World AIDS Day
Lord Patel Excerpts(1 year, 12 months ago)
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Lord Goldsmith of Richmond Park (Con)
The right reverend Prelate is right. We continue to support stronger health systems around the world more broadly, because that in turn helps to end AIDS-related deaths and prevent new HIV infections. As was said earlier, women with HIV have the highest maternal death rates, which is why our ending preventable deaths approach remains a priority for the UK.
Education—particularly the education of women and girls—has for some years been a top priority, as enshrined in the integrated review and the international development strategy. It remains a priority and will remain one.
Lord Patel (CB)
My Lords, a key challenge for the UK in meeting the target of eliminating HIV transmission by 2030 is the elimination of undiagnosed cases which, of the total of 107,000 cases, are currently probably around 5,000. How do the Government intend to tackle that?
Lord Goldsmith of Richmond Park (Con)
My Lords, much of the work that we support is through the multilateral system—we were talking earlier about the Global Fund. Increasing diagnosis rates remains a key priority for not just the Global Fund but other multilateral organs. Through our support for those institutions, we are in turn supporting increased and escalated efforts to boost diagnosis rates.
Integrated Review: Development Aid
Lord Patel Excerpts(3 years, 7 months ago)
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Lord Patel (CB) [V]
My Lords, the Foreign Secretary said that ODA is important for boosting international research. Cuts to the development assistance grant of more than £120 million over a year will have a devasting effect on established research and development projects in middle and low-income countries. The cuts will affect 800 UK-led projects in 69 countries funded through the Global Challenges Research Fund. For example, there are the Royal Veterinary College’s projects in 10 countries involving 144 staff researching zoonosis and antibiotic resistance in poultry production. There is a cut of 67% in funding for projects in Jordan on understanding vaccine development for MERS-CoV, and a 73% funding cut to Royal Academy of Engineering projects in 17 countries involving hundreds of people that will affect leadership development programmes. The Royal Society’s Future Leaders: African Independent Research fellowship programme, which helps develop future academic science leaders, has had its funding cut by 67%, leading to the immediate termination of jobs.
The cuts are halting research in scientific collaborations and will undermine the Government’s ambition for the UK to be a science superpower and their pursuit of new forms of global relationship, giving the message that the UK is not a reliable partner. Global challenges require global partnership. With the UK at the helm of G7 and COP 26, now cannot be the time for the Government to row back on their ambition. Science is the heart of many solutions in health and climate that we desperately need right now. The Government having built relationships and leadership now want to step back. In financial terms, the cuts may seem modest, but their impact is huge. Once lost, research capacity takes time to build and, in the meantime, the UK will cede ground to other countries. What plans do the Government have for the global partnership in science, research and development with middle and low-income countries? Is there an understanding in the Government of the damage being done by these cuts?
Health: Maternal Health
Lord Patel Excerpts(13 years, 10 months ago)
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Lord Patel
To ask Her Majesty’s Government how they propose to meet Millennium Development Goal Five on improving maternal health and maternal morbidity.
Lord Patel
My Lords, before I introduce today’s debate, it gives me great pleasure to congratulate the Minister, the noble Baroness, Lady Verma. Last week, the Prime Minister of India bestowed on her the high honour of Pravasi Bharatiya Samman in recognition of her work.
I thank the long list of distinguished noble Lords from all sides of the House who are taking part in the debate. That demonstrates the huge interest that your Lordships’ House has in the subject and signifies the need for a longer debate. It is a pleasure to note that the noble Lord, Lord Green of Hurstpierpoint, will make his maiden speech. I look forward to that. Given his distinguished career, I have no doubt that the House will hear a lot more from him.
The topic of today’s debate is how the UK Government propose to meet millennium development goal 5, relating to maternal death, maternal health and maternal morbidity. It is fortuitous that the Government published at the end of December 2010 their framework, Choices for Women: Planned Pregnancies, Safe Births and Healthy Newborns, for improving maternal health in the developing world. I congratulate them on producing that document, which sets out clearly the vision of the UK Government and their ambition to improve maternal health globally. It sets clear goals in each of the areas mentioned for the UK Government to meet by 2015. It is a little less clear about how this will be done, but I have no doubt that we will explore that today.
