July 2005:

Presenters:

Abstract:

Laura Moffatt MP introduced the speakers and thanked Tyco Healthcare for sponsoring the meeting. She also thanked the members of the APPG AIDS and colleagues from the HIV Sector for attending the meeting and for their continuing support of the group.

Rt. Hon. Hilary Benn MP, Secretary of State DFID :

Thank you for inviting me to speak today. And thanks to Neil Gerrard, as chair, for the excellent work of this group. This is a good moment for us to reflect on the year so far.

This has been an extraordinary year. I can’t remember a time when development was more at the centre of political debates. Development is now a moral and practical cause whose time has come.

Millions of people are rallying to this cause. In Edinburgh we marched as a white tide encircling the castle, calling for poverty to be made history. The Live8 concerts were watched by 2 billion, and raised the world’s biggest ever petition. Asking for action: not charity, but justice. 

I think what was achieved at Gleneagles was very significant. A historic package to help Africa.  Fair to say, I think, the most the G8 has ever done for Africa and poverty eradication.  Who would have thought – a year, let alone 5 years ago – that these things would be possible? 

This is progress by any measure. Will it make poverty or AIDS history? Maybe not yet. But it has put us in a stronger position to do so.

How did this happen?  Because people – lots of people, some in this room today, have argued strongly and consistently for it.

As you all know the fight against AIDS has been an important part of our work for some time now – our Call for Action, launched at the London Lighthouse on World AIDS day in 2003; our new Strategy, Taking Action, launched by the Prime Minister a year ago tomorrow, and this year during our Presidencies of the G8 and EU.

It is clear that AIDS is undermining global efforts to eradicate poverty. Our actions, therefore, must match the scale of the epidemic itself. So what have we done?

In publishing “Taking Action” we announced that we would put at least £1.5 billion over three years into tackling AIDS. The largest ever UK investment on AIDS. And of this, £150 million will be for orphans and other children affected by AIDS. Taking Action also committed us to a leadership role, as we looked ahead, at that time, to our Presidencies in 2005.

So what did we achieve at Gleneagles?

We made extraordinary progress on aid. A commitment to increase global aid by an additional $50 billion by 2010, with half - $25 billion -  going to Africa. We are now reversing the shameful decline in aid - remember, in the mid-1990s, per-capita aid to Africa collapsed by a half. And a commitment by 15 EU countries to finally reach the long held UN 0.7% target by 2015. And Britain has set a target of 2013.

G8 Finance Ministers agreed to debt cancellation worth up to $55 billion, and helped the Paris Club agree the biggest ever African deal on debt for Nigeria, worth $17 billion, and where Nigeria has committed to use these new resources for poverty reduction.

And, specifically on AIDS, I think it’s worth taking a close look at the Communiqué text itself. 

“With the aim of an AIDS-free generation in Africa”

An AIDS-free generation in Africa. Now wouldn’t that be an extraordinary prize?  Ending the 6,000 new infections every day; treating the 6 million who could already benefit from treatment. 

“significantly reducing HIV infections and working with WHO, UNAIDS and other international bodies to develop and implement a package for HIV prevention, treatment and care”

This builds on the UNGASS target, but, crucially, commits the G8 to further action.  We now have to work together to implement what’s been agreed.  There are already discussions underway with UNAIDS, WHO, our G8 colleagues and others, and we will have started to develop this early in September.

I can’t emphasise enough the importance of a comprehensive response – and that must include prevention.  We need to both stop infection through prevention, and treat those already living with AIDS.

We hear a lot about the treatment gap, but let’s not forget that only 20% of poor people have access to the prevention services they need. I am very proud of the role the UK played, and let me pay tribute to Gareth Thomas here, in securing a strong new UNAIDS HIV Prevention Policy just before Gleneagles.

It will help countries quickly provide expanded prevention programmes: Prevention programmes that are evidence-based, human rights-based and respond to the realities faced by communities. And that means delivering sexual and reproductive health services, condoms, and harm reduction – which includes clean needles and syringes to drug users who need them.

