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The Minister of State, Department for International Development (Alistair Burt)
It is, as always, a pleasure to serve under your chairmanship, Mr Hollobone. I thank the hon. Member for Cardiff South and Penarth (Stephen Doughty) for securing this important debate to commemorate World AIDS Day. I thank all hon. Members who contributed; this subject unites everyone in the House, including my hon. Friend the Member for Aberdeen South (Ross Thomson), the hon. Members for Ealing, Southall (Mr Sharma), for Strangford (Jim Shannon), for Cumbernauld, Kilsyth and Kirkintilloch East (Stuart C. McDonald), for Stockton South (Dr Williams) and for East Lothian (Martin Whitfield), and the two Front-Bench spokesmen, the hon. Members for Dundee West (Chris Law) and for City of Durham (Dr Blackman-Woods). They asked a range of questions. In the time available to me, I will not be able to cover them all, but in the time-honoured way, my Parliamentary Private Secretary has very kindly got a note of everyone who is here, so I will cover the questions I do not answer by way of letter. I will make sure the answers get out there.
This is an opportunity for colleagues to reflect on where we have got to. I am grateful to the hon. Member for Cardiff South and Penarth for mentioning the Lord Speaker, who did so much when he had the opportunity to do so, and the haunting quilt. It was particularly noticeable when there was the odd square of anonymity because somebody still did not want to reveal something. I think of the pain behind that expression, of what people have been through in the past, and of what some people still go through. The fact that they are unable to talk about it, when for many of us it has become much easier to deal with and talk about, is a measure of the pain behind some of those issues.
None of us has the experience of the hon. Member for Stockton South. We all noted his work in Uganda, where he used his commendable skills in the best possible way. I still remember visiting AIDS orphans in South Africa with my daughter at a time when it was very clear that the babies could not be kept at home because of the shame and stigma attached to the disease, so they were just dispatched. I remember thinking that the nurses looking after them were making an extraordinary contribution. The afternoon that we saw them, my daughter and I said we did not know what we could do in life that would possibly be as valuable as the love that those people demonstrated towards those children. That was 20-odd years ago. Time has moved on and we are doing so much more.
Let me reflect a little on the progress that has been made, which colleagues mentioned, and then answer some of the tougher questions that come the way of a Minister. It is all part of the day job, even for an issue on which we are all broadly moving in the same direction. I commend the hon. Member for Cardiff South and Penarth for his speech, and the work of the all-party parliamentary group on HIV and AIDS, which has achieved so much over the years. I thank him for advance sight of the questions in his speech. It was much appreciated.
We have come a long way since the first ever World AIDS Day in 1988. We now have 20 million people with access to potentially life-saving HIV treatment—a big improvement on the year 2000, when less than 1% of those in need had access. We can be very proud that the number of new infections in children has also dramatically declined. It is important to put on the record the UK’s contribution to those achievements. Colleagues have been generous about that, and of course it covers Governments of all persuasions. The UK continues to play its role. We are proud to be the second-largest international funder of HIV prevention treatment and care. That work is impossible without our partners, through which we invest. Our contribution to the Global Fund to Fight AIDS, Tuberculosis and Malaria helped to provide more than 11 million people with antiretroviral therapy by the end of 2016. Our significant pledge of £1.1 billion to the fifth replenishment of the global fund will now help provide enough life-saving antiretroviral therapy for 1.3 million people living with HIV.
Our investments in research and support to Unitaid help improve access to medicines, diagnostics and prevention for those affected by HIV in low-income countries by bringing promising new health technologies to scale faster and more cheaply. The hon. Member for East Lothian was right to raise the importance of carrying on with such research. We must also recognise UNAIDS for its continued leadership of the global HIV response, for pushing for ambitious global targets to stop new infections and to ensure everyone living with HIV has access to treatment, for protecting and promoting human rights, and for producing the data we need for decision making.
Civil society with its links to communities and people living with HIV also has a critical role to play in leading the social movement for prevention, championing the rights of the most at-risk populations and those living with HIV, providing care and support services to communities that others are simply unable to provide, and—vitally—holding Governments to account.
Jim Shannon
In our contributions, some of us have recognised the good work of Churches and missions across the seas and at home. For the record, does the Minister too recognise the importance of their input physically, financially and emotionally into making the changes?
Alistair Burt
I do. The hon. Gentleman’s connections with Churches and Church movements not only in this country but worldwide are well known. Absolutely, that is an important point to put on the record because to some extent it sets the record straight about the commitment of the Church and Christian communities to this particular sort of work, which is important. In some parts of the world, only the Church network is there to provide social care across the board. We would all be the poorer without being able to support that.
