§ Question again proposed, That this House do now adjourn.4.39 pm
§ Mr. Hugo Swire (East Devon) (Con)
It is with a degree of hesitancy that I rise to take part in this afternoon's debate, not least because those who have spoken thus far have shown far greater knowledge of the subject than I have. They represent the International Development Committee, the all-party Africa group and the all-party AIDS group, all of which have done sterling work on this problem.
I wanted to take part in our debate, because I believe that it shows the House of Commons and Members of Parliament at their best, in stark contrast to yesterday's proceedings, which showed the House of Commons at its worst. This debate is relevant to the fears and aspirations that my constituents and other people have for our own country and the future of the world. I have been interested in the subject for some time, but I fear that I have nothing original to add this afternoon and will be guilty of repeating points that have been made far better by others. If nothing else, however, that repetition will bring home the horror of the situation.
Until I decided to speak in our debate, I confess to being woefully ignorant of the devastating nature of the AIDS epidemic. In the mid-1980s, a glamorous lady called Marguerite Littman, who was married to a leading QC called Mark Littman, was, perhaps because she was American, ahead of the game. When AIDS first entered our consciousness, especially in London, she became involved at an early stage with the London Lighthouse, and persuaded the Princess of Wales to take an interest in the Terrence Higgins Trust. As a result, AIDS began to lose its stigma, at a time when the condition was not properly understood. Marguerite Littman's mantle passed to celebrities such as Sir Elton John, and I pause to pay tribute to Bob Geldof, Bono and others, who have campaigned hard on the issue and strengthened the Government's resolve to do something about it.
The Secretary of State talked about the need for long-term planning and support. In the two decades since the mid-1980s, 65 million people have become infected with HIV and 20 million have died. My hon. Friend the Member for Rutland and Melton (Mr. Duncan) said that about 50,000 people are infected in the United Kingdom. As a better-off country we can control the epidemic, but developing countries simply do not have the resources to do so. The hon. Member for Walthamstow (Mr. Gerrard) believes that as many as 70 million people could be affected over the next few years, once we know the figures for what might be termed the developing countries in the former eastern bloc. It is estimated that 3.2 million children under 15 live with the virus, and the United Nations forecast for world population growth has been revised down, because nearly 300 million people are expected to die of AIDS before 2050.
We have talked a lot about how to cure or prevent AIDS. I should be grateful if in his winding-up speech the Under-Secretary would tell us how we can solve the lottery for anti-retroviral drugs. There is a desperate need for a solution, as 6 million people could benefit 1521 from those drugs, but only about 300,000 receive them. How many of those individuals receive the treatment for as long as they need it, and how many have it withdrawn at a critical time? We have heard the problems to which that can lead, including mutation of the disease.
It makes any father of small children and any son, and indeed anyone, weep to think of the devastation that this epidemic is causing in Africa—a continent that has enough of its own problems, including the droughts and famines that we all know about and, unfortunately, the corruption of so many of its leaders. On top of all that, there is the AIDS epidemic, which is a far greater threat than all those other things put together.
The worrying thing about all the figures that we have been bandying around is how uncertain they are and how many people are still living with the time bomb of not realising that they have AIDS. We have an enormous way to go on education, to which I shall return in a moment.
We are clearly failing to educate the educators, as so many of them are dying. A figure that struck me as horrific was that 20 per cent. of the adult population in Malawi has HIV, with almost 800,000 orphans needing care. What about the infrastructure of that country? My hon. Friend the Member for Banbury (Tony Baldry) said that a quarter of its education budget is being spent on burying teachers. Can that really be so? The Secretary of State himself said that the teachers are dying more quickly than replacements can be trained. Again, we know that the situation has arisen, so what are we going to do? How can we help that country to have the education and teachers that it so desperately needs to prevent that situation from getting any worse?
The announcements made in the past few months, following the Government's call for action, are extremely welcome. The church and voluntary groups in East Devon are genuinely heartened by the steps that the Government are taking, but some fundamental outstanding problems still need to be addressed. We have heard again this afternoon about how the drug companies are trying to reduce the price of drugs and make them available at a cheaper price than in Europe. For most people, however, the drugs are still far too expensive.
Whenever we have tried to help Africa, we have seen a problem in terms of distribution. We have still not got our distribution right, as we see when we try to deliver food aid and so on, as there is insufficient infrastructure. I believe that we will have to concentrate on that issue far more in future.
