Ebola

Baroness Williams of Crosby Excerpts

Thursday 6th November 2014 Lords Chamber

[Baroness Williams of Crosby (LD)]

My Lords, I echo the comments of the noble Lord, Lord Crisp. The heroism of those who have volunteered from the NHS, and from all over the world, as health medics to work against Ebola is unbelievably impressive and should raise our sense of the possibilities of a human response of the kind that is needed for the desperate position laid out by the noble Baroness, Lady Kinnock.

I shall be quick. The first point is that the WHO has now named 15 countries that are on the edge of being likely to slip into Ebola epidemics unless there is preventive action as soon as possible. Those 15 countries are all in Africa, mostly in west Africa. There is also, although we have not mentioned this so far, an instance of an outbreak of Ebola separate from the west African outbreak in, of all countries, the Democratic Republic of Congo. Already, 88 deaths have been attributed to Ebola in that country and are not related to the west Africa epidemic, which is rather frightening—it means that we are now looking at the spotty emergence of the Ebola epidemic.

I want to make a rather larger point. I declare an interest as a member of the board of the Nuclear Threat Initiative in Washington, DC, which is currently supporting the one and only global surveillance of infectious diseases, in a unique international network. It is called CORDS and is doing some remarkable work. This last point is the most important one. In a Question to the Government last week, I raised the issue of whether any thought has been given to calling a special meeting of NATO. I mention NATO following a long conversation that I had with the chief assistant adviser to President Obama, Mr Weber of the Department of Defence, now at the Department of State. He made it clear that he thought the NATO countries should call upon NATO to hold a special summit meeting to consider what help it could give, because it is one of the very few organisations in the West that has the capacity for an immediate response in engineering, construction and medical terms.

I want to make it very clear that, as the noble Lord, Lord Crisp, said, we need the rapid engineering to put up field hospitals and immediate centres to deal with the epidemics in rural areas, where—as in, for example, Sierra Leone—the infection rate is now nine times what it was two weeks ago, according to reports from the WHO. We should seriously consider this possibility, recognising the scale and, even more, the immediacy of the crisis, given the 15 countries that are now seriously at risk.

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

My Lords, I, too, would like to thank the noble Baroness, Lady Kinnock, for securing this debate and for so ably and movingly introducing it. On behalf of DfID, I thank noble Lords for their tributes to the department in this crisis. As I said the other day, if anything shows the importance of aid, both morally and for our self-interest, it is this epidemic. We are all globally linked and noble Lords made that point extremely clearly. I assure the noble Lord, Lord Giddens, and the noble Baroness, Lady Kinnock, that we will be examining the lessons from this crisis. Because of that global linkage, it becomes extremely important that we draw out what we can learn from this.

My noble friend Lord Ridley and other noble Lords are right that the root of this—the cause of the spread of this epidemic—is poverty. Of course, we will need to work internationally to improve and strengthen our international organisations. However, as my noble friend Lord Chidgey says, we need other countries to respond as well, not only to this crisis but to that analysis, and to take forward the ability to respond internationally.

The noble Lord, Lord Giddens, is also right that we need to make huge efforts to contain this in case we should see, as we do not yet see, a levelling off of numbers; obviously, we hope that with the measures we put in place we may be able to detect that. However, if and when we see that, we should not lessen our efforts, otherwise the epidemic will spiral further. He and other noble Lords are right about the economic effect of Ebola. As regards Sierra Leone, the IMF estimates that its GDP growth is likely to be about 6% rather than the 11.3% it had estimated before this crisis. As other noble Lords—the noble Baroness, Lady Kinnock, my noble friend Lord Fowler and others—have emphasised, the health systems we are facing here reflect the fragility of these states, which is why the epidemic has been able to take root.

We are certainly very fortunate in the United Kingdom to have the outstanding staff in DfID who are working both here in the UK and in Sierra Leone. I pay tribute to them as well as to the staff in the Ministry of Defence, the FCO, the Department of Health, from across the NHS and from NGOs who have volunteered their services in one of the most dangerous situations in the world. The audio diary that we hear on the “Today” programme should bring it home to everyone how important, but also how incredibly challenging, their work is. The noble Baroness, Lady Armstrong, spoke of health workers, and the numbers are extraordinary. Some 852 NHS front-line staff and 130 staff via Public Health England have volunteered, which is clearly outstanding.

The Ebola epidemic in west Africa continues to grow. The latest figures from the WHO as of 31 October put total cases in the region at 13,567, with 4,951 deaths. We know that that number is an underrecording. The UK has now committed a total of £230 million to the response in Sierra Leone. As noble Lords know, we are focusing on that country while the United States focuses on Liberia and France on Guinea. That sum includes the commitment to aid-match the first £5 million of the appeal launched by the Disasters Emergency Committee. I, too, pay tribute to the DEC and to the public response to its appeal. We are now the second largest bilateral contributor in this epidemic. We have committed, among other things, to provide over 700 beds. I can assure the noble Lord, Lord Alton, that the first UK 92-bed treatment hospital opened yesterday in Kerry Town. That facility includes 12 beds that are set aside for health workers who are staffing the beds, which will increase to 20. As I said in a previous answer to the noble Lord, Lord Alton, it may well be best, on a case-by-case basis, to treat a case there in Sierra Leone rather than to expose that person, if very sick, to being transported home. The intention is to be able to provide the same level of care, whether it is here or there.

