(EXPLOSION BLASTS) JOHN HURT: There is now a danger that has become a threat to us all. It is a deadly disease, and there is no known cure. It was just 30 years ago that the biggest public health campaign in British history shocked us all into accepting a new epidemic. Everyone was petrified. And... a lot of people that I knew died very, very quickly. And a lot of people I knew died in the '80s. I mean, it was one after the other. But whilst it's easy to think that AIDS is a thing of the past, here in the UK, the number of people with the virus which actually causes it is still rising. My name is Chris van Tulleken. These days, I spend most of my time in this lab at University College in London, and I study HIV, a virus that's infected 70 million people and killed 35 million of them. The good news ` the NHS in England and Wales have just announced trials for a new drug that can prevent HIV, and in Scotland, it's available now. The bad news ` there is still no cure. So I'm getting out of the lab to meet people living with HIV. He'd sort of spent the weekend in bed with what I thought was man flu. And then it was three days later that he died. And I'll be questioning the scientists fighting the virus. Will we cure it? We're gonna try, you know. And there's a real possibility. There are billions of pounds of research money being invested in labs like this all around the world. We now have powerful antiretroviral drugs that mean HIV doesn't have to be a death sentence. And PrEP, the new drug combination that's been all over the headlines recently, can prevent you catching it in the first place. But the battle is not over yet. I'll travel to the front line of the AIDS epidemic... She has lost six children? Yeah. Yes. OK. ...to discover how science is racing to stop over a million deaths a year. We were able to, in our trial, diagnose 92%... Really? ...of those individuals who are infected. And I'll meet those dedicated to beating this disease. We have a responsibility, all of us, to destigmatise, to normalise the testing and encourage more and more people to get tested so that every six months or every year, whatever it be, you go and get tested for HIV, just like you do everything else. Copyright Able 2017 (REFLECTIVE MUSIC) Despite what many of us might think, HIV is still a problem in this country. There are over 6000 new infections every year. And the risks are now being taught to a whole new generation. When you think about HIV, right now, what pops into your head? What do you think about? Dirty things, really,... Is it frightening? ...in the nicest possible way. In a way, yeah. I've heard some stuff that the government, like, made AIDS. Write it down ` government conspiracy. And then obviously, it spread through needles. Drugs. Drugs. People who are gay, they get blamed for the spread of it. It's of Freddie Mercury, because he died of HIV. I've come to William Farr School in Lincolnshire and a special class on a unique virus. So, we're gonna talk about how that virus actually gets passed on. So which bodily fluids are we talking about? Like, blood. Yep. Infected blood. Anything else? Semen. Semen, yeah. Any other body fluids that you guys know of? It's OK. So, we've got vaginal fluids and rectal secretions. But you know what? We're talking about them here today. Do you think you could spot somebody with HIV? No? No? So would you have any idea that I have HIV? STUDENTS MUMBLE: No. No? OK. So, I'm HIV positive. I was diagnosed over 10 years ago. You've all spent this time with me and couldn't tell. And actually, anyone else you meet, you may not be able to tell. Go on. Thank you. 'Lizzie Jordan now works to educate young people about the virus.' Yeah, I'd love a cup. 'She found out she was HIV-positive after her partner Benji suddenly fell ill.' He went to work on a Friday, came home complaining of what he thought was a sinus infection. He'd sort of spent the weekend in bed with what I thought was man flu. And, you know, (SPEAKS INDISTINCTLY) it'll be fine. (CHUCKLES) And then, so, it was three days later that he died. 'Doctors broke the news that Benji had died from an AIDS-related illness without ever even knowing he was HIV-positive. I mean, that was probably six weeks before. Seeing those pictures, even I find that amazing. 'No one knows when or how Benji contracted the disease, 'but people can live for 10 years or more without any symptoms at all.' Is it hard to watch that? It's bittersweet, because that's the last bit of footage we have of him. Um... Yeah. Oh. Yeah. Mm. (SNIFFS) You must've been in... total shock. It just didn't make sense... how you can be so fit and well... and then die. You know, literally die and drop dead. But HIV ` it never popped into your head. You never thought...? Not once. And it wasn't even on my radar. It wasn't even something I considered. 'When Lizzie discovered she was also HIV-positive, her next thought was ` 'Had she unknowingly passed the virus to their baby?' Jay by then was 18 months old and had been breastfed for 18 months, natural delivery ` all the things that I knew a HIV-positive mother wouldn't do. 'Despite a one in four chance of infecting her child, they were lucky; the test came back negative.' I mean, the only reason your story is listenable to is cos you're standing here, kind of, fit and well and looking amazing. But that fires me up even more to make people get tested. You know? You cannot tell. Yeah. Lizzie is one of over 100,000 people in the UK living with HIV. And it's estimated around 18,000 of those are undiagnosed, because for many years after infection, there's often no outward signs that anything is wrong. It's what helps the virus to silently spread. OK, so, a quick lesson ` a quick biology lesson. 'HIV is a virus, and it specifically infects the cells of your immune system.' So, this is a white blood cell. And on the surface, these little things that almost look like pollen, those are HIV particles. 