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Mali

John Barrett: To ask the Secretary of State for International Development if he will make a statement on the prevalence of tuberculosis in Mali; and what action he is taking to assist in the treatment of people suffering from tuberculosis in Mali. [135205]

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Hilary Benn: According to the Malian National Campaign Against Tuberculosis, the number of reported tuberculosis cases in Mali has risen from 1,886 cases per year in 1995 to 2,757 in 2002. This is partly due to the prevalence of the disease among HIV/AIDS sufferers. The Malian Government have recently launched a fresh initiative to persuade tuberculosis patients to come forward for treatment.

DFID does not have a direct development assistance programme to Mali. Our assistance is mostly channelled through multilateral agencies, including the EC, and amounted to an estimated £12 million in 2001. However, DFID is playing a major role in supporting tuberculosis control worldwide. We support tuberculosis research programmes at the London and Liverpool Schools of Tropical Medicine, as well as providing significant contributions to the Medical Research Council and the World Health Organisation to tackle tuberculosis and other diseases. We have also committed US$280 million over seven years to the Global Fund to fight Aids, Tuberculosis and Malaria (GFATM). Decisions on which countries receive assistance are made on the basis of technical merit by the GFATM. Mali has not received support from GFATM for tuberculosis programmes, but will have another opportunity to apply in 2004.

Maternal Health

Angus Robertson: To ask the Secretary of State for International Development (1) what response his Department will make to the report on maternal mortality published on 20 October by the World Health Organisation, UNICEF and the UN Population Fund; and if he will make a statement; [134466]

(2) what assessment his Department has made of global trends in maternal health; what impact this assessment has made on his Department's funding policy; and if he will make a statement. [134467]

Hilary Benn: DFID works with international partners to monitor global trends in progress towards the Millennium Development Goal of improving maternal health and its associated target of reducing the maternal mortality ratio by 75 per cent. between 1990 and 2015. The report on maternal mortality in 2000 published on 20 October by the World Health Organisation, UNICEF, and the UN Population Fund estimates that there were 529,000 maternal deaths worldwide in 2000, with a maternal mortality ratio of 400 maternal deaths per 100,000 live births. The majority of the burden is borne in sub-Saharan Africa and South Asia.

The report is important in highlighting the magnitude of the problem. Inadequate information systems in many poor countries mean there is a high degree of uncertainty around the estimates and so they are less useful in assessing trends over time. A proxy indicator for monitoring trends is the proportion of births attended by a skilled health worker. Skilled attendant coverage in developing countries increased from 42 per cent. in 1990 to 52 per cent. in 2000 but there was substantial variation between regions. Coverage rose significantly in East and South East Asia and in Northern Africa. It is highest in Latin America, at 85 per cent. In contrast, there has been little progress in

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sub-Saharan Africa and South Asia, where women give birth without assistance from skilled attendants in more than half of cases.

Evidence from middle-income countries suggests that significant progress can be made through improved access to skilled attendance at birth, timely access to emergency obstetric care in the event of life-threatening complications, family planning services and action to address unsafe abortion. Strengthening the health system is central to an effective response. If poorer countries are to make similar progress, substantially increased action is needed.

DFID is focusing attention on this Millennium Development Goal. Our Public Service Agreement includes targets on skilled attendance in Africa and Asia. Our approach includes advocacy in the international arena, support to countries to strengthen health systems and maternal and reproductive health services, and support for research and improved measurement tools. Since 1997 we have committed approximately £1.5 billion to support countries to strengthen health systems. In addition we are supporting the maternal health work of international multilateral agencies and international NGOs.

Reconstruction Funding

Mrs. Spelman: To ask the Secretary of State for International Development what impact the additional funding for reconstruction of Iraq announced on 14 October will have on his Department's projects for middle income countries. [134486]

Hilary Benn [holding answer 27 October 2003]: Funding for the reconstruction of Iraq will not affect programmes for middle income countries in this financial year. However, in the light of the needs in Iraq and our commitment to increase the proportion of our direct assistance to low-income countries to 90 per cent. by 2005–06 we will make reductions beyond those currently planned, to other middle income country programmes over the next two years, particularly in 2005–06.

