LGBT People: Diplomatic Service
Lord Herbert of South Downs Excerpts(10 months, 1 week ago)
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Lord Ahmad of Wimbledon (Con)
My Lords, I note what the noble Baroness has said. As the noble Baroness, Lady Hayter, also pointed out, it is important that we are proactive, but also sensitive, in our approach. I assure the noble Baroness that that is exactly the approach of the FCDO, led by the permanent under-secretary in this respect.
Lord Herbert of South Downs (Con)
My Lords, I draw attention to my entry in the register as chair of the Global Equality Caucus, and the Prime Minister’s special envoy on LGBT rights. The fact that people can now serve openly, regardless of their sexual orientation, throughout the Diplomatic Service, including at senior rank, with a number of such ambassadors representing our country, is obviously an immensely important step forward. Nevertheless, are there not still a number of countries where it would be very difficult for members of our Diplomatic Service to be open about their sexual orientation, particularly at senior level? That is a sign of the polarised world in which we increasingly find ourselves. Will my noble friend assure me that the Government will continue to take all possible steps to promote LGBT+ rights wherever possible, and particularly to take action in countries where those rights are being reversed?
Lord Ahmad of Wimbledon (Con)
Again, I acknowledge my noble friend’s important work as the special envoy for LGBT+ rights on behalf of the FCDO. I very much welcomed his direct participation. He rightly raises the issue of countries around the world. There are about 65 such countries—he alluded to this—31 of which are in the Commonwealth. We have taken a practical approach. The noble Lord, Lord Collins, will remember that during the premiership of my right honourable friend Theresa May we took specific steps on allocating finance, and then worked quite sensitively on, for example, legislative reform, to see how progress could be made. That focus continues.
International Development White Paper
Lord Herbert of South Downs Excerpts(1 year ago)
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Lord Ahmad of Wimbledon (Con)
On all the questions that the noble Baroness raises, what we have first of all done in terms of framework, without going into the specifics of country, is that for all posts and departments within the FCDO, the commitment is that UK ODA will ensure the delivery of 80% commitment by considering women and girls in every element of their different programmes. The Foreign Secretary recently wrote to heads of mission on this specific point to ensure that submissions that are put back to the centre on business plans reflect that every post is committed to that particular element.
The noble Baroness also talked about sexual and reproductive health within our women and girls strategy. That is a specific objective and priority, and is a key component, again, within my work on preventing sexual violence in conflict. I can give the assurance that we have instructed and have been looking at programmes with that framework. As for some of the programmes in specific countries, if the noble Baroness has particular countries she wants to follow up on, I will of course highlight where we are able to work in these areas.
I would go as far as to say that there has been, at times, regression in this area of women and girls’ rights all over the globe, including sometimes among people you would expect more from. Part of our job is not just to speak about it but to deliver some of these outcomes. Let us not forget also that some of these outcomes about safe abortion also have great barriers nationally, so we must find the right delivery partners to ensure that women who want to make choices of their own are able to do so in a safe environment. That is why it is important that we identify local partners who can deliver these outcomes, supported by UK financing and support.
Lord Herbert of South Downs (Con)
My Lords, I draw attention to my roles as chair of the Global TB Caucus, the Global Equality Caucus and the Prime Minister’s special envoy on LGBT Rights—all, I should say, unpaid. I very much welcome this White Paper and agree with those who have commended the work of my friend and colleague, Andrew Mitchell, in this area. I think it is an excellent White Paper.
The White Paper notes that progress on human rights around the world is now at risk, and that is certainly the case in relation to LGBT+ rights. Therefore, I welcome the Government’s announcement yesterday of a new £40 million programme over five years to support LGBT organisations. That will make a real difference to human rights defenders on the ground.
The White Paper also notes that the sustainable development goals are almost all off track. That applies also to tuberculosis. Sustainable development goal 3.3 says that TB, along with other major diseases, will be beaten in just six years’ time. At the current rate of progress, tuberculosis will be beaten in 100 years’ time. It is now, once again, the world’s deadliest infectious disease, which kills 1.5 million people a year. Some three out of five people with drug-resistant TB are still not being reached. Will the Government continue in their important work to beat this terrible disease, which is quite unnecessarily claiming so many lives?
Lord Ahmad of Wimbledon (Con)
My Lords, I first acknowledge and thank my noble friend for his important work in this area. He mentioned the term “unpaid”; well, what more can I say?
My noble friend is also quite right to draw attention—I alluded to this in my response to the previous question—to the regressive nature of some of the challenges we are facing on the world stage, including in multilateral bodies. As the UK Minister for Human Rights, I can say that we have seen that taking place across the piece, whether on issues of women and girls, LGBT rights or access to fundamental services. It is therefore right that a country such as the United Kingdom, with other key countries, continues not only to advocate but to strengthen our resolve and support. Therefore, I am glad that my noble friend has also highlighted the new commitment we have made on the issue of supporting the LGBT community. I also recognise that, at times, that community comes under particular threat and challenge in different parts of the world, and that is why I feel that diplomacy and development—their joining together was alluded to, but I am not going to reflect on experience—are two arms that need to work very much together. Sometimes, it is the discreet diplomacy on quite sensitive issues, particularly across the human rights element, that allows us to unlock some support and indeed progress in these particular areas.
