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Approximately 13 per cent. of the South African population are at risk from endemic malaria, another6 per cent. face the risk of epidemic malaria. The provinces of Mpumulanga, Kwa Zulu-Natal and Limpopo suffer the greatest burden of the disease and it is in these provinces where DDT is used, after its reintroduction in 2001.
The decline in cases in the table starting in 2001 is noticeable, though there are no reports to substantiate the extent to which this effect was due to the re-introduction of DDT. Both the South African Department of Health and the World Health Organisation (WHO) propose that it is a cost-effective prevention strategy for the provinces which provides a prevention service for a population of some 4.2 million.
DDT use was originally stopped in South Africa because of concerns about its environmental impact. It was reintroduced after careful assessment to demonstrate its effective and safe use. The Stockholm Convention on Persistent Organic Pollutants states that countries should only use DDT for malaria control under guidance from WHO, which South Africa is doing.
DFID supports the WHO managed Southern Africa Malaria Control Programme, with a grant of£18 million over six years. The project will finish in 2007. WHO has been successful in working with Governments in the region to revise and update their policies concerning all aspects of malaria control, including the safe and effective use of DDT for indoor residual spraying. A significant amount of material can be accessed at http://www.malaria.org.zw/
WHO is also organising a conference in Brazzaville in June of this year to review experiences in the use of DDT in Africa. DFID has asked to be kept up to date with the lessons and recommendations from this meeting.
John Bercow: To ask the Secretary of State for International Development what assessment he has made of the recent report in The Lancet on the World Bank and malaria treatment. [69990]
Mr. Thomas: DFID has carefully reviewed the critical report published in The Lancet, as well as the World Bank's response in the same issue. As a member of the donor group for the Bank's malaria booster programme DFID will continue to hold the Bank accountable to its commitment to increase its financing to malaria control, and improve the effectiveness of this work.
In its Global Strategy and Booster Programme on malaria the World Bank recognises that from 2000 to 2005 its investments in malaria control were not sufficient for success on a large scale. DFID is encouraged that new agreements totalling US $62 million made under the Booster programme to DR Congo, Eritrea, Niger and Zambia do represent increased commitment and demonstrate demand from countries for Bank lending for malaria control.
DFID supports the World Bank's position that countries should be able to define their own drug policies based on local patterns of resistance, and with the support of the World Health Organisation (WHO), who provide updated technical information on the most appropriate strategies to control malaria. In large countries there may be cause for different policies in different parts of the country.
John Bercow: To ask the Secretary of State for International Development what recent discussions he has had with the World Bank on the use of chloroquine to treat malaria. [69991]
Mr. Thomas: As a member of the donor group for the World Bank's booster programme on malaria, DFID is in close contact with World Bank officials on progress in this programme, and issues such as the procurement of drugs that arise with the programme. DFID supports the World Bank's position that countries should be able to define their own drug policies based on local patterns of drug resistance, and with support and technical guidance from specialist agencies such as the World Health Organisation (WHO). In large countries there may be cause for different policies in different parts of the country.
DFID also looks to specialist agencies such as the World Health Organisation to provide international guidance on the choice of antimalarial drugs for malaria treatment programmes. WHO advises that chloroquine is still effective for certain strains of malaria, but when resistance develops artemisinin-based combination therapy (ACT) should be used, which is more effective and can delay the emergence of resistance.
Malnutrition (Millennium Goals)
John Bercow: To ask the Secretary of State for International Development what assessment he has made of the impact of malnutrition on the ability to meet the other Millennium Development Goals. [69963]
Mr. Thomas: As highlighted in the recent United Nations (UN) report, "Progress for Children: A Report Card on Nutrition", several key Millennium Development targets may be missed due to nutritional problems of children in developing countries. DFID shares the concerns of the report and is convinced of the critical importance of hunger and malnutrition to achieving, not only the Millennium Development Goal (MDG) for hunger (Goal 1), but also to achieving other MDGs.
Children who are malnourished in their early years never reach their full physical or mental potential, trapping them in poverty. They are less likely to attend school and, when they do, they perform poorly (Goal 2, Education). Women are often disproportionately affected by food shortages as in the family they often eat last and least. Educating girls and ensuring good nutrition empowers women and girls (Goal 3, Gender Equality). Child mortality (Goal 4) is dramatically affected by hunger, and malnutrition is implicated in two thirds of child deaths. A malnourished mother will give birth to a low weight child and is more likely to suffer complications during pregnancy and birth (Goal 5, Maternal Health). Finally, those who are malnourished are more susceptible to disease and are less likely to attend school and be able to afford medicine (Goal 6, Combating Disease).
DFID is working closely with the UN, other development partners and developing country governments to address the affects of malnutrition on the MDGs. DFID continues to respond to humanitarian needs and has committed £40 million to the immediate relief effort in the Horn of
Africa and £67 million to the southern Africa crisis. DFID is also putting in place social protection mechanisms or welfare transfers; cash, food or other forms of in-kind transfers. They provide predictable and long-term assistance for the chronically hungry to help people before a crisis develops. This includes a three-year commitment of£70 million to the Productive Safety Nets Programme which got under way in Ethiopia last year and is helping over 7.2 million people fight hunger and malnutrition.
