Sub-Saharan Africa: Healthcare

Lord Boateng Excerpts

Thursday 16th July 2015 Grand Committee

Asked by

[Lord Boateng]

To ask Her Majesty’s Government what assessment they have made of lessons that can be learnt from the outbreak of Ebola in Sierra Leone regarding the strengthening and development of sustainable healthcare systems in Sub-Saharan Africa.

[Lord Boateng (Lab)]

My Lords, I draw attention to the relevant entries in the Register of Members’ Interests. In particular, I am adviser to Gilead Sciences Inc, chair of Christian Aid’s In Their Lifetime Appeal and a trustee of the Planet Earth Institute. When I was fortunate enough to have my Question chosen, I had hoped that the debate would take place in the context of an end to the Ebola crisis, an end to the outbreak in Sierra Leone and that the last case would have been reported. Sadly, that is not the case and Ebola is still very much with us.

Lawrence Summers, the distinguished economist and a former Treasury Secretary in the US has described Ebola as a “stress test” on national health systems. Sierra Leone, Liberia and Guinea have clearly been found wanting. They simply could not cope. There were too few trained health professionals, too little equipment, too few supplies and too little capacity for public health surveillance and control. It is a stress test that the world cannot afford to fail, and a stress test that in some ways the WHO did fail, and the world was threatened. I suspect that if the perception of the threat had continued as it was at the outset of the crisis, more attention would be paid to the subject in our media and elsewhere today. But we are where we are.

The threat to the rest of the world is seen by all too many in the rest of the world to have passed and the circus is already beginning to move on. There is a sense that Ebola is yesterday’s story. As those who are attending today’s debate understand, that is not the case: it is still an ever-present threat and danger. This debate is particularly timely as it takes place at the same time as the world’s leaders, including our Secretary of State, are considering the future funding of development and the millennium development goals in Addis Ababa. Their considerations will have a considerable bearing on our success or otherwise in responding more effectively to the test that Ebola has presented to the health systems of west Africa and the wider world.

However, it is worth noting that a real contrast is to be drawn—Lawrence Summers draws it—between what happened in Sierra Leone, Liberia and Guinea, and what happened in Nigeria where, to a certain extent, the stress test was passed in at least one respect. Nigeria’s response to Ebola was able to be characterised by the WHO as,

“a piece of world-class epidemiological detective work”,

which it was. It was able to launch a response of aggressive, co-ordinated surveillance and control, using a system for Ebola that it already had in place for polio. That enabled Nigeria to have a response that was not able to be replicated in Sierra Leone, Liberia or Guinea where the health systems, for a variety of reasons, were already substantially degraded and underfunded. In Sierra Leone, that was most obviously because of the conflict from which it was recovering and from problems associated with that, including investment in health, healthcare and governance.

In the Lancet Lawrence Summers, building on his 2035 commission report, put the cost of health systems strengthening in the developing world at around,

“$30 bn a year for the next two decades”.

He identified this sum,

“through a combination of aid and domestic spending”,

as,

“well under 1 per cent of the additional gross domestic product that will be available”,

from the expected growth in low and middle-income countries during the next 20 years, so that $30 billion is affordable. He goes on in the report to identify a lack of investment in public health and a lack of innovative research and development in the field of infectious diseases that affect the poor as having contributed to the crisis. We have an opportunity at this time, at the conference in Addis and the upcoming conference in New York, to do something about it.

Save the Children has estimated that the cost of dealing with the Ebola outbreak has been nearly three times the annual cost of investing in building a universal health service in all three affected countries. We have to ensure that the world learns the lessons of the crisis by a renewed focus on supporting systems of universal health coverage in the developing countries of sub-Saharan Africa. Will the Minister please tell us what steps the UK Government are taking to promote universal health coverage to give developing countries the resistance to contain this kind of outbreak in the future?

