The Secretary of State for International Development (Mr. Douglas Alexander): The humanitarian situation in Gaza is extremely serious and will worsen now that the winter rains have started. Nearly a year after the conflict, 75 per cent. of Gazans still rely on some form of food aid, more than 60 per cent. do not have daily access to drinking water and 10 per cent. have no access to mains electricity. The United Kingdom continues to press Israel for full access to humanitarian aid in line with internationally accepted humanitarian principles.
Mr. Swire: What assessment has the Secretary of State made of the implications of the 18 million litres of raw and untreated sewage being discharged into the sea off Gaza for the population of Gaza and the surrounding environment?
Mr. Alexander: That is but one of the health consequences of the conditions currently being visited on the people of Gaza. As I said, we have made clear representations to the Israeli Government. Only yesterday, I spoke to Defence Minister Ehud Barak and pressed him for wider access to a range of humanitarian goods. The reconstruction effort that we all wanted to see after Operation Cast Lead has not been possible because of the constraints on access that continue to affect the community. The hon. Gentleman's point is well taken, and I can assure him that we take many opportunities to press the Israelis to ensure that the necessary reconstruction efforts are now made.
The Secretary of State will doubtless be aware that those seeking anything other than the most basic medical treatment in Gaza are required to travel abroad. However, in the period ending in June, no
fewer than 40 per cent. of applications for travel permits for health care were refused by the Israeli Government. What pressure can he bring to bear to ensure that that situation improves?
Mr. Alexander: In recent days-as I said, only yesterday-I have spoken with Ehud Barak, and last week I met Mr. John Ging, the outstanding head of the United Nations Relief and Works Agency, who is doing genuinely heroic work in extraordinarily difficult circumstances in the Gaza strip. That is testimony to the continuing efforts that we are making through a range of different channels to press not simply for greater humanitarian access, but ultimately for the necessary political resolution to the situation in the middle east, which would facilitate the kind of movement that the hon. Gentleman suggests.
Dr. Brian Iddon (Bolton, South-East) (Lab): Is my right hon. Friend aware that 8,000 children in Gaza are without school desks, and will he facilitate the importation of the metal components necessary to complete the construction of the desks?
Mr. Alexander: We seem to be in the rather bizarre situation in which desk parts for UNRWA schools have now been permitted to enter-I understand that some deliveries have been allowed-but the fittings necessary to assemble those desks have not. That is but one example of the difficulties being suffered in Gaza at the moment as a result of the constraint on movement and access. As I said, I discussed that position recently with John Ging, the head of UNRWA, and we will continue to press the Israelis to admit educational materials.
Richard Burden (Birmingham, Northfield) (Lab): Some 50,000 homes are estimated to have been destroyed during the Israeli attacks on Gaza, but cement, panes of glass and steel girders are still not getting in to repair them. I appreciate what my right hon. Friend says about his meetings with Mr. Barak, but if the Israelis are not listening, what are we going to do about it?
Mr. Alexander: I have sympathy with my hon. Friend, who has great knowledge of the region and the challenges facing it. In some ways, the difficulty is exemplified by the issue of cement. John Ging told me that Hamas is building a watchtower opposite the Israeli watchtower at the crossings using cement that presumably has been smuggled in through the tunnels from Egypt. However, at the same time, the Israelis are denying the cement to rebuild the schools that will give the young people of Gaza exactly the opportunities that hon. Members on both sides of the House would want them to enjoy. That is why we are continuing to press the Israelis. However, with humility we recognise that that is not a task for the United Kingdom alone. The European Union and the United State have key jobs, which is why we continue to work in international forums to press the case for those humanitarian supplies to be allowed in for reconstruction to take place.
Alistair Burt (North-East Bedfordshire) (Con): What contribution does the Minister think might be made to ease the humanitarian situation by the release of Gilad Shalit, with all the possible implications for the improvement of relations should his captivity by Hamas be ended?
Mr. Alexander: Of course, we have called consistently on Hamas to release Gilad Shalit without further delays or any kind of conditions. Although we welcome the video tape released recently by Hamas, around 2 November, as part of the prisoner swap deal, the continued captivity of Gilad Shalit, as was raised with me by Ehud Barak, the Israeli Defence Minister, is utterly unacceptable. Hamas has a clear responsibility to release him without delay.
Mr. Alexander: I think that there is wide recognition on both sides of the House that continued humanitarian efforts are needed to support the people of Gaza and, indeed, the west bank, given the difficulties that currently afflict them. Equally, however, most hon. Members recognise that ultimately the resolution in the middle east lies in politics. I believe that the challenge at the moment is to get behind the efforts being made-I am glad to say-by President Barack Obama and his team, in the first year of his presidency, to support and facilitate the emergence of a comprehensive middle east peace plan. That seems to be the most effective way in which we can buttress the humanitarian work on which we are engaged.
