World Water Day

Jim Shannon Excerpts

Tuesday 11th March 2014 Commons Chamber

[Naomi Long (Belfast East) (Alliance)]

I am grateful for the opportunity to be able to raise the important issue of access to clean water, sanitation and hygiene.

Members will be aware of my long-standing interest in the issue both through my involvement in international development and my professional background. For 10 years before entering full-time politics, I practised as a civil engineer and spent the last five years of my engineering career working in sewerage rehabilitation and design. Others have said that that was good preparation for politics, but I could not possibly comment.

Through my work, I became increasingly aware and supportive of the work being done by WaterAid and other non-governmental organisations and charities to address the deficit of clean water and sanitation infrastructure in many developing nations. I believe it is vital to keep international development needs, especially those as basic and essential as water and sanitation, on the political agenda. Given that 2.6 billion people have no access to adequate and hygienic sanitation methods, the subject of the debate is inevitably and unavoidably broad, but the issue also impacts widely across a range of development objectives. That breadth of impact has contributed to the continuing and increasing political attention that matters related to water and sanitation have been receiving, as there is growing recognition that investment in water and sanitation can have a transformational effect on the lives of people in ways that were previously overlooked.

The timing of the debate is apposite for several reasons: first, world water day is on Saturday 22 March; secondly, we are at a defining moment with respect to the post-2015 development agenda; and, thirdly, the Sanitation and Water for All high-level meeting will take place in April. I will touch on each of those reasons in my speech, but I want to begin by noting the significance of water and sanitation in the context of last Saturday’s international women’s day.

Of the 2.6 billion people without access to adequate and hygienic sanitation methods, 526 million are girls and women. The impact on their lives, however, is disproportionate. These are girls and women without access to any form of sanitation, meaning that they are forced to defecate in the open, or in bushes or ditches, and they are forced to cope with menstruation in the absence of any real privacy, which adds further indignity to their ordeal. This forces women to make difficult choices: to wait until dark to use a public toilet, where one is available; to defecate in the open; or instead to defecate in their own homes. The World Health Organisation has calculated that women and girls in developing countries spend 98 billion hours each year searching for a place to go to the toilet, more than twice the total hours worked every year by the entire UK labour force.

Women who lack safe access to sanitation, or have no access at all, may end up waiting until it is dark to go to the toilet, have to walk long distances to find an isolated spot in the open, or use often poor public amenities. There are many reported incidents of men hiding in public latrines at night, waiting to rob or assault those who enter. Women and girls defecating in the open are also more at risk of rape and sexual assault.

A WaterAid poll of women in the slums of Lagos in Nigeria, where 40% of women are forced to go to the toilet outside, found that one quarter have had first-hand or second-hand experience of harassment, a threat of violence or actual assault in the past 12 months alone. Furthermore, 67% of women interviewed in Lagos said that they felt unsafe using shared or community toilets in public places.

The second choice is to defecate at home, which carries with it enormous social stigma and can result in isolation. In addition to the stigma, resorting to so-called “flying toilets”—plastic bags or buckets used at home—has detrimental consequences for the health of the family. The links between poor sanitation, water, and illness are well established, with an increased risk of diarrhoea, as well as infections such as trachoma, which can lead to blindness.

[Jim Shannon (Strangford) (DUP)]

Some 768 million people have poor water quality, more than 2.5 billion people have poor sanitation and 1.8 million people die from diarrhoea as a direct result of that, so does the hon. Lady feel that the Minister should be saying in his response that international water aid should be a priority?

[Naomi Long]

I agree with what the hon. Gentleman says, and he is right about the importance of water and sanitation. The biggest single health improvement in the UK came as a direct result of the introduction of sanitation and sewerage systems; in this city alone that one measure added 15 years to average life expectancy.

As a result of trying to limit going to the bathroom for long periods of time and drinking less water over the course of the day, women are also more susceptible to urinary tract infections and dehydration, adversely affecting their health. As women are generally responsible for the disposal of human waste when provision is inadequate, they are also exposed more frequently to diseases such as dysentery and cholera. It has been calculated that every day 2,000 mothers lose a child due to illnesses caused by poor sanitation and dirty water. Half the hospital beds in developing countries are filled by people suffering from diseases caused purely by poor water, sanitation and hygiene. Such statistics are staggering, unimaginable and, in this day and age, unjustifiable. These women and girls are suffering from shame, indignity and disease in their everyday lives as a result of something as routine and necessary as carrying out basic bodily functions.

Lack of access to private sanitation facilities also prevents many young girls from continuing in school beyond puberty, limiting their ability to become financially independent and to contribute fully to their community, and denying them the right to a proper education. History shows that the health, welfare and productivity of developing country populations are closely linked with improvements in water, sanitation and hygiene. Few interventions have a greater impact on the lives of the world’s poorest and most marginalised people, particularly women and girls, than reducing the time spent collecting clean water, dealing with sanitation and addressing the health problems caused by poor sanitation and hygiene. Although vaccines offer some hope of improvement on the health front, their efficacy is significantly improved where programmes are undertaken in conjunction with improvements in water, sanitation and hygiene. Neither can vaccines alone free women and girls from the time and physical burden of collecting water or from the safety risks posed by lack of sanitation.

I wish briefly to discuss an opportunity the Government have to make such an intervention: the Sanitation and Water for All high-level meeting taking place in Washington on 11 April. The Sanitation and Water for All partnership, of which the UK Government are a founding member, aims to bring about a step change in the performance of the WASH—water, sanitation and hygiene—sector, acting as a catalyst to overcome key barriers and accelerate progress towards universal and sustainable access. It is a global partnership of Governments, donors, civil society and other development partners working together to co-ordinate high-level action, improve accountability and use scarce resources more effectively. The biennial high-level meeting presents a unique opportunity to increase political prioritisation, and to strengthen accountability and the commitment to strengthen the sector’s performance. I want to take this opportunity to press for the Secretary of State for International Development to represent the UK at this important meeting.