'Like all viruses, in order to survive, HIV needs to get inside the cell. 'But then it does a very special thing.' And it unstitches your DNA, and it inserts its DNA into the gap. The virus literally becomes a part of you. And that is why it's so hard to cure it. You can live for years, even decades, without any symptoms at all. But all that time, the virus is replicating in your cells so that your immune system will reach a point where you can no longer defend yourself against really minor infections. And that's when you develop the syndrome of AIDS ` Acquired Immune Deficiency Syndrome. The virus is HIV; the disease, in the final stages, is AIDS. 1 These days, I worry we've become complacent, even ignorant, of the risks. So I want to find out how many of us have even taken a test. Have you ever had an HIV test? I haven't, no. Why? Um, just because I've never felt the need to do it, really. And actually, I'm pretty, um` I'm not that` What's the word? I don't get involved with that many people ` partners and that kind of thing. If you have a new partner, do you always insist on an HIV test? Um, I insist on a full test. A full test? OK, so the whole lot. I'm a bit paranoid. (CHUCKLES) Have you been tested? I have been tested. Um... OK. My` Hopefully my mum doesn't watch this. (LAUGHS) Your mum will be so happy to know that her daughter is being responsible and having HIV tests. Yeah. I mean, I think you can't be complacent. Have you ever had an HIV test? No. Why? Uh, I have always had protected sex. Always? OK, wow. Always, yeah, as a general rule. (CHUCKLES) As a general rule. You may be the only man on the planet who's always done it. Actually, I tell a` (CHUCKLES) You're gonna keep getting tested regularly? Yeah. OK. Like, even if... sometimes even if I haven't had sex with anyone, I'll go and get tested anyway. Do you think you'll go and have one now? Um... You know what? I think that there's such a stigma around it that the thought of going into a doctor and asking for one would actually be, like, quite embarrassing, personally. Really? Yeah. I would find it really uncomfortable doing that. But not all British men feel this way. In July 2016, Prince Harry took an HIV test in the full glare of the media. The result was negative, but the effect ` a positive example for the whole world to see. Was that your first HIV test that you'd ever had? It was my first HIV test. First ever, in your 30s? Yeah, in my 30s. You know, this is something that, from a guy's point of view, is... It's nerve-wracking. I think it's nerve-wracking regardless of who you are or what you've been up to. And then all the media are standing on the other side of this mirror, and I know exactly what they're thinking, like, as I'm sure you know as well. And they're thinking, 'Ooh, imagine if? What if? What if?' And I'm sitting there going, 'Jeez, what if?' Yes, I could've done it in private ` what's the point in that? I mean, for everybody else, go and get it done in private. I don't suggest everyone else does it live, but it's the responsible thing to do, from my point of view, to get the message out there. What are the things that stop us all getting tested regularly? It's the fear, isn't it? It's the stigma. The word 'AIDS'... I mean, just when you say that, it just gives me goosebumps. And I think there's so much stigma simply around a name. When the AIDS came along, everyone was petrified. And... a lot of people that I knew died very, very quickly, and a lot of people I knew died in the '80s. I mean, it was one after the other. And everyone was so frightened. You know, when you went for your annual blood test or you had a cold or you had anything, you thought, 'Have I got HIV? Have I got AIDS?' I was delivering meals to people who were so ashamed, they wouldn't come out their front door. They'd` We'd put the meal on the doorstep, and then you'd walk down the garden path, and you'd hear the door open and slam very quickly... because they were so ashamed to be seen. Meanwhile, Prime Minister Margaret Thatcher's government struggled to share what emerging information they had. (KNOCKS) Hi. Hello. Hi. How do you do? Nice to see you. I'm Chris van Tulleken. 'Norman, now Lord Fowler, was the secretary of state for health 'when the AIDS crisis erupted in the 1980s.' So there was nothing we could do. Someone who'd got HIV ` there was literally nothing one could do. We had absolutely no drugs to treat people with, and therefore, the only thing that you could do, basically, was public education. Warn people ` frankly, as directly as you could ` about the dangers. (EXPLOSION BLASTS) JOHN HURT: There is now a danger that has become a threat to us all. It is a deadly disease, and there is no known cure. Anyone can get it, man or woman. So don't die of ignorance. Wow. The thing that strikes me is they're very frightening ads, and the music is terrifying. Do you think that that was really effective? Yes, I think it was effective. You know, we were in a crisis. It grabbed your attention. And although, you know, you can talk about Hollywood horror and all the rest, it was hard-hitting, and you needed people to watch it. This was the leaflet. We were quite explicit. READS: 'How do you become infected? Because the virus can be present in semen and vaginal fluid, 'this means, for most people, the only real danger comes from 'having sexual intercourse with an infected person. 'This means vaginal or anal sex. It could also be that oral sex can be risky, 'particularly if semen is taken into the mouth.' So, you know, we were going on in this... in this way. I mean, this is strong stuff for a` for a Tory government in the 1980s, isn't it? I obviously had reasonably well publicised battles with the prime minister. March 1986 ` the prime minister, Margaret Thatcher, came back and said,... (READS) 'Do we have to have the section on risky sex? 