The G8 also emphasised - for the first time ever - the need to develop a safe and effective microbicide. New technologies are vital to give women the power to protect themselves from HIV infection. The communiqué called for advance purchase commitments and other innovative finance tools to encourage increased investment in microbicide and vaccine research and development.

This year the UK will do all we can to support this effort and maintain HIV prevention momentum throughout. That is why on World AIDS Day on 1^st December, as part of our UK Presidency of the EU, we plan to hold a major event on prevention.

“with the aim of as close as possible to universal access to treatment for all those who need it by 2010”

This commitment moves us a long way forward. It builds on the WHO and UNAIDS “3 by 5” initiative - to get 3 million people on treatment by 2005.  And while it is now clear that we will not reach that ambitious target, as the UN’s African AIDS envoy, Stephen Lewis has said, this has been an incredibly successful initiative.  It has provided important momentum and leadership – and 1 million people on treatment are alive now who wouldn’t have been without it.  I’m delighted that Charlie Gilks, who leads the 3 by 5 effort in WHO, is here today and I look forward to hearing more from him. And let me say how pleased I am to be able to provide Charlie on secondment to WHO today.

This new AIDS treatment target signals our clear ambition.

“Limited health systems capacity is a major constraint to achieving this and we will work with our partners in Africa to address this, including supporting the establishment of reliable and accountable supply chain management and reporting systems”

We will only reach this target if there are major improvements to existing health care services. Without these we get good quality anti-retroviral treatment and care to people who need it.  More effective services will help remove bottlenecks in drug production and supply, and they rely on more doctors and nurses being employed, better efforts to promote awareness and availability of services, greater NGO effort to make treatment effective, and a massive increase in testing facilities so people can find out if they need treatment.

And we will only make progress on any of the diseases of poverty if we invest enough in the national health services of the poorest countries. We need to help them provide basic services for free, if that is what their governments want to do, and make these services more effective. DFID is already a major donor to the health sector, including through budget support, and we will be doing more. 

Our support in Uganda helped the Government end user fees for basic services, and we have invested £100 million in the Malawi health service. We will learn from these and other innovative approaches and take similar steps in the countries that want our help. One of the priorities for the IMF and World Bank annual meetings in late September is the expansion of health services, alongside supporting more effective AIDS programmes.

“We will also work with them to ensure that all children left orphaned or vulnerable by AIDS or other pandemics are given proper support”

A comprehensive response to the epidemic must include reducing the numbers of children affected by AIDS, and providing those young people already orphaned and affected, with all the help they need. To be concrete - I mean free and good quality schooling and health care; an environment where young people can make informed choices and have those choices respected, and where sexual and reproductive health services are on offer to all young people, as well as adults.

Young people are extremely vulnerable, and without the measures I have just described, can easily face a future of despair, not hope. And for vulnerable families, home support, and income support through cash payments, is absolutely vital.  

The UK will continue to push – as hard as we can -  to get these responses right – and that is why, in early November, we will host with UNICEF, the Global Partners Forum to help build momentum around the need to provide proper support to these children.

“We will work to meet the financing needs for HIV/AIDS, including through the replenishment this year of the Global Fund to fight AIDS, TB and Malaria”

UNAIDS have estimated how much is needed to do more to fight AIDS in low and middle income countries. They think that at least $15 billion is needed in 2006, $18 billion in 2007, and $22 billion in 2008, in order for these countries to mount an effective response to AIDS.

The Global Fund tells us they need $7 billion to fight AIDS, TB and Malaria for the years 2006 and 2007.  By hosting their Replenishment Conference we are doing our bit to make sure the Fund achieves a far more ambitious funding level. As EU President, we are already working with our European partners to encourage an even stronger European commitment, as well as encouraging all our G8 partners and others to do their bit.

The Global Fund is incredibly important – but we also know that it is only one part of what is needed. This is why at the replenishment conference we will have a special session to take forward the recommendations of the Global Task Team.

Because unless we get all of the donors to work well together, countries won’t be able to fight AIDS effectively. And at that meeting UNAIDS will also report on their Resource Needs estimates. These estimates have been based on a very broad assessment of the services and infrastructure required for AIDS at a sufficient scale to reach all in need by 2010.

