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House of Commons

Wednesday 20 January 1999

The House met at half-past Nine o'clock


[Madam Speaker in the Chair]

Population and Development (Cairo Conference)

Motion made, and Question proposed, That this House do now adjourn.--[Mrs. McGuire.]

9.33 am

Mr. Tony Worthington (Clydebank and Milngavie): The Cairo conference held in 1994 was an enormously significant event, as 180 nations gathered together to sign a declaration of commitment to put human rights at the centre of reproductive health. Since Cairo, the basic right of all couples and individuals to decide freely and responsibly the number, spacing and timing of their children and, most important, to have the information and means to do so has been accepted, thus giving people the right to attain higher standards of sexual and reproductive health.

We are, however, a long way from realising that ideal. More than 580,000 women--99 per cent. of them live in developing countries--die each year as a result of pregnancy or childbirth. It is estimated that about 20 million unsafe abortions occur each year, resulting in about 70,000 deaths and millions of disabilities. At any one moment, 120 women who do not want to get pregnant do so for lack of access to contraception. Each year, between 15 million and 19 million young girls give birth. Between 100 million and 132 million women and girls have been subjected to female genital mutilation. More than 30 million people live with HIV/AIDS, the vast majority of them--85 per cent.--in Africa or Asia. That is a catalogue of totally avoidable disaster.

The technology and resources to avoid such disasters are easily available and not expensive, and success in that field would mean that all people would win, wherever they live in the world, but especially women and children living in the poorest parts of the world. The hon. Member for South-West Devon (Mr. Streeter) recently accompanied me to Nigeria, where we saw a country whose per capita income is plummeting; one of the many reasons for that is that the population is soaring. In Nepal, the population is rising rapidly and people are fleeing the hillsides because of deforestation and because those areas cannot support a growing population. In Botswana and Namibia, rapidly growing populations are making the shortage of water more acute, with waterholes drying up and people having to leave the surrounding area.

World population is surging upwards by about 78 million each year. This year, slightly more than 10 years after reaching 5 billion, the number of people will reach 6 billion. We cannot go on at that rate: population growth is the world's biggest sustainable development

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issue. To an overwhelming extent, that growth has occurred in the poorest parts of the world. One fact that staggers me is that, in 1900, Europe had three times the population of Africa; by 2050--150 years later--Africa will have three times the population of Europe, including Russia. Nevertheless, the greatest numerical increase will have occurred in Asia.

Because these children have already been born and because the developing world's population is so young, nothing can avert huge population growth in the near future; but the sooner the world's population is stabilised because that is what people want, the better it will be for everyone. Throughout western Europe, whether in Britain, Italy, Sweden or Spain, we choose to have small families. I want to ensure that every woman and every family in the world has the right to make the same choice.

The timing of the debate is impeccable. In February, a major forum for non-governmental organisations will be held in The Hague; and a conference of parliamentarians to assess Cairo-plus-five will take place at roughlythe same time. The all-party group on population, development and reproductive health, chaired by my hon. Friend the Member for Clwyd, South (Mr. Jones), has taken a prominent role in the planning of those conferences. The United Nations Commission on Population and Development meets in March; and, from 30 June to 2 July, there will be a special session of the United Nations General Assembly to consider progress since Cairo. Today's debate gives the House a chance to assess progress since Cairo, and to hear from the Government their evaluation of the progress made and their policy for the future.

Let us first address the issue of resources. The funding target agreed in Cairo in 1994 was £17 billion, of which two thirds was to be provided by developing countries and one third by developed countries. By the end of 1995, the developing countries had spent £7.5 billion on population development and reproductive health activities. Donor countries had contributed £2 billion. Those were early days post-Cairo, but in order to reach the agreed target by 2000, donor countries must increase their contributions by 23 per cent. each year.

Any funding shortfall is not academic but has profound consequences for individuals. The United Nations Fund for Population Activities has calculated that the current rate of underfunding will result in 120 million unwanted pregnancies, 49 million additional abortions, 5 million deaths of infants and young children and 65,000 maternal deaths over the years 1995 to 2000.

How is Britain doing as a nation? To their credit, the previous Government increased the amount of aid resources devoted to reproductive health. However, they did so within the restrictions of a constantly falling aid budget. The research organisation Population Aid International has evaluated the performance of all donor nations. Only the Scandinavians get A grades; we receive a B-minus. Of course, the organisation evaluated the performance of the previous Government; it did not take into account our creation of the Department for International Development or the wonderful 28 per cent. increase in DFID's aid budget following the comprehensive spending review. We have put much more energy into debt and trade issues that will help developing countries.

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Today's debate will give the Government a chance to reaffirm our commitment to reproductive health and to commit ourselves to further development of our contribution to this field of human rights. Britain is commended for our technical expertise, and I praise the first-rate efforts of NGOs such as Marie Stopes International and Population Concern, which are respected throughout the world for their contributions. I also commend the BBC World Service and the International Planned Parenthood Federation for their highly successful "Sexwise" radio programmes that are aimed at young people. The programmes were first broadcast in south Asia, but will now go worldwide to eastern Europe, central Asia, Africa, the Americas, the Arab world and south-east Asia. Radio has enormous public education potential in countries with vast distances and poor services. I was pleased to hear from the BBC that the story in The Observer about reductions in the World Service is wrong and that it is planning further investment after years of cuts.