As the noble Baroness, Lady Hayman, noted, ensuring safe burials is key to turning around the epidemic. With the United Kingdom’s support, International Red Cross burial teams in the western area, which accounts for approximately a third of Sierra Leone’s population, are now burying 100% of reported bodies within 24 hours. That is a huge improvement over the situation just a few weeks ago.

We are also expanding laboratory capacity and have pledged £20 million to establish, equip and run at least three new laboratories. We are also providing isolation within communities through up to 200 community care centres, which are the most effective way to prevent further spread. The noble Lord, Lord Crisp, noted that that model is innovative and unique and he is correct. The purpose is to have safe, humane isolation as the key to reducing community transmission. The faster we can bring down those transmission rates, the sooner the health system can resume functioning. Noble Lords mentioned the challenges with other diseases, maternal care and so on, which are also being undermined by this epidemic.

Some of the CCCs are to be located within primary healthcare facilities, which will allow rapid separation of patients presenting with fever—suspected Ebola cases—from others, which will allow healthcare workers to continue to offer routine services such as antenatal care, routine immunisation and other essential health services. The noble Baroness, Lady Kinnock, in particular, flagged the concerns of pregnant women who are reluctant to come in for care. Of course, the centres also help to protect healthcare workers, which, again, is absolutely vital.

We are also supporting this with social mobilisation work. I too noted the very interesting report from the BBC World Service on what it is doing to encourage behaviour change. All that work is overseen by a command and control centre to co-ordinate the response.

Many noble Lords have mentioned the weakness of the health systems in Sierra Leone and elsewhere. Of course that is, as I said, part of the root of the problem. Clearly our current priority must be to help tackle this epidemic; but obviously, we will then wish to help Sierra Leone to return to the trajectory it was on before the crisis, which was moving from a fragile state after conflict to a middle-income economy. That, of course, will include the strengthening of its health system. I note what my noble friend Lord Fowler has said about health workers, and I know the efforts that have been made by the NHS to try not to draw upon staff from developing countries such as Sierra Leone.

We are engaging with partners to ensure that other countries in the region are prepared. We are ensuring that our bilateral programmes in high-risk countries actively support national emergency preparedness. It is of course encouraging to see that, in the first instance, Nigeria was able to contain the case that arrived in Lagos, and to see the way in which it ensured that although others were affected, the virus did not spread further. However, we are constantly vigilant, because other cases may develop.

The UK is also playing a leading role in galvanising international support—a number of noble Lords mentioned that. We are very glad that, last Friday, the UK signed an MOU with Norway to establish the deployment of up to 200 Norwegian health personnel in Sierra Leone. We also welcome the Government of Australia’s commitment yesterday to manage and run a 100-bed treatment facility in Sierra Leone. The EU has pledged €1 billion towards that, and we will be meeting with all our partners to discuss bringing aid forward.

We are working closely with UN agencies, for example with UNICEF on social mobilisation, child protection and so on. A number of noble Lords—especially the noble Baroness, Lady Kinnock, and the noble Earl, Lord Listowel—emphasised the dire situation of children. We are working very closely with UNICEF to support the needs of vulnerable children, including those who have been orphaned by Ebola. We do not underestimate the challenges that they face.

[Baroness Williams of Crosby]

My Lords—

[Baroness Northover]

I am very short of time; I will be very happy to speak to my noble friend afterwards, and I will come on to her point about NATO. NATO is following closely the situation through its crisis management and civil contingency functions, and the allies are assessing whether and how NATO would add value at this stage of the response. However, I also note what my noble friend Lord Chidgey said with regard to what the military might or might not be able to contribute.

The noble Lord, Lord Patel, is right to emphasise the need both for treatments and for vaccines. I hope he will be reassured that we are prioritising both. It is immensely encouraging to see the work of the Lister Institute, for example, and the possibility of a vaccine. Clearly, it could be critical to this epidemic if that work was brought forward, but it will certainly be critical in stemming future epidemics. I note very much what the noble Lord says.

An unprecedented outbreak requires an unprecedented response. That is what we have committed to and we are encouraging the international community and all the international players in each country to play their part to ensure that this terrible epidemic is defeated. As noble Lords have said, poverty is at the root of what we are seeking to address here. That is why we have made the commitment to aid to the poorest countries, as the noble Earl, Lord Listowel, pointed out. That is what it is all about.