HIV and AIDS

Jim Shannon Excerpts

Tuesday 10th December 2013 Westminster Hall

[Jim Shannon (Strangford) (DUP)]

It is a pleasure, Mr Dobbin, to contribute to this debate, which I congratulate the hon. Member for Airdrie and Shotts (Pamela Nash) on bringing to the Chamber. She has been a champion of the issue here and in the House, and it is clear from the questions being asked that there is interest in and compassion for those who most need help.

I thank the hon. Member for Stafford (Jeremy Lefroy) for his contribution. Not many people can say that they belong to the Kilimanjaro club, and I do not believe any other hon. Member can do so. I also thank the hon. Member for Newcastle upon Tyne North (Catherine McKinnell) for her valuable contribution.

It is good to make a contribution on such an important issue because MPs and parliamentarians have a role to play not just here at home, but internationally. The debate is about the international response to HIV and AIDS, and sometimes when looking elsewhere in the world, it is good also to look at home. HIV is prevalent in other parts of the world but, unfortunately, it is also an issue at home: during the past 12 years, there has been a 384% increase in Northern Ireland, which is a large increase. When focusing on the issue internationally, we must always remember what is happening in our own country.

More than 35 million people live with HIV/AIDS, and in the past year 2.3 million were newly infected. That is the magnitude of the issue. Every hour, 262 people die from AIDS. In a debate here last year, I and others asked what can be done to halt the epidemic, and the reason for this debate today is to ask what steps the Government are taking. Are they addressing the issue effectively?

There was an increase in the number of under-15-year-olds diagnosed with the disease last year, and although diagnosis is good because treatment can start, it is not good that more people are being so diagnosed. We must look at that issue. The hon. Member for Airdrie and Shotts referred to a large drop of 50% in HIV infection in sub-Saharan Africa and that is good news, which arises from steps taken by Governments internationally in the global war against AIDS, malaria and other diseases.

When addressing the international response to HIV/AIDS, we must remember groups such as the Elim church mission in Newtownards in my constituency, which works hard on issues such as health, education, house building, business, farming and orphans. It addresses such issues in Zimbabwe, Swaziland and Malawi, three countries where there has, unfortunately, been a large increase in the diagnosis of AIDS. In the last couple of years, I have had the opportunity to meet some young people from Swaziland who have AIDS, or are orphans because their mums and dads died of it. No one could be other than impressed by the smiles of those young people and their zest for life, which was a result the Elim church mission and many other groups and individuals from other churches making financial, physical and practical contributions to help such people and to give them hope and a chance in life. The hon. Member for Airdrie and Shotts talked not just about medical help but about the hope that can be given, and I too will focus on that.

When we saw and heard those young people, I thought that African choirs are some of the most wonderful. Ours are also good, but African choirs have a different flavour, especially those with young people. Their zest for life and interest in others impresses me. Their Christian belief sustains them, and makes one humble.

Just last month, the Global Fund to Fight AIDS, Tuberculosis and Malaria confirmed £12.07 billion to fight those diseases. The bigger countries have pledged to address the epidemic throughout the world, and that sum was an increase on the 2010 figure but falls short of the £15 billion that is estimated to be needed for the next three years. We have made a commitment, but it has not been significant enough to address the total issue, and we must look at that again.

[Nic Dakin (Scunthorpe) (Lab)]

I congratulate my hon. Friend the Member for Airdrie and Shotts (Pamela Nash) on securing this timely and important debate. Given that last year, 320,000 HIV-positive people died from TB, which is the leading cause of death in people with HIV, does the hon. Gentleman agree that it is crucial that TB REACH be properly resourced in future so that innovative solutions are not sacrificed as we try to tackle these dreadful diseases?

[Jim Shannon]

I thank the hon. Gentleman for his intervention. HIV cannot be considered alone; TB and malaria must also be considered because they incapacitate people who are HIV-positive. A joint strategy is required.

It has been disclosed that the Government will add £1 billion to the overseas aid budget in the next year due to an increase in Government spending. Will the Minister confirm that that money will be earmarked specifically for dealing with HIV/AIDS? We cannot ignore the overseas budget, and although some people may have concerns about increasing it, I believe that it is right to do so.

Will the Minister respond to the suggestion that the UK will deliver its contribution dependent on other countries doing their bit, and that if their pledges fall short—I hope they will not—the UK and USA may not deliver their commitment? Will she confirm that the Government’s contribution is ring-fenced and will be delivered, whatever amount other countries may deliver under the global health fund? At meetings and summits such as G8, Governments make commitments to respond to world disasters, but when looking back a year later, I sometimes wonder whether they actually delivered on their commitments. Delivery is important, particularly this year, and the present momentum of reducing HIV/AIDS must be maintained. The disease ravages those in third-world countries, makes children orphans, condemns mothers to sickness and destroys communities.

Previous speakers have referred to technology. Scientific progress has been significant. The hon. Member for Newcastle upon Tyne North referred to drugs and their availability. They can preserve life and communities. We must translate that into making a difference to the world’s population. I believe, as do many Members, that a person is measured by their compassion and interest in others. This great nation of the United Kingdom of Great Britain and Northern Ireland will also be measured by its compassion for others. I know that our Government are delivering physically and practically, and I hope the Minister, whom I have the highest respect for, will outline in detail what the United Kingdom will do in the global war against the HIV/AIDS epidemic.

