§ Lord Freeman rose to ask Her Majesty's Government whether progress to date with the efficient use of resources in East Africa arising from debt relief and increased direct overseas aid is satisfactory.
§ The noble Lord said: My Lords, I thank the Minister for coming to the House to answer the Question. All of us are very conscious of two facts. The first is that the enormous humanitarian crisis unfolding in Iraq must be concentrating not only her mind, but the minds of those in her department. The second is that her energy and experience in East and West Africa is well known and much respected. I look forward to her contribution to the brief debate. I couple that tribute to the Minister and her department with praising the work of the civil servants in London and in East Africa, specifically Kampala. That work is often unsung, but I want to place on record my appreciation, and I hope that of other noble Lords, for their work.
§ I declare an interest as chairman of the Busoga Trust, a Christian charity operating in Uganda with the express purpose of digging and maintaining water wells in the districts of Kamuli, Luwero and Busoga in southern Uganda. Over 20 years, some 1,000 wells and water sources have been dug. I pay tribute to all those involved, both in Africa and in the United Kingdom. It may be a modest achievement in comparison with the overall problems in Uganda, but it is nevertheless in my judgment a marvellous contribution to the alleviation of poverty there. I also pay tribute to colleagues in WaterAid and CAFOD with whom I have recently been in touch.
§ This brief debate should be addressed to East Africa and aid efficiency. It is important to note that the policy of Her Majesty's Government on direct support to non-governmental organisations active anywhere in the world changed in 2000. In East Africa, that specifically meant that the Government's assistance went to the governments there, in terms of direct aid and support of the budget. That is therefore indirect allocation to specific projects on which the governments of Uganda and other countries in East Africa have decided. I am not criticising that change in policy, but I want to point out that some causes for concern have arisen as a result of it.
§ The purpose of the debate is to see how the United Kingdom is helping East African governments to help themselves. I hope that my contribution will be regarded as constructive and positive, and not in any way suggesting interference from these shores. It is certainly not supposed to be paternalistic. We must respect the drive to democracy in East Africa, and encourage it. For example, there have been very encouraging signs recently from Kenya.
§ In the time available to me, I want to focus on rural water supplies, because they are so important for the alleviation of poverty. Clean water sources help to reduce infant mortality and bring a dramatic improvement to the quality of life of those who live in 77 rural Africa. Uganda is not a proxy for the whole of East Africa, but in the interests of brevity I want to draw some conclusions from what is going on there.
§ We are all delighted that Her Majesty's Government have declared 2003 as the international year of fresh water. The importance of fresh water supplies for the alleviation of poverty and the improvement of health, particularly in rural areas, cannot be repeated often enough. In 2000, the World Health Organisation recognised that about 2.4 billion people around the world lacked access to basic sanitation. In Africa, roughly one-third of the population does not have access to clean water or sanitation facilities. I know from my own personal experience the sight of one dirty well and the filth, squalor and inhumane effects caused by drinking and even collecting that water as compared with a fresh water source.
§ The United Nations target is to reduce that lack of access to clean water by one half by 2015. The question is whether that is feasible. We hope that it is, but the United Nations report at Kyoto, in March, indicated doubts about whether the target can be met even by 2030. I ask the Minister to enlighten us as to whether Her Majesty's Government believe that we should stick to the target of halving that lack of access to clean water and better sanitation standards by 2015 and whether the target is still attainable.
§ I turn briefly to Uganda. The Government of Uganda have a very strong political commitment to the reduction of poverty. One notes with particular support the Ugandan Government's "Poverty Eradication Action Plan in 2000". However, Uganda is highly dependent on aid, with more than 50 per cent of national expenditure drawn from donations, both governmental and private, from around the world. I pay tribute to the Ugandan Water Minister who, last August, in my conversations with him, said that we must do better than the millennium target of trying to halve lack of access to clean water and sanitation by 2015. We must try to do better, and we must examine how we can do so.
§ The most recent statistics from Uganda show that access to clean water in rural areas stands at about 50 per cent and access to good sanitation at about 75 per cent. DfID's country aid stands at £83 million—the latest figure that I have—with the amount allocated to water at £3 million, for a water spend of about 3 per cent.
