International Development (Official Development Assistance Target) Bill

Baroness Northover Excerpts

Friday 23rd January 2015 Lords Chamber

[The Parliamentary Under-Secretary of State, Department for International Development (Baroness Northover) (LD)]

My Lords, on behalf of DfID and the Government, I am delighted to speak in support of the Private Member’s Bill sponsored by my noble friend Lord Purvis. As the noble Lord, Lord McColl, put it, he introduced it with a passionate, comprehensive and evidence-based speech. I pay tribute to my right honourable friend Michael Moore for having the vision, grasp and commitment to introduce and then pilot this vital Bill through the other place. I also pay tribute to all those who have supported the Bill there and here, and for the cross-party agreement here.

I pay tribute to those who have helped to develop the UK’s outstanding record in development, including the right honourable Clare Short and my noble friend Lady Chalker, whose speech showed her long and deep commitment to this area and her understanding of how underpinning economic growth brings the relief of poverty. I thank the noble Lord, Lord Collins, and the noble Baroness, Lady Royall, for pledging the Opposition’s support for the Bill, which is exceedingly welcome.

As other noble Lords have, I pay tribute to the NGOs for doing all that they have to explain, from their own work, why the Bill and the commitment of better-off countries is so important. It is transformational to those in extreme poverty and at the very margins of life around the world. I also pay tribute to DfID staff working in-country—for example, those on rolling shifts in Sierra Leone and those currently locked down in the DRC—and to others from the United Kingdom whose work in humanitarian crises or in longer-term development is so important.

To hear praise from my noble friend Lady Tonge as she crows, as she put it, particularly warms my heart as we do not always please her. I also note the pride expressed by the noble Baroness, Lady Flather, and she is right.

I am delighted to be part of the United Kingdom Government who have, for the first time, met the 0.7% target of GNI going to support worldwide development. I thank noble Lords for their tributes to that and, from the Government Front Bench, I make it crystal clear that we support the Bill, which will enshrine this commitment in legislation. This was in the coalition agreement and I am delighted that we are so close to ensuring that the legislation is agreed.

[Lord Davies of Stamford]

Is the Minister going to be able, in the course of her remarks, to respond to my question: why did the Government, who are so evidently in support of this measure, do nothing about it for nearly five years? Even now, it has not been brought forward as a government Bill although the Government appear to be in the process of taking credit for it.

[Baroness Northover]

I have in my notes an answer to the noble Lord, which was slightly lower down in what I was seeking to address. He said that he was mystified as to why we were dealing with this now. What occurred to me was that I was somewhat mystified that the previous Government had not legislated for this, despite their commitment. What we should welcome—and that is true across this House—is that we have finally ensured that we have met that 0.7% commitment, and that we are now seeking to legislate. That is the important thing and I welcome the cross-party support for it.

The House of Commons has passed the Bill overwhelmingly and handed it to us. It is now our responsibility to help ensure that my noble friend Lord Purvis is able to carry this through and into law. We have heard outstanding and compelling speeches and even those who feel that this is not the right move—

[Lord Tugendhat]

I take the Minister’s point about the responsibility to carry it forward into law, if that is what the majority want. However, I hope she will agree that this is an amending and revising House, and that there is a duty to seek to amend and improve Bills, regardless of where they are. I think back to the debate we had some months ago on the referendum Bill where many noble Lords opposite, whom I supported, argued that just because such a Bill had a majority in the Commons that was no reason not to try to improve it in the Lords. The same applies on this occasion.

[Baroness Northover]

I will be coming on to that in a while. Perhaps the noble Lord will be satisfied to wait a little for that.

As I have said, we have heard outstanding and compelling speeches which have recognised that aid is transformational. It is also interesting to note that even those who do not feel that this is the right move are committed in terms of aid, which of course is important. The noble Lord, Lord Lipsey, is an economist and not one to misuse statistics, but he expressed more than 90% agreement to what we are doing in terms of aid. I for one will bank that. I knew that we would have a powerful debate on this Bill, that noble Lords would speak from huge experience, and that we would take a far-reaching international perspective.

We know only too well that no man is an island—I might feminise that. As my noble friend Lord Purvis made clear, the first point to make is the moral case, and many noble Lords have made that case. Indeed, it was made with particular power by the right reverend Prelate the Bishop of Derby and—not least through his presence here—the former Archbishop of Canterbury the noble and right reverend Lord, Lord Williams of Oystermouth. I welcome his engagement, and we are pleased to see them involved today. My noble friend Lord Steel quoted strong passages from two global religions as to why we must do this. We heard my noble friend Lord Chidgey’s moving account from Juba, as well as those from the noble Lord, Lord Judd, and others. They all made the moral case exceptionally clear.

As noble Lords also laid out, we recognise our interests and how we are all interlinked. We can see that a weak health system in Sierra Leone, seemingly a distant place, results in an epidemic taking hold on an unprecedented scale. Even in Britain we have felt the effects of that. International development is not an optional extra or an afterthought; it is vital. Investing now to help the poorest can and will prevent some of the terrible situations we see today from happening tomorrow and affecting us. I was especially struck by the powerful speech of the noble Lord, Lord McConnell, about what might have happened had this measure been implemented 40 or 45 years ago. The noble Baroness, Lady Royall, quoted Nelson Mandela saying that:

“Poverty is not an accident”,

while my noble friend Lady Manzoor talked about tackling poverty.

The 2004 report of the UN High-Level Panel on Threats, Challenges and Change, of which our colleague the noble Lord, Lord Hannay, was a leading member, noted the interconnectedness of our world. That was a very important conclusion for the panel to come to. I shall quote from the report:

“Development and security are inextricably linked. A more secure world is only possible if poor countries are given a real chance to develop. Extreme poverty and infectious diseases threaten many people directly, but they also provide a fertile breeding-ground for other threats, including civil conflict. Even people in rich countries will be more secure if their Governments help poor countries to defeat poverty and disease by meeting the Millennium Development Goals”.

Quite so, and that underpins the powerful speech of my noble friend Lady Falkner about what other countries should be doing. It is excellent that at least we are taking the lead in this.

One of the most important principles of effective development is to ensure continuity. It is no use moving into a development programme one year and abandoning it the next. Continuity and certainty of programmes over a number of years are essential to securing good development outcomes. That is why we have committed to budgets over four years and why a Bill such as this, which commits us to spending 0.7% of our national income, is so important. There is otherwise the risk that the international development budget will fluctuate and fail to provide our partners with certainty when they need to make critical investments in health and education. I can recall, as no doubt can other noble Lords, when Ireland was delighted to make the commitment that it would reach an aid budget of 0.7% by 2007. I remember that that happened after an internal struggle. I also recall, with great disappointment, how quickly it moved away from that—and it is not yet achieved. Neither, prior to 2013, did we in the United Kingdom achieve it.

There is voter pressure in the United Kingdom for other budgets; for example, for the Department of Health, the Department for Education, and the DWP. Their budgets are very large, as my noble friend Lady Barker pointed out, and they are, largely, predictable. That has never been the case for overseas aid. The pressures are very clear as regards that budget, yet we seek to support similar projects: for example, getting girls into and through schools, and establishing and maintaining clinics, as the noble Baroness, Lady Tonge, rightly demanded of us.

I hope that the noble Lord, Lord Tugendhat, recognises that need for predictability. I am sure that he supports our long-term financial commitment to the EU—would it not be easy to push that budget back and forth?—yet we grant to the EU according to our legal obligation, and we are right to do so. The EU can then plan and budget. This is no different. The conflict across borders—

[Lord Tugendhat]

It is totally different. The problem that I—and I think other members of the committee—have is that while we are fully supportive of aid and made that quite clear, we also made it clear that we are worried, as are others, about the way in which money is spent. We are dealing with multiyear programmes. With such programmes, you will run into a lot of trouble if you have to spend on what is called—since the noble Baroness invokes Europe—the douzième provisoire: that is, if you have to spend one-12th on an annual basis instead of spreading it over the commitment. In the case of the EU, there is a formula by which the member states are assessed, and we pay according to that formula. However, it is not linked to projects. The problem here is that you have a multiyear project and you are saying that a given amount has to be spent each year. The Minister may or may not agree with me, but she is invoking a false parallel.

[Baroness Northover]

Having been a Minister in the Department for International Development, I know that there is obviously flexibility in the department, because humanitarian conflicts will arise, which you have to put money into, while you also sustain support for various other projects. The noble Lord might read the NAO report; one of the things that struck me when I read it was that every department in government has to budget, and they know more or less what their budgets will be. There may be contingencies, and they may have a contingency fund, but they have to plan. It is not just left to what they may decide to do after six months or so.

The situation is no different in DfID. I assure the noble Lord that if he reads the NAO report very carefully he will see that it concludes that business was properly stress-tested and assessed. I think I should proceed, because I am now on 14 minutes, and I will come on to some of these other points. I will also be happy to meet the noble Lord after this debate, if that would help, so that we can explore some of those issues.

Noble Lords will be fully aware of the kind of projects that DfID is involved in; during this debate noble Lords have very helpfully outlined a number of these areas. A number of noble Lords emphasised in particular our support for women and girls and how right this is, including my noble friends Lady Hodgson, Lady Jenkin, Lady Manzoor, and the noble Baronesses, Lady Kinnock and Lady Flather. We fully recognise the importance of supporting women and girls and thank noble Lords for supporting us in doing that. In addition, as part of that, the emphasis on maternal health and family planning was mentioned by the noble Lord, Lord Watson, as well as by the noble Baronesses, Lady Tonge and Lady Flather.

Mention was made of women giving birth on a concrete slab. Today is my eldest son’s birthday. This morning I found myself thinking that, had I given birth in a developing country, he would have died and so would I. Noble Lords who think about it will probably recognise that either they or their close family might very well have been in that situation. As has been said, poverty is not an accident. It is not something that certain groups need to suffer from or should suffer from.

