Developing Countries: Budgetary Support

Baroness Tonge Excerpts

Wednesday 15th May 2013 Lords Chamber

[Baroness Northover]

The right reverend Prelate is quite right. He will have noted that my right honourable friends the Prime Minister and the Foreign Secretary have focused very much on this and are emphasising it at the G8. DfID has a number of programmes assisting in the development of the tax collection regimes in countries in which we work, because we recognise that it is extremely important that those within developing countries, whether they are international companies or prospering citizens, contribute to the country’s development.

[Baroness Tonge]

My Lords, the Minister told us that the Government want value for money in international development—and rightly so. Will the Government therefore consider stopping aid to the Palestinians in the West Bank and Gaza, and persuading, if not forcing, Israel to pay for its illegal occupation of those territories?

[Baroness Northover]

My Lords, having visited the West Bank and Gaza, as has the noble Baroness, I would be extremely reluctant to do anything to stop aid to those in Palestine. I am sure that we will come on to a further discussion of the Middle East in the debate that is to follow. We continue to engage very actively in seeking to take forward a Middle East peace process, because that is the key to sorting out the problem.

Rape in Armed Conflict

Baroness Tonge Excerpts

Wednesday 9th January 2013 Lords Chamber

[Baroness Tonge]

My Lords, I congratulate my noble friend Lord Lester for not only securing this debate but having the courage to raise what is a very contentious issue. It is difficult to estimate how many women have been raped during armed conflict, but a survey in the American Journal of Public Health a year ago estimated that in the Congo, over 1,000 women were raped every day. We know that rape is a weapon of war and, as the noble Baroness, Lady Kennedy, said, is also a step to genocide.

Closer to home, I was fortunate—or unfortunate—enough to be in Tirana in the spring of 1999 when the people of Kosovo were fleeing from the Serbs. I was fortunate because I witnessed the unquestioning and generous help that ordinary Albanians were giving the refugees, mostly total strangers to them. However, it was harrowing to visit one of the hospitals and hear the stories of some of the women who were brave enough to tell what had happened to them. Some had been gang-raped by soldiers, some had been brutally raped and then abused with rifle butts, broken bottles and, in one case I heard of, with burning plastic bottles. Noble Lords can imagine the suffering.

The trauma is suffered on many levels. There is appalling physical injury and infection to be dealt with. There is great mental suffering. Children may have witnessed the rape of their mothers and are deeply traumatised as well. Husbands may reject or leave a wife who has been raped. There is social exclusion from the group, and shame heaped upon the victim by the community. Many women do not admit what has happened to them because of this.

If pregnancy results from the rape, support and counselling will be needed for the victim, although I think the idea of proper counselling in conflict zones is just pie in the sky. The majority of women will want safe abortion; without safe abortion provision, women who have been raped will try to end the pregnancy by unsafe means. The International Conference on Population and Development, held by the UNFPA in Cairo as long ago as 1994, stated in its programme of action that human rights abuses occur when a woman is forced to carry an unwanted or unviable pregnancy; this is degrading and causes mental suffering especially when the pregnancy is the result of rape.

I was not going to repeat the legal arguments but I think we have time to remind ourselves. As my noble friend has told the House, under the Geneva Convention, women who have been subjected to rape as a weapon of war fall into the category of “wounded and sick” and should have equal access to medical treatment. The UN Convention Against Torture recognises that safe abortion is a necessary element of complete medical services for injuries resulting from torture. Rape is torture, and the denial of correct medical treatment after rape is therefore, in itself, cruel and inhuman treatment—torture, in other words.

The purpose of this debate is to try to clarify just what treatment women can get from the humanitarian programmes provided by DfID. Despite President Obama’s lifting of the “global gag” rule when he came in office, abortion is still effectively banned as part of US humanitarian aid, as we have heard, which ignores the fact that the USA recognises girls and women raped in armed conflict as victims of torture. The UNFPA receives funding from the USA and would lose its funding from that source if it was using money from other donors, such as us, for abortion in the same field of operation. The UK Government have been exemplary in recognising the need for safe abortion as a necessary part of treating women who have been raped in conflict, but some of us have had confusing replies when we have tried to establish whether the USA ruling is preventing other countries doing this work when funds are pooled by agencies such as UNFPA.

