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My hon. Friend also mentioned the importance of cash transfers. Social protection programmes, including cash transfers, have been shown to be highly effective in reaching OVC and promoting their access to basic services. She also mentioned South Africa, where cash grants have resulted in an increase in height for children under three years, thereby indicating that the impact of AIDS can be mitigated.

My hon. Friend also mentioned baby milk and how we ensure that babies are fed correctly. It is important that we use this debate to highlight the fact that the WHO guidance promotes very strongly that, in such circumstances, breastfeeding exclusively for the first six months of life is the best way forward. I still think that we have a long way to go in explaining why that makes such a difference, particularly in these circumstances.

The hon. Member for Edinburgh, West (John Barrett) asked how we will monitor progress on delivering the strategy and using public resources. That point is very important given the current economic situation. There has never been a time when we have so needed to be able to demonstrate to the UK population the value for money that they are getting as a result of their taxes and the choices the Government have made to prioritise and focus on our responsibilities to the developing world. Therefore, he is right that we need to talk about impact and outcomes, and not just about interventions, resources and programmes.

In that specific context, we will publish biennial reports over the seven-year lifetime of the strategy, which will ensure transparency and accountability for its implementation. They will present and analyse data from a series of templates, and will focus primarily on efforts being made at country level, but they will also define our work globally. We are also in the process of commissioning inputs from all relevant parts of DFID and Whitehall so that we can produce the baseline report in line with our commitments. There is a very clear process.

Mr. Clifton-Brown: I raised the problem of the biennial reports. What if the strategy is not working? A report will be produced every other year, in which time an awful lot could go wrong. Is it not possible, with modern reporting mechanisms, to produce annual reports?

Mr. Lewis: I do not think that I will concede that point. Why? The hon. Gentleman is right that it is the responsibility of Ministers and senior officials to monitor the matter on an ongoing basis, not simply biennially. It is also more than legitimate for parliamentarians to ask questions or stimulate debates and to ask for more frequent updates. However, we must be careful—he raises this point frequently in another context—not to bog down our people who work in the countries affected and in DFID with endless reporting mechanisms that stop them doing the job that we ask them to do. I also think that we need a reasonable period so that we can make serious judgments about progress, which is linked to what the hon. Member for Edinburgh, West said about DFID staffing arrangements. We should ensure that we have a smart and effective operation and that we make the best use of our resources, but I do not want
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our officials or in-country people to be bogged down in unnecessary, undesirable reporting. In the end, that would not help us.

Some 92 per cent. of DFID staff said in the recent capability review that they enjoyed going to work every day. Any Department would celebrate that, as would any organisation in the private sector. It is a remarkable tribute to the leadership of DFID and its senior civil servants. I sometimes think that we do not state such things often enough. It is not only politicians who are attacked; civil servants are frequently attacked too—they are described as “bureaucrats” and so on. I have never worked with such a mission-driven group of people. We are very fortunate and privileged. It is also useful to put on record that in the capability review, DFID was the top performing Department. That is a source of great credit to staff at every level of the Department, of which I am proud to be a Minister.

The hon. Members for Edinburgh, West and for Cotswold (Mr. Clifton-Brown) asked about the United States Administration, who have given us a massive opportunity. They have removed some of the ideological and philosophical constraints that were placed on our approach to HIV/AIDS. Ironically, when we look back, we might find that the resources and investment that President Bush made in HIV/AIDS in Africa was his top achievement. The problem was that some of the constraints and restrictions to which I referred were undesirable in relation to our ability to make significant progress on prevention.

Only this week, the Obama Administration made a significant announcement. They are going to increase further the resources that the previous Administration invested in health generally. For the first time, the American Administration are saying that they believe that we must maintain a level of commitment to vertical funding specifically for HIV/AIDS work and, additionally, that they must play a role as a partner in building health systems in developing countries. In the end, long-term, sustainable change comes as a consequence of building those health systems. Those are massive steps forward.

On South Africa, there was a diabolical period in that country’s history, when the President was in denial about what needed to be done on HIV/AIDS. Consequently, public policy reflected that attitude, with unnecessary and tragic consequences. I am delighted that the interim President changed that policy and that a new, progressive and enlightened Health Minister was appointed. I flew to South Africa to support and endorse her new approach to HIV/AIDS, which is a move away from the denial years. We announced specific extra resources to help her with the new strategy. Now that there have been elections, we hope that the new President will retain this strong level of commitment to a new, authentic and serious approach to HIV/AIDS.

