Global Fund to Fight AIDS, Tuberculosis and Malaria

Lord Bishop of Derby Excerpts

Tuesday 4th June 2013 Lords Chamber

[The Lord Bishop of Derby]

My Lords, I too want to thank the noble Lord, Lord Fowler, for his persistence and commitment to this very important work and for his prophetic leadership.

I want to focus on TB, which, as we know, is preventable and manageable but needs the right resources. I commend the enormously impressive work of the global fund and, as mentioned by the noble Lord, Lord Fowler, the importance of national Governments. I want to particularly remind us of the importance of the global fund’s aspiration to work with what it calls civil institutions: partnership with people on the ground. To explore what that might mean and to encourage the Government to take that aspiration seriously in the way that we offer funds and seek accountability, I want to talk a little about Peru, which is recognised as among the countries with the highest TB burdens in the western hemisphere. If I understand them correctly, the indicators show that TB control in Peru may actually be deteriorating.

My second reason for talking about Peru is that I am privileged to be a friend of the Bishop of Peru. He and his family come from Chesterfield in my diocese and he visits us when he is in this country. This year, we have in our diocese of Derby a harvest appeal fund to help him build a school, a clinic and a church on one site where there will be proper provision from the system, civic society and education. That is a model of partnership. Last week, I spoke to Dr Townsend Cooper who is running a project for the diocese in Peru. He describes the working of all these efforts from the point of view of civil society—the church on the ground—as “filling in holes”. They do not have a sense of working in partnership; they feel they are running round filling in holes.

I will give one example of a case that he is treating at the moment that he discussed with me last week. They are helping a 13 year-old girl in Ventanilla who has cerebral palsy from a birth injury and was recently diagnosed with TB of her spine. The existing system swung into action: she was admitted to hospital and had surgery and medicines. Then, of course, she was sent home to complete the treatment, and home for this 13 year-old girl is one room on the back of a family property that she shares with her mother. She was discovered in this place by one of the visitors from the diocesan medical team. She was unable to go to hospital by bus because the surgery on her back made that journey virtually impossible. Taxi drivers refused to take her because, as the noble Lord, Lord Fowler, said, there is a stigma about having TB and she is regarded as dirty. Quite frankly, she would not have the money for a taxi anyway. The diocesan medical team picked her up and began to visit her. They did very simple things: hygiene, transport, education for her and her mother about management of the treatment and co-operation. What the doctor calls a very small amount of targeted help has transformed the situation, and the initial investment in the treatment is now again beginning to bear fruit.

That is just one little story, but I share it because it shows the problems of people of good will and faith on the ground who are trying to fulfil the aspiration to work with civil society. It alarms me that the director of this project says they feel like they are filling in holes. It is not a comprehensive enough system of outreach, partnership and co-operation so that the good work being done by the fund and national Governments is not biting as much as it might to make the difference.

I would like to make two points. First, I support the request for the Minister to comment on the Government’s pledge to increase investment in this fund. I also want to ask what the Government might be able to do to encourage the fund to take seriously its aspiration to work with civil society, and how to bed that in better so that those on the ground trying to fulfil this part of the complex response to TB do not feel that they are just filling in holes but are part of a more joined-up and coherent system.