I do not want to steal the thunder of my hon. Friend the Member for Canterbury (Mr. Brazier), who will make the winding-up speech for my party, but I wish to mention a few proposals that I believe go in the right direction, although I do not know whether they go far enough. I believe that we need a far more co-ordinated strategy in which we work closely with the host Governments, pharmaceutical companies and NGOs. I am confused about one thing in that regard—the approach in Uganda. There has seemed to be conflict this afternoon as to whether the multi-agency approach—I think that the Secretary of State said that 20 different organisations had gone into Uganda—was 1522 causing confusion. Surely, the fact that those different agencies are going into a country allows them to achieve things that one organisation might be frustrated in trying to achieve. I think that the approach was a positive move.
The Secretary of State will remember that, some months ago, I came to him on world water day and presented him with a large tap. I have the photograph; indeed, I sent him one to commemorate the occasion. That is another issue that is part and parcel of how we deal with controlling the epidemic. Basic sanitation and hygiene play an important role in combating this dreadful epidemic.
The question of anti-retroviral drugs needs to be thought through more closely. For instance, should we give more to pregnant women? The hon. Member for City of York (Hugh Bayley) talked in terms of it being a lottery and having to make judgments as to the best application of those drugs. We must consider that, although it is a difficult choice.
My final point is on the question of stigma. I started my brief contribution by recollecting the stigma of AIDS when it first came on to the public stage in London 20 or so years ago. People in this country who are HIV-positive, or who have AIDS, no longer suffer that stigma, which is all to the good. In Africa in particular, however, the culture is different. We all know about Chief Buthelezi being so much more open—because so many of his family have died—than President Mbeki, who has been living in a world of his own on the question of AIDS. If we consider the figures for South Africa, it is unbelievable that someone in such a position of responsibility can behave in that way. I urge the Secretary of State to use all his powers to try to put this question on the table again and again when he meets the leaders of those countries.
The UK's presidency of the G8 and EU next year gives us the opportunity to show how much we care about this epidemic. Equally, we should not ignore the problem in this country, small as we may think it to be. On that point, I part company with the hon. Member for Walthamstow, who is returning to his place, on the question of screening people coming into this country. I do not believe that to be divisive; it is common sense, and we would be foolhardy not to take it seriously. In addition, when we talk about AIDS, perhaps we can use our presidency of the G8 and EU to discuss in detail the whole question of the sex trade, and the number of people coming into the united Kingdom from eastern countries, which will cause huge problems and could have far-reaching consequences in relation to the AIDS epidemic in this country.
This afternoon's debate has been on HIV/AIDS in the developing world. We have concentrated mainly on the African continent. Equally worrying, however, are the statistics that we will start to discover in relation to the eastern bloc, to which Members referred earlier.
At the outset, I said that I had nothing particularly useful or new to add to the debate. But I am passionately convinced that the British Government have a duty to lead from the front on this. Clearly, apart from the United States, other countries are not doing as much. We have a moral responsibility, and having heard the debate this afternoon—a non-partisan debate—I believe that we have the courage and determination to 1523 put this issue back on the agenda and raise public awareness of what, for many people, as I said at the beginning, is the defining challenge of our era.
§ Mr. Julian Brazier (Canterbury) (Con)
After a number of excellent debates on this subject in Westminster Hall, it is absolutely right that it has been brought to the Chamber. I am delighted to welcome it. It is a sobering thought that, night after night, we see the most harrowing pictures of what is going on in the Darfur region of Sudan, on which I had a meeting just this morning, yet the total death toll so far in that region, with all the horror involved, would amount to only a few months of the grim toll being exacted by AIDS around the world.
We have had an excellent debate, starting with a speech by the Secretary of State, who set out clearly the Government's programme, which to a large extent commands support in all parts of House.
My hon. Friend the Member for Rutland and Melton (Mr. Duncan) made an outstanding speech, striking a note that echoed around the House—a note described in flattering terms by the hon. Member for Carshalton and Wallington (Tom Brake), who also made a thoughtful speech. Of course, we all expected my hon. Friend not to be controversial.
This is indeed a grave subject. The hon. Member for Walthamstow (Mr. Gerrard) rightly pointed out that in five or six years twice as many people in the world might be infected. I did not agree with him about screening—I think that we should consider it seriously to protect our own population—but that does not for a moment absolve us from our duty to help other countries, and I am proud that we are the second biggest donor.
