International Development: Budget

Lord Bishop of Derby Excerpts

Tuesday 11th June 2013 Lords Chamber

[The Lord Bishop of Derby]

My Lords, I, too, would like to add my thanks to the noble Lord, Lord Empey, for introducing this debate, and I hope that noble Lords will see that not only do the right reverend Prelate the Bishop of Chester and I sit on the same Bench, we have a similar view on this issue. I thank my friend and colleague the noble Lord, Lord Judd, for his wisdom. I hope that I can simply embroider his words because he has said all that needs to be said. Not least is the point that this is not simply about a crude choice, it is about priorities and the particularity of aid alongside the necessity of the military.

I need to declare some interests. I am a trustee of Christian Aid, but tomorrow night I shall be having dinner with the adjutant of the Royal Hospital Chelsea, so I have some military friends and connections as well. I want to take a steer in my brief remarks from the Book of Common Prayer. The morning prayer, the second collect, is as follows:

“O God, who art the author of peace and lover of concord”.

I shall explore the difference between peace and concord. Peace is a spiritual state. It wells up in our hearts, developing harmony and good will towards others. It is what drives aid, it is what unites us across this House, and it is what unites the British people in the Government’s policy to protect 0.7% of our income for aid. There is a desire for peace through harmony, generosity and connection.

When we come to the concord bit, we have to put in place arrangements to deliver it, and it is concord that we cannot agree on. That is where we need political arrangements and sometimes military interventions to try to ensure that there is some concord. These things do not fit together easily and must be properly distinguished. I want to look at each of these emphases and put some questions to the Minister.

If we think about ordering, about the concord that we have to try to create and support across the world, my military friends would remind me that the military has always been involved in creating concord through delivering what we call aid or humanitarian support. I can give examples of this from Alexander the Great to the Napoleonic Wars. More recently, there is a priest in the diocese I serve who was in the Royal Air Force. He tells moving stories about his time as a serviceperson of being involved in humanitarian work such as the rebuilding of schools and getting supplies through lines in order to feed people who were trapped behind them. There is a long and important tradition of the military playing a constructive role in the delivery of what we would call aid. In that sense, we need to look at that military capability, which is often important in a natural disaster. Aid agencies tend to need to plan and budget carefully, but the military has the resource and dynamism to get in there and connect. If the military is going to be part of the aid scenario, we have to look at how that co-ordinates with what we understand about aid, aid agencies and DfID. Is there a case for joint training and planning, especially in relation to natural disasters, and should a co-ordinated effort be made? It is a question that can be asked and it needs to be pursued.

Let us think about the peace that aid agencies, DfID and others stand for alongside the military trying to develop and preserve concord, particularly through aid exercises. Let us think about aid more narrowly—the peace that comes from the heart through trying to connect human beings by helping women and girls, reducing infant mortality or whatever it might be. As the noble Lord, Lord Judd, said, there are tensions because, to deliver aid, people try to offer a kind of neutrality about the political context of finding order and concord. Whether there is peace or disorder, aid needs to be delivered.

Aid agencies and those in partnership with DfID try to work in partnership with the local, and often the local can see aid workers, if they are associated with the military, as foreigners and the enemy. Therefore, the aid operation on the ground, working through partnership, is put in serious danger by being associated with a foreign power.

Of course, as we have heard, the whole aid thrust of DfID and the aid agencies is about poverty reduction. It is not just about good ordering and trying to create the stability that people need. It is about positive things, such as tax justice, land distribution and trade arrangements. There is a much bigger agenda than the military can ever be involved in. So there is a place for military co-operation with the delivery of aid in some contexts. However, that must not compromise the ability of DfID and aid agencies to deliver aid in complex situations where it might be a handicap to be associated too closely with military operations that are associated with interference from a foreign power.

I conclude by asking the Minister to address a number of questions. First, will poverty eradication remain the key purpose of UK aid? Secondly, will the 0.7% commitment be targeted to aid and development and ring-fenced from foreign policy costs? Could there be some kind of quadruple lock to preserve that? Thirdly, what plans are there for the MoD and DfID to work more closely together? Fourthly, does the Minister recognise our concern for aid work if we blur the boundaries between military activity and the provision of aid? That puts the whole credibility of aid and those who deliver it in serious jeopardy.

Global Fund to Fight AIDS, Tuberculosis and Malaria

Lord Bishop of Derby Excerpts

Tuesday 4th June 2013 Lords Chamber

[The Lord Bishop of Derby]

My Lords, I too want to thank the noble Lord, Lord Fowler, for his persistence and commitment to this very important work and for his prophetic leadership.

I want to focus on TB, which, as we know, is preventable and manageable but needs the right resources. I commend the enormously impressive work of the global fund and, as mentioned by the noble Lord, Lord Fowler, the importance of national Governments. I want to particularly remind us of the importance of the global fund’s aspiration to work with what it calls civil institutions: partnership with people on the ground. To explore what that might mean and to encourage the Government to take that aspiration seriously in the way that we offer funds and seek accountability, I want to talk a little about Peru, which is recognised as among the countries with the highest TB burdens in the western hemisphere. If I understand them correctly, the indicators show that TB control in Peru may actually be deteriorating.