§
In its January 2003 global report which referred—although not exclusively—to Uganda, the National Audit Office looked at how money is being spent around the world. On page 12, it stated:
The water sector is … characterised by ineffective utilisation and non-sustainability of services. In the rural area"—
of Uganda—
over 30 per cent of rural systems are non-functional, the water handling and storage is often unhygienic, resulting in water from a safe source being contaminated by the time it is consumed. Poor care and maintenance of facilities have rendered many protected water sources, especially boreholes to be abandoned".
§ The Ugandan Government commissioned a report, published just a few months ago, in December 2002, looking at how effective the rural water programme 78 was in Uganda. It was only a couple of years ago that the local districts in Uganda started receiving funds directly from the government to spend on trying to improve water sources. A report to the government by independent experts based in Uganda found, first, poor collaboration and co-ordination of the district offices with the non-governmental organisations including overseas charities. Secondly, they found that the procurement process is weakened by political influence which has greatly affected the quality of water and the cost-effective implementation of water plans. Thirdly, they found some financial mismanagement which I am sorry to say has included some corruption and bribery in the awarding of contracts, which is not uncommon around the world. The experts came to the conclusion that, overall, the government were getting very poor value for money in the water programme.
§ In May 2002, Mr Lars Christian Moller produced another independent report on Uganda entitled. Is the Water Sector Delivering. He concluded that funding for water in the previous two years had increased by 300 per cent but that production—the supply of fresh water wells—had decreased by 35 per cent, hence increasing the poor value for money. I calculate that of the wells dug in Uganda which are contracted by the local districts with either private sector suppliers or non-governmental organisations and overseas charities, the government may be paying for about 60 per cent of the provision of the well and the Busoga Trust is paying the other 40 per cent. In other words—and I am not complaining about this—we are subsidising the production of those wells. The five-year plan which has been in operation in Uganda since September 2002 estimates that it will be possible to increase the coverage of clean water supply in rural areas from about 50 to 54 per cent, in 2002, to only 58 per cent by 2006, because there is not enough money in the system.
§ So what are the solutions? I think that there are three. First, more money must be made available to the Ugandan Government. That has to come either from an increase in resources in Uganda or, preferably, a change in the proportion of UK aid that is allocated to the water sector. Secondly, I think that the Ugandan Government themselves should provide some direct funding to the non-governmental organisations specifically to help to improve hygiene, engineering advice and the proper maintenance of the water wells. Finally, I hope that Her Majesty's Government will continue—I know that they have tried, but I think that they must continue—to encourage the Government of Uganda to audit the water development programme more thoroughly and more comprehensively.
§ We are all on the same side in this. We need a more rapid alleviation of world poverty. That must happen in rural Uganda. I hope that your Lordships will wish the United Kingdom and Ugandan Governments Godspeed in this mission.
§ 7.37 p.m.
§ The Lord Bishop of PortsmouthMy Lords, I am grateful to the noble Lord, Lord Freeman, for drawing 79 attention to an area of the world and an aspect of the international economy which it would be easy to neglect as our attention is directed to dramatic events elsewhere. I am glad to be able to express my support for his concerns on what is in effect my first day back after three months' study leave. I, too, pay tribute to the Minister for her commitment to world development ideology and action and for the respect in which she is held for that in all parts of your Lordships' Chamber. I shall not detain your Lordships long. I cannot match the statistics quoted by the noble Lord, Lord Freeman, but in order to combat the view that is sometimes held that bishops are, generally speaking, generally speaking, I shall do my best to focus on four areas.
First, in his "State of the Union" speech in January, President Bush expressed the view that Al'Qaeda had attacked US interests in East Africa and may have supporters there. The rights and wrongs of US international economic policy apart, and perhaps asking an obvious question and for an obvious reassurance, is the Minister able to reassure the House that the Government's debt relief policy will not be "adjusted" downwards in order to protect such interests? Can she say, to the contrary, that in the light of the increased instability in Africa, the Government are preparing to act even more strategically in their overseas aid policies?
The second area is debt relief. Here we enter questions of policy and the fine dividing line between what supposedly "works" and what supposedly "doesn't work". Christian Aid's view has long been that debt relief should not depend on arbitrary fiscal sustainability criteria, which I might add often seem to resemble in macrocosm what SRB indicators often represent locally in microcosm—that is, "You can't get such and such an amount until you have achieved such and such a series of targets". We are not often dealing with countries and economies that can talk that language and get anywhere.
