can begin by setting a clear timetable in Scotland with a route map and annual reporting. We can make sure that resources are guided not by profit but by need, and we can truly be, in the Tom Mann sense, citizens of the world. Thank you very much indeed, Mr Laird. I now call Gillian Martin, who is the final speaker in the open debate for around six minutes. I too am glad that the Government has made time to hold a Government debate on World AIDS Day, because it allows us to amplify the key aims of the National AIDS Trust to work tirelessly to promote the information that people need to prevent new cases of HIV, to secure the rights of people living with HIV, and to fight against HIV stigma and discrimination. That also gives us a chance to let our constituents know what services are out there and to highlight the importance of testing. HIV Scotland makes it easy for anyone who is worried that they may have the virus to get tested quickly. They can send self-testing kits and they can be delivered in discrete packaging to their home and signpost them to people to other forms of support. I was pleased to hear that the minister is determined to get more people tested. We certainly have come a long way in the decades since HIV and AIDS entered the public consciousness. Of course, the strives and clinical treatment are a huge part of that, and HIV is now in a condition that is treatable and manageable. Those who are receiving a diagnosis can expect to live long, healthy lives with managed care. That extraordinary headway that has been made and how the virus is seen by society is due in large part to the bravery of people who have come before us in speaking it out and to organisations such as HIV Scotland and Waverly Care, making massive contributions to tackling stigma. Although stigma does remain and it is concerned to read yesterday in the Herald newspaper, a piece by Grant Sugden, the CEO of Waverly Care, who said that in a recent survey by the National AIDS Trust, only a third of people surveyed agreed that they would have sympathy for anyone living with HIV. I found that really quite staggering and really depressing. It seems that from that response that HIV is still associated with promiscuity or behaviours that lead people to think that contracting HIV is the fault of the person with the disease or pointing to some kind of moral failure. Those damaging and hurtful stereotypes persist. I think of the dreadful ignorance campaign in the 1980s, with its sinister voice over images of terrifying icebergs, tombstones and ridiculous scaremongering messaging. It really was at the root of many of those problems that are around stigma that we still see today. It is great to hear the minister commit to the new public messaging campaign. Apart from that campaign being completely and utterly useless at giving any public health information, it was hugely stigmatising and set the public discourse, which very quickly became deeply homophobic and anti-public health. From the survey that Mr Southern cites, it seems that the legacy of that campaign remains, and it does stop people from coming forward for testing and blinds them to how the virus is actually spread. I want to echo my roddick's points about HIV prevention drug, PEP, which is currently almost exclusively accessed by men with HIV. In the first eight months, the first eight months during which PEP was available in Scotland, only 10 out of the 1,299 people who accessed the drug were women, which begs the question, are women not coming forward? If not, why not? That is why I intervened in the minister, as I did in her speech. Of course, one of the aims of the national AIDS trust is to completely eradicate HIV and to decline cases in Scotland and the wider UK are obviously hugely welcome, but despite the progress that we have made in preventing, treating and managing HIV over here, the illness is still a critical public health issue in other parts of the world, particularly in the global south. I have massive sympathy for everything that was mentioned in Richard Leonard's speech in that regard. One in 21 heterosexual African women are living with HIV. UNICEF has reported that, globally, a child was infected with HIV every two minutes. Of the estimated 2.7 million children living with HIV over the world, just half of them are receiving antiretroviral treatment, meaning that others will have a very short life expectancy. The figures on how many children in sub-Saharan Africa are orphaned due to AIDS are similarly frightening. The point to poverty and inequality has been the main driver for that ongoing public health crisis. We are managing it here in the UK. Things are a lot better than they were, but, as Richard Leonard said, there are other countries that are not managing it. They need assistance from big pharma and from Governments that are managing it successfully. It shows that we can never rest in the fight against HIV and we should never make outdated assumptions about who can be infected. Nearly 40 years on from the discovery of HIV, we know so much more about the virus. We know that people with access to healthcare can live with it, but we also know that it is a diagnosis that is still rife with stigma. Some demographics in Scotland might still be hard to reach when it comes to testing and treatment, but, as long as HIV infection remains a problem anywhere in the world, we must talk about it and act to eradicate it in countries that do not have access to healthcare or public health messaging that we do. We now move to the wind-up speeches, and I call Carol Mocken for around six minutes. I join all my parliamentary colleagues in marking World AIDS Day this year in the chamber tonight. In closing for Scottish Labour, I would also like to take this opportunity to remind those at home