Noble Lords have made mention of our commitment of 0.7%, and some have suggested that the increase has not improved the quality of that spend. I assure them that the Development Assistance Committee of the OECD concluded recently in its formal peer review of DfID on the effectiveness of the way in which we have scaled up our spending in recent years, planning carefully to meet the target—and I have seen that this is very much the case—while at the same time increasing the quality of our spend. As noble Lords were speaking, I found myself thinking about the commitment that we have been able to make, for example, on so-called neglected tropical diseases. We hope that they are no longer neglected, so we can combat blindness, which is totally avoidable—something that we were able to do because of the increase in the budget.

In response to the noble Baroness, Lady Tonge, of course there are many lessons to learn from Sierra Leone. This was an unprecedented crisis. We have done a huge amount, as was noted during the debate, to ensure that it did not become a pandemic. She will know the details of our support there.

[Baroness Tonge]

Could the Minister perhaps expand a little bit on that matter? We would learn a lot if there was a proper inquiry into what happened in Sierra Leone in the years running up to the epidemic.

[Baroness Northover]

I am really running out of time, and I think that we have another Question down on that matter. We can certainly discuss it, and we will learn a lot of lessons from what has happened.

Noble Lords are very concerned that what we do is carefully audited. That is where Clause 5 is very important, and the independent evaluation that we put in place in 2010 from ICAI is extremely helpful. Of course, we will keep that under close watch to make sure that aid is effectively spent.

The noble Lords, Lord Lipsey and Lord Tugendhat, mentioned the House of Lords Select Committee on Economic Affairs report of 2012, which the noble Lord, Lord Lipsey, urged noble Lords to read. I also urge them to read the debate in your Lordships’ House on 22 October 2012 on that report and, in particular, the outstanding contribution by another economist, the noble Lord, Lord Stern, professor of economics and government at the LSE. He made an extremely cogent case.

My noble friend Lord Astor asked about the calendar year versus the financial year. We are monitored internationally on the calendar year, not the financial year, and we wish to be consistent with international best practice, which is why we will continue to report in that way.

The noble Lord, Lord Tugendhat, rightly encouraged us to place more investment in developing countries. We recognise the important role that the private sector plays in development, but he will recognise that it is not necessarily targeted at countries that most need it. It is true that that and remittances are playing a very important part, and that kind of investment is clearly key in lifting China and India out of poverty. However, that still leaves many people in poverty, which is why we are involved with so many multilateral organisations. For example, my noble friend Lady Hooper mentioned Latin America and the noble Lord, Lord Cashman, mentioned South Africa. Our involvement with the Global Fund and the World Bank helps to address poverty in those countries. We have to try to ensure that we have a more equitable society globally. Relying on foreign direct investment and remittances does not necessarily achieve that.

My noble friend Lord Astor wondered whether this was just about DfID’s spending. It is not; it is about official development assistance. Most of it is spent by DfID but other departments, such as the Foreign Office, the MoD and the Department of Energy and Climate Change rightly also have ODA budgets. I say to my noble friend Lord Shipley that ODA restraints mean that you cannot spend the money on arms. He is quite right: that would not be an acceptable route to go down. I can write to my noble colleague Lady Tonge about Addis.

I have mentioned the National Audit Office report. I suggest that noble Lords take a very close look at that. As regards those who are concerned about the money that was spent at the end of 2013, I point out that we had the Syrian crisis, with many more displaced people facing a winter in Syria. There was a lot of pressure from your Lordships that we should commit spending to that. We also had Typhoon Haiyan, which cannot be put down to DfID suddenly deciding to do something, and my noble friend Lord Fowler rightly chivvied me endlessly to support the Global Fund, which he and the noble Lord, Lord Chidgey, emphasised the significance of in terms of dealing with AIDS, TB and malaria. All departments work to a budget. DfID knew that its budget was increasing and, fortunately, we were able to increase our commitment in some very important areas.

My noble friend Lady Williams rightly emphasised the involvement of young people. As my noble friend Lady Jenkin said, it is fantastic that people involved in the ONE Campaign are present in the Gallery. I pay tribute to my noble friend Lord Fox. I obviously did the right thing in supporting him when he was introduced in the House and look forward to his further contributions.

As noble Lords have said, and as my noble friends Lord Purvis and Lady Suttie emphasised, passing this Bill means that we can move on from the debate on whether we do this to how we do it, and ensuring the quality, predictability and effectiveness of our absolutely vital aid. I hope that noble Lords will give the Bill a Second Reading. Given that this is a simple and effective Bill, which has been carefully scrutinised and amended in the Commons, I hope that it will proceed through all its stages formally and by acclamation. However, if that is not the case, I am sure that noble Lords will engage fully in scrutinising the Bill and, most importantly, making sure that we pass it for all the reasons that they have laid out.

Developing World: Maternal and Neonatal Mortality

Baroness Northover Excerpts

Thursday 15th January 2015 Lords Chamber

[The Parliamentary Under-Secretary of State, Department for International Development (Baroness Northover) (LD)]

My Lords, like other noble Lords, I pay tribute to the noble Baroness, Lady Hayman, for securing today’s debate, and for her long-standing commitment to maternal and neonatal health. I commend the other contributions we have heard today, which, as ever in your Lordships’ House, have ranged very widely. I also thank noble Lords for their tributes to DfID for our work. We have heard the devastating figures, and as my noble friend Lady Hodgson pointed out, a human face was given to those figures.

The noble Baroness, Lady Hayman, my noble friend Lady Hodgson, the noble Baroness, Lady Kinnock, the right reverend Prelate, the noble Baroness, Lady Tonge and now the noble Lord, Lord Collins, have all pointed out that this relates fundamentally to the rights of women and their unequal status, unequal access to nutrition and education and being forced into early marriage—we have heard the range of challenges. Gender inequality is key.

This is a very timely debate, coming right at the start of 2015, the final year of the millennium development goals and the year in which new goals will be agreed at the UN in September. Globally, as the noble Baronesses, Lady Hayman and Lady Tonge, said, we have made significant progress in reducing maternal mortality. The maternal mortality ratio dropped by 45% between 1990 and 2013. Each region of the world has seen significant improvement, though none, as noble Lords pointed out, has yet reached the goal of a 75% reduction in mortality.

These improvements have been driven largely by more women having access to skilled birth attendants—nearly 70% of births now take place with a skilled attendant. I note what the noble Baroness, Lady Tonge, and the noble Lord, Lord Alton, said about the high level of maternal morbidity. I pay tribute to the All-Party Parliamentary Group on Population, Development and Reproductive Health for its outstanding report, Better off Dead?, as well as to the work on fistula by the noble Lord, Lord Patel. It is not just a matter of physical morbidity. As my noble friend Lady Hodgson pointed out, the mental health of mothers is key. I hope that my noble friend will be pleased to note that mental health is included in the targets for the SDGs proposed by the open working group.

The noble Baroness, Lady Hayman, noted the number of neonatal deaths and that it had not moved in the direction that maternal mortality had. The MDGs did not include targets for newborns; consequently, they received less attention and less progress has been made. The noble Lord, Lord Patel, in particular emphasised how much more we still need to do. Nearly 3 million newborns still die every year, accounting for around 44% of all deaths of children under five, and 1 million of these die on their first day of life, as noble Lords noted. Eighty-five per cent of newborn deaths result from three preventable causes, as the noble Lord, Lord Patel, and other noble Lords pointed out.

The noble Lord, Lord Patel, emphasised the high incidence of neonatal deaths in a few countries, identifying particularly large numbers in the populous countries of India and Nigeria—the noble Lords, Lord Collins and Lord Alton, made reference to that as well. As the noble Lord, Lord Patel, noted, it is shocking to see the proportion of babies not breastfed in the first 24 hours. I was shocked when I visited India early last year to discover that this was indeed widespread. I can assure the noble Lords, Lord Patel and Lord Alton, that prioritising women and girls and seeking to address neonatal health is uppermost in our discussions in India. My right honourable friend Lynne Featherstone has been to India this week as a champion to combat violence against women and girls, so it is very high in the Government’s priorities.

As noble Lords made clear, faster progress in these crucial areas will be achieved only when girls and women are able to access the care and services that they need when they need them. They include better nutrition, access to education and access to clean water and sanitation. The United Kingdom has a strong track record of working to improve maternal and newborn health—and I thank noble Lords again for their tributes. In 2010, we made commitments to save 50,000 maternal lives and 250,000 newborn lives by the end of 2015, and we intend to meet them. We have already exceeded our target for maternal lives saved through a combination of increased investments in family planning, skilled birth attendants and making health systems stronger—all issues that noble Lords addressed. A number of noble Lords emphasised family planning, and we share their view that this is crucial, which is why we emphasised it at the London summit in 2012. A recent report shows that we are broadly on track to meet our commitments. Nevertheless, we are not complacent; we know how extremely important that issue is.

I agree with the noble Baroness, Lady Kinnock, that we need to make sure that we have adequate funding for sexual and reproductive health and that that includes funding from the country Governments themselves. The summit was encouraging, and I hope that the noble Baroness was able to see the commitments that came forward. We need to make sure that those are delivered. We agree that it is vital that girls and women should be able to access comprehensive packages of sexual and reproductive health.

Ensuring that the post-2015 development agenda continues to advance the social, economic and political empowerment and human rights of girls and women remains a top priority for the United Kingdom, and we will continue to work tirelessly to ensure that the final framework advances the needs of girls and women. The noble Baroness, Lady Kinnock, mentioned prioritising what women want in terms of safe abortion. Where girls and women have taken the decision to terminate a pregnancy, our aim is to ensure that they do not put their own lives at risk. Improving access to safe abortion saves maternal lives and reduces maternal ill health; I stress that very strongly.

Beyond international targets, we know what is needed on the ground. We need to see high-quality reproductive midwifery and emergency obstetric services being delivered through well functioning health systems. There is much more that we need to do. Most of these deaths are preventable. We must ensure that clear targets for improved sexual and reproductive health and rights are included to prevent maternal and newborn deaths. They must be secured in a post-2015 framework. We are working extremely hard on this and anything that noble Lords can do working with southern voices in these next crucial months is vital.