On a slightly different matter, I also ask my noble friend the Minister to what extent emergency contraception—hormone—pills are used after rape. Emergency contraception is not abortion; it prevents ovulation. It can be taken up to two days after intercourse; five days for some of the new products which are becoming available. Intra-uterine devices can also be used up to five days after sexual intercourse and will prevent ovulation if they contain copper. These methods are very easy to administer. They are cheap and do not carry quite so much baggage as surgical abortion for people working in the field.

If the evidence is lacking, will research be commissioned urgently so that we can live up to our legal and moral obligations to minimise the terrible suffering of victims of conflict and sexual violence?

Gaza

Baroness Tonge Excerpts

Monday 23rd July 2012 Lords Chamber

Asked By

[Baroness Tonge]

To ask Her Majesty’s Government what assessment they have made of the recent report by Medical Aid for Palestinians and Save the Children on the health of children and pregnant women in Gaza.

[Baroness Northover]

My Lords, the UK is very concerned about the health of the people in Gaza, as highlighted by this report, and we are already acting on the issues raised. We provide multiyear funding for food security and service delivery. We also work with partners to promote humanitarian access and the entry of medical supplies and materials for infrastructure rehabilitation.

[Baroness Tonge]

My Lords, I thank the noble Baroness for that Answer. Despite the claim by the Foreign Secretary in this year’s Foreign Office report that human rights lie at the heart of our foreign policy and DfID’s annual report trumpeting value for money in delivering overseas aid, humanitarian assistance in Gaza has not worked. This report tells us that since the deliberate destruction of the sewage plant in Gaza during Operation Cast Lead five years ago—

[Noble Lords]

Question!

[Baroness Tonge]

My Lords, this is important and I beg noble Lords to listen. The children of Gaza are denied their human rights. They have become malnourished and anaemic; they suffer from chronic diarrhoea; they are stunted in growth and psychologically disturbed; and they are being poisoned by 10 times the safe level of chlorides and nitrates in their drinking water. Three children have already drowned in sewage.

[Noble Lords]

Order!

[The Minister of State, Ministry of Justice (Lord McNally)]

My Lords, the noble Baroness has been in this House long enough to know that she is now abusing Question Time. I know that she feels strongly about this matter but she must ask a short question.

[Baroness Tonge]

I am glad to ask a short question. Can the Minister tell this House when the Government will demand that Israel pays for the damage it has done to the infrastructure of Gaza and allow materials through the crossings? In the light of these conditions and the continuing expansion of the settlements in the West Bank, will we be supporting the upgrade of the EU-Israel Association Agreement in Brussels tomorrow?

West Bank and Gaza

Baroness Tonge Excerpts

Tuesday 29th May 2012 Lords Chamber

Asked By

[Baroness Tonge]

To ask Her Majesty’s Government what discussions they have had within the European Union concerning aid from the European Union to the Occupied Territories of Palestine in the West Bank and Gaza.

[Baroness Northover]

My Lords, we hold regular discussions in the European Union on aid to the Occupied Palestinian Territories. Most recently we worked to develop and support the conclusions of the May European Union Foreign Affairs Council, which set out EU priorities for assistance to the Occupied Palestinian Territories in order to maintain the viability of the two-state solution.

[Baroness Tonge]

My Lords, I thank the Minister for that Answer. Does she realise that when David Cameron became Prime Minister, he pledged not to cut the overseas aid budget but to ensure that it was well spent? Does she also realise that in the past 10 years, $76 million-worth of damage has been done to European Union and UK-funded infrastructure projects in the West Bank and Gaza? Does she not think that by giving this aid we are financing the illegal occupation of another country? Will the Government press the European Union to suspend the EU-Israel Association Agreement until the Israelis have either compensated the Palestinians for the damage or refunded the money to the European Union?

