SUMMARY

Questions to the Secretary of State for Health (23/06/2009)

Questions to the Secretary of State for International Development (13/5/2009)

Lords Questions: UN conference on drugs, Vienna (11/5/2009)

Lords Questions: HIV treatment for failed asylum seekers (25/05/2009)

Questions to the Secretary of State for International Development (25/3/2009)

Questions to the Home Secretary (23/3/2009)

Lord Questions: Contaminated Blood (5/3/09)

Questions to the Secretary of State for International Development (17/12/2008)

Lords Questions: World AIDS Day (8/12/2008)

Questions to the Secretary of State for Health (23/06/2009)

Dr. Iddon: (Lab) Why has my right hon. Friend rejected Lord Archer’s recommendation that patients who have contracted the hepatitis C virus from contaminated blood should receive the same compensation as those who contracted HIV from contaminated blood, as in the Irish Republic and several other countries?

The Minister of State, Department of Health (Gillian Merron): I deeply regret that patients have contracted serious infections as a result of NHS treatment 20 or more years ago. However, it is the different circumstances of patients that are reflected in the different financial arrangements. We will review the Skipton fund, which was set up for those infected with hepatitis C, in 2014, 10 years after its commencement. I cannot accept the comparison with Ireland, because the Irish blood transfusion service was found to be at fault, and that was not the case here.

Questions to the Secretary of State for International Development (13/6/2009)

Mark Durkan (Foyle) (SDLP): I welcome the Minister’s indication that the cholera outbreak is under control, but what is his assessment of the situation in Zimbabwe in respect of HIV/AIDS, a problem that was callously and deliberately neglected by the Mugabe Administration?

Mr. Lewis: Part of the extra support made available by us, both in the past and most recently, to strengthen health systems is about ensuring that the Zimbabwean health system has the capacity to tackle HIV/AIDS properly. We also want the new President in South Africa to remain committed to the new approach to HIV/AIDS there, which does not just affect attitudes in that country, but affects attitudes to how HIV/AIDS is tackled across the African continent. Our support for strengthening the health system means that we hope for a rapid improvement in the fight against HIV/AIDS.

Lords Questions: UN conference on drugs, Vienna (11/5/2009)

Lord Cobbald: To ask Her Majesty’s Government whether they have made any changes to their drugs policies following the United Nations high-level drugs conference in Vienna in March.

Full debate here, section on HIV below

Lord Brett: My Lords, the Government believe that in resolving these issues there should be a balanced approach and that harm-reduction policies are an essential part of it; for example, in relation to the HIV/AIDS pandemic across the world, and the lack of access to drugs in poor countries. On the other hand, we do not accept the case for decriminalisation and we believe that a balanced approach carried forward with our European partners, who are broadly in agreement with us, is the best way to tackle this international and domestic problem.

Lords Questions: HIV treatment for failed asylum seekers (25/05/2009)

Baroness Tonge: My Lords, the Minister will know that failed asylum seekers are treated for tuberculosis without charge. However, does she acknowledge that failed asylum seekers with diabetes or HIV/AIDS have to pay for their treatment, yet they are at a much greater risk of contracting TB clinically and most live in the unsanitary conditions that lead to TB infection in individuals? Will the Government reconsider their refusal to give free NHS care to these very vulnerable people?

Baroness Thornton: My Lords, the noble Baroness will be aware that we certainly regard TB as a public health issue, and anyone who is suspected of having TB will receive their treatment promptly, and it will of course be free. The noble Baroness is aware that we are reviewing the other issues that she has continued to raise with the Government, because it is not in anyone’s interest that people do not receive the treatment that they need for conditions such as HIV, TB or related illnesses.

Questions to the Secretary of State for International Development (25/3/2009)

Mr. Russell Brown (Dumfries and Galloway) (Lab): What recent discussions he has had with his international counterparts on global efforts to tackle HIV/AIDS.

The Parliamentary Under-Secretary of State for International Development (Mr. Ivan Lewis): DFID Ministers and officials maintain an extensive dialogue with key international partners. I have recently discussed AIDS issues with senior figures at the global fund, the World Health Organisation, the UN Population Fund and the World Bank, and with Ministers during recent country visits to Nigeria, South Africa and Uganda.

