Examination of Witnesses (Question Numbers
100-119)
MR GARETH
THOMAS MP, MR
MARK LOWCOCK
AND MR
JOHN DENNIS
23 FEBRUARY 2010
Q100 Mr Evans: Another health subject
is HIV/AIDS, which you have already touched on. We all had an
opportunity to see some of the projects involved with that and
I think we were all impressed with what we saw. It is tremendous
if one considers that in parts of Zimbabwe some of the aid is
somewhat thin. Certainly where we were in Bulawayo and Harare
we saw some tremendous projects, so I was very pleased with that,
but still last year 140,000 people died in Zimbabwe of AIDS. Compared
to other countries, Zambia for instance, where the amount of money
spent is way above, I think it is US$187 per person as opposed
to Zimbabwe where it is $4, why is there such a staggering disparity?
Mr Thomas: I think often the disparity,
frankly, relates to the political situation in Zimbabwe and the
ability for the international community to spend money effectively
to tackle HIV/AIDS. With our programmes on the health sector we
have wanted to get to a stage where other players in the international
donor community would support it. The Global Fund are now funding
the health workers' support programme. As I say, I think as the
economic situation stabilises there will be more opportunities
to do more on healthcare, of which HIV/AIDS will continue to be
a priority for ministers. Nevertheless, I think the UK can take
some pride in the success that there has been, notwithstanding
the significant levels of death because of AIDS that there is
in Zimbabwe, for the fact that it has not been even higher. HIV
prevalence has come down, it has halved over the last 10 years,
and our aid into the sector over that period has been absolutely
pivotal to helping those who wanted to make a difference in this
area in Zimbabwe be able to do so.
Q101 Mr Evans: I have got no doubts
about that whatsoever. We went to see one of the hospitals there
where the storeroom had eight months' worth of supply whereas
two years ago they would have had nothing.
Mr Thomas: That is right.
Q102 Mr Evans: Getting the capacity
and getting those drugs out into the villages and into the more
rural areas is clearly something that needs to be done. Within
the infrastructure that exists there, are we able to target some
of the high risk groups like sex workers, children and, indeed,
gays and lesbians?
Mr Thomas: We have a behaviour
change communications programme which is run by an organisation,
Population Services International, who are very well established
in this field who are doing hugely important work in terms of
getting those prevention messages out on AIDS. There is a whole
programme of work around voluntary counselling and testing which
has also been very important in making a difference. I am sure
the Committee will be familiar with the way in which those who
have migrated from Zimbabwe potentially would not get access to
information about how to avoid becoming HIV positive, but through
funding we give to the International Organisation on Migration
we have been able to provide support for them to get help and
information to those migrating from Zimbabwe to avoid the obvious
risks at transit points, et cetera. One of the keys in terms of
preventing the spread of AIDS and HIV infection is making sure
there is good access to condoms and that is something we have
continued to be in the lead on in the provision in Zimbabwe.
Q103 Mr Evans: One other area which
helps greatly is male circumcision which apparently improves the
rate of protection to 60%. The target is to circumcise 80% of
the males within Zimbabwe as soon as they possibly can. Apparently
the cost of that will be around $140 million but they will save
over $3 billion if that could be achieved. We visited one of the
clinics and talked to a couple of people who had gone through
it, so they were acting as peers to encourage other males to go
through the procedure. Do you envisage upping the amount of money
that we will be directing towards male circumcision within Zimbabwe
over the coming months?
Mr Thomas: Rather than just focusing
on one specific intervention in response to one specific disease,
however important that disease is, and I have a longstanding interest
in HIV/AIDS, I think the challenge for us, both in DFID and the
wider donor community, is how do we get more support more generally
into the health sector in Zimbabwe and get a clear coordinated
plan that looks at maternal health, that looks at HIV/AIDS, that
looks at a range of other diseases too. Many of the responses
that you need to tackle HIV/AIDS or to tackle maternal health
are common across the piece in terms of having good health workers
and good infrastructure in place. The challenge is to continue
that process of coordination under good leadership from the government
of Zimbabwe to get a series of clear health priorities in place
which the international community could get behind. That is certainly
what our ambition would be to support. Whether it has to be just
DFID upping our funding levels on healthcare or whether there
are other players in the international community, such as the
Global Fund, who can take up that extra financial need is something
that we need to continue to review. Health is certainly one of
the areas that we watch very closely.
