Examination of Witnesses (Questions 515
- 519)
TUESDAY 25 JULY 2000
RT HON
CLARE SHORT,
MR DAVID
CLARKE, DR
JULIAN LOB-LEVYT
AND MR
BOB GROSE
Chairman
515. May I welcome you once more, Secretary
of State, to our Committee, this time to consider the terribly
important and tragic issues of HIV/AIDS which we have been studying,
not just taking written evidence for the last four months but
also because on each of our visits overseas HIV/AIDS has impacted
on everything we have seen in India, Bangladesh, Pakistan, and
also in the African countries we have visited, Kenya, Uganda,
Rwanda, Mozambique, South Africa, Malawi and Zambia. HIV/AIDS
is a dominant problem in all of those countries. So we feel that
this is a really important developmental issue. I understand that
you have a short statement to make and I am sure what you are
going to do is answer a lot of the questions we have in mind right
at the beginning so one of the issues we want to ask you straightaway,
and perhaps you could include it or cover it during your initial
statement, is the situation you see on the outcome of the Durban
Conference and the Okinawa Statement, which of course was yesterday
reported to the House by the Prime Minister. No doubt you will
tell us how optimistic or pessimistic you are that the international
community has an agreed effective strategy and adequate funds
to tackle the HIV/AIDS pandemic. Secretary of State?
(Clare Short) Thank you very much. I
noted your interest. Andrew Robathan made an important speech
in the debate on Mozambique helicopters indicating the scale of
this and yet it was not discussed in a way that immediate crises
are. I want to make some very short introductory remarks. The
first point I want to make is that we at our very best are only
part of an international system. Sometimes when people get emotional
about things like AIDS they say, "What is the United Kingdom
doing? Can the United Kingdom do more?" as though we can
do it, and we cannot. We are not the whole of the international
system. We do not operate everywhere. We can try to be a leading
force both in influencing the international system to operate
better and to do good work from which we learn and which drives
forward our understanding of what can be done. But sometimes the
discussion is as though a government like ours can lead the whole
world effort, and of course we cannot. The second thing is that
within that, therefore, as well as trying to strengthen international
co-ordination and forward-thinking and effectiveness of implementation,
we have up to now worked on prevention. I think up to now that
has been right and we have then driven forward programmes and
efforts where we were strong and where we could get in and that
has been opportunistic because you depend on governments and responses
to be able to get beyond very small interventions. I think we
are moving, as the document presented to the Committee showed.
I am sorry it is so long. I think it could have been summarised
and I apologise for that.
516. We have read it very carefully. It needed
to be long.
(Clare Short) Okay, good.
Mr Rowe
517. Do not encourage them!
(Clare Short) We are widening and deepening our own
efforts and thinking. I do not apologise for it and I think it
is right still to put a massive effort into prevention. That saves
lives, saves suffering, saves economic cost but of course as ever
more people get the illness, which has all the economic consequences
it has in the education sector and all the other sectors, one
needs to put more effort into care but still with a major effort
on prevention. The third thing I would say is that the major barrier
to more effective action in many countries, but particularly in
Africa, where the consequences are so great, has been the unwillingness
of African governments to move—with the great exception
and the fine lead given by Uganda and Senegal—so when people
splash around numbers and say $2 billion is needed, that sounds
all very well and it sounds as though the only problem we have
got is that miserable, rich donors will not provide the money.
That is just untrue. We have not been able to spend or get in
and when there are governments that will not move, that are hiding,
pretending, not facing it, we cannot be a substitute for a government
that will not take action. We can find little interventions or
NGO efforts but it is impossible for us, and that has been a major
problem for us across Africa and indeed other countries. As with
the debt campaign, a lot of campaigners talk as though all governments
in developing countries are good governments dedicated to their
poor and dedicated to the right policies, and that is not so.
We need to mature this debate to get more effective action and
more effective pressure into the international system. My final
point, which is responding to your question, and I might bring
Julian in on it too, is we think that Durban has probably been
a turning point. The amount of energy and noise and attention
to a conference hosted in Africa and, in a funny kind of way,
the controversy around President Mbeki's position may have helped
to make the noises louder and the debate more vigorous, and there
has been something of a sea change, a mobilisation in Africa.
South Africa itself has been neglectful to get to this point without
having had a really serious strategy, but is now moving. Okinawa—how
much that adds? The right things are said, as you would expect,
and it is important to get the right things said rather than the
wrong things said but implementation is also very important. A
lot of the things that were said at Okinawa were good. One of
the things I am very pleased about in the time we have been in
Government is that the G7/8 have been forced to pay more and more
attention to development and that is a great achievement and I
think that will continue. You will know that there now is agreement
that there will be a report annually on progress against the international
development targets at G8. Otherwise it is just so disgusting
that the world's richest countries meet and talk only about their
own affairs. I think we might have achieved something of a sea
change. Could I ask Julian to comment on what Okinawa added.
Chairman
518. I ought to welcome Julian Lob-Levyt—
(Clare Short)—Who is the head of our Health
and Population Department.
519. And Bob Grose.
(Mr Grose) HIV Adviser.
(Clare Short) For his sins.
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