HIV: Women and Girls

Angela Crawley Excerpts

Tuesday 12th April 2016 Westminster Hall

[Angela Crawley (Lanark and Hamilton East) (SNP)]

It is a pleasure to speak in the debate and to serve under your chairmanship, Ms Buck.

We are discussing HIV, which curses the lives of people in all walks of life across the globe. Yet many of the women who are infected are unaware of the status of their condition and are unable to access the treatment that they rightly need to go on to live a long and sustained life. I thank the hon. Member for Finchley and Golders Green (Mike Freer) for securing this debate on tackling HIV and AIDS specifically in women and girls.

Perhaps due to the lingering stigma attached to HIV since the time of the virus’s discovery more than 30 years ago, its impact on women is often disregarded in policy. Recognising that the barriers, stigmas and issues of access to services and treatment all require further consideration, let us use today’s debate to turn the trend on its head—we must recognise that, globally, HIV is the No. 1 killer of women of reproductive age.

We must also recognise the UNAIDS 90-90-90 target, which we heard about from the hon. Gentleman: the ambition by 2020 to have 90% of all people living with HIV knowing their HIV status; 90% of all people with diagnosed HIV infection receiving sustained antiretroviral therapy; and 90% of all people receiving antiretroviral therapy having viral suppression. That should be not only an ambition but a reality, and we must ensure that we do all that we can to make that the case.

There are, without doubt, issues of HIV infection among women in the UK, but the heaviest concentrations of HIV infection are in the developing world. In such places, women are most affected. In sub-Saharan Africa, the region with the highest burden of HIV, 57% of people living with HIV are women, and figures from 2014 show that, among women of all ages, there were 12,500 new HIV infections every week. Those figures are huge. The effect of infection on each life is devastating; the lives of young girls, future women, will be devastated unless we do more to act. We must ensure that the UK plays a prominent role in securing a future for them. It is vital to consider how aid programmes funded by the UK and the devolved Governments can help to change that deadly trend.

There is a correlation between disproportionate rates of HIV infection among women and gender inequality. Gender inequalities have far-reaching consequences for women living with, and at risk of, HIV. To name but a few, issues include domestic violence, the role of sexual violence and the lack of access to income and property. Only last month, with the Women and Equalities Committee, I visited the UN Commission on the Status of Women, which focuses primarily on women’s economic empowerment. We must ensure that we unpick such gender issues and learn how best to tackle them. I ask the Minister how DFID intends to monitor and track the progress of sexually transmitted disease and to set targets for achieving those goals. The disease will not disappear by itself, and ultimately we must do all that we can to end the epidemic.

Advances have been made to improve access to antiretroviral treatment, but socioeconomic barriers for women to overcome remain. In particular, UNAIDS research identifies food insecurity as a barrier to adherence to antiretroviral therapy. Without adequate dietary intake, people undergoing antiretroviral therapy cannot experience the full benefits of treatment. That can create a vicious cycle. Women are usually those involved in producing, purchasing and preparing food. When a woman is HIV-positive, household food security is impacted as responsibilities shift to the younger women in that household, often raising additional issues of food insecurity for their families.

It is believed that 90% of HIV-positive children contract the virus from their mother during pregnancy, delivery or breastfeeding. Inadequate nutritional status may increase the risk of HIV transmission, and women therefore need access to information and replacement feeding options to minimise the risk of transmission during breastfeeding. It is unacceptable that the number of women and girls contracting HIV infections continues to be a growing trend, especially in developing countries. Young women aged between 15 and 24 are five times more likely to be affected than young men of the same age. The problem of HIV in Africa is complicated and there is no magic bullet. However, we must do more to educate men and boys about how they can prevent this disease, so that we prevent such harrowing statistics. Adolescents between 15 and 19 make up 74% of the new HIV infections that affect young girls and women.