The DFID office in South Africa is working on supporting the country’s Government, private sector and NGOs so that they can have a new, effective strategy to tackle AIDS. It is not for me to appoint Cabinet Ministers in this country, let alone any other, but we are great advocates and supporters of the current Health Minister and we wait to see who will be in the Cabinet that the new President will assemble during the next few days. We believe that the Health Minister has the vision, credibility and support to lead a tremendous push on HIV/AIDS, which could begin to make a real difference.
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It is not just about what happens within South Africa’s borders: if South Africa adopts a progressive approach to HIV/AIDS, it would be profoundly significant for the continent of Africa.

The hon. Member for Cotswold asked what level of detail DFID can provide on its delivery. I point him to the DFID response to the excellent Select Committee report. However, I should also like to correct something he said, because I do not wish to mislead him. We cannot publish some of the details about the money we will spend and the strategy we will adopt country by country at the moment because we have to be nimble and flexible, and ready to take advantage of opportunities such as the change in the political context in South Africa. More to the point, if there are political obstacles, such as those that existed previously in South Africa, we have to find other ways of getting resources to the front line. We can publish information but, inevitably, we have to retain flexibility and the capacity to respond and to change our interventions.

The hon. Gentleman also asked about targets for preventing mother-to-child transmission. Our position is that we will intensify international efforts to increase to 80 per cent. by 2010 the percentage of HIV-infected pregnant women who receive ARVs, which will reduce the risk of mother-to-child transmission in low-income and high-prevalence countries. Maternal, new born and child health services, including preventing mother-to-child transmission, are important entry points for women and their children and families to access broader health and AIDS services, and there is strong evidence for the effectiveness of PMTCT interventions. We are making significant progress.

Mr. Clifton-Brown: I used to be chairman of the all-party group on population development and reproductive health. As I said, I am keen that men take more responsibility for the problem. To enable them to do so, they need greater access to family planning services. Will the Minister assure us that that will be part of his strategy to deal with the problem, because it is lacking at the moment?

Mr. Lewis: The hon. Gentleman is absolutely right. The idea that it is somehow an issue for women only is, frankly, a mistake. Men have major responsibilities when it comes to preventing and reducing HIV/AIDS. Too often, it is presented as a women’s issue, which we understand and recognise. That is why we must send strong messages to men about their individual behaviour. We must also send a strong message to men in political leadership roles and men who are leaders of faith networks, villages and rural communities. They can make a massive difference because they can influence the behaviour of other men and how communities respond to the problem. Our approach must be a combination of empowering women and giving them access to the right support and treatment, with a focus on prevention, and, equally, as we know, the behaviour of men has got to change significantly if we are going to achieve all our objectives.

The hon. Gentleman asked how we will ensure that we reach the most vulnerable people. We are committed to working with UNICEF and NGOs to review the
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impact of social protection, particularly cash transfers, on vulnerable children. We are carrying out a six-country study, we have committed £200 million for social protection systems in eight countries in Africa that will provide essential support for children affected by AIDS and their families, and I have referred to our specific work in Zimbabwe.

I pay tribute to my hon. Friend the Member for South Ribble for his tremendous work over a long period as chair of the all-party group on AIDS, and to the group for its work. There is no question: without the all-party group on AIDS, the issue would not have as much focus and priority as it does. If he could relay our thanks to the staff and members of that group, I would be grateful.

My hon. Friend focused on the human realities. I, too, have visited orphanages and seen the efforts made to keep families together and give kids continuity in family life experience even when their parents, tragically, have passed away. I think that we all know that only in recent times has our own country begun to care for orphaned children in a positive and progressive way; only in the past 20 years have we started to understand what children in such dreadful and horrendous circumstances need.

I agree entirely with my hon. Friend when he says that we should not satisfy ourselves with the fact that we are offering a basic level of care to children without parents. We should be seeking more than ever to offer such children the best. Part of that involves the technical assistance, learning and expertise that we can make available to developing countries, as well as networking to ensure best practice in influencing change in how children in such circumstances are cared for throughout the developing world.

The charity in my hon. Friend’s constituency that he endorsed, FOMO, does an excellent job. It represents the finest in UK traditions of grassroots organisations raising money to benefit the poorest people in the world. We should all be proud of it, remembering that although we can be proud that the Government, the country and the population are passionate about the agenda, there is a limit to what can be achieved by Governments alone. It is important that we recognise the contribution made by exceptional citizens doing remarkable things, often in the developing world, and by voluntary and non-governmental organisations.

Sir Nicholas, thank you for the generous way in which you have chaired these proceedings. This debate has been the House of Commons at its best. We all share a collective determination to be able one day finally to say that we were part of a journey that led us to win the war against HIV and AIDS.

Sir Nicholas Winterton (in the Chair): I congratulate the Minister, the Opposition spokesmen and all those who have participated in the debate on the quality of their contributions. It has been interesting and stimulating for me, in the Chair, to listen to them.

Question put and agreed to.

4.33 pm

Sitting adjourned.

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