I assure my noble friend that we will remain very much committed on the issue of tuberculosis, which he mentioned, as well as malaria. We have world-class research, and we are working with key partners such as India, as I said at the Dispatch Box. We are delivering some of the essential vaccines which are needed, so that we do not see those diseases that used to spread as a plague on many parts of the world returning again. That needs resilience as well as ensuring support and innovation in research. The United Kingdom remains very much committed in that respect.
World AIDS Day
Lord Herbert of South Downs Excerpts(1 year, 11 months ago)
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Lord Goldsmith of Richmond Park (Con)
It is certainly the case globally that women with HIV have some of the highest maternal death rates, which is why our ending preventable deaths approach, which is a major focus of UK ODA, has a strong rights and equality focus and will remain a priority for the UK. In the domestic and UK context, I shall certainly convey that suggestion to the Department of Health.
Lord Herbert of South Downs (Con)
My Lords, I welcome the Government’s recent commitment of £1 billion to the Global Fund which, in the circumstances fiscally here in the UK, is a remarkable and generous donation and makes us one of the best contributors still in the world to that important fund. Of the 650,000 deaths from AIDS every year globally, to which my noble friend Lord Fowler referred, some one-third are from tuberculosis, which is the biggest single cause of death of people who have HIV. The co-infection of the two diseases remains a serious problem. Does my noble friend recognise the importance of tackling both major epidemics—tuberculosis and HIV—together? That commitment will continue to be important if we are to have some chance of beating these diseases—although there is no chance of beating TB by 2030—at least within the lifetime of a generation.
Lord Goldsmith of Richmond Park (Con)
I first thank the noble Lord for his comments about his contribution to the Global Fund. I agree with him—in the face of the budgetary pressures that we are facing, I was very relieved and pleased that we were able to make that commitment to the Global Fund, which is doing extraordinarily important work.
The noble Lord also makes an important point about TB. It is the case that until just a few years ago, the trajectory of TB was very much downwards. It was one of those historic illnesses that we had almost got to grips with, or certainly believed that we were getting to grips with. One problem is that we are seeing the weakening of the effectiveness of antibiotics. Currently, there is a limited supply of antibiotics and, if we continue to abuse them, as we are doing globally—well over half the world’s antibiotics are used just to keep animals alive in factory farm conditions in which they would not otherwise survive—that will be the height of irresponsibility. We will be wasting globally this treasure—because antibiotics are a miracle cure that our ancestors would have dreamed of—just to get our animals a bit fatter a bit quicker and to keep them alive in conditions in which we should not be keeping them in any case. So this is a priority—the UK is leading on this issue, and is doing extraordinarily important work on it—but I do not think that we can solve the problem that the noble Lord raised unless we get to grips with our abuse of antibiotics.
Overseas Development Assistance: Budgets and Awards
Lord Herbert of South Downs Excerpts(3 years, 7 months ago)
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Lord Ahmad of Wimbledon (Con)
My Lords, I agree with the noble Lord’s final point. Any money spent in respect of alleviating the suffering of humanity, wherever that may be, is money well spent. On his challenge to me to justify this, I can point no further than to the support we have given throughout the Covid-19 pandemic to helping countries directly. We are also the people who put the architecture in place for the COVAX facility, which is now helping people with vaccinations globally, through a contribution of £548 million made by the UK.
Lord Herbert of South Downs (Con)
My Lords, is it not an irony that the ODA budget was one of the most scrutinised in government, where outcomes are actually tracked by the Independent Commission for Aid Impact? Would that other government programmes had such scrutiny. Is it not a further irony that this budget has been subject to cuts, with the harsh effects that we have now seen, when it would already have fallen because of the contraction in the size of the economy? Will my noble friend confirm that that is the case, and by how much the budget would have fallen anyway before this action was taken?
Lord Ahmad of Wimbledon (Con)
My Lords, I agree with my noble friend’s final point. As I said in my original Answer in response to the noble Lord, Lord McConnell, we saw a contraction in last year’s budget, where there was a real drop in the actual spend on ODA resulting from the economy contracting in the manner that it did. I also agree with my noble friend on the importance of scrutiny of ODA. That is why the Government have committed to working with ICAI on its valuable work, and that will continue to be the case.
Tuberculosis
Lord Herbert of South Downs Excerpts(3 years, 8 months ago)
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Lord Herbert of South Downs
To ask Her Majesty’s Government, further to the announcement by the World Health Organisation on 22 March that an estimated 1.4 million fewer people received necessary care for Tuberculosis in 2020 compared with 2019, what they are doing to tackle Tuberculosis globally.
The Minister of State, Department for the Environment, Food and Rural Affairs and Foreign, Commonwealth and Development Office (Lord Goldsmith of Richmond Park) (Con) [V]
My Lords, the impact of Covid-19 on other global health issues such as TB is deeply troubling. The UK has a proud legacy of fighting TB globally. Our current pledge of up to £1.4 billion to the Global Fund to Fight AIDS, Tuberculosis and Malaria is tackling all three diseases and helping countries to strengthen their health systems. We also invest in TB research and innovation to help people access new TB treatments.
