Global Fund to Fight AIDS, Tuberculosis and Malaria

Baroness Tonge Excerpts

Thursday 12th December 2013 Lords Chamber

[Baroness Tonge (Ind LD)]

My Lords, I thank the noble Lord, Lord Chidgey, for securing this debate and congratulate the noble Lord, Lord Verjee, on a brilliant maiden speech—I congratulate him even more on surviving cerebral malaria.

I have not exactly heaped praise on the coalition Government in the past three years, but I praise them for having the vision and good sense to see that overseas aid, prudently spent, not only benefits people in developing countries but will eventually benefit us all by reducing poverty and migration and increasing our markets abroad.

Not being a great fan of “vertical lines of expenditure” on specific issues, I was sceptical when the Global Fund was set up, but I accepted that the three diseases that we are discussing were causing such devastation that a new approach was clearly needed—and the Global Fund was that new approach. It has been successful, as we have heard from the fund itself in the excellent briefing that we have received from it and from other noble Lords. I shall therefore congratulate the fund but not repeat what has already been said by other speakers.

Replenishment of the fund is now needed, and we have heard of the plans for it. We must keep up support for the fund and nag other countries to keep pledges. Drug resistance is growing and we must stay vigilant.

This applies also to my main interest, which is population and development, and expenditure on sexual and reproductive health, particularly family planning. According to the ODA, funding for population assistance is still increasing, but at a much slower rate than prior to the financial crisis. This is despite the tremendous boost given to accessible family planning by our coalition Government at the summit in London last year and carried forward by the Gates Foundation, to which we owe a huge debt of gratitude.

Allowing women in the least developed countries to have access to family planning to limit the number of children they have is still crucial to the achievement of the millennium development goals. If the world’s population continues to increase, the MDGs become harder to achieve. We may feel that we are making progress, but more and more people coming into the world will need more help and more treatment. It is crucial therefore to keep up the pressure on family planning provision, always ensuring of course that there is no coercion. If you consult the statistics, you will see that economic growth always follows reduction in family size; it is not the other way round, as used to be believed. And that, reduction in family size, is the way out of poverty for most developing countries.

One of the factors which led to my lack of enthusiasm for “vertical” programmes such as the Global Fund—this has been alluded to by the noble Baroness, Lady Hayman—is that while a patient may get his or her treatment for HIV/AIDS or TB, the provision of reproductive healthcare and contraception may be in another clinic or another place, necessitating another long journey to a health centre—and sometimes the provision does not exist at all. I am delighted, therefore, that the Global Fund is now trying to ensure that more comprehensive health systems will be set up alongside the treatments for AIDS, TB and malaria. I would love to hear the Minister’s assurance on that. There is a direct link, too: contraception in the form of condoms is after all the first defence against AIDS while we are waiting for a vaccine. Every health facility dealing with AIDS should remember this fact and have those available.

Once again, I congratulate the Global Fund and the current and previous Governments on having achieved so much in international development during the past two decades, and I look forward to the next decade with some confidence.