My noble friend Lady Tonge mentioned the omission of “sexual rights” from the UN Secretary-General’s recent synthesis report. This report is one of many inputs into the process. We still wish to see the full sexual and reproductive health and rights package reflected in the final framework. We need to ensure that women can access contraceptives if they wish to prevent pregnancy and, if they become pregnant, have access to skilled health workers who have the right drugs and equipment at the right time in the right place to be able to respond to complications during pregnancy and childbirth. I was very moved at the Christian Aid carol service to hear some of the stories from Kenya.

We need health financing systems that mean women do not have to make choices between accessing care and feeding their families. I agree with the right reverend Prelate in terms of finance that a sustainable solution can come only when countries finance their own healthcare adequately. He is absolutely right that tax reform is a key part of that.

We need supporting information systems that tell us whether our efforts are working and how and where to improve them, ideally taking advantage of new technologies, as the noble Lords, Lord Alton, Lord Collins and others mentioned. All this is why universal health coverage must be an important part of the post-2015 agenda. Strong health systems are vital. It is because Sierra Leone and Liberia have fragile health systems as fragile countries that the Ebola epidemic was able to take hold. That is why we are involved in such countries and why such health strengthening has received 20% of DfID’s budget.

We need to continue to work on the social determinants of health, such as poverty, better nutrition, education, and so forth, as I have said. Crucially, as noble Lords have made clear, we need the empowerment of girls and women, to enable them to have voice, choice and control within their households, their wider communities and across their nations. Noble Lords have made a powerful case for that. That means working at every level. I agree with the right reverend Prelate that that clearly involves working at community level and we have our aid-matching system as one of the key mechanisms for that. There are others in our portfolio of support for civil society.

All this is doubly important when we are talking, as noble Lords have, of the hardest-to-reach groups: the youngest, the poorest, the most geographically isolated and those affected by conflict—those left behind by the progress towards the current MDGs. That is why the new set needs to ensure that they leave no one behind. More rapidly declining rates of maternal and newborn deaths will tell us when we are getting this right.

House adjourned at 6.19 pm.

Syrian Refugees

Baroness Northover Excerpts

Tuesday 13th January 2015 Lords Chamber

[Lord Selkirk of Douglas]

To ask Her Majesty’s Government, with reference to the Oxfam survey which found that 65 per cent of Syrian refugees feared they might not be able to return to their homes, how they are co-ordinating with host countries such as Jordan, Lebanon, Turkey and Iraq to improve the living conditions, educational opportunities and employability of those who have fled the conflict in Syria.

[The Parliamentary Under-Secretary of State, Department for International Development (Baroness Northover) (LD)]

My Lords, the United Kingdom is working with and through Governments and partners in the region to meet the needs of Syrian refugees and their host communities, including for food, shelter and education. In the current financial year the United Kingdom has committed over £62 million to activities in Lebanon, £39 million for activities in Jordan and £53 million for activities undertaken at a regional level, including in Iraq and Turkey.

[Lord Selkirk of Douglas (Con)]

I thank the Minister for her very positive reply. Although providing food, shelter and medical assistance must remain an immediate priority to reduce human suffering, given that there are over 1.3 million refugees under 18 and that the United Nations says that two-thirds of these are receiving no education at all, does the Minister accept that the provision of schooling and vocational education is essential, in the longer term, for them to get a better chance of obtaining employment? Does she agree that, looking further into the future, there is a case for the host countries to relax restrictions on refugees getting legitimate jobs, especially where there are both skills shortages and gaps in the local labour market?

[Baroness Northover]

My noble friend is absolutely right. We are deeply concerned about the impact of the crisis on Syrian children. As he probably knows, we helped to launch—and gain international support for—UNICEF’s No Lost Generation initiative. We have allocated £82 million to provide protection, trauma care and education for affected children. In response to the other points in the Question, we are in close consultation with authorities in host countries on the legal status of refugees and the importance of self-reliance through income generation.

[Lord Alton of Liverpool (CB)]

My Lords, the Minister will have seen reports not only of Syrian refugees dying on the high seas trying to escape, but, this weekend, of refugees dying of the cold in Lebanon, where there are 400,000 in the Bekaa valley alone. Has she seen the request by the United Nations refugee agency for an urgent, immediate response to that crisis? Will she also tell us how many refugees we have been able to accept in the United Kingdom, given the United Nations’ request that over 100,000 need to be accepted by developed nations, and following yesterday’s welcome decision by Canada to accept a further 10,000?

[Baroness Northover]

There are immense pressures on the Syrian refugees. In terms of the challenges of winter, the United Kingdom has contributed £32 million towards what is called “winterisation”—that is, the provision of warm blankets, tents, shelters, stoves and so on. As regards admission to the United Kingdom, a number of people have come through the vulnerable persons relocation scheme, but we have in addition given sanctuary to more than 3,800 Syrian nationals and their dependants.

[Lord McConnell of Glenscorrodale (Lab)]

My Lords, citizens and political leaders across Europe have rightly made a stand over recent days for humanitarian values, human rights and tolerance. I wonder whether there might therefore be an opportunity for the Government to discuss with the European Union an overall raising—and implementation—of the target for introducing refugees from these horrific camps in Jordan and elsewhere into the member states of the European Union in far greater numbers than have been admitted so far.

[Baroness Northover]

The noble Lord is right to draw attention to what happened last week and to the stand that we have taken for freedom of speech and the rule of law. What is clearly essential here is a long-term political solution. It is very clear that the refugees in the region wish to return to Syria. Therefore, the contribution that the United Kingdom is making to support refugees in the region is extremely important. We are the second-largest bilateral supporter. As I say, we are granting asylum where appropriate, as are other EU countries, but it is extremely important that we take forward a political solution here.

[Lord Ashdown of Norton-sub-Hamdon (LD)]

My Lords, I repeat my declaration of interest as president of UNICEF UK. Is my noble friend aware that Syria now ranks as the largest humanitarian crisis that we have had since the Second World War, with 2 million children now in desperate need as an unusually cruel winter sweeps across the Middle East? Is she aware that the last UN appeal for funds was 40% underfunded at the end of last year, despite the Government’s acknowledged generosity? Will she assure us that the Government will be as generous in this year’s UN’s appeal and do everything they can to encourage laggards to follow their lead?

--- Later in debate ---

[Baroness Northover]

I can give all those assurances. We are a leading contributor, as my noble friend rightly points out. We also encourage other nations, both at the Kuwait pledging conference and at the UN General Assembly, to bring forward their own contributions, helping to raise $3.3 billion. However, he is right about the scale of this crisis. We continue to play our part internationally.

[Lord Hylton (CB)]

My Lords, almost three years after the start of fighting in Syria, and given that a political solution is a long way off, is it not clear that resettlement in third countries outside the region will be necessary? Will Her Majesty’s Government therefore consult the International Organization for Migration on this very point?

[Baroness Northover]

A political solution has to be the way forward, given the population of some 22 million in Syria. At the moment, 12.2 million people within Syria require assistance. It is critical to try to take forward a political solution, and we are working internationally on this. The UN is working on it. There are conferences further down the track. It is extremely important that that is addressed.

[Baroness Symons of Vernham Dean (Lab)]

My Lords, was not the Minister right when she said a little earlier that a long-term political solution is needed, and that this is a short-term crisis? She has acknowledged that this is one of the cruellest winters in the Middle East, and children are dying now—they cannot wait for the long-term political solution to come forward. Can she tell us whether the Government will review the figures of the refugees who we are taking at the moment? Compared with the numbers that we should be looking at, 3,800 is a tiny number. What numbers are our European partners taking? How do we compare? Will the Government please find it in their hearts to be more generous in taking these people who are in dire difficulty?

[Baroness Northover]

It is because they are in dire difficulty now that we are putting in our bilateral support of £700 million, which is way ahead of most other countries. We have also taken more refugees and asylum seekers here than most other EU countries. As the noble Baroness will know from her experience in the Foreign Office, that is not the long-term solution that is required. If she looks at the Oxfam survey of the refugees, she will see that they wish to return to Syria and not to move to other countries. We have to support them in that political aim, and support them right now in their immediate needs. That is what we are doing.

Ebola

Baroness Northover Excerpts

Thursday 8th January 2015 Lords Chamber

[Baroness Northover (LD)]

My Lords, I start by thanking my noble friend Lord Fowler for securing this important debate and all noble Lords who have contributed for their considered responses. As my noble friend Lord Fowler and others have made clear, this epidemic has terrible individual consequences, as well as wider social and economic consequences.

I join noble Lords in my extremely deep concern for Pauline Cafferkey. The Royal Free has just issued a statement, and I understand that her condition remains critical and is unchanged. The bravery and compassion shown by Pauline and her colleagues have helped to save thousands of lives in Africa. Like my noble friend Lord Fowler, I pay tribute to all those who have volunteered to help in that dreadful crisis. I here commend the son of the noble Lord, Lord Patel, Dr Neil Patel, as he undertakes his own challenging tasks in Sierra Leone, leaving shortly. It is vital that we never compromise the safety of such extremely brave volunteers and I can give the Government’s unequivocal commitment on that. Clearly, Save the Children and Public Health England keep this under constant review. They are reviewing the situation at the moment and we will update noble Lords as soon as possible.

I note what the noble Lord, Lord Collins, said on that and what he said about standing rosters. We have taken forward quite considerable amounts of development to ensure that those who wish to volunteer are properly trained before such a crisis and are able to be deployed in humanitarian disasters. There is new training offered by the Royal College of Surgeons to ensure that those who volunteer are safe and effective in dealing with the need in question, so I hope that the noble Lord will be encouraged to hear that. Guidelines on this particular crisis are kept under review all the time.

Noble Lords will appreciate that DfID is still focused on containing and eliminating the Ebola virus in Sierra Leone, where the UK has the leading international response. I thank the noble Lord, Lord Patel, for his tribute and I will pass it on to my outstanding colleagues in DfID. So far, we have committed more than £230 million to combat Ebola in Sierra Leone, and have already delivered more than 1,200 treatment and isolation beds and three new Ebola testing laboratories. We are also working closely with the Government of Sierra Leone to train and equip burial teams to ensure safe burial practices.