Lord Herbert of South Downs (Con)
My Lords, I thank my noble friend for his Answer. Many people believe that tuberculosis is a disease of the past. It is in fact, sadly, a disease of the present, still killing 1.5 million people a year globally quite unnecessarily. By the time this World TB Day has ended, there will have been another 4,000 needless losses of life, and 700 of those will be children. No epidemic in human history has been beaten without a vaccine, yet there is no effective adult vaccine for tuberculosis. I am grateful for the many things that the Government are doing to tackle this disease globally, but will my noble friend assure me that the Government will remain committed to funding the vital research and development for the new tools that will help us to beat this terrible disease by the time of the sustainable development goal which committed to end it in nine years’ time?
Lord Goldsmith of Richmond Park (Con) [V]
My Lords, tackling TB is a crucial part of improving lives. As the noble Lord says, every death from TB is preventable. That is why the UK has been a leading donor on TB for many years; we are consistently among the top three most generous countries. Our research investments have been transformational and have led to at least five new diagnostic tools for TB. Although the pandemic has forced us to take tough decisions, tackling TB remains a priority and global health remains a top UK ODA priority, as set out by the Foreign Secretary just a few days ago. We will provide more information on how we will continue to take a leading role in due course.
VSO: Volunteering for Development Programme
Lord Herbert of South Downs Excerpts(3 years, 8 months ago)
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Lord Goldsmith of Richmond Park (Con) [V]
My Lords, despite the changes that were recently announced, our aid budget will continue to serve the primary aim of reducing poverty in developing countries through a number of different means. The new strategic approach to ODA will ensure that every penny we spend goes as far as possible and makes a world-leading difference. The Foreign Secretary has set out how we will deliver better results for the world’s poorest, as well as for the UK, through focusing on the seven global challenges where the UK can make the most difference.
Lord Herbert of South Downs (Con) [V]
My Lords, I welcome the approach set out in today’s integrated review, but our aid spending and what we can do globally are crucial to soft power. It seems that the large sum of money that has been taken out of the ODA budget has, in one year, potentially impacted, for example, aid programmes in Yemen, research and development programmes on global public health and the funding of LGBT groups. All of this will impact our soft power, just as it does volunteering. Will my noble friend report back the strong views of many of us on this side of the House, as well as others, that the 0.7% target should be restored as soon as possible?
Lord Goldsmith of Richmond Park (Con) [V]
My noble friend is right to value our ODA in the context of the tremendous soft power that it brings the United Kingdom. I will convey his message to the Government. The creation of the FCDO and the strategic oversight of ODA spend by the whole of government means that we will do aid better across government, even if the budget is temporarily smaller. We will ensure that the UK’s aid secures a greater impact across the globe. We will combine our aid with diplomacy to maximise its impact, focusing our efforts on where the UK can make a world-leading difference and ensuring that the UK is a force for good across the globe.
LGBT International Rights
Lord Herbert of South Downs Excerpts(4 years, 1 month ago)
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Baroness Sugg (Con)
My Lords, we are clear that states must not use Covid-19 as a cover for repressive action, including discrimination against LGBT citizens. Like my noble friend, I am concerned about the impact Covid is having on HIV care and prevention, and we are taking steps to action this. The global fund, to which the UK is the second-largest donor, is reallocating up to $1 billion to continue prevention and treatment services. The UK is fully committed to equitable global access to safe and effective Covid-19 vaccines.
Lord Herbert of South Downs (Con)
My Lords, I draw attention to my entry in the register of interests. As chair of the Government’s international LGBT conference, which regrettably had to be postponed, may I ask my noble friend to update the House on what is happening with this important event, which offers the opportunity to demonstrate to the world the Government’s commitment to the promotion of LGBT rights? Will she also say something about the opportunity to announce a funding commitment for the groups all around the world that fight hard to promote LGBT rights and which rely on support from the UK and other Governments?
Baroness Sugg (Con)
My Lords, we are looking forward to hosting the international conference. As my noble friend said, our ambitious plans, sadly, had to be postponed. We are looking at alternative options that will ensure that the event achieves all we want it to and is safe for our delegates; we hope to make an announcement on that shortly. We have a strong record on funding and supporting LGBT rights programmes, and that will continue.
International Day against Homophobia, Biphobia and Transphobia
Lord Herbert of South Downs Excerpts(5 years, 6 months ago)
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Nick Herbert (Arundel and South Downs) (Con)
I beg to move,
That this House has considered the International day against homophobia, biphobia and transphobia.
I am grateful to the Backbench Business Committee for granting this debate at such an appropriate time, given that the International Day against Homophobia, Biphobia and Transphobia is tomorrow, and was also marked by the House last year.
In previous debates, including last year, I spoke about how LGBT+ rights are now a tale of two worlds. A year on, it is worth recapping where the world has gone forward, and also where it has gone backwards. Seventy countries still criminalise homosexuality, or at least sexual acts between men, and 45 of those also criminalise sexual acts between women. Only 42 states actively protect against hate crimes based on sexual orientation, and 11 countries still carry the death penalty as a maximum punishment for LGBT conduct. Only three countries in the world—Brazil, Ecuador and Malta—have nationwide bans on conversion therapy, and we have seen alarming reverses of LGBT rights in countries such as Armenia, Brunei, Chechnya, Tanzania and Turkey. I will come on to those issues shortly. First, however, I think it is worth acknowledging that in other countries things have been moving in the right direction.
