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Health Care (Africa)

Mrs. Curtis-Thomas: To ask the Secretary of State for International Development what measures have been taken towards his Department's target of 67 per cent. of births in Africa being assisted by skilled birth attendants by 2006. [57001]

Hilary Benn: DFID recognises the importance of skilled attendants at birth to prevent deaths and injury of mothers and children. The 2004 DFID strategy Reducing Maternal Deaths: Evidence and Action
 
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highlights that skilled attendants can only work effectively within a functioning health service with a proper network of services and referrals that is accessible to all women. Therefore, DFID's approach is to support country Governments in their efforts to develop their overall health services including access to skilled attendants for women giving birth.

The UK invests substantially in helping countries in sub-Saharan Africa develop their health services; for example, we support international groups such as the World Health Organisation (WHO) and United Nations Population Fund (UNFPA), provide direct support to country Government's overall and health budgets, and fund some targeted projects. We also fund a lot of operational research.

In addition to supporting Government health plans, DFID also invests in programmes tackling specific issues. The shortage of health care workers in many African countries is a barrier to improving access to skilled birth attendants. In Malawi, where the shortage is particularly severe, we are supporting the Government's ambitious plans to tackle the problem. DFID is providing £100 million to the Malawian health sector—£55 million of which is earmarked for the emergency human resources programme which aims to improve recruitment and retention of health workers.

DFID is committed to a year on year increase in spending on maternal health. DFID's bilateral expenditure (excluding spend through general poverty reduction budget support) on programmes marked as contributing towards improving maternal health has increased by 34 per cent. over the last three years (and by 41 per cent. if reproductive health services which contribute to reducing maternal mortality are included).

Mrs. Curtis-Thomas: To ask the Secretary of State for International Development what representations he has made to the governments of African countries on increasing the priority given to health care. [57002]

Hilary Benn: The average spend on health in many developing countries in Africa is well below the $35–40 per capita that the World Health Organisation (WHO) recommend is necessary for essential health services. That is why the UK Presidencies of the G8 and EU last year focused on increasing the amount of aid provided to support African plans for poverty reduction, including for improving health services. G8 countries committed to provide an additional $25 billion by 2010 and to support the removal of health user fees where countries wish to do so. African countries, for their part, committed to increase domestic resources channelled to development and develop long-term plans, including for health.

DFID helps countries to strengthen their health services both through financial assistance and discussions about budget support with partner governments covering the priorities given to health in budget allocation.

During my recent visits to Kenya, the Democratic Republic of Congo (DRC), Burundi, and Rwanda I discussed the importance of prioritising health care. Through visits to clinics in Kenya and Ethiopia earlier this year, I saw for myself how these governments are trying to tackle health care challenges.
 
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HIV/AIDS

Mrs. Curtis-Thomas: To ask the Secretary of State for International Development what assessment he has made of the effectiveness of his Department's work to reduce HIV/AIDS in (a) Sierra Leone, (b) the Mano River region and (c) the whole of Africa; and if he will make a statement. [57014]

Hilary Benn: HIV/AIDS is a serious problem and DFID is working hard with African country Governments and international agencies to tackle it. In 2004, Taking Action: The UK Government's Strategy for Tackling HIV and AIDS in the Developing World" was launched. An interim evaluation of implementation of the strategy is underway but results are not yet available. During 2006, reports will be produced, including a mapping of UK Government programmes on HIV and AIDS, a working paper on reaching women, children and vulnerable groups, and country case studies. This interim evaluation will provide preliminary indications of progress.

In Sierra Leone, DFID's focus is on improving governance and security, both of which impact on the causes and effects of HIV and AIDS. In addition, DFID helps organisations in Sierra Leone to raise awareness in young people about HIV and AIDS issues and improve access to condoms. Annual reviews show that knowledge of HIV and AIDS among young people is impressive.