Mr. Brown: I thank the Minister for his reply. Thanks to the co-operation of branded pharmaceutical companies, generic competition in HIV drugs has reduced first-line drug prices for patient treatment from more than $1,000 a year to less than $100. As well as persuading his other Government counterparts to take HIV seriously, what more can the Minister do to persuade more companies to adopt an enlightened, co-operative approach and help reduce prices for second-line HIV drugs, which are so desperately needed as they do save lives, but which remain very expensive?

Mr. Lewis: My hon. Friend raises an important issue. Our aim is to reduce the cost of HIV/AIDS drugs by £50 million a year over the next few years. Only this week, I wrote to UNITAID asking it to set out a timetable for the launch of a patent pool for HIV medicines. I welcome GlaxoSmithKline’s recent commitment to explore the potential for patent pools to make the development of new medicines for neglected tropical diseases easier, and I believe the time has now come for other pharmacological companies to respond positively to this initiative and join forces so that we can make the contribution to driving down prices and improving access to HIV/AIDS drugs.

Mr. Nigel Evans (Ribble Valley) (Con): Antiretroviral drugs are rightly being made more affordable and generally more available, thanks to the support of the United Kingdom, the United States of America and organisations such as the Bill and Melinda Gates Foundation. Education is vital important, and we should be focusing some of our attention on prevention. What discussions has the Minister held with his opposite numbers about ensuring that education is made available so that the message about how people can avoid getting HIV in the first place can be communicated, and particularly about trucking routes in some countries, such as India, and in Africa?

Mr. Lewis: The hon. Gentleman makes a very important point. The new American Administration’s recent announcement about removing some of the ideological and philosophical barriers that prevented us from engaging internationally on prevention and education presents an opportunity for the world community to come together and make a greater impact. We have announced an unprecedented commitment of £1 billion for the global fund and £6 billion to strengthen health systems, but the hon. Gentleman is right to say that we must look innovatively and imaginatively—perhaps through community leaders, faith group networks, informal networks
and peer influence—at educating populations in every country. We have to use all the tools at our disposal to ensure that we get across the strongest conceivable message about HIV/AIDS. I also believe that the South Africans’ change in policy will significantly help us in Africa.

Hilary Armstrong (North-West Durham) (Lab): My hon. Friend knows that HIV/AIDS particularly affects women and children in the poorest countries. What are he and the Government doing to work with other countries to make sure that at a time when the economic situation is giving such difficulty, particularly to the poorest countries, the international community none the less keeps up its commitment to supporting the poorest in tackling such tragic diseases as HIV and AIDS?

Mr. Lewis: My right hon. Friend is absolutely right, and I pay tribute to the tremendous work she has done over many years on these issues. The Prime Minister has made it absolutely clear that this is not the moment for the world to retreat from its commitment to the developing world, such as through his advocacy through the World Bank of a vulnerability fund to ensure we protect the most vulnerable at a time when the recession will hit them the hardest, and the reform of international institutions to make sure they are far more responsive to the needs of the developing world, and our hosting last week in London of a meeting of senior African leaders to ensure that they have a strong and clear voice in the forthcoming G20 summit. It is important that as we fix the international economic system we make sure that that fixing advantages, rather than disadvantages, the developing world.

Mr. Gary Streeter (South-West Devon) (Con): The Minister, to his credit, is known for his outspokenness. Will he make sure that his international counterparts recognise that confronting the dreadful disease that is HIV/AIDS is not just about access to drugs and condoms, important though those things are? If we are to tackle this disease, we must confront, head-on, the true cause: men behaving in a sexually promiscuous manner in too many countries throughout Africa and elsewhere. Will he impress upon his counterparts the fact that issues of public awareness and education are vital if we are to get under the skin of this disease?

Mr. Lewis: My right hon. Friend the Secretary of State said that I was not outspoken any longer—I rarely disagree with him, and I am not going to start now.