In September last year in India, section 377 of the penal code, which prohibited same-sex intimacy as against the order of nature—doubtless a legacy of the UK’s laws—was struck down by the Supreme Court of India after a case was brought by a coalition of civil society groups. Homosexuality is now effectively decriminalised in this major country, although it is also true that there are no legal protections against discrimination. This is a momentous decision, because the Indian penal code was used as a template in other former colonies. There is a huge role for the UK to play in supporting legal cases against those colonial laws for which we have an historic responsibility elsewhere in the Commonwealth.
Chris Elmore (Ogmore) (Lab)
I am exceedingly grateful to the right hon. Gentleman for giving way and I congratulate him on securing this truly important debate. He mentions the Commonwealth. We are currently chairing the Commonwealth and the Commonwealth Heads of Government meeting was held here last year. It will be held in Kigali in Rwanda in 18 months’ time. I know it was on the agenda last time, but does he agree with me that it is extremely important that the Foreign Office—I know the Minister cares deeply about this issue—keeps challenging Commonwealth countries on the discrimination of LGBT communities in their own countries? We must preach and change our own laws of course, but it is right that we use our soft power to influence Commonwealth countries around the world.
Nick Herbert
I agree with every word the hon. Gentleman says. The UK can play an important role in that respect. The Prime Minister said the right things at CHOGM last year, but we must follow through with funding. The Minister will no doubt tell us about that and he supports action in this area. We must continue to encourage the Government to pursue this issue.
In Angola, a new penal code was adopted in January this year to replace the Portuguese legacy colonial penal code. It removed a “vices against nature” law that criminalised same-sex activity. New legislation adopts broad new legal protections, banning discrimination on the basis of sexual orientation and employment and offering services to LGBT people.
In March this year, the Kenyan Court of Appeal ruled that an LGBT non-governmental organisation could be registered, on the grounds that registration was constitutional and that forbidding its registration was unconstitutional because it contravened the freedom of association or assembly. That is a very important advance in a Commonwealth country. Similarly, a court ruling on decriminalisation is anticipated in Botswana next month.
In Trinidad and Tobago, the High Court ruled last month that the criminalisation of “buggery” was unconstitutional, as it contravened the law protecting human rights to privacy and expression. That could provide an important precedent for other Caribbean countries which share similar colonial laws.
In February this year, the Taiwanese Government introduced draft legislation to promote equal marriage. That followed the ruling by the constitutional court in 2017 that same-sex couples have a constitutional right to marry. It gave that Government two years to introduce legislation. A referendum rejected amending the civil code, but significantly the Government have gone ahead and introduced a new law anyway. It will be the first Asian country to legalise same-sex marriage.
Chile, Portugal, Luxembourg, Pakistan and Uruguay have all made it easier for trans people to change their legal gender. Across the piece, these are encouraging advances but they make the reverses elsewhere seem even more stark.
Mr Tanmanjeet Singh Dhesi (Slough) (Lab)
I thank the right hon. Gentleman for giving way and I congratulate him on securing this very important debate. As we celebrate the International Day Against Homophobia, Biphobia and Transphobia and show proudly that we stand in solidarity with the LGBTQ+ community, does he agree with me that it is horrifying and deplorable that hate crime against the community here in the UK has been on the rise? Between 2016 and 2018, police-recorded hate crime based on sexual orientation and gender equality increased by 27% and 32% respectively.
Nick Herbert
The hon. Gentleman is right to draw attention to the rise in hate crime in this country. While the UK does so much to promote LGBT+ rights abroad, we must remember that there is work still to do in our own country. I will come to that.
I want to talk about the reverses in LGBT+ rights seen elsewhere in the world, some of which are really serious. In Tanzania in November last year, LGBT activists were forced into hiding in Dar es Salaam after officials announced a taskforce to identify and punish gay people. In the same month, there were police arrests at a same-sex ceremony in Zanzibar. The national Government in Tanzania has refused to intervene in worrying provincial crackdowns, following a ban on NGOs that had been distributing contraception and outreach to control the spread of HIV/AIDS.
There have been other crackdowns on private events, meetings and roundtables convened to ensure HIV advocacy. That development, seen in Tanzania, in other African countries and in Asian countries, is worrying because it interferes with the important global public health agenda to tackle HIV/AIDS. If some of our most discriminated-against and marginalised groups are oppressed in that way, we will make it harder to ensure that they have access to treatment. The concern is not just about human rights, important though that is. It is also about effective global healthcare programmes. That gives us a second and important reason to be concerned about the discriminatory policies and practices in these countries.
Notoriously, earlier this year Brunei announced that it would apply sharia law, which would impose the death sentence for homosexual conduct between men. There was an outcry, with action by civil society and business boycotts. It was discussed in this House, and I know the Government took action at a diplomatic level to persuade the Sultan of Brunei that enforcement of this sharia law was completely inappropriate for a modern country. It is therefore good that the Sultan announced that the death penalty moratorium will be extended for these offences, but it is important to say that that is not good enough. The status quo ante is restored for that specific offence, but that still leaves in place sharia law for other offences. Frankly, we should not welcome that as an advance when all that happened was, following an international outcry, the leadership in Brunei, buckling under pressure, were required to reverse a terrible announcement.