Listening to the hon. Member for Northampton, North (Ms Keeble), I thought of Stalin's cynical observation that one person dead was a tragedy and a million deaths were a statistic. In the individual cases she described, she clearly demonstrated just how much misery, throughout country after country, this ghastly pandemic is bringing.
My hon. Friend the Member for Banbury (Tony Baldry), Chairman of the Select Committee on International Development, made a number of important points. Perhaps the most important involved the Prime Minister, who has said that he will move this issue up the agenda at the G8 meeting. It would be interesting to know what he will press the G8 to announce as benchmarks for dealing with this ghastly problem.
I join a long list of people in praising the hon. Member for City of York (Hugh Bayley) and his all-party group for their work. Because he has raised the point before, the Minister should tell us what pressure we can put on the European Union to tackle the huge sums that are tied up in dormant projects. Let us invest them in AIDS projects, and other good causes. We should not leave them sitting there doing nothing.
My hon. Friend the Member for East Devon (Mr. Swire) described himself as hesitant, but I heard no hesitation. He gave us plenty of food for thought. He referred to trafficking in prostitutes, particularly minors. We had a good debate on that in Westminster Hall yesterday. It requires more action, not just from our Government but from the west as a whole.
1524 AIDS is a silent enemy, still often hiding behind the wall of stigma and discrimination—even, to some extent, in this country. Although drug treatments and public education have curbed its spread in most parts of the developed world, that is certainly not the case in nearly all third world countries. In Africa alone, 25 million people are living with HIV. There are 12 million AIDS orphans, who have been referred to again and again. The disease is spreading fast in other parts of the third world, particularly in Asia and especially in the Indian sub-continent.
This is a disease that hits hardest where there is widespread poverty and inadequate health care, where many people go hungry and malnourished, where men leave their rural homes and travel to cities to find work, and where girls and women are ignored when they refuse to have unprotected sex. To be blunt, one of the saddest aspects of AIDS is that it spreads fastest in countries where rape is common, as it is in a number of African countries.
As a number of speakers pointed out, AIDS is not just a health issue. It affects individuals. It is a disease that shatters families, communities and whole countries. Beyond the huge personal cost of losing a loved one, there is the economic loss to the country—and, of course, the even greater economic loss to the family. In some countries, AIDS is wiping out whole sections of the work force—teachers, farmers, health workers, civil servants and young professionals.
We have heard a lot today about the deaths of teachers. To give a different statistic, according to the United Nations, in Swaziland, school enrolment has dropped by more than a third because young girls and, to some extent, young men too have been taken out of classrooms to act as carers.
I make no apologies for returning to the subject of Uganda, the most successful example of all: it has achieved an 80 per cent. reduction in the rate of new infection. I was puzzled by the remarks of the hon. Member for Walthamstow on that matter. The fighting has not entirely stopped in Uganda. There is still a major civil war going on in the north. However, even if it had stopped, I do not understand his logic. The fact that fighting has stopped obviously makes it easier to tackle the problem. However, in most cases, other countries that did not have civil wars have not tackled the problem anything like as effectively.
§ Mr. Gerrard
I was not suggesting that Uganda had not been successful, because clearly the Ugandans have made a significant difference. The point that I was making is that there is surprisingly little hard, research-based evidence about why certain interventions work and others do not. Sometimes, we make assumptions about what has worked, rather than knowing why something worked. There is no doubt that, in many countries in Africa, civil war has been a factor in the spread of HIV. I know that there is still violence in Uganda, but it is not at the level that it was. I am sure that that has been a factor.
§ Mr. Brazier
The hon. Gentleman is right that where there is greater stability it is much easier to tackle the problem. The fact that the bulk of the country is now peaceful has made it possible to tackle it. I agree on a 1525 further point. It is difficult to build a picture of what works and what does not. I strongly suspect that what works best in one country and one culture is not necessarily what will work best elsewhere, but two points about the Ugandan position are important. The first, which has already been mentioned by several hon. Members, is the ABC programme, which is based on a balanced mixture: abstinence, being faithful to the partner and condoms. Interestingly, someone mentioned Botswana, where there is a small Government programme. There is quite a large private sector programme there organised by De Beers. The Ugandan ABC approach has been taken straight off the shelf and is being adopted.