The noble Lord, Lord Collins, mentioned differences in Liberia. I am sure he will know that there are all sorts of cultural differences between the two countries—different social norms and so on—which underpin what has happened in them in this epidemic. I am quite happy to go into further detail outside as to why there have been differences here.

As the noble Baronesses, Lady Kinnock and Lady Hayman, indicated, there are tentative signs that we may have reached the peak of the disease in Sierra Leone. But as both were saying, we should not be complacent; the response is far from over. Like my noble friend Lord Chidgey, I pay tribute to the response that has come from African countries.

The economic impact of this should not be underestimated. Various noble Lords, including the noble Lord, Lord Giddens, made reference to that but I think we are all aware of it. The noble Lord also flagged the financial commitments of the World Bank. We are acutely aware that promises do not necessarily get delivered and we are working very hard to ensure that, where promises have been made, they are duly delivered.

We agree that a long-term interest in affected countries is essential to ensure recovery. The EU is convening a meeting in early March to look at resources for this and the WHO has a special session in late January to agree reforms, so a number of things are under way.

While our principal focus must continue to be on the ongoing response, it is essential, as my noble friend Lord Fowler pointed out, that we learn lessons from these actions both here in the United Kingdom and internationally. This Ebola outbreak has been unprecedented. More than 8,000 people have died and it is crucial that we make changes to ensure that this never happens again—and that lessons are carried over for other potential epidemics, as was pointed out by noble Lords, in particular my noble friends Lord Fowler and Lord Chidgey.

It is evident that international reform is required. The World Health Organization and the wider international system did not respond quickly enough to this threat before it got out of control. While progress has been made in efforts to strengthen global health security following SARS and avian flu outbreaks, the Ebola outbreak demonstrates that there is still much to do in responding efficiently to public health emergencies. As I have mentioned, the WHO executive board is convening a special session later this month to examine some of these issues, and I am sure that the points made by noble Lords, including the noble Lord, Lord Patel, must be considered. In particular, we need to look at surveillance, stronger early warning and response mechanisms, and how the global community identifies and responds to potential crises in the future. Like the noble Baroness, Lady Kinnock, I noted that Nigeria managed to check cases in the initial stages and it should be commended for that. Lessons needs to be learnt from how that was achieved, even though, again, we cannot be complacent.

The international community needs to be ready to respond rapidly and deploy public health experts immediately. The noble Baroness, Lady Hayman, had a number of important perceptions here as to changes that might be needed and the way in which the international system needs to link to what happens within a particular country and be sensitive to the arrangements and the views, beliefs and practices within those countries. This was a point which my noble friend Lord Chidgey also made.

In linking to national systems, a number of noble Lords emphasised the importance of strengthening health systems. We have been investing heavily in strengthening health systems in Sierra Leone through our bilateral aid programme but, barely 10 years after the end of a devastating civil war, health systems are still fragile and unable to cope with a crisis of this scale. My noble friend Lord Fowler made it crystal clear that the weakness of health systems is fundamental in this case. International support from DfID, but also from the World Bank, IMF and UN, will be critical in supporting Sierra Leone and the wider region to recover from this devastating crisis. Supporting the health sector ravaged by Ebola will be a priority, as well as supporting vulnerable groups such as orphans, children, women and girls.

I heard what my noble friend Lord Fowler said about consistency in support. That seemed to me to be an argument for the 0.7% Bill, which will come before this House on 23 January. I hope that noble Lords will support it. The aid budget has often been subject to easy battering in the past. Consistency and predictability are vital, which is why it is important to legislate for that level of aid. I welcome the support of the party opposite on this. Investment in human development is vital to the elimination of poverty and the growth of developing countries. I can assure noble Lords that we fully recognise that. In DfID, 20% of our budget in Sierra Leone has been spent on health programmes, and that will continue to be the case when this crisis is over as well. We agree that weak health systems in the affected countries have contributed to the rapid spread of Ebola.

We also agree that there has been a significant drop in the utilisation of health services, a point made by my noble friend Lord Chidgey and others, including the noble Baroness, Lady Hayman. We are therefore working with experts to determine strategies to decrease malaria deaths, including using new drugs and making sure that there are adequate stocks in Sierra Leone to try to address this. We recognise that it is vital to prepare the health sector for future shocks and have started to consider this challenge. National institutions are crucial but we also recognise that it will take time to build up health systems capable of dealing with major epidemics. That is why we focus on poorer developing countries; that is where the need is greatest.

To improve response to infectious disease outbreaks we need to ensure that, as far as possible, we have proactively identified potential diseases and developed technologies such as vaccines and treatments to address them. A number of noble Lords made this point. We need to be able to deliver rapidly clinical trials of promising candidates, resolve intellectual property disputes over them, scale up production, put in place adequate delivery capacity and manage the increased liability risks, while securing financing for all this.

I would dispute what my noble friend Lord Fowler said about reducing our aid spend in Sierra Leone. In 2010-11, we spent £51 million; in 2013-14, it was £69 million.

Our support for vaccines has been a major move by DfID under this Government. My right honourable friend Stephen O’Brien was quite remarkable in the way that he brought forward the proposals on support for what were called neglected tropical diseases, and I think that people will pay tribute to him and DfID for the work that was done. I think that we have a strong record in this regard, and that is something that we will continue to focus on and to regard as very important.

Our focus remains on ridding Sierra Leone and the surrounding region of Ebola. It is critical that we learn the lessons from this crisis to ensure that it never happens again. We realise how a crisis like this affects us all and how it has devastating consequences, both individually and more widely on societies and economies. We understand that, and we all need to see what lessons need to be learnt and then—most importantly, as the noble Lord, Lord Giddens, indicated—acted upon.

Global Development Goals

Baroness Northover Excerpts

Thursday 11th December 2014 Lords Chamber

[The Parliamentary Under-Secretary of State, Department for International Development (Baroness Northover) (LD)]

My Lords, I, too, thank the noble Lord, Lord McConnell, for securing this debate. He has a formidable record in this field, as have all others who have participated in the debate. I knew that it would be an extremely well informed and deeply thoughtful debate, and it has proved to be so. What shines through is an understanding of why this is so important. The right reverend Prelate urges us on in communicating what has been achieved since 2000, even with the financial crash of 2008 onwards, in the relief of poverty. He is surely right.

As noble Lords know, the year ahead of us is absolutely key—as the noble Lord, Lord Hannay, made clear, not only on MDGs but on climate change and many other issues. A key moment, and the culmination of the subject of this debate, will be the summit in September 2015, where the world will seek to come together to agree a new set of sustainable development goals to take us to 2030. We believe that the international community has a duty to produce an inspiring framework that will put us on a sustainable development pathway to eradicate extreme poverty within a generation, building on the successes of the MDGs.

The United Kingdom has played an active role in the post-2015 development process to date. From my right honourable friend the Prime Minister’s co-chairmanship of the high-level panel to the recent Open Working Group on Sustainable Development Goals, we have been extremely active. With the formal intergovernmental consultations on post-2015 running from January to July 2015, and with the report of the UN Secretary-General on post-2015 released last week, today has been a timely opportunity to reflect on the progress the international community has made so far.

First, I will touch on the work of the open working group. Over 13 sessions, member states in the group discussed a range of issues and inputs into the post-2015 agenda, and ultimately its July report proposed a framework of 17 sustainable development goals and 169 targets. The UK Government have welcomed the breadth and balance of this report and there are a number of extremely positive aspects to it. There is a strong focus in the proposals on the eradication of extreme poverty, and welcome goals on gender equality, peaceful and inclusive societies, and access to justice. There are some useful objectives on environmental sustainability and we will continue to work so that this is integrated within the agenda.

As my noble friend Lady Jenkin pointed out, the power of the MDGs was in their simplicity, and the ability for planning and finance ministries to take them in their entirety and to help define their national plans, rather than to pick and choose which targets were most politically expedient. We have heard from statistical experts and implementing ministries in developing countries that turning the current 169 targets into meaningful, measurable and manageable action on the ground would be nearly impossible. Making long lists—and we know this very well in this House—can result in whatever is missed out not being counted. This is why there is an argument for an overarching inclusive approach. Over the coming months, we look forward to working with other member states, civil society and technical experts to ensure that what we agree in September is a genuinely workable framework.

As the noble Lord, Lord Hannay, said, what we surely cannot allow is failing to agree something meaningful. As noble Lords have noted, the UN Secretary-General released his report, The Road to Dignity by 2030. Tasked with synthesising the many contributions to the post-2015 discussions to date, the Secretary-General has called on member states to strive, with the highest level of ambition, to end poverty, transform all lives and protect the planet. As the noble Lord, Lord McConnell, and others have said, he set out the six essential elements that member states should strive towards: dignity, people, prosperity, planet, justice, and partnership. The elements can provide a helpful organising framework for the negotiations to come, and they point towards a focused outcome on post-2015. It is important that the final framework is inspiring and that we can communicate it. That certainly provides food for thought.

We have also been clear on the need for a framework that can be monitored and implemented—again, as the noble Lord, Lord Hannay, said. I note the Secretary-General’s proposal for a technical review of targets to ensure that each is framed in language that is specific, measurable and achievable. One of the downsides of the MDGs was in effect the use of averages, which left many behind—although that was never intended. The UK remains a strong advocate of the principle “leave no one behind” and it is notable that the Secretary-General’s report also supports this approach.

Leaving no one behind must be, in our view, a key to the new goals. The noble Lord, Lord Judd, flagged an ageing world population. We know that around the world, as the world of work changes and as cities grow, there is a serious danger of older people, possibly increasingly infirm, being left out as economies may grow. Women are so often left behind, as we have heard. LGBT people may be left behind. Those with disabilities may be left behind. I thank the noble Lord, Lord Low, for his tribute for what we have done in terms of disabilities, particularly what my right honourable friend Lynne Featherstone has done to ensure that we include those with disabilities. As the noble Lord, Lord Low, notes, 15% of the global population has a disability and 80% of those with disabilities live in developing countries. That is why leaving no one behind is so essential.