While that sharia law remains in place, despite what the Government have said about signing up to conventions on torture, it remains a huge concern that we see, in this country and others, increasing pressure on LGBT+ people with religion used as a pretext. We must stand up for the universality of human rights and say it is wrong to have such offences, which should not be on any kind of statute book. They certainly should not be enforced.
In Armenia, incredibly, Members of Parliament called for a trans activist to be burned alive after she addressed their Parliament’s human rights committee last month. In Turkey, Istanbul pride was cancelled and last week in Ankara 75 LGBT+ activists were arrested and are currently awaiting release.
In the debate last year, Members raised the brutal treatment of gay men in Chechnya. We expressed concern about the fact that the Russian Government had not done enough to crack down on that terrible treatment of gay people. There was meant to be an independent inquiry and there was meant to be a report, but nothing effective has happened.
Worse still, since our debate there has been a further crackdown. There have been reports that at least 40 people in Chechnya, presumed to be LGBT+, were detained in concentration camps and tortured, and that there were at least two deaths. Human Rights Watch has reported that it interviewed four men who were detained for between three and 20 days between December 2018 and February this year at the Grozny Internal Affairs Department compound. Police officials there kicked them with booted feet, beat them with sticks and polypropylene pipes, and tortured three of the four with electric shocks. One man was raped with a stick. There have even been murders of gay men by the authorities in Chechnya.
What have the Russian Government done to condemn that and to assure the global community that such activities will not be permitted in future in the state for which they have responsibility? Russia is a member of the Council of Europe and a signatory to the European convention on human rights. It is absolutely intolerable that it should permit such brutal treatment of any section of the community—any minority—in a state for which it has responsibility. The message must go from this House to the Russian Government, loud and clear, that we will not accept these egregious breaches of human rights, that we and the global community will hold the Russian Government to account, and that we will not stop raising this issue until they do something about it.
Mr Dhesi
I thank the right hon. Gentleman for raising that issue. Excellent organisations such as Stonewall have highlighted what has been going on in Chechnya—just as he has done—for three years. Does he agree that, while it is good that our Government are condemning it, they must continue to put pressure on the Russian authorities in calling for an immediate end to these atrocities, and also join in the demand for an independent investigation?
Nick Herbert
Yes, I do agree. There needs to be an independent investigation of these terrible atrocities.
I will end my speech shortly because I know that many other Members on both sides of the House wish to speak.
Nick Herbert
I will make a fraction more progress, if my hon. Friend will allow me.
Let me raise two further key issues. The first relates to how we respond. I shall leave it to the Minister to set out the many ways in which the Government have used their resources of soft power and, indeed, funding to ensure that groups around the world can promote LGBT+ rights. We must commend them for that, but we must ensure that the funding is sustained. Few countries in the world are in a stronger position than the United Kingdom, because of our own record on human rights, because of what we have achieved in our own country, and because of the soft power that we are able to exercise globally and in organisations such as the Commonwealth, to promote LGBT+ rights on the world stage. I congratulate the Government on taking many initiatives in this respect, but those initiatives must be sustained.
The Government will shortly assume the co-chairmanship of the Equal Rights Coalition, a nascent intergovernmental organisation to promote LGBT+ rights, along with the Argentine Government. I urge the Minister and his ministerial colleagues in other Departments—including the Defence Secretary, who is responsible for equalities, the Foreign Secretary, and the new Secretary of State for International Development—to note the importance of that chairmanship and of the conference that we will hold next year and to ensure that sufficient resources are committed to what will be a very important period. It is an opportunity for the UK to lead in this area, but that initiative requires greater co-ordination, greater organisation and dedicated resources.
Mark Menzies
I pay tribute to my right hon. Friend for his work in leading today’s debate and for shining a spotlight on many other occasions on corners of the world where LGBT people have been facing genuine hardship. May we, and in particular the Minister, use this opportunity to urge on countries that have been quite progressive on this but where we have seen some slippage—I reflect particularly on Cuba, where organisations such as Cenesex, which was led by Mariela Castro, drove LGBT rights but where only last weekend the LGBT march in Havana was outlawed and disrupted and people face arrest, and on Paraguay and Brazil, where we are hearing similar mood music, with LGBT rights slipping back? It is important that we support our friends to do the right thing.
Sandy Martin (Ipswich) (Lab)
The right hon. Gentleman is talking about this country showing leadership. Last year, the World Health Organisation removed the classification of gender dysphoria as a mental illness, which was an important step forward and no doubt happened in part thanks to pressure from the UK. But the application process for gender recognition certificates in this country is still largely based on the conception that gender dysphoria is an illness. I have written to the Minister for Women and Equalities, who I believe also happens at present to be Foreign Secretary—
Sandy Martin
Defence Secretary. I apologise; I lose track of who is who—as I am sure Ministers do as well. Will we see movement on this to ensure that we really are doing the right thing here, as well as following WHO rules?