[Baroness Northover]

My Lords, the Government have not only maintained aid but increased it. I am sure that the noble Baroness will be pleased to know that. On aid to the Occupied Territories, the EU has sustained its level of aid, as has the United Kingdom. We make it extremely clear that demolitions do not help take things forward. It is extremely important for the future of Israel and of the Palestinians that they seek a negotiated settlement. Anything that stands in the way of that, including demolitions, is a mark against it and does not help the process.

Sudan and South Sudan

Baroness Tonge Excerpts

Thursday 17th May 2012 Lords Chamber

[Lord Elton]

My Lords—

[Baroness Tonge]

My Lords—

[Noble Lords]

Order!

UN: Sustainable Development and Family Planning

Baroness Tonge Excerpts

Monday 19th March 2012 Lords Chamber

Asked By

[Baroness Tonge]

To ask Her Majesty’s Government whether they will promote the connection between sustainable development and family planning at the Rio+20 United Nations Conference on Sustainable Development.

[Baroness Northover]

My Lords, the coalition Government’s positions on sustainable development and family planning are clear. We will be emphasising the links between them, both in the preparations for and during the Rio+20 conference.

[Baroness Tonge]

I thank my noble friend for that reply. I congratulate the Government on their commitment to family planning and to stabilising the world’s population by choice. This is essential for sustainable development. However, will the Minister confirm that the Government will seek to have family planning included in the post-millennium development goals framework when it is discussed?

[Baroness Northover]

The noble Baroness has contributed enormously in this area and I thank her very much for the tribute paid to the department for its expansion of work on this issue. The Government are well aware of the background to the initial MDG negotiations. Discussions are very much in the early stages for a post-MDG framework post-2015. The UK will work to ensure that all the relevant development issues are included in the most appropriate way possible.

Niger

Baroness Tonge Excerpts

Wednesday 25th January 2012 Lords Chamber

[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.

[Baroness Tonge]

My Lords, some of us may be old enough to remember that in times of plenty the Pharaohs used to build up stores of excess supplies to use in times of famine. I wonder whether the international community has made any progress in pre-empting these crises by making sure that there are stores in strategic parts of the world that are likely to suffer famine in advance of the famine occurring.

[Baroness Northover]

The World Food Programme and UNICEF are indeed already stockpiling supplies and a lot of work is going into how best to ensure that these crises do not occur. The Question from the noble Baroness, Lady Kinnock, was all about how to pre-empt such crises and develop resilience in an area where already the population is exceptionally vulnerable. A lot of the problems are because of rising food prices rather than necessarily food scarcity. The noble Baroness’s point is well taken.

HIV and AIDS in the UK

Baroness Tonge Excerpts

Thursday 1st December 2011 Lords Chamber

[Baroness Tonge]

My Lords, I begin by congratulating the noble Lord, Lord Fowler, and the committee, of which I was a member, on this report. I consider it to be a very important piece of work and I would have hoped that the Government would have accepted all of our recommendations. Perhaps that was a bit too much to ask for; sadly, we have a little more persuading to do. I want to talk about two or three aspects of the report and I make no apology for repeating some figures that we have already heard, because they are very important and need to be engrained on everyone's mind.

HIV infection is growing in the United Kingdom. By next year, there will be more than 100,000 people living with the disease in this country and in AIDS treatment, one of the great medical successes in recent years—a quite fantastic medical success—the costs are now approaching £1 billion a year. Yet we still have to remember the title of the committee’s report: No Vaccine, No Cure. It is not curable but for the fortunate people who are diagnosed early, this disease has become a rather nasty long-term condition, which can be controlled with the right treatment, so that people can go on to live a relatively normal lifespan. We have already heard about early testing being desirable. Unfortunately, this has led to a young generation growing up now who think that AIDS can be cured, like any other STD. It is, “No worries, then”—you go to the doctor.