'I should have thought it could do immense harm if young teenagers were to read it.' Unless you explained to people exactly what it was all about, then there was absolutely no point in doing it. What else were we gonna say? At the time, Caroline Bradbeer was a junior doctor at St Thomas' Hospital in London, trying to cope as best she could. We didn't really know what was happening. We did know that, statistically, at that stage, once somebody had developed AIDS, the average survival was less than two years. I think it was about 18 months. There was nothing, really, we could do. And I felt so... helpless, really. Sometimes, when they died, you were glad for them. The virus was a complete mystery to doctors, and scientists didn't have a clue where it had come from. But as we've learned more about HIV, researchers have been able to trace the epidemic all the way back to its very beginning. I've come to meet my friend and colleague Dr Stephane Hue, who uses genetic analysis to track the spread of the virus. Here, you can see, let's say, a family tree of the HIV strains that are circulating across the world. This family tree goes down to a single point here, to a single ancestor. Right? So` Hold on. So to a single... person, the first person who was infected with HIV? That's right. So, we believe that this jump has occurred between 1910, 1930 ` quite a lot before the virus was first identified. So the virus that has infected 60 million people and killed half of them came from one person? Yes. So naturally, we want to know not who that person was, right, but we want to know ` where did that virus come from? We realised very early on that this virus belongs to a family of viruses that mainly infects primates, OK? So, there's been a long` Monkeys and apes. Exactly. Monkeys and apes. And it turns out... we inherited HIV from chimpanzees. So in other words, in the world, the virus that's the most closely related to HIV is SIVcpz, which is a virus that infects chimpanzees. The question I get asked is, 'Did someone have sex with a chimpanzee?' If you've seen wild chimpanzees in their habitat, right, their aggressivity, their teeth, right, their strength, realistically, no, that's not what's happened. 'It's believed the virus made the jump to humans in central Africa, 'where chimps are sometimes butchered for their meat.' You know that I have lived in this part of the world, and so I've brought some photographs. And this is a man... butchering... OK. ...a small monkey. But I think you get a very good idea that this is not an environment where it's possible to avoid contact with the monkey blood. Exactly. And we think this is how the virus was introduced into the human population. For more than 50 years, the virus had such a small impact, it wasn't noticed. But by the early 1980s, the world was facing a new and deadly disease. Without any effective drugs to treat it, doctors like Caroline Bradbeer were delivering what amounted to a death sentence to an increasing number of patients. One of those was Gerry Paterson, who's managed to survive against extraordinary odds. Oh my gosh. (VOICE CRACKS) This is an absolute delight. Come round here. Sorry, I'm a bit welled up. Oh, sweetie! They haven't seen each other for years, but the memories are still vivid. It really is. You look wonderful. So do you. Well, I was ushered straight into a cubicle. The curtain went back, and in you walked. And you'd got the result back, and it was an HIV-positive result. And you... I was being admitted. I knew I could talk to you... A spade's a spade. I said, 'Give it how it is.' You said two years. And here we are 28 years later, and we're having afternoon tea! It's wonderful, isn't it? I mean, it's just such an incredible thing. I'm so glad you came through it. (CHUCKLES) Gosh. Golly. So young. How old were you? 28. For young men like Gerry, the symptoms were devastating. The immune system was just crashing. The Kaposi sarcoma, which was a form of cancer on the skin, would be these lesions appearing. The banes of my existence were warts on my fingers,... Mm. ...molluscum. Yes, which, of course, makes` looks horrible, because it looks like awful acne. And of course, the gauntness was the other thing, the atrophy in the face. They shrunk down to a level where you think, 'Why are they still alive?' But by the late 1990s, everything was about to change. Scientists had discovered the first effective treatments against HIV, and Gerry had held on long enough to become one of the first to try them. It was amazing when we suddenly had treatments that worked. Mm. It took a while... to believe it. It took a while to persuade both the clinicians and the patients to take the medication, because we'd had so many false starts, and there was always the worry that the side effects would be worse than the benefits. But once it became clear that people could get better, you saw the most amazing things. I had the warts. I had the molluscum. And within weeks, I looked at my hand; the warts had gone. He is very lucky, but it would've been even better if he hadn't been infected in the first place. Nowadays, if people are taking their medication properly, actually, the consultation goes along the lines of, 'Where are you going on your holidays?' It's a bit like going to the hairdresser. It really is... just carrying on giving the same prescription, which is incredible. So 30 years later, we now have drugs that can keep HIV under control. But there's still a long way to go. 1 Whilst a diagnosis of HIV is not a death sentence in Britain any more, thousands of us don't know we carry the virus. You know, I spoke to people in my lab about whether or not they would have regular tests, since we all handle live virus. And they all said no. None of them have regular HIV tests. So why is that? Is it because