Nick Herbert
Through the hon. Gentleman’s intervention he has made his point to the Government and I am sure the Government will reply. But the broader point is right: to lead on the world stage, we must ensure that our domestic agenda is fully complete. There are still outstanding issues in relation to trans equality, to ensuring education is genuinely LGBT-inclusive and to asylum for LGBT+ people. There are intersex issues where a response to a consultation is awaited. Most obviously there is still Northern Ireland’s failure to introduce equal marriage despite strong public support for that in Northern Ireland. All those things need completing as well.
None of this is for Governments alone, although the UK Government’s role is vital: it is also for business, civil society and NGOs to play their part. I congratulate all the NGOs that are engaged in promoting LGBT rights both in the UK and globally on their work. The all-party group on lesbian, gay, bisexual, and transgender rights, which I have the honour to chair, will continue to work with them.
We have a common objective. It was very well expressed by the Prime Minister in her foreword to the “LGBT Action Plan” that the UK Government published last year. She said she wanted to make the UK
“a country where no one feels the need to hide who they are or who they love”.
That should be our ambition for the world as well.
Several hon. Members rose—
Nick Herbert
I thank my right hon. Friend for his response and for saying that the Government’s intention is to re-energise the Equal Rights Coalition. This is a really important moment for the UK Government to show continuing leadership in this area.
I thank all my right hon. and hon. Friends and Opposition Members for their contributions. I think we show the House of Commons at its best when we are able to debate these issues on an entirely bipartisan, cross-party basis, and demonstrate that our concern to promote equality is universal in this House of Commons and that we are not divided on the issue. In many speeches, we have recognised that there is still work to do.
A couple of issues raised related to the influence of religion on LGBT+ people. Next week, the all-party parliamentary group on global lesbian, gay, bisexual, and transgender rights will announce and call for evidence on a major new inquiry on the relationship between religion and LGBT rights. I think that we have to start to look at that relationship as an important driver of some of the concerns expressed today.
Madam Deputy Speaker (Dame Eleanor Laing)
I deeply regret that the commentators who criticise what goes on in this House and constantly find fault with the way in which Members of Parliament conduct themselves and their debates are not here to pay attention to this excellent debate, which has been thoughtful, gentle and constructive on all sides of the House. I only wish that people would sometimes pay attention to what is best about the way in which we conduct matters here in the House of Commons.
Question put and agreed to.
Resolved,
That this House has considered the International day against homophobia, biphobia and transphobia.
World TB Day
Lord Herbert of South Downs Excerpts(5 years, 8 months ago)
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Nick Herbert (Arundel and South Downs) (Con)
I beg to move,
That this House has considered World TB Day and the efforts to end tuberculosis globally.
I am delighted to be able to introduce this debate. It was World TB Day on Sunday, but this is not an anniversary that we should be having to mark at all. It is wrong and extraordinary that we still have to debate the toll from death and suffering of a disease that has been curable for well over half a century, since the discovery of antibiotics by Fleming in 1928. It is unnecessary that so many people die from tuberculosis.
Imagine if the World Health Organisation announced tomorrow that a new disease had been discovered that was highly infectious, airborne and susceptible to drug-resistance, and that next year 10 million people would fall sick, of whom 1.6 million people would die. Imagine the global response to that news. That is in fact a description of the reality of tuberculosis. TB kills more people every year than HIV/AIDS and malaria combined —1.6 million people last year. Of course, there is overlap between HIV/AIDS and TB, because the AIDS epidemic in the 1980s drove the resurgence of tuberculosis. A disease that the world thought it had beaten has come back with a vengeance.
TB was first declared a global health emergency 25 years ago, in 1993. Since then, 50 million people have died. Just consider that. A disease is declared a global health emergency and subsequently 50 million people die, yet that disease is treatable and curable. That represents nothing less than a catastrophic failure on the part of the world’s Governments to deal with a disease that we should deal with more effectively.
Dr Dan Poulter (Central Suffolk and North Ipswich) (Con)
My right hon. Friend is making some good points and I congratulate him on securing the debate. He mentions the failure of world Governments. There is clearly a need for greater urgency in the approach taken by the international community in dealing with this issue, but what about the behaviour of pharmaceutical companies, which rarely invest in drugs that will help people in low and middle-income countries in the way that they would do in lucrative medications that they can sell in higher income countries, such as Great Britain?
Nick Herbert
My hon. Friend makes a good point, but I do not blame pharmaceutical companies, because I think this is a clear case of market failure. The fact is that the demand for better TB drugs, which we need, falls largely in low and middle-income countries, so there is no commercial case for sufficient investment in these new drugs. It can therefore proceed only on a public-private partnership basis. Some pharmaceutical companies have a pro bono programme for the drugs that do exist, such as Johnson & Johnson, where there is a drug to deal with drug-resistant TB. However, that is still insufficient.
This market failure is a striking contrast with what happened with AIDS. There was a serious response to the AIDS epidemic from pharmaceutical companies, not only from publicly funded programmes, but from commercially funded investment. As a consequence we have had extraordinary innovation, and new drugs that can prevent HIV and ensure that it is not a death sentence are available. What is the difference between the two? AIDS was a disease that was killing people in the west and TB is a disease that kills the poor. That is the fundamental difference. That is why we have not had the same level of investment in tuberculosis. Another fundamental difference is that TB was already curable with antibiotics. It is just that these antibiotics were not being delivered, TB patients were not being identified and we did not have the health systems to do it.
