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The number of reactors identified by pre-movement and gamma interferon tests shows the worth of these tests, and we are grateful to the farming community for the commitment and responsibility that it has shown in relation to the TB testing programme. We have worked
hard with many stakeholders, including the Wildlife Trusts group, which the hon. Gentleman mentioned, to raise awareness about the simple biosecurity measures that can be employed to keep cattle and badgers apart.
The hon. Gentleman asked about compensation, particularly in relation to constituents who are organic farmers. There is extensive evidence of significant overvaluation under the previous scheme, which used individual valuations rather than the table valuations used today. The Government must be conscious of the need to protect the taxpayer as well as the farmer. The hon. Gentlemans party usually trumpets the protection of the taxpayer, so perhaps he should bear that in mind. We have not ruled out changing the current compensation system, but any changes would have to be justified and to take into account the needs and protection of all the parties concerned, and that will always include the taxpayer. We are confident that table valuations generally provide a fair balance between the costs that taxpayers and farmers are expected to carry. That is not a new idea; it is used in other parts of the world where TB affects cattle, and it has been used in Britain in the past.
The role that culling badgers could play in tackling TB has been a matter of continuous debate since the 1970s, and the issue is undoubtedly complex and controversial. The Independent Scientific Group on Cattle TB showed in its report, which took 10 years to complete, that there is a cycle of disease between cattle and badgers. It also concluded that culling badgers is unlikely to make a significant contribution to tackling the disease. Indeed, the study showed that there was a risk that it might make the situation worse. We must have regard to that report.
Mr. Gray: That was the reports conclusion, but it was drawn up within the constraints set by the Government and it involved a very small cull. How does the Minister explain the fact that the Governments chief scientific adviser, Sir David King, overturned that report and said that there was a place for culling badgers?
Joan Ruddock: I was about to say that we referred the matter to the Governments chief scientific adviser, who then expressed his view. I wanted to put it on the record that that work took 10 years to complete, and that we cannot simply set it aside. We have not yet made a decision on culling. We must make a sensible and informed decision, and it must be the right decision rather than the quick one that the hon. Gentleman would have me make.
We have the report of the Independent Scientific Group on Cattle TB following those 10 years of research, and we have the assessment of the evidence on badger culling provided by the former chief scientific adviser, Sir David King. As the hon. Member for Shrewsbury and Atcham said, we also have the report of the Environment, Food and Rural Affairs Committee following its inquiry on the issue. He
quoted the Select Committee, which did not make any outright damning criticism of the Government and their actions. It produced an extremely considered report and made many important points, some of which he referred to. He said that there is no simple solution and that a multifaceted approach must be adopted. That underpins what the Government are doing: the issue is multifaceted and we acknowledge that there is no simple solution. We are trying to work across several fronts to tackle this serious problem. That the Badger Trust and the National Farmers Union both applauded the report is probably unique in the experience of those who have dealt with this controversial topic, and he is right to point out the significance of that.
The report made recommendations on frequent testing, biosecurity, work on vaccines and the consideration of a limited cull. All those recommendations are either already being pursued by the Government or are under consideration. As the hon. Gentleman is undoubtedly aware, it is not appropriate for a Minister to respond to that report in this debate. There is a proper procedure to follow in which the Government consider in depth what the report says. We will make an appropriate written response in the allotted time.
Daniel Kawczynski: On culling, I appreciate that there will have to be a detailed analysis of the report before feedback is given, but can the Minister give us any idea of how long the process will take? She said that it will not take 10 years to decide whether a limited cull is appropriate, but can she give me any comfort by letting me know how long it is likely to take?
Joan Ruddock: I can only repeat that it will take as long as it takes to get the right decision. That is crucial, as the decision must be the right one. This is a matter of deep concern. Ministers appreciate the issues and the need for a decision. The decision will be taken, and the report will be responded to appropriately.
There will be three key aspects to the Secretary of States decision: what impact the proposed measure would have on the disease, what the science tells us and how practical the solution is. We must also consider public acceptability. We need to proceed carefully. We have already given some information in response to questions that have been asked. For example, we have been asked how culling would be carried out, if it were used. We have ruled out gassing and snaringit is important to put that on the record. Research on methods of culling will be published when the reports have been peer reviewed and when we have decided whether badger culling should take place.
The hon. Gentleman asked about the TB vaccine and whether its use should continue. I assure him that work on that continues, although unfortunately it is some years off it being a final solution. We think that an oral badger vaccine will be ready by 2014 and that an injectable badger vaccine will be ready by 2010, although we would not expect that to be widely used.
The best estimate for cattle vaccines is 2015. The test must allow differentiation of vaccinated cattle and those infected with disease.
Our ultimate aim has to be the eradication of bovine TB, but that cannot be a realistic short-term goal, given the incidence of the disease. Our first priority is therefore to focus on the GB strategic framework on TB to control the disease and prevent further spread. Once the disease is under controlthat must be our hope for the futurethe aim will become eradication. TB is a scourge; it has caused enormous hardship and places a huge financial burden on both the farming community and the taxpayer. We share the hon. Gentlemans desire to end the problem and to increase the comfort of his farming community.
