HIV (Developing Countries)

Jim Shannon Excerpts

Wednesday 19th December 2012 Westminster Hall

[Jim Shannon (Strangford) (DUP)]

I congratulate the hon. Member for Mid Derbyshire (Pauline Latham) on bringing this important issue before the House. Some people know about it and others have acquired knowledge of it, as I have through my office and the organisations that I deal with.

The topic is worthy. Many of us cannot fail to be touched by the scenes on television from Africa and other parts of the world, and we often think, “If only the children had more food.” However, looking more deeply at the issues, they need not only more food, but more medication and, in many cases, HIV medication. The hon. Lady referred to the statistics. Some 1.7 million people died of AIDS in the past year, and there have been 2.5 million new infections this year, so there has been an increase to about 38 million people with HIV infections across the whole world. Those figures put the issue into perspective, and bring into focus where we are on this.

Every year, one of the girls in my office takes a two-week summer holiday in a small country called Swaziland. I will speak specifically about that country, because I have some knowledge of the area. She does it through the Elim Church’s international missions; the headquarters are in Newtownards in my constituency. The missions do marvellous work in Swaziland, in schools, education, and health, and in trying to build lives and give people more quality of life and opportunity. Two years ago, we had the youth choir over from Swaziland. What put the issue into perspective for me, perhaps for the first time, was meeting some of those young people, who were in their teens or early 20s. I did not know this until they had returned home, but the girl in my office said, “Jim, many of those people you met have AIDS—not by choice, but from birth.” That puts the issue into perspective; it certainly did for me.

In Swaziland, the people are very similar to those in Northern Ireland—they have the same friendliness that we have, and that the Scots also have, and which we are renowned for—and it is also about the same size as Northern Ireland, but there is one big difference: 40% of Swaziland’s population has HIV/AIDS. The perspective is that nearly half the population has it, and the difficulty is that no one talks about it. I agree with what the hon. Lady said about educating people better to address the key issues that affect them.

When someone goes into an overcrowded hospital in Swaziland, they find two people on each bed and another lying beneath each bed. That is the nature of their hospitalisation. They are probably there for tuberculosis, cancer or some other problem, but they will never admit that the underlying issue is HIV/AIDS, and we must address that. Those lovely young people from Swaziland whom I met had what I would call heavenly voices, but that belied the undercurrent of their health issues.

In Swaziland, to use that country as an example, people do not protect themselves against HIV. They do not use the condoms that are given out for free, because that would be an acknowledgment that they were already ill or could become ill. We have to get past the barrier that seems to exist. In Swaziland, as in many other African countries, male circumcision is also available as a method of trying to reduce the number of people with HIV/AIDS. Will the Minister give us details, if she has them—if not, I am happy for her to reply in writing—on how much the use of condoms and male circumcision has reduced HIV/AIDS in Swaziland, in which I am particularly interested, and across the world? For every one starting treatment, two become infected, which gives us an idea of the massive mountain that we have to climb.

My office sponsors a child in Africa. It is not big money; every week £1 goes into a box to sponsor a young orphan in Swaziland. Through the Elim missions, that money gives orphans clothing, school fees, school books, food and, most importantly, the HIV medication that they need to allow them to live a full, normal life—small moneys, but big dividends and big returns. The kids live on a farm and are sponsored by people from all over the world who understand their illness and how to treat it. The orphanage has a hospice, with a nurse who picks up the first signs of infection. They have hope and a future, but unfortunately the same cannot be said of most people with AIDS in Swaziland, not because of ignorance, but because they just do not want to face the key issues.

An entire generation is missing due to this disease. Grandmothers look after toddlers because the parents have died of AIDS. The grandparents who concentrate on the children perhaps do not want to talk about it. They do not talk about it to their grandchildren, because they do not want them to know that their mums and dads died from it. Again, we can see the dangers for that third generation. A middle generation is missing because of the epidemic, and the older generation is keeping that from their grandchildren, so another generation is being raised not to talk about this unspoken illness.

