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8.49 pm

Ms Sally Keeble (Northampton, North) (Lab): I am grateful to have secured this Adjournment debate about HIV/AIDS orphans and vulnerable children in sub-Saharan Africa. This has been an historic day in the middle of a remarkable week, and I am particularly pleased to be able to speak on an issue on which Labour has set the agenda not just for the country but for the world. It is this Labour Government who have led the world in tackling debt relief, global poverty, trade reform and HIV/AIDS and who have, more recently, been leading the debate on the future of Africa. Those are policies that have resonated around the country, with young and old, and around the world. They have been a hallmark of the values that we in the Labour party hold dear, and a shining beacon of Labour's achievements and of the kind of world that we want to create.

The group that I want to talk about, however, is one for which there is still a desperate need for support. We will all have our images and memories from the past four years of this Parliament. Certainly for me, the saddest ones were of the HIV/AIDS orphans whom I saw and met in sub-Saharan Africa. A whole generation of children are growing up without parents and, so often, without hope. On a personal level, I found that to hold one of these little children, so very fragile that the wind could blow them away, was one of the saddest experiences of my whole life. To see them growing up alone in their huts in the African countryside or on the streets of African cities, children who have literally been abandoned to fend as best they can in a harsh, cruel world, is tragic. There is a whole generation of these children: some 12 million now, some 25 million by 2010. Whatever happens to HIV and AIDS—and there are signs that in some places infection rates may, thankfully, be slowing down—the number of orphans will rise inexorably.

One person described that generation to me as the brick wall that Africa is heading for, and quite apart from the human tragedy, these children are also a massive social and development challenge. They will grow up mostly without health, without schooling, without social skills, often with illness and with high levels of crime and delinquency. My hon. Friend the Minister knows the statistics; they are horrendous, so I will not recite them.

This evening I want to press my hon. Friend on what the Government are doing about the orphans and vulnerable children within their overall HIV/AIDS strategy and to press for funding for community-based services. I am grateful to a number of agencies for their help, support, advice and, indeed, inspiration over the past 18 months. One is World Vision, whose work for HIV/AIDS orphans I have seen in Lesotho, South Africa and Ethiopia. Another is UNICEF, which arranged for me to see HIV/AIDS orphans work in Mozambique, and has provided advice and support. Another is NCH, which has provided advice on child care policies; often HIV/AIDS work focuses on health care, whereas work with orphans and vulnerable
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children needs to be guided by sound child care policies. SABMiller has also provided valuable insights from its experience in sub-Saharan Africa.

Most of all, I want to pay tribute to the community-based organisations that do such remarkable work in the most difficult circumstances to look after these children. The Kenyan Network of Women Against Aids, which cares for some 1,300 children in Nairobi, provides food for children five days a week—including teenage girls, to keep them from prostituting themselves just for the price of a meal. It provides meals during the week, but at weekends it cannot, so the children do not eat at weekends. Yet that organisation, which advises the Kenyan Government, receives international delegations and has, I believe, organised events for the UK Government, does not have secure funding. Children in my constituency twinned with KENWA—the Kenya Network of Women with Aids/HIV—and sent the orphans gifts last Christmas, which was a most heart-warming experience.

There is also Kuvumbane in Mozambique, which supports 900 women with HIV/AIDS and about 2,000 orphans. It is based in Xai-Xai, the capital of the province of Gaza, just three hours' drive on a tarred road north of Maputu, so it is not a remote project, yet it has no regular funding. It has occasional supplies of food from the World Food Programme and teams of volunteers, most of them completely unpaid, to provide community-based care, but with no equipment at all.

I went out with that organisation recently and saw a family of orphan children living in a hut on their own. The thatched roof had been damaged, so the rain came in and the younger children had coughs and colds. They also had fungal disease on their heads. The youngest was only a year old when his mother died a year ago, and we can only imagine what his prospects are. I met another family of five children whose father had died a couple of years ago. When I arrived, their mother was lying down, desperately ill with AIDS. She managed to stand up and speak briefly and we could but wonder at the horror for those children of watching their surviving parent die.

I shall remember for a long time the plight of another young woman. She was not a child, but she was very young to be dying such a horrible death. Her parents had died. Her aunt had died. She had no siblings and her own baby died at a year old. When I arrived, she was lying on the floor of her hut moaning. She could not drink and was in complete agony. A volunteer was with her, the only person to be there at her death; but there were no painkillers to ease her suffering and give her more dignity in dying—no mattress, no pillow. Nothing. The lack of resources for community care is horrific.

There are several projects in Zimbabwe, in Harare and Bulawayo, which probably do not want to be identified, but where people have thought through with the greatest attention sophisticated strategies for child care. They shelter children from abuse by the police and take them off the streets. They help them with memory books so that they can come to terms with the loss of their parents. Most of all, they feed children—not enough to satisfy them, but it keeps them from starving.