Dr. Gavin Strang (Edinburgh, East) (Lab): I believe that hon. Members on both sides of the House will agree that the Government have a good record on promoting the interests of the developing world. Under the comprehensive spending review settlement published in October, the aid budget will have increased by more than three times in real terms between 1997 and 2010. In that time, the UK will have more than doubled the proportion of gross national income spent on overseas development assistance, and we are on track to meet the United Nations gold standard of 0.7 per cent. by 2013. Hon. Members will be aware that what I call the gold standard has existed for 30-odd years. When Labour was in power before, UK expenditure was lifted virtually right up to 0.7 per cent., but, of course, it fell and fell under the Conservatives. To our credit, we are raising it again to the 0.7 per cent. target, which the whole House should support.
However, all the evidence shows that the fight against HIV and AIDS is crucial to the prospects for any significant economic advance in the developing world. Unlike many of the diseases that claim lives in our country, AIDS is largely a young persons disease. That means that it has robbed developing countries of many of the people to whom we would normally look to contribute to the economy and to raise living standards. As the World Health Organisation pointed out in 1999, in the worst affected countries of southern Africa, the development gains of the past 50 years are being reversed by the epidemic. We will not see advancement of any significance in those countries until serious progress is made to end the AIDS epidemic in them.
The latest estimate by UNAIDS is that 33 million people now live with HIV, including 2.5 million children. Two and a half million people were newly infected last year, and 2.1 million people died, including 290,000 children. The developing world is hardest hit: 68 per cent. of the new infections and 76 per cent. of the deaths last year were in sub-Saharan Africa, where AIDS is the primary cause of death. Estimated HIV prevalence has more than doubled in eastern Europe and central Asia since 2001, and the declining trends in some countries such as Burundi are reversing.
In the past eight years, the international community has made a series of commitments to address HIV/AIDS. In September 2000, Heads of State and Government at the UN millennium summit issued the millennium declarationa powerful statement of pledges to address the major challenges facing humanity. Under its provisions, the international community is committed to halting and beginning to reverse the spread of HIV/AIDS by 2015.
Further progress was made in 2005, and the UK Government can take pride in the Gleneagles commitment by G8 Governments to ensuring universal access to treatment by 2010. Many hon. Members will remember the Gleneagles summit. I well remember the run-up to it, all the work that was done by non-governmental organisations to build it up, and the huge march and demonstration in Edinburghcolossal!as part of the build-up to what was achieved by our Government. A
climate was created at the summit for getting some real decisions on targets. That pledge was broadened at the UN world summit later that year and became an international commitment to ensure, as nearly as possible, universal access to prevention, treatment, care and support by 2010.
As the world has belatedly come round to the urgency of the HIV/AIDS crisis, there has been some progress on the ground. In 2001, the world spent just $1.6 billion on fighting AIDS. In 2007, total available resources reached $10 billion. The number of people in low and middle-income countries receiving antiretroviral treatment increased fivefold between 2003 and 2006, reaching 2 million by the end of that year. There has been a reduction in HIV-associated deaths, which is thought to be partly attributable to the recent improvement in access to treatment. In addition, preliminary data suggest that there has been a reduction in risky sexual behaviour in a number of countries including Cameroon, Haiti and Kenya.
As I have outlined, the international community has geared up its response to HIV/AIDS in terms of both political and financial commitment, but the global effort is still nowhere near the scale that is needed if we are to get to grips with the AIDS crisis. We are still falling far behind on treatment and prevention. Despite recent increases, the WHO estimated last April that only 28 per cent. of people needing antiretrovirals get them and only 11 per cent. of HIV-positive pregnant women in Africa are getting drugs to prevent transmission to their unborn children. My hon. Friend the Minister will be well aware of the efficacy of that treatment, which is available in hospitals.
The effort to increase access to treatment has not been matched in the field of prevention. Just one person in five has access to basic prevention services, and surveys indicate that just 12 per cent. of men and 10 per cent. of women in sub-Saharan Africa had been tested for HIV and received the results. Moreover, all those efforts continue to be hampered by stigma and discrimination.
Hilary Armstrong (North-West Durham) (Lab): I am concerned that one of the consequences of the way in which HIV/AIDS has spread, particularly in sub-Saharan Africa, is that 75 per cent. of the young people who live with the disease in that area are female. The effect of HIV/AIDS on women and girls is absolutely phenomenal. That is why I am proud to be associated with Voluntary Service Overseas and its campaign with ActionAid this year to highlight the effect of HIV/AIDS on women. It says to Governments that when they intervene, they need to support and empower women in communities, because those women will then be able to take steps to stop others getting HIV/AIDS. I say that because I know that many girls are, for example, frightened to ask partners to use condoms because of violence, rape and so on, and the whole situation is being made worse.