Many noble Lords will recall the high-level panel’s proposal that no post-2015 target should be considered achieved unless met by all relevant social and economic groups and we are pleased that this has been reinforced in this latest report. Building on this, the report also emphasises the importance of data to the post-2015 agenda. The UK has been clear throughout that a data revolution is needed better to collect, use and open up data for maximum effect, bringing together all those who are relevant in this area. The noble Lords, Lord McConnell and Lord Judd, and others have noted that as being a vital tool in this regard.

I note what the noble Lord, Lord McConnell, said in his opening remarks—others echoed this—about how essential it is that women are central to these goals. My noble friends Lady Jenkin and Lady Hodgson put the case extremely effectively for why women and girls must be front and centre. The UK Government have argued strongly for a dedicated goal that addresses the causes of gender inequality, as well as for gender-sensitive targets and indicators throughout.

I am also very glad that climate change and the environment have been integrated into the whole process of these goals, as there was a danger that the issue was just going to be running alongside. That integration is clearly essential, as noble Lords have pointed out; the noble Lords, Lord McConnell, Lord Judd, Lord Hannay and Lord Collins, my noble friend Lord Chidgey and others have all emphasised it and numerous NGOs have made that case, as the noble Lord, Lord Judd, noted. Those in developing countries, as we have just heard from the noble Lord, Lord Collins, are indeed the most vulnerable to climate change. It is also a matter of global security, as noble Lords have said. It is impossible to consider eradicating poverty by 2030 without addressing climate change, so we firmly believe that the framework must include measures in this regard.

On peace and security, the noble Lord, Lord Hannay, who is a member of another UN high-level panel, knows a great deal about the need to integrate development for global security, and this is all consistent with that. The noble Lord, Lord McConnell, and others mentioned this, and it will indeed be critical to ensure that peace and security, the ruler of law, access to justice and inclusive economic growth are reflected in the final outcome.

The noble Lord, Lord Collins, mentioned universal health coverage. Health, including sexual and reproductive health rights, is a prerequisite for human and economic development and we are strongly supportive of universal health coverage as an essential means to achieve health outcomes.

The noble Lord, Lord Low, rightly talked about the need to integrate. He flagged education, which of course needs to be properly integrated. We do not want processes that duplicate but ones that are mutually supportive, and we will have to look right across the board as far as that is concerned.

My noble friend Lord Chidgey mentioned working with parliaments. Indeed, we support the need for effective monitoring and accountability at all appropriate levels for this framework and that very much includes parliaments, which play a pivotal role.

On universality, I reassure the noble Lord, Lord Cashman, that the UK is clear that the next framework should be universal and all countries should have responsibilities in it, so it will apply to the UK. Discussions are continuing at the moment between departments in preparation for that.

There is more to the post-2015 agenda than goals and targets alone, of course. In July next year there will be a major conference in Ethiopia at which the international community will decide how best to finance the new framework, and the Secretary-General’s report acknowledges the importance of an ambitious set of means of implementation, including overseas development assistance and other resources.

I thank those who have paid tribute to the UK on reaching 0.7% of GNI devoted to overseas development. I think that the UK should be proud of reaching that goal, especially at a time of austerity. I assure the noble Lord, Lord Hannay, that the Government are fully committed to supporting my right honourable friend Michael Moore’s Private Member’s Bill, which will enshrine this, and I am delighted that my noble friend Lord Kirkwood will be leading the Bill through the Lords, supported right around the Chamber, I hope. It is enormously helpful to hear the voices in support of the Bill. From the Government, of course, I shall be strongly supporting it.

It is because we have met 0.7% that we have been able to become such a significant donor for multilateral organisations, such as the Global Fund and Gavi. I heard what my noble friend Lord Avebury said about Gavi. I would gently point out that the United Kingdom is the largest donor to Gavi. Although, of course, I am absolutely delighted to hear about other countries increasing their level of commitment, that has to be measured against the enormous commitment that the United Kingdom Government have already put in. It is extremely important, and my right honourable friend the Secretary of State has recently announced up to £1 billion in direct funding contributions for 2016-20. That is in addition to our existing long-term commitments. I fully recognise the contributions that Gavi makes, as my noble friend outlined.

Significant progress has clearly been made over the past year in terms of what is being brought forward internationally. I will engage with my noble friend Lord Eccles, who has such a long and distinguished history on the economic side of development, not least through the CDC. We fully recognise that people are pulled out of poverty through the economic transformation of their countries. I absolutely agree with him. Our focus on human development, so that people have the education and skills to participate in our globalised world, underpins much of what we do. It is one of the reasons why we support the development of health systems, so that economies can power ahead. It is also why we ensure that we focus on governance, that that is strengthened so that, for example, countries can draw in taxation that they need to support their human development. The noble Lord, Lord Collins, mentioned the importance of taxation. It is also why we seek the reduction in tariff barriers, to ensure that countries can trade with each other. The CDC, with which of course the noble Viscount is so very familiar, helped fund the expansion, for example, of mobile money in Kenya, including those who were outside the banking sector, enabling them to be brought within the economy so that it could move forward. Human development goes hand in hand with, and underpins, economic development, so I do not see a contrast between our approach in terms of underpinning human development and focusing on economic growth.

The noble Lord, Lord Cashman, was concerned about the reduction and clustering of the goals. I will come to this in a little bit more detail in a moment. We clearly welcome the breadth and balance of the report of the Open Working Group, but we are concerned about whether 17 goals and 169 targets are sufficiently focused and whether actually they then lead to leaving things out, because you can be pretty sure they are not going to be as comprehensive as you would wish.

We are moving forward into the next stage. There will be the intergovernmental negotiations, co-facilitated by the permanent representatives of Kenya and Ireland in New York, that help to define the final post-2015 framework. The United Kingdom will be an active participant in this process, and we will continue to work closely with other member states within and beyond the EU and with civil society and other key stakeholders to press for the ambitious framework we need.

The noble Lords, Lord McConnell and Lord Cashman, spoke about the EU. We have advocated for a proactive EU approach to the post-2015 discussions, and, having worked closely with other EU member states and the commission, we are confident that the EU commission on post-2015 will reflect joint priorities and assist us as we try to secure an inspiring and implementable framework. The EU can be a very powerful group if its members work together—the noble Lords are absolutely right. That is why we have been working so closely together to try to have a common approach. I assure noble Lords that a great deal of effort has gone into that.

It was interesting to listen to the list of organisations that the noble Lord, Lord McConnell, mentioned, in which the United Kingdom plays a leading part. The organisation he did not mention, which of course also influences this discussion, is the G77. He will know that those different organisations have conflicting approaches.

The MDGs were, largely, drawn up by one hand: by a Member of this House, the noble Lord, Lord Malloch-Brown, from the Benches opposite. The MDGs had a simplicity, and they had an effect. As the noble Lord, Lord Hannay, indicated, that was not widely anticipated. However, that is what happened, so all now recognise the importance of their replacement. It is excellent that the world has engaged in this area. The risk is that what is produced does not have the clarity and purpose of those first goals, in which case it will not guide and will not have the effect that we all wish. Of course those first MDGs had limitations. We are in the final stages now, and I welcome this debate and the engagement of all noble Lords here, who have such huge expertise and influence. I hope that all will apply that expertise and influence to ensure that what replaces the MDGs is directed at ending extreme poverty by 2030. That is why leaving no one behind, and the desegregation of data so that we know whether people have been left behind, is so critical.

As the noble Lord, Lord Collins, pointed out, it is both morally right to address poverty and in our national interest to do so. The challenge is to secure the bold and visionary agreement that he so rightly seeks, as we all do. We live in interesting and risky times; there is so much to play for here. We must ensure that we work together, and internationally, to build on the remarkable achievements of the MDGs and put in place something that learns from them and is inclusive, and which renders the horrendous poverty and deprivation, to which the noble Lord, Lord Judd, so eloquently pointed, a thing of the past.

AIDS, Tuberculosis and Malaria

Baroness Northover Excerpts

Thursday 11th December 2014 Lords Chamber

[The Parliamentary Under-Secretary of State, Department for International Development (Baroness Northover) (LD)]

My Lords, I also thank my noble friend Lord Fowler for putting this issue once again on the Order Paper, for his passionate and informative introduction of it, and for his long campaigning history in this field. He makes the point that, although progress has been made, there is still much to do. I fully agree with that. I also congratulate him on the publication of his book AIDS: Don’t Die of Prejudice, as was noted by my noble friends Lord Lexden and Lord Avebury. The concerns he raises in that book and elsewhere—the noble Lord, Lord Cashman, and my noble friend Lord Lexden referred to this—about the discrimination and bigotry that surround this issue are, as noble Lords have indicated, of tragic significance.

Various noble Lords addressed the legal and societal barriers to human rights in this field. I can assure them that the Government are at the forefront of promoting human rights around the world. We regularly engage with Governments that violate these rights. We also support civil society groups that advocate for the relevant groups. I have just come from a meeting with Stonewall and the Kaleidoscope Trust. We explored how best to support voices in this area. I assure noble Lords that we will continue to engage in as effective a way as we possibly can.

Clearly, the level of prejudice is very striking. I saw that at first hand, when I visited South Africa recently. Representatives of the lesbian, gay, bisexual and trans -gender community told me of the difficulty they had, even in an environment where the law would seem to protect their rights, in accessing specialised services geared to their needs. I learnt also of the terrible plight of rape survivors in South Africa and southern Africa, about 30% of whom become infected with HIV, and who risk rejection from society. It is enormously challenging. AIDS, TB and malaria remain among the biggest causes of death and illness in developing countries. In 2013 alone HIV/AIDS killed 1.5 million people, malaria killed 584,000 people and TB killed 1.5 million people.

Progress has been made: new HIV infections are declining in many of the worst-affected countries; there has been a significant reduction in malaria incidence and deaths; and the world is on course to halve TB deaths by 2015, compared with 1990 levels. Clearly, the Global Fund has played a major part in this and that is why we are so strongly supportive of it. As my noble friend Lord Chidgey spelt out, since 2002, Global Fund-supported programmes have kept 7.3 million people alive with HIV therapy, distributed 450 million insecticide-treated nets, and detected and treated 12.3 million TB cases. These efforts to end the AIDS epidemic accelerated last year, with increases of 20% in the number of people being treated for HIV and malaria through Global Fund-supported programmes, and smaller increases in numbers being treated for TB. That is a truly remarkable achievement.