The scenario is replicated across Africa and the whole world; we have statistics and information relating to places such as Indonesia. Will the Minister respond about the educational drive that we need? It has to be an educational drive that people will respond to, not one that sounds good on a piece of paper that can be sent off without our knowing how the drive works or whether it will be successful. We need to know that it will ensure that we can put an end to losing entire generations. I have looked through the statistics on India. It has had an AIDS campaign since 2001, and it has reduced new infections by 50% in 10 years. The statistics illustrate that; there were 270,000 infections in 2001, and 120,000 in 2012. However, there are still 2.1 million people in India with AIDS, which gives us an idea of the magnitude of the problem.

There have been many pharmaceutical developments, and some of the costs are fantastically different. In America, one dose of medication would cost $12,000, but the same medication can be produced in India, where there are pharmaceutical companies, for $300. Again, we must focus on that. With the wonders of modern medicine, HIV/AIDS no longer has to be a death sentence; medication and care can allow people to have a long life. That life will not be as long as ours in this Chamber, because the disease reduces people’s length of life and their time on this earth, but it will be longer than if they were under the threat of the disease without any medication.

Medication is not always readily available, and given the cost implications, it is clear to many that change must come from stopping the spread by educating people and changing their mindset. If that needs the help and support of those of us in the western world, I believe that we should give it.

[Sir Tony Cunningham (Workington) (Lab)]

Does the hon. Gentleman agree that, in many African countries, for education to be successful, it needs political leadership behind it? Without that, we will struggle.

[Jim Shannon]

I thank the hon. Gentleman for his intervention. I absolutely agree that we need leadership at the very top in all countries, and that we need to make the necessary commitment.

The pupils who came over here as part of the choir from Swaziland were young, and although they were AIDS carriers, they were clearly focused on what they had to do for the future. If we can keep young girls at school, or give them an improved livelihood, so that their focus is on the good things of life, we can reduce the number who can be infected by AIDS. I support the efforts of the hon. Member for Mid Derbyshire to highlight this issue in the hope of securing attention and help for people who are so much in need, in Swaziland and many other countries across the world.

--- Later in debate ---

[Lynne Featherstone]

The hon. Gentleman raises an important point. He may be aware that the Prime Minister raised the issue at the Commonwealth Heads of Government meeting. I have spoken to Foreign and Commonwealth Office Ministers about the issue, and in my international champion role I have developed key messages. Three of those messages are on women, and they address: leadership; rights and laws; and impunity, access, justice and enforcement. There are two messages on homosexuality, and it has been agreed that all travelling Ministers will raise the issue when appropriate. That must be done appropriately as it is easy to raise feelings that the issue is a western construct. The issue, therefore, has to be worked out with the countries not in a preaching way, but in a way in which we can discuss our differences and move the agenda forwards. Human rights are a priority, and we have all made that clear on many occasions. Nevertheless, we work across many countries that come from a different place from us.

In parallel, the UK Government complement grass-roots demand for change through our diplomacy on human rights overseas. We are committed to ending religious intolerance and persecution and discrimination against individuals on the basis of their sexuality. We regularly review the commitment to and respect for all human rights in other countries, including the likely direction of travel over the coming years. Where we have specific concerns about a Government’s failure to protect their citizens’ rights, we raise those concerns directly at the highest levels of the Government concerned.

I will now answer some of the other points that were raised by Members and try to finish ahead of time—we are running over because of the Division.

The hon. Member for Airdrie and Shotts (Pamela Nash) asked about direct budget support payments to Uganda and the condition of renewed payments. Aid to the Government of Uganda is predicated on fundamental commitments and agreed principles, so any renewal of general budget support depends on those conditions being met. The route is always open, and there is nothing we would wish more than for countries to want to come back to the same table as us. I am hopeful that that will be the case one day, but it is very early days as we try to address the diplomacy and geopolitics on the Democratic Republic of the Congo, Rwanda and Uganda.

