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Ms Sally Keeble (Northampton, North) (Lab): Does my right hon. Friend agree that a problem is developing owing to the short-term use of anti-retrovirals? Sometimes the courses are stopped after six months, so can he tell us what is being done to deal with that problem?
Hilary Benn: That is the exact problem to which I am referring. There are worries about the development of resistance, so long-term sustainability is vital. Ministers and health officials in developing countries say that they need to know what they will receive in the long term so that they can plan ahead and thus avoid the problem that my hon. Friend raised.
Research can make a contribution towards tackling the epidemic. The UK Government were the first to fund the international AIDS vaccine initiative, which is an attempt to speed up the process of developing an AIDS vaccine. Of course, such a vaccine is the holy grail because we would be in a very different position if we had it. This year, we joined other G8 members in establishing the global HIV vaccine enterprise, which is another attempt to speed up the difficult process of finding a vaccine.
We also need to develop new HIV prevention technologies, and the UK is supporting microbicides research. That cutting edge hard science is an attempt to develop an effective microbicide—trials are currently taking place in Africa—that women will use. That would enable them to take decisions about their protection, given that it is sometimes difficult for them to get a partner to use a condom. That is one reason why microbicides are important, so we have invested £18 million in the research since 1999.
I say in all honesty that the world faces no bigger development challenge than beating the epidemic. If children's parents die of AIDS, their lives will be much harder than they would otherwise be. If teachers die of AIDS, we will not be able to educate all the kids whom we want to get into primary schools. If nurses and doctors die of AIDS, they will not be able to administer anti-retrovirals or distribute condoms to people in their communities. If workers die of AIDS, the prospects for economic development in many developing countries will be severely damaged. For every one of those reasons, in addition to the terrible human cost of the disease, we all have a practical and moral responsibility to do everything possible to beat the epidemic.
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Mr. Alan Duncan (Rutland and Melton) (Con): I thank the Secretary of State for his warm welcome to me in this job and his broad and informative review of the growing world crisis. There is little difference on both sides of the House about the problem. Indeed, it is a bit of a challenge to follow the Secretary of State without reiterating everything that he said over the past half hour, but I am nevertheless glad to have the opportunity to debate the matter because it is important to the well-being of the world. No one in the Chamber is in any doubt about the magnitude of the HIV/AIDS crisis and how vital tackling it is to our future and that of others. It is probably the most harrowing cause of misery and poverty in the world today.
The problem in Britain is bad enough because it is estimated that 50,000 people are living with HIV, which is the highest number ever. We are confident, however, that although the situation is appalling for sufferers, we can at least treat the problem because we are a rich country. For the world as a whole, and especially its poorer countries where the crisis is most acutely concentrated, the problem is far worse.
It is hard to comprehend the scale of the tragedy. I have written in my speech that 38 million people are now living with the disease, but I have to correct myself because the Secretary of State says that the figure is 58 million—I am sure that he is right. The suffering that comes with the disease is spreading and the virus is on the increase. Last year, nearly 5 million people became infected with HIV, and 2.9 million died from AIDS. The magnitude of those figures is of course appalling, but the situation is worse than that because the disease often strikes the most vigorous and youthful.
In sub-Saharan Africa alone, some 12 million children have lost one or both parents to AIDS and it is predicted that the number of AIDS orphans will rise to 25 million by 2010. The Secretary of State said that the figure is 18 million, but the scale of the problem is so massive that it almost does not matter how many millions we cite. We must remember that the sufferers live in countries with a national income per head that is typically a small fraction of ours. In the fight against the disease, AIDS to Africa is the equivalent of the Somme to this country in 1916, or even much worse.
As the Secretary of State said, the AIDS crisis is now evident in Asia. India ranks second only to South Africa on numbers of infections. It reaches that high number although only—one says "only"—about 0.9 per cent. of the adult population is HIV-positive, compared with more than 20 per cent. in South Africa.
However, if India's rate of infection were to rise to a mere—in comparative terms—5 per cent., not only would millions more Indians be condemned to death, but so could millions of their neighbours. India's population alone is far bigger than Africa's. If the disease were to spread to Bangladesh, Nepal and Pakistan, we would face a regional epidemic affecting more than a quarter of those alive in the world today. Surely that means—to be fair, I think the Secretary of State said this—that although Africa is the worst affected area at the moment, and thus the natural primary focus of our efforts, there is compelling evidence that future programmes must be designed to arrest a potential massive explosion of HIV/AIDS elsewhere as well.
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The figures are appalling and the agony that they represent is especially severe for the developing world: children without parents; parents without children; children unable to go to school because they are orphans; countries unable to create wealth because their work force is dying of AIDS. This is a crisis that the world must know about and we cannot ignore it. So we fully support the millennium development goal to begin to reverse the spread of HIV/AIDS. HIV/AIDS, poverty and the state of civil society are all linked. That goal must be central to any poverty reduction strategy and if, when we have the presidency of the EU and the G8, we make it a high, if not the top, priority, then all the better.
I certainly welcome the Department's HIV/AIDS strategy paper and congratulate the Secretary of State on his Department's work. However, a number of concerns arise from the National Audit Office report on the response by the Department for International Development, which I am sure the Minister will mention when he winds up the debate. The report says that there have been problems with sharing new knowledge on tackling HIV/AIDS with the Department's in-country teams. That is worrying, but I am sure the Minister will address it. The report also states that more guidance and advice on treatment could be given to country teams. That again is vital. There are also concerns about how well the Department measures its strategy's effectiveness. Those are serious issues and it will be interesting to hear the ministerial response.