In this connection, the Government are to be congratulated on shifting policy HIPC style (the acronym stands for "heavily indebted poor countries") towards a situation where they are not just paying off past debts—without which local national economies would be crippled in the long term—-but moving East African countries towards a position where they can invest in social and educational development.
Paul Ladd, of Christian Aid, has presented me with some impressive figures which indicate that Uganda, among other countries, was an early beneficiary from debt relief and enhanced aid, and has therefore managed to abolish user fees for primary education, which has resulted in sustained annual growth rates of over 5 per cent. Would the Minister care to tell us how government policy in this area can be extended along those lines in other areas mentioned by the noble Lord, Lord Freeman—for example, in relation to water supply?
Thirdly, there is the question of progress in debt relief. I am not the world's most brilliant mathematician, as my colleagues will assure noble 80 Lords—or perhaps alarm them by saying—but as I understand them, the figures tell us something different. Ethiopia, whose decision point was November 2001, will not, according to World Bank projections, manage to sustain its debt after the supposed completion point by the third quarter of 2004. Will the Minister comment on Christian Aid's contention that,
Even some of the countries that are seen as 'successes' of the scheme are still spending more on servicing their debt than on education or healthcare"?I ask that question in a context of profound admiration for what the Government are doing.Finally, I think that many people would want to welcome the proposals outlined in January by the right honourable gentleman the Chancellor of the Exchequer for an international finance facility which would double the amount of development aid provided by the richest countries to the poorest.
It is commendable that we are seen to be grappling with what seems to me to be the main issue of international, not economy, but justice. If I may put it in theological terms, this is about human beings as stewards rather than exploiters of creation. By "creation" I do not mean merely what is there. produced by nature, but what we help to create: in our stewardship, in terms of increased knowledge, in pushing at the boundaries of knowledge, and in our technology. Does the Minister agree that, laudable as such an initiative is, it can run the risk of appealing to self-interest on the part of the givers rather than being seen as something that is right in its own way?
I confess that, the more I ponder these issues, the less comfortable I become. I suppose it is partly the result of returning to your Lordships' Chamber in Lent a bit thinner than I was before Christmas and realising that to be a comic microcosmic example of the macrocosmic issue—the need for a fundamental change in the global economy, if, that is, we are to have a just, sustainable and participatory society which has a long-term future.
§ 7.44 p.m.
§ Baroness NorthoverMy Lords, I, too, wish to thank the noble Lord, Lord Freeman, for introducing this important debate. There are so many areas of the world that must surely demand our attention. As the right reverend Prelate the Bishop of Portsmouth said, it would be too easy to forget them as the news media focus so intently on Iraq. But when we ask whether aid for Iraq is being taken from the DfID budget, we ask the question with all these needs in mind.
The noble Lord, Lord Freeman, focused on several important issues. The point has been raised as to whether the Government are correct to deal so exclusively with governments, often ignoring those NGOs with long track records of getting aid to where it is needed. To lose their expertise not only places at risk those who would benefit from it now; it also poses a risk down the line as the NGOs become less effective as they lose funds. I look forward to the Minister's reply on those points.
81 The noble Lord, Lord Freeman, focused in particular on water. There is hardly a more important element. It is vital to survival. Water contamination has always been the cause of high levels of mortality. After all, it was only when sanitary reform was implemented in Britain and a clean water supply established that there was a decline in early mortality and a marked increase in life expectancy. The right reverend Prelate made the key point of how important it is to reduce debt lest poor countries are simply paying off their debt.
I want to examine some of the issues facing the countries of East Africa and the areas where we might help whether in terms of debt relief or direct aid. I turn first to Tanzania. Half the population of Tanzania lives below the poverty line. Education indicators are worsening and health indicators are poor. Primary school enrolment fell from 98 per cent in 1981 to 75 per cent in 1996. Because of poverty, parents take their children out of school.
The AIDS epidemic has taken its toll. It is the leading cause of death among young people. Life expectancy is 51 years and is falling. Will the Minister comment on any progress that is being made? Is there any sign of the situation being turned round? Will she comment also on measures taken by the Government to tackle corruption, to improve productive opportunities, especially for the poor, and to improve educational status?
The Tanzanian Government's weak organisational capacity is a serious constraint on their ability to promote poverty eradication. There is also a lack of accountability and widespread corruption. Are there any hopeful signs in terms of the Tanzanian Government taking effective anti-corruption measures? Is this a country where it would be better to go through NGOs than through the government?