Secondly, I want to come back to the intervention that I made on the Secretary of State. I understand what he means by the three "ones". He could pass that on to some of his colleagues in other Departments—charities are faced with lots of competing Government Departments giving them small sums of money with different strings attached. However, the point must not be carried through to the extent that one says, "It has all got to be organised by the Government."
§ Mr. Brazier
I am delighted to see the Secretary of State shake his head. That clearly was not what he meant. One thing that clearly did work in Uganda was that an awful lot of different agencies all pulled together in the same direction. There was strong political leadership, but the Churches, NGOs, local government and the private sector—employers—were heavily involved.
So many things need to be done. We have covered a large number of them in the debate, but I will dwell on just a couple more; I do not want to detain the House much longer. There has been much reference to the importance of building the infrastructure necessary to administer medical care, focusing particularly on drugs. I particularly like the idea of the hon. Member for City of York of using distance learning through the Open university to rebuild nursing, teaching and training—all the different areas that are needed to rebuild infrastructure. The situation is so bad in some countries that we need a large-scale programme to turn it around. That is one method of getting what in the defence field is often called the multiplier effect.
§ Mr. Brazier
I thoroughly agree. The Government argue that some third-world countries are producing a surplus in certain categories, but it is absolutely monstrous that we are a net importer in categories such as nursing in particular—but also in medicine and teaching, among others—from countries that have 1526 critical shortages of such skilled professionals. However we choose to organise our public services, it should not be done at the expense of those countries.
§ Hugh Bayley:
I thoroughly agree with the point made by the hon. Member for Carshalton and Wallington (Tom Brake), and with the hon. Member for Canterbury (Mr. Brazier) when he said that we must stop taking African countries' precious resource of skilled personnel. One possible answer is to train people to do an African health worker's job—to work as a barefoot doctor—or an African teacher's job, so that their skills are tailored to Africa's needs. Incidentally, as a result those skills would be less transferable.
§ Mr. Brazier
The hon. Gentleman makes a very powerful point, and such an approach would improve the situation from both angles. Training could probably be completed faster if it were tailored to the local situation, and the non-transferability would be of considerable benefit. Some international bodies would doubtless object to that idea, but it seems to me a splendid one.
Drugs are at the heart of this issue. The long-term search for a vaccine is vital—literally so; it means the difference between life and death for millions of people—but in the meantime we must focus on antiretroviral drugs. It is a shame that more credit has not been given where it is due: to the pharmaceutical companies, which have shown considerable responsibility through their willingness to sell drugs in Africa at a tiny fraction of their market price. For example—perhaps I should not pick an example out, but this one comes to mind—six of GlaxoSmithKline's HIV/AIDS medicines are available in the poorest countries at prices that are discounted by up to 90 per cent. compared with developed world prices. We need to bring all the parties involved together to make this work, not just all Governments.
There is another small but important point. In order to establish whom to treat, we have to think about how to extend testing, which is a question not only of removing stigma, but of making the necessary resources available. Sadly, in some countries the ongoing disproportion between the resources available and the numbers of people involved make such discussions fairly academic. None the less, in countries where the situation is in the balance, and in those that are moving towards the 1 per cent. and 2 per cent. level, testing is absolutely critical in order to prevent that figure from increasing.
It is far too easy for us in the developed world to think of HIV/AIDS as somebody else's problem. On one point I do agree with the hon. Member for Walthamstow: although I am in favour of screening, it will never work completely. Doing something to tackle the problem is right not only in itself—all who are present today believe it right to do something—it is also vital to our own self-interest. It is easy to think of this as somebody else's problem, affecting nameless, faceless people who live a long way away. It is up to us not to pass the buck to another generation. We have to assist and educate; we have to nurture the sufferers and their orphans; we have to warn those who are not yet infected, but whose ignorance about the illness is one cause of its 1527 continuation. What our generation does about this problem will determine the course of history for a large part of the third world.
§ 5.9 pm
The Parliamentary Under-Secretary of State for International Development (Mr. Gareth Thomas)
It is a genuine pleasure to respond to what has been an excellent debate. I pay tribute to my hon. Friend the Member for Northampton, North (Ms Keeble), who has been a consistent advocate of more funding and more support for orphans and vulnerable children. I also pay tribute to my hon. Friends the Members for City of York (Hugh Bayley) and for Walthamstow (Mr. Gerrard), whose chairmanship of two all-party groups added considerably to the debate that preceded the preparation and presentation to the House of our strategy, entitled "Taking Action".
