HIV and AIDS: Vaccine
Baroness Kinnock of Holyhead Excerpts(9 years, 5 months ago)
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The Lord Privy Seal (Baroness Stowell of Beeston) (Con)
My Lords, it is the turn of the noble Baroness, Lady Kinnock, but perhaps all noble Lords would be brief so that we can hear as many questions as possible. We will hear from the noble Baroness and then from the noble Lord, Lord Brooke. We should have time for both.
Baroness Kinnock of Holyhead
My Lords, scientific innovation and generous funding have, as we know, eradicated smallpox and are now close to eradicating polio. We live in a time when a person who tests positive for HIV is no longer facing a death sentence, so we have clearly seen real progress. Yet 35 million people still live with AIDS, and without a vaccine I do not think that we will ever see the end of this epidemic. The interesting point is that donor Governments gave less financial support in 2013 than they had previously. Will the Minister join me in condemning these cuts in R&D, which is of course fundamental and essential? Will the Minister take action against EU member states and, indeed, the US Government, which reduced their funding in 2013?
Baroness Northover
The noble Lord, Lord Walton, indicated the real challenges here. This needs basic research, and the Medical Research Council and the Wellcome Trust are best able to assess what may have better prospects. They have stepped up their contributions.
Health: HIV
Baroness Kinnock of Holyhead Excerpts(9 years, 5 months ago)
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Baroness Northover
The noble Baroness is right to associate this with the use of drugs, and she will also know that in those countries that have addressed needle use HIV has been reduced—for example, in the United Kingdom it is minimal. We realise the significance of this challenge worldwide, particularly, for example, in eastern Europe. I will look closely at what she has suggested.
Baroness Kinnock of Holyhead (Lab)
My Lords, while HIV is clearly a health issue, does the Minister agree that in many countries gender inequalities remain the driving force behind this epidemic? Studies have shown that women and girls experience violence and are, therefore, at increased risk from HIV and live lives full of threat. Does the Minister agree that the needs and rights of women and girls are not being adequately addressed in response to HIV, and will DfID call for an in-country response to HIV, which includes, as the UN has requested, the creation of specific budgets intended to cater for the specific needs of women and girls?
Baroness Northover
The noble Baroness is quite right to associate this with violence against women and girls and the inequality of women and girls. She will know that the infection rate among young women is twice as high as that for young men, for the very reasons she has given. It is absolutely fundamental to our approach to address that inequality and try to combat violence against women and girls.
Ebola
Baroness Kinnock of Holyhead Excerpts(9 years, 6 months ago)
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Baroness Kinnock of Holyhead
To ask Her Majesty’s Government what assessment they have made of the international response to Ebola.
Baroness Kinnock of Holyhead (Lab)
My Lords, at the outset I must pay tribute to the considerable contribution that the United Kingdom and its NGOs, health workers and service personnel are making in efforts to respond to the Ebola crisis. Despite those and other great efforts, as the world now knows, Ebola continues to destroy lives, livelihoods and communities. It impairs national economies and is severely damaging what are already very fragile basic services. It is reversing years of development efforts with devastating effects and there is a danger that this epidemic could undo years of efforts to stabilise the west African region and lead to new tensions between neighbouring countries.
Against that background, does the Minister agree with Kofi Annan, who has said that:
“If the crisis had hit some other region it … would have been handled very differently”?
He went on to say:
“When you look at the evolution of the crisis, the international community really woke up when the disease got to America and Europe”.
That judgment is echoed by Dr Chan, the director-general of the WHO, who has emphasised,
“the dangers of the world’s growing social and economic inequalities”.
She said:
“The rich get the best care. The poor are left to die”.
Hearing that, does the Minister agree that Ebola is tragically highlighting the basic reality that Governments and commerce must give higher priority to investment in the prevention of disease in developing countries? Should donors not be spending much more on global health, including overcoming malaria, TB and HIV, when those plagues are fundamental causes of underdevelopment and when more has to be spent on treatment simply because too little is still being invested in prevention?