The Scottish National party believes firmly that the empowerment of women is key to tackling and battling global poverty, and we are not alone. The First Minister is quoted as saying that the SNP sees the empowerment of women as the key in battling global poverty. Scotland’s First Minister has said:

“For virtually every nation, fully empowering women is probably the single simplest way, in which they can sustainably increase their productive potential. Gender equality can help to transform the global economy.”

The World Bank has said:

“Putting resources into poor women’s hands while promoting gender inequality in the household and in society results in large development payoffs.”

The UN General Secretary has said that

“removing the barriers that keep women and girls on the margins of economic, social, cultural and political life must be a top priority for us all—businesses, governments, the United Nations and civil society.”

The Scottish Government have taken action where possible to help the world’s most vulnerable people through their small grants programme. This programme supports NGOs to make a big impact and reduce poverty worldwide. The grant also includes using community sport to educate young people about HIV and using technology for a mobile phone app to improve emergency care in Zambia.

The HIV crisis is impacting developing nations, but it can be stopped. In order to best contribute, UK aid must focus on education about HIV transmission and on empowering women who are at most risk of infection. I urge the Minister to consider the effects of HIV on women and girls. How does the Department intend to monitor and track its progress in achieving the sustainable development goals? It is the responsibility of all Governments wherever possible to provide leadership in this debate. I hope the Minister will be able to respond to my questions.

--- Later in debate ---

[Patrick Grady]

I am sure we can all give examples from our constituencies or broader areas of interest of specific projects or programmes that have made a difference. An issue relating to some of the broader questions that have been asked about DFID is to do with its different priorities: the way in which it is leveraging the 0.7%, which we all welcome, and how that can be done as effectively and as holistically as possible. Having some flexibility to try to innovate in new areas and support small, dynamic projects is definitely one area for consideration.

There is the important question of education specifically about HIV/AIDS, which we have heard about, but there is a broader question of education as well. Although it is true that, as I have said a number of times—my hon. Friend the Member for Lanark and Hamilton East said it too—there is no silver bullet to global development, educating women and girls is about as close as we can get. Broader access to education—not just education on HIV/AIDS but, more broadly, education that trains and empowers women with the skills they need to take into society—can reverse the negative spiral that I spoke about at the beginning of my remarks. That economic empowerment is crucial.

[Angela Crawley]

I want to highlight again the need to educate men and boys on their role as community leaders, partners, fathers and brothers, because they also have a role to play in education.

[Patrick Grady]

Indeed. Speaking from my 36 years’ experience as a man, I entirely agree about the need to tackle all these issues. Education, in a range of different forums and of both men and women, is important.

Access to treatment is also crucial. It has been interesting to read in some of the documents supplied in preparation for the debate about the progress made in terms of prophylactic and preventive treatment such as the dipivirine ring trials and various other medical advances, which are incredibly encouraging. It is important that they are invested in and supported. That is why the points made, especially by the hon. Member for Finchley and Golders Green, about intellectual property in the development of pharmaceuticals is key. That has come up in numerous Westminster Hall debates on international development, in particular on tackling preventable disease. It would be interesting to hear from the Minister how the Government intend to take forward those proposals—I was interested to hear that movement in that direction appeared in the Conservative manifesto.

Just as with education, where specific education and improvements in education across society as a whole is needed, the same is true in treatment. We need to be able to treat the specific symptoms, effects and infections and boost the overall level of wellbeing of society as a whole. That is where questions of food security and so on come in.

Humanitarian Crisis in the Mediterranean and Europe

Angela Crawley Excerpts

Wednesday 9th September 2015 Commons Chamber

[Hywel Williams]

I thank the Minister for that intervention and look forward to his response to my other questions about the VPR scheme. On Monday I asked the Prime Minister a question about that scheme, and said that at the request of many organisations and my constituents I had written to the Immigration Minister in July about the matter. In his reply the Minister referred to the VPR scheme, stating clearly that it

“was designed to focus on need rather than meeting a quota.”