they're too afraid to have a test? They don't want the information. Or is it because they're not afraid enough? It's been several years since my last test, and to be honest, I've left it longer than I should've. But these days, testing can be as simple as ordering a do-it-yourself kit over the internet. I think everyone should HIV-test, because there's almost no one for whom the risk is zero. For me, it's much more than zero. You know, I've had more than one sexual partner. I've had unprotected sex previously. And I work in an HIV lab, mainly. I handle enormous quantities of live virus ` so fluid that is... hundreds or thousands of times more concentrated virus than you'd ever find in the sickest patient's body. Yeah, I'd be lying if I said I didn't have some butterflies about this. Your how-to test guide. (CLEARS THROAT) So there's a 'if your result is positive' ` the basics. If I test positive, I think I am... I'm not comfortable, but I think I am OK with saying... I have HIV. Or at least... I think I would be such a hypocrite if I didn't that I wouldn't be able to live with myself. So, you need to remove the buffer pot. (CLICK!) READS: Push test device hard into the buffer pot. So, it's like a pregnancy test. If you get two lines, you're positive. OK, just gonna get a cup of tea. 'As I wait, I'm running through all the ways I might have caught HIV. 'I've been careless in the lab. My wife's recently become positive and hasn't told me.' This is a weird situation, and I think that the legacy of the public health campaign is it turns me about HIV, and I think many people` - (ALARM RINGS) - Ooh. There we go. It turns... - (ALARM RINGS, STOPS) ...people of my generation into HIV hypochondriacs. OK, so that is a negative result. (EXHALES SOFTLY) Gosh, I feel a real` Honestly, my heart is really, uh, pounding. Oh. That is a load off, though. The unequivocal truth is it is better to know. It's better to know if you're negative, and it's better to know if you're positive. And it's better to understand if you are negative that you may not always be negative, that the next time you have unprotected sex warrants another HIV test. (CONTEMPLATIVE MUSIC) So what's it like nowadays for the 6000 people who test positive in the UK each year? Michael. Hi. How you doing? Chris. Really nice to meet you. 'I've come to Glasgow, where 31-year-old Michael is coming to terms with his recent news.' 4th of July, it was. I'd been on a` So, 4th of July, so two months ago. Two months ago, yep, really recent. Was on a dating app. Now, when you're on it, you always get messages popping up, saying to you, 'HIV test? STI test?' And things like that. And I thought, 'HIV test. I'll get it done ` take it off my list.' Nothing to worry about. And I was actually quite blase with it, assuming it was gonna be negative. Went in, and the gentleman that was passing me my results says to me, 'We've got your results back, and they are HIV-positive.' Um... Yeah, it's probably the worst` worst words that you can hear getting told to you. Um... I just went numb. Completely numb. I had no thought. I had no feeling. (SIGHS) There was nothing. Pure blankness. As far as I was concerned, that was my death certificate written for me. Really? As much as I knew. You get HIV; it develops into AIDS. And unfortunately, there's no cure. Obviously, cos I was crying, trying to take it in, he told me this does not mean that I'm gonna die. 'You won't develop any AIDS, because it doesn't happen any more.' Worst-case scenario ` what'll happen is I'll be on two meds a day, two tablets that I'll need to take for the rest of my life. There are very few miracle drugs in modern medicine, but this really is` I would describe it as a miracle drug. We always say, 'This isn't a cure. You're not cured. You still have HIV.' So if you ever stop taking these, you understand that the virus will come back. Bounce back. But the astounding thing to me is still that if you do keep taking these every day at the same time, that your life expectancy is essentially unaffected. Perfect. Have you missed a day? Nope. Not a single one? Not a single one. Antiretroviral drugs, or ARVs, block the enzymes that HIV uses to infect immune cells. This stops the virus multiplying any further and brings HIV levels in the blood down to almost zero ` as long as you keep taking the pills. Today, two months after starting treatment, Michael is going to find out how much virus is still present in his body ` what doctors call his 'viral load'. Thank you. We'll look at some of your results. It's been a few weeks now since you started treatment for HIV. Tell me how that's gone for you. Really well, actually. That's good to hear. As you are aware, I was really concerned about side effects. Mm-hm. None. Absolutely none. Well, what else would you want to know about this? My viral load. The viral load. I thought you'd be coming in for that. That is a key one that I want to know. So, I've seen people whose viral loads are more than a million copies. And that numbers the amount of virus that you have in every millilitre of your blood. So, this value was just reported a few weeks ago, and this value is 'not detected'. Physically, we've switched off the virus making new copies of itself, and now there's no copies in your blood at all. I want a copy of that. I want that in black and white. We'll print that off for you. I can get that framed. And I'm amazed that it can happen so quick. How do I ensure that always stays non-detectable? So, the virus is not cured. Yep, yep. There are copies of the virus in your body, but they're all completely suppressed. And the reason of that is that you're taking your tablets. And just to clarify as well ` that's... I am not infectious? There's no way, even with unprotected sex ` if that happens ` that I can infect somebody? So if you're able to take your tablets, a pill every day, you'd have almost no risk of passing on HIV to anyone else. I can just get on with my normal life without actually having to think about HIV. And I've got my life back. And it's great. (CHUCKLES) Michael is one of the lucky ones. But the trouble is you have to be diagnosed before you can benefit from the amazing treatment we now have. Nearly one in five people who have the virus don't know they're infected. And one of them was 43-year-old Adi. We have to preheat the oven to 160 degrees centigrade. Perfect. This one's new to you, isn't it? New to me as well. She had no idea she had HIV until a brain infection caused by her depleted immune system left her struggling to walk and talk. Brain infections are common in patients where HIV has gone undiagnosed for many years. Hi. I'm here to see Adi. 