The Parliamentary Under-Secretary of State for International Development (Mr. Michael Foster): The United Kingdom remains strongly committed to reducing death and suffering from tuberculosis and sees it as an important part of the global effort to improve the health of the poor. Our focus is the delivery of the global plan to stop TB, which aims to save 14 million lives. My Department combats TB through our contributions to multilateral organisations such as the World Health Organisation, partnerships such as Stop TB and the Global Fund, our bilateral programmes and our support for research.
Annette Brooke: I thank the Minister for his answer. Given that TB is a lead cause of death among those living with HIV, what proportion of that funding goes into supporting integrated services for people with TB and HIV, and what monitoring does his Department carry out on the impact of such funding?
Mr. Foster: The hon. Lady is absolutely correct to point out the clear links between tuberculosis and HIV. Some 15 per cent. of new TB cases are among people living with HIV/AIDS. That is why we are looking to invest £6 billion to 2015 in whole-health systems and services, so that we can get diagnosis and treatment not just for people with TB or HIV/AIDS, but for people with a range of health problems.
Mr. Tom Clarke (Coatbridge, Chryston and Bellshill) (Lab): Although I welcome the Minister's reply, may I draw to his attention the fact that the World Health Organisation has indicated that only six out of 10 smear-positive tests are being undertaken, even though the problems are increasing? Does he agree that we should use all our influence to ensure that new diagnostic tools are used wherever that is possible?
Mr. Foster: My right hon. Friend is absolutely right to point out the need for the speedy diagnosis of TB. That is why I am pleased to say that we as a Department have committed to giving some €60 million a year to UNITAID, which is aiming to triple access to rapid tests for multi-drug resistant TB by 2011.
Mr. Geoffrey Clifton-Brown (Cotswold) (Con): Given the Select Committee on International Development's criticism of the Government's failure to act on the interaction between HIV and not just tuberculosis, but malaria and other diseases, and given also the fact that his Department has informed the Committee that it collects data only every two years, can the Minister give the House a positive assurance that we will see full transparency on the issue, full performance measurements, an impact assessment and an emphasis on outputs, and not just financial inputs, which is the Government's norm on such problems?
Mr. Foster: I disagree with the hon. Gentleman that our focus is on inputs and not outputs. Nothing could be further from the truth. I would point out that if we are going to get the information that he requires in detail, it would mean health workers who provide primary care on a range of issues having to break down how they spend their time diagnosing TB on the one hand and, on the other, malaria, treating people with extreme forms of diarrhoea, and so on. The best thing that we can do is support whole-health systems to improve the health of a nation, particularly through an emphasis on primary care. That is what our £6 billion commitment is all about.
Gordon Banks (Ochil and South Perthshire) (Lab): What more can my hon. Friend do to increase international support for UNITAID and its ambition to increase accessibility to low-cost drugs for TB, malaria and AIDS, especially as yesterday was world AIDS day?
Mr. Foster: I am proud of my Department's record, with its contribution to investment in health, and UNITAID in particular. Next year's mid-term review of the millennium development goals might be an opportunity for our international partners to look at their contributions to development and perhaps take the opportunity to step up to the plate.
The Secretary of State for International Development (Mr. Douglas Alexander): My Department's latest Afghanistan country programme evaluation was published in May this year. Although the challenges remain daunting, life for many Afghans is improving, with support from the United Kingdom and the international community. Indeed, a majority say that they are better off now than under the Taliban.
I am grateful to the Secretary of State for his response. Can he reassure me that there is no longer any basis for the concerns expressed by some in the military and other observers that there was some difficulty
in achieving seamless working together between his Department and the military in bringing a better life to the people of Afghanistan?
Mr. Alexander: I hope that I can offer exactly the assurance that the right hon. Gentleman seeks. I will be seeing General Sir David Richards later this afternoon, which is but one example of the close working relationships that have been established. A staff member from my Department is currently heading the provincial reconstruction team in Helmand. Only yesterday I received word that we have two civilians working in each of the forward operating bases. We also have a significant number of civilians operating in Helmand. That was not the case several years ago. We have scaled up the operation and the joint working in Helmand over recent years, and I am confident that a genuinely comprehensive approach is being taken by all arms of the British Government.