My second reason for talking about Peru is that I am privileged to be a friend of the Bishop of Peru. He and his family come from Chesterfield in my diocese and he visits us when he is in this country. This year, we have in our diocese of Derby a harvest appeal fund to help him build a school, a clinic and a church on one site where there will be proper provision from the system, civic society and education. That is a model of partnership. Last week, I spoke to Dr Townsend Cooper who is running a project for the diocese in Peru. He describes the working of all these efforts from the point of view of civil society—the church on the ground—as “filling in holes”. They do not have a sense of working in partnership; they feel they are running round filling in holes.

I will give one example of a case that he is treating at the moment that he discussed with me last week. They are helping a 13 year-old girl in Ventanilla who has cerebral palsy from a birth injury and was recently diagnosed with TB of her spine. The existing system swung into action: she was admitted to hospital and had surgery and medicines. Then, of course, she was sent home to complete the treatment, and home for this 13 year-old girl is one room on the back of a family property that she shares with her mother. She was discovered in this place by one of the visitors from the diocesan medical team. She was unable to go to hospital by bus because the surgery on her back made that journey virtually impossible. Taxi drivers refused to take her because, as the noble Lord, Lord Fowler, said, there is a stigma about having TB and she is regarded as dirty. Quite frankly, she would not have the money for a taxi anyway. The diocesan medical team picked her up and began to visit her. They did very simple things: hygiene, transport, education for her and her mother about management of the treatment and co-operation. What the doctor calls a very small amount of targeted help has transformed the situation, and the initial investment in the treatment is now again beginning to bear fruit.

That is just one little story, but I share it because it shows the problems of people of good will and faith on the ground who are trying to fulfil the aspiration to work with civil society. It alarms me that the director of this project says they feel like they are filling in holes. It is not a comprehensive enough system of outreach, partnership and co-operation so that the good work being done by the fund and national Governments is not biting as much as it might to make the difference.

I would like to make two points. First, I support the request for the Minister to comment on the Government’s pledge to increase investment in this fund. I also want to ask what the Government might be able to do to encourage the fund to take seriously its aspiration to work with civil society, and how to bed that in better so that those on the ground trying to fulfil this part of the complex response to TB do not feel that they are just filling in holes but are part of a more joined-up and coherent system.

Health: Neglected Tropical Diseases

Lord Bishop of Derby Excerpts

Wednesday 30th January 2013 Lords Chamber

[The Lord Bishop of Derby]

My Lords, I, too, thank the noble Baroness, Lady Hayman, for securing this debate on a very important topic and, as we have heard, a very neglected one. There are great signs of engagement and creativity, as noble Lords have said, but the statistics and effects are absolutely horrifying. I want to develop the point that has just been made about an integrated and sustainable approach. For medical intervention and investment to be effective—I think the noble Baroness used the term “smart aid”—there has to be an embedding in the local culture. Often, there have been ways of handling these things for many years, and it is not easy for western medicine to come in with all its technology and suddenly change the situation. In fact, an article in the Lancet in March 2012 provided evidence of the hostility to this kind of intervention because people in the local community did not understand it and were threatened by it. The article said that it was important, alongside the medical intervention, to enable what it called “behavioural change” and an “integrated biosocial approach”.

I want to give an example of that and encourage the Minister, and our own investment from this country and the work of the London centre, to take this approach seriously. I declare an interest as a trustee of Christian Aid, and it is good that there are other Christian Aid supporters here. Christian Aid commends what it calls a “community health approach”, which is local, joined-up and sustainable. It has four aims: to respond to local priorities; to integrate the approach to the various diseases and health issues; to develop a local health system; and to involve local people and local resources.

I will give your Lordships an example. A cross-border malaria initiative in Zambia was launched by Christian Aid and a number of partners in July 2010. So far, 100 local people have been identified, engaged and trained up to work as volunteers to enable this integration of the care response and its embedding in the local community. That is the kind of approach that I think we must commend and invest in.

I have two other quick points. Resourcing is crucial. Although it is not the main topic of this debate, I cannot resist reminding noble Lords that before Christmas we debated the issue of tax justice. Much of the wealth that is created in countries where these tropical diseases are prevalent is through tax avoidance schemes and is taken out of the country to where it cannot be taxed to provide local resources for a local response. We need to recognise that that is part of the picture.

Finally, I will say something about vigilance. In the 1960s, sleeping sickness was virtually eradicated in Africa, but by the 1990s, it was beginning to return. There is a frightening pattern in a lot of aid and welfare interventions that almost get there but somehow do not quite integrate and create something sustainable. The problem then creeps back. That is why I commend to the Minister, and ask her to take very seriously, this approach of community health, which is local, sustainable, joined-up and able to build a system so that the approach to neglected tropical diseases will be a lasting and effective one.