HIV: Women and Girls

Patrick Grady Excerpts

Tuesday 12th April 2016 Westminster Hall

[Patrick Grady (Glasgow North) (SNP)]

It is a pleasure to serve under your chairmanship, Ms Buck. I congratulate the hon. Member for Finchley and Golders Green (Mike Freer) on securing what has been a considered and useful debate on tackling HIV and AIDS in women and girls. I congratulate him too on his work as chair of the all-party group on HIV and AIDS, of which I am a member. There were useful contributions from the hon. Member for Harrow West (Mr Thomas), who brings considerable experience to the debate, my hon. Friend the Member for Lanark and Hamilton East (Angela Crawley)—I shall reflect in particular on some of what she said—and the hon. Member for Strangford (Jim Shannon), who spoke of being a voice for the voiceless. I do not think there is any question of his voice not being heard. He spoke with his usual commitment and passion.

This debate is timely, as has been mentioned, taking place as it does in the context of the adoption of the sustainable development goals. Indeed, some of us will be back tomorrow for a debate on the implementation of those goals in the round. However, today’s debate is a useful opportunity to reflect on the particular issue of tackling HIV and AIDS, for all the reasons that we have heard, in particular the need to make rapid progress now that the goals are agreed. The number of people around the world living with HIV and AIDS continues to rise, despite the progress being made, and indeed partly as a result of it, given the enhanced longevity from treatment—an HIV infection need not be a death sentence per se. Nevertheless, transmission continues to increase and, as we have heard, in particular parts of the world that may affect women and girls disproportionately.

Three themes arise from what we have heard in the debate: general issues and challenges, such as those I have touched on; the steps and strategies needed to tackle those challenges; and the ways in which we fund and prioritise those steps. I will reflect briefly on those, making sure, of course, that the Minister has plenty of time to respond to all the questions that have been asked.

We have heard that HIV/AIDS is the No. 1 killer of women of reproductive age around the world. In our part of the world it is sometimes difficult to comprehend that, because it is not necessarily true in every individual country, or in developed countries such as ours. However, in developing parts of the world it is of particular concern. During the recess I was in Zambia with the Westminster Foundation for Democracy. The overall prevalence of HIV/AIDS in the country is 12.4% of the population—some 500,000 women. Yesterday I welcomed Jacqueline Kouwenhoven, who is Dutch born but is a Member of the National Assembly of Malawi. She is the Member of Parliament for the Rumphi West constituency. In Malawi the prevalence of HIV/AIDS among men is 8.1%, but among women it is 12.9%. That is a pretty stark demonstration of the disparity, and the disproportionate impact that HIV/AIDS has on women, which is reflected in other statistics we have heard in the debate. I think others have discussed how 74% of new HIV infections in 2014 among adolescents in Africa were among girls and women. That is 12,500 new infections every week, and it gives us a sense of the scale of the challenge.

There is a challenge in two respects. First, there is a challenge for the individuals, as HIV/AIDS limits their life chances and lowers their life expectancy, limiting their ability to work, contribute to society and live flourishing, dignified lives of their own. However, there is also a broader development challenge, in the form of a barrier to societal and economic development, starting at household level, because younger children may be taken out of school to provide care or take up income-generating activities. That has a knock-on effect on whole societies. My hon. Friend the Member for Lanark and Hamilton East quoted Scotland’s First Minister, Nicola Sturgeon, on the importance of empowering women fully, as the simplest way for countries to increase their productive potential sustainably. Interestingly enough, the quotation came from a speech given to the Chinese Friendship Association in Beijing in July 2015. As we have come to expect, Nicola Sturgeon is not afraid to be a voice for the voiceless and to speak out, without fear or favour, around the world on issues of gender equality. That goes to the heart of the point made about the need for political leadership—both an holistic response to a holistic challenge, and political leadership to drive that response forward.

The steps needed to tackle the spread of HIV and AIDS among women and girls in particular fall into two key areas. The first is prevention, in its broadest sense. We have heard a lot in the debate about education, including education specifically for awareness—of status, safe practices and cultural barriers. All those things are important, and we have heard about some of the support that the Scottish Government are providing. A particularly interesting example came about through the small grants scheme, which allows the funding of small, innovative programmes. The Yes! Tanzania programme conducted a feasibility study on using its sports facilities to educate young people about the transmission of HIV and AIDS, and used the study to put the lessons into practice. It will deliver both sport and sexual health training to more than 60 community sports coaches, teachers and peer leaders, and through that method will reach more than 2,000 young people in Arusha in Tanzania. Hopefully it will go on to measure the impact of the work.

Using small grant funding can be a useful and innovative way to try out new techniques and to reach young women and men in particular, through forums where they might not traditionally have expected to receive such education. It would be useful to hear the Minister reflect on whether there any lessons he can learn from that kind of thing.

