Post-2015 Development Agenda

Debate between Meg Hillier and Jeremy Lefroy

Thursday 21st March 2013 Westminster Hall

[Meg Hillier (Hackney South and Shoreditch) (Lab/Co-op)]

It is, as ever, a pleasure to serve under your chairmanship, Mr Walker. I congratulate my hon. Friend the Member for York Central (Hugh Bayley) on securing the debate and on corralling the all-party parliamentary groups with a strong interest in this matter to make the important case for the British Parliament to have influence on the Prime Minister’s work in this area.

I chair the all-party group on Nigeria and, with Lord Crisp, I co-chair the APG on global health, so I have a strong interest in the area. I am proud to be a Co-op MP as well as a Labour MP, and a strong supporter of work that has been done on loans to small businesses and co-operatives in developing parts of the world.

Thirteen years ago, we set up the first millennium development goals, which were, as my hon. Friend said, a great triumph. They created huge momentum to tackle poverty, and I am delighted that the Prime Minister has such a key lead role in ensuring that we focus on the next development goals from 2015. It is his chance to make a place in history, and I wish him all the best in doing that. Let me add, too, my congratulations to the Government on delivering their 0.7% development aid target.

While I am on this roll of congratulations, let me also congratulate the Secretary of State on her commitment and business-like approach on the matter. She made it clear that part of her job, and the job of her team and the Government, is to secure good value for money for every single pound of aid spent. Taxpayers’ money is a valuable resource and we need to ensure that we provide value for money. I speak as a member of the Public Accounts Committee, which has looked into the matter, and the Committee will continue to challenge the Department to ensure that it achieves that aim.

The momentum to tackle poverty has made a big difference. In 2000, official development assistance was $72 billion. Between then and 2009, it rose to $128 billion. Although such rises cannot be put down to the MDGs alone, they have helped to focus our efforts. The figures have dropped in the last two years as a result of the global recession, so it is particularly welcome that our Government are showing the way and that the UK Parliament has backed them to send a signal to other developed countries that such assistance is important to global health, well-being and security.

In 2015, there will still be almost 1 billion people living on less than $1.25 a day. Moreover, the maternal mortality ratio has declined by less than 1% since 2000, so while the MDGs have made a difference, there is still a lot to be done. What should we be asking from the Prime Minister in his role on the high-level panel, and what should the focus be? One of the interesting issues is around inequalities, because while the millennium development goals focused rather a lot on averages, those averages can mask inequalities. An average reduction can mask a lack of progress among the very poorest people, and that needs to be in the panel’s minds when it makes recommendations.

There also needs to be thought about how measurement is conducted. It can be easy to go for goals that are seemingly easy to measure, but that measurement must be achievable at a local level. When measuring progress on development goals, there must be some understanding of the local challenges. I will touch a little later on some of my experiences in Nigeria, because even within one single nation, various states face different challenges. Moreover, the goals and indicators cannot be vague. We need to be clear about outcomes and what the new goals achieve.

Several hon. Members have discussed the key matter of local participation and empowerment. Development must involve working in partnership with countries, rather than being something that is done to countries. The all-party group on global health produced an interesting report about empowering health workers. It is important that, as well as passing on useful lessons to other countries, we learn lessons for our own national health service. In Malawi, for example, we see a desire, with strong political leadership, to increase the number of midwives and reduce maternal mortality. Wherever we are in the world, we can all learn from that driving political force. Many countries produce policies out of necessity. Lower level health workers are therefore empowered, trained and supported to provide early interventions that can save lives, whereas we tend to follow a more hierarchical model, notwithstanding some of changes that have been made in recent years to empower our nurses. We must learn from each other and not be seen to be doing things to other countries.

Agriculture is important—I will touch on that in a bit more detail in a moment—and integrating climate change policies into the development goals is critical. In Nigeria, for instance, the Government are parcelling up areas for private companies to deliver to the grid, which will provide a welcome boost to the power sector, but if that is not done in a green way, we will be shooting ourselves in the foot as we try to maintain our commitment to international climate change obligations. The Prime Minister must consider such matters as he leads the high-level panel. The panel is meeting soon, so this debate is timely and will, hopefully, help the Prime Minister to realise that he has support from Britain, as well as giving him some ideas.