Clearly there are huge needs. But this year we have made extraordinary progress in raising new money, and I’ll talk more on this in a moment. But let’s be clear that these overall increases in aid will contribute to - at the very least – the ability of countries to fight AIDS across all fronts - many of which have been costed in the UNAIDS estimates.

“and actively working with local stakeholders to implement the '3 Ones' principles in all countries”

We don’t just need to provide more money, we also need to ensure it works. The UK has led the way on the 3 Ones, and this is now firmly embedded in the global response to AIDS. And that is where the Global Task Team fits in. It was set up at the “Making the Money Work” meeting – that we held in London on March 9 – and has brought together all those involved, to find ways of improving coordination.

At the moment four different UN agencies claim to take the lead on youth HIV prevention.  Clearly that can’t be right – and it doesn’t help countries fight AIDS.   That is where the Global Task Team is making progress – working out the best way to share efforts, and putting in place timetables to bring about real change. I applaud the excellent work UNAIDS has done on this. We will continue to give this our full support.

So, what does all this mean on the ground, in the poorest countries?

Well, last year I visited Zambia, one of the worst hit countries, where 16% of the adult population already has HIV – up to a million people, and where almost 1 in 10 of the population is an orphan. Kalingalinga is in a densely populated part of Lusaka, and here 1 in 5 people have HIV. The mother and child clinic I visited has a staff vacancy rate of over a third, and yet offers free treatment. And whereas worldwide only 10% of pregnant women have access to the drugs that can prevent HIV transmission to their babies, here 90% of the mothers who visit the clinic get tested and treated – a very high number given the stigma attached to AIDS.

As I remember, they had around 1,000 people on ARVs – with 5 staff – and hoped to have 5,000 on ARVs by the end of the year – still with the same 5 staff.

And more broadly we are supporting the Zambian government through a £20 million programme to improve health care services – without which very little progress on AIDS is possible; the UK gives another £20 million for direct support to AIDS, and a further £10 million for social protection work, which reaches many vulnerable families, and includes support  for orphans.

The work I saw is a model of what is required across Zambia, across Africa, and globally. Yet there are big challenges - only 23,000 people in Zambia are on treatment, yet WHO estimate that almost 150,000 need treatment. And there is no excuse for delay, as Nelson Mandela said in 2003, “We must start now… If we discard the people who are dying from AIDS, then we can no longer call ourselves decent people.”

And that is why the steps we have made at the G8 are so important. They will go someway to ensuring progress, and not just in Zambia, but in all of the poorest countries.

The new aid committed by the G8 and Europe will begin to narrow the finance gap, but clearly the world still needs to do more.

That is why the UK has called for the International Finance Facility as a means to front-load aid to meet these needs. As a first step, we hope to get technical agreement on the IFF pilot for immunisation at the beginning of August – and if launched - we currently have support from France, Germany, Spain and Sweden – this initiative could save the lives of 5 million people, would help improve national immunisation services, and by offering a secure market, would encourage investment and competition in vaccine production.

And because we all still need to do more, the UK also supports the use of air passenger taxes to raise money for development, and in particular the health sector.

And we hope to make more progress this year too.

Our objective is to agree ambitious targets at the September UN Millennium Review Summit: a global commitment to universal access to HIV prevention and AIDS treatment by 2010; support to all orphans and children affected by AIDS; meeting the resource needs, including for the Global Fund, and making these resources more effective through implementing the “Three Ones”  principles and progressing the Global Task Team’s recommendations.

We recognise that the 2000 Millennium Summit did not give enough attention to sexual and reproductive health.  We want the September Summit to rectify this, not least to reflect the importance of sexual and reproductive health services as a cornerstone of efforts to prevent HIV. Negotiations on the September 2005 World Summit outcome are happening now, and we are engaging closely to ensure HIV and AIDS issues, and related reproductive health issues, are properly dealt with.

We know what needs to be done, and now we have more of the means to make a big difference. This will not be easy. The progress we want will take many years. But what we have achieved recently shows what can be done if we all put our minds to it, and if we all work together.

That is why I applaud all of your hard work to make the G8 agreements such a success, why I am hopeful for the future, and why I do believe we will ultimately be successful.

Thank you.