I recognise that no one-size-fits-all approach is either possible or necessary to address the issues of developing universal coverage. No one is suggesting an NHS in every country, as if one were promoting a chicken in every pot. It is much more complicated than that but there is inevitably a need for a mix of public and private, such as a role for insurance-based systems. All that has a role to play but there is at the end of the day a need for an irreducible minimum. That is, a recognition that there are some public goods the provision of which requires a role for Governments, with properly resourced departments of health, science and higher education working together with the support of ministries of finance across government to mobilise all the relevant departments in developing sustainable, effective healthcare systems that are backed up by assertive policies for public health and which tackle the root causes of the outbreak of such pandemics.

There is a need for adequate funding mechanisms and cross-sectoral work, led by finance ministries whose streams of work programmes are not dependent on the vagaries of external funding but rooted in a local set of priorities, determined locally and with a focus on value for money, local accountability and meeting the needs identified through the grassroots participation of the citizenry, who are essential to effective public health responses. All the evidence shows, as Christian Aid has shown on the ground in Sierra Leone, that you get a better response when you mobilise communities —when you work with traditional healers and leaders, alongside community healthcare workers and others, all to develop a response that is firmly rooted in communities, reflects their priorities and is capable of winning their support and confidence. It is that challenge to trust and confidence, and the lack of those now in institutions and Governments, which is one of the greatest casualties to have emerged from this crisis. It needs to be restored.

Underpinning all that work are adequate flows of revenue and resourcing which are not solely dependent on aid and development assistance from donors but rooted in the need to do better at revenue-raising locally and make sure, for instance, that we address issues and failures in the collection of revenue from extractive industries. That was a recommendation from the Select Committee of the House of Commons. There is also the need to make sure, as the Prime Minister has emphasised in a number of his interventions in this area, that we do better on illicit flows between jurisdictions and the loss to country revenues as a result of companies actively arranging their affairs and individuals to avoid tax.

So all those issues, and the response to them, need to be examined if we are to learn the lessons of this crisis. How do the Government intend to implement the Select Committee’s recommendations on improving DfID country funding and bilateral in-country assistance programmes? How do they intend to ensure that local communities are involved in that?

Finally, we need to ensure that we address an all too often neglected area of development policy—namely, the role of science and research and development. We need to make sure that diagnostic institutions and laboratories are established to build on the lessons we have learned from the Ebola crisis, and we must take account of the lack of trained personnel. The Ebola epidemic has decimated the health workforce in Sierra Leone. There are too few doctors to ensure effective recovery from the disease. The total absence of postgraduate medical training in Sierra Leone bedevils an effective response and the whole healthcare system in that country, rendering it unable to train its own doctors in-country. Will the Minister agree to receive a delegation from the Royal College of Paediatrics and Child Health, which has come forward with a proposal to address this need which it has forged, together with its partners in Sierra Leone, and other institutions in the United Kingdom, including King’s College? So we have a crisis and a problem but also an opportunity to ensure that we put in place mechanisms that not just end the present suffering but avoid the possibility of yet further suffering in the future.

EAC Report: Development Aid

Lord Boateng Excerpts

Monday 22nd October 2012 Lords Chamber

[Lord Boateng]

My Lords, this is an important debate. We owe the Economic Affairs Committee of the House a debt of gratitude for making it possible and for the serious and weighty consideration, so well exemplified by the contribution of the noble Lord, Lord MacGregor, that it has given to this subject. Even when one disagrees with some of the committee’s conclusions—and I certainly do—no one can doubt for one moment that they are worthy of very careful consideration. It would be dangerous in the extreme for anyone to dismiss them out of hand.

From the outset, I declare an interest in this debate. I was the Chief Secretary whose fingerprints are all over the commitment to the UN target on ODA. I confess that. I am an adviser to and trustee of a number of not-for-profit organisations that either have been or hope to be the recipients of grants from DfID. I make no apology for that. I believe that NGOs have an enormous contribution to make, not always realised, frankly, on the part of government donors, to the development of the poorest parts of our world, and have insights into how best to innovate and deliver to the very poor that governments very often do not have.