[Jim Shannon]

I would like to reiterate what the hon. Gentleman has said. The Elim Church in my constituency—to give just one example—does fantastic work in Swaziland with young boys and girls who have HIV/AIDS. Some of the good work that the hon. Gentleman has been discussing, and that he asks DFID to do, is also being done by church groups throughout the United Kingdom. I mentioned the Elim Church, but the Presbyterian Church, the Church of Ireland, the Methodists, the Baptists and the Roman Catholic Church all do it as well. It is good to recognise some of the good work that other groups do.

[Patrick Grady]

I am sure we can all give examples from our constituencies or broader areas of interest of specific projects or programmes that have made a difference. An issue relating to some of the broader questions that have been asked about DFID is to do with its different priorities: the way in which it is leveraging the 0.7%, which we all welcome, and how that can be done as effectively and as holistically as possible. Having some flexibility to try to innovate in new areas and support small, dynamic projects is definitely one area for consideration.

There is the important question of education specifically about HIV/AIDS, which we have heard about, but there is a broader question of education as well. Although it is true that, as I have said a number of times—my hon. Friend the Member for Lanark and Hamilton East said it too—there is no silver bullet to global development, educating women and girls is about as close as we can get. Broader access to education—not just education on HIV/AIDS but, more broadly, education that trains and empowers women with the skills they need to take into society—can reverse the negative spiral that I spoke about at the beginning of my remarks. That economic empowerment is crucial.

[Angela Crawley]

I want to highlight again the need to educate men and boys on their role as community leaders, partners, fathers and brothers, because they also have a role to play in education.

[Patrick Grady]

Indeed. Speaking from my 36 years’ experience as a man, I entirely agree about the need to tackle all these issues. Education, in a range of different forums and of both men and women, is important.

Access to treatment is also crucial. It has been interesting to read in some of the documents supplied in preparation for the debate about the progress made in terms of prophylactic and preventive treatment such as the dipivirine ring trials and various other medical advances, which are incredibly encouraging. It is important that they are invested in and supported. That is why the points made, especially by the hon. Member for Finchley and Golders Green, about intellectual property in the development of pharmaceuticals is key. That has come up in numerous Westminster Hall debates on international development, in particular on tackling preventable disease. It would be interesting to hear from the Minister how the Government intend to take forward those proposals—I was interested to hear that movement in that direction appeared in the Conservative manifesto.

Just as with education, where specific education and improvements in education across society as a whole is needed, the same is true in treatment. We need to be able to treat the specific symptoms, effects and infections and boost the overall level of wellbeing of society as a whole. That is where questions of food security and so on come in.

[Dr Lisa Cameron]

In addition to a medical model, does my hon. Friend agree that it is extremely important that couples counselling is also offered to help in coming to terms with HIV diagnosis, reducing stigma and the risk of violence and desertion by a partner, and ensuring that adaptive coping strategies are applied?

[Patrick Grady]

That is a useful point. My hon. Friend brings considerable experience of those issues to the debate, so it is useful to have her contribution.

That brings us to funding and prioritisation. I generally echo all the questions directed at the Minister so far. On the prioritisation that DFID is prepared to give to the sustainable development goals, every credit is due to the Government for the role they played in the negotiation and establishment of those goals, which are a hugely comprehensive framework for global development. We now have a road map that can take us to the kind of world that we know is possible, which will allow us to reach other targets such as the 90-90-90 target, which has been referred to. However, I do not think I am alone, even in the Chamber, in being slightly disappointed by the lack of emphasis given to the sustainable development goals in the Command Paper, for example, or the lack so far of a joined-up Government approach or even of information about that. Indeed, my hon. Friend the Member for Lanark and Hamilton East raised questions about monitoring.

Other mechanisms also need to be considered. The Global Fund is due for replenishment, so it would be interesting to hear a timetable from the Minister for the Government’s commitment. They have said repeatedly that they are prepared to give up to £1 billion, so my question has repeatedly been: if they are prepared to give up to £1 billion, why not just give £1 billion? The Global Fund knows how much money it needs and the UK has an opportunity to show global leadership by committing as much as it can to that replenishment.

Finally, the point about middle-income countries is crucial. I spoke about Zambia earlier on, and the definition of a middle-income country stretches from a GDP per head of something like—I do not have the figure in front of me—$1,500 to $13,000. In that vast range, a country can suddenly become a middle-income country and find itself less able to access the resources and support that helped it to attain that status. It would be interesting to know how the Government intend to support countries as they transition to middle-income status to reduce the risk of back-sliding in so many areas, not least HIV/AIDS transmission.

HIV is a preventable and treatable disease and we have the knowledge and ability to reduce transmission and improve access to treatment, especially with regard to women and girls. If we do that, we boost development, help to build stable societies and grow economies. Everyone benefits, but we must have the political leadership and willingness to invest effectively.