A presentation on Birmingham's ambition to become a Fast Track City for HIV prevention and go further to include prevention of Hepatitis B and C into the approach in partnership with NHS and the voluntary and community sector. The presentation was part of the England HIV Commission visit to Birmingham

1. Birmingham: a Fast-Track City
HIV Commission Evidence Hearing
21st February 2019
Dr Justin Varney
Director of Public Health

2. What is the Fast-Track Cities initiative?
 Global initiative - partnership between cities and four core
partners:
• The International Association of Providers of AIDS Care (IAPAC)
• The Joint United Nations Programme on HIV/AIDS (UNAIDS)
• The United Nations Human Settlements Programme (UN-Habitat)
• The City of Paris
PAGE 2

3. What is the Fast-Track Cities initiative?
 Commitment to attain the UNAIDS 90-90-90 targets:
• 90% of all people living with HIV will know their HIV status (awareness
and diagnosis)
• 90% of all people with diagnosed HIV infection will receive sustained
antiretroviral therapy (ART) (treatment)
• 90% of all HIV-diagnosed people receiving sustained ART will achieve
viral suppression (prevent transmission)
• Zero stigma is the fourth, but no less important, target
PAGE 3

4. What is the Fast-Track Cities initiative?
 More than 300 cities worldwide
 England:
• Brighton
• Bristol
• Liverpool
• London
• Manchester
• And Birmingham in 2020…
PAGE 4

5. What is the Fast-Track Cities initiative?
 Paris Declaration:
• End AIDS as a public health threat in cities by 2030 – includes AIDS-
related deaths from TB and viral hepatitis
• Put people at the centre of everything we do – special focus on vulnerable
and marginalised; leave no one behind; work in partnership with
communities
• Address the causes of risk, vulnerability and transmission – work with
communities of marginalised and vulnerable populations
• Use our AIDS response for positive social transformation – build equitable,
inclusive, responsive, resilient and sustainable societies
• Build and accelerate an appropriate response to local needs – services
will be innovative, accessible, equitable and communities will be included
• Mobilise resources for integrated public health and development –
mobilise additional resources and strategies to achieve the 2030 ambition
• Unite as leaders – develop an implementation plan and join an
international network
PAGE 5

6. What is the Fast-Track Cities initiative?
PAGE 6

7. What is the Fast-Track City initiative?
PAGE 7

8. INITIAL THINKING ON BIRMINGHAM AS A
FAST TRACK CITY

9. PAGE 9

10. Our Ambition As A City
PAGE 10
Birmingham – a city of growth where
every child, citizen and place matters
• Birmingham is an entrepreneurial city to learn,
work and invest in
• Birmingham is an aspirational city to grow up in
• Birmingham is a fulfilling city to age well in
• Birmingham is a great city to live in
• Birmingham residents gain the maximum benefit
from hosting the Commonwealth Games
• Birmingham as a green city

11. Why now?
 The UK Government has committed to the elimination of HIV transmission
by 2030
 We are already doing well in Birmingham but there’s more that can be
done
 We want to improve health and wellbeing for everyone in Birmingham,
especially those in challenging circumstances
 Joins up the Hep B vaccination programme, the Hep C Elimination
programme, HIV programmes
 Lots of good work but not a joined up system-wide approach
 We want to do it!
PAGE 11

12. Birmingham’s Ambition
 HIV 90-90-90-0 targets
• Confirm
• Maintain
• Go further
 And targets for:
• Hepatitis B
• Hepatitis C
PAGE 12
+

13. Birmingham – the story so far…
 September 2019
• Gained Political support for Fast-Track Cities+ ambition
 November 2019
• Workshop of some key stakeholders to explore support and ideas
 November 2019 – February 2020
• Ongoing discussions with University Hospitals Birmingham NHS Trust
(HIV teams, BBV teams, Umbrella Sexual Health service), Public Health
England and Gilead
• Heartlands HIV team (UHB) started process for Trust-level support
• Development and delivery of HIV awareness sessions to wide range of
Council and third-sector teams to reduce stigma
PAGE 13

14. Birmingham – what’s next?
 February 2020
• HIV Commission Evidence Hearing
 February 2020 – November 2020
• Further work with all stakeholders across the city to develop plans, gain
senior support and produce a Fast-Track City+ strategy (test, treat,
prevent, educate)
• Develop and define the Hepatitis B & C targets and indicators
• Strengthen local partnerships including business sector
• Map, identify and include missing stakeholders
 December 1st 2020
• Launch of Birmingham signing up to the Fast-Track City Initiative
PAGE 14

15. What are we already doing?
 Routine opt-out antenatal testing that has almost
eliminated vertical transmission
 Opt-out testing for all BBVs in the substance misuse,
sexual health, BBV and TB services
 Developing targeted outreach to engage testing
 100% at-risk neonatal Hep B vaccination
 Hep C Elimination programme is operating in
Birmingham
• Community pharmacy Hep C testing
• UHB testing bus in city centre
PAGE 15

16. Fast Track in the
wider context
Creating a
Mentally
Healthy City
Creating a City
Without
Inequality
Living Wage
City
Homeless
Prevention
Strategy
New Drug &
Alcohol
Strategy for
Birmingham
Fast Track
Cities
Umbrella
Sexual &
Reproductive
Health
Services
NHS Long
term plan &
Service
transformation
PAGE 16

17. Next Steps
 Can you, your team or your organisation help
us to achieve our Fast-Track City ambitions?
 Can you help us test, treat and educate more
people?
 Can you help us eliminate transmission?
Contact us:
 publichealth@birmingham.gov.uk
 @healthybrum
PAGE 17