I think that need is a good and humane yardstick. The need in the current circumstances is undoubtedly very large; indeed it is perhaps enormous. Applying need as a principle for action allows for a timely and measured response and for the use of discretion. However, the Prime Minister has announced that we will take 20,000 refugees. I am sure that those people will be in great need, but 20,000 seems to be a fixed number. On Monday I asked him what he will say to the 20,001st person who applies and who has a provable and legitimate need.

[Angela Crawley (Lanark and Hamilton East) (SNP)]

A UNICEF report indicates that at least a quarter of those seeking refuge in Europe are children, and in the first six months of this year more than 106,000 children claimed asylum in Europe, up 75% on last year. The Prime Minister made assurances today during Prime Minister’s questions that Syrian children will not automatically be returned when they are 18. That is a welcome instruction, but we would like assurances because the issue will remain deeply concerning for children who come to this country unaccompanied. Can the Minister provide assurances that they will also be protected?

[Hywel Williams]

I will pose that question to the Minister and thank the hon. Lady—in fact, she is blessed with clairvoyance because I was going to ask that question myself.

I referred to a question that I asked the Prime Minister on Monday about the 20,001st person, and his response was disappointing. Indeed, it was either dismissive or even alarming. He said merely that we should concentrate on the 20,000—that is all he said, period. I am all for concentrating on the 20,000 to the extent of offering entry to as many genuine cases as possible as soon as possible, and not over the five years that the Government intend, but 20,000 looks to me like a quota. Hon. Members will recall what I said about my answer from the Immigration Minister and the VPR scheme being based on need and not a quota. By their very nature quotas inevitably lead to artificial and possibly brutal cut-offs, and pit one person’s genuine need against that of another as they both join the queue. I do not think that is a humane way of doing it.

The Prime Minister’s reply suggests to me either that he and his colleagues have not thought the matter through, or that they have done so and are reluctant to engage with the real consequences, which are not hard to imagine. For example, one can envisage a popular campaign in the press, perhaps in favour of admitting an injured child as No. 20,001. One can imagine a campaign in favour of admitting siblings or other relatives of people already admitted, or, as the hon. Member for Lanark and Hamilton East (Angela Crawley) said, at the end of five years and the current terms of the VRP scheme, a campaign not to send a young person who has thoroughly adopted a British identity back to a strife-ridden country. One can imagine the problems that will arise with that artificial cut-off. I was glad to hear that the Prime Minister is looking at this matter because it is serious and needs considering.

This is easy for me to say, but I would not have started from this point. As many hon. Members have said, one root cause of our current predicament is the Government’s reluctance to engage earlier with the UNHRC Syrian resettlement scheme, which led to the setting up of the VPR scheme in the first place. Therefore, there are some causes that we can discern, and there are ways forward.

Briefly, let me mention a couple of points from my own party’s policy on this matter. We wish to see a Welsh migration service set up to co-ordinate migration into Wales and Wales recognised as a country of refuge.

Finally, I have a question for the Minister on the response of the Welsh Government. I hope that I will not be seen as partisan in this matter. On Monday, the hon. Member for Dundee West (Chris Law) asked the Prime Minister about the response of the Scottish Government. The Prime Minister said that

“in the letter the First Minister of Scotland wrote to me, she said that Scotland would be willing to take 1,000 refugees.”—[Official Report, 7 September 2015; Vol. 599, c. 57.]

That is very praiseworthy indeed, and we have heard that that is a starting point and not an end point. When the Minister winds up, will he tell me—or perhaps put it in a letter—whether he has had a similar offer from the Welsh Government?

--- Later in debate ---

[Ms Ahmed-Sheikh]

I agree with my hon. Friend, who passionately articulates the sentiments felt by us all. As a parent, I want to be able to explain to my children that I—that we—did all we possibly could to help. Our children are asking questions, and we should not be ashamed of our answers.