The judiciary in Tanzania is inefficient and corrupt. The police are poorly managed and under-resourced. Half of Tanzania's households have inadequate access to safe water, and the burden of collecting water falls mainly on women and girls. Will the Minister comment on what is happening to improve access to safe water, to improve sanitation and promote hygiene, and to combat the diseases that cause so much infant mortality? I now turn to Uganda. The BBC country profile notes:
Since the late 1980s Uganda has rebounded from the abyss of civil war and economic catastrophe to become a model of relative peace, stability and even some prosperity".Democratic reforms have been introduced, the country's human rights record has improved and western backed reforms have been introduced. However, Uganda still does not have multi-party politics. Poverty levels are dropping. Here the experience of HIV/AIDS is extremely instructive. Uganda was one of the first countries to be devastated by HIV/AIDS and it was the first sub-Saharan African country to reverse its own epidemic. The government fought against the disease with a relentless campaign of education, which surely should be the model for 82 elsewhere. There is now widespread knowledge of how the disease is spread among Ugandan people. A strong political commitment was shown. Will the Minister comment on how these lessons might he carried across into other East African countries?Nevertheless, the disease continues to take its toll. At the end of 2001 there were almost 1 millions AIDS orphans in Uganda. It will be many decades before the social and economic effects of AIDS are effectively reversed. I note also that access to safe water is as low as 34 per cent, which is obviously a very worrying figure.
However, adult literacy increased from 38 per cent in 1995 to 63 per cent in 2002. Oxfam notes that,
things have dramatically changed in Uganda. Since the introduction of universal primary education in 1997 the number of children in primary education has more than doubledBut conflict and crime continue to make progress very difficult. The main rebel group is the Lord's Resistance Army, based mainly in Sudan and operating in the north of Uganda. They have been involved in a brutal campaign of atrocities, including the abduction of children who, if not massacred, are then forced to fight for the LRA. Will the Minister give some information on whether the pledges by both the Ugandan and Sudanese governments to safeguard civilians and repatriate refugees are having any real effect?In the context of aid to Uganda and in the light of our debate on Thursday, we should not ignore its involvement in the Democratic Republic of the Congo. There were reports yesterday that another 1,000 people were massacred in Ituri province. Although Uganda has denied any involvement, its hands have been far from clean in this respect in the past. The strongest possible signals need to go out to the Ugandan Government that the UK will not stand by and tolerate their involvement in the crimes in the DRC.
In Kenya, at the moment the picture looks particularly promising. For the first time since independence in 1963, Kenya has chosen a new president. That was at the end of December 2002 when the opposition won a convincing majority. The elections, applauded as the cleanest and most peaceful in Kenya's history, were followed by a smooth and unprecedented transfer of power.
The programme that the Kenyan Government promised, and then sought to implement, of universal primary education surely needs very strong support. I note that we are co-funding a scheme to provide text books and materials for all Kenyan primary schools. But teachers will also be required. Is the Minister able to comment on how the introduction of universal primary education is going in Kenya?
Healthcare in Kenya is very worrying. Kenya, again, suffers from a high and growing rate of HIV/AIDS as well as high child and maternal mortality. The health infrastructure is deteriorating. About 15 per cent of the population suffers from AIDS and, again, there are almost 1 million AIDS orphans. Many people there have all sorts of misconceptions about the 83 disease, including the assumption that a person who seems well cannot pass it on. I note that DfID is supporting a project to improve access to quality reproductive health services, including family planning. I should like to know how that has progressed.
Kenya has been making very welcome moves to clean up its government. Thus, on 25th February it announced a special commission into the theft of £400 million of public funds in the country's biggest-ever corruption scandal. Other landmarks include the resignation of Kenya's most senior judge, following his suspension pending investigation on charges of corruption, intimidation and instituting torture. There is investigation, too, into land grabbing.
But Kenya has made it plain that it will need new aid if it is to deliver all that it and the international community want. Many of its people are truly living on the edge. UNHCR reckons that currently up to half a million Kenyans are facing severe food shortages and require urgent intervention in the north-west of the country.
The noble Lord, Lord Freeman, said that there are themes common to the concerns in all these countries. The provision of clean water is absolutely basic. Without that there will be no progress in increasing life expectancy. But we also need to see a reduction in corruption, the improvement in democratic government and the strengthening of local economies. For real progress to take place, major improvements in education and healthcare will be needed.