It was 25 years ago that the noble Lord, Lord Fowler, as Secretary of State for Health, launched the never-to-be-forgotten “Don't Die of Ignorance” campaign, with its collapsing tombstones. My children trembled in front of the television set during that campaign. It had impact. They have never forgotten it, and it certainly slowed the spread of that disease in the UK. The noble Lord should always be remembered for his courage in pushing through that campaign, against what I know was some pretty tough opposition.

I do not know how much that campaign cost, but I know how inadequate spending on prevention is today. We have heard that £2.9 million is being spent on prevention—the cost of a house in my old constituency—despite the Government using “prevention” 35 times in their response to the report. I counted each mention because I am a pretty sad person sometimes. Despite those 35 times, only £2.9 million has been spent on prevention yet, as we have heard, nearly £1 billion is spent on treatment in one year. On another preventable statistic, as we have heard, a lifetime of treatment is estimated to cost between £250,000 and £350,000. For the individual and for the Treasury, prevention has to be and is better than cure.

I want to emphasise a few more aspects of prevention, which may not have occurred to some people. AIDS is one of many sexually transmitted diseases and in my view we should not single out one disease for a campaign, as we did recently with chlamydia. That was a wasted opportunity. AIDS is a very serious disease, but I repeat that we have a sexually active population. Sexual images are everywhere and much advertising uses them. Heterosexual and homosexual activity is on our TV screens, in the cinema, and on the internet and YouTube. I do not watch YouTube but I know that young people watch it a lot. That activity is everywhere and young people are immersed in it, but whoever has seen an actor talk about condoms or sexually transmitted disease before hopping into bed with the leading lady? I never have in my lifetime.

I do not want to sound like an old prude but we have to accept that this is the way people behave. They must have the freedom to live their lives, heterosexual or homosexual, as they wish—so long as their actions do not affect others, which sexually transmitted disease does. That is good John Stuart Mill stuff: they are limiting the freedom of people to enjoy their lives. Therefore, people must be given the right warnings and information, and they must be given to all sections of the population, not just the target groups. I have talked to some AIDS campaigning groups about this, and I can say that a spin-off from this more generalised approach to the whole population may help to diminish the stigma which AIDS sufferers have to contend with. I repeat: it is a sexually transmitted disease like gonorrhoea, syphilis, trichomonas, chlamydia and even warts. Are your Lordships feeling uneasy yet, sitting on your red Benches? They are all sexually transmitted diseases and can be prevented. Let us be open about them all and push preventive messages for all of them, especially AIDS.

In their response to the report, the Government said at page 8 that they do,

“not support the Committee's recommendations on the need for a national campaign aimed at the general public, as there is little evidence that this would be effective”.

Where is the evidence? I do not think we saw that evidence and we should if it exists. There should be no ifs and buts from the Government. We must massively increase preventive campaigns or face huge bills and destroyed lives. We must also have statutory sex-and-relationships education in our schools, covering all aspects of sexual activity. Stop caving in to the religious lobbies—state education must provide this.

We have another problem however—I hope on a lighter note—even if we got the Government to agree on these issues. It is the reorganisation of the health service which, as noble Lords probably know, is not one of my favourite topics. The Health and Social Care Bill will have a huge impact on the treatment, care and prevention of AIDS and every other sexually transmitted disease, because everything is being broken up. Treatment of the disease is to be commissioned by the national Commissioning Board and provided nationally. HIV prevention will be commissioned by Public Health England, I think either via or with local authorities. Sexual health promotion generally will become the responsibility of local authorities. Genito-urinary clinics, many of which treat AIDS patients too at the moment, will be the responsibility of local authorities, but the AIDS bit will somehow have to be funded by the national Commissioning Board.

AIDS testing will be done by local authorities. GPs will be encouraged to monitor and maintain AIDS patients already being treated, but the cost of their drugs will be commissioned nationally. Failed asylum seekers with AIDS, still sexually active in the population, are currently denied free treatment. Who will be responsible for them? Do noble Lords get my drift? Said quickly, it all begins to sound like a Gilbert and Sullivan patter song. During the Christmas holidays, I am going to work on the NHS reorganisation plans to make a nice little ditty out of all those various quangos and the way in which they will connect with one another.

