Official Development Assistance

Lord Fowler Excerpts

Thursday 15th December 2022 Lords Chamber

[Lord Fowler (CB)]

I very much agree with what the noble Baroness just said. To start, I will say something which I hope has the unanimous approval of the House: it is very good to see Andrew Mitchell back in the Government as Minister for Development. He did so much in the past, as the noble Lord, Lord Bruce, mentioned, and we look forward to what he will contribute in future. In all conscience, he has inherited a very difficult position.

I am sure that there will be an array of financial numbers of one kind or another in this debate. They are very important but, crucial as they are, I would like to concentrate on some of the casualties that the world is suffering from our failure to meet global health challenges. It is a measure that perhaps the noble Lord, Lord Hannan, might agree to. I declare my interest as an ambassador for UNAIDS but hasten to add that the views I express are very much my own.

I will concentrate on HIV/AIDS because it establishes so much of what is wrong at the moment. AIDS is one of the deadliest pandemics of our time. Some 36 million people have died so far from AIDS. Every minute a life is lost to AIDS. The fallout from Covid-19 and the war in Ukraine has hit the AIDS response worldwide, with the result that progress against the HIV pandemic has stalled. Risks have increased, but resources for the response have reduced. Worst of all, the aim of eliminating HIV as a public health risk by 2030 is very much in doubt. I was in Geneva a week or two ago, talking to the health organisations there, and I am bound to say that there was not much confidence that we would, on present policies, meet that target. One of the problems has been that domestic funding for the HIV response is low. It is low in low-income and middle-income countries and has fallen for two consecutive years. Progress in ensuring that all people living with HIV are accessing life-saving antiretroviral treatment has also stalled. The number of people on HIV treatment grew more slowly in 2021 than it has over a decade.

It is important to mention that there is an important difference between the position today and the position in, for example, the 1980s. In the 1980s we had no medicines and no way of combating HIV. It was, in effect, a death sentence. We obviously used advertising and every other means to warn people. Only yesterday, a man came up to me in this House and thanked me on behalf of a whole range of other people for that advertising, which he said had saved his life. It probably saved many lives, but nothing like the number of lives that can be saved by antiretroviral drugs. The really sad thing is that, although antiretroviral drugs lead to a normal, useful, full life after treatment, we are not using their full potential. That is the real tragedy of the situation. It is so different from where we were before. Then we did not have the means. Now we have the means, but what do we do? We do not use them. That is something that this Government should address.

Another issue is that we have not seen the end, or even the beginning of the end, of the discrimination that has perpetuated this pandemic. Some 68 countries have criminal laws that punish consensual, same-sex relations. There is not a lot that this Government can do in the sense of taking action themselves—I seek to persuade people, when I speak outside this country, that Britain has done a great deal since the really serious days when we followed such policies—but we can take all action possible to combat the position.

One position I would like to raise is the change which has taken place as far as the victims of AIDS are concerned. It used to be the case, and it is still portrayed on television as being the case, that all victims are young men. It is certainly true that in the past the majority of victims were young men; it was tragic to see in the hospitals bed after bed occupied by young men who were going to die. But today we have a situation where women have progressively taken a bigger proportion of the victim total and, most tragically of all, so have small children—100,000 have died in the last 12 months. All those things need to be taken into account.

On current trends, we will miss the United Nations target of ending AIDS as a public health threat by 2030. Let us be clear that the result of that will be more AIDS-related deaths and more infection. The real tragedy is that we could face, combat and defeat that. We are a wealthy country; such countries need to remember what is at stake. What is at stake is thousands of deaths and new infections, all preventable. What is at stake is the end of the pandemic or a pandemic which goes on and on. Beating pandemics is ultimately a political challenge. We can end AIDS by 2030, but only if we are bold in our actions and investments. We need courageous political leadership and we need people worldwide to insist that their leaders be courageous.