HL Deb 17 July 2002 vol 637 cc1228-30

2.53 p.m.

The Earl of Sandwich

asked Her Majesty's Government:

What contribution they have been able to make to a reduction in HIV prevalence rates in sub-Saharan Africa, and in which countries.

Baroness Crawley

My Lords, sub-Saharan Africa is the worst affected region in the world, with an average HIV prevalence rate of 9 per cent, corn pared to a global prevalence rate of 1.2 per cent. The figures are rising. However, successes in reducing prevalence rates in Uganda and Zambia provide us with much to learn and much to hope for. The Department for International Development continues to work throughout Africa, including Uganda and Zambia, to combat HIV/AIDS. We have committed over £180 million to direct programme funding in 2000–01 and considerable additional funding to support non-governmental organisations and international institutions such as UNAIDS and the World Health Organisation in the fight against AIDS in Africa.

There is no magic bullet. Prevalence rates generally are still climbing, and the sheer scale of the epidemic means that HIV/AIDS is and will continue to be one of the biggest threats to development in Africa.

The Earl of Sandwich

My Lords, I thank the Minister for that reply. She implied, I think, that it was only through long-term education and raising awareness that countries will defeat this terrible scourge. It is only because of Barcelona and other conferences that we have suddenly become aware of that.

There is a tremendous need for political will, above all in sub-Saharan Africa. Does the Minister agree that it is only in countries such as Uganda, where there is a degree of political control and national unity, that the campaign can succeed? Why, if the Government have such political commitment, is their contribution—drawn from existing aid budgets, not new ones—still so small?

Baroness Crawley

My Lords, I agree with the noble Earl that political will is important. However, it is not sufficient in itself. In countries such as Uganda and Senegal, we have seen political leadership of the highest order in the fight against HIV/AIDS. In those countries, we have also seen a demonstration of the importance and effectiveness of supporting strategies to promote awareness and behavioural change through information, education and community mobilisation. Those countries have also supported the prevention of infection through condom promotion and the treatment of sexually transmitted infections. There has also been support and encouragement for voluntary counselling and testing.

It is significant that, in those countries, there has been a real effort to reduce the stigma associated with HIV/AIDS and the denial that goes with it, both of which lead to a greater problem.

Baroness Rawlings

My Lords, the Minister will be aware of the importance of sexual and reproductive health in the fight against HIV/AIDS. Can she reaffirm the Government's commitment to providing sexual and reproductive health services in sub-Saharan Africa? Which non-governmental agencies do the Government use to promote better standards of sexual and reproductive health in Africa?

Baroness Crawley

My Lords, I confirm that the Government support sexual and reproductive health programmes in southern Africa. We contribute to programmes organised by the WHO, UNAIDS and the UN Family Planning Association, among others.

Baroness Massey of Darwen

My Lords, can the Minister say whether it is true that, of the 28.5 million people in Africa affected by HIV/AIDS, 58 per cent are women? What implications does that fact have for programmes of intervention?

Baroness Crawley

My Lords, my noble friend is right. Throughout Africa, women are more vulnerable to HIV than men and are affected at an earlier age. The prevalence among teenage girls in some countries of sub-Saharan Africa is five times greater than among boys. Girls are more vulnerable because they become sexually active at a younger age and are often unable to negotiate safe sex or to stop coercive sex. In some communities, girls must sell sex to make a living.

Lord Avebury

My Lords, how great is the United Kingdom's contribution to the global fund for AIDS, malaria and tuberculosis? To what extent have we encouraged the European Union to make an equivalent contribution, proportionate to its ability to pay?

Will the experience of the Brazilians—particularly with the manufacture of generic drugs under the Agreement on Trade-Related Aspects of Intellectual Property Rights (TRIPS), which allows patents to be broken in cases of national emergency—be read across to southern Africa? Does the Minister think that the global fund will be instrumental in helping that to happen?

Baroness Crawley

My Lords, the UK's contribution to the global fund is £140 million over five years. It is being made from previously unallocated funds. The UK's bilateral spending on HIV/AIDS-related work in 2001–02 is over £200 million. I am sure that, following the Comprehensive Spending Review, the House will welcome the increase in resources to assist programmes tackling AIDS in Africa.

I will write to the noble Lord about the situation in Brazil.