The hon. Gentleman rightly raises the important issue of the role of women in society, and highlights the fact that the way in which men in many developing countries see relationships is a major part of the problem. In that sense, we need strong political leadership to make clear the appropriate role of women in society and to empower women in local communities. We must make it clear that we give them the opportunity to fight for their rights. We also need a very clear zero-tolerance approach to violence against women to be enshrined in developing countries’ legislation.

Mark Durkan (Foyle) (SDLP): Organisations such as Concern Worldwide stress the need for conditional linkages between the issues of HIV/AIDS, and nutrition and food security. Will the Government do more to support efforts to integrate HIV prevention, mitigation, care and treatment with programmes dealing with livelihood, nutrition and food security?

Mr. Lewis: The hon. Gentleman makes a very important point; we need to make a link between rural communities, agricultural development, food security and diseases. We want increasingly, at a local level, to integrate our responses, bringing together health, education and food security. The aim is to operate in an integrated way, rather than in silos.

Andrew Stunell (Hazel Grove) (LD): The global downturn makes health care in the least developed nations increasingly problematic. Will the Minister reassure the House that the UK Government will press ahead with prevention programmes and will not be deflected either by the falling value of the pound or the sincerely held but mistaken views of others?

Mr. Lewis: The Prime Minister has made it absolutely clear that our commitment in respect of 0.7 per cent. of gross national income by 2013 remains as strong as ever, so there will be no retreating from our commitments. We are the second-largest bilateral donor in terms of health systems and the attack on diseases in the world—as I said in my answer to my right hon. Friend the Member for North-West Durham (Hilary Armstrong), this Government will not retreat from our commitments. More importantly, we will provide leadership on occasions such as meetings of the G20 and the G8 to make sure that other international leaders do not walk away from the commitments that they have made, largely as a result of leadership shown by our Prime Minister and this country.

Questions to the Home Secretary (23/3/2009)

Dr. Brian Iddon (Bolton, South-East) (Lab): I understand that my hon. Friend was in Vienna recently, at the United Nations General Assembly special session on the misuse of drugs. Will he tell us what position Britain took at that assembly, and what the general outcome of it was?

Mr. Campbell: We made no secret of the fact that the UK Government were disappointed by the political declaration that came out of the long deliberations, and also the conference itself. We did not support views on difficulties concerning use of the term “harm reduction” in the declaration. It is inconsistent to refer to millennium goals that talk about tackling HIV and AIDS, but to do and say nothing about clean needles. We signed up to the declaration reluctantly, but we will continue the process to ensure that harm reduction gets a fair hearing.

Lord Questions: Contaminated Blood (5/3/09)

Lord Patel: My Lords, what policies do the Government have to prevent transmission of infections to haemophiliacs via blood products?

Baroness Thornton: My Lords, the noble Lord will be aware, more than I am indeed, that in 1985 heat treatment for plasma-derived blood products became available. That removed the risk of HIV and hepatitis C and all blood donors are tested. To remove any potential for transmission of infection through donor-sourced products, since 1988 all children in the UK have an access to recombinant—that is, synthetic clotting factors, which are completely safe. In February 2003, the Government announced additional funding to extend availability to adult haemophiliacs in England and all haemophilia patients are now eligible for treatment with those synthetic products. We will continue to provide funding for that; we are committed to this. Expenditure on these products has risen from £21 million in 2004-05 to £46 million in 2008-09.

Baroness Barker: My Lords—

The Earl of Onslow: My Lords, there is an expression that I was brought up with, which goes “fair words butter no parsnips”.

Noble Lords: Liberal Democrats!

The Earl of Onslow: My Lords, I am on my feet. Why should I break the habit of the lifetime? Fair words butter no parsnips. Would it not be much easier just to say that both Governments have made a terrible error in this issue and that compensation will be paid, period? That is all that needs to be said.

Baroness Thornton: My Lords, all Governments have been apologising for this since 1987, and there are funds available for those people that both Governments have established.