For example, why should cash-strapped local authorities—I have been a member of one—or Public Health England get excited about testing for AIDS or prevention of AIDS if the budget for treatment lies with another body? In reality, they will be one phase removed. Arguments about savings “in the long term” in my experience in management, fall on deaf ears because all budgets are short term and even Governments seldom look beyond the next election. Ah, but I hear you cry, we shall encourage integration and co-operation. This, I suppose, is where the health and well-being boards come in, but without representation on those boards from the national Commissioning Board responsible for AIDS treatment, how will they integrate? What about a local authority which has a particular religious majority, or just plain old-fashioned stigma, prejudice, ideology or disapproval? What about that authority? This may severely restrict the choices made and the services it provides.

As well as the health and well-being boards, health services require full staffing and plenty of resources for those staff to find the time to contact colleagues in other services to integrate and co-operate with. Call me an old cynic but I was in the thick of it for many years in the NHS and I know the reality. These words and phrases are pushed out so easily but are so difficult to implement in practice. Noble Lords will have gathered that I am disappointed by the Government’s response, but I am prepared to accept that it may be different once they get to grips with the consequences of their own health reforms.

International Development

Baroness Tonge Excerpts

Monday 11th July 2011 Lords Chamber

[Baroness Verma]

My Lords, the noble Viscount is right. If we fail to respond to the unmet need for family planning, the consequences of rapid population growth will impact on us all. Reducing unplanned births and family size would save on public sector spending on health, water and social services and reduce pressure on scarce natural resources. Reducing unintended pregnancies particularly among adolescents in developing countries would improve their educational and employment opportunities. This would contribute to improving the status of women, increasing family savings, reducing poverty and inspiring economic growth.

[Baroness Tonge]

The noble Baroness will know that Afghanistan, in particular, has faced civil war and political unrest for many decades. Forty-two per cent of the population live on less than $1.25 a day and three in five children are malnourished. Nevertheless, the fertility rate is 6.6 births per woman, many of them very young girls. With a rapidly rising population, only 15 per cent of women in Afghanistan can access contraception. Will she ensure that our Government’s programme to Afghanistan reflects these facts and prioritises maternal health and family planning?

Overseas Aid: Famine Relief

Baroness Tonge Excerpts

Wednesday 6th July 2011 Lords Chamber

Asked By

[Baroness Tonge]

To ask Her Majesty’s Government what plans they have to provide famine relief to the people of Ethiopia, Uganda, Somalia and Kenya.

[Baroness Verma]

My Lords, my noble friend Lady Tonge will be pleased to know that on 3 July the Government announced significant funding for the World Food Programme to help feed 1.3 million people in Ethiopia. The UK is the second largest bilateral donor in Ethiopia. Additional responses are rapidly being prepared for Somalia and Kenya, and we are closely monitoring the situation in Uganda. We are vigorously pressing other donors to play their part in helping to prevent a major catastrophe.

[Baroness Tonge]

I thank the noble Baroness for that response. Is she aware that the population of the four countries currently threatened by famine has grown from 41 million in 1960 to 167 million now and that it is still rising fast? This huge rise is unsustainable and makes populations more vulnerable than ever to drought and crop failures. Will she now repeat the Government’s pledges to give more money to maternal health and, in particular, ensure that when we deliver food aid to starving populations we should also deliver contraceptive supplies and health education to try to ensure that the children whose lives we save today will not be bringing their children to the feeding centres in 10 or 20 years’ time?

[Baroness Verma]

My Lords, my noble friend is aware that the DfID programmes are concentrating on ensuring that maternal and reproductive health is at the centre of all our programmes. Of course, the noble Baroness is right that the populations in these particularly poor countries are growing far more rapidly than those in more developed countries. However, it is through education and supporting women to get better healthcare that we will be able to address this problem.