In the broader Mano River region, DFID does not have full development programmes in either Guinea or Liberia, but does provide humanitarian assistance to both these countries. However, both countries have accessed funding through the Global Fund to fight AIDS, TB and Malaria (GFATM)—$9.6million to Guinea and $7.6 million to Liberia. DFID has committed £359 million until 2008 to GFATM and supports the secretariat in the development of performance measures to better demonstrate its results and improve its effectiveness.

DFID is continuing to support improvements to funding and international co-ordination of HIV and AIDS control. For example, we have doubled our financing to the Joint United Nations programme for HIV/AIDS (UNAIDS) to support progress on the Global Task Team and are co-chairing the Global Steering Committee on Scaling Up towards Universal Access which will be of benefit to all poor countries including those in West Africa. DFID has committed to spending £1.5 billion to support AIDS work between 2005 and 2008.

Iraq

Mr. Rob Wilson: To ask the Secretary of State for International Development whether the Department has incurred costs for employing private security companies in Iraq since April 2003. [56420]

Hilary Benn: From April 2003 to 28 June 2004, DFID employed two private security companies to provide security support for our programme in Iraq. The total cost to DFID was £5.6 million in 2003–04 and £2.7 million in 2004–05. Since 29 June 2004, the Foreign and Commonwealth Office (FCO) has managed life support provision centrally for all UK Departments
 
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working in Iraq. This life support includes security support contracts, as well as other costs such as vehicles, building work, food and accommodation for UK personnel. Each Department then reimburses the FCO for its share of the cost. DFID's share of these life support costs is estimated at £23 million in 2004–05 and £28 million in 2005–06. Without the close protection provided by private security companies, it would be impossible for DFID staff and contractors to carry out much of our work in Iraq; for example, visiting Ministries and projects outside the secure compounds in Baghdad and Basra.

Kenya

Mr. MacDougall: To ask the Secretary of State for International Development what measures are being taken to provide aid for the people in areas of Kenya affected by famine. [57737]

Hilary Benn [holding answer 10 March 2006]: Last week I increased our commitment by a further £15 million of humanitarian assistance as an emergency response to drought-hit parts of Kenya. This brings the total UK contribution to areas of Kenya affected by famine to £29.7 million since the start of the crisis in July 2004.

The funding is channelled mainly through the UN bodies, particularly the World Food Programme and UNICEF, as well as non-governmental organisations. Two thirds of these resources are for the targeting and distribution of food aid to those most in need, channelled through the UN.

DFID is also working with others to tackle the long term causes of chronic hunger and poverty in the region. We are in discussion with the Government of Kenya and with the UN on how to do this. Safety nets programmes for example, are being developed to deliver timely, adequate and predictable transfers of food or cash to those who were formerly dependent on food aid.

Lesotho

Ian Lucas: To ask the Secretary of State for International Development what recent assessment he has made of the availability of anti-retroviral drugs in Lesotho. [56237]

Hilary Benn: In the last quarter of 2005, DFID provided both financial and technical assistance to the National AIDS Secretariat to undertake a review of the HIV/AIDS response in Lesotho. That report is not yet public, but the information provided as follows is taken from it.

Anti-retroviral treatment (ART) started in Lesotho in 2002. There are now 15 sites across the country. The Government run 11 of those sites and the Christian Health Association of Lesotho (CHAL) manages four. By September 2005, there were 3,448 people receiving treatment. The private sector does provide treatment, but there is no reliable data available. There is similarly no data for the number of children receiving treatment.

Services are provided free through the public sector, though there is a charge of 10 Maluti (roughly equivalent to £1.00) for registration. There is significant demand for care and no apparent stigma or
 
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discrimination limiting uptake of services. Overall financing for the ART programme is relatively secure, primarily through resources provided by the Global Fund for AIDS, TB and Malaria.

Major challenges to increasing access to treatment include the generally weak health infrastructure (per capita public health expenditure is in the region of £16.00) and a shortage of skilled health personnel in key elements of the ART programme. The World Bank and Development Co-operation Ireland are working to address these issues through their support to the Department of Health.

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