A practical humanitarian response to this tragedy requires three main strands of action. First, the UK must takes its fair share of refugees. It is right that we should seek to relocate those families and individuals in Syria and in the region who are in immediate peril. I welcome the action from the Government. I agree that we should do more to support these people, but we must also play our part in responding to the immediate crisis in Europe itself. It is the right thing to do. When the other great nations in Europe are standing side by side to work together to tackle the largest humanitarian crisis in decades on our shore, the UK should not seek to stand back from our responsibility, distancing ourselves from the collective responsibility of European membership. European membership is about democracy, equality, the rule of law and respect for human rights. It stands for pluralism, non-discrimination, tolerance, justice and solidarity, and we should fulfil these very principles. When the leaders of Europe meet, the UK must discuss with our allies and partners what we can do to play our maximum part.

In Scotland this week, over half of our councils have stepped up to pledge their support for those affected by this crisis. The Convention of Scottish Local Authorities has had an overwhelming and unprecedented response from local authorities on this issue. Every party leader in the Scottish Parliament supports further action. I will not be the only Member here who has been inundated by calls, letters and emails from constituents pledging support or seeking ways in which to give support directly. By every measure, there is a clear majority of people across Scotland and the UK who support a compassionate and proportionate response from this Government.

Secondly, this humanitarian response must not be used as a cover or pretext for military action in Syria. The deterioration in the security of the region can be traced back directly to the disastrous decision to join with George Bush in pursuing illegal military action in Iraq. We must not make that same mistake again here. How could we possibly fathom another UK Prime Minister, in his second term of office, pushing for a military solution to a humanitarian crisis? An increase in offensive military action against Assad or Daesh would not stabilise the situation within Syria. Instead, what must happen now is that the UK must seek the support of the other permanent members of the UN Security Council to secure safe corridors and camps for refugees throughout the middle east. I know that this approach has already gained support from across the House, and I welcome that progress. When SNP colleagues and I met with a range of stakeholders in Scotland last week to hear their experience of working in Syria, there was wide support for such an approach. Action on this basis would be the antithesis of previous military campaigns in the region, as it would be defensive in nature, have a clear and achievable objective, and would be underpinned by international law.

In March 2011, the Prime Minister stood in this House and said of the situation then facing Libya:

“Do we want a situation where a failed pariah state festers on Europe’s southern border, potentially threatening our security, pushing people across the Mediterranean”?—[Official Report, 14 March 2011; Vol. 525, c. 27.]

At that point, the Prime Minster was determined to prevent a humanitarian crisis on the periphery of Europe. As we now know, the total additional cost of Operation Ellamy in Libya is estimated to be about £320 million. In the past, this Government and others before them have spared no expense in pursuing military action. We are engaged in military action against Daesh. On this basis, we should be prepared to welcome those who are fleeing its tyranny.

[Angela Crawley]

The threat of reprisal against lesbian, gay, bisexual, transgender and intersex people who live under Daesh, or as refugees who have fled the area, is particularly salient. Will my hon. Friend join me in urging the Government to commit to appointing a special envoy to ensure that international attention does not forget the plight of these especially threatened people?

[Ms Ahmed-Sheikh]

I absolutely do, and I hope that Ministers take up my hon. Friend’s excellent suggestion.

I agree with EU President Juncker, who spoke so passionately about this issue today. For the world, this is a matter of humanity and human dignity. For Europe, it is a matter of historical fairness. This is a continent where so many have been refugees at one time or another, fleeing war, dictatorship or oppression. We need to treat others as we would hope to be treated ourselves. I am proud that Europe is seen as a safe haven for those fleeing horrific circumstances. We should not cower in fear from Europe’s reputation as a beacon of democracy and justice in a dangerous world. As President Juncker pointed out today, Jordan, Turkey and Lebanon—countries far poorer than the UK—are making huge efforts in moral and financial terms to address this crisis. One in five people in Lebanon today is a refugee. Italy, Hungary and Greece cannot be left alone to deal with the enormous challenge facing us in Europe.