I am not sure that I would ever describe appearing before the Select Committee chaired by hon. Member for Banbury (Tony Baldry) as a pleasure, but I welcome the International Development Committee's emphasis on AIDS orphans, which helped us in our preparation and our work. I also pay tribute to the hon. Member for East Devon (Mr. Swire) for his helpful remarks in the debate. As ever, it is a pleasure to be presented with a long list of questions about what the Government are doing by the hon. Member for Carshalton and Wallington (Tom Brake), and it is also a genuine pleasure to be able to respond to the hon. Member for Canterbury (Mr. Brazier). I take this opportunity to congratulate the hon. Member for Rutland and Melton (Mr. Duncan) on his new position and to wish him a distinguished, but lengthy, spell as the shadow spokesman.
As all hon. Members have said, it is the scale of the AIDS epidemic that truly shocks. Some 25 million people are infected in sub-Saharan Africa alone, with 3 million of them becoming infected only last year. About 2.2 million people have died in Africa as a direct result of AIDS. If that were not blight enough, we can expect the 11 million orphaned in Africa to rise to 18 million by 2010, which is truly shocking.
It is right that the focus of our response to the epidemic is on sub-Saharan Africa, but the potential of AIDS to devastate communities in Asia, in the Caribbean, eastern Europe and central Asia must also drive our response to the epidemic. It is estimated that 7.4 million people have already been infected with HIV in Asia and that, outside South Africa, India already has the largest number of people living with HIV. We have a real window of opportunity now to prevent what has happened in sub-Saharan Africa from devastating India and other parts of Asia and the Caribbean. We must seize that opportunity.
I want to focus in my opening remarks on a comment made by Kofi Annan, who described the face of AIDS today as being increasingly that of a woman. It is worth mentioning that to the House. In sub-Saharan Africa, some 57 per cent. of infected adults are women, and some 75 per cent. of young people infected are women or girls. We know that women are more biologically vulnerable to HIV infection than men, but their susceptibility is reinforced by their lack of social, political and economic power in too many developing 1528 countries. That is why, as the hon. Member for Rutland and Melton mentioned, an abstinence-only response to HIV/AIDS is entirely inappropriate. Sadly, most HIV-positive women in Africa have been infected by their husband or sole monogamous partner. We need to recognise that in our response.
At the heart of the "Taking Action" document that we published in July are five aspects of what we believe to be the necessary response. First, political leadership is important. I hope that the House will agree that the fact that the Prime Minister launched the document with the Secretary of State is a sign of the UK Government's commitment to driving the issue up the international agenda. I shall provide more detail later of what we intend to do on HIV/AIDS during our G8 and EU presidencies. AIDS is consistently part of the agenda of both the Secretary of State and myself in our discussions with the Governments of developing countries.
In order to help promote our political leadership, I agree absolutely that civil society has a key role to play, as do faith communities. The hon. Member for East Devon rightly pointed out that some people far more famous than us, such as Bono and Bob Geldof, have played a crucial role in raising the issue high on the international agenda.
International action is the second pillar of our response. We must strengthen the multilateral system, which is one of the reasons why we have increased our funding to UNAIDS and to the World Health Organisation.
Funding is, of course, the most important factor that we must address in the coming months, and the commitment by the Chancellor of the Exchequer and the Prime Minister in the comprehensive spending review signalled to the international community the need to do more given the funding that the UK has committed. The EU has a role in providing more funding, and we will address the issue raised by my hon. Friend the Member for City of York on the European development fund with the Commission. It is worth putting it on record that the Commission and European member states have provided more than 50 per cent. of the global fund.
Fourthly, we need better AIDS programmes. Hon. Members and organisations outside the House rightly said that we needed to do more on orphans and vulnerable children. I hope that they recognise that we have listened to those concerns, and that orphans and vulnerable children have been raised up our agenda in terms of both funding and assistance that DFID country offices offer to developing country Governments.
Crucially, our decision, which the Secretary of State announced last September, to support the funding of treatment is a significant addition to better AIDS programmes and a more comprehensive response. The final element is better long-term solutions, including better funding for microbicide and vaccine research and—many hon. Members alluded to this point—consistent and continuing funding to develop health systems in country.
