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Health Investment

Mrs. Iris Robinson: To ask the Secretary of State for International Development what plans he has to encourage developing countries to invest in health through (a) building infrastructure and (b) providing training. [212223]

 
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Mr. Gareth Thomas: DFID recognises that there is a critical need to enhance capacity in developing countries to deliver high quality, essential health services to the poor and support countries in their attempts to reach the health related millennium development goals.

DFID's approach is to support countries themselves to develop comprehensive policies and strategies to build sustainable health systems, elements of which include a trained workforce and health infrastructure. Wherever possible, this will be within the context of a countries' own overall poverty reduction plans. Over the last five years, DFID has provided significant support for health services development, including £560 million in Africa alone. Of this, an estimated 5 per cent. to 20 per cent., depending on the country, is spent on developing the capacity of the workforce.

HIV Treatment

Mrs. Iris Robinson: To ask the Secretary of State for International Development (1) what steps he has taken to improve access to care and treatment for HIV sufferers outside the UK; [212220]

(2) if he will encourage G8 leaders to set a date and timetable for ensuring treatment for all HIV/AIDS sufferers. [212221]

Mr. Gareth Thomas: AIDS is a centrepiece of the British Government's agenda for the G8 presidency this year. By the end of 2005 DFID wants to have agreement among donors and the international system on a well co-ordinated and funded plan to tackle AIDS so that we can move forward on treatment, prevention, care for orphans as well as research into better treatments, vaccines and microbicides. DFID will also work to maintain momentum for HIV prevention and take forward efforts to bring together HIV prevention efforts with sexual and reproductive health services.

The UK supports efforts to provide increased, and eventually universal, access to treatment and care for people with AIDS. We support the WHO and UNAIDS '3 by 5' goal to provide anti-retroviral therapy to three million people in developing countries by the end of 2005, of which two million will be in Africa. DFID is advocating for equitable provision to women and children, and if appropriate, encourage a target of at least 50 per cent. of treatments being directed to women and children.

A recent report (January 26) of the progress of the WHO programme showed us that in the second half of 2004, the number of people on ARV therapy in developing and transitional countries increased dramatically from 440,000 to an estimated 720,000. This shows that progress can be achieved with an effective, coordinated, sustained country led HIV/AIDS response. However, ARV treatment is only one element of the treatment needs of HIV positive people in poor countries, many of whom do not have access to good nutrition, clean water, antibiotics or even testing so that they know that they are positive.

Mrs. Iris Robinson: To ask the Secretary of State for International Development what steps he has taken to minimise prices of medications for HIV/AIDS patients in the developing world. [212222]

 
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Mr. Gareth Thomas: One third of the world's population still lacks access to essential medicines. The UK Government are committed to increasing access to medicines in developing countries, including for the treatment of HIV and AIDS. There has been significant progress in this area. A combination of increased donor financing, competition from generic medicines, offers by research-based companies and improved health systems has led to a reduction in the price of first line antiretroviral medicines of as much as 98 per cent. over the last four years.

The UK Government have contributed to this reduction in prices in a number of ways. We worked with our international partners at the World Trade Organisation to reach the decision of 30 August 2003 allowing developing countries with no, or insufficient, manufacturing capacity in their pharmaceutical sector to import copies of patented medicines. These can be imported from countries such as India, following the issuing of a compulsory license in both the importing and exporting country. This important decision should help to increase the supply and availability of quality medicines.

DFID has significantly increased its funding for AIDS related programmes, including for treatment. The Department has committed to spend at least £1.5 billion on AIDS- related programmes over the next three years, and have doubled our funding to the Global Fund to fight AIDS, TB and Malaria. Increased donor financing to buy medicines has contributed to the reduction in prices by increasing demand.

DFID has also committed over £1.5 billion since 1997 to strengthen developing country health systems. This includes support to pharmaceutical procurement systems. Good quality systems can help to reduce prices. In addition, the UK supports the World Health Organisation's (WHO)'s work on 'pre-qualification' which increases access to quality, affordable medicines—both patent and generic—in developing countries.

The UK Government have also worked directly with stakeholders, including the pharmaceutical industry, to increase access to medicines. In 2001 the Prime Minister established a high level UK Working Group on Increasing Access to Essential Medicines in the Developing World". This reported in November 2002, recommending more support for research and development for diseases disproportionately affecting developing countries, and a global framework to facilitate voluntary, widespread, sustainable and predictable, differential pricing by pharmaceutical companies. This was followed in June 2004 by Increasing access to essential medicines in the developing world: UK Government policy and plans", which detailed how the UK Government are working in partnership with developing country governments, donors, international agencies, NGOs and the private sector to increase access to medicines.

DFID has been engaging with pharmaceutical companies to develop a framework encouraging 'good practice' in the pharmaceutical industry so as to increase access to medicines. This framework seeks to recognise the good work of the many companies in the industry, and to encourage pharmaceutical companies to go further by:
 
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Engaging in widespread differential pricing of medicines in developing countries.

Increasing research and development investment for diseases affecting developing countries, including through engagement in public-private partnerships.

Working to support broader health and development goals in developing countries, including by considering voluntary licenses, and

Reporting on activities designed to increase access to medicines.