We surely need to deal now with the reality that the world has simply not prepared itself for an effective response to any severe, sustained and contagious health emergency. The progress which is claimed by some to be taking place is, to say the least, uncertain. Experts grimly tell us that we are not close to reducing mortality or stopping Ebola’s transmission, which will not happen for some time. On just one day this month, 2 November, 61 new cases were reported across Sierra Leone, bringing the nationwide toll to 4,059 cases. According to Save the Children, five people are being infected every single hour in Sierra Leone.
However, Ebola emerged 40 years ago, so why after four decades of huge scientific advance is there no vaccine and no cure? Could it be because Ebola has no R&D incentive for a profit-driven global pharmaceutical industry? Professor Peter Piot, the director of the London School of Hygiene & Tropical Medicine, who is of course the scientist who first identified Ebola, has said that it would not have been difficult to contain the outbreak if those on the ground had acted quickly. He has also said, however, that tragically:
“Something that is easy to control got completely out of hand”,
as isolation, care and tracing and monitoring contacts, which have worked before, will not prevent the spread now. He went on to say:
“It may be that we have to wait for a vaccine to stop the epidemic”.
The awful truth is that no one knows the real death toll in Sierra Leone. We do know, however, that there is the most terrible suffering and misery. I will give just one all-too-typical instance. A woman with a nine year-old child and a six year-old child lost her husband to the disease. Naturally, she had nursed him. Now she is dead and both children have Ebola. They are orphans and victims. But hugging loved ones should not be a death sentence. Obviously, as in every culture, the women of west Africa are the carers of their families. They are consequently the front-line health workers who are most exposed to and affected by Ebola. In fact, in Liberia, 75% of those infected with or killed by Ebola are women.
Even before this crisis Sierra Leone had one of the world’s highest maternal mortality rates. Now, because of the collapse of healthcare and the fear of contracting Ebola in hospital, many more women are dying in childbirth because they are afraid to go to hospital. Donors, including the UK, clearly need to take account of the higher risk that women and girls face of getting Ebola. In addition, priority should be given to sexual and reproductive healthcare, and it is vital that there is a proper response to the increased vulnerability of women and girls to violence during the Ebola crisis. Can the Minister tell the House whether efforts are being made to ensure that women are engaged at national and community level in shaping responses to this crisis?
After years of devastating civil wars, already fragile basic services are now desolated. In Sierra Leone, nearly 40% of the population do not have access to clean water and sanitation is worse than rudimentary. As a result, maintaining the level of hygiene needed to prevent the further spread of a virus which is transmitted through contact with body fluids is extremely difficult, and clearly the lack of basic services is putting at risk the lives of all those who care for Ebola patients. There is surely a need to make systematic and rapid efforts to ensure universal access to these basic services in all the hospitals, homes and schools. Without that, a future public health catastrophe is inevitable. In addition to addressing the response being made to inhibit the current epidemic, can the Minister clarify whether the Government are making a long-term response to the Ebola outbreak in west Africa that promotes the systemic changes required to deal with any future outbreaks?
The president of the World Bank has said that:
“We were tested by Ebola and we failed … miserably in our response”.
He then asked:
“Why don’t we have a multibillion dollar fund of $10bn, $15bn or $20bn … so that once there is a global health emergency it can be drawn down on … quickly?”.
He is surely right to ask that question, so what is the answer from our country and our Government? Are we going to try to win this battle or will we actually fight to win the war?
Ebola
Baroness Kinnock of Holyhead Excerpts(9 years, 6 months ago)
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Baroness Northover
I am sure that there are serious lessons to be learnt. We are fortunate to have international organisations but we need to make sure that we strengthen and improve them in the future.
Baroness Kinnock of Holyhead (Lab)
My Lords, can the Minister give us some information about the thousands of children who have been orphaned by Ebola in the affected countries? Families and friends are now too frightened to take them in when they are in such need. Are those children being properly identified and what is being done to give them care, counselling and support in the misery that they are now suffering?
Baroness Northover
We are acutely aware of that, as is the international community. The noble Baroness will know that UNICEF and Save the Children are also flagging up this enormously challenging situation.