Q104 Mr Evans: Clearly all the donor
organisations talk to one another anyway and that is important
to make sure there is no duplication or people working against
one another. When we visited the clinics we saw a number of posters
with famous Zimbabwean footballers who were saying that they were
getting this procedure and encouraging others to do so. It does
seem to me to be economic commonsense, never mind humane commonsense,
to ensure that as many people as possible have this particular
procedure to better protect the nation, particularly when you
look at the colossal number of deaths. This is a bit of a lobbying
plea really. All I would ask is that you look at this again and
make absolutely certain that not for the want of directing the
money there, which as I say will pay dividends in the short and
medium-term, we support this procedure as much as we possibly
can.
Mr Thomas: I recognise both the
lobbying plea and I fear one of the specific recommendations that
will emerge from your report, and we will obviously respond to
the report in the usual way and no doubt faster than we would
normally.
Q105 Chairman: I think it might be
the next government that has to deal with that.
Mr Thomas: Mr Evans, I think your
point in general about support for HIV/AIDS is well made, not
only in the context of Zimbabwe but actually in the context of
Sub-Saharan Africa more generally. We are five years on from Gleneagles
where that commitment to try to deliver universal access to anti-retroviral
drugs was one of the pivotal elements of the Gleneagles Agreement.
We are probably two-thirds of the way towards achieving that commitment,
so massive progress has been made but the target has not yet been
reached. One of the issues that ministers in DFID are looking
at is how we can use the international meetings that are taking
place this year to refocus attention on that commitment to universal
access, to look at what has worked in Sub-Saharan Africa, what
has not worked perhaps, and what else the donor community needs
to do. There will be an international meeting that takes place
in London very shortly that looks at the Zanu-PF question.
Q106 Mr Evans: Hopefully when President
Zuma comes as well on South Africa, maybe pushing him a little
bit more on that area.
Mr Thomas: I hear your message,
Mr Evans.
Q107 Richard Burden: One of the other
major health areas, and you have alluded to it yourself, is the
issue of water and sanitation. Six million people still have not
got access to clean water and sanitation and obviously there was
the bad cholera outbreak just a little while ago. When we met
the Mayor of Bulawayo during our visit, if there was one priority
that he wanted to identify it was the issue of the water system
in the city. He said it was close to collapse and that was not
unique in Bulawayo and his plea was for donors to concentrate
on trying to address that as an issue. Where would you see the
issue of investing in the water and sanitation infrastructure
to rank compared to other priorities in terms of health and so
on?
Mr Thomas: That is a very difficult
question to answer. In the longer term there is no doubt that
for a series of economic and social reasons as well as health
reasons we need to see more investment in water and sanitation
in Zimbabwe. That is absolutely clear. Through some of the programmes
that we already have, not least the Protracted Relief Programme,
there is work taking place on water and sanitation, but I would
not want to give you the sense that there is a clear long-term
sector-wide plan on water and sanitation which we are leading.
This is one of the issues where as the humanitarian situation
stabilises and as hopefully too we see progress on the politics
in Zimbabwe the donor community with the government can start
to put together a plan for beginning to see much longer-term,
more sustained investment in water and sanitation going forward.
It might be one of the areas potentially that the Multi-Donor
Fund that we are in the process of trying to establish under the
leadership of the World Bank can look at. In the same way that
water and sanitation is a key long-term issue, so is investment
in the road network in Zimbabwe and investment in access to electricity.
These are long-term issues which we will have to address. However,
given the humanitarian need that still exists, and I think will
exist for at least another couple of years, the balance of our
programme focusing on the delivery of basic services plus, where
we can, targeted assistance to support reforms in key ministries
is broadly right for the moment, but we have got to keep in view
those longer term issues like the Mayor of Bulawayo has identified,
I think that is absolutely right.
Q108 Richard Burden: When you mention
the Multi-Donor Trust Fund, are you saying that this is an issue
they could look at?
Mr Thomas: Possibly, yes.
Q109 Richard Burden: Or that they
are looking at?
Mr Thomas: The Multi-Donor Fund
is not up and running yet, there is still a series of preparatory
meetings that are taking place to sort out how the fund will operate
and what it will focus on. Exactly what it does we are still in
discussion on, but it certainly could look at water and sanitation
issues. Frankly, if you are looking at a series of other longer
term issues, such as infrastructure, roads, et cetera, you have
got to think about water and sanitation issues to some extent
anyway.
Q110 Hugh Bayley: Could I come in
on the issue of the diaspora before we move on to a different
subject. There are many thousands of Zimbabweans in this country
and they tend to be relatively better educated because the better
educated migrants migrate longer distances. They are very committed
to their country and because of human rights abuses or political
or economic pressures they do not want to be there at the moment,
but might well return if there was political change. When the
Government is talking next week to President Zuma, will you be
talking about the issue of a right to vote given particularly
that South African citizens in this country are entitled to vote
in South African elections?