I am heartened that 60 lower and middle-income countries have run national and regional consultations in an attempt to achieve a more meaningful input and to buy into the process. That will hopefully lead to a joint method of working, rather the goals being imposed on them.

A separate process is under way to agree global sustainable development goals. There will be a report on those goals at some point between this September and September next year, but there is no firm date for it yet. Those goals may significantly overlap with the post-millennium development goals, so it would make sense to bring the two sets of targets together at some point. I hope that when the two sets are being drawn up, each group will be thinking about the other group’s work.

I want to focus on health. The process of developing post-2015 goals is ongoing, as I said, but there seems to be reasonable agreement about what the overall list of goals should contain. However, there is not yet a clear consensus on what their hierarchy should be, and on what the headline goals and sub-targets will be. The hon. Member for Stafford (Jeremy Lefroy) said that the International Development Committee’s report recommended not having too many goals.

The all-party group on global health hosted a fruitful session with a lot of development agencies and others with an interest in this area. The event was standing room only in one of the larger Committee Rooms in the main House, and we heard a long list of suggestions for new MDGs. The Prime Minister’s challenge is to ensure that the list of new MDGs is not so long that it becomes meaningless, thus allowing people to hide behind what they are doing rather than what they ought to be doing. That will be the political challenge, but it is not an easy one to face.

I fear that health issues are unlikely to be as prominent in the headline priorities of the new MDGs as was the case with the original MDGs, when of course they constituted three of the eight goals—on child mortality, maternal health, and HIV/AIDs and malaria. It is vital that people continue to make the case that global health issues should not be neglected in the future list of priorities, which is partly why I am speaking in the debate.

We need a joined-up approach to improve health. The many single disease-specific goals in the MDGs were successful at focusing global attention on critical areas that might otherwise have been neglected, such as malaria. However, they also were in danger of creating silos of activity that were a barrier to building strong overall health systems, so the post-2015 agenda should correct that by emphasising the need for joined-up, holistic health services, in addition to placing a stress on the importance of programmes to prevent people from becoming ill in the first place.

Of course, those aims are also important for reducing poverty, because those in poor health will be poorer. For instance, if we look at just the impact of polio alone, a disabled child in Africa is a burden on their family as they will be unable to work and support themselves, and that of course affects their life expectancy considerably.

Health must be central to development. Good health is critical to achieving the other development goals, so it must not be neglected. Healthy populations are more productive, not only because people can go out to work, but because ill health is a cause as well as a consequence of poverty. The World Health Organisation estimates that catastrophic health costs push 100 million people into poverty every year. We cannot make development progress in any sphere without addressing health needs.

Many believe that we will end up with one stand-alone post-2015 goal for health, and some consensus is forming behind the idea that it will involve universal access to health care. It came out strongly from the meeting of the all-party group on global health that was held before Christmas that that goal would suffer from focusing on a process rather than an outcome, and would be in danger of diverting attention towards addressing the financial barriers that stop people from receiving health services, rather than the quality of those services. In addition, it could ignore the wider determinants of health in society.

Arguably a better goal would be on improving the life expectancy of the bottom 25% relative to the rest of the population, because that would focus on those in greatest need and ensure that we did not water down the aims on which there is a fairly strong consensus—certainly in this House and among a lot of the groups that came to the all-party group’s meeting and submitted their thoughts. That goal would have the advantage of focusing on outcomes, addressing the critical issue of health inequalities, and being equally relevant—this is a very important point for the post-2015 agenda—for high, middle and low-income countries. It could be applied across the board, and it is important that we look at the post-2015 MDGs in that context.