I must put my hands up, too, to the responsibility of having led a mission for four and a half years. As its head I held a notional responsibility for the operation of DfID in a particular region. I say “notional responsibility” because the reality is that the Foreign Office-appointed head of mission in any country has very little influence let alone control over the activities of the Department for International Development in that country. I shall come to that in a moment because it is an issue that has to be addressed. For all those reasons, I have form as long as your arm when it comes to DfID.

I regard myself as a friend of the Department for International Development and appreciate enormously the dedication and commitment of its staff globally. In my experience, no other development organisation globally enjoys the universally high reputation that ours does. It deserves real credit for that. Although I am a friend of the department, I am not an uncritical one because there are areas, a number of which are highlighted in the report, where the department could certainly do much better. I want to address a number of those in the course of my remarks.

First, a department with the responsibilities and the budget that this one has ought to be capable of working in a more collegiate way across government than in fact it does. The reality is that not only does it often fail to work collegiately with the Foreign and Commonwealth Office, it also fails to take advantage of the huge expertise across government in certain areas that are absolutely central to the alleviation of poverty and the development of those countries that are so desperately in need of development. I shall give a number of examples of that from my own ministerial experience, quite apart from anything else.

The Department of Health, about which no doubt we will hear more in due course from the noble Lord, Lord Crisp, is full of expertise when it comes to healthcare delivery systems. There are nurses and doctors all around the country at various stages in their careers who very much want to and often are making a contribution to the alleviation of poverty and suffering in our world—underfunded or unfunded. Do they get the help and support from the Department for International Development that they ought to? I am afraid that they do not. The department, which has more money at its disposal than it can deal with and which is busy handing it over in large quantities to the European Union and a range of other multilateral organisations, some of which frankly do not deal with the money as they ought, has not been prepared to make money available to another government department so that it can be spent more effectively on behalf of the taxpayers of this country to meet the objectives that we as a country have signed up to. That, quite frankly, is a scandal. I would like the Minister to tell us just how much of the ODA budget is expended through other government departments. If, as I suspect and indeed as I know, it is a minute proportion of the total amount available to it, why is that the case?

DfID does not have the staff to monitor and deliver the resources at its disposal as the department itself accepts they ought to be monitored and delivered, so why not allow other government departments to take responsibility for facilitating the sort of partnerships between hospitals, universities and a range of organisations in this country and their counterparts in the developing world which, with just a little seed corn funding—and sometimes with more than just a little bit extra, but a steady and sustainable stream of funding—could make a huge difference to the poorest in our world? There is a case that the department has to answer for its failure in this regard. I hope that HM Treasury will look at this carefully, will drive in a way that it has not always driven in the past—indeed, I put up my hands because I did not drive as I ought to have done—and will encourage co-operation between government departments across the piece. That is an issue to which I hope we will return in the course of our debates on this subject.

I turn now to one area where the department needs to be prepared to abandon some of the orthodoxy that hitherto has tended to predominate. For all its strengths, the department has a tendency to be theological in its approach to development. If something does not fit in to the mindset that is the established wisdom of the department, it is treated with the utmost suspicion. I give the example of science, technology and innovation. I have yet to see a country that has been able to develop and grow its economy without science, technology and innovation, and yet for years the department has had a downer on promoting science. It had to be dragged kicking and screaming by a line in the Chief Secretary’s letter to appoint a chief scientist in the first place. We were told that it was not necessary for the department to have a chief scientist because it was not something that had a direct bearing on the alleviation of poverty—please, do me a favour. The reality is that the poor need science. Without the growth that is stimulated by science and innovation, we are never going to see the developing countries of the world reach the level of human and economic development that is their due. I would like the department to assure us that, this time around, it is giving its chief scientist a budget so that the department can do the work that it is there to do.