Tuberculosis

Jim Shannon Excerpts

Wednesday 27th November 2013 Westminster Hall

[Grahame M. Morris (Easington) (Lab)]

It is a pleasure to serve under your chairmanship, Mr Dobbin.

In the last three Westminster Hall debates that I have attended—on the privatisation of the east coast main line, the privatisation of blood products laboratories and free schools—I have found myself at loggerheads with Government Members. Unusually, however, today I find myself nodding in agreement with the excellent contribution of the right hon. Member for Arundel and South Downs (Nick Herbert). I pay tribute to my hon. Friend the Member for Scunthorpe (Nic Dakin) for securing this timely, important and significant debate.

I echo the right hon. Member for Arundel and South Downs in paying tribute to the work of the all-party group on global tuberculosis and its members and officers, including the hon. Member for St Ives (Andrew George), who has been an absolute stalwart of the group for a number of years.

I will concentrate on one aspect of this terrible condition that is close to my heart. As Members know, I have the pleasure of representing Easington in east Durham. Easington is a coal mining constituency with a long and distinguished history as one of the great heartlands of the north-east coalfields. I thought it would be poignant in this debate to reflect on why our pits were closed and why Britain now imports more than two thirds of the coal burned in our power stations, when once we imported none.

The UK coal industry was modern, efficient and very health conscious. My right hon. Friend the Member for Neath (Mr Hain) spoke about the incidence of TB among South African miners, which is relevant. I have just come from the annual general meeting of the all-party group on coalfield communities, where we talked about the problems that we face in coal mining communities, the physical legacy of pollution and the ill health associated with mining. That is another reason why this debate is close to my heart.

Although, by its very nature, mining will never be completely safe—it is an extractive process—our mines were about as safe as they could be, and the health, safety and well-being of miners was paramount. There are those who would argue that that drove up costs.

Today, much of the world’s coal production has been offshored and outsourced to countries where health and safety standards are minimal and labour is cheap. There is still blood on the coal, but nowadays it is more likely to be the blood of miners in Colombia, China or South Africa. The price of the irresponsible pursuit of profit and cheap labour is the health and safety of mineworkers worldwide.

Mining is one of the biggest employers of men in South Africa. Tens of thousands of those miners are migrant workers, from neighbouring countries such as Mozambique, Lesotho and Swaziland, who work and live in crowded townships in mining areas. As has been said, diseases such as malaria, TB and HIV/AIDS are rife. South Africa’s mining industry has been the subject of intense international and national media scrutiny due to the recent industrial unrest. Members will be aware of the appalling shooting of striking miners by armed police in scenes reminiscent of the worst days of apartheid. Mining is one of the driving forces of the South African economy; it contributes some 20% of the country’s gross domestic product and is a major employer.

What has not been subject to the same degree of media attention is the devastation caused to miners and their families by TB. The disease remains the leading cause of death in South Africa today. One third of all cases in sub-Saharan Africa have a link to the mines. TB is an airborne disease, spreading through the air when people who have it cough or sneeze, and it is often fatal if left untreated. Rates of TB among South African mineworkers are estimated to be as high as 7,000 per 100,000. That huge figure is 28 times the World Health Organisation’s definition of a health emergency and is the highest such figure in the world.

As we have heard, TB is closely linked to HIV, which is also a challenge in the mines. It is estimated that people with HIV are 21 to 34 times more likely to develop active TB. As we approach world AIDS day, it is important to reflect on that and on the interactions between the two. Such high HIV infection rates, coupled with cramped living conditions and exposure to silica dust, which damages miners’ lungs, creates a perfect breeding ground for the disease. The effects are devastating not only for the families of the many miners who die from TB, but also for communities, companies and Governments.

From a commercial point of view, the disease dents productivity—the issues I am raising are relevant to the British mining companies involved in South Africa—puts a drain on health budgets and spreads far into the rural areas that miners migrate from. Migration also means that the problem is not exclusive to South Africa, which is one reason why sub-Saharan Africa is not on track to meet the target of reducing deaths from TB by half by the expiration of the United Nations millennium development goals in 2015.

[Jim Shannon (Strangford) (DUP)]

I apologise for not being here earlier; I had other business and could not get here any quicker.

The hon. Gentleman mentioned world figures for TB, but the exact number of TB sufferers is not known and many of them cannot be found. How does he think we can best address that problem?

[Grahame M. Morris]

I am grateful to the hon. Gentleman for that relevant point. An estimated 3 million people with TB in southern Africa have not been reached, but programmes, such as TB REACH and those supported by the Department for International Development, exist to identify those people and to secure treatment for them. My point is about the incidence of known TB among miners in South Africa.

TB is curable with drugs, and the costs are relatively modest. Spending £15 a person should be easily affordable. Global underinvestment and indifference mean that the disease killed an estimated 1.3 million people globally in 2012. The failure to deal decisively with TB has allowed drug-resistant strains of the airborne disease to develop, which are much more difficult and significantly more expensive to treat.

Earlier this year, members of the all-party parliamentary group on global tuberculosis, including me, met the Secretary of State for International Development. I want to echo the words of Government Members and compliment the Minister and the Secretary of State for their commitment on this issue. We met them to put TB at the forefront of their dealings with major Anglo-American mining interests, particularly in the gold mining industry, which has a high incidence of TB as well as high rates of HIV. As my right hon. Friend the Member for Neath mentioned, an estimated 750,000 cases—I had to check that incredible figure, as I thought it was a printing error—of TB each year, 9% of the global total, come from South Africa’s gold mines.