'I've come to the Mildmay Hospital in East London, 'where they specialise in rehabilitating patients like Adi.' Hi, Adi. I'm Chris. (SPEAKS INDISTINCTLY) Chris. How are you? Nice to meet you. Very very nice to meet you, Adi. Nice to meet you. Can I join in, Adi? Yeah, yeah, yeah. Is that all right? Yeah, yeah. We've done our warm-up now, Adi, so we might come across to the parallel bars. Oh, we're gonna walk over there, are we? Adi is now on ARVs, and her HIV is under control. But the damage to her brain may never be fully reversed. You can't just feel them? Yeah, no, no. And it's worth saying ` it's very obvious ` simply standing here, I can feel your muscles flexing, and you're sweating to do this, aren't you? Just standing here is quite hard work. Is that true? (GIGGLES) I shouldn't say sweating. You're glowing. You're perspiring gently. So, Adi's been coming... started in January 2015. And when you came in January, how good were you at the parallel bars? Ah, very bad. Very bad. Very bad. Nice and slowly, one hand at a time. It's very interesting for me as a doctor to try and work out where the problem is. STAMMERS: Do you` Wh` What's happened here? I guess it's quite similar to if someone's had a stroke, whereby there's been some damage to the brain, and it's affecting, I guess, her` her ability to contract her muscles, with her strength and her coordination, which leads to these problems with her balance, difficulty standing, and also with your coordination in terms of your speech as well. It seems to me that you're working very hard to make the words with your mouth and tongue. Yeah, yeah. That is` And that` Is that a thing you've had to relearn to do? Yeah, yeah, yeah. Adi, are you always this cheerful? (LAUGHS) Has that always just been your nature? We're gonna come and have a sit down. Do you wanna go and have a seat? Yeah, yeah, yeah. I'm conscious you are really working away here. Yeah, I bet you're getting tired. What was Adi's prognosis when she came here? It was very bad. She had just been given about three months to live. So she had virtually no functioning immune system? No, she didn't. So you were in a bad way. Mm-hm. And you were given three months to live. It's remarkable, I think, to work with someone like you, Adi, where you've had this very severe brain damage, really ` let's call it what it is ` but at your age, the brain is sufficiently plastic that you can retrain it and gain a lot of function. Exactly. Exactly. And there has been quite remarkable improvements. (ALL SING 'AMAZING GRACE') 'Singing therapy is now helping Adi to rebuild her power of speech. 'And the Mildmay has been at the forefront of treating HIV and AIDS for the last 30 years, 'ever since Princess Diana famously challenged the attitudes of the time by shaking hands with patients here. 'And her legacy continues to this day.' (CHUCKLES) Adi, I think you've got a visitor. Who? Prince Harry! (LAUGHS) (CHUCKLES) Prince Harry! Hello. Stay, stay, stay. How are you? (CHUCKLES) I'm fine. Nice to see you again. Nice to see you too. I heard you singing outside. LAUGHS: Yes, yes. Amazing. Literally ` Amazing Grace, wasn't it? It was. Hello. 'Prince Harry has met Adi before, and she has made real progress.' Understandably, there's huge frustrations for you because of your speech. People... People... Yeah. Thank you, Prince. We'll see you. Thank you. 'Adi's story proves that when it comes to HIV, an early diagnosis is crucial. 'And the only way to be sure of that is regular testing.' Key point of this is how easy it was, and how easy it was for you as well. You had a home testing kit; I went in. And the only reason I did it live is because I wanted to show to everybody how easy it is and how normal it is. Imagine if we could create a movement where everybody goes` everyone goes and gets tested. You know, if you're not gonna get tested for yourself and you're not gonna go and get tested for your loved ones that you could possibly infect, then ` I don't know whether it's a selfish thing to say or not ` but if you respect what my mother stood for, go and get tested for her. You know, you got 20 years next year since she died, and 30 years ago, she was in this hospital, and she did something that no one else had ever done before. And she started this whole thing. Is that partly what's inspiring you to do this? Yes. You know, if she were still here today, she` cos she'd probably get tested every month, just to prove the point. There's so much stigma simply around a name or an acronym, that we need` we need... we need... You know, it's 2016, for God's sake. I mean, we need to start rethinking the whole... Acquired` What is it? Acquired Immune Deficiency Syndrome. When you actually lay it out and you spell it out, suddenly you go, 'It's not actually that terrifying at all.' Obviously, if you speak to someone who's suffering from it, of course it's terrifying, cos it can kill you. But the point I'm trying to make is if you can't even say the word without cringing or worrying or freaking out about it, how the hell are we gonna help everybody and solve this problem before it gets too big? I think most people would admit that they've had sex without a condom, and that is always a moment that` the next day, probably, when you think to yourself, 'You know what? Christ, I probably need to go and get a check-up.' Why did you want to take this on as a cause? The issue itself needs... a straight guy, mid-30s ` early 30s ` (CHUCKLES) ...to come in and... and try and normalise it. You know, once again, I'm fortunate enough to be in this position, to be able to make a difference. Let's start in the UK. Let's lead by example and then help everybody else. In Britain, we've come a long way in the last 30 years. But huge challenges still remain. I'm off to a part of the world where the worst-case scenario that doctors feared for the UK has now become a catastrophe of unimaginable proportions. 