People who undertake such work have commitment and are enormously dedicated, with the insight and thought to care for children, but they completely lack
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the resources to put care services in place. I know that my hon. Friend the Minister can point to the policies of the Government, their support for the UNICEF framework and the money to implement policies. It is true that the UK Government have led the way in combating HIV/AIDS with financial resources, support for the use of anti-retrovirals, the allocation of funds for orphans and in pressing for a more co-ordinated approach to the UNICEF framework, but there is an issue about delivery. The best intentions in the world will fail if they are not efficiently implemented and monitored, and there are some difficulties with that.

Of the £150 million that the Department for International Development has set aside for HIV/AIDS orphans and vulnerable children, £85 million is being spent through the Department's African country programmes. Some of the money is going into budget support for Governments to advance their national orphans and vulnerable children plans. Having spent some time looking at the work in six of the sub-Saharan countries most affected by HIV/AIDS, it is not at all clear, with the exception of South Africa, that there is any capacity to deliver programmes. There are not even departments to run them. Even if there are central Government departments, there are no regional or local structures so that policies and resources can cascade down.

To say that is not to belittle those countries. Complex services are needed and they are difficult to deliver. After all, only under the Labour Government have we had a Minister for children and co-ordinated children's services across Government. In Kenya, the department with lead responsibility for children is the equivalent of our Department for Culture, Media and Sport, and children's services are very much a junior partner. In Lesotho, the First Lady has responsibility for such services. I had long discussions with her. She is an inspiring woman with a deep commitment and a profound understanding of what is needed to bring about change in her country, but she is not actually in government and has no departmental resources. The situation in Zimbabwe is desperate; for example, in Bulawayo, the second city, there are fewer social workers than there are Zimbabwean social workers in the social services department of one outer London hospital.

If the money is to deliver services, there must be some clear accounting for how it is spent. Providing a form of words to fit the policy requirement simply will not deliver the services on the ground that children need. Perhaps what is needed is a kind of barium meal for the international community's financial systems, which would trace the money that goes from the British taxpayer to the delivery of services for the orphans and vulnerable children in sub-Saharan Africa.

As my hon. Friend the Minister knows, I have put a proposal to him for a funding stream structure that could provide financial support directly to the community-based services concerned. In practical terms, that would provide support where it is most needed: at the community level where the caring takes place—food for the feeding schemes, hygiene items for the home-visiting schemes, school fees or, where school is free, money for school books and uniforms, and money to re-thatch hut roofs. The organisations that carry out those activities operate well below the radar of
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national and international Government agencies, but they are able to provide the small-scale interventions that make all the difference to enable children to have some reasonable prospect for the future.

Such a proposal would also have two other important functions—first, to develop and systematise community care programmes. That is desperately important. It is better understood in the communities that I visited in Africa than it has ever been in the UK that children belong in their own homes, not in residential institutions. What is needed to keep them in their own homes is, as I said, a complex network of small-scale interventions.

Such interventions include, for example, help with getting birth certificates, so that children can get Government grants for free schooling, which is the kind of thing that I saw the volunteers of Kuvumbane do for the children in Mozambique; protection of their property rights, so that they can keep ownership of their parents' homes, which is often the first step to being able to provide them with a secure life after their parents have died; help with food and clothing; and home visiting by an adult. Home visiting also includes providing the help, psychological support and counselling that children need when they are grieving the loss of their parents. That is something that we do not often think about, because we so often think about how to feed children who are hungry, rather than how to comfort them when they are mourning. Those are very hard services to develop and deliver, and they may have to be provided from the base up, rather from central Government down.

The other big purpose that such a funding stream would achieve is to support African civil society. In a number of cases, the organisations that I have visited group together into some kind of network, but they very much lack the resources to develop and to extend their work and impact through their countries.

The amounts of money needed for such activity are quite small, and I fully recognise that it is impossible for the UK Government to provide individual grants at such a small scale and localised level. Arguably, the level is too small even for the country Governments. It is the kind of function that, in this country, local government would undertake, and could be managed by a group of organisations—indeed, some organisations have expressed an interest in doing so.

Half of everything that we know, we learn in the first five years. We in this country recognise, in providing services for our own children, that those early years are when we must put in the investment if we are to influence the adults of the future and the shape of society in future.

The wheels of the international community may be grinding on this issue, but they grind extremely slowly. Those children cannot wait for the money that has been earmarked for them to trickle down. I press my hon. Friend the Minister to give a commitment on this, and he can do so in the certain knowledge that after the election, a Labour Government will continue to transform not just this country, but the wider world and lead the international community in development policy, as they have done in the past eight years, thus ensuring that the otherwise lost generation of HIV/AIDS orphans and vulnerable children will inherit a very different world.
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9.4 pm

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