The UK has played, and continues to play, a critically important part in these successes. I can assure the noble Lord, Lord Collins, that we are very active in seeking others’ help; that is one of the reasons why we have used the help as we have, in order to lever the other assistance that needs to come in internationally. We worked with the Global Fund to develop a new funding model that prioritises investments in countries with low incomes and a high burden of disease—countries such as the Democratic Republic of Congo, where over 11% of all global malaria deaths take place. The model has increased allocations to these countries by 40%. It is worth noble Lords bearing that in mind, as we seek to tackle the high burden of very poor countries that the Global Fund has identified.

One year ago, the UK pledged up to £1 billion to the Global Fund for 2014-16, but our contribution does not end there. For example, last year the UK worked with the Global Fund and others to pool our procurement of insecticide-treated nets—the most effective intervention to prevent deaths from malaria—and used our market power to drive sustainable reductions in prices. Noble Lords rightly highlighted the challenge of cost here: that is saving $140 million over two years. The Global Fund is now rolling out similar approaches across a range of commodities. Savings will be used to enable the Global Fund to reach more people with life-saving interventions.

However, although these achievements are impressive —and I think they are worth noting, as noble Lords flag up what else needs to be done—clearly we are not complacent. Improvements are not uniform in all countries; we have heard that referred to in this debate. Resistance to effective medicines is indeed a growing threat and devastating rebounds can occur quickly if there is any let-up in prevention and treatment efforts.

One issue in particular that is concerning is the impact of the AIDS epidemic on women and girls. The noble Lord, Lord Cashman, referred to this. Every hour, 50 young women are newly infected by HIV. The infection rates are twice as high as in young men. The Global Fund, with UK support, has made a strong commitment to the health of women and girls, and we are very pleased that that is the case. It is increasing its own capacity and building capacity at country level to mainstream women’s and girls’ concerns into programme design. But the power dynamics within societies that underlie these problems will not be easily tackled, and we look to the Global Fund to redouble its efforts. Of course, programmes such as the use of microbicides are also relevant here, as the noble Lord, Lord Cashman, said.

There were a number of specific issues that noble Lords mentioned. The noble Lord, Lord Fowler, mentioned the AIDS conference in 2014. That happened to be held in the same week in July as the Girl Summit —which I hope the noble Lord was acutely aware of—and at which Malala spoke, among others, as I referred to yesterday. It was a stunning occasion and I was very glad to be able to be there. I was also happy to go to Australia; my noble friend will have to ask the previous Chief Whip about why I was not allowed to. Nevertheless, I was the beneficiary, therefore, of being able to attend the Girl Summit here, in Simon Hughes’s constituency. FCO colleagues from the high commission in Canberra attended the meeting in Australia on behalf of the United Kingdom. The noble Lord will know how committed we are in terms of the Global Fund and as far as tackling HIV, malaria and TB is concerned.

The noble Lords, Lord Cashman and Lord Chidgey, and my noble friend Lady Barker challenged us on lower-income countries. We support the Global Fund’s new funding model, which funds the most cost-effective interventions where the need is greatest, which is in the low-income, high-burden countries; but we do ask the fund to focus more heavily on key populations in the middle-income countries, where they are investing. I hear what noble Lords say; but it is also important that we all galvanise here, to ensure that Governments themselves—such as the Government of India, where the noble Baroness, Lady Barker, saw what she saw and I have seen it, too—step up to provide those services. They cannot simply be underpinned because we have the Global Fund; we must make sure that we are not neglecting the poorest in the poorest countries for the sake of those countries in which something more can, and must, be done.

The noble Lord, Lord Cashman, referred to harm reduction. Clearly, we are firmly committed to supporting harm reduction to reduce HIV transmission in injecting drug users. My noble friend Lord Fowler referred to that as well. The United Kingdom has indeed—no doubt, chivvied along by my noble friend Lord Fowler—led in this regard.

We are supporting market shaping, which I think we have spoken about before. The noble Lord, Lord Cashman, and my noble friends referred to ARVs. We are working with others to try to ensure that we have got reduction in prices, to get ARVs to as many people who need them as we possibly can.

My noble friend Lord Avebury and the noble Lord, Lord Collins, asked about bringing together TB and HIV. We are well aware of that as a co-infection and it is part of our ongoing work. In 2011, when we reviewed this, that was one of the issues we particularly focused on. As noble Lords will know, we are working through UNITAID, UNAIDS and also the Stop TB Partnership and are seeking further product development research and market shaping for TB vaccines as well as HIV drugs and diagnostic tools.

My noble friend Lord Avebury invited me to suggest what the Chancellor might do in the future—in the year, I think, beyond the general election—which is an interesting suggestion. I am afraid that I cannot foresee exactly what will happen in that general election, though perhaps he can. But he will know that the Department for International Development’s budget is ring-fenced until 2015-16, and therefore the commitment that he might have wanted to see in the Autumn Statement was already in place in terms of the funding for DfID.

I am extremely happy to meet Peers and CSOs in the way my noble friend Lady Barker suggested, and if the noble Lord, Lord Collins, wants to join, I am very happy to talk about that and our support for research. I hear what noble Lords are saying about drug-resistant diseases. I have a personal interest in this issue, in that one of my children is currently being treated in hospital for such a thing. It brings into focus exactly what Jim O’Neill is saying. Looking at this whole area will be exceedingly important.

The Global Fund has made a fantastic difference. We have been a major support of it in terms of tackling TB, malaria and HIV. We will continue in that way. We welcome people’s engagement in ensuring that we are focusing as we should. We listened carefully to what noble Lords are saying but they should not doubt our commitment in this area.

Malala Yousafzai

Baroness Northover Excerpts

Wednesday 10th December 2014 Lords Chamber

[Baroness Berridge]

To ask Her Majesty’s Government what plans they have to recognise the award of the Nobel Peace Prize to Malala Yousafzai for her contribution to girls’ education nationally and internationally.

[The Parliamentary Under-Secretary of State, Department for International Development (Baroness Northover) (LD)]

My Lords, on behalf of the UK Government I would like to congratulate Malala Yousafzai and Kailash Satyarthi on sharing the Nobel Peace Prize today. Both have achieved a great deal. Malala is a truly remarkable young woman who has done much for girls’ and boys’ education globally and specifically within Pakistan. My right honourable friends the Prime Minister and Deputy Prime Minister have publicly recognised her achievements, including the award presented today.

[Baroness Berridge (Con)]

I thank my noble friend for her Answer. However, when Malala addressed the General Assembly of the United Nations she stated:

“One child, one teacher, one book and one pen can change the world”.

We have so often failed to recognise the dedication and risks that teachers take in some circumstances, as Malala’s teachers did. As DfID funds so much girls’ education in Pakistan, could Her Majesty’s Government consider creating some kind of scholarship for professional development, or award, in honour of this Nobel Peace Prize, to honour those teachers?

[Baroness Northover]

My noble friend is right to highlight the contributions that good teachers make. We all know that, and DfID is indeed committing significant resources to education in Pakistan. Probably the most important thing is to sustain that commitment, both in terms of trying to get girls into school and also good teachers into those classrooms for all of those children.

[Lord Young of Norwood Green (Lab)]

My Lords, I am grateful to the noble Baroness, Lady Berridge, as I tried—and failed—to get this as a Topical Question when the award was first announced. Her timing is superb, as we know, because Malala received her award this morning. Perhaps the best way that we can recognise Malala’s astounding achievement, as a very courageous young woman with a wise head on her shoulders, is to invite her to address both Houses of Parliament. There is an honourable precedent for this: we have had previous Nobel Prize winners. Although the Nobel Peace Prize has had a somewhat chequered history, on this occasion they have got it absolutely right. She is a superb role model for young women and girls in this country, in a situation where many women, unfortunately, are being enticed to sacrifice their lives in rather foolish missions to become jihadist brides. She is a wonderful example. We could invite the UK Youth Parliament as well. I welcome the Minister’s response.

[Baroness Northover]

I heard Malala at the Girl Summit in July, and she was superb. She had a fantastic grasp of the importance of education for women and girls. I point out that she is in her GCSE year. We need to ensure that she is not deflected too much, for her own future, from her own exams and studying.

[Baroness Hussein-Ece (LD)]

My Lords, as has been mentioned around the Chamber, Malala has inspired many young people and young women around the world. She also expressed her concerns last year to President Obama. She said that,

“drone attacks are fuelling terrorism. Innocent victims are killed in these acts, and they lead to resentment among the Pakistani people. If we refocus efforts on education it will make a big impact”.

Do Her Majesty’s Government support what Malala has said? What are we doing to honour what she has said: to ensure that education is at the forefront, rather than conflict?

[Baroness Northover]

My noble friend will know that we put a great deal of stress on working in fragile and conflict-affected states. We fully recognise that development should be a driver towards peace and stability, which is one of the major reasons why we invest what we do in education.

[Lord West of Spithead (Lab)]

My Lords, I was privileged to show Malala and her family around the Palace of Westminster and to talk with her about Pakistan. She is the most amazing young woman. Could the Minister confirm—maybe she cannot say in detail what is happening; if she cannot say it on the Floor of the House, maybe she would write—that we are ensuring that Malala is protected? She has been shot once; she is in an area of this country where we know that there are jihadists. I would like to know that our nation is looking after this amazing woman.

[Baroness Northover]

The noble Lord will know that I cannot go into detail. We are indeed protecting her.

[Baroness Afshar (CB)]

My Lords, what is being done to teach the teachers? The problem in Pakistan is that the teaching available beyond schooling is imperfect, to say the least, as far as women are concerned. Would it be possible to offer scholarships for some of those bright women to train as teachers in this country?

--- Later in debate ---

[Baroness Northover]

Again, the noble Baroness is well aware of the significance of this. We are putting a great deal of effort into teaching the teachers. For example, in Pakistan we are training 90,000 teachers a year in Punjab and 16,000 in KP. She will see the scale of that, but it is extremely important that the training we offer is high quality.