As has been said, this Government have done a great deal to assist the East African countries. I welcome that. I welcome the progress that the countries themselves have made. I trust that the present conflict in the Middle East does nothing to deflect from the needs of Africa.
§ 7.55 p.m.
§ Baroness RawlingsMy Lords, I, too, thank my noble friend Lord Freeman for initiating so eloquently this special debate on aid to East Africa and add my respect for the Minister for all the work that she does.
Perhaps I may begin by turning to the situation in Ethiopia. In December, the UN launched a joint appeal with the Ethiopian Government to call for humanitarian assistance in 2003. This was in response to reports that the recent rains had ended and that there was a growing need for food.
According to recent figures provided by DfID, 5.9 million people in Ethiopia were in need of food provided under the UN's World Food Programme in January 2002. By December of that year, the figure had doubled with 11.3 million people being identified and a further 3 million people at risk. This rapid increase is an example of how quickly widespread drought can impact on a highly vulnerable population.
My noble friend Lord Freeman, the right reverend Prelate the Bishop of Portsmouth and the noble Baroness, Lady Northover, all referred to the important role that the British Government have 84 played in providing humanitarian support. In Ethiopia alone, £17.3 million has been provided bilaterally for humanitarian assistance during 2002 and an additional £15 million has been pledged for the early part of 2003.
We on this side of the House hope that the contribution that Britain is making to support the humanitarian crisis in East Africa will encourage others to act. However, my noble friend Lord Freeman is correct to focus the attention of the House on the efficient deployment of any aid that we provide. Therefore it is vital that with any humanitarian crisis, the situation is constantly monitored as it unfolds so that any assistance given is not only timely but is also the most appropriate to the country's needs.
What systems have the Government put in place to ensure that food is distributed efficiently in order to reach those most in need at the time they need it? I hope that the Government will continue to keep the humanitarian situation in Ethiopia under review and involve international and non-governmental organisations in this monitoring. In the case of Ethiopia, what measures have the Government taken to maintain in-country dialogue on the humanitarian situation between the Ethiopian Government, other donors and non-governmental organisations?
As I have outlined, the provision of food is vital to the short-term relief of the humanitarian crisis in the region. However, while it is important that we respond to the short-term humanitarian crisis, it is important, too, that we examine opportunities to provide longer-term solutions to the situation without forgetting to find ways of reducing the risk of future humanitarian disasters.
It is with regard to that that I turn to the situation in Kenya, Uganda and Tanzania, where the need for humanitarian assistance also exists. At this stage it would be remiss of me if I did not mention one of the finest organisations in this field. My noble friend Lord Freeman mentioned the importance of aid efficiency in East Africa. The Aga Khan Development Network, known as the AKDN, is one of the major contributors and does the most outstanding work in that area.
The AKDN comprises private development agencies to improve living conditions and opportunities in East Africa and other specific regions of the developing world. It has individual mandates that range from health, education, and the built environment to rural development, infrastructure and the promotion of private sector enterprise. It works in close partnership with governments, DfID, NGOs, private sector institutions, communities and individuals, maintaining always the strictest neutrality and remaining independent of all political allegiances. Its education services provide schooling of quality to over 10,000 students in Kenya, Tanzania and Uganda, from the pre-primary through to the secondary level. The Aga Khan University Institute for Educational Development is supporting those efforts. The Aga Khan University has also established campuses in those three countries.
85 Kenya has extremely high levels of poverty with over half of the population living below the poverty line. The situation is worsened by the spread of HIV/AIDS, as we have heard, which continues to pose a major threat to the development of the country. However, as we have heard from the noble Baroness, Lady Northover, we can take some comfort from recent political developments with their election results providing an important opportunity to achieve reform in Kenya.
With regard to aid accompanied by reform and education, I ask your Lordships' indulgence as I mention education yet again and especially the importance of education for women. I feel that the lack of education is one of the major roots of nearly all these problems. Education offers one of the best hopes for lifting many in the region out of poverty. We on this side of the House back the Government in their support of the new Kenyan administration to drive forward policies on poverty reduction, including their commitment to provide free primary education and to combat the spread of HIV/AIDS.