1 (SOFT CONTEMPLATIVE MUSIC) I've come to South Africa, the worst-affected country in the world, where nearly 200,000 people still die every year. So, South Africa is an example of what happens when you don't have a really effective public health campaign in the early stages of an HIV epidemic. So, in the UK, we did; in South Africa, they didn't. And so today, there are seven million people living here with HIV. It has one of the highest infection rates in the world. This is the front line of the war against the virus. In a bid to end the epidemic, the UN has now set an ambitious global target. They're calling it 90-90-90. Diagnosis of 90% of people with HIV; getting 90% of those on to medication; and suppressing the virus in 90% of those. (INTRIGUING MUSIC) The latest scientific models show that if the 90-90-90 goal is achieved, it could end the epidemic in 10 years. So I'm heading to a clinic in KwaZulu-Natal, the hardest-hit province in South Africa, to see how they're trying to reach that target. 'As I arrive, I take the opportunity to speak with some locals 'who are selling fruit outside the clinic.' How are you guys? Do you mind talking to me? We're making a programme about HIV, and I wanted to know what` what you all thought about it. (CHUCKLES) Oh! (WOMEN SPEAK ZULU ENTHUSIASTICALLY) (WOMEN SPEAK JOKINGLY, LAUGHTER) My Zulu is a bit rusty, I'm afraid. (SPEAKS ZULU) MALE TRANSLATOR: The lady, she's saying, basically, all the kids have passed away because of HIV. I hadn't understood how serious it was. (SPEAKS ZULU) She has lost six children? Yeah. Yes. I'm very sorry. I'm very sorry. Thank you. Is it a thing that young people understand? (WOMEN SPEAK ZULU) - You get these from the clinic? - (WOMAN SPEAKS ZULU) Nothing can prepare you for hearing stories like these. 'But at the Macabuzela clinic, this is what they're dealing with every single day.' (WOMAN SINGS A CAPPELLA) 'Which is why it's all the more amazing that they begin each morning with such an uplifting song.' (WOMEN SING ENTHUSIASTICALLY IN ZULU, IN HARMONY) (SINGING CONTINUES) The clinic covers an area of 13,000 people, roughly the same as a busy GP practice in the UK. (A CAPPELLA SINGING CONTINUES) And many of the common conditions they treat are the same. High blood pressure, diabetes, mental health, epilepsy, diarrhoea,... asthma. 'But strikingly, at the top of the list is the term "people living with HIV and AIDS". 'I really want to understand why HIV is so widespread in this part of the world. 'The first patient is a teenager. Diagnosed HIV-positive just two months ago, 'she prefers to stay anonymous.' What was it like to find out you were positive? (SPEAKS ZULU) You told your mum? You told your brother. OK, so not your mum` So only one person knows? Do you know the person that you think you caught it off? Did you tell him? No. Why? (CHUCKLES) He's 25 years older than you? Mm. He's in his mid-40s. OK. When you had sex, were you worried about HIV? Did you say, 'We should use a condom'? And because she was in love with him, just allowed him to do unprotected sex. OK. Yeah. They just dated for a week. He just slept with her, then dump her. OK. Gosh. 10 Rand, or any money. The girl collects her prescription ` the same antiretroviral drugs as in the UK ` and heads to school. It's a desperate story ` but not unusual. Teenage girls in this part of South Africa have an 80% chance of becoming HIV-positive during their lifetime. How does this make you feel? Cos you're a young woman. Does this make you mistrust men? So often, by then, it's too late? It's too late most of the time. It's not a shortage of drugs that's killing people here. South Africa now has the biggest antiretroviral treatment programme anywhere in the world. (WOMEN SPEAK INDISTINCTLY) 'For a doctor like me, it's baffling there are still nearly 200,000 AIDS-related deaths here 'every year.' I think they have come to regard this as completely normal. There's the market. In that room, in that portacabin, are all the drugs to completely... end transmission and mean that no one, almost no one has to die. That's the thing I don't feel I've in any way really got under the skin of is ` what are all the complicated factors that mean that people don't go and seek treatment? (LIGHT PERCUSSION MUSIC) 'On the way back to my hotel, I decide to drop in at a local bar.' (CALLS OUT) 'As a bloke, I want to hear what some of the men have to say.' WOMAN: Hey! Can I get a beer, a bottle of beer? How are you, sir? Yeah, fine, man. What's your name? Zoltani. Zoltani? Yes. We've discovered, out... out in the clinics, that the young men don't wanna get testing, and they don't wanna get treated, and I'm trying to understand why. (CHUCKLES) Why haven't you had an HIV test in three years? Do you have`? You have a girlfriend now? Yeah, I have three. You got three girlfriends? In KwaZulu-Natal, 30% of people have HIV. So there is a good chance that one of your three girlfriends will have HIV. You should go and get tested. Go do it tomorrow. Go and get tested. My own time. 