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Competition for survival in the game of AIDS Monopoly

Organisations working in the area of HIV/AIDS are predicting significant reductions in their ability to cater for clients and educate the public.

Their pessimism results from uncertainty over the effects of the decision to no longer ring-fence local authority funding for HIV/AIDS from 1995.

Already the government grant to the Terrence Higgins Trust has been cut and the organisation has had to make sever cutbacks, including the shelving of programmes on prisons and roadshows for AIDS education.

In April Michael Ross, a doctor involved in the treatment of prisoners addicted to drugs, warned of an HIV epidemic in Britain’s prisons.

He said that prisoners were sharing needles, a problem worsened by Health Care Services guidelines which allowed prisoners withdrawing from drugs only a one week supply of methadone.

Dr Ross said that the minimum period for methadone withdrawal was seven weeks and that government policy was leading to needle-sharing which increased the risk of HIV spread.

The Terrence Higgins Trust’s prison programme had included education about the dangers of sharing needles and encouraged alternative approaches in order to reduce HIV risk.

In its annual report the London Lighthouse, a leading HIV/AIDS charity, draws attention to the implications of current NHS changes on the provision of services for people living with HIV. It is concerned that local authorities will increasingly opt the cheapest options available and reduce the number of cases treated.

The Lighthouse points out that, if it is not successful in competing for contracts, ‘the level of statutory income will reduce, which will affect the quantity and/or quality of services that are provided, unless other sources of income are found’.

The Lighthouse report also expresses concern over the effects of closures of London hospitals, which it believes will lead to an increase in early discharges for those with HIV/AIDS.

If so, demand for convalescent and home support care provided by the voluntary sector would increase. In the face of reductions in funding to such organisations, the need for services may well outstrip the capacity to supply them.