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Mr. Julian Brazier (Canterbury) (Con): After a number of excellent debates on this subject in Westminster Hall, it is absolutely right that it has been brought to the Chamber. I am delighted to welcome it. It is a sobering thought that, night after night, we see the most harrowing pictures of what is going on in the Darfur region of Sudan, on which I had a meeting just this morning, yet the total death toll so far in that region, with all the horror involved, would amount to only a few months of the grim toll being exacted by AIDS around the world.

We have had an excellent debate, starting with a speech by the Secretary of State, who set out clearly the Government's programme, which to a large extent commands support in all parts of House.

My hon. Friend the Member for Rutland and Melton (Mr. Duncan) made an outstanding speech, striking a note that echoed around the House—a note described in flattering terms by the hon. Member for Carshalton and Wallington (Tom Brake), who also made a thoughtful speech. Of course, we all expected my hon. Friend not to be controversial.

This is indeed a grave subject. The hon. Member for Walthamstow (Mr. Gerrard) rightly pointed out that in five or six years twice as many people in the world might be infected. I did not agree with him about screening—I think that we should consider it seriously to protect our own population—but that does not for a moment absolve us from our duty to help other countries, and I am proud that we are the second biggest donor.

Listening to the hon. Member for Northampton, North (Ms Keeble), I thought of Stalin's cynical observation that one person dead was a tragedy and a million deaths were a statistic. In the individual cases she described, she clearly demonstrated just how much misery, throughout country after country, this ghastly pandemic is bringing.

My hon. Friend the Member for Banbury (Tony Baldry), Chairman of the Select Committee on International Development, made a number of important points. Perhaps the most important involved the Prime Minister, who has said that he will move this issue up the agenda at the G8 meeting. It would be interesting to know what he will press the G8 to announce as benchmarks for dealing with this ghastly problem.

I join a long list of people in praising the hon. Member for City of York (Hugh Bayley) and his all-party group for their work. Because he has raised the point before, the Minister should tell us what pressure we can put on the European Union to tackle the huge sums that are tied up in dormant projects. Let us invest them in AIDS projects, and other good causes. We should not leave them sitting there doing nothing.

My hon. Friend the Member for East Devon (Mr. Swire) described himself as hesitant, but I heard no hesitation. He gave us plenty of food for thought. He referred to trafficking in prostitutes, particularly minors. We had a good debate on that in Westminster Hall yesterday. It requires more action, not just from our Government but from the west as a whole.
 
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AIDS is a silent enemy, still often hiding behind the wall of stigma and discrimination—even, to some extent, in this country. Although drug treatments and public education have curbed its spread in most parts of the developed world, that is certainly not the case in nearly all third world countries. In Africa alone, 25 million people are living with HIV. There are 12 million AIDS orphans, who have been referred to again and again. The disease is spreading fast in other parts of the third world, particularly in Asia and especially in the Indian sub-continent.

This is a disease that hits hardest where there is widespread poverty and inadequate health care, where many people go hungry and malnourished, where men leave their rural homes and travel to cities to find work, and where girls and women are ignored when they refuse to have unprotected sex. To be blunt, one of the saddest aspects of AIDS is that it spreads fastest in countries where rape is common, as it is in a number of African countries.

As a number of speakers pointed out, AIDS is not just a health issue. It affects individuals. It is a disease that shatters families, communities and whole countries. Beyond the huge personal cost of losing a loved one, there is the economic loss to the country—and, of course, the even greater economic loss to the family. In some countries, AIDS is wiping out whole sections of the work force—teachers, farmers, health workers, civil servants and young professionals.

We have heard a lot today about the deaths of teachers. To give a different statistic, according to the United Nations, in Swaziland, school enrolment has dropped by more than a third because young girls and, to some extent, young men too have been taken out of classrooms to act as carers.

I make no apologies for returning to the subject of Uganda, the most successful example of all: it has achieved an 80 per cent. reduction in the rate of new infection. I was puzzled by the remarks of the hon. Member for Walthamstow on that matter. The fighting has not entirely stopped in Uganda. There is still a major civil war going on in the north. However, even if it had stopped, I do not understand his logic. The fact that fighting has stopped obviously makes it easier to tackle the problem. However, in most cases, other countries that did not have civil wars have not tackled the problem anything like as effectively.

Mr. Gerrard: I was not suggesting that Uganda had not been successful, because clearly the Ugandans have made a significant difference. The point that I was making is that there is surprisingly little hard, research-based evidence about why certain interventions work and others do not. Sometimes, we make assumptions about what has worked, rather than knowing why something worked. There is no doubt that, in many countries in Africa, civil war has been a factor in the spread of HIV. I know that there is still violence in Uganda, but it is not at the level that it was. I am sure that that has been a factor.

Mr. Brazier: The hon. Gentleman is right that where there is greater stability it is much easier to tackle the problem. The fact that the bulk of the country is now peaceful has made it possible to tackle it. I agree on a
 
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further point. It is difficult to build a picture of what works and what does not. I strongly suspect that what works best in one country and one culture is not necessarily what will work best elsewhere, but two points about the Ugandan position are important. The first, which has already been mentioned by several hon. Members, is the ABC programme, which is based on a balanced mixture: abstinence, being faithful to the partner and condoms. Interestingly, someone mentioned Botswana, where there is a small Government programme. There is quite a large private sector programme there organised by De Beers. The Ugandan ABC approach has been taken straight off the shelf and is being adopted.

Secondly, I want to come back to the intervention that I made on the Secretary of State. I understand what he means by the three "ones". He could pass that on to some of his colleagues in other Departments—charities are faced with lots of competing Government Departments giving them small sums of money with different strings attached. However, the point must not be carried through to the extent that one says, "It has all got to be organised by the Government."

Hilary Benn indicated dissent.

Mr. Brazier: I am delighted to see the Secretary of State shake his head. That clearly was not what he meant. One thing that clearly did work in Uganda was that an awful lot of different agencies all pulled together in the same direction. There was strong political leadership, but the Churches, NGOs, local government and the private sector—employers—were heavily involved.

So many things need to be done. We have covered a large number of them in the debate, but I will dwell on just a couple more; I do not want to detain the House much longer. There has been much reference to the importance of building the infrastructure necessary to administer medical care, focusing particularly on drugs. I particularly like the idea of the hon. Member for City of York of using distance learning through the Open university to rebuild nursing, teaching and training—all the different areas that are needed to rebuild infrastructure. The situation is so bad in some countries that we need a large-scale programme to turn it around. That is one method of getting what in the defence field is often called the multiplier effect.

Tom Brake: Does the hon. Gentleman agree that, by using distance learning, capacity will be built in developing countries, but the health workers will then come to the UK to work unless we deal with that problem?

Mr. Brazier: I thoroughly agree. The Government argue that some third-world countries are producing a surplus in certain categories, but it is absolutely monstrous that we are a net importer in categories such as nursing in particular—but also in medicine and teaching, among others—from countries that have
 
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critical shortages of such skilled professionals. However we choose to organise our public services, it should not be done at the expense of those countries.

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