I recognise DFID's substantial funding of £123 million to India's National AIDS Control Organisation, but that, too, received some criticism from the World Bank, which described the organisation as deficient in its handling of AIDS control schemes. That is a concern when so much money and so much else is involved. I hope, again, that Ministers will say how they think taxpayers' money is being diverted, or used, for that good cause. Of course, it highlights the significance of the debate, which will not go away, which is the relationship between the direct funding of Governments and the role of non-governmental organisations.
The crux of the matter globally is the balance between prevention and treatment. One prevention strategy, the prominence of which has risen, is the promotion of abstinence. It would be untrue to say that any promotion of abstinence is absolutely naive or misguided because it is not. After all, it forms a third of Uganda's successful ABC strategy—abstinence, be faithful, condoms—which is credited with the drop of infection rates from 30 per cent. to 6 per cent. over the past 12 or so years. However, we must be realistic about human nature. Most people are not born as natural monks or nuns and the promotion of abstinence will only ever go so far. Although we can try to change people's way of life by encouraging abstinence before marriage and faithfulness during marriage, people are bound to engage in sexual activity in more risky circumstances. So, above all, prevention must be about creating a culture of condom use.
In Britain, buying condoms is as normal as buying a pint of milk. I do not for a moment underestimate the challenge of spreading that safe sex culture, but it is the key to stopping the virus spreading, and I commend the Department for taking that approach. It is also why Thailand is praised as an exemplar in the fight against
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AIDS. The number of new infections in that country fell from a peak of 140,000 in 1991 to 21,000 in 2003 because of the Thai Government's persistent message on the vital need to use condoms.
So I hope that the Secretary of State, in his usual adept and diplomatic way, will continue to say to our friends in the American Administration and elsewhere that condoms are a top priority. After all, within the United States prevention of HIV/AIDS has been mainly tackled by encouraging safe sex, and what is right for the United States is also right for the developing world. Resources devoted to tackling HIV/AIDS are precious and we should recognise the American Government's generosity in giving $15 billion over five years towards that aim. However, it would be a terrible shame if some of that were not used as effectively as it might be.
Prevention is also, of course, cost effective, but there remains the question of the vehicle for changing cultures. NGOs have an invaluable role to play in that, and I wonder whether the Secretary of State thinks that the emphasis in direct budget support in recent years has, to some extent, been at the expense of the effectiveness of NGOs. As my hon. Friend the Member for Canterbury (Mr. Brazier) said in his question on Uganda, NGOs often have a reach that governmental organisations cannot match. In communities in which faith plays a major role, faith-based organisations, for instance, can tie in very effectively with the institutions of civil society to achieve changes in behaviour.
Before HIV/AIDS can be prevented, however, there must be popular recognition that the problem exists. That cannot be solely provided by the richer countries of the international community. Indeed, it would be quite wrong to do anything other than recognise that the willingness to tackle HIV/AIDS must come from within each country. That can never fully happen without political leadership from the top, as Kofi Annan has said.
Only if people are told the truth about HIV/AIDS and if the disease is, as the Secretary of State said, not stigmatised can we hope to defeat the epidemic. That is why Chief Buthelezi deserves the highest praise. His family has suffered horribly from the disease and it is real statesmanship to break the stigma and denial of AIDS in South Africa. I hope that the Government will draw President Mbeki's attention to what Chief Buthelezi has said. It really is extraordinary that the President of a country that has 5.3 million sufferers from HIV/AIDS could deny knowing anyone affected by the disease. South Africa is the regional leader and if the Secretary of State and the British Government are prepared to be frank with President Mbeki about the example he sets, the Secretary of State will have the full support of the Opposition.
It would be a terrible mistake, though, to think that an emphasis on prevention should mean that we regard treatment as a secondary issue. Although prevention and treatment may compete for funding, we must not see them as a matter of either/or. Treatment, after all, gives hope. It changes HIV/AIDS from a death sentence to a lifelong illness. That is what having the disease now means in America and Europe. It is quite simply the difference between life and death.
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A decade ago, treatment cost perhaps $10,000 a year; now it can cost as little as $200—still unaffordable for most in the developing world, but at least within reach if there is adequate budgetary support. Developed donor countries have an essential role in funding treatment, and we must remember that anti-retroviral drugs, like anything else, benefit from economies of scale. The more funding there is for them, the more affordable they will continue to become for the poorest people in the world. Perhaps the most striking and disturbing statistic of all those mentioned today is the fact that only between 400,000 and 500,000 people in the developing world are receiving the treatment from which others could benefit if there was wider access to those drugs.
We can also hope to see the spread of effective generic anti-retroviral drugs help to dispel belief in magical cures. For some people to preach that certain foods can address the problem is perhaps one of the most evil political deceits of the modern age. With real cures properly available, the word would soon get around that fantasy cures are just that.
I hope that the Secretary of State agrees that to ensure that resources are devoted to the development of affordable and effective anti-retroviral drugs, a generous proportion of the global health fund should be ring-fenced solely for the propagation of pharmaceutical research into such drugs. We shall reach the ultimate goal of a vaccine or a cure for AIDS only if we spend money on researching treatments.
AIDS can be tackled if there is a will. I do not doubt that that will permeates every shade of party allegiance or opinion in the House. The Department for International Development is doing its best. It is doing a good job, and I look forward to its doing an even better one.
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