Mr Thomas: I think the point you
make about the issue of the right to vote for the diaspora has
been recognised as one of the issues that the Electoral Commission
when it gets on to do its work will have to address. We all want
to see progress on those political parts of the GPA where progress
has been much slower. I think the big ticket items are getting
the Electoral Commission established so that it is in a position
to do its work, of which looking at the voter roll and the issues
around the diaspora is one of a series of issues that are key
to getting free and fair elections to take place.
Q111 Hugh Bayley: One other thing
I wanted to raise that affects the diaspora is this: there are
circumstances, as you are acutely aware, where money from the
UK may appear politically tainted in Zimbabwe. The diaspora traditionally
sent a lot of money back through remittances which has played
a vitally important part in allowing Zimbabwe to survive an economic
collapse. When I met the International Organisation for Migration's
(IDM) director of programmes in Zimbabwe, she talked about imaginative
schemes that operate in other countries of the world whereby the
government of the country in question from which the migrants
have migrated and donors match dollar for dollar, pound for pound
remittances that are sent back. Given that remittances tend to
be spent locally, not by government agencies but by families on
essential services, would your Department look at the feasibility
of setting up a scheme both to encourage Zimbabwean citizens living
in this country to remit money and to find a good channel for
transmitting money from your Department? Is that something you
would examine?
Mr Thomas: I am not sure we would
want to look at a programme that matches exactly what one particular
Zimbabwean living in the UK or elsewhere donates to his or her
family as such. There are a whole series of obvious technical
difficulties with such a scheme. We certainly do want to make
it easier for remittances to get back. I would go along with the
director-general of IOM in this regard: there are a whole series
of innovative programmes around remittances and the use of technology
making it easier and cheaper for people to get remittances back
which are being deployed in other countries. One thinks of Kenya's
M-PESA programme, for example, where remittances are being sent
using mobile phones from a whole series of countries, as I understand
it, to the individual recipient in-country. We are looking at
a programme of work to try and spread the benefits of that technological
innovation around remittances. I would hope Zimbabwe would be
a beneficiary in that regard. As you may be aware, we have tried
to get much more information into the public sphere about the
different rates of interest and different types of financial product
that are available for people who want to remit money to be able
to do so to try and create much greater competition and, as a
result, drive the administrative costs, commissions, down for
those sending money back.
Q112 Andrew Stunell: Children have
certainly been victims of the current difficulties and it could
be said probably that Zimbabwe used to have the best educational
system in southern Africa, and it has now probably got the worst,
yet DFID is still only contributing about 2% of aid to education.
I wondered if you could give us some account of how that priority
was set and whether you feel it should be a greater contribution
in the future.
Mr Thomas: We have a couple of
programmes that are supporting the education sector. One is a
programme of support to orphans and vulnerable children, which
is managed by UNICEF which helps to pay the school fees of a number
of the most vulnerable children in Zimbabwe. We estimate that
we have helped almost 250,000 schoolchildren through that process
and we are hoping that the programme will expand this year to
reach almost 600,000 children directly. Some of the other benefits
of that programme include better access to nutrition, to healthcare,
to welfare and to psychosocial support services for those young
people so that in turn they can benefit better from the education
that is available to them. The other source of funding for the
education sector is an Education Transition Fund which we launched
the idea of back in June last year and pledged £1 million
to it. Our interest has generated pledges now worth a total of
$50 million and we are in the process of sorting out the procurement
process to enable the purchase of substantial textbooks for schools
in Zimbabwe. One of the problems in the education sector, as I
suspect you will have seen, is as a result of the political instability
there has been a substantial loss of good quality materials for
teachers to use. We hope that this fund will be one opportunity
to begin to restore that damage.
Mr Lowcock: Can I just clarify
the point on your 2% figure, which I suspect we gave you.
Q113 Andrew Stunell: You did, yes.
Mr Lowcock: I think that refers
to the £1 million towards the wider Multi-Donor Fund programme
the Minister has just described for textbooks in particular. Probably
what we should also have explained is that the programme of support
for orphans and vulnerable children, which again the Minister
has described, is also that education dimension, so to give a
fair overall summary of how much we are putting into education
we should include that as well. I apologise that we did not do
that the first time. I just wanted to correct that on the record.
Q114 Chairman: How much is that?
Mr Lowcock: I will have to calculate
that for you, Chairman. It is significant, and we can do it quickly.
