That the draft Mutilations (Permitted Procedures) (England) (Amendment) Regulations 2010, which were laid before this House on 8 November, be approved.
The House divided: - Ayes: 304 / Noes: 221 - Question accordingly agreed to.
The Minister of State, Department for International Development (Mr Alan Duncan)
I am grateful to my hon. Friend the Member for Bath (Mr Foster) for raising this topic. Achieving the millennium development goals, including the two vital targets on clean water and improved sanitation, is at the very heart of the coalition’s agenda on international development. I recognise and respect his interest in water and sanitation, and in particular his high regard for WaterAid, which we, too, consider a valued partner in our work.
Speaking personally, I am also convinced of the importance of water, sanitation and hygiene. In Hoa Binh province in Vietnam, I have seen how these simple interventions can make a remarkable difference to people’s health and opportunities. One local woman showed me the new latrine in her garden that had vastly improved her life, and told me that she had pinned up a hygiene advice sheet in her house to educate her whole family. I have also inspected at close quarters some latrines—of variable quality, I have to say—in rural Bangladesh. Indeed, I am proud to say that I am fast becoming something of a ministerial latrine expert. I commend to the House the UNICEF booklet entitled “Low-cost latrine options”, which contains an encyclopaedic list of various designs, including the Blair pit latrine. Known as a VIP latrine, it is a ventilated, improved pit, designed and used, as it happens, in Zimbabwe.
Furthermore, I am proud that the United Kingdom is the first country in the G20 to set out how we will meet our promise to spend 0.7% of our gross national income on aid from 2013. This also places a serious responsibility on us to use the money well, and water, sanitation and hygiene fit squarely within that agenda. Each pound of taxpayers’ money in this area can bring direct, tangible benefits for poor people. As many will know, we are currently reviewing all our bilateral and multilateral aid. I cannot therefore make any detailed announcements on numbers today, but we have a high level of ambition in this area and my right hon. Friend the Secretary of State has already stated in the House that we know we will support tens of millions of people in gaining access to sanitation over the next four years.
Today I can outline seven principles of how we, the British Government, will respond to this global crisis. First, we will ensure excellence in our Department for International Development country office programming. A vital part of our efforts will be through our bilateral programmes. Our current programmes in Bangladesh will affect up to 30 million people by 2011. Our current programmes in Ethiopia, Sierra Leone, the Democratic Republic of the Congo and Nigeria will provide up to 17 million people with access. We will also be making new commitments under the bilateral aid review. We will of course ensure that there are sufficient and qualified staff in DFID country offices to deliver our programmes. There will be close co-ordination with our climate change work, including work on water management, and we will continue to ensure an excellent humanitarian response, dealing with issues of water storage, water supply, health care in emergencies and cholera pandemics.
Secondly, we will link our work on water, sanitation and hygiene especially closely with our work on health. We cannot achieve other key millennium development goal targets in the absence of action on something as fundamental as basic water supply, sanitation and hygiene promotion. Recent articles in the Public Library of Science medical journal, launched last month by the Under-Secretary of State for International Development, my hon. Friend the Member for Eddisbury (Mr O’Brien), conclude that 2.4 million deaths each year could be prevented if people had adequate access to hygiene, sanitation and drinking water. They emphasised, as has my hon. Friend the Member for Bath, that diarrhoea is the biggest killer of children in Africa, with about 4,000 under-5s dying every single day. Yet simply washing hands with soap can reduce the risk of diarrhoeal diseases by 42% to 47%.
This issue was once much closer to home. It was John Snow who, in London in 1854, first traced a cholera outbreak to a contaminated water source in Broad street in Soho. This very institution of Parliament was brought to a standstill in 1858 by the “great stink” of inadequate sanitation. In 1862, Florence Nightingale, through her meticulous statistical analysis, showed that high death rates in the British Army in India were actually due to poor water, sanitation and hygiene. Today, globally, we must follow in the great British tradition of investing strongly in water, sanitation and hygiene to deliver the health gains that we need. Clearly, as diarrhoea is today the main killer of children in Africa, we cannot achieve the MDG on child mortality without that, and the evidence shows it will also play a major role in improved nutritional status, as well as reductions in pneumonia, maternal and neonatal infections and preventable blindness. So we will complement and co-ordinate our direct actions on health, and our sizeable new commitments on malaria, reproductive and maternal health, with substantial and closely linked actions on water, sanitation and hygiene.
Thirdly, we will increase our focus on gender and disability. Currently in the developing world, too much time is wasted, day in and day out, collecting water. That time could be spent in other productive, caring or educational activities. Women lose out most, as they are twice as likely to fetch water and they also face indignity, and often the risk of violence, because of a lack of sanitation facilities. Clean toilets in schools can contribute to keeping girls in school, and that alone is a reason to take action. Standard designs for water and sanitation may be inaccessible for people with disabilities, but simple modifications can solve that. They can reduce stigma and the burden of care, and increase dignity and social integration. So we will support innovation and scaling up of what works, to benefit women, girls and people with disabilities.