HIV/AIDS (Children)

Mrs. Brooke: To ask the Secretary of State for International Development (1) how the expenditure on orphans and vulnerable children that is specified in the AIDS strategy will be recorded to ensure that it reaches those children; [211155]

(2) what indicators the UK Government are intending to use for monitoring expenditure of the £150 million allocated to meet the needs of orphans and children made vulnerable by HIV and AIDS. [211154]

Mr. Gareth Thomas: A new sector code Social Protection for Children" has been created in DFID's internal coding system. All expenditure which attracts this sector code and is also AIDS relevant (has an AIDS code) will be recorded as contributing to the £150 million on orphans and vulnerable children mentioned in the UK AIDS Strategy as activities are actually undertaken and paid for (not just as funds are committed). DFID might create other codes in the future if AIDS-related orphans and vulnerable children work is being undertaken which cannot be described as social protection".

Mrs. Brooke: To ask the Secretary of State for International Development what steps the UK Government are taking to ensure that orphans and children made vulnerable by HIV and AIDS are considered as a priority issue in the European Union's forthcoming revised Programme for Action on Poverty Diseases. [211156]

Mr. Gareth Thomas: Along with other member states, we are engaging in the consultation process towards a new Programme for Action on HIV/AIDS, malaria and tuberculosis which the EC expects to adopt in 2006. The current Programme for Action does not address orphans and vulnerable children and we will consider how best to address this gap in the forthcoming consultations. Discussions on the new EU development policy have only just started. The Commission has produced a 'Consultation on the future of EU Development Policy Issues Paper', which includes consideration of the broad themes of 'Development of human resources and citizens' rights' and 'Combating inequality and promoting social cohesion', both of which are likely to include consideration of orphans and vulnerable children. Consultations with members of the European Parliament and other member states will take place in due course.

Mrs. Brooke: To ask the Secretary of State for International Development what action the UK Government will be taking in 2005 to secure the commitment of other (a) G8 Governments and (b) EU member states (i) to endorse and (ii) to earmark resources
 
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for the implementation of the framework for the protection, care and support of orphans and vulnerable children living in a world with HIV/AIDS. [211157]

Mr. Gareth Thomas: DFID will use its Presidencies of the G8 and the EU to increase action on AIDS. This will include attention to the situation of children affected by the pandemic, the orphans and vulnerable children. Committing resources to implement the Framework for the protection, care and support of orphans and vulnerable children (OVCs) living in a world with HIV and AIDS", which is the global guidance developed by UNICEF and partners and widely endorsed by the international community, including DFID, is key. The framework is being translated into national OVC action plans—16 have been developed in Sub-Saharan Africa and more are being planned.

DFID has announced a commitment to spend at least £150 million over three years on OVCs (of which £44 million will go to UNICEF for the development and implementation of national OVC action plans). We will be encouraging other G8 and EU member states to increase their support to national programmes. The USA has, like us, already earmarked funding and endorsed the framework as have Germany and Denmark. Canada and France also see OVCs as a priority issue, yet others have not yet followed this line.

Along with other member states we are engaging in the consultation process towards a new Programme for Action on HIV/AIDS, malaria and tuberculosis which the EC expects to adopt in 2006. The current Programme for Action does not address orphans and vulnerable children and we will consider how best to address this gap in the forthcoming consultations. Discussions on the new EU Development Policy have only just started. The Commission has produced a 'Consultation on the future of EU Development Policy Issues Paper', which includes consideration of the broad themes of 'Development of human resources and citizens' rights' and 'Combating inequality and promoting social cohesion', both of which are likely to include consideration of orphans and vulnerable children. Consultations with members of the European Parliament and other member states will take place in due course.

Mrs. Brooke: To ask the Secretary of State for International Development what his Department's priority countries are in regard to orphans and other children made vulnerable by HIV and AIDS. [211165]

Hilary Benn: At the launch of Taking Action: The UK's strategy for tackling HIV and AIDS in the developing world", the Prime Minister announced that £150 million would be dedicated to helping orphans and other children made vulnerable by AIDS, especially in Africa.

Our priority countries are those countries where we have a Public Sector Agreement. In Africa these are Democratic Republic of Congo, Ethiopia, Ghana, Kenya, Lesotho, Malawi, Mozambique, Nigeria, Rwanda, Sierra Leone, South Africa, Sudan, Tanzania, Uganda, Zambia and, Zimbabwe.

DFID will be working in most of these countries in support of the development and implementation of national action plans for the protection, care and
 
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support of orphans and vulnerable children. In addition, we will be providing support to some of the worst affected countries in Southern Africa, such as Namibia and Swaziland through a regional programme of support implemented by UNICEF.

Mrs. Brooke: To ask the Secretary of State for International Development what his plans are for including Asian countries in future plans for orphans and vulnerable children. [211166]

Mr. Gareth Thomas: DFID is planning a programme of support to UNICEF in Asia to help prepare an improved regional analysis of the needs of orphans and vulnerable children, and to enhance advocacy by Asian groups involved in this work. This will include those affected by HIV and AIDS. The bilateral programme already provides some support in this area and there are plans to extend our support to orphans and vulnerable children through our country assistance programmes. For example in India, DFID supports targeted interventions for street children, who are particularly vulnerable. DFID also provide funds for the UNICEF/Government of India school AIDS education programme. In Cambodia DFID is supporting the review of the national HIV and AIDS plans, which is expected to strengthen action for orphans and vulnerable children.

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