Baroness Barker: My Lords, does the Minister agree that perhaps the most chilling point in the excellent report from the noble and learned Lord, Lord Archer, is that many of these people were infected as a result of being given experimental products without their consent or knowledge? In light of that, does she agree that the current system of compensation is inadequate and ineffective and that the Department of Health and the Department for Work and Pensions need to act rapidly to ensure that those people who still survive no longer face an uncertain future in dire poverty?

Baroness Thornton: My Lords, £140 million have so far been given to the people who are infected, and we shall consider carefully the recommendations of the noble and learned Lord, Lord Archer, particularly relating to payments for infected individuals and their carers.

Questions to the Secretary of State for International Development (17/12/2008)

Mr. David Burrowes (Enfield, Southgate) (Con): What assessment he has made of the effect of recent political developments in South Africa on policy to tackle HIV/AIDS in southern Africa. [244088]

The Minister of State, Department for International Development (Mr. Gareth Thomas): There has been a marked change in language on policy to tackle HIV/AIDS in South Africa since the appointment of Barbara Hogan as the new Health Minister. We welcome in particular the launch of a major public awareness campaign on 1 December and the announcement of plans to scale up prevention of mother-to-child transmission services.

Mr. Burrowes: No doubt responsibility for the 10 wasted years of HIV denial, and its effect on some 1.5 million orphans, lies squarely on the shoulders of the South African Government, but what is the Minister’s judgment on the Department’s influence, given its significant presence in South Africa during those years and given that in other so-called middle income countries such as Brazil, Botswana and India the Foreign Office has taken the lead in the light of their epidemic HIV incidence? Are the prospects of influence better or worse?

Mr. Thomas: I agree with the hon. Gentleman to the extent that Barbara Hogan represents a breath of fresh air in South Africa. We are seeing an end to the culture of denial about HIV and AIDS in South Africa that is extremely welcome. We have sought to get behind the public awareness campaign that Barbara Hogan has launched, and the scaling up of mother-to-child transmission prevention services, by committing some £15 million in a new programme announced by the Under-Secretary of State for International Development, my hon. Friend the Member for Bury, South (Mr. Lewis), in a recent visit to South Africa.

Greg Mulholland (Leeds, North-West) (LD): Thirty-three million people in the world have HIV, yet only one in three has access to the medicines they need to keep them alive. The Minister knows well that one of the biggest problems is the cost of medicines. What progress has he made regarding discussions on the concept of the patent pool, whereby pharmaceutical companies would create generic copies and be paid a fair royalty so that people could access the medicines that they desperately need?

Mr. Thomas: The hon. Gentleman may know that under the TRIPS—trade-related aspects of intellectual property rights—agreement of 2003 there are arrangements for developing countries to access generic copies of drugs. We have sought to encourage that process. We need to see better access not only to first-line anti-retroviral drugs but to second-line and third-line anti-retroviral drugs to deal with the more complex strains that occur when people are developing a resistance to the drugs. We will continue to work with pharmaceutical companies and a range of other players to achieve that end.

Lords Questions: World AIDS Day (8/12/08)

To ask Her Majesty’s Government, in light of World AIDS Day, what further action they are taking to assist those in the poorest countries affected by HIV/AIDS.

Lord Tunnicliffe: My Lords, on World AIDS Day the UK Government launched a monitoring and evaluation document to help us to evaluate the impact of the AIDS strategy launched in June, which included commitments of £6 billion to strengthen health systems and services and £200 million for social protection programmes, in addition to the £1 billion previously committed for the Global Fund to Fight AIDS, TB and Malaria. We also announced a package of £15 million to help to revitalise and reinvigorate South Africa’s AIDS response under the leadership of the new Health Minister, Barbara Hogan.

Baroness Northover: My Lords, I thank the noble Lord for his reply and for DfID’s work in this area. There are now almost 12 million children orphaned by AIDS, which is double the number of only about seven years ago. How can we ensure that, despite economic recession, the needs of such children are not forgotten? Does he recognise not only the moral case here but also that the very stability of some of these countries and their communities may be undermined unless there is extremely strong international support at this time?