We support Ugandan civil society groups, including the Civil Society Coalition on Human Rights and Constitutional Law, which trains in advocacy and covers the costs of legal cases to protect LGBT communities. That is just one example. Where we cannot give directly to Governments, we find other ways to help people in countries where possible.

My hon. Friend the Member for Mid Derbyshire specifically raised a number of points. Under the global fund’s new funding model, there will be a targeted band for countries, such as Ukraine, with higher incomes and a lower disease burden that remain at risk from rising epidemics. That allocation band includes countries that should focus resources on most-at-risk populations, which are the groups that we have discussed. The UK has consistently argued that such groups should be prioritised in that context. That was the argument I used in Ethiopia when then Prime Minister Meles and I discussed public health, transmission and other such issues.

My hon. Friend is right that Gilead has shown leadership in joining the medicines patent pool, which we strongly support. We are encouraging other companies with patents for new first-line treatments for HIV/AIDS to consider beginning formal negotiations to enter that pool.

On the G8 and the post-millennium development goals, we will use our influence with the international system to deliver our global commitments. As part of our G8 presidency, we will be reporting on progress against existing commitments and holding members to account. There is definitely a view that we need to finish the job. As exciting as it is to think about post-2015 MDGs, there is still much work to be done on the goals we are in the middle of right now.

Several Members raised the issue of the Why Stop Now? UK blueprint, which is where we slightly part company. Our review of progress on the UK’s position paper will happen in the early part of next year, and it is there that we will make our next decisions based on evidence. We think that just spending a lot of our resources to create another blueprint will be just that—using a lot of our resources—when we basically know what we need to do. We want to get on with working with international partners on implementation, rather than having to stop and bring all our resources back to create another plan. We want to work with stakeholders to ensure a robust and accountable analysis of DFID’s HIV results. We are still discussing the time frame because our review of our position paper needs to align with a number of other international processes. I am aware of the call for a blueprint, but I do not think it is necessarily the way we want to go. I apologise if that disappoints anyone. Indeed, I see the AIDS Consortium sitting in the Public Gallery, and I think I have shown my commitment. My first speech as a Minister was an address to the annual general meeting of the AIDS Consortium, which I have since met to discuss all the issues.

I must be quick, but a number of Members raised the issue of the relationship between HIV and tuberculosis. My right hon. Friend the Member for Arundel and South Downs (Nick Herbert), whom I used to work with at the Home Office, specifically raised that issue. TB is the leading cause of death for people living with HIV. DFID supports leadership among countries on integrated responses rooted in knowledge of local epidemics, with donor support harmonised in line with national plans to deliver quality integrated HIV, TB and reproductive health services, which was a call across the Chamber.

I acknowledge the two issues raised by my right hon. Friend on the TB REACH programme and on vaccination, both of which I will consider further. At the moment, DFID’s support for TB research includes £205 million to the Global Alliance for TB Drug Development and £14 million to the tropical disease research programme.

The hon. Member for Strangford (Jim Shannon) mentioned how condom use and circumcision have helped HIV prevention work in Swaziland and the rest of the world. I thank him for highlighting the challenges in Swaziland, and DFID agrees that a combination prevention approach, including condoms, male circumcision and education, is essential to an effective response.

[Jim Shannon]

I also mentioned how pharmaceutical companies in India are able to produce the same anti-HIV drugs more cheaply than companies in America. Without promoting any company over any other, does the Minister agree that, if cheap medication is available in India that is every bit as effective as other medication, we should be sourcing medication from India, given our DFID contribution to countries across the world?

[Lynne Featherstone]

I thank the hon. Gentleman. We have heard the point that he has made so well.

I thank all hon. Members who have spoken, particularly my hon. Friend the Member for Mid Derbyshire, who secured this important debate. It is heartening to see so many Members who genuinely hold HIV as a priority and will pursue the wonderful goal of zero infections.