Colleagues who represent former British mining communities, such as my right hon. Friend the Member for Rother Valley (Mr Barron), and I are determined to push the battle against TB up the political agenda here in the UK. Along with the South African mining unions, I want to see the British Government make the British mining companies involved in South Africa sign up to a new protocol launched by the South African Department of Health. That would help ensure that mining companies abide by a legal framework governing the treatment and compensation of occupational TB.

In the past, too many stricken miners simply returned to their towns and villages to die lingering and often painful deaths. In the 21st century, it simply cannot be acceptable that mining companies, or any other employers, should systematically endanger the health of their workers. Rates of TB in the mines have been estimated at 28 times the World Health Organisation’s definition of a health emergency. This is a global health emergency. We need Governments, employers and drug companies to act accordingly.

People do not have to live in a mining constituency to know that keeping the lights on should not come at the expense of the health and lives of South African miners and their families, or those in any other countries. That is simply wrong. Global mining operations headquartered in the UK must accept their social, moral and ethical obligations to address the issue as a matter of urgency.

--- Later in debate ---

[Mr Kevin Barron (Rother Valley) (Lab)]

I congratulate my hon. Friend the Member for Scunthorpe (Nic Dakin) on applying for and securing the debate. We have heard some of the dreadful statistics on TB throughout the world, and I want to spend a few minutes looking in detail at the cost of treating TB when it has not been caught first time round.

Last year, there were an estimated 450,000 cases of multi-drug-resistant TB. It is believed that 10% of those involve extensively drug-resistant TB and are, effectively, impossible to treat. Drug resistance is really a man-made problem resulting from the misuse of anti-TB drugs and the poor management of the disease. Drug-resistant TB can be passed from person to person in the same way as TB that is not drug-resistant. Clearly, early and rapid diagnosis and treatment completion are essential to control TB. As many Members, including my hon. Friend the Member for Scunthorpe, have said, TB is the leading killer of people living with HIV/AIDS and accounts for one in five AIDS-related deaths.

Drug-resistant TB develops primarily because it is treated with a number of drugs taken over six to nine months. If medication is taken incorrectly or stopped prematurely, the TB bacteria can re-emerge and become resistant to the drugs used to treat TB. That sometimes happens because of the provision of substandard drugs, because patients do not complete their treatment or because the drugs are available only intermittently.

Multi-drug-resistant TB is a form of TB that does not respond to the standard treatment using first-line drugs and that is extremely difficult and expensive to treat. As I suggested earlier, extensively drug-resistant TB occurs when resistance to second-line drugs develops on top of multi-drug resistance. Drug-resistant TB can take two years or more to treat with drugs that are less potent, more toxic and much more expensive than those used to treat a standard case of TB. The drugs are toxic and are commonly associated with severe side effects, of which permanent deafness is the most common. Almost all of them have limited effectiveness, and most are more than 40 years old, as the hon. Member for Mid Dorset and North Poole (Annette Brooke) said. Fewer than 50% of multi-drug-resistant TB cases are successfully treated and considered cured.

On costs, multi-drug-resistant TB can be up to 450 times as expensive to treat as a standard case of TB. In all 27 high-burden multi-drug-resistant TB countries, the treatment cost is greater than the annual average income. If multi-drug-resistant TB is not correctly treated and develops into extensively drug-resistant TB, the chances of someone being successfully cured are less than one in 10. The world needs to recognise that. Extensively drug-resistant TB patients are practically impossible to treat, but they often remain infectious and capable of transmitting the disease to others. That scenario is often described as a time bomb.

[Jim Shannon]

Everyone is aware of the high prices of the normal drugs, but a number of countries—India is one—can produce similar, effective drugs more cheaply. Should we source those similar, cheaper drugs to help spread the cost?

[Mr Barron]

I am sure that is the case; indeed, the global fund does do that. However, that does not prevent the supply of drugs, even if they are affordable in part, from becoming intermittent. As a consequence, we end up with the more extreme cases of TB.

The UK Government have played a leading role in the response to TB globally, investing in research and development on new tools to tackle TB, supporting efforts to increase the profile of the disease through the Stop TB Partnership and supporting key institutions such as the global fund, which accounts for more than 80% of donor funding to tackle TB in developing countries.

I mentioned in an intervention that I visited Ethiopia earlier this year. I went there with Results UK in the February recess, along with the hon. Member for South Derbyshire (Heather Wheeler), my hon. Friend the Member for Workington (Sir Tony Cunningham) and two Members of the other place. In Addis Ababa, we visited St Peter’s hospital, which is Ethiopia’s national TB referral hospital. With support from the global fund, St Peter’s provides care for TB referral cases and patients with multi-drug-resistant tuberculosis. It also provides care and treatment to people living with HIV/AIDS, which is of course closely linked to TB.

The hospital demonstrated that, with proper funding, low-income countries can use minimal resources efficiently and effectively to respond to the threat of drug-resistant TB. As I said in my intervention on the right hon. Member for Arundel and South Downs (Nick Herbert), we also visited Awasa and looked at the great work TB REACH was doing there to find the missing 3 million cases.

While we were in Ethiopia, we did not look just at TB, although that was our primary aim. We also looked at Ethiopia’s strong planning and innovative response to its human resource crisis. It is using its health extension programme, which quite a lot of our money has gone into developing. Funding to support such successful interventions has been provided by key multilateral organisations, including the global fund and TB REACH. I reiterate that, in addition to what they have done already, the UK Government have put £1 billion over three years into the global fund, and they are much to be credited for that.

