Examination of Witnesses (Questions 18-19)
MR GARETH
THOMAS MP, MR
ANDREW ROGERSON
AND MS
ROBIN GORNA
16 NOVEMBER 2006
Q18 Chairman: Minister, thank you very
much for coming in. I apologise for the change in plan. As you
know, we have re-scheduled this particular session a couple of
times and this is not the easiest week to co-ordinate everything,
but it does not in any way detract from the fact that we think
it is extremely important that we have an annual review of how
we are doing as a country in delivering the ambitious targets
on ultimately the fight against HIV/AIDS. I should at this point
record that the former member of this Committee Jeremy Hunt's
contribution to focusing on the need to have annual targets and
this annual review that we are having is part of that process,
and that is one of the issues we want to discuss with you, although
the evidence we have just had demonstrates that targets, as we
all know, are one thing but finding the policies that will deliver
those targets, particularly when working in a whole variety of
different countries, is something else. Having read your submission,
it gives a lot of detail about the very good work that the Department
is doing on a whole variety of programmes in a whole variety of
countries but it still does not have any indication of what your
benchmarks are and what your targets are other than in funding.
You are quantitatively saying that you are putting all this extra
money in but you are not actually saying, although I can read
that there are an awful lot of good initiatives, how you are setting
your agenda. Are you going to be doing that, and perhaps, because
I have been discourteous, you should introduce your team before
you answer the question so that we have that formally on the record?
Mr Thomas: Mr Bruce, I wonder
if, as well as introducing the two officials with me, I could
just say a very short word by way of introduction. You asked me
to introduce my officials. Andrew Rogerson is the Head of our
Human Development Group within the Department, and Robin Gorna,
within that group, heads our AIDS team. Just by way of a short
introduction, and perhaps with Jeremy Hunt's memory in mind, let
me say that I think the single most significant event in the fight
against AIDS over the last 18 months has been the agreement that
was first initiated at Gleneagles and then was taken forward by
the UN, particularly the UN General Assembly in June this year,
to draw up plans for as near as possible universal access to treatment,
prevention and care. I understand through UNAIDS that over 80
countries have set some targets so far, that over 40 of those
have a series of targets in key areas and that 20 of those countries
are at the moment moving forward with costing their plans. Work
on those plans is continuing, in particular to ensure that the
needs of marginalised groups, such as men who have sex with men,
injecting drug users, sex workers, are properly recognised. Among
the key challenges over the coming 12 to 18 months will be to
continue to put in place the finance so that these plans can be
implemented, and, secondly, crucially, I think, to strengthen
the technical assistance, particularly through the UN, to ensure
that these plans are delivered effectively. In terms of answering
your question: should we put in place our own separate targets
for how our aid money delivers results on AIDS, I do believe that
we should be able to understand the results that our money is
achieving, but I think the targets for the response to AIDS must
be country owned and they must be put in place by the country.
Ideally they should be targets which the whole of the donor community
in a particular country endorse, whether they are interim targets
or whether they are the ultimate targets. I think we can show
how our programmes have made a difference, and I am happy to go
into some detail for the Committee if you would like, but our
approach is not to have separate targets ourselves but to come
in behind the targets that countries themselves set. I recognise
that is different, for example, from the approach that the American
PEPFAR Initiative takes, but I do believe that our approach is
appropriate.
Q19 Chairman: Thanks for explaining
that and I think that is a perfectly reasonable position. The
only comment is that, reading the submission, which, as I say,
does summarise a lot of clearly very good, very appropriate and
very leading initiatives that DFID is taking; I would not want
to detract from that at all, but it still raises the question
that the only quantitative information is how much money has gone
in, and even if it were not so rigid as a target some kind of
evaluation of the effect of DFID's involvement towards the wider
targets would seem to me to be worthwhile in terms of even engaging
the public, saying, "What is the British Government's contribution
to achieving the international targets?". Is that something
you feel you could consider?
Mr Thomas: I think it is perfectly
reasonable that the Committee and the public at large should want
to have confidence that our aid money is delivering results. We
will be completing an evaluation of our AIDS strategy; we are
working through that at the moment, which I hope will give a collective
sense of how our money is making a difference. We also have the
opportunity through, for example, our country systems plan process,
to look at a whole series of our interventions in particular countries,
including interventions to tackle AIDS, but again let me say that
we can demonstrate where we have had an impact and we have also
examples where we have set targets and where we are making progress
on those targets. The crucial thing about those targets is that
they are country owned. One example which I think the Committee
will be familiar with is Malawi, where we have put £100 million
by way of investment into the health sector, which obviously will
help in the fight against AIDS, and the approach over the next
five or six years is to see a doubling in the number of nurses
and a trebling in the number of doctors. We are increasing the
pay of nurses by some 50% to help achieve that, and since April
this year, and it is too early to make general conclusions, I
understand that some 700 nurses who had formerly left the health
sector in Malawi have returned. That I think is an example of
results. Obviously, it is not AIDS specific, but increasing the
number of health workers is crucial to improving the response
to the fight against AIDS in Malawi and indeed elsewhere.
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