I would like an assurance that the department is actually working with higher education institutions in this country and that it is actually prepared to spend some money in those institutions on promoting science and innovation across the piece, particularly in relation to agriculture. We are facing one of the gravest crises in food security that our world has ever seen. That is the reality on the ground. It cannot be solved simply by resorting to food parcels and humanitarian relief. Today, a number of parliamentarians met MPs who represent farmers in Uganda. They are desperate for hands-on technical support in relation to their crops, for the development of drought-resistant seeds, and for the most basic forms of agricultural research and development. Their own Government are not spending up to the AU targets on agriculture as they ought to be. Sometimes we look at issues of conditionality when we grant direct budgetary support and sector support, but ought we not to make it a condition, when offering general budgetary support, that at least the Governments should set their budgets so that they spend up to the targets they have already committed to? If they do not, why should British taxpayers expend their hard-won resources on support for budgets that do not meet the needs of the poorest in those countries? While I do not advocate a return to conditionality—indeed, I am opposed to it and sceptical of some of the new forms now being imposed on the developing world—there are some forms of conditionality that relate to fitness for purpose that should be required by DfID if it is to continue with direct and sector budgetary support along the lines that it indicates it intends to do. I hope that it will take into account the Economic Affairs Committee’s strictures when it comes to sector and general support because there is a great deal of good sense behind them.

My final point is one where, again, you come up against the theology within DfID and the most amazing resistance to co-operation with the Ministry of Defence. There can be no development without security. In the Sahel, we are witnessing, centred around Mali but spreading throughout that region, one of the gravest threats to development and security that Africa has ever seen. I hope that we will hear some reassurance in the course of the debate that DfID will be prepared to co-operate with the Foreign Office and the Ministry of Defence in using the conflict pool to address the situation in the Sahel. If it does not, and we find that the African Union is unable to access the resources it needs to offer a military, economic and public diplomatic response to the crisis in the Sahel, we will reap a terrible whirlwind across the continent.

If ever there was a time for an agency such as the British Council to be freed up to work in that region, with resource, it is now. Scandalous as it is, the proportion of resources available to the British Council for that sort of work has gone down and has done so when DfID is awash with money. How much money has DfID made available to the British Council in each of the past five years? How much does it intend to make available to it in the next five years? I am afraid that the answer to that question will reveal a continuing reluctance on the part of DfID to share the taxpayer largesse that has been made available to it.

I support and applaud the Government’s commitment to the 0.7% target. I support and applaud the incredible work being done by DfID and our partners throughout the world. But there really is much more to be done. We need to be bold; we need to be innovative; and we need to be prepared to work together in ways that go beyond the old and established ways of thinking and doing things. We need to be prepared to take some risks if we are to fulfil the moral commitment that we have made as a nation. At the same time, we need to applaud the fact that we have made it and have done so with the overwhelming support and concurrence of the British people. It says something about a nation when the majority—61% of UK adults—agree that we should be spending what we are on overseas development. It says something about a nation when, up and down the country—in church halls, in village halls, in chambers of commerce, in trade union branches, in communities rich, poor, rural and urban—people are getting together on a daily basis to see how they can make the world a better place. This House is doing the right thing by giving this report, its conclusions and the Government’s response to it the serious consideration that they deserve.

Global Fund: AIDS, Tuberculosis and Malaria

Lord Boateng Excerpts

Wednesday 4th July 2012 Lords Chamber

[Lord Boateng]

My Lords, the whole House—and, indeed, the wider world—owes the noble Lord, Lord Fowler, a debt of gratitude, not only for this debate but for his leadership on this issue. The Global Fund is a unique and special model for development in that it is a partnership between donor Governments, civil society and the private sector. That is a very special partnership and I declare an interest, serving as I do on the global health advisory board of a major pharmaceutical company led by Sir Richard Feachem, the founder of the fund.