Final decisions have not yet been taken on where reallocation will occur, However, in order to protect funding for the poorest countries they are likely to involve reductions in planned spending of around £100 million for middle income countries, other than Iraq, over the two years 2004–06. This includes the reallocation of £50 million for Iraq. As a consequence of the temporary increase in funding for Iraq, which we expect to return to middle income status soon, we will also need to move a further estimated £50 million from planned middle income country programmes to low income country programmes. This in line with our commitment to the 90 per cent. target. The reallocations of planned expenditure should be viewed in the context of a development assistance budget that will increase by £900 million over the current spending review period 2003–06.

Safe Drinking Water

Mr. Robathan: To ask the Secretary of State for International Development what reports he has received on (a) the delivery of food aid to Zimbabwe to its

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final recipients and (b) allegations of its subsequent confiscation by local members of Zanu-PF; and if he will make a statement. [135206]

Hilary Benn: The WFP and the international NGOs all provide detailed reports on the distribution of their food aid. An incident reporting procedure has been established by WFP and if there is any politicisation of the food aid the distribution is halted immediately and is only resumed once problems have been rectified. There has been one isolated minor incident reported several months ago when food aid was confiscated by Zanu-PF officials. This was dealt with effectively by WFP and in recent months no such incidents have been reported

The grain marketing board handles the government's food relief programme and the distribution is largely controlled by Zanu-PF officials, with the army, police and other party officials getting preference.

Mr. Robathan: To ask the Secretary of State for International Development what assessment he has made of the World Food Programme's aid programme in Zimbabwe. [135207]

Hilary Benn: DFID staff based in Harare maintain very close contact with the world food programme and its operations in Zimbabwe. We are confident that they are implementing an effective programme under very difficult circumstances. The WFP undertake their own internal evaluations of their activities and we review the reports regularly.

We have recently provided a further £5 million to the WFP for its operations in Zimbabwe and of this £0.5 million will be used to further improve its monitoring and reporting capacity.

Mr. Paul Marsden: To ask the Secretary of State for International Development what proportion of the population of Zimbabwe has access to a plentiful supply of safe drinking water. [135257]

Hilary Benn: It is not possible to provide accurate figures as many services are declining as a result of the deteriorating economy.

According to the national environmental health office in the ministry of health and child welfare (MOHCW), access to safe water in urban areas is above 90 per cent. This figure will be an overestimate as a result of the rapid increase in urban migrations and the rapid increase of un-serviced informal settlements in semi-urban areas (especially Harare and Bulawayo). City councils are having difficulties in procuring water treatment chemicals due to lack of foreign exchange.

The rural proportion had an estimated 75 per cent. coverage but this will vary around the country. This will also be an over estimation because it does not take account of the distance people may have to travel to get to the water point or the large number of water points that are not operational.

Somalia

Angus Robertson: To ask the Secretary of State for International Development what assessment his Department has made of the security of deployed aid workers in (a) Somaliland and (b) other regions in

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Somalia; in what ways the security situation has changed since April; and if he will make a statement. [134755]

Hilary Benn: Since it declared independence from the southern Somalia, Somaliland has developed stability and greatly improved security. In December 2002 and April 2003, Somaliland organised successful municipal and presidential elections, which cemented its democratic credentials and helped to maintain security and stability. Unfortunately, in recent weeks there have been three murders of European expatriates in Somaliland including, on 20 October, the murder of two British schoolteachers in the town of Sheikh. There is no hard information on the motives for these killings and we await the outcome of on-going investigations by the Somaliland authorities. We and the rest of the international community continue to monitor the security situation in Somaliland closely, and we are reviewing our travel advice.

Elsewhere in Somalia the situation remains unsettled without any form of effective Government or early prospect of elections. IGAD-sponsored reconciliation talks in Kenya are being reassessed following last week's IGAD Summit and could make progress soon. The region is principally run by armed factions, and there is no guarantee of stability or security there. The UK currently advises against travel to Southern Somalia, where a Kenyan aid worker was recently murdered. UN agencies and international organisations still run humanitarian operations in the south. Somalia has been in a volatile situation since the onset of the civil war in the late 1980s and collapse of the government in 1991.

Although there have been a number of deaths of Europeans there has been no real change in the overall security situation since April 2003.

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