HIV/AIDS (Hansard, 25 April 2001)

§ 2. Mr. Neil Gerrard (Walthamstow)
What outcomes she will aim to achieve from the special General Assembly of the United Nations on HIV/AIDS. [157643]

§ The Secretary of State for International Development (Clare Short)
Our aim at the United Nations General Assembly special session on HIV/AIDS is for a short, tightly focused and action-oriented political declaration that implements across the world effective programmes for prevention and care, building on the successful reduction of infection levels in countries such as Uganda and Thailand. As my hon. Friend knows, we have invited a representative of the British voluntary sector to join the UK delegation at UNGASS, and I would like to now invite my hon. Friend, as chairman of the all-party AIDS group, to join the delegation on behalf of parliamentarians.

§ Mr. Gerrard
I thank my right hon. Friend for that reply. Will she join me in welcoming the withdrawal by pharmaceutical companies of their court action in South Africa? Does she agree that it creates an opportunity for the UN to reaffirm the right of developing countries compulsorily to license patents where there is a national emergency so that they can have improved access to drugs, particularly to deal with opportunistic infections? However, that should be done in the context of dealing with the social and economic consequences of HIV, and not just providing medical care.

§ Clare Short
I certainly welcome the withdrawal of that court action, which was always ill advised, but it does not mean that we suddenly have an answer to the problem. Even at cost price, anti-retroviral drugs are more expensive than most African countries can afford. They might cost only $1 a day, but most countries in sub-Saharan Africa spend less than $5 a head per year on health care and most poor, infected people are not in touch with any health care system, as my hon. Friend knows. We need international co-operation between the pharmaceutical companies, the Governments of developing countries and the international community to put in place basic health care systems and deliver treatment for opportunistic infections, such as TB, which is killing more people than many other illnesses. I hope now that the court case is out of the way, we can make progress, but I hope also that no one will pretend that anti-retrovirals are the answer, because they are not.

§ Dr. Jenny Tonge (Richmond Park)
I welcome what the Secretary of State has just said. There is indeed a great danger that drugs could be seen as the answer to the AIDS pandemic, but they could make it worse if they are not 290 used properly. Does the right hon. Lady agree that while education and condom use are the only real answer in the short term, a vaccine against AIDS is the only long-term solution? The international AIDS vaccine initiative needs $1 billion to further its trials and continue research, so when she goes to the United Nations in June, will she persuade other Governments and our own to increase their contributions to ensure that the vaccine becomes a reality?

§ Clare Short
I agree with the hon. Lady. One thing that everyone should know is that infection rates are dropping in many countries. Uganda has led the way with public education and prevention work. Infection rates among young people in Uganda have gone down, and the same is happening in Kenya and Zambia. Things can be done if countries get organised, inform their people, supply condoms and so on. We have been supporting a lot of that work, and there is hope. We should implement all the lessons of success.
I agree that there can be a vaccine, and that is the view of the scientists. The hon. Lady knows that the UK Government were the first to contribute to the international AIDS vaccine initiative. I understand that there have been many other contributions since, and a shortage of funds is not currently the problem, but I shall check that and do all that I can to ensure that there are sufficient funds to find a vaccine as quickly as possible.

§ Mr. John McFall (Dumbarton)
My right hon. Friend will be aware that this week 50 African heads of state and ex-President Bill Clinton are meeting in Nigeria to set the scene for the UN conference in June. She will be aware also of the remarks of the Minister of Health in Nigeria, who said that no one will escape the devastation in Africa, not least the 50 million who will die in the next decade as a result of HIV and AIDS. The United Nations Commission on Human Rights voted yesterday to support a Brazilian resolution for universal help for everyone with HIV and AIDS, so will my right hon. Friend ensure that the British Government give practical expression to that resolution?

§ Clare Short
I am not familiar with the Brazilian resolution. However, I repeat that most poor and infected people in Africa are not in touch with any health care system; if drugs were free, they would not get them. Since 1997, we have committed £1 billion to help support the building of primary health care systems across the world. That is what we need, along with prevention, care for those who are infected and treatment of opportunistic infections. We must then take up pharmaceutical companies' offer of cheap, anti-retroviral drugs, when that can be done responsibly. We are working on that strongly in the international community. I am glad that there is now a much bigger commitment from African heads of state than previously, so I hope that we can make faster progress.

§ Mr. Speaker
Order. There is far too much private conversation in the Chamber.

§ Mr. Bowen Wells (Hertford and Stortford)
Has the Secretary of State had the opportunity to read the report of the Select Committee on International Development on HIV/AIDS? Hon. Members may not be aware that 2.8 million people died of HIV/AIDS last year, three 291 times the number of people who died as a result of murder, violence and war; we are therefore dealing with an important question.
Will the Secretary of State confirm that she will be increasing the Department's expenditure on HIV/AIDS which, at the moment, amounts to only £1 million per annum? Will she reverse the decline in expenditure on HIV/AIDS in southern Africa? Has she concluded the programme that she was seeking to devise on a new compact or strategy within the Department to tackle the HIV/AIDS problem in Africa and throughout the world?