Finally, I have travelled the Commonwealth on many occasions over the years. When we were out in Addis Ababa, we had a meeting with DFID—I say this because the Minister is here—and it was one of the most positive meetings I have ever had. The DFID people knew exactly where global fund money and our taxpayers’ money was going: to help people in dire need of an improvement in their health, as well as in their quality of life, through water supplies and things like that. We always hear negative views about what happens to taxpayers’ money when it goes to the developing world, so it is worth putting on record that that was the most positive experience I have had since becoming a Member of the House.

Mobile Army Surgical Hospital

Jim Shannon Excerpts

Wednesday 9th October 2013 Commons Chamber

[Dr Phillip Lee (Bracknell) (Con)]

I never thought I would see the day when the words “Mobile Army Surgical Hospital” would be the title of a debate of mine. I grew up watching the television series “MASH”, which partly inspired me to become a doctor. I want to make a serious proposal about a capability that this country should be able to deploy abroad. I started thinking about the issue following the Syria vote in August. I voted against both motions before the House that day. After that, I thought that I should come forward with a constructive suggestion for our engagement with the crisis in Syria. This is my suggestion.

I will present a history of field hospitals in general—just a brief one; don’t worry—and discuss the humanitarian response capability that we need. I shall then mention the challenges of bringing that about and, perhaps more importantly, the details of the facility.

I became a doctor for a number of reasons, but a couple of things spring to mind. One is a book called “The Red and Green Life Machine” written by a commander in the Royal Navy, a chap called Rick Jolly. The title refers to a field hospital in the Falklands war, set up in a disused abattoir in San Carlos bay. I read the book when I was about 13. I watched every single episode of “MASH” and developed desire and ambition—initially, to become a trauma orthopaedic surgeon. I subsequently went to medical school and decided that I would be a GP. What inspired me was the desire to do something to help people in distress.

However, I stress that I am no pacifist. I did not vote in August against the intervention lightly; in fact, I am in favour of quite significant intervention if it is well thought through, coherent and backed up with a strategy for the region. However, I am against the wilful, somewhat reckless destruction of assets in a small way because that can breed more problems going forward.

We are experiencing the ongoing crisis in Syria through our TV screens. I first visited the country in 1998 and I went back as vice-chairman of the Conservative middle east council in February 2011, about three weeks before the civil war started. I have a sense of association with the country. I enjoyed both my visits—particularly the first one, when I was backpacking around as a medical student. I visited Homs, Hama and the beautiful parts of Aleppo that I fear are no longer intact. When I came back from my second visit, I was gripped with a sense of foreboding that trouble was about to start, although not as quickly as it did. I also felt the sense that Britain’s engagement with the country in its crisis should be constructive and trying desperately to bring about a peaceful end to the war.

The problem is that since then there have been more than 100,000 deaths and more than 2 million people have migrated away from the chaos. There has been one public use of chemical weapons, and it has been suggested that there have been others. We have all had to endure some pretty appalling footage of death and destruction, primarily affecting innocent civilians—women and children. It is pretty shocking to have to endure it.

Our response should be multi-pronged. We could foresee a situation in which hard power is wielded, but soft power should also be considered. This is where I come to the MASH or mobile surgical hospital facility that I envisage for Britain. The history of field hospitals goes back to the Napoleonic wars and the gentleman called the father of combat medicine, Baron Dominique Jean Larrey. From that concept of forward surgical hospitals bringing medical support to combatants at the front line, things developed slowly. I guess that the fastest development took place during the Korean war in the early 1950s; the “MASH” TV series is based on that war, although it was always associated with the Vietnam war because of when it was made. During the Korean war, major developments were made in pushing field hospitals closer to the front line. There was the famous image of a Bell helicopter with two casualties strapped into stretchers on either side, with the purpose of bringing people back to be treated very quickly. The dictum was, “Life takes precedence over limb, function over anatomical defects.”

Since then, there have been massive advances. I have not yet visited the hospital at Camp Bastion in Afghanistan, but I am told that it is a remarkable facility delivering the very best trauma care. Of particular note to Britain is our experience in Kosovo in 1999, where the British Army managed to create, in effect, a tented village for a load of refugees as well as medical facilities. It was a fantastic success, and proof of what our military are capable of.

[Jim Shannon (Strangford) (DUP)]

I congratulate the hon. Gentleman on bringing this innovative idea to the House for consideration. I have a Territorial Army ambulance unit in my constituency and they are renowned for the good work that they have done and can do. Does he see the MASH unit being staffed by regular soldiers or TA soldiers, because I believe that both could do the job equally well?

[Dr Lee]

I was going to come to that. I see it as being a reserve force, not part of the regular Army, although I suspect that there will be some logistics staff maintaining the kit and the facility.

--- Later in debate ---

[Dr Lee]

Yes, I was going to come to that. There should be a DFID-funded capability.

The capability needs to be constructive. A friend of mine has talked about having blue overalls, not blue helmets. In other words, we have a United Nations force with blue helmets, so why do we not have a force of people in blue overalls? Our intervention should not necessarily be military in appearance—we can also intervene in other ways. The capability should be resourceful. We are good at this stuff. We can draw on our experiences in the Balkans and the Falklands—I mentioned Rick Jolly’s field hospital—and prior to that. We are very good at this; we have the clinical expertise, in particular. The capability should be able to be expeditionary—that is, to go abroad. In the case of Syria, I foresee a situation where it could be located in a friendly country such as Jordan. It should also have a domestic application. God forbid that there is ever a chemical attack in this country, but the facility could also be deployed here.