[Baroness Kinnock of Holyhead (Lab)]

My Lords, does the Minister agree that tackling the barriers that women and girls face, not least to education, has to involve an urgent need to tackle the negative effects on their life chances of cultural attitudes, social norms, domestic duties, early marriage and pregnancy? Surely those elements dictate that access to education is made impossible.

[Baroness Northover]

Indeed. I agree with the noble Baroness.

[Lord Avebury (LD)]

My Lords, what steps does my noble friend think the United Nations can take to convince the people of Pakistan that the deprivation of women and girls’ education is costing their state and public enormous economic potential? Will that be something that she could draw to the attention of the Government of Pakistan?

[Baroness Northover]

Many people in the Government of Pakistan are aware of that and there is an encouraging increase in the number of girls as well as boys in school.

[Lord Collins of Highbury (Lab)]

My Lords, obviously education is key to women’s rights. The issue that we heard about last week was the London conference on Afghanistan. Can the Minister update the House on the outcomes of that conference, particularly for girls’ education and women’s rights?

[Baroness Northover]

There was a major emphasis on girls’ education and women’s rights and I participated in many events to do with that. I was very impressed by what the wife of the President said about the need to shape their own future, otherwise others will do so.

Tuberculosis

Baroness Northover Excerpts

Monday 8th December 2014 Grand Committee

[The Parliamentary Under-Secretary of State, Department for International Development (Baroness Northover) (LD)]

My Lords, first, I thank the noble Lord, Lord Collins, for securing this important debate. I also thank all other noble Lords who contributed to the debate this afternoon. This is indeed a very important area and I am glad that we have recently had Oral Questions on it and that my noble friend Lord Fowler has a related debate on the Global Fund on Thursday. I was very glad to speak at the All-Party Group on HIV and AIDS, of which I used to be an officer, at the launch of its report Access Denied, and I am very happy to share my speech.

As the noble Baroness, Lady Hayman, pointed out, these are not only diseases of poverty; they are diseases that cause further poverty. I thank the noble Baroness for her tribute to DfID. Like her, I pay tribute to our outstanding institutions that are working in this area, and I welcome her new involvement with Cambridge University Health Partners. We have a formidable academic record in the United Kingdom in this area.

The noble Lord, Lord Collins, pointed to a market failure in drug development in relation to diseases of poverty. Other noble Lords made reference to this as well. Between 1975 and 2000, just 13 new drugs were registered for use against the so-called diseases of poverty. That is about 1% of the total number of new drugs developed globally. Of course, the question is: why have those diseases been so badly neglected? As noble Lords have indicated, the answer lies in the lack of incentives for the pharmaceutical industry. Developing and bringing a new drug to market is an extremely costly and risky business and the industry did not see the incentives to bring those drugs forward. If we add the extremely limited profit margins associated with making those badly needed drugs available, it is not hard to see that fundamental market failures have meant that the development of affordable and accessible treatments has not been prioritised in the way it should have been. Noble Lords were quite right in their analysis of that.

The noble Lord, Lord Collins, and others mentioned the product development partnerships—PDPs. These have changed the situation, harnessing the best of the private sector so that it is channelled for the public good. The noble Lord, Lord Collins, also spoke about de-linking and several noble Lords spoke about intellectual property. All PDPs negotiate access to intellectual property for all products developed in order to ensure affordability and access. We need a number of approaches, not just de-linking, to ensure that many players can be involved and to bring in the expertise and resources from the private sector that may contribute to the PDPs.

The noble Lord, Lord Collins, and the noble Baroness, Lady Healy, asked whether we would commission a report on de-linking. I assure them that a number of groups are already looking at this, including a Treasury-sponsored group looking at antimicrobial resistance. If they want further details of that, I am sure that we can assist in that regard.

Since the emergence of PDPs, we have seen 10 new technologies brought to market and there are more than 350 candidates in the pipelines of PDPs collectively, including 90 drug and vaccine candidates and 32 diagnostic or vector control candidates. The UK is a leading investor in PDPs; in 1999, we were the first Government to provide support to a PDP, and currently support 10 PDPs covering neglected diseases. Since 2008, we have committed approximately £323 million to PDPs.

I assure the noble Lord, Lord Collins, that DfID has an open access policy. All research funded by DfID has to be placed in the public domain. For product development research, all new products must be made available for the lowest possible price. The noble Baroness, Lady Gould, rightly emphasised the key importance of such access to medicines and vaccines. I hope that they are reassured by what I have just said.

I am pleased to report that the DfID-funded PDPs have a strong track record of delivering a wide range of new technologies for diseases of poverty and of getting those into use in the developing world. This has included five new diagnostic tests for TB and six new drug combinations for malaria.

My noble friend Lord Lexden referred to the long history of TB and humankind. Like him, as a former historian, I am fully aware that that history is very different from the situation today. However, TB disproportionately affects the most vulnerable and marginalised in society. In 2013, 9 million people fell ill with TB and 1.5 million died. TB ranks as the second leading cause of death from an infectious disease worldwide, after HIV. The UK remains committed to help achieve the goals of the Global Plan to Stop TB to reduce deaths and prevalence of TB by half, compared to 1990 levels, by 2015 through our bilateral and multilateral support. A big part of that effort is investing in research into more effective diagnostics, treatment and vaccines. Noble Lords are absolutely right about that.

I assure my noble friend Lord Lexden that DfID is already the second-largest government funder in this regard. Following a funding gap for TB drugs this year, we gave an extra £5 million to the TB Alliance. I want to highlight the work of two DfID-funded PDPs in particular. The Foundation for Innovative Diagnostics has developed GeneXpert, a new diagnostic test for tuberculosis that gives fast and accurate results in four hours, compared to a previous wait of between six and eight weeks. Noble Lords will appreciate immediately how important that is. The Global Alliance for TB Drug Development is about to start a registration trial for a new combination of TB drugs. If successful, it has the potential to reduce treatment times for drug-resistant TB from between 24 and 30 months to six months—another issue that my noble friend raised.

What are we doing to change the global landscape? We recognise that effective co-ordination is crucial but challenging, given the number of different players in the field, including Governments, philanthropic organisations, the private sector and others. As well as investing directly in research and development, the UK will continue to play our part, working with others to improve co-ordination and maximise overall returns for the global poor. We are working with the WHO Secretariat as it develops a mechanism to implement the recommendations of the recent consultative expert working group process.

We welcome the proposed global observatory for health R&D, to be based at the WHO, which will provide an opportunity for co-ordinating information about what health research is going on globally. In tandem, the WHO Secretariat is developing a mechanism to operationalise the pooled WHO member states fund for product development, which, if established, will aim to attract new funders and donors to support product development. We currently chair the PDP funders group—an informal group of bilateral agencies and philanthropic foundations that provide support to PDPs and encourage others to invest.

The noble Baroness, Lady Hayman, emphasised the need to build research capacity. We are working not only within the United Kingdom but she will know, I hope, that we are also working within Europe generally, supporting the European & Developing Countries Clinical Trials Partnership, which has a UK lead—the Medical Research Council. The EDCTP is a partnership of 16 European and 48 African member states to pool resources and skills and to co-ordinate and implement clinical research.

I note what my noble friend Lord Lexden said about the incentive of a prize. I suggest that he might look to a major donor with an interest in naming such a prize. Given the impact on India, he might initially look to that country.

The noble Lord, Lord Collins, also mentioned HIV funding. We discussed this the other day. He will know that past vaccine research looked promising but looks less promising now and needs a basic research approach. That work is therefore much more appropriately taken forward by the MRC and the Wellcome Trust, which have been increasing their funding for AIDS vaccine research. I note that an incredibly interesting research paper may indicate that HIV may be weakening slightly. Let us hope that it heads in that direction.

The noble Baroness, Lady Gould, mentioned the Ring Study. DfID has committed £15 million to the International Partnership for Microbicides, and I hope that she will be encouraged by that.

The noble Baroness, Lady Healy, talked about TRIPS. DfID supports countries that use provisions to overcome IP barriers through TRIPS.

Solving many of the challenges that we will face tomorrow will rely on the R&D investments that we make today. DfID has an outstanding record in this area in terms of its support over the last few years. We are committed to maintaining our record of funding high-quality, high-impact research and playing our part in improving global communication. We are committed to putting that knowledge into use so that ultimately it will save lives. We also emphasise that rights should underpin our support for the poorest and most marginalised, as my noble friend Lord Lexden made clear should be the case.

Noble Lords mentioned Ebola. That has shown how interlinked we are. It will not have escaped the notice of the pharmaceutical industry that a disease that was seemingly limited to a poor area geographically and socially may well have a far wider impact. Those who had Ebola vaccines on their books are now able to power ahead. We need to ensure that we support those suffering from the so-called diseases of poverty. We also need to recognise that we are in a changing world, and we need to do our best to ensure that that is fully recognised.

Syrian Refugees: Food Aid

Baroness Northover Excerpts

Tuesday 2nd December 2014 Lords Chamber

[Lord Beecham (Lab)]

My Lords, I beg leave to ask a Question of which I have given private notice.

[The Parliamentary Under-Secretary of State, Department for International Development (Baroness Northover) (LD)]

My Lords, the UK has committed more than £700 million in response to this catastrophe, of which more than £150 million has gone to the World Food Programme, funding food for refugees in Jordan, Lebanon, Turkey and Iraq and those in need inside Syria. We are in close contact with WFP, our other partners on the ground and other donors to assess what more should be done. The rest of the world needs to play its part both in terms of pledging money but also making good on its promises.

[Lord Beecham]

My Lords, I am sure we are all grateful to the Government for the resources that they have put in. However, 1.7 million refugees from the dreadful events in Syria are now threatened with starvation as a result of lack of funding for the World Food Programme’s support. In addition to the terrible hardship those innocent people face, it is surely unreasonable to expect Jordan, Lebanon and Turkey to assume total responsibility for them when they are already under immense pressure. Will Her Majesty’s Government press other nations in the region, notably the wealthy Gulf states, including Qatar, which is, after all, spending a fortune on preparing for the 2018 World Cup, to do much more to assist? Would it not also be in their own interests to do so rather than allowing ISIS and other extremists to exploit a possible tragedy for their own ends?