and abroad who are no longer with us having lost their life to this terrible disease. The work that we must continue should always be done with them in mind. I bring back Jamie Greene's reminder that, behind statistics, there are always people and their families. The on-going battle against AIDS is a remarkable story for co-operation in research and development that has had a positive effect in the world, or at least here in Scotland, and I will come back to the points made by Gillian Martin and Richard Leonard later. The Government motion correctly commends the work of those who have ensured that we have vastly reduced the number of HIV diagnoses across Scotland. A feat that I have no doubt will continue for years to come, but the intended goals cannot stop there. I say at this stage that, as my colleague has said, we will be supporting the Tory amendment about the access to sexual health services and that it should be timely and it is important that we move forward to make sure that treatments and prevention strategies are at the front of all our policymaking. I also want to talk a wee bit about some of the points made by other colleagues about rural inequality and making sure that we do look at that. The minister did nod vigorously when we talked about that, and I am sure that she will mention that in our closing remarks. I also want to thank my colleague Gillian Mackay, who mentioned the important point about cost for people living across rural Scotland. That is also quite a sensitive part where someone may be worried about exposure before they are ready to do that if they have to access something in a very rural community. All those points are so important. I would also like to thank Joe FitzPatrick for bringing that hope in his constituency about where we might go with this. That is a really important point for us all that we must seek to make sure that we are talking about where there is success. Many members in the chamber talked about stigma today, which is so important. This morning, I listened on the radio to Waverly Care, who we are talking about. Although it is incumbent on the Scottish Government to do something about that, it is about everyone in the chamber. We all have a responsibility to act, and we have called and Waverly called. It is just so great that the minister today has said that they are going to have this anti-stigma campaign. Emma Roddick painted a picture about history on this one, and Brian Whittle raised a number of people that, in my lifetime, stood up and were counted. It is an important fact because Dr Gohani mentioned and others the petrifying advertising that went on in my lifetime in the 80s. It is so important that we get this campaign right. I hope that the minister might mention that again. Scottish Labour shares the view of the Government-led out to reduce transmission to zero by 2030. As my colleague Paul Cain discussed, that is why our amendment calls on the Government to outline a clear timescale for eliminating HIV transmission in Scotland by 2030 and commit to providing the Scottish Parliament with an annual progress report, as others have mentioned. I hope that the minister will support the motion there, because it is about how we are seeking to get there that we can make the biggest difference. I can also thank my colleague Claire Baker. It is really important that we are talking about this. We talk about the various transmission routes that we have and about other action plans that may come together to help us to get where we need. Given the havoc that this disease has brought for so long, it is incredible to think that we could reach the stage where it is both under control and potentially no longer being transmitted at all. It was so unthinkable not so long ago. I cannot begin to imagine the extent of the work and dedication that went into that in achieving that in terms of the research and also people who really made us stand up and be aware so that we pushed and pushed on those facts. I want to come back also to Gillian Martin's point and Richard Leonard's point about across the world. The reality in many other parts of the world is stark. I believe that Scotland and the wider UK have a responsibility to alleviate the suffering that many are experiencing on a day-to-day basis. To do that, we must continue to play a lead role in the fight against AIDS for generations to come, passing on the hard-won knowledge that we have gathered to the rest of the world. That begins with pushing against the damaging rhetoric coming from some quarters about foreign aid funding should reduce. The vast benefits of foreign aid has seen millions able to survive with HIV and continue to live a prosperous existence in its communities. It reinforces our role across the globe and we must not cut our efforts on that as we have heard by Gillian Martin and Richard Leonard about the way in which others live in other countries. If I can just come back to research, innovation and research must remain key and the introduction of PREP has been a remarkable positive in that regard alongside a focus on prevention, specialist care and contact tracing that promotes a modern and considered approach to tackling the problem. I thought that it was important that, in the closing remarks that I did, I mentioned Alex Cole-Hamilton's wish for the minister to speak about some of the areas that have very long ways, such as in Lothian and how they hope to tackle that. If we can maintain the current trajectory and ensure accountability, we will be going a long way to improving the lives of thousands of people at home and, no doubt, many more abroad. That can only be good and we can do this and I hope that across-party we can work together because this is so essential that we make a difference globally with HIV and AIDS. It