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Tony Baldry (Banbury) (Con): As on so many international development issues, the House is broadly agreed on this topic. I would not gainsay or disagree with anything in the Secretary of State's comprehensive opening speech. I compliment my hon. Friend the Member for Rutland and Melton (Mr. Duncan) on his excellent debut at the Dispatch Box in his new role. Given that he was appointed to his brief only early this week, his grip on the detail of such a complex subject was impressive, and we look forward to hearing him frequently at the Dispatch Box.
I will try not to repeat anything that has been said before, but I shall begin by reinforcing what the Secretary of State said about the report produced by the all-party group for Africa, which is chaired by the hon. Member for City of York (Hugh Bayley). He is a colleague on the International Development Committee and his group has produced an exemplary report. The group received secretarial support from outside bodies, but its use of the expertise available in both Houses and of expert witness testimonies meant that it was able to produce a first-class report. It is a model for anyone interested in this matter, and I hope that people will take the time to read it.
As has been noted by both the Secretary of State and the hon. Member for Walthamstow (Mr. Gerrard), however, the problem of HIV/AIDS is not confined to Africa. There is a danger that people sometimes regard HIV/AIDS in the developing world as an African phenomenon, but the disease is growing in intensity in India, China, and in the former republics of the Soviet Union and central Asia. The hon. Gentleman said that some 70 million people may be infected in those countries alone.
One of the most pernicious aspects of the disease is that many people can be carriers for a very long time without knowing that they are infected. As a result, they do not appreciate that they are harming and affecting other people. We must therefore recognise that it threatens all the developing world and not just Africa—even though the situation there is clearly desperate.
No one would gainsay anything in the Government's call for action. I am very pleased that the Secretary of State's comments, and Government policy, acknowledge the need to focus on children orphaned by HIV/AIDS. The change in today's business did not allow time for the Select Committee's evidence on orphans and HIV/AIDS to be tagged on to this debate, but anyone interested in this matter should know that the Select Committee took oral and written evidence on orphans and children made vulnerable by AIDS. That evidence offers some compelling reading.
In its report, the all-party group stated that analysts were already talking about Africa's orphaned generation and that, at current rates of infection, that was unfortunately no exaggeration. It said that at the end of 2003, UNICEF had estimated that 11 million children under the age of 15 in sub-Saharan Africa had lost one or both parents to HIV/AIDS. The report said that, by 2010, there will be 42 million orphans in the region, of whom 20 million will have lost one or both parents to AIDS.
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The population of the UK around the end of the second world war must have been about 42 million. It is staggering to think that, in Africa by 2010, the equivalent of the UK's population in 1945 will be AIDS orphans. As many people have said, being a member of the International Development Committee is sometimes harrowing but it is also a privilege. When the Committee travelled to Africa to look at DFID projects, one of our collective concerns was whether sufficient attention was being paid to those orphans. At present, as the Secretary of State said, many are being cared for by grandparents whose own life expectancy is limited. Others are being cared for by NGOs, but care arrangements are often totally random.
Members of the Select Committee were worried whether there was sufficient registration that would ensure that orphans did not get lost in the system. It is vital that those children be registered at birth and have birth certificates; if they do not, they will very often lose out on the little support that is available.
I recall a harrowing cameo at a feeding station in Malawi. Mothers were queuing to get supplementary feeding rations, and a little girl of 12 came forward with a younger sibling of about six. Their parents had died but because the elder child was not a mother according to the technical definition of the feeding programme, and because no documentation was available, those two children were denied any supplementary food. In fact, they were probably two of the most deserving and needy people in the queue that day.
In his response to the Committee, the Secretary of State said about birth registration that
"the UK does not have an independent policy position on birth registration, but will continue to follow the UNICEF lead in this area. Birth registration is important . . . We recognise the need to advocate more strongly that governments do more to develop birth registration services. In the short run community identification is a pragmatic solution to the problem."
The Secretary of State also acknowledged that there had been a slow national response to children orphaned by AIDS in Africa, and it is an issue to which we will have to pay more attention.