I have already alluded to the fourth principle: ensuring cost-effectiveness and value for money. Water, sanitation and hygiene are among the most cost-effective health interventions, according to the World Bank and the World Health Organisation. Hygiene promotion comes out as just $5 per disability-adjusted life year, known as DALY, averted—a measure of the impact of the intervention on reducing sickness and death. Sanitation promotion is also within the top 10 interventions, at $10 per DALY. We will work to ensure that whether we are working through multilateral, non-government or Government partners, we further improve the value for money we are achieving with UK taxpayers’ money.
Fifthly, we will directly empower communities and help them to hold their Governments to account. The community-led sanitation programmes which the UK and others have supported, first in Bangladesh and now spreading rapidly in Asia and Africa, have shown the powerful influence of shared action. Once communities start to work together on ensuring latrines and hand-washing for all, not just the few, experience shows that they go on to work together in addressing other problems. Natural community leaders emerge and they gain confidence to do more.
We have also been supporting citizens to hold their own Governments to account. We fund a global network of southern civil society organisations, the Freshwater Action Network, in south Asia and Africa. Local groups, for example, are carrying out citizen audits to investigate whether there are latrines in schools and presenting the findings to their local Governments. Lessons on what works are being shared via the global network. The network is also taking part in regional intergovernmental conferences, bringing the views of poor people who are demanding water and sanitation directly to the decision makers, and we will continue to support and develop such innovative and empowering approaches.
The sixth principle is that we will build further evidence and test innovative approaches. We will keep building evidence regarding both the cost-effectiveness of our interventions and what really works at scale. The British Government are funding the largest research programme in the world on sanitation and hygiene in the developing countries—the SHARE consortium—bringing together leading researchers and practitioners. We are supporting a major trial in Zimbabwe, examining the link between sanitation and nutrition. Not having latrines and not washing hands can cause intestinal infections and long-term malabsorption of nutrients, and so damage the long-term growth and development of children. This research is potentially vital to achieving global targets on nutrition. We will also investigate how we can use the entrepreneurship of the local private sector for providing and maintaining water supplies. The results from these will not just inform our programming but that of other donors too and, most importantly, the investments and policies of developing countries themselves.
Finally, we will work with others in the sector to ensure a collective response to this global crisis. We know it is possible to achieve results at scale: 1.3 billion people have gained access to sanitation since 1990, but particularly in Africa our collective efforts and resources have still not been enough.
The sanitation MDG target is likely to be missed by 1 billion people, and Africa is off-track for both water and sanitation. The UK is already the largest donor to basic water and sanitation systems in low-income countries. These simple systems reach people in rural and peri-urban areas where there are the lowest levels of coverage, and so are targeted well to the poorest people. Globally however, aid to basic systems has declined from 27% to just 16% of aid in the sector over the last five years, and only 42% of the sector’s aid goes to low-income countries. I am pleased that DFID supports an annual report, known as the GLAAS report and produced by UN-Water and the World Health Organisation, giving a global picture of how aid to water and sanitation is allocated. That will help us to hold each other to account, and assist better targeting in the future.
We must be realistic. We alone cannot solve all the problems. We also need others to play their part in focusing aid resources on the people who need them most, and this is not just about aid. Developing country Governments have the leading role to play in ensuring action on water and sanitation, backing it with their own policies, programmes and resources. In this way, donors can support countries to achieve their own targets in the way that they want.
Sometimes, however, there is not the political will or capacity to develop credible investment plans. We will therefore work closely with all our partners in the sector to solve this global crisis together, including through the UK leadership role in the sanitation and water for all initiative, where we are at the forefront of helping to address some of these wider issues. This global partnership of 31 developing countries, six donor countries, nine multilaterals and development banks and countless southern and northern civil society networks has come together with the common goal of ensuring both results on the ground and accountability in respect of them. The sanitation and water for all initiative has already achieved changes that should lead to improved results in Ghana, Burkina Faso, Senegal and other countries.
We will find new ways to work jointly with other donors. Specifically, we are looking for ways to enable fragile states, and those that are most off-track on the targets, to develop the capacity and plans to ensure access to water, sanitation and hygiene. It is imperative that we find ways for these countries to attract and use the finance for achieving results at scale.
The British Government know how important this agenda is, and we have a clear picture of the needs. We are ready to play our role in a global effort, complementing our leading role on health. In the coming weeks, we will finalise our commitments across the board and our policy support to this vital area. I can already confirm, however, that the Government have great ambition in water, sanitation and hygiene, and that that will continue to be an important part of DFID’s business.
Question put and agreed to.