is a privilege to close this debate for the Scottish Conservatives. Sadly, I do remember the early 1980s when the first cases of AIDS were discovered. I was a teenager at the time. I was around 16. Looking back, I don't think I fully grasped the gravity of what was happening at the time. I couldn't possibly have imagined that, in 1981, an estimated 40 million people would lose their lives to AIDS-related illnesses in the decades following the first diagnosis. Paul O'Cain has said today that we stand in solidarity with those who are living with AIDS, but, as Clare Baker has pointed out as well, we cannot be satisfied with the progress. Brian Whittle has highlighted several heroes—Magic Johnson, Freddie Mercury and Gareth Thomas. To have lost so many lives is heartbreaking, but so too is the awful truth that many were stigmatised and shamed before they died because of their illnesses and all too often they chose because of who they chose to love. Sadly, as my colleague Jamie Greene pointed out today, there are still parts of the world where infections are rising because people are afraid to go for a test or seek treatment for fear of retribution. Whether my colleague likes it or not, Gilead developed 11 anti-retrovirals that treated over 16 million people. I say to Mr Leonard that, without their funding, many HIV charities would be now non-existent and so many lives would have been lost. For many years, HIV and AIDS were vectors of social prejudice. They were lightning rods for bigotry, homophobia and discrimination. While attitudes have changed over time, they have not changed enough. Shaming and fear-inducing tactics are often used to change behaviour, but the HIV stigma of the 1980s and 1990s still looms large. Data released earlier this year by the Terence Higgins Trust shows that public attitudes on HIV are still stuck in the 1980s. Jo Fitzpatrick referenced the terrible stigma, which was the main theme of his speech. Stigma can stop people from getting tested, as we know, but according to the National AIDS Trust, roughly one in 16 people living with HIV in the UK do not know they have the virus. Gillian Martin quoted alarming statistics that there is still a huge stigma and hurtful stereotyping. As we have heard today, testing is pivotal and so is addressing the barriers that prevent people from getting tested. My colleague Jamie Greene stressed when in doubt tests and I do commend you for your courage for posting the testing video. Gillian Mackay highlighted underlying issues of division, disparity and, she said, disregard. It is a huge issue when it comes to eradicating, as she said, barriers to progress. As the Scottish Conservatives amendment emphasises, timely access to sexual health services is so, so important. Dr Sandesh Gulhane stressed the importance of a well-functioning sexual health service. Paul O'Kane has cautioned a postcode lottery and Alex Cole-Hamilton and Jamie Greene and Emma Roddick have made calls to improve access to treatment services in rural areas, including in the highlands. If someone does get tested and receives a positive diagnosis, HIV stigma means they can feel isolated and alone when they're most vulnerable. I was struck by a comment made by Nathaniel J. Hall, who starred in the TV series that we've highlighted today. It's a sin. He was diagnosed with AIDS at just 16. Nathaniel said, there's a lot of working through all that shame of being gay and trying to unpick all that homophobia and he'd internalise that. And then it came to the other thing. I'd contracted the virus. I didn't tell anyone. He said, I didn't tell my friends, my family, I told very few friends until about 2017. Imagine being 16 years old, being given a life shortening diagnosis, which is what it was at the time and trying to cope with it alone. Imagine trying to do that while dealing with decades of bigotry that makes you believe that because you're a gay, there's something wrong with you. Presiding Officer, we need to keep working towards the goal of zero transmission by 2030. We also need to aim for zero stigma, so rightly pointed out today by Emma Roddick. We need to provide the mental health support to people with the diagnosis of HIV and AIDS if they need it. With early diagnosis and treatment, people with our HIV can lead a normal life, so I welcome the announcement today by the Minister of a Public Awareness campaign. But no one should feel as though they must go through it alone. This is about emotional health as well as physical health. Many of us in the chamber today are wearing our red AIDS ribbons. They were first introduced 30 years ago at the height of the AIDS crisis by the Visual AIDS Artist Caucus in the United States. In 1992, actress Elizabeth Taylor wore a red ribbon to the Oscars and it became an internationally renowned symbol of compassion, support, awareness and hope. She dedicated so much of her life to AIDS activism even though she was warned that it was one of her lame-duck causes that could hurt her professionally. She stuck her head above the parapet over and over again as government the world over scrambled to come up with a coherent public health response. As Mary Todd and Dr Sandesh Kalhane emphasised, with advancements in medical treatment, a diagnosis is no longer a death sentence. Anti-retroviral medicines can effectively reduce the viral load to undetectable levels and PrEP can prevent HIV if taken properly. We have come so far since the red ribbon first became embedded in our collective consciousness as a symbol of solidarity and hope. The UK has met and surpassed the UN 1990 target. There has been a huge reduction in HIV transmission in the UK and in Scotland, but the fight to end AIDS is not over yet. I thank members for their participation in this incredibly important debate. I am