The hon. Member for Rutland and Melton asked a number of specific questions, and I shall try to address them. He asked about the support that we are giving to 1529 the National Aids Control Organisation in India. NACO has a new head, with whom I am scheduled to hold discussions when I visit India in three weeks' time, and NACO's attitude and response has changed. Sonia Gandhi deserves considerable praise for her speech at the world AIDS conference, which highlighted the fact that India must do more to respond to the threat of AIDS. Our official discussions with NACO and the ministerial discussions that we hope to hold will provide further opportunities to offer support in tackling the epidemic in India.
The hon. Gentleman asked about South Africa's attitude, which has changed dramatically, and that of President Mbeki in particular. South Africa has embarked on a comprehensive treatment programme on which 8,000 people are already being treated. The South African Government acknowledge that the implementation of their strategy has been slow because of weaknesses in some of their health care systems. Working with organisations in civil society, we have introduced a £10 million programme on AIDS in South Africa, and I hope that the experience of that programme will help the South African Government.
The hon. Gentleman and a number of other hon. Members asked about the National Audit Office report. The hon. Member for Banbury asked why DFID was particularly targeted, and it was a surprise to us, not least because we were about to start an internal evaluation of our response—perhaps the NAO got wind of it.
The hon. Member for Rutland and Melton asked whether we have a separate system for monitoring the impact of the money that we spend. The NAO report recognises that we monitor our response through our core business reporting systems in country. We recognise that we must respond to that specific recommendation, and we are looking to do so. It is also worth recognising that the NAO praised DFID's flexible and country-led response to the epidemic.
The hon. Gentleman asked about the US attitude. As the Secretary of State said, we must recognise the considerable contribution made by both President Bush and the US Congress and Senate in allocating some $15 billion to the fight against AIDS.
When President Bush visited the UK last November, he insisted on establishing with us a task force to look at how we can work more efficiently together in five African countries—Uganda, Kenya, Ethiopia, Zambia and Nigeria. That work is being taken forward. We have worked closely together to offer advice to the Kenyan Government, and all the relevant officers in the five countries that I listed are working with their American counterparts to provide the necessary advice and support.
I also wish to put on record my appreciation of the support and engagement extended to us by Randall Tobias, the American AIDS tsar. He has, quite rightly in my opinion, been the leader of the work to achieve cooperation.
The hon. Gentleman alluded to what he called the tension that arises when money is given to civil society organisations, as opposed to budget support. I think that there is a place for both options. The Government's 1530 funding of civil society organisations has increased by about 30 per cent. since 1997. By comparison, budget support represents about 15 per cent. of our bilateral funding programme. Where the conditions are right and there is good dialogue about AIDS and other matters, budget support is entirely the right option, but we must never forget the contribution made by civil society organisations, and especially those that are faith based. In many parts of Africa, they provide the tangible response and also the leadership that is needed in the communities that they represent.
Several hon. Members alluded to the huge benefits arising from the fall in drug prices. Clearly, we need to continue to work with the many pharmaceutical companies that have offered their support to the Governments of affected countries by, among other things, reducing the prices of anti-retroviral drugs. We need to continue to press for lower prices for those drugs, but we must also meet the challenge of getting anti-retroviral drugs out to the communities that need them. Continued support for strengthening health systems in those countries will be fundamental to that process.
Several hon. Members spoke about the need for better funding for vaccine research, and about the need for better co-ordination in the search for a vaccine. The House will know that the question of an AIDS vaccine was discussed at the American-led G8 summit at Sea Island. The British Government will lead the G8 summit next year, so it will be our responsibility to take that work forward. In due course, we will announce how we intend to progress the vaccine enterprise to which the G8 countries are committed.
I should point out that the British Government were the first donors to support the international AIDS vaccine initiative. In 2000, we offered some £14 million for that purpose and we are considering making further funding available to drive forward our response.
The hon. Member for Carshalton and Wallington asked a series of questions about the global fund. He was right to say that Britain will double the funding that it will make available over the next three years, and we have committed £250 million to the fund over the period until 2008. He asked whether the Government were entirely convinced about the global fund's effectiveness, and it is important that we recognise that the fund is still in its infancy.
Teething problems at country level are bound to arise. We have worked closely with the global fund to sort out problems highlighted by our officers, and we have had a very good response at all levels of the fund. Its director, Richard Feacham, has made a huge contribution to the fight against AIDS, and I want to place on record my appreciation of his work.