John Bercow: To ask the Secretary of State for International Development when he expects the Millennium Development Goal for reducing rates of child malnutrition to be met. [69964]
Hilary Benn: There is no Millennium Development Goal (MDG) which specifically looks at child malnutrition. However, MDG 1 seeks to eradicate extreme poverty and hunger and MDG 4 seeks to reduce child mortality. An indicator associated with MDG 1 is to reduce the proportion of underweight children by half and under MDG 4 there is an indicator to reduce the mortality of under five-year-olds by two thirds.
DFID does not make assessments of when individual goals are likely to be reached. However, we draw on data from the United Nations (UN). For both the indicators mentioned, the UN's latest assessment is that across the developing world as a whole, progress is insufficient to meet the targets by 2015—and in fact both are described as 'lagging far behind'.
DFID measures its progress against a set of public service agreement (PSA) targets, which tie in to the MDGs. In our 2005-08 PSA, DFID has adopted targets for selected countries in Africa and Asia. We have targets to reduce under-five mortality rates for girls and boys by 24 per 1,000 live births in Asia and by eight per 1,000 live births in Africa.
Progress against the PSA targets is assessed twice-yearly in DFID's autumn performance reports and departmental reports. The most recent analysis of progress against the PSA targets was published in DFID's departmental report 2006. The target for Asia was judged off track as the number of live births per 1,000 has reduced only by four. It is too early too tell whether the target for Africa will be reached by 2008, though a reduction of four per 1,000 live births has been achieved to date. The departmental report also gives details of how DFID is seeking to improve off track targets.
The departmental report 2006 was laid before Parliament on 9 May 2006. It is available both in hard copy in the Library of the House of Commons and electronically on DFID's website (http://www.dfid.gov.uk/pubs/files/departmental-report/default.asp).
John Bercow: To ask the Secretary of State for International Development what assessment he has made of the recent UNICEF report on malnutrition in children; and what steps are being taken by his Department to improve malnutrition rates in developing countries. [69965]
Mr. Thomas: More than one quarter of all children under the age of five in developing countries are underweight. Poor nutrition contributes to half of the 11 million child deaths each year. Improving nutrition is essential in tackling poverty and is a critical factor in
achieving the Millennium Development Goals (MDGs). At international level the UK Government is one of the biggest donors to UNICEF. DFID has worked closely with UNICEF in the development of its health and nutrition strategy.
UNICEF's “Progress for Children: A Report Card on Nutrition”, states that achieving improved nutrition requires action across sectors. DFID's approach to nutrition at country level has always been that it cannot be dealt with in isolation. DFID's support for better nutrition therefore encompasses improved food security, support for agricultural production, fisheries and market access, better water and sanitation, education and strengthening health services for women and children.
Particular strategies are implemented in areas of high HIV prevalence, following natural disasters and during conflict. To be successful, programmes to improve nutritional status must be integrated into wider country led poverty reduction strategies.
State Failures
John Bercow: To ask the Secretary of State for International Development what steps are being taken by his Department to tackle the indicators of state fragility and failure in Africa identified in the Failed States Index 2006. [69967]
Hilary Benn: There is no international agreement on what constitutes state fragility. A common way of estimating fragility is derived from the World Bank's Country Policy and Institutional Assessments (CPIA). CPIA scores divide low-income countries into five categories of performance plus an unranked group. The lowest two categories plus the unranked group are used by DFID and other donors as a list of fragile countries. Our understanding of fragility set out in our January 2005 policy paper ‘Why we need to work more effectively in fragile states’ is therefore similar to that of the “Failed State Index” but not the same.
Our policy on fragile states sets out how we can most effectively tackle the challenges and the underlying causes of weakness. Our approach includes support to early warning systems, analysis to understand the underlying political drivers of fragility and the funding of interventions that are tailored to the specific needs of those states where we work. But aid alone is not enough, and we work with others to help ensure that the international system as a whole works together to reduce fragility and address its causes.
In Africa we are working in the Sudan, Democratic Republic of Congo, Zimbabwe, Somalia and Sierra Leone—all states identified by the “Failed States Index”. In each of these we have tailored our support to best tackle the fragility and support poverty reduction and growth.
A copy of the 2005 policy paper is available in the Library of the House.
Water Strategies
Mr. Drew: To ask the Secretary of State for International Development which countries the UK is helping to develop their water strategies. [69525]
Hilary Benn: DFID is committed to helping achieve the Millennium Development Goal (MDG) targets of halving the proportion of people without access to safe water and basic sanitation by 2015. Our programmes are focussed on sub-Saharan Africa and parts of Asia, where achieving the target will be most difficult.
DFID's Water and Sanitation strategy was set out in the 2004 Water Action Plan. This included commitment to doubling spending on water in Africa to £95 million by 2008.