Health: Ebola
Baroness Kinnock of Holyhead Excerpts(9 years, 6 months ago)
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Baroness Northover
I am more than ready to endorse that view. It is astonishing to see the number of volunteers who have decided that they wish to go out to this extremely challenged region. We are humbled before that effort. My noble friend is right that we have to tackle this as a public health crisis but it is also encouraging to see the amount of effort now going into developing potential treatments and vaccines. It may come to nothing but I am extremely pleased that the United Kingdom is again leading in terms of the trials of the vaccine at the Jenner Institute in Oxford. If that works out, those vaccines should be available by the end of the year.
Baroness Kinnock of Holyhead (Lab)
My Lords, does the Minister agree with President Kim of the World Bank that the world community has “failed miserably” in its response to Ebola? Dr Chan, head of the WHO, who was mentioned earlier, drew attention to the appalling neglect of the pharmaceutical companies, saying that, after 40 years of Ebola, there are still no vaccines or medicines. She said:
“The rich get the best care. The poor are left to die”.
South Sudan
Baroness Kinnock of Holyhead Excerpts(9 years, 10 months ago)
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Baroness Kinnock of Holyhead
To ask Her Majesty’s Government what assessment they have made of the concerns expressed by the Disasters Emergency Committee over the prospect of famine in South Sudan.
Baroness Northover (LD)
My Lords, the humanitarian situation in South Sudan is extremely critical and could get dramatically worse due to existing vulnerabilities and the unpredictability of the current conflict: 4 million people are at immediate risk of food insecurity and up to 7.3 million people are estimated to be at some risk. Should harvests fail, famine in late 2014 is a very real possibility in conflict-affected areas.
Baroness Kinnock of Holyhead (Lab)
My Lords, I thank the noble Baroness for a very comprehensive and encouraging analysis of where we are in South Sudan. However, in view of the grim predictions made by the Disasters Emergency Committee, does she agree that the international community has to do more, provide more funding to ensure that we can make a difference and act very quickly to avert a catastrophic famine? She will know that humanitarian access is a major obstacle facing relief agencies working in South Sudan. What are the Government doing to press for greater humanitarian access to be granted by all parties in the conflict in South Sudan, including cross-border access?
Baroness Northover
The noble Baroness shows great understanding of the situation in South Sudan. As she rightly points out, the key to this is the conflict there. That is at the heart of why there is a problem—and why there is a problem with access. She rightly highlights the difficulty of getting aid in. We are working very hard on logistics with the UN, the ICRC and international NGOs to try to get assistance in through air transport and other means but it is proving extremely difficult. Clearly, the cessation of hostilities would be the key to sorting this out.
Sudan: Meriam Ibrahim
Baroness Kinnock of Holyhead Excerpts(9 years, 11 months ago)
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Baroness Anelay of St Johns (Con)
My Lords, this is a matter of great concern to the whole House but, because we have now had a contribution—naturally—from a Member of the Bishops’ Benches, on my reckoning we should return to the Labour Benches. I appreciate the disappointment of my noble friend Lord Chidgey, who has been very patient.
Baroness Kinnock of Holyhead
My Lords, is the Minister aware that a number of courageous and remarkable Sudanese women will be in London this week to attend the summit on ending sexual violence? These women have dared to speak out against widespread sexual violence, the near total impunity for its perpetrators and cruel and degrading treatment such as the public flogging of women. Can the Minister therefore assure the House that, as well as continuing to press for the release of Meriam Ibrahim, the UK will work to ensure that a review takes place of the Sudanese criminal code, which permits torture and the denial of fundamental rights?
Baroness Northover
As I mentioned just now, we are seeking to have the Government of Sudan review their penal code in the light of the obligations that they have made. The noble Baroness highlights the global summit this week and we are very pleased that women from civil society in Sudan are there. There is also a faith meeting there and, in answer to an earlier question, it is highly likely that this case will come up during that.
Development: Post-2015 Agenda
Baroness Kinnock of Holyhead Excerpts(10 years, 1 month ago)
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Baroness Kinnock of Holyhead
To ask Her Majesty’s Government what is their assessment of the case for the United Nations Open Working Group on the post-2015 development agenda recommending a stand-alone global goal on inequality when it reports to the United Nations General Assembly in September.