'But going to the clinic can be fraught with embarrassment and fear for these men.' When you go and you test positive at a clinic, people will know? It's so important for you to have some confidentiality. If I knew ` when I went and had an HIV test and then every month when I had to go and get my pills to be treated ` everyone would know, you know what? Honestly, I might not get tested. I hope I would, but I can't say, hand on my heart, that that wouldn't push me away from the clinic. (LIVELY PERCUSSIVE MUSIC) So, if the men won't come to the clinic, a pioneering scientific trial is taking the clinic to the men in a bid to diagnose 90% of people who have HIV. For the past four years, testing teams have been visiting every home in an area of 22,000 people. No one is singled out, and people can avoid the stigma of their neighbours knowing. (LIGHT DRUM MUSIC) How are you, my friend? 'Temba, a 60-year-old widower, 'was one of those who tested positive when field workers visited his home in 2014.' Can we see? WOMAN: Yes, you can come in. Can I sit on the bed? (BED CREAKS) Do you like taking the pills? (SPEAKS ZULU) One pill at 7 o'clock every day. Yeah. Do you know your viral level? Can we see the paper? First viral load was 18,000. And then as soon as he started taking the drugs ` so then, what, August to November ` LDL, which is lower than detectable limit. Undetectable, undetectable, undetectable, undetectable. So the pills are working very well. Do you think you will ever have a girlfriend or a wife in the future? (WOMAN TRANSLATES) (SPEAKS ZULU) He's thinking about it. This treatment, it helps you live a long time, but it also stops you pass` passing the virus on. So that's the key thing. There are two benefits. It makes you live, and it stops you giving the virus to anyone else. So as long as your viral level is undetectable, which yours is, you won't give the virus to anyone. (SPEAKS ZULU) Temba is just one small part of a much bigger plan ` to try and end the epidemic within 10 years. But has the trial come anywhere close to reaching the UN's 90-90-90 target? To diagnose 90% of people with HIV, to get 90% of them on to medication and suppress the virus in 90% of them. 'At the Africa Health Research Institute, I'm catching up with Professor Deenan Pillay, 'who wants to show me how well they've done. 'First up ` diagnosis.' We were able to, in our trial, diagnose 92%... Really? ...of those individuals who are infected in this area. We achieved that target. So the next question is ` what proportion of these individuals come to clinics? And unfortunately, what we find is only 47% get into care, and that's too low to get anywhere near to start to reduce the epidemic. So you've managed to get less than half of people with HIV into treatment? Why? It` It's a tremendous success... that we've been able to go into people's homes and convince them to be tested for HIV. But the point of that is that they get on to treatment. Right. I want to understand ` that isn't because of a shortage of drugs or a lack of money. The resources are there, if you can get people to... to use them. Is that right? We` We provided... mobile clinics. We provided the care for their HIV infection with no shortage of drugs or diagnostics and always with sufficient staff. I think defeating this awful HIV epidemic requires an understanding of society as well as individuals as well as medicine. And without an understanding of all of those, we will never defeat it. I think, you know, 20 years ago, no one... I don't think anyone thought we'd get to this point where, basically, we've overcome all those kind of scientific, medical obstacles. We have highly effective treatment that works with very few side effects, and it's cheap, and there's enough of it for everyone out there. At this point, we're butting up against the hardest problem of all that feels so simple ` just persuading human beings to be rational and do the right thing. And... (CHUCKLES) I'm sure we will get there, but that... that, I guess, in any medical challenge, that is the hardest bit. 1 (SOFT GUITAR MUSIC) Back here in the UK, it's easy to assume we're winning the battle against HIV. Sitting here feels so different to KwaZulu-Natal that it is hard to believe that there could be any epidemic... of infection at all. But what can we do about the 6000 new British infections every year? Although condoms have made a huge difference to safer sex, people still don't really like wearing them. And given the choice, I'd rather not wear one either. So what if there was a radical new way to prevent infection? This is Harry Dodd. As a sexually active young gay man, he doesn't want to take any chances. So he's signed up to a clinical trial of a revolutionary new pill called PrEP. It contains two different antiretroviral drugs and can prevent HIV being contracted. OK. Well done. 'And Harry has regular check-ups to make sure it's working.' What is PrEP? PrEP stands for Pre-Exposure Prophylaxis. So it's prevention that you take ahead of being exposed to the risk. Do you mind if I have a look? HARRY: Go ahead. Are the drugs the same as the ones we use to treat HIV? They are, cos they work brilliantly to control the virus, and that's what you're doing, whether you're preventing it or you're treating it. So the advantage of pre-exposure ` if you think there's gonna be an exposure in future ` is that the drug's there ready and waiting. If you take the pill properly ` every day, as instructed ` the chances of contracting HIV are negligible. For Harry, it's removed a lifelong fear of contracting HIV. Growing up knowing you're gay, that fear haunts you from the first time you become sexually active. You have this guilt and fear and worry and concern with almost any sexual partner you have. Even with the condom, there's still the worry of the big... the big one, which is