HIV: Women and Girls

Desmond Swayne Excerpts

Tuesday 12th April 2016 Westminster Hall

[The Minister of State, Department for International Development (Mr Desmond Swayne)]

It is a great pleasure to follow the hon. Member for Hackney North and Stoke Newington (Ms Abbott), who spoke with infectious enthusiasm about her experiences in Uganda, the programmes she saw there and the genuine commitment to community empowerment.

I thank my hon. Friend the Member for Finchley and Golders Green (Mike Freer) for focusing his forensic intellect and our attention on this vital life-and-death question, on the eve of the replenishment of the Global Fund, with the UN’s high-level meeting on ending AIDS and this year’s AIDS conference coming shortly thereafter. This is a year in which we must make a change in the trajectory of this disease with respect to women and girls.

I clearly have to reassure my hon. Friend. I do not believe that this is the best forum in which to take him through the Department’s website, but I am confident that we can arrange a time to do so, perhaps when there is a screen in front of us. On the goal that he found absent, the high-level departmental goals will not specify every disease upon which we want to make an impact. I put it to Members this way: we put our money where our mouth is—follow the money. We are the second largest donor in the world in response to the AIDS epidemic.

In 2014-15, we spent some £374 million on our response to AIDS. In the current cycle, we have committed £1 billion, subject to the 10% burden share, to the Global Fund. We support UNAIDS, UNITAID, the Clinton Health Access Initiative and the Robert Carr network for outreach to civil society. All those things are vital, and they have had an impact. The response to the AIDS epidemic has seen in the past five years 15 million adults being treated for the disease, 1 million babies of infected mothers being able to avoid infection themselves and a two-thirds reduction in the number of new infections—and yet, as my hon. Friend pointed out, in sub-Saharan Africa 50% of the people who are infected do not know it, and among young women, only 15% know they are infected. Clearly, this has to be our main effort if there is any prospect of us getting to zero: to zero new infections, zero—

[Catherine McKinnell (Newcastle upon Tyne North) (Lab)]

rose—

[Mr Swayne]

I am sorry. The hon. Lady has rather thrown me—I give way to her, if she must.

[Catherine McKinnell]

I apologise for interrupting the Minister’s flow, because he is making a very important speech. I have listened carefully to the debate, which I commend the hon. Member for Finchley and Golders Green (Mike Freer) for securing. I agree with my hon. Friend the Member for Hackney North and Stoke Newington (Ms Abbott), the shadow Secretary of State, that because of what the Minister is saying, the Government should be very clear that that is their aim. I still do not understand why they have not explicitly stated it in their information. I hope he is coming to that point.

[Mr Swayne]

I hope that I will be given the chance to get there, and that my statement today will be regarded as something of an explicit statement in lieu of what Members have not been able to find on the website, but that is a question we might come back to.

As I was saying, this has to be our main effort if we are going to have any prospect of getting to zero: to zero new cases, zero deaths and, as the hon. Member for Hackney North and Stoke Newington and my hon. Friend the Member for Maidstone and The Weald (Mrs Grant) pointed out so importantly, to zero stigma and discrimination—a vital part of the equation.

How are we going to achieve that? I believe that the proper principle is to deploy our resources where the need is greatest, where the burden is greatest and where the resources are fewest. I have to reassure my hon. Friend the Member for Finchley and Golders Green in respect of his perfectly proper concern about middle-income status countries. The reality is that the Global Fund deploys half its resources in middle-income countries and specifically has programmes to deal with neglected, vulnerable populations in high middle-income countries. We have given £9 million to the Robert Carr fund specifically to address some of those issues.

I put it to hon. Members that as countries develop and become wealthier—I accept entirely that, as the hon. Member for Glasgow North (Patrick Grady) pointed out, there is a question of what defines a middle-income country, and there is a wide spread—there has to be an expectation and a challenge to them to start deploying more of their resources to deal with the problems of healthcare and AIDS in particular. It is very much part of the Addis agenda that countries deploy their own resources, and part of the challenge to us and to the Global Fund is to hold them to account for doing so.

My hon. Friend the Member for Finchley and Golders Green was right to challenge me on the issue of research and development. I do have concerns, but we are the leading investor in product development partnerships, which delink the market incentives for research and development and replace them with the prioritisation of public health objectives. Some 11 new products are now on the market in low-income countries as a consequence of the partnerships that we have developed. In addition, we have invested. We are the fifth largest funder of UNITAID and have put €60 million into its programme for developing diagnostics and treatments. Indeed, there is also its groundbreaking development in the treatment of paediatrics, with some 750,000 treatment regimes for children.

[Ms Abbott]

I agree with the Minister that as countries get wealthier, in principle they should take responsibility for their own HIV/AIDS programmes. However, when there are allegedly middle-income countries that are members of the Commonwealth but which, to all intents and purposes, are going backwards on LGBT rights, does Her Majesty’s Government not have a responsibility to intervene with the type of projects that would make it easier to access marginalised communities?

[Mr Swayne]

I accept entirely that there is a challenge to all the developed world and all right-thinking countries to hold those regimes to account for their treatment of human rights and respect for human rights. Nobody should be left behind—that is the principle that we have to abide by—and we must find programmes and measures to deal with that. I accept that the hon. Lady is right on this issue.

On the issue of research and development, we are alive to this problem, but let us consider it a work in progress. I accept entirely that there are still problems, but I am glad that the World Health Organisation is now implementing what it calls an observatory on research and development, and that a working group will be set up to drive the matter forward.

The issue of condoms was raised by the hon. Lady and by the hon. Member for Strangford (Jim Shannon). I am very much in favour of the distribution of high-quality male and female condoms. What is more, I want to see much wider distribution of the benefits of microbicides, which were raised by the hon. Member for Glasgow North with respect to the rings and gels that are being used and in which we have invested some £20 million. I believe that that is essential.

The hon. Member for Strangford raised a key point—I think his words were that AIDS is being used as “a weapon of war.” He is right about that, and I want to see reproductive and sexual health as a key part of our response to any humanitarian emergency.

Of course, I want to see a successful replenishment of the Global Fund. That is essential—[Interruption.] The hon. Member for Glasgow North is signalling that he wants a commitment to be made now, but I am going to have to disappoint hon. Members over a figure and commitment now. That has to be left to the Secretary of State and it can only be done once the bilateral aid review and the multilateral aid review have been published. However, I am impressed by the way in which the Global Fund has attempted to address our preoccupation with women and girls and to make its response to women and girls central to its strategy. We now want to see how that changes things on the ground, because women’s needs are highly complex and our response has to be correspondingly comprehensive.

My hon. Friend the Member for Finchley and Golders Green asked me on a number of occasions how we were going to address the needs of women and girls, and it is a response that goes well beyond what we can do specifically to address the issue of AIDS. It is a question of changing culture and of changing law. It is a question of changing the perception of human rights. It is a question of changing economic development and of giving women the power to protect themselves. It is about empowering women and giving them information and access to family planning services. It is about giving them an education and a livelihood. All these things will empower women to ensure that they are enabled to negotiate the terms under which sexual intercourse takes place. However, I tell my hon. Friend this: a world free of AIDS—one in which absolutely no one is left behind—is one in which the rights of a girl are promoted and protected from the minute she is born.