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7.52 pm
The Earl of Sandwich: My Lords, on behalf of the whole House I congratulate the noble Lord, Lord Bates, on the sincerity of his maiden speech. My noble friend has already mentioned his expertise. The noble Lord entered Parliament as a keen 30 year-old in 1992 as MP for Langbaurgh in North Yorkshire and was soon given jobs as a PPS here and there; he then became a Government Whip and later a Minister. I notice that he used to put family before cricket in his list of recreations, but that has now been changed to cinema and walking. After 1997, to his credit the noble Lord went back to do an MBA at Oxford and then returned to the world of high finance, now running his own firm. He comes to us as deputy chairman of the Conservative Party and we look forward to what he will have to say in the future.
Like my noble friend, I feel a degree of frustration because at the UN Millennium Summit eight years ago, 189 world leaders made a historic promise, but as we have heard, we are nowhere near the development goals. While there are overall gains in health and education, we are missing goals in the poorest countries and most isolated regions of the world. Under-five mortality rates, for example, are generally falling, but not in countries such as Ethiopia where 6 million children are malnourished. Two weeks ago, world leaders gathered again and made more solemn commitments. How much are they worth? The likes of Bono and Geldof were there to remind them. However, I believe that our own Prime Minister is sincere in keeping poverty on the G8 agenda, especially poverty in Africa. In the end, considering the crisis in the background, there was reasonable progress and consensus at the UN.
We have heard, for example, of the billions raised for malaria. A further $1 billion will be raised through the Global Campaign for Health, which hopes to mobilise more than a million health workers, as strongly advocated by my noble friend Lord Crisp. Some $2.2 billion will help to provide water and sanitation. What will be the contribution of Her Majesty’s Government to this fund? It is the International Year of Sanitation, and charities such as WaterAid, UNICEF, Pump Aid and IIED have successfully raised the profile of this issue. It is extremely important because some 2.6 billion people lack adequate sanitation, while more than 1 billion still have no access to safe water.
I am glad that civil society organisations have a higher profile in these meetings. This time the NGOs were well represented by the Self-Employed Women’s Association in India. Moreover, one leap forward was taken this year by our own DfID when it signed up to the International Assessment of Agricultural Knowledge, Science and Technology for Development. The noble Baroness, Lady Chalker, will know all about it. This began as a radical World Bank initiative in favour of the informal agricultural sector. It means that donors are at last recognising the poorest farmers as agents of reform rather than leaving them to become the victims of trade liberalisation. Under the scheme, small farmers will be given more access to urban and export markets by means of micro credit and other services.
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In summary, child health MDGs cannot simply be left at the door of primary healthcare because illness is caused by so many of the external factors which prevent the poor, above all, from enjoying a healthy and sustainable rural and urban environment.
7.56 pm
The Lord Bishop of Ripon and Leeds: My Lords, I add my gratitude to the noble Lord, Lord Alton of Liverpool, for focusing our attention on the millennium development goals in general and child mortality in particular, and to the noble Lord, Lord Bates, for his incisive comments on the place of conflict in this debate. We face a massive challenge both as Governments and as Christian churches. In the Anglican Communion, we have been challenged by the Lambeth Conference to pay far more attention to international justice issues, in accordance with the Christian assertion of human beings made in God’s image and Jesus’ own words of especial concern for the poor. The highlight of that conference for many of us was the day here in London affirming our pressure on world Governments to act in our name to achieve those goals, and we were immensely encouraged by the Prime Minister’s support for those aims, which I invite the Minister to reaffirm now.
We have heard the depressing figures and details of the continued growth in child mortality in some countries of sub-Saharan Africa, but we need to be careful that the actions of developed countries do not put children’s lives at risk. It can be no accident that, according to Save the Children, the highest increase in child mortality in recent years has been in Iraq—150 per cent over 15 years of sanctions and war. Whatever the justification for that action, we cannot be released from its unintended consequences, and I look for an assurance that the millennium development goals will be considered not only with regard to aid policy, but also to economic and military strategies.