HIV, and PrEP takes that fear and that anxiety away from that experience. OK, Harry. (CHUCKLES) We look for that one spot for negative, two spots for positive. Um... One spot ` negative. Brilliant. How do you feel? Are you relieved that the test is negative? Of course I'm relieved that the result's negative, but I didn't have any anxiety beforehand, because I appreciated that I'd been taking PrEP for three years and that the chances of me contracting HIV are pretty much non-existent. The thing that is amazing to me about this is in this pot is the power to end the epidemic. Yeah. I mean, I completely agree with you. This is the thing we need. Whoo! (CHEERING) (ENERGETIC DRUM MUSIC PLAYS) At last summer's London Pride Festival, Harry took to the streets with hundreds of others to campaign for PrEP to be made available on the NHS. What do we want?! CROWD: PrEP! When do we want it?! Now! What do we want?! PrEP! When do we want it?! Now! Then, in December 2016, the National AIDS Trust won an appeal court ruling that NHS England and local authorities do have the power to fund the provision of antiretroviral drugs for the prevention of HIV. And so a �10 million trial over the next three years was announced in England and then a further one in Wales, whilst NHS Scotland announced that PrEP will be available there this summer to those who need it. Cost is a big factor, and NHS England has challenged drug companies to supply at lower prices. Now 10,000 more people will take part in these clinical trials to answer what NHS England says are 'outstanding questions', paving the way for a full rollout. But not all views on the subject were based on clinical concerns. So, this is an article in the Daily Mail. The headline is, 'NHS told to give out �5000-a-year lifestyle drug to prevent HIV ` 'as vital cataract surgery is rationed. 'What a skewed sense of values.' Calling it a lifestyle drug, I think, totally misunderstands. Almost all the conditions we treat in the NHS could be largely prevented if people lived different lifestyles. We never have a discussion saying, 'We should not give out blood pressure and cholesterol medication 'to people who are overweight and unfit.' And to single out this particular, highly effective pill as being a 'lifestyle drug'... is really poisonous. But whatever our attitudes to sexual health or even sexual morality, the use of PrEP has been all over the headlines recently, and it does raise interesting, difficult questions. I wanted to ask my own boss, Professor Greg Towers, a leading expert on HIV, what he thought. What do you think about the idea that, for a lot of people, PrEP is a lifestyle drug? It allows them to have high-risk sex. Well, it allows them to not get HIV, which is the point. I mean, you know, it's not our business to be focusing on what people do. It's about making a decision based on how to improve the health of people in the UK and how to do that in the most cost-effective way. Those people taking that drug will cost the NHS less if they don't get HIV. There is more money to treat patients if you save money through not having to treat people for their entire lives with very expensive drugs, rather than for a period where they're at risk of getting HIV. Why aren't we rolling it out in England and Wales in the way they have in Scotland? We're doing another trial. We need to work out what drugs we're gonna give. We need to work out who we're gonna give them to. Will everybody take it? Will the right people take it? Will the right people have access to it? You have to have due process. You have to make sure that this is going to be the appropriate thing to do and to work out the appropriate way to do it. So it isn't like we're doing a little trial and we're testing it in a few hundred people. We're actually` It is actually, in practice, gonna be offered to quite a large proportion of the eligible population. Yeah. I don't know how big the eligible population is, but yeah, 10,000 people is a lot of people who won't be at risk. So, why do you think that condoms and 'personal responsibility' aren't enough to stop the spread of HIV? People just don't use them. You know, some people object to using them. They don't wanna use them. So it just doesn't work. We know that now, and I don't think that's a realistic proposition for stopping the spread of HIV. Do you think a cure's on the horizon? A cure for HIV is, unfortunately, I think, a big ask at the moment, because we don't understand enough about the biology of the virus and its relationship with the immune system. A lot of people are working on it; it's certainly a possibility. Will we cure it? We're gonna try. The truth about HIV is that its treatment has been one of the biggest breakthroughs in medical history. But it's a disease that's not going away. In the UK, new infections show no sign of falling, and many people are still diagnosed too late. We have a potential end in sight, but we have to get rid of the stigma. We have to get rid of the hate and the shame. Science has already given us the tools we need to defeat HIV. What a fantastic thing for humanity to be able to say, 'We've cured HIV.' Let's start in the UK. Let's lead by example. We've got some of the most powerful drugs in medicine that mean people can live long, healthy lives with HIV, and crucially, they'll be uninfectious. We even have pills that you can take that prevent you catching the virus in the first place. Pills that are now available on the NHS ` in Scotland, at least. The money you spend on PrEP saves you all that treatment. I mean, it's like` It doesn't make any sense not to put it out there. It's just an economic no-brainer. So, it seems to me that the remaining challenge is about harnessing social and political will to put these scientific breakthroughs to best use, because if we can do that, I believe we can bring the epidemic to an end.