Dr. Strang: I am grateful for my right hon. Friends intervention. I shall touch on the gender issue, although not as much as I would like. I am grateful to her for raising that important issue. That is where we are: women and, of course, children are involved. I am pleased that she was able to put that point on the record.
It is clear that a far greater acceleration of financing is required. UNAIDS estimates that even last years resources were more than $8 billion short of what should have been spent if the world were on track to meet its commitments. Even if donor countries continue to increase spending at the current pace, the funding gap will widen, we will not achieve universal access by 2010, and our 2015 commitments will be jeopardised.
I am sure that the Minister will agree that we should not be starting from this point. Had the world responded to the emerging AIDS crisis on the scale required 20 years or so ago, the scale of todays problem and the cost of the necessary action to address it would be far smaller. We face the same choice today. For every patient who began antiretroviral therapy in 2006, six other individuals became infected with HIV. Failure to act on a proper scale now will mean still greater expense in the decades to come.
To meet the goal of universal access around the globe by 2010, UNAIDS estimates that we must spend some $92 billion over the next three years, more than quadrupling the annual funding available to more than $42 billion by 2010. Obviously, that makes assumptions about the build-up in inflation during the time needed to achieve that, but those are the sums.
My hon. Friend will be aware of the Stop AIDS Campaign, which brings together many of the United Kingdoms leading groups in this field. Stop AIDS has calculated the UKs fair share of that $92 billion, in line with our relative wealth and population. On that basis, it suggests that its fair share of the worlds HIV/AIDS expenditure is just over $5 billion, or £2.5 billion sterling, over the next three years. We should seek to achieve that target.
The establishment of the Global Fund to Fight AIDS, Tuberculosis and Malaria in 2001 was a landmark in the fight against HIV and AIDS. Resources available to the global fund are now considerably better. When I initiated a debate in November 2004, there was real concern that the fund could become an irrelevance. The eighth round of proposals, which was launched this month, is well financed compared to previous rounds, and the global fund already has $9.7 billion in pledges for the three years from 2008 to 2010. However, my hon. Friend will be aware that the fund needs between $6 billion and $8 billion every year to meet its objectives, and the UK Government back that figure, for which we are grateful. There is still a shortfall of between $5 billion and $8 billion for the 2008-10 period. I hope that the Government will continue to push for global fund resources to reach the levels that we need to see if the organisation is to fulfil its remit. We are all agreed on that. The global fund is working well and bringing in more resources, and we must do all that we can in terms of cash and by using the influence that my hon. Friend, my right hon. Friend the Secretary of State for International Development and others bring to bear, to make the global fund one of the great landmarks in the history of this century.
As I have mentioned, progress has been made in getting treatment to people who need it. A significant reason for that is the fall in the price of first-line drugs from around $10,000 per patient per year to $130. However, still more people are needing second and third-line therapies as their first-line treatments cease
to be effective. Patenting restrictions are tighter on these newer drugs. The WHO has found that the prices paid for such treatments are often unaffordably high in countries lacking generic alternatives. As my hon. Friends ministerial colleague, the Under-Secretary of State for International Development, my hon. Friend the hon. Member for Harrow, West (Mr. Thomas) advised last year, second-line treatments can cost as much as 10 times more than other treatments.
We know that the Government support the right of developing countries to use the flexibilities in respect of trade-related aspects of intellectual property rights to ensure affordable access to drugs, including the use of compulsory licensing provisions. In addition, they have expressed interest in patent pooling. I would be grateful if the Minister gave an indication of the progress that has been made. Clearly, we will be looking to the new strategy on HIV/AIDS to bring forward action to help developing countries to make affordable medicines available.
Of course, the affordability of drugs is only part of the picture. Efforts to secure universal access by 2010 can succeed only where there is a supporting infrastructure accessible to people in need. As my hon. Friend the Minister knows, average health spending in sub-Saharan Africa is just £5 per person per yearless than a third of the WHOs recommended minimum of £17.
As the Under-Secretary of State, my hon. Friend the Member for Harrow, West told the House, there is an estimated shortage of more than 4 million health care workers worldwide. Last May, Médecins Sans Frontières reported that the rate at which people could start treatment was slowing and treatment waiting lists were growing due to a shortage of health care workers in southern Africa. In this context, my hon. Friend who is responding to the debate may want to mention the UKs involvement in the new international health partnership, which aims to improve co-ordination among donors to deliver improved health systems. I know that he takes a considerable interest in that and recognises what a challenge it is for our Government and his Department.
In many countries, we look to the state to provide the necessary infrastructure, through state-run services such as health and education. However, we should not lose sight of the fact that it is not just the state that has an important role to play. The voluntary sector, including faith groups, does vital work. It is also in the interests of the private sector, such as mining companies in South Africa, to ensure that their work force, with their families, have access to the prevention and treatment services that they need. Every effort should be made to encourage those companiesand some of those big, major companies have British head officesto do all they can for their employees and their employees families, and for the wider population.
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