Baroness Kinnock of Holyhead (Lab)
My Lords, since 1990, the base date against which progress towards the MDGs is measured, hundreds of millions of people have been lifted out of poverty. The world is within reach of seeing every child enrolled in primary school and many fewer lives are being lost to hunger and disease. The global population as a whole is healthier, wealthier and better educated than ever before. In addition, the millennium development goals galvanised political commitment and challenged the complacency and apathy that stood in the way of progress.
All of that is encouraging. Regrettably, however, the promise offered by the millennium declaration in 2000 has not been met. It promised freedoms, solidarity and social justice, the right to development and human rights for all. That pledge was negated, though, when the eight richest country Governments drew up the MDG targets and indicators. They were top-down and decided behind closed doors. They therefore left unfinished business, such as the fact that the improvements in the past 20 years have still not reached significant minorities, who continue to be denied basic social, economic, civil and political rights. Then there is the unfinished business that arises from increasingly excessive concentrations of personal wealth when it is clear, as Oxfam says, that:
“We cannot afford to have a world of extreme wealth and extreme inequality”.
The logic of that is plain: when just 8% of the world’s population earns half of the world’s income and the remaining 92% shares the other half, power is abused, economic growth is stunted and social tensions are exacerbated. That is why it is now vital to achieve proper controls on tax-dodging and on the use of wealth to buy political favours. It is essential that the post-2015 agenda addresses the structural causes of poverty and injustice by tackling inequality, social exclusion, skewed financial systems and gender injustices.
Twenty years ago, more than 90% of the world’s population lived in low-income countries. Now 75% of the world’s poorest people live in middle-income countries. There is a new geography of poverty and it presents a main challenge for the post-2015 agenda. We can tick the boxes when we use the MDGs, which were set 14 years ago, as our benchmarks, but social exclusion and environmental sustainability are just not factored in. Now they must be, not least because the gaps in wealth obviously produce chasms in opportunity.
Children born to poor families are between five and 10 times more likely to die in their first year, and the gap is widening. Up to 70 million children are still not enrolled in school, and the most marginalised children—child labourers, poor rural girls, slum dwellers and ethnic minorities—are doomed to fall still further behind. Inequality, in short, makes poverty congenital.
Post-2015, the reduction of inequality must therefore be an explicit policy because chronic systemic inequity limits mobility, restricts the choices that people can make and cancels their potential. Inequalities inflicted upon the so-called hard-to-reach poor originate and endure because of their gender, ethnicity, religion, caste, disability, language, sexual orientation and geographical location. These people are born marginalised and socially excluded, and are pushed out even further. These are the most powerless of the poor and, across many of the MDGs, they are being left further behind. Nothing should be allowed to stand in the way of the global efforts needed to tackle the gross inequality that ODI director Kevin Watkins has called,
“one of the greatest development challenges of our age”.
With that in mind, the new goals should include targets to eliminate wealth and gender gaps and to secure improvements in child survival, antenatal care and school participation. Unlike the MDGs, the post-2015 agenda will be universal. That is a bold aim, and it needs to be; the true scale and nature of disadvantage is hidden in the MDG assessments by aggregate figures and averages. They distort the picture of results and, consequently, the policies based upon them.
The post-2015 framework must therefore include timely, disaggregated data so that vulnerable groups are clearly identified. To be focused and effective, action must be based on accurate and reliable information and rigorous monitoring. That necessity must be recognised in September when the UN General Assembly discusses the recommendations of the open working group on the post-2015 agenda. Those recommendations include a focus on inequality. I am persuaded by the arguments made by the Overseas Development Institute in favour of equality-related targets and indicators, which Kevin Watkins describes as stepping stones for reducing inequalities, with timelines for 2020 on the way to universal goals in 2030.
What goes into the post-2015 agenda and sustainable development goals really matters because those goals will set the global sustainable development agenda for the next 15 years. It is essential, therefore, that multilateral government action focuses on redistributing global wealth and opportunity as an explicit objective of all programmes to combat and overcome world poverty.
Whether we support a stand-alone goal or targets across a number of agreed goals depends on whether we believe, as I do, that arguing the case in all the relevant areas of policy can ensure that inequality issues get a comprehensive hearing and can be at the centre of any new framework. I welcome the fact that Save the Children is campaigning for a cross-cutting approach with disaggregated data, stepping-stone targets, targets on eradicating extreme poverty and the inclusion of an appropriate inequality dimension in each target or indicator across the board in the post-2015 framework. This will be needed to monitor progress in reducing inequality objectives identified, for instance, on child health and access to education. Indicators that have been identified can then be disaggregated and equity criteria applied to disability, ethnicity or location.