very glad of the consensus and support that I am feeling across the chamber on this issue. I am pleased to confirm that the Government is very happy to support both of the Opposition amendments today. Today is a stark reminder that, although there has been huge advances in treatment and diagnostic tools in recent years, that virus has not gone away and the stigma surrounding an HIV diagnosis persists and far too many people have died and will continue to die. In Scotland we have made tremendous progress as I set out in my opening speech, but we cannot and must not become complacent. I am determined that we build upon our successes and I am grateful that the work that has gone into this elimination proposal will help us to do that. I have every faith that the HIV transmission elimination strategy implementation group will continue to drive momentum and to deliver real tangible results. I will not repeat the detail of my opening remarks, but I hope that the announcements that are made today demonstrate the commitment that this Government has to eliminating HIV transmission within Scotland by 2030 and to ensuring that those living with HIV are able to live long and healthy lives free from stigma and discrimination. I am going to try to respond to many of the issues that were raised during the debate. Jamie Greene opened by reflecting on the sadness but also the hopefulness of today. I know that members around the chamber share that sense of being on the cusp of something really momentous and I am absolutely delighted to be public health minister at this moment in time in Scotland. I commend him for his work in this area, particularly that publicly testing and using his position of power to tackle stigma. I did announce the commitment to widen access to the e-prep pilot, which I hope will improve access to prep for all of those living in remote and rural areas, but I also hope that that will have an impact in urban areas. I have to draw an analogy between the development and that service with some of the advances that we have had in telemedical access to early medical abortion, for example, at home. That is one of the few positives that I can see has come from the pandemic. Our sexual health teams with that advance have demonstrated their ability to be agile and to change the way that they deliver care and to enhance their person-centred focus. There are so many clinicians around the country and teams that have worked in this area for so long that we need to be very grateful for. I am very intrigued by the detail of it and I hope that the minister will share that when she can with other members. There are two very important things that face-to-face contact provides that remote and e-pilots do not. One is that, if someone receives a positive diagnosis, they will need that one-to-one personal interaction with somebody who knows what they are talking about. The other is obviously those who are taking prep and are also tested for many other things, often due to other sexual behaviours. I wonder whether that will be addressed as well, because there is no replacement for that physical going into sexual health services, which, for too often too many, is simply not available when they need it. I am certainly more than happy to provide detail as we develop it. That is what the Labour Party amendment asked for, and I am more than happy to keep the chamber updated. As a remote and rural MSP, I have heard directly from constituents who have been given very difficult news in the circumstances in which they have had to travel alone, a very long distance, often a flight to a hospital to be given that news alone, and who have said to me that I would rather have had that news by telemedicine in the comfort of my own home with support and family around me. I think that that illustrates that we need to work in a person-centred way. There is not one-size-fits-all in this particular debate, and I trust that the sexual health people working in those clinics are absolutely phenomenal at working in that person-centred way, without judgment and certainly without pre-judgment, without assumption, and day in day out get decisions right alongside the people that they care for. Paul O'Kane talked very eloquently about the homophobia and moral panic that has absolutely been front and centre of this AIDS debate since the HIV virus first burst onto the scene and into our lives. As the minister with responsibility for the blood donor system, I am absolutely delighted that he is giving blood. Every donation saves up to three lives, so thank you, and thank you too for using your position of power to tackle stigma and to lead the way. A number of people asked for more detail of the pilot. The pilot will probably necessarily, because we are trying to gain results from it, be limited to a certain geographical area. We are still developing it, but the service that we develop on the back of that pilot will be targeted at those people who are able to self-manage rather than geographically targeted, so it will potentially, when the final service is developed, help both rural and urban areas. Gillian Martin and others asked about women, and I absolutely acknowledge that there is much more to be done. The educational resources that will be available to clinicians as part of the widening access to PrEP will highlight that it is not only gay and bisexual men who are at risk of acquiring HIV. It is about risk profile, not gender. Evelyn Tweed gave some incredible statistics, highlighting the very worrying and persistent idea that some people have that they are not the type of person who might catch HIV. That is another very powerful argument for a marketing campaign if ever we needed one. Emma Roddick has ever gave a beautiful and powerful speech on this topic and should definitely