What are the Government's plans? I applaud the start made by DFID, but the Population Action International report says that the British contribution will have to treble if it is to be a fair per capita share of a fully subscribed and honoured Cairo commitment. It is particularly important that Britain should do well because of worries about the contribution of others, particularly the world's major economies. I shall mention three in particular.

The United States has the worst record of all developed nations in terms of its failure to meet the United Nations aid commitment of 0.7 per cent. of gross domestic product. It is unlikely--although I have not managed to check--that President Clinton gave a commitment to any improvement in his state of the union address yesterday. The United States appears to give a substantial amount to family planning services, but that is merely a reflection of its huge economy. The funding is extremely volatile and cannot be relied upon. It depends on who has the upper hand in Congress at a particular time.

The moral McCarthyites are uppermost at the moment and forbid any expenditure where there is even the suspicion that money is being spent on abortion. Unfortunately, in their desire to protect the unborn, those fundamentalists withhold money that would save the lives of women in childbirth. Women are killed by unsafe abortions, and countless thousands of infants and children die because of a lack of resources. It is a strange morality that kills the born so as theoretically to protect the unborn. We cannot rely on the Americans to honour their commitment to Cairo.

The Japanese are also big givers, but there must be question marks over the stability of their contribution given the turmoil in the far eastern economy. There are also doubts about how much of Japan's contribution is devoted to reproductive health as compared with general welfare. There is a trend in Japanese giving to distribute aid to neighbouring countries rather than to the areas of most need and greatest poverty. It is strange that, although the Japanese play a prominent role in international organisations that are concerned with population development and reproductive health, the pill is not available in Japan. That greatly weakens Japan's credibility in human and women's rights terms. It is therefore doubtful whether Japan will be able to contribute as much as we had hoped to the Cairo commitment.

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Another of the potentially big givers with which we are concerned is the European Union. I hope that there can be much improvement in this area. The Government are also concerned about the issue, and the Select Committee on International Development is investigating the situation. The EU performance gives me and many others cause for concern. It is the most constipated of donors: a great deal seems to go into the organisation's mouth and great intentions are spouted, but little seems to come out easily from the other end.

In 1994, the Commission announced its intention to increase funding for population programmes more than tenfold by 2000. What has happened? Is the EU contribution skewed to the poorest nations? No, in recent years there seems to have been a greater concentration of funding to Mediterranean countries. There also appears to be a shortage of expertise, which is scattered around the multiple directorates-general that have some responsibility for development.

European NGOs and others have extreme difficulty understanding the EU system. It is hard to find one's way around a system that is interminable in terms of delivery. Organisations, particularly poor organisations in developing countries, simply lose patience with a system that can take years to process a proposal. When proposals are processed, the funding is often unreliable. I welcome the Government's views on the likelihood of change.

I turn to other areas of particular concern. I shall not refer to the importance of services for young people because my hon. Friend the Member for Calder Valley (Ms McCafferty) will seek to catch your eye, Madam Speaker, to talk about her valuable work in this connection. In this country and elsewhere in the world, we cannot adopt the posture of the ostrich and simply wish that young people would stop doing it. It is futile simply to aim our services at married couples and those whom we deem to be mature. In sub-Saharan Africa, eight out of 10 young people are sexually active. Many babies are born to very young women--there are 15 million births a year to girls aged 15 to 19. I applaud NGOs such as Population Concern that are involved in this difficult work which is often greeted with hostility. Unless those young people are fully aware of AIDS and how to combat it, for example, they will simply never become adults.

The IPPF and others are doing valuable work in eastern and central Europe of a very different focus. Those countries often had services that have collapsed with the disintegration of the USSR. They are becoming poorer and poorer. Those countries had services, but they were the wrong services because they were based on abortion, so in many countries there were as many abortions as there were live births. It is not allowable under the Cairo protocol, and rightly so, to use abortion as a method of birth control.

It is my belief that, sadly, the biggest challenge to face this country and Europe in the next 10 years will be a further collapse of the area of the former USSR. We must not forget the reproductive needs of people in those countries. I commend the Europe section of the IPPF for the work that it has been doing. I support the--often new--family planning associations in those countries where there has been no tradition of volunteering and where civil society has had to be built up. Women there now have to pay for services that previously were free.

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Those are volatile countries where the threat of fascism and further social upheaval is constantly present. We have to support the family planning associations and other volunteers who are emerging, often in a hostile atmosphere. What reassurance will the Minister give me that such work is of great importance to the Department for International Development and that he will ensure that we and the European Union generally support it?

Finally, I turn to the scourge of HIV and AIDS. The figures are nightmarish. More than 33 million people are affected worldwide and they are overwhelmingly in the poorest parts of the world. For example, in Botswana, 25 per cent. of the population is HIV positive. An increasing proportion are women who have been infected by their straying husbands. Already in Botswana--this figure is stark--the life expectancy of the population has fallen from 61 to 47. The number of orphans is sky-rocketing as the vast majority of those who die are aged 20 to 50. At clinics that I visited in Tanzania, staff could not dream of testing pregnant women for HIV because women would no longer attend clinics that tested them and gave them bad news about themselves and their babies.

It is difficult in humanitarian terms to think of a more pressing case in respect of which the Cairo commitments should be honoured. Will the Minister tell me whether there are any international signs of optimism in policy approaches or of countries successfully reducing rates of infection?

I am grateful to the House and the Minister for listening to those points. I hope that the whole House and the country will back the Government in their work to support the outcome of the 1994 Cairo conference. I look forward to hearing from the Minister how the Government are approaching the deliberations on Cairo plus five years.

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