The core goal should be to try to develop a stable world that we all appreciate, and that can be brought about by making friends and influencing people. The Arab street is not necessarily with the British or the Americans. We need to persuade civilians on the ground that we do not always have a malign, vested interest—a sense that we are just doing it for ourselves—in our approach to the middle east, but that we are there to do constructive and good things and to genuinely help people.

Turning to details and capacity, as a result of the conversations I have had I envisage a facility with at least 50 beds, perhaps more. If it is as successful as I think it will be I suspect we will extend it, but 50 beds is a good starting point. I think it should include a CT scanner, which is often not available in more rural areas and far-flung destinations. It is possible to put CT scanners in containers and companies such as Marshall Land Systems in Cambridge make container hospitals. There is no reason why we cannot do this. We need to consider whether the facility should also have paediatric and obstetric services, because it is not just soldiers such as those in the “MASH” television series who will be coming in, but children who have been affected by a neurological agent—such as those we saw in that dreadful footage—and pregnant women who have sustained injuries.

Cost is always relevant when it comes to Government spending and there are some figures available. Apparently the Finns purchased a hospital for deployment for about £5 million. I envisage that my proposal will probably cost between £5 million and £10 million. I think it should be a military asset, because the military is best placed to run it, but it should be staffed primarily with reservists, not regulars. Military logistics are important: the army are the best people to get this facility quickly into the field, and Kosovo is an example of that. The army’s command and control systems are relevant.

My hon. Friend the Member for Beckenham (Bob Stewart) has rightly referred to the facility’s security, which is of paramount importance. I think it would be a target. The facility would focus on hearts and minds and on delivering care on the ground, and if I were an Islamist jihadist I would think, “We need to knock that out, because it’s going to start changing minds and attitudes.” The facility’s security would need some thought. For example, RAF Akrotiri is stationed close to Syria and the deployment of troops may need to be considered in exceptional circumstances.

Clarity of funding is clearly important, as my hon. Friend the Member for Woking (Jonathan Lord) has said. The politics of international aid are tough on the doorsteps of Bracknell—trust me: I experience it quite often. This proposal would be one way of using DFID funds for something that is demonstrably humanitarian and of leveraging in some funds to a defence asset that would be used primarily for humanitarian purposes, but—this would always be at the back of my mind—that could also be deployed if we ever go to war.

[Jim Shannon]

We are discussing examples of armed conflict in places such as Syria and Kosovo. Does the hon. Gentleman also see this MASH unit playing a role in responding to humanitarian crises or disasters?

[Dr Lee]

Yes, I do. In fact, the last American MASH unit was deployed in response to the 2006 earthquake in Pakistan and it was then given to the Pakistanis. I would hope that the facility would be used less for military purposes. There are likely to be future crises and I think it should be used in response to them.

Oral Answers to Questions

Jim Shannon Excerpts

Wednesday 12th June 2013 Commons Chamber

[Justine Greening]

My hon. Friend is right to raise the issue, as the International Development Committee did. The incoming Government have a clear-cut manifesto commitment to increase the proportion of GDP from tax collected. We support that, and we hope and expect that they will get on with it.

[Jim Shannon (Strangford) (DUP)]

There have been reports from Pakistan of Christian groups who say they have not had access to the aid coming from the United Kingdom Government. What steps have the Government taken to address that issue directly with the Pakistani Government to ensure that Christian groups get the aid that they should get?

[Justine Greening]

We intend to make sure that our aid reaches all the people who need it, irrespective of ethnic background or anything else. We raised all such issues with the Pakistani Government in the past and will continue to do so with the new Government, now that they are in place. I hope I can do that when I visit Pakistan in the coming weeks.

Drug-resistant Tuberculosis (Developing Countries)

Jim Shannon Excerpts

Tuesday 4th June 2013 Westminster Hall

[Jim Shannon (Strangford) (DUP)]

I thank the hon. Gentleman for bringing this important issue to Westminster Hall for debate. A group of children and young people from Swaziland were recently in my constituency. They were a Christian choir, and every one of those children had AIDS. In Swaziland, 40% of people have AIDS. Does he feel that we need to address such issues at the highest level? That choir is an example of what can happen when medication is available; if they can survive AIDS and TB, they can make a contribution to their country and ultimately across the world.

[Jim Fitzpatrick]

I agree with the hon. Gentleman, and I am sure that the Minister will repeat that agreement on the positive outcomes that result from appropriate treatment.

First, the report recommends that we strengthen the global fund by doubling the UK’s contribution. International donor funding, including the majority of the UK’s response to TB in developing countries, comes almost entirely through the global fund. In 22 high-TB-burden countries, six are totally reliant on the fund and in another 15 it accounts for two thirds of their budget. To scale up access and treatment for DR-TB, which remain woefully low, the resources the global fund has at its disposal need to increase. The Government have a key role to play in the replenishment of the fund, having been a key driving force behind the recent reforms it undertook. I commend the Government for that policy. What are their thoughts on our contribution to the fund to address the threat of TB and DR-TB? A lead from the UK should happen as soon as possible, to help leverage more from other donor Governments in this important replenishment year.

Secondly, the report recommends investment in innovation through TB REACH and continued investment in research and development. The Government have already shown leadership in support of developing new, badly needed tools to tackle TB—a policy of successive Governments that I hope will continue. Some of those tools have come to market, specifically new rapid diagnostics, but despite that, 3 million people each year still fail to access diagnosis and treatment for TB, which includes a large portion of people with drug-resistant strains. We need to accelerate our efforts to diagnose TB by rolling out new technologies, and it is clear that we need to think outside the box. TB REACH is one way to do that.