We must not ignore our own country where rates of child mortality are still too high. I look forward to the results of the Good Childhood Inquiry to be published by the Children’s Society in February. But there is evidence enough already of the stubborn persistence of poverty among children here, and where poverty is prevalent, it is difficult to bring down infant mortality rates. This is a crucial issue for the future health of the world and particularly so at a time of substantial financial pressure. It is essential that we do not allow that pressure to divert our attention from the importance of these goals. I look forward to a robust commitment on the part of the Government to real reductions in child mortality which until then must remain a serious blot on the consciences of us all.
8 pm
Lord Crisp: My Lords, I, too, congratulate my noble friend Lord Alton on securing the debate and the Government on the positive role they played in New York two weeks ago in securing so many commitments from the world community.
One commitment was to increasing the number of health workers in Africa by 1 million. I wish to make one simple and practical proposal. To achieve that
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The UK is well placed to do something about this. It has a fantastic track record in health education of doctors, nurses and others, there is fantastic good will and a huge amount of voluntary activity which is already under way and which could be harnessed to better effect. So, seized with this idea, in the summer I contacted 30 or 40 leaders of UK health and education institutions and asked them whether we should be doing more and, if so, what we could do. I sent out a survey to them on 4 August; on 31 August, of the 40 that I sent out, I received 133 replies. That shows how they had passed it on to other people and how much interest and energy there is in this issue. At the same time I wrote to Africans in six countries and asked their opinion, and they came back to me. All the Africans and British who responded said the same thing—yes, we could do more—and they suggested some practical actions.
Let me list merely three. First, if you are going to expand, train the trainers. Secondly, provide us with voluntary tutors who can come and work in my college of health in Malawi. One tutor will mean that we will train 15 more nurses this year. The third action is what they call an adjunct faculty. In my medical school in Jima in Ethiopia, if you can provide me with a cardiovascular doctor for three months, they can do all the cardiovascular training in the medical course for five years in that period. These are very practical, direct things that many people are already doing in many areas.
The other interesting thing about the 133 replies from the UK is how many said that this is of mutual interest and mutual benefit because our people gain from this kind of activity in Africa. There is huge good will. I am talking to DfID and the NHS about how we can take this further. I urge the Minister to support this approach and to look at the detail of how we could harness this huge good will and the huge expertise in the UK.
8.3 pm
Lord Joffe: My Lords, I congratulate the noble Lord, Lord Alton, on introducing yet another important debate and the noble Lord, Lord Bates, on his maiden speech.
I will restrict myself to the maternal health target, which is the most severely off-track of all the MDG targets and which has direct relevance to child mortality. It is clear that without radical progress the target of reducing maternal deaths by three-quarters by 2015 will not be met. At the global level, maternal mortality decreased by less than 1 per cent between 1990 and 2005; worldwide, one woman dies every minute in pregnancy and childbirth, adding up to more than 500,000 deaths each year; and in many countries, such as Liberia, the maternal mortality rates are getting worse.
However, fortunately change is possible even in low-income countries. Countries such as Sri Lanka and Malaysia have all slashed their maternal mortality
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I return to the critical importance of securing new and increased investment in maternal health. It is very encouraging that at the UN summit last month a task force headed by our Prime Minister was set up to launch an innovative international finance initiative for health systems, as pointed out by the noble Lord, Lord Crisp, which aims to raise funding for 1 million new health workers. Another initiative which could be taken is a small tax on currency transactions which, according to the UN University, has the potential to generate $33 billion annually.
It is also encouraging that the UN high-level summit last month demonstrated that there is a renewed appetite for the fight against poverty. The energy and commitment around maternal health and fighting malaria is genuine progress, as was the strong focus on new health workers. But much remains to be done in turning rhetoric into action.
In conclusion, I thank Oxfam for an excellent briefing and pay tribute to the Prime Minister, our Government and DfID for the leadership they have shown in the initiatives to reach the millennium targets.
8.06 pm
Baroness Northover: My Lords, I, too, thank the noble Lord, Lord Alton, for making sure that the relief of poverty, particularly of children, was on our agenda as soon as we returned from the Recess. We have had impressive and incredibly concise contributions from many experts in this area and a welcome speech from the noble Lord, Lord Bates.