use statistics more often. I think that stating that people with HIV who have half the chance of being kissed is a powerful way of describing the lingering ignorance and the impact of stigma. Dr Gilhane talked eloquently about the medical advances over time. Nowadays, HIV is significantly less fatal than smoking, for example, which is still quite a common pastime and will kill two-thirds of those people who do it. It is no longer the fatal disease that it once was. Jo Fitzpatrick took the opportunity, as ever, to highlight the fabulous work that is going on in Tayside to tackle both HIV and its world-leading work on tackling hep C. I want to take the opportunity to commend him for his work while he was in this role. I know that he shares my absolute thrill at having been part of this exciting moment in history—that goal of elimination is in sight. He took the opportunity, as I would expect from a past public health minister, to reiterate that vitally important message. People on effective treatment cannot pass on the virus. If there is one message that comes out of the debate today, that will be a powerful message to see replicated in all our media tonight and tomorrow. Claire Baker was absolutely right to highlight the effort that is required to reduce the risk for people who inject drugs. The Scottish Government has funded numerous projects that were designed to identify and enlist in treatment those people who have acquired HIV in that population. For example, last year, we funded the Cocoon project, which is a project that provides a person-centred approach to people who inject drugs and are at risk of poor sexual health, blood-borne viruses and increased mortality. That project provided a point of care BBV testing and treatment, as well as testing for other diseases such as Covid-19 and other STIs. The main aim of that project was to provide that holistic service that combines all care at a single point, while integrating wound care, naloxone provision and other harm-reducing measures. I think that that is just one example of—certainly—Clear Baker. In the speech that I mentioned about standard 4, which is the one that was about BBV testing, can she give me assurances that she is speaking with Angela Constance, the minister, and that they are speaking regularly with ADPs about delivery on this, which has to be done by April? Absolutely. I have regular catch-ups with Angela Constance, and absolutely that would be a very high priority for both of us. Gillian Mackay, while I was shocked to learn that my esteemed colleague was born whilst I was at university—wisdom in one so young—just astonishing, was very pleased to confirm that we are considering a HIV testing week as part of that marketing campaign. I, as a mum of three, have been tested three times. I would have absolutely no qualms about being tested again. I am sure that many around the chamber would join that campaign should we decide that was the best way forward. Brian Whittle and myself share that absolute passion for sport and believe in the power of sport to change the world. It is no surprise that I commend, along with those sporting heroes such as Gareth Thomas, who are using that public position to counter stigma. I also share much of the concern that Richard Leonard expressed. Whilst we are focused here today on eliminating HIV in Scotland, we must not forget that HIV is only manageable with access to the right treatment at the right time and unequal access to HIV antiviral cost life. We know that the disruption to health services caused by Covid is likely to have made any quality worse. It is estimated that, in 2021, more than 38 million people around the world had HIV. Of those, 16 per cent had not been tested and did not even know their status. That is over 6 million people, more than 9 million people waiting to start antiviral treatments. We must end this first and foremost because we can never accept any life lost needlessly. Secondly, we are a connected global community and nowhere is safe until everywhere is. We continue to forget that at great cost to ourselves. To answer both Carol Mochan and Alec Cole-Hamilton, I am aware that, in August this year, NHS Loosland has recruited additional staff to increase the number of clinics and to reduce the waiting times for our patients to start PrEP. I am extremely grateful for this debate this afternoon. I want to say thank you to all of us here in the chamber today, but I also want to commend and say thank you to the key stakeholders, many of whom are in the chamber today—HIV Scotland, Waverly Care and the Terence Higgins Trust. Those organisations have been working in this field for decades, beginning in any era when it was much tougher to stand up and speak out than it is now. I am so grateful to be working with you all today. I know that the chamber will be unified to support to end HIV transmissions within Scotland by 2030, and it is that unified collaborative approach that will ensure that we reach that target and better the lives of those living with HIV in Scotland. That concludes the debate on World AIDS Day. It is now time to move on to the next item of business, and there are three questions to be put as a result of today's business. The first is the amendment 7025.2, in the name of Jamie Greene, which seeks to amend motion 7025, in the name of Marie Todd, on World AIDS Day, be agreed. Are we all agreed? The amendment is therefore agreed. The next question is the amendment 7025.1, in the name of Paul O'Kane, which seeks to amend motion 7025, in the name of Marie Todd, on World AIDS Day, be agreed. Are we all agreed? The next question is the amendment 7025, in the name of Marie Todd, on World AIDS Day, be agreed. The motion is therefore agreed. That concludes decision time, and I close this meeting.