As the Minister knows, TB REACH is a Stop TB Partnership-hosted initiative that gives small grants of up to $1 million to find and treat those who do not have access to TB diagnosis or treatment. It is an incubator for innovation and pushes the frontiers of technology. It works closely with DFID-funded UNITAID. In short, TB REACH goes where others cannot and shows Governments and donors how to reach the unreachable. Critically, it often demonstrates with data what projects could be scaled up. The Minister may wish to express a view on whether she agrees with that assessment. Beyond their contribution of core funding to the Stop TB Partnership, which does not cover TB REACH, I ask that the Government become a donor to TB REACH, to maximise their investments in UNITAID and support the expansion of new diagnostic tools to detect and ultimately treat cases of TB, in addition to the work of the global fund. The funding allocated should be directed by the evaluation of the Stop TB Partnership later this year. I will be interested to hear her view on that recommendation.

Thirdly and finally, I want to mention a national strategy for TB in the UK and the importance of a global target within that. A national strategy for TB has never been developed, despite the public health risk the disease presents. The UK has seen rising rates of TB since the 1980s and DR-TB increased by 26% in the past year alone. I welcome that the Under-Secretary of State for Health, the hon. Member for Broxtowe (Anna Soubry) indicated that her Department is supporting Public Health England to develop a strategy. I bumped into her before the Division and thanked her for her leadership on the matter, in which I have a constituency as well as a personal interest. I was recently invited to a seminar, organised by the Barts and Royal London TB unit, by Dr Veronica White, the consultant in respiratory medicine. Unsurprisingly, it is the biggest TB team in the UK and does sterling work locally and nationally.

With all that in mind and given the clear link between global and UK rates, will the Government set a specific target on their contribution internationally to tackling DR-TB as part of a comprehensive TB strategy, led by Public Health England?

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.

Oral Answers to Questions

Jim Shannon Excerpts

Wednesday 31st October 2012 Commons Chamber

[The Prime Minister]

My hon. Friend is entirely right. Last week’s news was welcome. The economy is growing, unemployment is coming down, inflation is coming down, the rate of small business creation is going up and a million more people are employed in the private sector than there were two years ago. The one absolute certainty is that the worst approach—Michael Heseltine confirms this in his report—would be to see more spending, more borrowing and more debt, because that is what got us into the mess in the first place. The Labour party has only one growth plan: the plan to grow the deficit.

[Jim Shannon (Strangford) (DUP)]

I thank the Prime Minister for his condolences on the death of my constituent, Corporal Channing Day. She was a courageous young lady. She always wanted to join the Army and for eight years served as a medic. Her job was to save lives—to run the line of fire in order to give aid. Imagine what it meant to a wounded soldier to see someone running to help them when all hell was bursting around them and to know that they were not alone. Corporal Channing Day is not alone today. She will soon return to the bosom of her family, to her mother, father, sisters, brothers, friends and family, who loved her dearly, and to the community, which is immensely proud of her achievements. This House and this great nation of the United Kingdom of Great Britain and Northern Ireland salute her courage, bravery and heroism.

Prime Minister, will you agree with me that Army medics are often the unsung heroes of conflict, and will you agree to meet me and my colleagues to discuss the implementation of the military covenant in Northern Ireland?

[The Prime Minister]

I would be very happy to meet the hon. Gentleman and his colleagues to talk about the implementation of the covenant in Northern Ireland. It is something I have spoken about with the First Minister and Deputy First Minister in Northern Ireland. I know that there are issues about its implementation, but I hope that it can be done, and I would be happy to have that meeting.

The hon. Gentleman spoke very strongly and movingly about Corporal Channing Day. I think he is absolutely right that those in the Royal Army Medical Corp do a fantastic job. It has been a huge honour and privilege for me to meet some of them, including in Afghanistan. When you see the service they provide, you really can put your hand on your heart and know that British military personnel in theatre are getting medical care that is as good as that which anyone in history ever got. What they do is truly remarkable.

Water and Sanitation

Jim Shannon Excerpts

Wednesday 21st March 2012 Westminster Hall

[Naomi Long]

I agree entirely with the hon. Lady. It is hugely important to maximise the benefit of our investment.

Lack of access to clean water, sanitation and hygiene also carries with it significant gender implications that can, in turn, impact more widely on communities.

[Jim Shannon (Strangford) (DUP)]

Will the hon. Lady give way?

[Naomi Long]

I would like to make a little progress first.

In developing countries, women and girls still shoulder most of the responsibility for the collection of clean drinking water from wells, which may involve long and arduous daily journeys. The provision of simple village standpipes could therefore improve not only health, but education outcomes for women and girls in particular, because, freed from that daily chore, they would have time to attend school. The provision of proper and private sanitation facilities in schools has also been shown to reduce education drop-out rates for girls reaching puberty. Women are more likely to bear the burden of caring for those who contract diseases as a result of poor access to water, sanitation and hygiene, and that significantly restricts the degree to which they can be economically active and independent. Most disturbingly, lack of access to water and sanitation can leave women and girls more vulnerable to violence and sexual assault, either as they travel long distances to collect water, or as they wait until nightfall before defecating in the open.

By investing in water and sanitation, we can improve the health and education of millions of people around the world and tackle gender inequality. Access to water and sanitation transforms lives, improves health outcomes and lifts people out of poverty. With every penny of public expenditure under scrutiny, it is important that the resources available for international development are invested in ways that will have maximum impact and are sustainable. Investment in water, sanitation and hygiene meets that economic test.