The MDG meeting in New York has been overshadowed by the financial crisis, but that very crisis should make us realise how vulnerable and interconnected we all are. Those at the margins are, of course, the most at risk, but we have seen how things that we have taken for granted are not necessarily rooted as we thought they were. But, if only because we are all interconnected, the MDGs are an important reminder to us of what, for peace and prosperity if nothing else, we need to be doing.
I was in Kenya this summer and my visit served as a salutary reminder to me of how quickly violence can erupt in places, even when you think a country is unlikely to experience it. When there is such dire poverty, clashes can quickly become a reality. We all know how important it is, therefore, to promote hope, reconciliation and, above all, economic development.
The MDGs remain a vital cornerstone in development. Without education, without reasonable health and without gender equality, economic progress of the
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Given that malnutrition accounts for a third of child deaths in developing countries, what is DfID’s reaction to the International Development Select Committee’s recommendations in this area? The latest AIDS strategy produced by DfID seems not to prioritise children as the previous one did. What will be done to ensure that they remain a focus for treatment and support? Can I be assured that the promotion of gender equality remains a cornerstone of DfID’s work? What is happening to those in DfID who particularly focus on this? Reducing maternal mortality and promoting family planning are also key policies which benefit children. What further plans do the Government have?
The policies for social protection, which, of course, underpinned our own development in the 20th century, have a great deal of promise. What further thinking does DfID have in this area? We know, too, that climate change will affect those at the margins first. It is already happening, as I saw in Kenya.
Addressing all the MDGs serves to assist children at risk. The vulnerability of children in the current financial situation shows how important it is that these goals remain at the forefront of international thinking. In New York, a further $16 billion was pledged, though pledges do not necessarily materialise. Contrast this with the $700 billion which, it seems, the US alone can manage to raise to bail out the markets. It is amazing what can be achieved when there is the will to do it.
8.10 pm
Baroness Rawlings: My Lords, I, too, thank the noble Lord, Lord Alton, for this debate, which could not have come at a more important moment. The millennium development goals are still in the public eye, as financial difficulties spread through the West. This means that countries, including the United Kingdom, which are crucial to the success of meeting the goals will now, more than ever, need frank debate on how we are to meet our obligations—a difficult task for each of your Lordships in three minutes. I, too, congratulate my noble friend Lord Bates on a very special—and brief—maiden speech.
The millennium development goals were ambitious but not unachievable. Given present trends, however, they are unlikely to be met. That would be a tragedy. We need a realistic examination of what more we could do and where we are going wrong. Many noble Lords have said that this is not a job for Britain alone, but we can show leadership in bringing together a response to the needs of the world’s poorest people.
The Government signed up to the development goals when times were good. We pledged that we would meet the UN target of spending 0.7 per cent of national income on aid. What assurance can the Minister
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I have raised the subject of China several times. China is a key player in this topic for several reasons. First, it has raised many millions of its own people out of grinding poverty. This has not been done entirely through its own efforts, but by increasing engagement with the world economy. Can the Minister tell the House what plans the Government have to encourage further liberalisation of world trade?
My second point about China is its increasing power in Africa as it searches for natural resources with which to feed its economy. What strategy do the Government have for working with China in very poor countries? Chinese development of African infrastructure, for example, could be harnessed as a catalyst for more general development.
Only last week I heard Sir David Attenborough raise the thorny topic of overpopulation, which he felt was a big contributor to environmental change as well as a big component of global poverty and, as a consequence, of child mortality rates. Sir David said that there are three times as many people on this earth as when he started making natural history programmes 50 years ago. He offered a noble solution: better education for women. This could be a decent start in realising part of our obligations to fulfil the millennium development goals.
8.13 pm
Lord Tunnicliffe: My Lords, I, too, congratulate the noble Lord, Lord Alton, for initiating this important debate. I would thank him with even more enthusiasm if he had done it a day or two later—that is, more than 24 hours after I found out I was going to pick up the DfID brief again. Inasmuch as this is a realistic statement in politics, I advise the House that I am the permanent spokesman for DfID in the House. I pay tribute to my noble friend Lady Crawley, who was the Government’s spokesman for DfID in many debates but has now retired from the Front Bench.