Dr. Gavin Strang (Edinburgh, East) (Lab): The House will, of course, welcome my right hon. Friend's assurance that his Department is working with the military. It is right to focus on the military intervention, not least because of the announcements by the President of the United States and the British Prime Minister this week. I think my right hon. Friend the Secretary of State would accept that it is our military personnel who are at the sharp end. These are the people who ultimately have to help us win the argument on the farms and in the villages and towns hundreds of miles from Kabul. Will he assure us that he and his entire Department will be working to achieve this, because at the end of the day we have to win hearts and minds if we are going to make the progress that we all want.
Mr. Alexander: Again, I hope I can give my right hon. Friend the assurance he seeks. It is right to recognise that we need a greater military effort from the international coalition in support of the Afghan Government, which is why we welcome the statement made overnight at West Point by President Obama, but we all recognise-not least our own military commanders-that ultimately there is no military-only solution to the challenges faced in Afghanistan, which is why it is necessary to complement the military surge with a political surge. That is the thinking underlying the Prime Minister's announcement at the weekend that there will be an international conference hosted here in London on 28 January, which I believe will provide a further opportunity to set out our genuinely comprehensive approach, incorporating not simply the military aspects of the campaign but its civilian aspects.
Mr. Michael Moore (Berwickshire, Roxburgh and Selkirk) (LD): It is understandable that in the Prime Minister's statement to the House on Monday and President Obama's speech last night, the primary focus was on getting the right military strategy and resources in place in Afghanistan, but does the Secretary of State accept that since 2001 only 5 per cent. of international aid has been spent on agriculture, so we have an urgent need to fix not just the military strategy, but also the development strategy?
I recognise that more needs to be done to co-ordinate the international effort. That has been a consistent message from the United Kingdom
for some time now. I welcome the conversations that I have had in recent months with Richard Holbrooke, who is seized of exactly the issue that the hon. Gentleman raises in respect of the centrality and importance of agriculture both to the economic viability of Afghanistan and to counter-insurgency efforts. It is also right to set out for the House that we recognise that we confront twin challenges-the need both to weaken the Taliban, which is why we welcome the announcement from the United States, and to strengthen the Afghan state. Of course that begins with security, but it does not end with security. The provision of genuine economic opportunity by the Afghans for the Afghans is going to be a critical element in this campaign.
Lindsay Roy (Glenrothes) (Lab): The investment of the Department for International Development in education in Afghanistan is to be highly commended. What have been the most successful investment outcomes so far from that huge contribution?
Mr. Alexander: Perhaps the most simple and straightforward metric is the number of children enrolled in school. In 2001, 900,000 boys were enrolled in school and the Taliban had made it illegal for young girls to enjoy primary education. We are now comfortably beyond 5 million children enrolled in Afghan schools, and more than 2 million of them are young girls. That alone is testimony to the work we are taking forward through the Afghan reconstruction trust fund, which is paying teachers' salaries. The Taliban recognise that that poses a direct threat to their prospective future for Afghanistan, which is why they continue to behead teachers and to bomb and burn schools, but we are determined to support the Afghan people in the educational endeavours that I have described.
Mr. Mark Lancaster (North-East Milton Keynes) (Con): In light of the Prime Minister's statement on Monday that there should be even greater co-operation between the military and DFID in Afghanistan, what changes to the Department's strategy in Helmand does the Secretary of State hope to see once the latest revision of the Helmand road map is completed?
Mr. Alexander: I have just explained to the House that I am meeting General Sir David Richards this afternoon, and the co-ordination that we are taking forward in Helmand will be one of the areas that we will discuss. We have to recognise that the effort in Helmand is not military alone; as the general recognises, a civilian component is also required. That civilian component involves supporting Governor Mangal and the provincial council in the efforts being made, for example, to transfer production from opium to wheat. It also involves ensuring that we support the primary health care being moved in. A great deal of work is being taken forward not just in Lashkar Gah, but also in the forward operating bases, and I will continue to keep these matters under review.
I am grateful to the Secretary of State for his answer, but he did not really make clear what changes he expects to take place. A report published recently by the London School of Economics' centre for civil society draws attention to claims by non-governmental organisations that foreign military strategies
for tackling insurgency with aid projects had "infringed upon the work" of NGOs and
"compromised their claims of independence and neutrality."
Mr. Alexander: I am surprised that the hon. Gentleman does not recognise the centrality of security to the challenge of development in Helmand, not least given his experience of Afghanistan. Of course we must begin with the recognition that an insurgency is under way, the fulcrum of which is in Helmand at the moment. That is why it is vital for us to strengthen the security of not just the efforts of the international forces, but the Afghan Government themselves. Only when that space is secured will it be possible for the effective work that we want to take place to be fully maximised. I do not see this as being a trade-off between providing security and undertaking development: I think it vital for security to be secured so that development can take place.
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