That goal would also be flexible by allowing each nation to decide what aspects of health are the greatest priority for improvement. We can consider the Malawi situation in that context, and there are interesting challenges in different parts of Nigeria, which is, of course, a federal country in which there are big differences between states. For instance, the transmission of HIV and AIDS is affected by the multiple marriages in parts of the country. Sadly, other parts of the country are still affected by polio. I visited Niger state about a year ago and met the governor, who has determined that every child in the state will receive a polio vaccination. However, not every governor in the country takes the same approach. Indeed, such a policy is a challenge for governors in many states, including Niger state, because of their rural districts.

I will not detain Members by talking about just Nigeria, but I saw in Niger state and other parts of Nigeria that strong political leadership can make a big difference. When the new MDGs and the post-2015 agenda are developed, we need to ensure that we allow room for local political leadership to work within the framework, It is about not emasculating that local leadership, but empowering it and the people to whom it is accountable, at federal as well as national level. We must remember, as I have said, that states in countries such as Nigeria can face different challenges.

I will touch on the issue of education. I have had the opportunity to visit the Minna teacher training college in Nigeria. In parts of Nigeria—not all parts, because it is such a diverse country—not enough girls are going to school. In recognition of that fact, with support from Save the Children and other NGOs, girls are being educated to become teachers, because in some rural areas, girls were not going to school because there were not enough female teachers. I met a number of young women at the college, many of them mothers themselves, and in many cases with their babies, who were training as teachers. They were in a separate compound from the rest of the college with barbed wire to protect them so that their fathers, brothers and husbands could be sure that they were safe and in an acceptable environment for a young Muslim woman. Having gained that education themselves, the idea was that they would go back to their villages and then more girls would go to school there.

I then had the privilege of visiting a village school. Parents had formed a committee to run the school, and part of their focus was to ensure that they were aware of any children not in school so that they would get into school, because education is highly prized in Nigeria.

That local school committee had been empowered and it was very interesting to talk to its members. In some ways, it was a bit like talking to a parent teacher association in Hackney, because the parents in Nigeria were equally focused on and proud of their three-year-old who could count, or equally determined that their under-five would receive some support or that their teenage girl would go on to do something. Those are the same sorts of aspirations that the parents I speak to every day in Hackney have for their children, so there is no particular difference.

The hon. Member for Congleton (Fiona Bruce) made a number of sensible points about jobs, because where do those young people in that village near Minna go on to? One of the really interesting issues in Nigeria, as in other parts of Africa, is agribusiness. I am delighted that our Prime Minister and President Goodluck Jonathan of Nigeria have signed a bilateral agreement to double trade from its level a couple of years ago by 2015. That is a very big challenge, but it is also a important issue, partly for this country—we need to create jobs and opportunities for our own businesses—and also because there is a very young population in Nigeria that needs work and opportunity. We already have interesting bilateral arrangements for skills development. Highbury college, Portsmouth, has a relationship under which people in Lagos are trained to certain levels of skills.

Agribusiness is an underdeveloped area, certainly in Nigeria and, judging from what the hon. Lady said, also in other parts of Africa. I am not entirely convinced—perhaps the Minister will comment on this—that the British Government have “got it” on the issue. Do we have the skill base to export as a business, in terms of food processing, development and so on? In one state in Nigeria, Zimbabwean farmers were brought in to help to improve the agricultural process and build it up. There are some excellent resources in Nigeria—land, people and produce—that could be developed, yet Nigeria is importing rice and coffee, whereas in the past it was a net exporter of those products. Big improvements could be made through bilateral trade links as well as through aid.

[Jeremy Lefroy]

The hon. Lady is making a very strong case on this issue. Indeed, when I and other colleagues were in Afghanistan, we saw great opportunities for the Afghan people to carry out their own food processing. At the moment, the raw materials go outside that country to be processed in other countries, and then they come back as commodities, which reduces job opportunities and increases prices in Afghanistan.

[Meg Hillier]

Of course, that process it is not very green, either. To go back to my comments about climate change, we should be shortening the food chain when it is sensible to do so.

DFID has done some good since it was established, but we need more joined-up government. The post-2015 agenda must not just be regarded as just DFID’s responsibility. The whole of the Government needs to engage in it—whether the Department for Environment, Food and Rural Affairs on agribusiness, or the Department for Business, Innovation and Skills.