The UN human development report estimates that for every pound invested in water and sanitation, £8 is returned in saved time, increased productivity and reduced health costs. It is therefore a prudent as well as a necessary investment. Lack of access to clean water and sanitation is estimated to cost sub-Saharan Africa 5% of its gross domestic product—an amount equivalent to the aid received by the region. That fact demonstrates the link between long-term sustainable development, and the specific direction of aid towards water, sanitation and hygiene projects. The impact of such investment could be multiplied if we collaborate with other Governments and with non-governmental organisations and charities that can assist by providing education to local communities through Church and community networks, and by supporting increased capacity among state and non-state players in the field.

The provision of water and sanitation is a fundamental part of the foundations on which our progress on other millennium development goals will be built. It is also an area that delivers significant economic and social returns. One would imagine, therefore, that it would be the aid investment of choice, but sadly that is not the case. Speaking of water and sanitation, Kofi Annan stated:

“No other issue suffers such disparity between its human importance and its political priority.”

In 2010, the UN-Water global annual assessment of sanitation and drinking water looked at the amount spent by donor countries on aid for that sector. It found that although levels of international aid have been rising since the mid-‘90s, the proportion spent on water and sanitation has declined. In the mid-‘90s, the proportion of aid spent on water, sanitation and hygiene was more than 8%, but that has now fallen to less than 5.5%. The UK’s bilateral aid to the WASH sector made up less than 2% of our total aid budget in 2010, and less than 50% of the average reported by other donors.

[Jim Shannon]

I congratulate the hon. Lady on bringing this subject before the House. She has mentioned the importance of water for sanitation, but it is used for other things such as watering crops, or the work done by the churches. Water is also used to make bricks for industry, so it is important for employment, health and food. Does the hon. Lady agree that sanitation is one part of the need for wider water provision?

Education Projects (Nigeria)

Jim Shannon Excerpts

Tuesday 20th March 2012 Commons Chamber

[Bob Blackman]

I thank my hon. Friend for that intervention. Clearly, not only enabling young girls to go into education but supporting them while they are there is crucial. That is one of the key elements of DFID funding that I strongly support and I trust it will continue well into the future.

Most schools do not have proper sanitation or even fresh water, and that is a considerable barrier preventing girls from being educated. DFID funding is being used to provide these basic facilities, and I warmly welcome that. No mention of Nigeria can be complete without referring to the security situation. The attacks orchestrated by Boko Haram have created problems, particularly in the north of Nigeria, and we should all express sincere condolences to the family of Chris McManus who, sadly, was murdered by his kidnappers recently.

[Jim Shannon (Strangford) (DUP)]

I congratulate the hon. Gentleman on bringing this issue to the House tonight. He has talked about DFID and about all the other groups that are helping. Is he aware of the many churches that do tremendous work in Nigeria through their educational projects? In particular, I am thinking of the Elim missions in my constituency, which, through Kingsway International, run an educational project that provides teachers and teaching, food and meals for the day and the books for the schools. It is not Government-funded; it is done through the churches themselves. Such projects also do tremendously good work in Nigeria, alongside all the other people who do likewise.

[Bob Blackman]

I thank the hon. Gentleman for his intervention. Clearly the work of churches, charities, Comic Relief and other organisations is extremely valuable in promoting the educational opportunities that are required in these areas.

On our visit, we had the opportunity to visit schools in Abuja and Lagos. We saw at first hand that DFID funding can make a big difference on providing toilets and new classrooms. In Abuja, we saw a school where thieves had stolen the water pump that provided fresh water for the children. One can imagine spending all day in school without access to fresh water or even basic toilet facilities. In Lagos, we saw a school that had had a new toilet block installed with DFID funding. However, we expressed concern that the cost of that—£37,000—seemed excessive compared with the cost of building generally in Nigeria.

It is important to recognise that the overwhelming majority of the population earn less than a £1 a day. We inquired about that project, particularly the procurement costs and the process that had been followed. We believe that DFID should carefully consider how best to ensure value for money in such a country as Nigeria. The tendering process seems fraught with problems and might not be the best way of obtaining good value for money. Surely we should be negotiating down these prices to make our money go further.

On our school visits we met the school-based management committees, which are equivalent to our school governing bodies. The main problem they face is training members and developing their powers. We heard at first hand how one SBMC had used its power to embarrass local politicians to release much-needed funding for a project. It used Facebook to threaten the governor that it would refuse to support his re-election bid unless funding was released for new classrooms. The governor released the money in a matter of days. DFID money is channelled via the education sector support programme in Nigeria and the girls’ education project. DFID will assist more than 800,000 children to enter education, including 600,000 girls, over the next four years. There can be no doubt that the ministerial team at DFID has ensured that proper targets and value for money are at the heart of the Department’s work. They have truly been the wind of change required for the projects in Africa.

We also had the opportunity to meet many politicians and officials, which helped to promote the relationship between the UK and Nigeria. In my opinion, this type of bilateral relationship is crucial as we increase the UK’s influence in the world. Anyone visiting Nigeria will be shocked at the wide disparity in levels of wealth and income. They will also be surprised, if not frightened, when being driven by car. The normal behaviour of car drivers in Nigeria is to sound their horn and point the car where they want to go irrespective of who or what is in the way. I should also report that my name became the subject of much hilarity for many of the officials I met. I would be a very rich man indeed if I had £1 for every time someone said “Mr Blackman? But you are a white man.”

Nigerians have a great love of the UK. They love premier league football, they universally love the Queen, they are staunch allies of the UK and they are a key member of the Commonwealth. China and other countries have seen the opportunities for investment there and we need to ensure that we retain and improve our relationship with Nigeria. There can be little doubt that Nigeria will become the key economy in Africa very soon, so it is in our vital national interest to continue to invest in infrastructure projects in Nigeria and particularly to invest in education.