I seek, this evening, to draw attention to one particular aspect of that partnership in the fight against malaria that urgently needs additional resource if the momentum is to be maintained. The reality is that the funds committed to malaria are expected to peak this year at just under £2 billion. They will remain substantially lower than the resources required to achieve the global targets under the millennium development goals, which are estimated at just under £5 billion for 2010 to 2015. We will not be able to build on the real gains that have been made in combating malaria globally, and in sub-Saharan Africa in particular, without added momentum being given by additional, concrete pledges to the Global Fund. The fund has been described by our own multilateral aid review as having given “very good value” to the taxpayer and,

“very high standards for financial management and audit”.

That is where the Global Fund is now, after the reforms, and we should back it. I commend the Secretary of State for International Development for the excellent work that he and the department have done in supporting development generally and healthcare in particular. However, we now have to concretise that support in terms of pledges if we are to see the gains already made consolidated.

I will make five quick points in relation to malaria. We know that interventions on it are cost-effective, saving more lives per dollar spent than interventions for most other diseases. We also know that it requires long-term financing commitment for country-implementation activities and, importantly, for research and development. From my own experience of a childhood lived under bed nets—and with ready access to drugs, because of the fortune of my parents’ financial situation—in a country which was first colonial, then newly independent, and where there was an effective public health system able to promote spraying as part of a unified response to the challenge of malaria, I know that it works. It is something where you can see real gains made and we have seen them in Swaziland, Namibia and South Africa.

In Swaziland there is a blessing: “Pula! Pula! Pula!”—let it rain, three times. Let the demonstrated largesse and compassion of the British taxpayer rain on the Global Fund.

Niger

Lord Boateng Excerpts

Wednesday 25th January 2012 Lords Chamber

[Baroness Northover]

The right reverend Prelate is right that the churches are very active in the region and DfID is working with a number of organisations. This is a region where, generally speaking, it is not possible to channel money directly through Governments. Therefore, a number of other organisations are the routes to support in the area.

[Lord Boateng]

In the light of the Minister’s very helpful answers to previous questions, will she consider how she might co-operate with her colleagues in the Ministry of Defence and the Foreign and Commonwealth Office in seeing how we can better support the African Union and ECOWAS in terms of their peacekeeping or conflict resolution capacity in view of the deteriorating situation in the Sahel involving the Tuareg?

[Baroness Northover]

The noble Lord is right. In terms of co-operation, the FCO, the MoD and DfID are working very closely together. My noble friend made reference to the building stability overseas unit, which is, as it were, a concrete example of that working together. The support for the African Union is very strong and will continue to be so.

Burundi

Lord Boateng Excerpts

Tuesday 5th April 2011 Lords Chamber

[Baroness Verma]

My Lords, the right reverend Prelate raises some very important points. However, through our regional work on economic integration and expanding focus on free trade, we think that our greatest support will be through developing Burundi’s ability to integrate into the East African Community through trade. That will be the determining factor for its growth. We will also work incredibly hard with the Burundi Government to ensure that peace comes through all sorts of means.

[Lord Boateng]

My Lords, the Minister’s recognition of the centrality of Burundi in the Great Lakes region is welcome. Given the fact that this is not only one of the poorest countries in the world but the most fragile in the region, how, in the absence of either a country programme or a resident ambassador, will it be possible to influence that country for good?

[Baroness Verma]

My Lords, the noble Lord is aware that our programme in Burundi was quite small, but we do support programmes through the EU and the World Bank. Through those programmes we feel that we are better placed to provide aid. We are also working very much with Trade Mark East Africa, which we have launched in the region, to ensure that Burundi is able to grow its private sector to develop economic growth.

International Aid Reviews: Conclusions

Lord Boateng Excerpts

Tuesday 1st March 2011 Lords Chamber

[Baroness Verma]

I thank the noble Lord for all his comments. In fact there was very little that I could disagree with. As he is very well aware through his own experience, building good partnerships is very important. He is absolutely right; we will be working with China and Brazil and, hopefully not too far into the future, with India, too. We are having very constructive conversations with our other partners who provide donor aid. Many have shown a very keen interest in how we have gone through our review process and are looking very closely at what we have managed to do to ensure that their programmes are also going to be targeted and focused so that we all work toward the same end, which is getting people out of poverty.