Mention was made of the Robert Carr civil society Networks Fund, of which we are proud to be a founding member. I cannot give a further commitment at this stage—we are yet to announce it—but I recognise the issue and we will come back to say what the future funding position will be in due course. I have noted what colleagues have said.
There is also greater shared responsibility from low and middle-income countries. Domestic resources constituted 57% of the total resources for HIV in low and middle-income countries, which is a step in the right direction, but more needs to happen to build a sustained response. As good as that is, as all colleagues have said, there is much more to do, so let me deal with some of the questions I was asked.
In terms of the broad strategy, the UK’s ongoing HIV commitment is that we want to see AIDS ended as a public health threat by 2030. That is an important priority for us. We are proud to be the second-largest international funder of HIV prevention, treatment and care, as I have said, and as a leading donor we will use our influence to ensure that we collectively deliver on the global commitment—to end the AIDS epidemic as a public health threat by 2030—and that no one is left behind.
In relation to the gag, we will continue to show global health leadership by promoting and supporting comprehensive, evidence-based sexual and reproductive health and rights. We are the second largest donor for family planning assistance and we are the largest donor to UNFPA, the United Nations Population Fund, so we will skirt around issues raised by the gag.
On a new HIV strategy, the note I have states that the 2013 review of the UK position paper on zero infections identified the integration of HIV as the key strategic priority. We intend to continue that approach, rather than to develop a stand-alone strategy or conduct a further review. However, I have heard what the House has said, so let me reflect a little on that, as I will on the Youth Agenda point—whether HIV is included. It is not currently. Clearly, the Youth Agenda is a very important part of our strategy and we recognise, as all in the Chamber do, the significance of adolescent girls in particular and the related issues. Again, let me have a look at that to see whether we can say anything further about it. I will come back to colleagues in due course.
For women and girls generally, it was right to recognise the heightened risk. Empowerment of women and girls lies at the heart of our development agenda. DFID is supporting the generation of new evidence to improve outcomes for women and girls, including the development of female-initiated HIV prevention technologies, research into how gender inequality drives epidemics, and a particular focus on improving what works for adolescent girls in southern Africa.
The UK is also working with the global fund to increase its focus on girls and women, which I think is in accordance with the House’s wishes. Giving greater attention to women and girls is a shared priority for us and the global fund. With UK support, the global fund has embraced gender equality as being central to accomplishing its mission of ending the three diseases as epidemics, including it as one of its four strategic objectives in the 2017 to 2022 strategy. Between 55% and 60% of global fund spending directly benefits women and girls. That includes programmes to prevent gender-based violence and to provide post-violence services. The number of HIV-positive women since 2002 who have received services to prevent transmission of HIV to unborn children has reached 3.6 million, and we will continue to press on that.
Stephen Doughty
I welcome what the Minister has said about looking again at the issue of a strategy and, in particular, the situation with young people and women and girls. We have obviously got the Commonwealth Heads of Government meeting here next year. I suggest gently to the Minister that it would be very helpful to have a strong statement setting out the UK’s views on HIV and AIDS in those communities while we have the Commonwealth Heads in this country.
Alistair Burt
It is a competitive field to get things on the agenda for the Commonwealth Heads of Government summit. I know that health will play a leading part, but the details have not yet been sorted. As would be expected, concerns about HIV/AIDS are certainly well up there and an announcement will be made in due course.
The UK Government will, however, be represented at the international AIDS conference in Amsterdam in July. Precise attendance is still to be finalised, but that depends on my diary and whether we can fit it in. I would really like to go because I think that is what colleagues would wish.
Turning to finance—on which I will write further—there are two issues. On the STOPAIDS suggestion of a 22% cut, our response is that the report gives a snapshot of the figures in a given year and does not always reflect everything that is going on as programmes come to an end and others start. It also does not reflect our huge multi-year global fund contribution. The timing of disbursements partly accounts for the difference in spend between years, but committing £2.4 billion since 2010 to multilateral funds is substantial.
The other issue was integrating the funds and the tracking. DFID uses an HIV policy objective marker to track spending on HIV within broader programming. The system ensures that programmes address a range of developmental priorities, such as health-systems strengthening, governance, social protection and sexual, reproductive and health rights. I take the point that it is difficult to track, but it is important that we put the funds into integrated services, as well as spending them directly.
There are the technical challenges of tracking, so let me take that away as well—not necessarily to change it, but to see what might be done better to give more transparency. We will keep the process of integrating the funds going. It is right and proper to do so, along with the other commitments that we make. With that, let me sit down to allow the hon. Member for Cardiff South a couple of minutes to sum up.