Sierra Leone: Ebola

Lord Collins of Highbury Excerpts

Monday 30th October 2017 Lords Chamber

[Lord Collins of Highbury (Lab)]

My Lords, I, too, thank the noble Baroness, Lady Hayman, for initiating this debate today and for giving us the opportunity to focus on the key priorities and lessons from Ebola in Sierra Leone. As we have heard, these relate to the need for strengthening healthcare systems, growing primary healthcare staff and training, scientific capacity in diagnostics and public health labs, and of course public health messaging and outreach.

In DfID’s bilateral development review, strengthening health systems across the world was a clear priority. This, too, as we have heard, was emphasised by the Commons International Development Committee. It also stressed the importance of linking this to the SDG 3 by taking into account how they work as a whole and how accessible they are. Like the noble Baroness, Lady Hayman, I welcome the support given by DfID to the President of Sierra Leone who has for the past two years identified health as one of his priority sectors. The two top goals—to bring about a significant reduction in maternal and child deaths and to be able to respond effectively to future Ebola cases—have been backed by DfID.

As we heard from the noble Baroness, the Resilient Zero and Saving Lives programmes provide for early identification and prevention, investment in sanitation, health workers training and access to good-quality basic services for women and young children. Over five years, the goal is to save the lives of over 22,000 children and over 2,000 women, as well as providing family planning for more than 134,000 women and girls. How is DfID making these programmes more sustainable in the long term? We have seen programmes work well but then, when things are pulled back, they are not as sustainable as we thought.

My noble and learned friend Lord Falconer raised the issue of the private sector, which is crucial, and we have received reports of CDC programmes which have been supporting and trying to bring in other private sector finance. One of its programmes during the outbreak was to ensure the sustainability of businesses so that they did not go completely under. I would like to hear more about those CDC programmes from the Minister and again plug the need for a proper debate on the role of CDC in Africa and its five-year plan.

Before the outbreak, the Sierra Leone Government were spending more on tax incentives for big companies than on development priorities such as health. How is DfID working with the Sierra Leone Government to encourage them to adopt the recommendations in the report, Supporting the Development of More Effective Tax Systems, by the IMF, the OECD, the UN and the World Bank? More broadly, how is it working to help Sierra Leone claim more tax revenues?

One other clear lesson that we have heard in the debate on the outbreak has been the role of community engagement, which all too often has been regarded as a soft and relatively non-technical add-on to medical interventions. Can the Minister update us on all the programmes funded by DfID that achieved tangible behaviour change around issues such as safe burials, early treatment and social acceptance of Ebola survivors? We are aware that DfID has been supporting those programmes, but it is their sustainability that we are interested in today. Clearly, we need to ensure this continues and is extended to enable civil society organisations to work with all communities.