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Bob Spink (Castle Point) (Con): I congratulate the Government on all that they are doing; they are certainly moving apace, as they should. However, will the Secretary of State pay tribute to the part that the private sector in this country plays? In particular, will he pay tribute to Merck Sharp and Dohme and the Gates Foundation, which have each pledged £33.3 million to the African comprehensive AIDS partnership? Merck is also providing free medicines in some cases.

Hilary Benn: I readily pay tribute to the work that a number of trusts, funds, voluntary organisations and, indeed, the pharmaceutical companies themselves are doing, including the work that has been done to reduce the price of anti-retrovirals—a point that I shall return to later. In this fight, we need all the help that we can get. I genuinely pay tribute to the contribution that the hon. Gentleman has described.

Money, however, is not the only answer, as I think everybody recognises. We also need stronger political leadership. I congratulate my hon. Friend the Member for Walthamstow (Mr. Gerrard) on his outstanding leadership of the all-party group on AIDS. I think that it is one of the world's foremost cross-party responses to the crisis. He, together with colleagues right across the House, has done outstanding work to make sure that we debate the issue and that the Government are kept to task in ensuring that we take the right steps to make a difference.

We need such global leadership, because as we move to 2005—the UK will have the presidencies of the G8 and the European Union—we need to encourage everyone, including other leaders and other countries. All the evidence shows that when there is strong political leadership, we can halt and reduce the spread of HIV.
 
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Let us take the example of Uganda, where there has been courageous political leadership. By that, I mean that it has been open and honest about the disease, how one gets it and what one can do to protect oneself. It has been fighting stigma and discrimination, and politicians and others, including community leaders, have been open and honest about the issue. All that work has helped to turn the tide of infection. Despite the fact that Uganda once had one of the world's highest infection rates, year on year the number of new infections continues to fall.

In Senegal, HIV never really took off. That was not good luck; once again, there was strong political commitment. People were brave and they spoke out. A free media provided information and a determined effort was seen to make things happen and to change people's behaviour. In Thailand, HIV raged at very high levels among the most stigmatised in society—sex workers and drug users—and then it turned around. There, the Government, working alongside others, helped to take the steps that were needed to save people's lives. They have succeeded in that country.

The truth is that we need a continued concerted effort on the part of the whole international community while recognising, however, that the people who face the biggest burden are the Governments and health ministries of the developing countries that are most severely afflicted by the AIDS crisis. To be honest, they are struggling with the task. It would be enough to make any Government struggle. However, we also have a practical as well as a moral responsibility to make sure that this increased international effort, the increasing resources that we are making available, and the desire to help are used in a way to help hard-pressed Ministers and officials in health Departments, doctors and others to deal with the disease.

In that context, I have talked about the successes in Uganda, but I also point out that, in 2003, 25 separate AIDS donor planning missions went to that country. The honest truth is that we can all turn up in succession, knock on the door and say, "We have come from the United Kingdom, you have a terrible AIDS crisis and we want to help. Here's our programme. Can we discuss how we are going to work together and how you will report to us on how you are using the money that we will make available?" That is very well meaning, but if there are another 24 people in the queue outside, we take up the time of Health Ministers and officials and that means that we are not pooling our resources, effort and desire to help in a way that will make the biggest difference.

For that reason, support for the three "ones" is important and that is why the UK Government have played their role in arguing that we should all sign up to them. The principles are very simple. They are not terribly profound but, boy, do we need them. They are that, in every country, we should have one plan for tackling AIDS; one body with responsibility for doing it; and one way of monitoring the progress that is being made. In other words, we should pool the effort, the energy, the money, the good will and support around one plan, one body and one way of reporting. When I was at the World Bank spring meeting in April this year, we organised an event to get major donors to sign up to these principles.

Mr. Julian Brazier (Canterbury) (Con): The Secretary of State is making a number of important points.
 
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However, in making the point about the three "ones", will he also acknowledge that part of the reason why Uganda was so successful was that the effort was not only politically led? Uganda brought in many other outside bodies—the Churches, communities, non-governmental organisations and so on.

Hilary Benn: Indeed, I acknowledge that. The hon. Gentleman is absolutely right. Leadership is required from everyone. When I used the phrase "political leadership", I did not mean just party political leadership or leadership from politicians. As the hon. Gentleman said, the role of NGOs, Churches and others is to provide leadership in this debate. Without that support, there would not have been the progress made in Uganda.