We also recognise, however, that humanitarian assistance and good governance alone may not be sufficient to tackle some of the deeper-rooted causes of poverty in the region. The heavily indebted poor countries (HIPC) initiative, as mentioned by the right reverend Prelate, has been described by the inspired president of the World Bank, Mr James Wolfensohn. He said:
This is a breakthrough … It deals with debt in a comprehensive way to give countries the possibility of existing from unsustainable debt. It is very good news for the poor of theHIPC is aimed at bringing about a reduction in the debts of some of the poorest countries. Noble Lords on all sides have recognised the damaging effects of unsustainable debt on efforts to reduce poverty in these countries and therefore the importance of providing access to the HIPC scheme for heavily indebted countries.In January, the noble Lord, Lord McIntosh of Haringey, stated that many countries that have been through the scheme are still in a position of unsustainable debt. I ask the Minister whether it is still the case that 15 countries have not even reached their decision point. In other words, a third of heavily indebted poor countries have received no debt relief under the initiative. I further ask whether the Minister agrees that there must be a radical revision of the terms of the initiative, so that more countries can qualify for debt relief in 2003.
Finally, I turn to the political situation in the region as a whole. Corruption has long played a role in diverting resources away from those most in need of aid. In the past we have often heard reports of large quantities of donated food being siphoned off by corrupt administrations and either stockpiled or sold off. I ask the Minister what measures we have in place to ensure that any aid that we send to the region reaches those for whom it was intended? Equally, so much of the humanitarian crisis in East Africa over the past decade has been exacerbated by conflict in the 86 region which has considerably reduced access to water, as mentioned by my noble friend Lord Freeman, the ability to grow crops and increased competition for already scarce resources.
In 1984 a state of civil war existed in Ethiopia that significantly impeded the ability of the international community to direct available resources to relief. I hope therefore that noble Lords will support the view that the best way to tackle famine across Africa is by the international community looking forward and working with African countries to end the cycle of corruption, economic stagnation, war and all the problems with water that condemn so many Africans to poverty and famine.
§ 8.6 p.m.
§ Baroness AmosMy Lords, I thank the noble Lord, Lord Freeman, for opening this important debate and I pay tribute to the noble Lord's work with the Busoga Trust. I thank him for his positive comments about the work of DfID in East Africa. I also thank the noble Lord and the right reverend Prelate for their kind comments about my work.
This debate has underlined the enormous challenges faced by the 90 million people in the three countries of East Africa: Kenya, Tanzania and Uganda. I shall also talk about Ethiopia, which was mentioned by the noble Baroness, Lady Rawlings. They are all desperately poor countries. In Kenya, Tanzania and Uganda we have an average per capita income of between 270 and 350 dollars a year. The challenge in each is to achieve sustained economic growth and to deliver the benefits of that to the poor, reducing the numbers living in abject poverty and providing basic education, good healthcare and decent livelihoods for all.
Debt relief and increased donor support provided by the international community have had a significant effect. All noble Lords mentioned the heavily indebted poor countries initiative. The Government continue to play a leading role in delivering debt relief for the world's poorest countries. So far 26 of the 37 eligible countries have qualified for debt relief under HIPC, the aim of which is to ensure that debt is cut to sustainable levels in the world's poorest countries. Six of those countries have reached completion point and received full debt relief. The remaining 20—I think the noble Baroness, Lady Rawlings, said there were 15—are receiving interim relief ahead of a debt write-off expected in the coming few years.
The United Kingdom continues to push for increased debt relief, where necessary, through so-called topping-up at completion point because we are concerned at countries coming out of HIPC with unsustainable levels of debt. Topping-up is provided on the basis of individual assessment of the country's need. We continue to be vigilant in ensuring that the international financial system offers the right blend of debt relief and concessional loans or grants for countries that have shown commitment to sound economic policies and poverty reduction strategies. I can assure the right reverend Prelate the Bishop of 87 Portsmouth that we will remain committed to the debt relief agenda and to long-term sustainable development in Africa.
The right reverend Prelate mentioned the debt relief situation in Ethiopia. We are working very hard with the World Bank and the IMF to address problems of Ethiopian debt, as the problems are due to shock beyond Ethiopia's control. That has happened in a number of countries, where they are unable to assess how much they will get in terms of commodity prices. We are very conscious of the debt sustainability problem in Ethiopia.