An article appeared in Delhi’s Hindustan Times on 29 August 2010, the day before the start of the first global meeting on maternal health, organised by the Bill Gates Foundation and the Indian Ministry of Health, which exemplified the problem in relation to maternal deaths. The headline was:
“She gave birth, died. Delhi walked by”.
It was the story of a destitute woman who died having given birth on a pavement on a busy street in central Delhi as thousands walked by.
In sub-Saharan Africa and south Asia, women die in childbirth, not of disease or epidemics but of conditions that are easily treatable: prolonged labour, haemorrhage, high blood pressure, infection and unsafe abortions. There is a lack of skilled attendance at births and a lack of access to emergency obstetric care.
The commitment made by world leaders in 1990 to reduce by 75 per cent by 2015 the 570,000 maternal deaths that occurred annually at the time—millennium goal 5—is the most off-track millennium development goal. While there was estimated to be some reduction to 350,000 yearly deaths by 2008, unless efforts are accelerated, the goal of reducing deaths by 75 per cent by 2015 will not be met.
In September 2010, an international alliance that included the United Kingdom was launched at the UN General Assembly. The UK’s leadership is well recognised globally, as alluded to by Melinda Gates in her New Year blog.
The causes of death remain the same: lack of skilled attendance at births, poor access to emergency obstetric care and health system failure. The Government’s framework states that it will address all these issues. It commits the UK, working in high-risk countries in sub-Saharan Africa, to reduce annual deaths by 50,000 by 2015. On the basis of what evidence are the Government confident that they can meet this goal? I hope that the Government will support other African countries, too, such as Tanzania, where there is a will on the part of local and national government, professional organisations and the population to improve maternal health, with some good examples of strong health systems. The UK can and must provide the co-ordination and leadership required and draw on the experience of professional organisations and individuals in the United Kingdom, who will happily contribute to the national efforts.
For the next few minutes, I should like to address obstetric fistula, a subject about which I have spoken previously—I make no apology for doing so again. At long last, after nearly six years of campaigning by a small group of people, obstetric fistula, from which an estimated 3.5 million women suffer worldwide, has come to the notice of the world’s politicians. I, for one, was very pleased that, following the adoption of a resolution by the UN General Assembly, the Secretary-General of the UN, Ban Ki-Moon, is calling for at least $750 million to treat the 3.5 million women who suffer from obstetric fistula. Of course, that is not possible, but I hope that the problem will at least get greater attention. As Ban Ki-Moon said, obstetric fistula is one of the most devastating consequences of neglect during childbirth.
Like maternal mortality, obstetric fistula is almost entirely preventable with skilled care during labour and access to emergency obstetric care. Obstructed labour, a major cause of maternal death, is also the main reason for a mother ending up with a fistula and, in most cases, a stillborn baby. She is left incontinent in relation to urine and she smells. She is made to live in social isolation. To the 3.5 million women with the condition, an estimated 50,000 to 100,000 new cases are added each year. Cost-effective, sustainable strategies, albeit on a small scale, have been instituted by a few dedicated groups.
I am privileged to be involved with one such group, co-ordinated by the International Federation of Gynecology and Obstetrics and the Royal College of Obstetricians and Gynaecologists in London. Over the past four years, it has established training centres for doctors and nurses and is in the process of treating 2,000 women with obstetric fistula. It has trained 32 doctors and nearly 50 nurses in Tanzania alone at a cost of approximately $300 for a woman treated and cured. That is not much. The UK’s framework for maternal health recognises that there is a problem that needs to be addressed. Beyond that, there does not appear to be any commitment. I hope that the call by Ban Ki-Moon will now energise DfID into some action.
The UK can provide a global lead in shaping the strategy to help to tackle the problem. We have a cadre of experienced surgeons in the UK. We have produced competency-based training manuals that are accepted globally for the training of doctors and nurses. We have the experience of running successful programmes. The UK can lead and co-ordinate with other partners. I hope that the Government will commit to some action. I know that the professional organisations stand ready to help. I am hoping for a positive response from the Minister. The publication of the framework demonstrates the Government’s recognition of the problem relating to MDG 5. I hope that resources to meet the goals will now follow.