I was about to say that the principles are good, but the question is: how do we turn those principles into practice on the ground? If countries want donor funds to be provided through a pooled funding mechanism, we are happy to do that. We will ensure that, by replacing any lost funding, the measures do not reduce the resources that are available. We will also continue to work very closely with UNAIDS, the World Bank, the World Health Organisation, UNICEF, the UNFPA, the European Community and the global fund to ensure that all the countries that are affected by AIDS are able to tackle the crisis effectively and not just those where the UK happens to have a country programme. Of course, we do not have programmes everywhere, and the World Bank, the European Community and the global fund are major funders of AIDS programme and we support them, too, through our financial support.

The other truth is that success will depend on action by developing countries themselves. The first point to make is that prevention is the fundamental building block. If we can prevent people from becoming HIV positive in the first place and going on to develop AIDS, we deal with many of the problems with which we would otherwise have to cope. Therefore the UK's funding is used to support many innovative programmes throughout the world.

When I was in Nigeria in December last year, I went to the local market in Abuja and saw a creative performance taking place on the back of a converted lorry in the market square. It was funny, engaging and made the point about prevention and openness. Afterwards, the performers—we are supporting this project—went out into the crowd to distribute leaflets and answer questions. That is one small example of a practical approach to get information about the disease, how one gets it and what one can do to protect oneself out to people who need it in such a society.

In another practical contribution, we are helping to provide condoms in many countries. UNFPA says that, in 2003, the UK helped to pay for 490 million condoms around the world. We often work closely with other donors, especially the United States, to support innovative marketing campaigns to get male and, indeed, female condoms to those who are most at risk.

We also have to recognise that AIDS is far more than about just health. It affects education, social structures, cultures and economies. For example, girls who spend longer in school are less likely to get HIV. In Kenya, we support work in about 2,000 schools, and the first
 
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18 months have already resulted in significant changes such as the delayed onset of first sexual experience, less sexual activity and the increased use of condoms. We are now expanding the programme to reach 5,000 schools.

Malawi, like all countries, depends on education to teach the next generation and to build the skills that the country will need to sustain its economy. However—this is another of the statistics that makes one stop in one's tracks—teachers in Malawi are currently dying faster than they can be trained. In such circumstances, what prospects are there of getting all kids into primary school let alone dealing with the AIDS epidemic? Effective prevention and treatment are not just about saving lives; they are also about reducing poverty and helping economies to develop.

We need to be determined to ensure that treatments reach the poorest people, which is why we are trying to make sure that half of those who benefit are women and girls. Getting women on treatment is good not only for women themselves, but for society, because if mothers live longer, there will be fewer AIDS orphans and the figures will not turn out to be as bad as was feared.

That is a reason why we, with others, continue to invest heavily in supporting the establishment of health services. The UK has invested over £1.5 billion in that since 1997. We are working with communities and people with HIV to help them to play their role in treatment and care. One-a-day drugs have simpler treatment regimes than other therapies, so it is easier not to forget to take them. We need better ways of distributing drugs so that people may access them more easily. Despite the welcome fact that drug prices have come down, only about 440,000 people in developing countries were on anti-retroviral therapy in June, which shows how far we have yet to go to reach the World Health Organisation "3 by 5" target, so we must work harder. We must understand that even if the drugs were free and available in huge numbers, health services, with doctors and nurses, would be needed to administer, treat and care for patients, so we must work on both those fronts.

We must address stigma and discrimination because they often inhibit people from getting the care and treatment that they need. Women may be too frightened of being beaten or rejected by their husbands to get tested for HIV, even though that could help to save their lives or stop their children from becoming HIV-positive. Stigma and discrimination can literally kill, so promoting human rights and tackling the problem, while dealing with issues involving sexuality, represents an important aspect of what must be done.

Many people in developing countries are frankly too frightened of HIV to get tested or to access the prevention services that they need, which is why we are working with the most vulnerable groups in many countries as part of our programmes. For example, when I visited Yunnan province in China earlier this year, I saw a programme that we are supporting with drug users and sex workers. That is a leading province in China owing to the fact that the country needs to address the AIDS threat, so it was heartening to see what it was doing with strong leadership from the top.
 
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We must acknowledge the fact that there is no instant solution to the crisis. If we are to beat AIDS, long-term predictable funding and support are required, which is why as well as increasing our AIDS budget, the Chancellor has proposed the international finance facility as a way of raising additional finance more quickly, which could provide more support for the fight against HIV/AIDS. Predictability is important because ART cannot be turned on and off. Countries need to know that if they start the process—and individuals need to know that if they start taking the drugs—the treatment will be available in the long term because it does not work any other way. Encouraging and supporting developing countries to use the treatment and sustain it over the long term will be a big challenge. We must appreciate that such countries will face difficult choices about who gets the treatment.

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