The noble Lord, Lord Freeman, talked in particular about water, as did other noble Lords. We are committed to the millennium development goals, one of which is to halve the proportion of people living in extreme poverty by 2015. Another seeks to halve the proportion of people without access to safe water by 2015. We have worked very hard to win international agreement to the sanitation target at the World Summit on Sustainable Development in Johannesburg last year.
It is true that it will be very difficult to attain all the goals related to water and sanitation, particularly in Africa and particularly the target on the supply of safe drinking water. There is no internationally agreed target on sanitation. That, of course, is regrettable, but we pushed very hard for it, because the challenges in sanitation are even greater than for water. We are working to build an effective response, through the international system, to support developing countries in achieving the MDGs. Our goal in the water sector is to enable poor people to lead healthier and more productive lives by helping to increase and to sustain their access to safe drinking water and appropriate sanitation.
We currently support a number of multilateral initiatives, including the Global Water Partnership, the World Bank Water and Sanitation Programme and the Water Supply and Sanitation Collaborative Council. We also support bilateral programmes in many countries in the developing world, including Uganda, Nigeria and South Africa, but also countries in Asia. The recent 3rd World Water Forum in Kyoto has been useful in maintaining momentum towards implementation of the Johannesburg commitment. There has been a strong reaffirmation by all countries of the commitment to water for poverty reduction.
On the specifics of water supply in Uganda, rural water coverage increased from 40 per cent in 1990 to 46 per cent in 2000. The figures for global water coverage in the same period were 44 per cent to 50 per cent. In Tanzania total water coverage was 48 per cent in 1990 and 54 per cent in 2000. We look at water policies in Tanzania in the context of our overall support for the poverty reduction strategy process. Water is regarded as one of the fundamental areas for improvement there. We discuss that regularly with the Government in an attempt to influence policies and to bring about improvements.
88 The noble Lord, Lord Freeman, asked about value for money in Uganda. Our policy thrust is to improve accountability for all public expenditure. We are encouraging a strong role for the directorate of water development in Uganda. A big thrust is to improve auditing and to measure performance. We are confident that improvements are beginning to be demonstrated that will flow to all in terms of water management.
The noble Lord, Lord Freeman, and the noble Baronesses, Lady Northover and Lady Rawlings, mentioned corruption. Corruption is a severe problem and a constraint on development in most developing countries. Experience demonstrates that corruption thrives whenever there are weak systems and that much past corruption has originated from bribes offered by companies from OECD countries.
We are collaborating with governments and other donors in the region to strengthen systems, particularly in the public sector, in order to reduce opportunities and incentives for corruption and to increase effective sanctions. In Uganda, for example, a joint Foreign Office/DfID anti-corruption strategy has been agreed with the Government there, and it forms the basis of a common reform agenda. We are supporting the reform of central procurement and public expenditure management procedures. There are also financial tracking and value for money studies to monitor implementation and expenditure at district level. The move to budget support has, by reducing project management responsibilities, enabled DfID to become more engaged in the wider issues that form the root of inefficiency in expenditure.
I must turn to the countries that were mentioned. In 1998 and 2000, Uganda was the first country to benefit from the heavily indebted poor country initiative. The result has been annual savings of about 90 million dollars on repayments. All debt relief is directed towards poverty-related programmes in the Government's poverty eradication action plan. Those programmes have doubled, as a share of total discretionary government expenditure since 1997, rising from 18 per cent to 36 per cent. As was mentioned, Uganda is also a major recipient of aid. We provided approximately £55 million in untied grants in 2003, mainly in the form of direct budget support to the Government.
The trend of reform so far is positive, and the results are clear. Uganda has maintained a high rate of growth—6.3 per cent in 2001–02—against a background of falling commodity prices. The proportion of the population living in poverty has fallen dramatically, from 56 per cent in 1992 to 35 per cent in 2000. Social indicators have improved, with primary school enrolment almost trebling between 1996 and 2000, and the incidence of HIV/AIDS has fallen from 20 per cent in 1992 to 6.1 per cent in 2001.
The noble Baroness, Lady Northover, asked how we could carry the lessons of Uganda into our work in other countries. What we have learnt from Uganda has informed our strategy in other countries, and we continue to examine success stories in other countries 89 that we can build on. There has been an increase in health funding at district level, leading to an expansion in out-patient attendance, which is up 40 per cent between July 2001 and June 2002, and immunisation coverage, which is up from 48 per cent to 63 per cent by June 2002.