Improved and more effective co-ordinating mechanisms are in place. There is a problem-monitoring and evaluation strategy for the global fund's work, but we shall continue to work with the fund to make it even more effective in-country.
My hon. Friend the Member for Walthamstow asked whether we considered that we had got the right balance in our funding to the global fund. We must recognise that other international bodies have an important contribution to make in the fight against AIDS. That is why we continue to fund the WHO, and why we have 1531 offered additional funding to support that body's "3 by 5" initiative. It is also one of the reasons why we are continuing to support UNAIDS and have actually increased our funding. It is the lead international body when it comes to co-ordinating our response.
We are now offering the right level of funding to the global fund. We announced the increase at this point because the global fund is likely to have to go back to other donors next year to ask them for more money in advance to fund its further programmes. We are demonstrating our confidence in the global fund by committing double the level of support, and I hope that that will help to lever in further resources from other G8 donors and from the private sector for the global fund's important and crucial work.
The hon. Member for Carshalton and Wallington and my hon. Friend the Member for Walthamstow, and others, asked me about the G8 and EU presidencies and how AIDS will feature in them. In the call for action that we published in December, we said that we would make AIDS a centrepiece of both presidencies and that remains our intention. As I have said, we need to produce our response to the American-led initiative at Sea Island to promote a G8 vaccine enterprise, and we shall do so in due course.
During the Irish presidency of the EU recently, we worked closely with the Irish and Dutch Governments and the Commission to support events with a major focus on microbicides. We are committed to taking that work forward, not least because the prize of a workable microbicide is genuinely in sight. Those in the know suggest that we might be only four or five years away from that point. If we were to develop a microbicide that was only partially effective, some 2.5 million lives could be saved. The development of a microbicide is much more likely in the short term than a vaccine, unfortunately, and that is why we must not lose sight of the importance of funding for microbicide work.
My hon. Friend the Member for Northampton, North specifically asked about the issue of orphans and vulnerable children. In the evidence I gave to the Committee, I highlighted the fact that fewer than half the countries in Africa had completed a proper analysis of the AIDS epidemic in their country, only six had developed a national policy on how to respond to the OVC crisis, and only four had in place the protective legislation to make the policy a reality. One of our key tasks, which we pledged to undertake in the "Taking Action" document, is to work with UNICEF to put in place the proper responses in the 17 countries in Africa where we are working. I look forward to having the opportunity to demonstrate to my hon. Friend how that work is progressing.
Several hon. Members mentioned the impact of the private sector. The pharmaceutical sector has a crucial role to play and many British pharmaceutical companies are already doing considerable work. I welcome that. However, it is worth acknowledging how the pharmaceutical market is split at the moment. Some 1532 50 per cent. of the market is in the US, some 25 per cent. is in Europe and just 1 per cent. is in Africa. It is worth bearing in mind the scale of the work we have to do to even up access to medicines, not only for AIDS but for other diseases in developing countries. I look forward to helping to take that work forward.
My hon. Friend the Member for Walthamstow asked about the work of the cross-Whitehall group. We are working with the Department of Trade and Industry on a proper response from the British pharmaceutical industry. We are working with the Department of Health on our engagement with the World Health Organisation and on health worker recruitment, which other hon. Members also raised. We have a code of practice and we have worked to strengthen it. One of the problems so far has been that while it covered NHS organisations, it did not cover many of the private sector organisations that provide health workers for the NHS.
We are trying to address that by strengthening the code of practice. We have memorandums of understanding with a series of developing-country Governments where health worker leakage—for want of a better phrase—is not a problem. However, we must also recognise that there are many domestic reasons why health workers are leaving and try to address them in country. That involves continuing to focus on ways of strengthening the health systems in those countries.
The Foreign and Commonwealth Office has done an excellent job of ensuring that our embassies around the world emphasise the call for action and the strategy and highlight to their interlocutors in developing-country Governments what else they can do to promote action against AIDS.
HIV/AIDS is an enormous challenge and one of the greatest threats to eradicating poverty and achieving the millennium goals that hon. Members of all parties support. However, we believe that the challenge can be met. I hope that hon. Members acknowledge that the call for action and strategy that we published in July constitutes a significant step forward in Britain's response to the fight against AIDS. I look forward, as does the Secretary of State, to continuing to work with hon. Members in implementing that strategy.