[Baroness Northover]

My Lords, the noble Lord is quite right about the fragility of the countries around Syria—not least, of course, Iraq and what is happening there. Just to reassure him slightly, the World Food Programme has fully suspended only in Lebanon, although that is enough of a challenge. As regards the other countries, in Turkey, Iraq and Jordan at the moment it is proposed that vouchers should be reduced, but the full suspension is happening only in Lebanon. The noble Lord is quite right that we need to engage internationally and I can assure him that we have been extremely active in that regard, not least in the Gulf. He will know that the United Kingdom helped to bring forward $1 billion at the various international gatherings that took place last year and this year brought forward $3.3 billion. We now need to make sure that the pledges that were made are delivered.

[Lord Cormack (Con)]

My Lords, the Government do not recognise the Government of Syria—that was perhaps premature. What discussions are we having with the Government of Syria to try to expedite delivery of relief?

[Baroness Northover]

We have to work with the Government of Syria, as my noble friend recognises, to get aid into Syria. There have been all sorts of access problems, which we are constantly working to resolve. He will know how challenging that is because of the variety of different groups in different places, which means that you cannot, for example, have safe corridors. However, that is an ongoing problem on which the United Nations is leading and working extremely hard.

[Baroness Lister of Burtersett (Lab)]

My Lords, last week a group of major charities wrote an open letter to the Prime Minister in the Independent. They welcomed the aid that the British Government are giving to Syria but said that aid is no substitute for accepting a reasonable number of refugees into this country. As I understand it, only 50 to 100 refugees have been resettled through the resettlement programme, which is far fewer than originally envisaged. At the pledging conference in Geneva, will the Government pledge to increase that number in response to that letter?

[Baroness Northover]

Clearly, the situation with refugees right across the region is extremely challenging. However, the United Kingdom’s emphasis is to try to make sure that the situation in Syria and around is alleviated. We are putting a huge amount of support, as the noble Baroness has recognised—I thank her for that—into those countries surrounding Syria. What is needed is to try to bring this incredibly challenging crisis to an end so that people are safe within their own country. We do not underestimate the challenge of that.

[Baroness Falkner of Margravine (LD)]

My Lords, does my noble friend agree that the only comprehensive and long-lasting resolution to this problem of refugees is to bring them back to Syria where they can live their lives in the communities they were in? What discussions have the Government had with the UN special envoy Staffan de Mistura about his attempt at a new plan to bring about those ceasefires?

[Baroness Northover]

I will need to write to my noble friend with the details of that.

[Lord Collins of Highbury (Lab)]

My Lords, the one thing that is clear is that this crisis will not come to an end in a short period. Does the Minister therefore accept that longer-term funding for host government authorities is necessary to ensure that their national infrastructures do not collapse under the weight of the refugees?

[Baroness Northover]

The noble Lord is right that a huge amount of support will need to go to these countries. That is what the United Kingdom is in fact doing, both as regards support within Syria itself but also for those countries around, some of which, as he well knows, were under a lot of pressure before this crisis occurred and are under further pressure. We have to ensure that the situation that developed in Iraq does not develop elsewhere.

[Lord Avebury (LD)]

My Lords, perhaps I may return to the question of the UK’s undertaking to accept a small number of refugees from the region, on which I received a Written Answer this morning. Can the Government not review the commitment to accept 500 refugees over the next five years? Is this not a very small commitment, bearing in mind the vastness of the problem?

[Baroness Northover]

I will certainly refer that to my colleagues.

[Lord Judd (Lab)]

It is reassuring to hear how seriously the Government are looking at the needs of surrounding countries and not only of the refugees themselves—that is a huge challenge—but does the noble Baroness not agree that this is an acute political issue as well? In Jordan, the number of refugees now is very much larger than the Jordanian population itself. The political implications of this in terms of future stability cannot be taken too seriously.

[Baroness Northover]

The noble Lord is absolutely right.

[Lord Foulkes of Cumnock (Lab)]

My Lords, the noble Baroness has not answered adequately the question raised by my noble friend Lady Lister and the noble Lord, Lord Avebury. She has dealt with the question of humanitarian assistance and with the political situation in Syria, which, as my noble friend just said, will last for some time, but she has not dealt with the question of those seeking asylum. As my noble friend Lady Lister said, we have been asked to take substantially more refugees, but we are very reluctant to take them and we are taking far fewer than other European countries. The noble Baroness is answering on behalf of the Government. Will she go back to the Home Office and her other colleagues and say that this House wants more sympathetic consideration for those people from Syria seeking asylum?

[Baroness Northover]

As the noble Lord will know, asylum claims are judged across the board fairly and squarely. As I mentioned in my earlier answer to the noble Baroness, Lady Lister, the United Kingdom is contributing disproportionately in supporting those in the region—way above many of our colleagues in Europe and internationally. I said in my reply to my noble friend Lord Avebury that I would take the comments back to my colleagues.

[The Earl of Sandwich (CB)]

Following the question raised by the noble Baroness, Lady Lister, is the Minister aware—I am sure she is—that there is an existing commitment to the United Nations High Commissioner for Refugees resettlement quota, which I understand is 500 people in the most vulnerable categories?

[Baroness Northover]

Yes, indeed, and we have prioritised women and girls at risk of violence.

[Baroness Hussein-Ece (LD)]

My Lords, my noble friend has explained the situation in terms of supporting the aid programme. However, I have just come back from a conference in Istanbul over the weekend and there was great resentment there about the number of refugees that they are looking after—some 1.5 million at a cost of £5 billion—and that is being compared to the contribution that some other European countries have made. Germany has taken 10,000 refugees and Sweden has taken more, while we have taken only a very few—hundreds. With the Syrian situation deteriorating, it is not getting any better soon. People are looking to some of the richer European countries such as ours to do a little more. I ask my noble friend whether there is any consideration about stepping up and taking more responsibility.

[Baroness Northover]

Again, I remind my noble friend of the huge financial commitment that the United Kingdom Government are making and that we are supporting all the surrounding countries, including Turkey. We have supplied mattresses and other non-food items and shelters for their distribution, as well as food aid within Turkey. I remind her of the huge contribution that the UK is making.

HIV and AIDS: Vaccine

Baroness Northover Excerpts

Monday 1st December 2014 Lords Chamber

[The Parliamentary Under-Secretary of State, Department for International Development (Baroness Northover) (LD)]

My Lords, today is, of course, World AIDS Day, and we have committed nearly £1 billion to tackling HIV through our programmes. There has been some progress on HIV vaccine research recently but no major breakthrough, although there are a number of promising research avenues. Expert opinion varies and it is not possible to say when a viable vaccine will be developed.

[Lord Collins of Highbury (Lab)]

I thank the Minister for that response. UNAIDS highlighted that only 24% of children living with HIV currently have access to HIV treatment. Given the clear need for more investment, will the Minister support the recommendation in the report launched today by the all-party group, Access Denied, to carry out an inquiry into alternative models of research and development investment, which separate the costs of R&D from the demands of profitability?

[Baroness Northover]

I will be speaking at the launch of that report later this afternoon, and no doubt we will have further discussions about it. One of the striking things about this is that in terms of research and development funding for new product development in 2012—the most recent figures available—33.6% went to HIV/AIDS, 17.1% towards malaria and 15% towards TB, so it is not a neglected area. But research into the vaccine is proving exceptionally difficult and the trials have proved disappointing. It is therefore necessary to move back to basic research and drive it forward that way. Meanwhile, a lot of effort is going into research and development on treatments. As the noble Lord will know, over the past decade there have been great advances in treatment. One of the key things, as my noble friend Lord Howe just indicated, is making sure that people know their status and are treated.

[Lord Avebury (LD)]

My Lords, I declare an interest as co-chair of the All-Party Group for Child Health and Vaccine Preventable Diseases. We understand that an effective vaccine against HIV/AIDS is still a long way off, but could my noble friend give us a progress report on two relevant product development partnerships that are funded by DfID? They are the International AIDS Vaccine Initiative, and the TB Alliance’s development of new drugs for TB patients who are also infected by HIV.

[Baroness Northover]

My noble friend rightly highlights the link between HIV and TB. The IAVI has developed new approaches to HIV vaccine research by focusing on the needs of developing countries and early-stage research. The TB Alliance has four combinations of drugs in late-stage development, and will soon launch a trial of a combination of drugs that are suitable for those who are co-infected with both diseases.

[Lord Walton of Detchant (CB)]

My Lords, does the noble Baroness accept that the major problem in identifying and preparing a vaccine against HIV is that the very term “HIV” stands for “human immunodeficiency virus”, and the consequence is that the virus itself disables the immune system to a very considerable degree? Since the discovery of a vaccine depends on stimulating the immune system to produce a vaccine, this is an exceptionally difficult and challenging scientific problem.

[Baroness Northover]

The noble Lord is absolutely spot on.

[Baroness Kinnock of Holyhead (Lab)]

My Lords—

--- Later in debate ---

[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.

[Lord Brooke of Sutton Mandeville]

My Lords, I declare an interest as I was the Civil Science Minister at the time when HIV came in. The late Lord Joseph and I had been advised by both the advisory board for the Research Councils and the MRC that there was no way in which research science could keep absolutely on the frontiers of all the subjects which were available to it. When HIV came in, they had to tell us that, unfortunately, research in virology had fallen back. Could my noble friend give us some indication of how far that setback has been repaired in the past 30 years, particularly given the salience of this issue in west Africa at present?

[Baroness Northover]

I just mentioned the level of research and development money going into product development for HIV. I expect the noble Lord will know that Imperial College is leading in this area. I visited the human immunology laboratory at Imperial, which is taking forward vaccine research in a number of different areas. The noble Lord will also know that the number of years it has taken to develop viable vaccines in various areas—10 years for measles, 16 years for hepatitis, 25 years for cervical cancer and 47 years for polio—bears out the particular challenge referred to by the noble Lord, Lord Walton.