Earlier this week, the Prime Minister made a speech on climate change in which he set some tough tests for how he will judge the success of the UK presidency of the G8. I would hope that the Prime Minister and the Secretary of State could set themselves some G8 benchmarks for international development, especially HIV/AIDS. I listened closely to the Secretary of State's speech, but the only possible benchmark I heard was when he talked of the need during the G8 presidency to try to ensure closer donor co-ordination. Of course that is vitally important, and with so many potential donors—state and NGOs—we cannot have them all knocking at the doors of underfunded ministries of health. However, it would be helpful to give a clear indication of what the Prime Minister hopes to achieve during the G8 presidency in relation to development and, especially, HIV/AIDS.
The Secretary of State mentioned health systems in countries such as Malawi. Those of us who have visited Malawi know that about a quarter of the education budget there now goes to pay for the funerals of teachers who have died. However, we must be careful when talking about the health systems of such countries, because we strip out so many trained nurses and doctors
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from them. Before the summer recess, Ministers in the Department of Health talked about reinforcing the NHS code on the recruitment of nurses from overseas. Early in September, the Minister of State issued a further statement. I have read the statement closely and the code still appears to be only voluntary. I am sure that the House will wish to return to the issue—perhaps in an Adjournment debate in the Chamber or in Westminster Hall—but I am far from convinced that we will avoid the danger of saying on the one hand that we need to do more for health services in countries in Africa and other developing countries and, on the other, continuing to strip out large numbers of nurses from them. One of the saddest scenes that I have seen recently was at the Lilongwe central hospital, which seemed to have almost no qualified medical staff. Prisoner patients with TB were shackled to their beds. A nurse training school cohort had just finished their training, but almost all of them were coming to the UK. Of course, we cannot prevent people with skills using them as best they can in the world markets, but we will have to consider the issue further.
My hon. Friend the Member for Rutland and Melton talked about condoms. There is a danger in HIV debates that we talk a lot about statistics and funds, but do not always address the two means of prevention—condoms and the search for a vaccine. I hope that perhaps one of the targets for the G8 presidency will be better international co-ordination, through the global health fund and other organisations, of the search for a vaccine. My hon. Friend the Member for Castle Point (Bob Spink) mentioned the work being done by Merck Sharp and Dohme and others, but however good that work is, it is still pitifully little.
A press release that Merck issued for the debate states that it has opened six major treatment centres since January 2002 in the worst affected regions of Botswana—one of the southern African countries with the best governance and best civil society—that 10,000 patients have been enrolled on the anti-retroviral treatment programme, and that 6,700 people have started therapy. Of course, that is worth while but the resource is tiny when compared with the overwhelming need. We all agree about the problem but much greater focus and energy need to be devoted to finding a vaccine for HIV.
I want to make a rather boring, machinery-of-government point, which the Secretary of State did not cover. I am not sure why the National Audit Office chose, out of all the Department's programmes, to have a go at its HIV/AIDS programme. In its criticisms of the role of specialist advisers in countries, the letters "HIV" could almost be replaced with "livelihoods", "health" or "gender". With the best will in the world, there must be an element of subjective value judgment about what specialist advisers in the Department's offices say. Not everything can be reduced to hard statistical outcomes—it is difficult to do that. At some stage—perhaps when the Select Committee next goes through the Department's corporate plan and annual review with the permanent secretary—we may need to consider why the Department believes that the NAO picked on that specific issue and what lessons need to be learned
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about value for money. It is clearly in all our interests to ensure that people outside do not say that money has been wasted.
We have all read articles in some newspapers that suggest that the HIV/AIDS threat is grossly exaggerated and that the estimates and predictions are wholly unrealistic. When the Under-Secretary winds up the debate, perhaps he could say why he believes that the NAO picked on that specific aspect of the Department's activities—it is one of the few times that the NAO has criticised it—and what the Department believes to be an appropriate response.
I hope that I have not repeated other hon. Members' remarks in the debate. It is good news that the Government have decided to discuss the issue on the Floor of the House; it demonstrates the importance with which we collectively view it.
4.13 pm
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