§ Clare Short
I have read a summary of the report, and I am afraid that the figures that the hon. Gentleman has just quoted are, unusually, wrong. My Department spent £100 million last year, not £1 million. We shall respond in the normal way; there is obviously some confusion. However, I am happy to confirm that those figures are wrong. We are a leading player in the international system, spend considerably and the budget has been growing. I am sorry that there has been a misunderstanding.
On the written strategy, we already have strategies on improving the health of the poorest people, as the hon. Gentleman knows, including our work on HIV/AIDS. A departmental strategy just on HIV/AIDS is about to be published; to be honest, I threw back the previous one, because it was written in impenetrable jargon which, as the hon. Gentleman knows, is a problem in this area of work, if not all others.
May I end with a genuine expression of respect for the hon. Gentleman's fantastic contribution to this area of work and his fine chairmanship of the Select Committee? We shall miss him greatly; I admire and respect enormously the work that he has done.

§ Barbara Follett (Stevenage)
What assessment has my right hon. Friend made of calls from some of the large pharmaceutical companies for a Marshall plan to combat HIV/AIDS?

§ Clare Short
I have had considerable talks with the pharmaceutical companies and their embarrassment about the court case may have been helpful. Those who call for an end to all intellectual property rules are not being helpful, as we need a global agreement to provide drugs and basic health care systems in the poorest countries. We can then provide drugs cheaply at cost or even less, but that has to be in return for a deal involving higher prices in developed countries so that pharmaceutical companies can get some return on their investment, particularly their massive research budgets. Otherwise, we will not get new cures for things like malaria and other diseases of poverty.
I am therefore hopeful that we can get a global agreement—if that is what my hon. Friend means by a Marshall plan—involving Governments, international financial institutions, purchasing funds, agreements on intellectual property and agreements that drugs that are provided. cheaply to the poorest countries will not be exported to the richest, otherwise we will dry up the funding of research. I am hopeful that we will get there.

§ Mr. Gary Streeter (South-West Devon)
May I strongly agree with the Secretary of State in her tribute to my hon. Friend the Member for Hertford and Stortford (Mr. Wells), who has chaired the Select Committee 292 magnificently for the past four years? On that point, will she reconsider her response to the report, of which she has read the summary, but not the main body? Whether the figures are, or are not, correct, does she not accept that the carefully considered report shows that there has been a dramatic decline in the United Kingdom's bilateral aid spend on HIV/AIDS in Africa over the past three years? Given the importance of the HIV/AIDS epidemic to people in many African countries, will she reconsider and make sure that that decline in spending is reversed in the next few years?

§ Clare Short
No. My respect for the hon. Member for Hertford and Stortford is second to none. There will be the proper and normal response to the Select Committee's report. The Committee has produced many high-quality reports. However, the figures are false, as are the claims that are based on them. We shall provide full details so that the hon. Gentleman and others who read them will be persuaded that the figures are wrong.

§ Mr. Streeter
I shall make one further point before the Secretary of State goes to the United Nations to discuss HIV/AIDS in Africa. Does the right hon. Lady agree that partly the success in Uganda is because donor Governments have worked closely with the Government of Uganda in agreeing a strategy for that country? There has been more success in Uganda because of the acceptance of that strategy by the Ugandan Government, who are working with bilateral donors? Does the right hon. Lady accept that, as is so often the case, our bilateral spend is much more effective than much of the money that is spent through multilateral agencies? Will she not take the route of giving more to the UN and spending less bilaterally, and ensure that we are at the forefront of the attack on HIV/AIDS in Africa? We are looking forward to seeing the strategy document, which I hope will put the UK at the forefront in tackling a dreadful disease that is killing so many people in Africa.

§ Clare Short
If the hon. Gentleman discusses these matters with those who are working on them in the international community, I am happy to say that I think he will find that the UK is seen to be at the forefront. I agree that when Governments give the lead, from president through to every village in public education, there is behaviour change, of the sort that we have seen among young people in Uganda. When Governments give the lead—more are doing so in Africa now—we can be more effective.
I do not agree that we should be divisive and say that bilateral is always best. We should work bilaterally where we have our historical obligations, and we should learn our lessons. We should be working also to make contributions to the multilateral system so as to make it more efficient. We should aim for an efficient and competent international development system that is working throughout the world. If we confine ourselves to the UK effort, there will be many countries where we do not make a contribution. Working as we have been, our influence spreads, as does the improvement in effectiveness throughout the world. That is the right approach.

§ Mr. Tony Worthington (Clydebank and Milngavie)
When my right hon. Friend goes to the UN General Assembly, will she say that when the target of 293 0.7 per cent. of gross national product was set for aid, that was pre-AIDS? We now need much more than a contribution of 0.7 per cent to tackle the problems in southern Africa. If we are to put in the basic services, every country that is in a position to do so will have massively to increase its aid.

§ Clare Short
As my hon. Friend will know, the world is going in the opposite direction. We have recently had the new preliminary figures from the Development Assistance committee in Paris, which monitors the world's performance. I am pleased to say that the UK is contributing 0.31 per cent. and is the world's fourth largest donor. That is a record for our country. However, overall international contributions are declining. I agree with my hon. Friend that that is terrible, especially in the face of the scourge of HIV/AIDS. We must do more to mobilise international public opinion. Public opinion is changing in the UK, and so we must make our contribution to the international effort. I agree with my hon. Friend.