World Summit on Sustainable Development and Aid for Poverty Diseases

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Dr. Palmer: I had not intended to intervene, but in view of the interesting comments by earlier speakers, I want to make a couple of points. I declare an interest in that I continue to advise my former company, Novartis. It is a pharmaceutical company although, as far as I know, it is not involved with AIDS drugs.

We all agree about the gravity of the situation. It is possible to spend too much time debating the relative virtues of different bodies for delivering aid because in reality it often turns out to be either the same or very similar people involved in the delivery. We all have our favourites. Some of us like the EU, some of us like bilateral aid, some of us like the United Nations and so on.

As my hon. Friend the Member for Luton, North said, the issue is urgent and the answer has to be to push ahead on all fronts as fast as possible. I have two points to make following his speech. Because of the sheer intensity of the crisis we are perhaps losing sight of the old adage that prevention is better than cure. In the efforts made by the European Union, by Britain bilaterally and by the UN we need also to stress that, as much as we attempt to deal with those who have already been infected, the AIDS pandemic can be contained by prevention.

Secondly, important though the debate on the price of drugs is, it needs to be linked to the debate on the delivery of the treatment. It is a mistake to think that that if only we supplied millions of pills, the problem would be solved. That leads us to the longer-term programmes of the EU, the WHO and Britain in bilaterally building up health care infrastructures in the countries concerned. I hope that in her discussions with her European colleagues the Minister will keep that aspect in mind as well as pushing the urgency of the whole issue, as all hon. Members have stressed.

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5.30 pm

Mr. Johnson: I rise to support one aspect of the speech of the hon. Member for Luton, North. It was an interesting contribution, particularly as he has a general prejudice in favour of bilateral aid, as opposed to EU aid or multilateral aid. It is not that one should be against EU aid, or of aid being provided through multinational institutions, but my experience is that the bilateral system works best.

I speak as one who had the benefit a few months ago of visiting South Africa, Uganda and Zimbabwe to see what is happening there in the struggle against AIDS. I have seen what NGOs are doing to prevent the spread of AIDS and its transmission from mother to child in the womb; and remarkable success has been brought about by hard working NGOs in reducing the infectivity rate in Uganda—from one in five or 10 to about one in 20. It is a considerable reduction. For Uganda, that is thanks largely to the donations of the Government. The UK is the biggest single bilateral donor to Uganda. There is also a political spin-off: we are also Uganda's biggest single trading partner. That is the best way to do it, because people have a clear idea of who is in charge and who is accountable. As the hon. Member who spoke for the Liberal Democrats—[Interruption.]

The Chairman: Order. I shall allow the hon. Member for Broxtowe (Dr. Palmer) himself to correct that if he wishes.

Dr. Palmer: I represent Labour interests.

Mr. Johnson: I know what it is, Mr. O'Hara; I long ago decided that some of the hon. Gentleman's contributions sounded as if they could have come from a Liberal Democrat. That may have sowed the confusion in my mind. I hope that the hon. Gentleman and the Committee will indulge me in my mistake.

Despite my false ascription to the hon. Gentleman of Liberal Democrat thinking, one of the sensible things that he said was that in the end it is the same old people who tend to do the job. That is profoundly true, regardless of whether it is the EU or the UK that gives the money; even UNICEF money goes to the same sort of micro-NGOs. Nevertheless, it is far better that the Department for International Development, which is very good, should have a direct sense of accountability; it is dispensing taxpayers' money, and the people on the ground know that they are accountable to the Department, which is big in South Africa. It is surprising, for one who grew up believing that Britain's world role had shrunk, to go to South Africa and find that we are a very big player and they take us very seriously. They listen to what the people from DFID have to say and the people from DFID ensure that British taxpayers' money is wisely spent.

I am not sure if the same can be said about EU funding and the EU representatives in Africa and other parts of the world. They try hard and they do a good job, but I am not convinced that their work is as effective as bilateral aid. The old rule concerning multinational money is that because it is everybody's money it is nobody's money. People do not have quite

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the same sense of accountability and responsibility when dealing it out.