[Lord Boateng]

My Lords, there is much to be welcomed in the outcome of this review, not least the new-found emphasis on agriculture, food production and wealth creation. Does the Minister recognise that there will be widespread concern in southern Africa, in particular, at the decision to end the bilateral programme in Lesotho, a small state that has been fragile in the past, and Angola, which is conflict ridden and has many millions of people who continue to live in grinding poverty?

Will the Minister assure the House that these two countries in particular will be the subject of concerted effort to improve donor co-ordination, particularly from the multilateral organisations that we fund, and will also be the beneficiaries of the southern African regional programme, within which region Angola and Lesotho quite clearly fall? Will she assure us that resources to that regional programme will be enhanced and will be delivered to those two countries?

[Baroness Verma]

The noble Lord maybe missed the part of the speech that said that the Secretary of State has committed to supporting regional programmes. As he absolutely rightly points out, some of the smaller countries will have greater responses from their regional areas than from bilateral programmes, which are smaller and less able to reach widely. We support the regional programmes very much.

I come back to the point about Burundi and Lesotho, which I keep pronouncing wrongly. We believe that they have comparative partners that are far better placed than us to deliver aid. Therefore, we will help them through the regional programmes.

In response to the noble Baroness, Lady Kinnock, I should say that our regional integration work, which is managed by TradeMark East Africa, which has an established office in Bujumbura, will provide support for Angola and Burundi, so that is covered well. We will not just leave them out there and we are not suddenly going to stop—the process will phase down by 2016.

The noble Lord is absolutely right that we have a keen focus on agriculture, which is really important for food security, not only for that area but for us, too. We have pledged from 2009, when the Opposition were in government, £1.1 billion over three years. We are therefore taking agriculture sustainability very seriously. We are committed to food security and agriculture and are working with the FAO as well as other multilaterals, including the International Fund for Agricultural Development and the World Food Programme, to ensure that we have a strong programme in place.

Public Bodies: Reform

Lord Boateng Excerpts

Thursday 14th October 2010 Lords Chamber

[Lord Taylor of Holbeach]

My noble friend need have no concerns on this matter, because Defra is well aware of the difficulties of these two bodies. They have suffered from mission creep, and within their budgets there will be a redefining of their role, which is very important. There will be plenty of opportunity because the Secretary of State will, indeed, be making announcements on these bodies in due course.

[Lord Boateng]

My Lords, the Caribbean Board is to be abolished, which will be of considerable—

--- Later in debate ---

[Lord Taylor of Holbeach]

I am sorry to have to disagree with the noble Baroness. Some of these decisions have had to be made by government, and we take full responsibility for making them. Consultations were done with each department, and each department was responsible for ascertaining from all these bodies their capacity to meet the tests that have been set. Discussions have thus been taking place within departments and I am quite surprised to hear from the noble Baroness that she has not been aware of the discussions going on in this field, because I know that she is very much involved in these things. Concerning the women’s commission, we are really keen to move away from the idea of having a single body to voice women’s issues. Women should actually be engaged in all public bodies and articulating their views across Government.

[Lord Boateng]

My Lords, the Caribbean Board—

[Lord Brooke of Sutton Mandeville]

At a similar point in a prior Administration, I was ministerially responsible for a department with 43 non-departmental public bodies. I received a Cabinet Office instruction almost to double the proportion of women on those boards within a matter of months. That order could have been carried out to the letter either by greatly raising the number of women board members or by conducting a massacre of male innocents on their own quarter-decks. At some risk to my own quarter-deck, I minuted back about which course I was to follow. Can my noble friend give an assurance that a competent mathematician will proof-read any similar instructions before they are sent out this time?