Q115 Andrew Stunell: Can I just pull
out a couple of points from your two replies, if I may. The underlying
problem is that a lot of schools have been lost to use and a lot
of teachers have emigrated or fled from the country. Are there
any specific plans that DFID is developing or working with the
Zimbabwean government on to get the restoration of school buildings
and bringing back teachers?
Mr Thomas: One of the things that
the Inclusive Government did when they came to power was to offer
a $100 allowance to all civil servants, including teachers, which
has helped to see a series of teachers returning to post and in
that sense has made a difference.
Mr Lowcock: The biggest issue
in our opinion is teachers. I am afraid it is going to be a significant
challenge for Zimbabwe to attract back many of the best teachers
who have left the country. The thing that will attract them back
over time is an improvement in the political and economic situation
and confidence in the future of their country, so it all turns
back on what the Minister was describing about the overall political
situation. Clearly there is also a school infrastructure problem
and textbook issue, but we think first teachers, second textbooks
and probably third infrastructure would be the order of priorities.
Q116 Andrew Stunell: Can I just ask
a question about textbooks? I asked a number of questions in Zimbabwe
and we received representations from some of the witnesses there.
My impression was that we had gone for a big bang solution to
getting textbooks which was leading to a substantial delay in
getting any textbooks in, when it might have been better or more
appropriate to have gone for a small-scale solution with more
rapid results. We were told by an official from the Department
of Education, I think, that they were still waiting for textbooks
which were supposed to have been ready at the beginning of the
school year. I would be interested in your commentary on that
situation and for some assurance about how the textbook programme,
for which we appear to have set aside funds, is actually going
to be delivered to a sensible timetable.
Mr Thomas: I think the first thing
is that our initial interest back in June in making money available
for the supply of textbooks has sparked considerable interest
from the wider donor community, perhaps more than certainly I
had expected. What we are trying to do is to make sure that money
collectively is well spent by having a central procurement programme.
We believe that will deliver substantial economies of scale. There
has been a process by which the Zimbabwe Ministry of Education
has been looking at trying to prioritise a particular core set
of textbooks to be delivered across the country. I recognise the
appetite inevitably for teachers to want to have access to those
books, but it is right that we get the procurement process right
and it is right that we try to deliver economies of scale. Given
the size of the pot and the increase in the size of the pot it
has clearly taken some time to get that right, but we hope we
are close to achieving that and getting the textbooks out.
Mr Lowcock: I would, if I may,
like to answer the question we promised you a subsequent answer
to, which is the share if we had included the programme of support
in our total programme in education. It would be about 6%, about
£2.4 million going into education through the programme of
support and then £1 million this year through the Education
Transition Fund. As the Minister said, we were trading off speed
with efficiency and value for money. We have got a much cheaper
deal and, therefore, can buy many more textbooks in the way we
have done the procurement, but I take the point you have made
about needing to think carefully about that trade-off between
speed and efficiency.
Q117 Andrew Stunell: So when do we
now expect those books to be available to schools, bearing in
mind the money was allocated back in July, August last year?
Mr Lowcock: We will need to check
when we expect the first deliveries, but the procurement process
is advanced now.
Q118 Andrew Stunell: And the schools
have no books.
Mr Lowcock: Well, most schools
have some books. Clearly, yes, there is an issue and that was
the trade-off we were trying to manage. I will find out for you
exactly when we expect the first deliveries.
Q119 Mr Lancaster: The Committee
went to see some projects directed at orphans and vulnerable children
and the Department estimates that more than 90% of the country's
orphans have been absorbed by the extended family. Indeed, 40%
of households in rural areas actually care for orphans and vulnerable
children but they have almost no financial assistance, so how
do you feel that external donors can help in this process and
support them?
Mr Thomas: There are a number
of programmes that we contribute to which have an impact on orphans
and vulnerable children and the financial needs either of the
individual children themselves or those who are looking after
them. I described the programme of support to orphans and vulnerable
children in answer to Mr Stunell. Paying for education fees of
the most vulnerable children is one obvious way in which we can
help. The second is through the Protracted Relief Programme which
we talked about in answer to questions from Mr Battle. That also
provides support often to some of the young people of Zimbabwe
who have lost parents and who perhaps head up households themselves
because of the loss of parents. Many of those people who have
taken in orphans and vulnerable children are beneficiaries of
the Protracted Relief Programme and in that sense get support
from the international community. As a Department we do not pick
the individual recipients, that is done through the NGOs who,
if you like, deliver the process and the support on the ground.
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