Dr Poulter
I am a little more sceptical about the operation of some pharmaceutical companies than my right hon. Friend. In fact, one reason that the global community was able to so effectively deal with HIV—he is right to identify TB as an AIDS-defining disease—was that international Governments brought pressure to bear on pharmaceutical companies to drop the price of the medications, and push medications out in low and middle-income countries. That has not happened with TB. Unless there is a concerted effort from global Governments to encourage pharmaceutical companies to behave with greater global awareness and corporate responsibility, I am not sure we will see much change in the situation that he is describing, and change is badly needed.
Nick Herbert
This is an interesting debate, but I disagree with my hon. Friend. The drugs are not in the pipeline, because the return on investment for these companies is insufficient in the first place. I do not think that they are sitting on drugs that are available for wealthier people, which, if pressed, they could simply roll out to poorer people. There is an insufficient quantum of investment in research and development. I will come on to that point. I do not think that the need can be met by the private sector alone.
I believe that there are three key reasons why we need to take more action against this disease: humanitarian reasons, economic reasons and reasons of global public health. The humanitarian reason is that so many people are dying needlessly from this disease and falling sick. The figures speak for themselves.
The economic reason is that this awful loss of life and this illness are a drag on economic success in the poorest countries, hindering their development. There will also be a serious economic impact if we fail to tackle the disease. By 2030, it is estimated that if the current trajectory of TB continues, that will cost the world’s economies $1 trillion. Some 60% of that cost will be concentrated in the G20, and it will be caused by the 28 million deaths over that period. That is a terrible statistic, because that is the period over which tuberculosis is meant to be beaten according to the sustainable development goals. The United Nations set those goals four years ago, and said that the major epidemics—AIDS, malaria and TB—would be beaten in 15 years’ time. We have just 11 years to go. On the current trajectory, TB will not be beaten for well over 100 years. There will be a further 28 million deaths during that period alone, as well as huge economic costs.
The global public health reason is the susceptibility of tuberculosis to drug resistance, because of the old-fashioned drugs that are used to treat tuberculosis. People who take the drugs do not continue with their treatment and it is a very serious fact that there are well over 500,000 cases of drug-resistant TB in the world. The highest burden is actually in the European region. Only one in four people who have drug-resistant TB can access treatment.
We know that there are 3.5 million missing cases of TB every year that are simply undiagnosed, accounting for one in three sufferers. The proportion is much higher for drug-resistant TB, where 71% of people are missing. This constitutes not only a humanitarian issue, but a serious risk to global public health, because this is an airborne, highly infectious disease.
Nic Dakin (Scunthorpe) (Lab)
The right hon. Gentleman is making a very powerful case. He has just said that because so many cases are undetected, the risk is compounded. That is an important issue, which needs tackling urgently.
Nick Herbert
I strongly agree with the hon. Gentleman. I commend the work he does on the all-party parliamentary group on global tuberculosis, which I have the honour to co-chair with my friend, the hon. Member for Ealing, Southall (Mr Sharma). The big problem is all of these undetected cases. We need to find and then treat millions more people.
There is hope. Last September, the UN convened the first high-level meeting on tuberculosis, which passed a strong declaration that recommitted the world to meeting the sustainable development goal target to beat the disease, and that specifically set a new target of diagnosing and treating 40 million cases of TB by 2022—a very tight timetable. It is vital that efforts are stepped up immediately so we can meet that new, ambitious target. It will require a significant increase in the level of spending on TB programmes globally from nearly $7 billion to $13 billion and on tuberculosis research and development from $700 million to $2 billion a year.
Two key issues arise from those ambitious new commitments, the first of which is accountability. How are we going to hold the world’s nations to account for their commitments at the high-level meeting? I mentioned that the world has already declared TB a global health emergency and has already set the sustainable development goals. The problem is that we keep talking about the disease but not delivering a sufficient global response to beat it, so accountability is crucial.
Among the problems with the otherwise good declaration passed at the UN is that independent accountability was struck out, but it is vital, because we have to hold countries’ feet to the fire for what they have committed to do. Accountability can take multiple forms: it can be done through bilateral relationships; intergovernmental platforms at the G20, the G7 and the Commonwealth; a further review of the UN high-level meeting and the commitments made; or international institutions such as the World Health Organisation. I must say, however, that if the WHO’s existing mechanisms had been effective, we would not be in this position.
My first point to the Minister, who I welcome to her place, is that the UK has a vital role to play in ensuring that there is more effective, sharper and independent accountability for the targets set at the high-level meeting. Without that accountability, I fear that we will not meet those new targets, and if we do not, we do not have a chance of beating the disease within the set timeframe.
The second issue is that we cannot escape the fact that we will need additional resource to meet the ambitions and that must come from the countries affected, particularly middle-income countries, which must find the resources to deal with it. We have seen a huge improvement in the response in India, for example. Resource must also come through multilateral institutions, particularly the Global Fund to Fight AIDS, Tuberculosis and Malaria, through which comes 70% of all international funding for TB. The UK can be proud that it is the third-largest contributor.