Frankly, I am somewhat sceptical about a general stand-alone inequality goal because I believe that it would risk losing the preferable option of inclusion across the entire post-2015 framework where disparities are growing. The co-chairs of the high-level panel, including the Prime Minister, have accepted the reality that, without explicit targets, poor people will be left behind. They wrote:
“We propose targets that deliberately build in efforts to tackle inequality and which can only be met with a specific focus on the most excluded”.
In agreeing with that, I ask the Minister: does she accept that, first, we need relevant data accurately to identify the most excluded; secondly, that we need explicit targets that capture inequality; and, thirdly, that we need targets that are incorporated into other goals, such as health and education, to focus attention on the specifics of existing disparities?
Inequality has been on the edges of development policy for far too long, generally because it has been considered too political. That must change. Inequity threatens efforts on poverty eradication, sustainable development, democratic processes and social cohesion, and it deprives people of their right to opportunity. World leaders can recognise and respond to the needs of the forgotten millions who are the most vulnerable and hardest to reach only if they make inequality a central focus of their objectives and their actions. Without that, they will continue to address symptoms instead of generating cures.
Sudan
Baroness Kinnock of Holyhead Excerpts(10 years, 2 months ago)
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Baroness Northover
My Lords, I pay tribute to the noble Lord for the spotlight that he has focused on the situation in Sudan. He is right about the dire situation of many of the people there. We have no doubt about the serious shortcomings of the Khartoum Government. The UK Government’s primary and only concern is the welfare of the Sudanese people. Our engagement and support is driven by what will make a difference to them. We cannot walk away and we work at every level to try to secure the kind of humanitarian access that is required, as illustrated by what the noble Lord said. We are not paying off the debt of the Sudanese Government.
Baroness Kinnock of Holyhead (Lab)
My Lords, President al-Bashir has been indicted by the ICC for multiple charges of crimes against humanity and genocide in Darfur, yet this cruel and vicious man is free to enjoy power and wealth while his regime’s oppression, corruption and aerial bombardments continue. Will the Minister give the House a clear undertaking that the UK will not follow the lead of the Netherlands and support calls being made for debt relief for a regime that does not care about the poverty and misery inflicted on Sudanese people?
Baroness Northover
We emphasise all the time that the Government of Sudan are responsible for meeting the needs of their own people. My right honourable friend the Minister for Africa raised a number of key issues relating to the areas the noble Baroness is talking about with the Government of Sudan and key regional figures in a visit last month and at the recent AU summit.
Girls’ Education Challenge
Baroness Kinnock of Holyhead Excerpts(10 years, 3 months ago)
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Baroness Northover
I congratulate my noble friend on her first Question in the House. She is absolutely right: educating girls is one of the best investments to reduce poverty. As many noble Lords know, educating beyond primary level, which is what she is flagging here, improves a girl’s life chances and delays early motherhood so that she is more likely to have healthy, better nourished children. In fact, ensuring that girls have between seven and 10 years’ education has a decisive influence over whether they can choose whom they marry. The Girls’ Education Challenge is concentrating particularly on supporting girls to progress through secondary school. My noble friend is absolutely right: ensuring that girls are safe on their way to school and at school is extremely important, but this is being addressed.
Baroness Kinnock of Holyhead (Lab)
My Lords, does the Minister share my concern that DfID’s business case for the Girls’ Education Challenge fund actually fails to list tackling violence against girls as one of its critical success criteria? Given that millions of girls are sexually assaulted at or on their way to school, does she agree that tackling gender-based violence and the need for social norm change should be priorities and should surely be included in the interventions currently taking place under the GEC fund?
Baroness Northover
The noble Baroness is right that combating violence against girls, as I have just addressed, is extremely important. It is no use trying to encourage girls to come to school if, on the way, they are attacked or will be attacked within the school. As the noble Baroness knows, dealing with this is a high priority right across DfID’s work, including in its education programmes.