[Lord Taylor of Holbeach]

I cannot guarantee the standards of proof-reading or mathematical skills, but I am sure that we have a highly skilled Civil Service and that no instruction will go out which is neither numerate nor literate.

[Lord Boateng]

My Lords, the Caribbean Board is to be—

[Baroness Verma]

My Lords, perhaps the Cross Benches can come in and then the noble Lord.

[Lord Taylor of Holbeach]

The noble Baroness makes valuable points and I take them on board. There is an ongoing review and dialogue concerning the Judicial Appointments Commission, because it is very important that this body achieves the high objectives which the noble Baroness has laid down for it. The Lord Chancellor is in regular contact with the Lord Chief Justice. The review’s aims will be to ensure a balance between the executive, the judiciary and independent responsibilities and, indeed, to ensure transparency and openness. I hope that reassures the noble Baroness.

[Lord Boateng]

My Lords, the Caribbean Board is to be abolished. That will be of real concern to the peoples of the Caribbeans and to all their friends, on all sides of the House and in the country. How is the profile of small island dependencies to be represented across Government, involving DfID, the FCO and the other government departments together with the wider diaspora community? These island dependencies, which have been neglected in the past, see themselves as neglected and will now see themselves relegated to the same league as the Government’s advisory board on wines—although even that function is not to be abolished.

Millennium Development Goals

Lord Boateng Excerpts

Thursday 7th October 2010 Lords Chamber

[Lord Boateng]

My Lords, in thanking the noble Lord, Lord Chidgey, for instigating this debate, I declare an interest not simply as a global board member of Food for the Hungry, a faith-based developmental charity, and an adviser to Light Years Inc, a champion of the African producer, but perhaps more importantly as the grandson of a small to medium-sized cocoa farmer, first in the Gold Coast and then in Ghana, and indeed the beneficiary of a cocoa marketing board scholarship—a link between urban and rural that made a real difference to the quality of education in Ghana. All too often, a false dichotomy is made in the African context between the rural and the urban.

The World Bank has drawn attention to the fact that around 70 per cent of the millennium development goals’ target group live in rural areas, particularly in Asia and Africa. For the most part, for the rural poor agriculture is a critical component of the success of the MDGs. Even though structural transformations are important in the longer term, more immediate gains can be made for poor households’ welfare through agriculture, which can help them overcome some of the critical constraints they now face in meeting their basic needs. Thus, a necessary component of meeting the millennium development goals by 2015 in many parts of the world is a more productive and profitable agricultural sector. Yet this is threatened by the fact that, as statistics show, support in aid for agriculture has fallen by 43 per cent since the mid-1980s. Recent data indicate that although the decline has slowed a bit—indeed, there is some hope that it may now be rising—the share of aid given by members of the OECD Development Assistance Committee, of which we are one, has declined from 17 per cent in the late 1980s to 6 per cent in recent years.

Attainment of the MDGs therefore requires that we heed the World Bank’s suggestion and go with its policy plan for 2010-12, which puts the emphasis on growth through an agricultural action plan. I hope the Minister will give us an assurance that the United Kingdom intends to put its efforts, and indeed its money, behind this plan. It has to be said, I fear, that perhaps we in the last Government did not do all we could to support agriculture. That is a fact. Looking at the figures, we see that the UK devotes less than a percentage point of its aid to agriculture. Its contribution is some $23 million, which represents 2.8 per cent of the DAC total. That really is not good enough. The World Bank has indicated that it needs to see a much greater emphasis on the part of donors if the trend of decline in agricultural production is to be reversed and if we are to have any hope at all of meeting the millennium development goals.

Kenya has shown the way in this. It is possible to end the sterile debate between smallholders and large owners and between commercial farming and farming by smallholders in rural areas by integrating the two. The point has been made by Dr Stephen Mbithi, chief executive of the Fresh Produce Exporters Association of Kenya:

“Until African agriculture is commercially viable there will always be hunger in Africa”.

There are many innovative and exciting ways in which we can help; I hope that we do.