This year marks the replenishment of the Global Fund. If we are to have a hope of meeting those TB targets, it is vital that it is replenished to a higher level than before. The investment case requires a pledge of $14 billion from the world’s countries, which will be combined with an increase of nearly 50% in domestic investment, so the money will also come from individual nations. That would suggest that the UK needs to commit £1.4 billion, which is an increase on the £1.2 billion it gave last time. That is the minimum that will be required to meet the Global Fund’s strategy targets and is proportionately the same as the UK previously gave, at about 13% of the budget.
I know other hon. Members want to speak, so I will make one final point. As my hon. Friend the Member for Central Suffolk and North Ipswich (Dr Poulter), who is no longer here, said, new drugs will be essential. New drugs for tuberculosis have become available only relatively recently; there have been no new drugs for more than 40 years. Most people do not know that we do not have an effective adult vaccine for tuberculosis, and no epidemic in human history has ever been beaten without one. We have to be able to meet the new targets for an increase in research and development, which includes providing public funding.
Again, the UK has a vital role to play because of the strength of our pharmaceutical sector and what we already do on research and development. We need a specific plan to implement a research strategy; we need to establish a baseline for countries to ensure that they are funding their fair share of research and development; and we need to establish a mechanism to co-ordinate that spend. Otherwise, again, countries will talk about the research and development gap, but never do anything to close it.
We should not need to be here. This is not a disease that we should have to talk about any longer—frankly, it is a moral disgrace that we still are. It is a needless loss of life. Many problems confront modern Governments, some of which are nearly intractable. This is not one of them. This disease can be beaten. We have known how to do that for more than half a century and, with new tools, we could do it better. In the words of the Stop TB Partnership’s campaign for World TB Day last Sunday, “It’s time” to beat this disease.
Jim Fitzpatrick
Not at all; it was a great speech, and well delivered.
As the right hon. Gentleman said, TB remains the world’s deadliest infectious disease. Despite it being entirely curable, it has claimed 1.3 million lives in the last year, including the 700 children who died every day.
According to the British Society for Immunology, one third of the world’s population is infected with the TB bacterium. We urgently need to enlarge our treatment of the illness and make vaccines that are safe, affordable and accessible. The BSI states that that is especially essential for pulmonary TB. We all know the tremendous impact that widely available vaccines could have on combating the disease, as the right hon. Gentleman has said; they are absolutely essential. Will the Minister comment on how much funding the Government can allocate to investing in the research to develop such vaccines?
Funding research into vaccines is especially important because of the increasing number of TB cases that are resistant to multiple antibiotics. That is an issue around the world, with more than half a million cases of drug-resistant TB reported in 2017. I ask the Minister what work is ongoing with colleagues to ensure that the Global Fund to Fight AIDS, Tuberculosis and Malaria is replenished as a means to combat the global spread of drug-resistant TB, as requested by the right hon. Gentleman.
The disease has played an important part in the history of public health in my Tower Hamlets borough. The UK has a high incidence of TB compared with much of western Europe, and London accounts for one third of UK cases. In my borough, the levels have decreased in recent years, which is good news. Incidence has halved from 64.7% in 2010 to 32.5% in 2015, but TB continues to affect Tower Hamlets disproportionately compared with other parts of the country.
Tuberculosis is a disease of poverty, and my constituents are among of the most vulnerable. The approach to tackling this complex disease needs to incorporate not only research into vaccines and cures, but spreading awareness to individuals who possess the aforementioned social risk factors.
Nick Herbert
I am grateful for the Minister’s response, which reiterated the UK Government’s commitment. I thank all hon. Members for their contributions today and for their commitment to beating this terrible disease. I reiterate that the UK has a leadership position, and this year we can show it by replenishing the Global Fund, pressing for independent accountability and trying to achieve better co-ordination for research and development. Yes, we have made progress, but there is more to do. The UK needs to continue to show the necessary leadership to beat this terrible disease.
Question put and agreed to.
Resolved,
That this House has considered World TB Day and the efforts to end tuberculosis globally.
Oral Answers to Questions
Lord Herbert of South Downs Excerpts(5 years, 8 months ago)
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Mr Hunt
The hon. Lady is absolutely right to say that if we are going to get this right we have to combine all that we do, particularly in terms of our soft power. The British Council has an immensely important role in Africa. In particular, we need to be better at joining up the work between the Department for International Development and the Foreign Office, and that is why we are proud to have joint Ministers on the Front Bench to ensure that that happens.
Nick Herbert (Arundel and South Downs) (Con)
The Minister for Africa (Harriett Baldwin)
The UK looks forward to co-chairing the Equal Rights Coalition with Argentina from May this year. We will use our role to promote and protect LGBT rights globally.
Nick Herbert
I thank the Minister for that answer. It is good news that the UK is taking over this role, but the Equal Rights Coalition is in its infancy and needs more work to ensure that the global fight for LGBT rights is effective. Will the Minister assure me that she will commit sufficient resources to the UK’s chairmanship of the Equal Rights Coalition and ensure effective co-ordination between Departments in this important year?
Harriett Baldwin
I pay tribute to my right hon. Friend’s leadership and to his all-party parliamentary group on global lesbian, gay, bisexual, and transgender rights for drawing cross-Government work together. I can assure him, on behalf of both the Foreign and Commonwealth Office and the Department for International Development, that we will certainly give the organisation the resourcing it needs. He will be aware that its work fits in with the Equalities Office’s overall strategy, including the international element.