Let me turn to some of the points made by the noble Lord, Lord Alton. We note the important role played by faith groups in achieving the millennium development goals. The Prime Minister expressly acknowledged that when he launched the call to action in 2007. In highlighting the potential impact of the food crisis, we recognise that poor nutrition is estimated to be an underlying cause in more than one-third of all deaths in children under five. This is one of the reasons why the UK Government announced in New York last month a further £40 million of emergency assistance for the Horn of Africa, including Ethiopia.
The noble Baroness, Lady Chalker, highlighted the importance of health systems; that is why the Prime Minister launched the international health partnership last year. It will provide longer-term and more predictable funding for poor countries, making them better able to make long-term plans, train doctors and nurses, pay salaries and maintain infrastructure. The Government
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The right reverend Prelate the Bishop of Liverpool noted the important role played by faith groups and others in achieving the millennium development goals. That was expressly acknowledged by the Prime Minister when he launched the millennium development goals call to action in July 2007. In July this year, faith groups showed their commitment to the MDGs at a rally in London. Spearheaded by the most reverend Primate the Archbishop of Canterbury, more than 1,400 robed bishops—a thought that makes me cringe—and other faith leaders from all over the world walked through the streets of London to call on global leaders to deliver the MDGs. The Walk of Witness ended at Lambeth Palace, where the Prime Minister spoke of the need of all faiths to work together to eradicate poverty.
We have discussed before the funding of aid; it is an extremely complex area. We recognise how NGOs and faith groups, with their various infrastructures, are so important and we believe it is important that all agencies work together. Nevertheless, we will channel much of our aid through the UN. We will seek UN reform, but the United Nations is uniquely positioned. It has a universal membership, a global mandate, unparalleled legitimacy and neutrality and it builds countries’ capacity. It also provides the global leadership on the millennium development goals, as clearly demonstrated at the recent high-level event on MDGs. Over half of the Government’s 25 priority countries are fragile states. It is also why, by 2011, an estimated 60 per cent of DfID’s bilateral assistance will be spent in such states.
The noble Lords, Lord Jay and Lord Bates, highlighted conflicts and the extent to which they undermine development by causing death, displacement and destruction of property and preventing the delivery of basic services. Countries in or at risk of conflict tend to be the furthest from achieving millennium development goals. DfID therefore works to reduce the risk and impact of conflict in almost 50 countries by joining forces with the Foreign Office and the Ministry of Defence on the Conflict Prevention Pool, which has a budget of £112 million in the financial year 2008-09. DfID also attempts to prevent development programmes exacerbating conflict by conducting strategic conflict assessments and conflict orders, and encouraging major partners to do likewise.
I, too, congratulate the noble Lord, Lord Bates, on his maiden speech. It is always good to have an emissary from the other place, and I hope that the noble Lord finds the attitude of his Whips echoed in our debates here. This is a particularly pleasant subject to debate, because there is a high level of consensus and we agree on what we are trying to do on international development. The Government are quite properly held to account for how they do it. We look forward to the noble Lord’s continuing involvement in these discussions.
The noble Earl, Lord Sandwich, touched on a number of issues, but particularly important is regional disparity. When one looks at the development goals overall, one sees a so-so position; but when one looks
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The high-level event to which the noble Earl, Lord Sandwich, referred was the first time that such a global coalition of Governments, business leaders, faith leaders and NGOs had been assembled under the auspices of the United Nations, not simply to talk but to make specific commitments. The high-level involvement and significant contributions demonstrated to the world that, in the face of economic crisis, we must do more, not less, to help the poorest countries. That touches on some of the points made later in the debate.
The noble Earl, Lord Sandwich, also rightly noted the importance of ensuring that commitments are turned into reality. This is why the Government attach particular importance to tracking implementation of the actions announced during the week of the event, and encouraging the UN to produce better analysis of where the MDGs remain off-track and what needs to be done to get them back on track.
The right reverend Prelate the Bishop of Ripon and Leeds highlighted the impact of the global financial crisis. The Government share that concern and recognise that it is now more important than ever to accelerate progress on the millennium development goals.
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