Those figures demonstrate development gains from which we should all take encouragement. At the same time, Uganda faces significant challenges over the next few years. Conflict and insecurity in the north, mentioned by the noble Baroness, Lady Northover, continue to hamper poverty reduction. Tensions in the region have risen in recent months. Defence expenditure has exceeded the limits agreed with donors, and that is one of the reasons why our assistance to Uganda last year was less than had been planned. Looking ahead, major political reforms will be needed to introduce a multi-party system, before the 2006 presidential and parliamentary elections. Tackling those challenges will be key to maintaining Uganda's impressive record of development success.
The noble Baroness, Lady Northover, mentioned Tanzania, the poorest of the east African countries. It has received debt relief and increased donor support, based on the Government's strong commitment to poverty reduction. Last financial year, the United Kingdom provided approximately £65 million in untied grants, mainly in the form of direct budget support, through a joint funding mechanism with 10 other donors.
Given that this is just the third year of the strategy, it is too early to identify the extent to which moving our resources into budget support in Tanzania has helped. However, we are beginning to see some results. There has been an increase in economic growth; the net primary school enrolment ratio has risen from 59 per cent in 1990 to 85 per cent in 2002; and there is also evidence that maternal mortality is reducing significantly. The supply of safe drinking water has improved in rural and urban areas. The Tanzanian Government face major challenges, including building their capacity, which was mentioned by the noble Baroness, Lady Northover, and that of local authorities to deliver the poverty reduction strategy. It is important that they do not to slip back into debt.
The position in Kenya has, until recently, been different. Kenya has had the advantage of lower levels of debt and has not needed debt relief, but, for many years, it has been a difficult environment in which to work effectively. The failure of the previous government to implement promised reforms gave the international financial institutions and ourselves no choice but to suspend budget support. We had, however, a £30 million programme, focused on four areas: a multi-donor civic education programme; work to improve the management of public services; fighting HIV/AIDS; and a private sector programme helping to reduce the burden of red tape, which also helped to tackle corruption.
As soon as the new government took office, they announced the implementation of universal and free primary education. More than 1 million children have 90 either returned to school or gone to school for the first time. Two weeks ago DfID provided an extra £10 million for textbooks and essential materials.
I turn to Ethiopia. The humanitarian situation mentioned by the noble Baroness, Lady Rawlings, is serious, with 11.3 million people identified as needing food aid, and a further three million requiring close monitoring. We have made a substantial response so far £37.6 million since the beginning of 2002—and we have been urging others to contribute to the appeal. We attach the highest priority to constant monitoring of the situation, which was raised by the noble Baroness, Lady Rawlings. The Ethiopian Government have improved their own monitoring since the famine of 1984–85. That is why we have prevented a shortage turning into a crisis and we have had regular meetings with NGOs and others in Addis Ababa to discuss the humanitarian situation.
With respect to aid effectiveness, there is convincing evidence that the gains realised through partnership, fostered through the provision of general budget support, lead to development that reaches a far larger scale, and is more sustainable, than individual projects with their associated large transaction costs. I assure the House that having moved to budgetary support, it does not mean that we will not continue to work with NGOs on our longer-term development agenda. We are asking tough questions about NGO funding, but that is because we want to ensure the best means of achieving poverty reduction.
The noble Baroness, Lady Northover, asked me about the massacre in Ituri. This is absolutely appalling, especially given the signing last week of the peace process in Sun City about the DRC. I have issued a statement on this today, and the noble Baroness will be aware that my right honourable friend Clare Short has maintained a dialogue between the presidents of Uganda and Rwanda with respect to the tensions between their two countries in the DRC.
I have gone well over my time. I conclude by saying that tonight's debate has underlined that the challenges facing us are huge. Our continued support, and that of the international community, is vital to the millions of people in the region. We are committed to delivering this support, but leadership can be taken only by the governments of the region. That is now happening, and the combination of their commitment and our support is starting to deliver results. Those results show that debt relief and increased donor support are not wasted efforts. They can make a real difference to turning around the lives of poor people, and to giving them the prospects of a better future.
§ Baroness CrawleyMy Lords, I beg to move that the House do now adjourn during pleasure for two minutes.
§ Moved accordingly, and, on Question, Motion agreed to.
§ [The Sitting was suspended from 8.23 to 8.25 p.m.]