A fascinating example of such wooliness and vagueness about authority and who is in charge was provided by the description of the regulation given to the Committee this afternoon. With the greatest of respect to the Minister, I asked several times exactly who was in charge of this amendment to beef up the regulation. The European Parliament has decided that there should be compulsory licensing for these drugs. It is in rather the same frame of mind as the hon. Member for Luton, North—it wants to stick it to the pharmaceutical companies and ensure that they dish out the drugs.

The Government, no doubt for sound tactical reasons, want a voluntary system and want the European Parliament to think again. However, it is absolutely unclear what will happen. Listening to the Minister and everybody else, it is totally unclear to me who is in charge of the amendment and how the matter will ultimately be resolved. That is a classic example of the wooliness and vagueness that characterise EU-type operations.

Dr. Palmer: I am grateful to the hon. Gentleman for giving way and forgive his absent-mindedness. Is not his criticism of what is essentially the consensus mechanism of the EU, which requires an agreement between different bodies before progress can be made, a little strange set beside his enthusiasm for aid administered through NGOs? With all credit to the NGOs, and they vary a great deal in quality, they are not accountable to anybody except to those who sit on their boards. We are debating what the European Union ought to be doing, and the European Parliament also debates what the EU ought to be doing. If we are spending money on this, should we not have some say in how it is spent?

Mr. Johnson: My criticism is not of the NGOs, as the hon. Gentleman rightly said. It is of the European Union institutions and their representatives—the emanations of the EU in Africa, which do not do quite as good a job of overseeing the spending of taxpayers' money as the Department for International Development. That is why, like the hon. Member for Luton, North, I think we should be prejudiced in favour of giving aid bilaterally through DFID.

I was perplexed, so I am grateful that the hon. Member for Broxtowe was able to reveal to me that there is a consensus mechanism at work. That is a very exciting thing that I did not know about. However, I am still unclear, despite his elucidation, exactly who will be in charge, where the buck stops in the consensus mechanism and whether the European Parliament or the Council of Ministers is sovereign in this question.

One thing is certain—this House will not be sovereign in it, and neither will Her Majesty's Government. That is the core of my objection. If we are to embark on a programme, it would be far better for us to have complete control over it and the ability to oversee its final delivery to the people who need it.

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5.39 pm

Dr. Lewis: I am certainly no expert on the subject of our debate, but I know a bit about history and past holocausts. When American forces overran such concentration camps as Belsen, Buchenwald and Dachau, they found to their horror tens of thousands of people in their final extremity. That terrible problem was tackled with a degree of single-mindedness that could be used to inform today's debate. The hon. Member for Luton, North hit the nail on the head in his recommendations.

No committees or international negotiations were involved in tackling that horrifying problem; instead, the medical forces of individual countries—principally, general practitioners and others from this country—immediately went to the scene of the disaster and administered help directly. A little later, the United Nations Relief and Rehabilitation Administration was involved in direct handling of the problem, co-ordinating efforts on a longer-term basis.

In preparing for today's debate, I was shocked by some of the briefing material that I was given. For example, an article in the British Medical Journal states that

    ''Aids will surpass the Black Death as the world's worst pandemic if the 40 million people living with HIV/Aids do not get life-prolonging drugs.''

It is difficult to see how the deliberations of solemn parliamentarians in their assemblies will lead to the direct application of the emergency assistance that is required, even with the best will in the world. I leave aside the anti-European Union prejudices that some of us may entertain.

I believe that significant progress has recently been made in resolving the litigation involving the companies that researched and developed the drugs. It is impossible to expect scientific firms to research and develop drugs if they know that the products of their research will be sold on for a price that covers only production costs, with no allowance made for their huge investment in urgently developing cures for diseases. If drugs companies, including some in this country, have succeeded in developing drugs that will contain a disease and prevent its spread to future generations, it is difficult to understand why we must go through a roundabout route, via international and European institutions, to get those drugs to those who require them.

That is especially true in an environment in which the application of money to a problem tends to be inefficient, to put it mildly. One cannot be confident that anything like all the money pumped in will reach the destination for which it was intended.

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