We are currently actively involved in seven African countries (Ethiopia, DRC, Malawi, Mozambique, Rwanda, Tanzania and Zambia), and through our funding of other agencies' programmes, we reach many other countries. In Asia, we have significant bilateral programmes on water and sanitation in China, India and Bangladesh. Our large humanitarian programmes in Iraq, Sudan and Afghanistan, also include assistance on provision of water and sanitation. We also provide core funding to the Global Water Partnership which assists countries in developing Integrated Water Resource Management Plans.
DFID closely monitors progress in water and sanitation and publishes regular updates on the DFID website. The latest update will published this month.
Work and Pensions
Post Office Card Account
Nick Herbert: To ask the Secretary of State for Work and Pensions if he will make a statement on the progress of the pilot schemes for the migration of Post Office Card Account holders to banking facilities. [68272]
Mr. Plaskitt: We ran a number of small-scale pilots between 13 February and 10 March 2006. Now that they have concluded we are evaluating the results. We will share the results with the Post Office, and I will place a summary report of the findings in the Library.
Pathways to Work
Liz Blackman: To ask the Secretary of State for Work and Pensions what progress is being made in engaging the private and voluntary sector in the Pathways to Work service. [68273]
Mrs. McGuire: Private and voluntary sector providers already play a key role in delivering a number of important programmes within our successful Pathways to Work programme. Their innovative approach has been a significant factor in helping over 21,000 people into work.
We want to draw further on the expertise and skills of a wide variety of organisations to help us to support people on incapacity benefits in getting back to work.
That is why we are currently consulting with a range of providers and stakeholders about our Pathways proposals and will announce our plans for future roll-out shortly.
Mr. Jim Cunningham: To ask the Secretary of State for Work and Pensions what progress is being made in engaging the private and voluntary sector in the Pathways to Work service. [67335]
Mrs. McGuire [holding answer 3 May 2006]: Private and voluntary sector providers currently play a key role in delivering a number of important programmes within our Pathways to Work pilots—notably New Deal for Disabled People and many of the other programmes in the 'Choices' package.
Discussions are continuing on how we can further draw on the expertise and skills of a wide variety of organisations that can help us to get people off incapacity benefits and back into work. We are consulting with a range of providers and other stakeholders about our proposals and intend to announce our plans for future roll-out shortly.
Benefits
Justine Greening: To ask the Secretary of State for Work and Pensions how much was spent on (a) jobseeker's allowance, (b) income support and (c) incapacity benefit claims later determined to be fraudulent in London in each year since 1997, broken down by London borough; and if he will make a statement. [57206]
Mr. Plaskitt [holding answer 9 March 2006]: The information is not available.
Mrs. James: To ask the Secretary of State for Work and Pensions if he will make a statement on progress in reducing benefit fraud. [65080]
Mr. Plaskitt: In 2004-05 fraud across the benefit system was estimated to be less that 1 per cent. of total benefit expenditure at around £900 million; which is less than £1 billion for the first time since systematic measurement of fraud began.
We have firm targets to reduce fraud and error in the benefits which are most vulnerable to fraud. The target for reducing fraud and error in income support and jobseeker's allowance for working age people was33 per cent. by March 2004, and 50 per cent. by March 2006. National Statistics published in December 2005 show that by March 2005, we had reduced fraud and error in income support and jobseeker's allowance by 44 per cent. Looking at fraud alone, this has reduced by more than two thirds compared to the 1998 baseline figure of 10.4 per cent.
We have set a challenging target to reduce levels of housing benefit fraud and error for working age claimants by 25 per cent. by 2006, and to maintain the 25 per cent. reduction by March 2008 against the 2002-03 baseline year. National Statistics published in January 2006 shows that by March 2005, housing benefit fraud has fallen by around 30 per cent. over a two-year period. However, over the same period there has been a 40 per cent. increase in customer error. The net effect of this is that fraud and error for working age claimants is now reported to be 2 per cent. above the baseline.
We are also taking steps to reduce customer error. We have an on-going programme of addressing complexity in benefits to make benefit rules easier and simpler for our customers to understand. Our processes and customer handling methods aim to make the claim making process straightforward thus lessening the opportunities for customers to make mistakes or leave out important information.
This shows we are getting results in preventing, detecting and deterring fraud. We have achieved this by a variety of methods. In 2004-05, through improved data matching, nearly 300,000 data anomalies were identified. The Targeting Fraud campaign has helped to increase public awareness of the problem of fraud. We now have a more appropriate sanctions regime. In 2004-05, in partnership with local authorities, we imposed nearly 43,000 prosecutions and sanctions—more than ever before and a fourfold increase since 1998. We have tightened our procedures to root out identity fraud. People are now required to verify their identity before they are allocated a national insurance number or have access to the benefits system. We have maintained the National Benefit Fraud Hotline, and for every £1 spent on its running costs, we identify overpayments of over £9 in defrauded benefit.
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