Lord Tunnicliffe: My Lords, the UK remains firmly committed to meeting the needs of orphans and vulnerable children. We will work to ensure that national plans of action are systematically integrated into national health education and social protection plans. Over the next three years, the UK will expand its social protection programmes to over £200 million, which will be channelled through both government and non-government organisations. On the second two points, the answer is basically that we agree. We recognise the importance of maintaining the momentum in this and other DfID areas. As my noble friend Lord Malloch-Brown said in the debate on Thursday, the Prime Minister repeated his commitment a month ago to overseas development assistance reaching 0.7 per cent of GDP by 2013. This has been echoed by the International Development Secretary and continues to be supported on all sides of the House.

Baroness Rawlings: My Lords, what is the Government’s view of the use of generic drugs in the poorest countries, which has reduced the price of the antiviral treatment to about $700 a year?

Lord Tunnicliffe: My Lords, we totally support it. We support the international efforts and the publication of information about such generics to help countries to understand their opportunities. We work with other countries to make sure that both generic drugs and developing drugs become affordable in the countries where they are needed.

The Lord Bishop of Carlisle: My Lords, it is recognised that faith leaders can have a great impact on the practice of communities. I have personal experience of South Africa, Mozambique and Angola and I have listened to a South African Anglican bishop powerfully preaching to a congregation about HIV/AIDS. Yet less than 5 per cent of the global fund for HIV/AIDS has been directed to faith-based groups. What are the Government and DfID doing to support faith groups in delivering programmes in partnership with government and to analyse the effectiveness of current AIDS spending to engage more effectively with the problem?

Lord Tunnicliffe: My Lords, I do not have specific information on the extent to which we help faith-based groups. Most of our money in DfID is spent through country programmes, which are focused where they can be most effective. Certainly, where a faith-based group helps in such a programme, we would co-operate with it.

Lord Avebury: My Lords, considering that children with HIV/AIDS are 40 times more likely to contract pneumococcal disease, a family of diseases that kills 1.6 million a year, will the Government consider integrating pneumococcal disease into their strategy and giving it the same prominence as they do malaria and TB, in consultation with the Global Alliance for Vaccines and Immunization and its initiative PneumoADIP, which promotes this strategy?

Lord Tunnicliffe: My Lords, the simple answer is yes. We entirely take the point that pneumococcal disease should be considered alongside the three other killers. We are supporting the organisations that the noble Lord mentioned.

Baroness Morris of Bolton: My Lords, it costs less than £1 to stop mother-to-child transmission of HIV/AIDS. What particular steps are the Government taking to ensure that these vital drugs reach pregnant women? In 98 per cent of cases that treatment can mean that they do not pass on the virus to their children, yet only about 10 per cent of pregnant women get these antiviral drugs.

Lord Tunnicliffe: My Lords, we share the view that transmission from mother to child is crucial and we are featuring that in all our country programmes. The whole programme is built around prevention, treatment, care and support. Prevention of mother-to-child transmission is crucial and has our full support in country programmes.

Baroness Gardner of Parkes: My Lords, the Minister mentioned prevention. This country has been doing research into various barrier creams and preventives, which would be of great benefit to the whole world. What progress is being made? Are we continuing that research and are we anywhere near an answer?

Lord Tunnicliffe: My Lords, the area into which we are putting particular efforts is microbicides, which we think will have a key effect. We are involved with and support trials. Microbicides are particularly effective for women, because HIV/AIDS is becoming a feminine disease, particularly among heterosexual communities. We have funded this to the extent of £50 million and we will carry on funding it. Unfortunately, we fear that it may be as much as three years before we start to see some positive results from those trials.

Baroness Billingham: My Lords, may I ask the Minister a practical question, which follows on from the earlier question about delivery and about children in particular? Everyone is aware that dealing with this area is one of Save the Children’s most fundamental tasks; its people in this field in deprived areas are perhaps those who are working in the most positive way. In what ways are the Government working alongside such agencies, which already have much expertise, rather than having to create our own?

Lord Tunnicliffe: My Lords, we universally try not to reinvent programmes that are serving these countries well. Our money will mostly go into programmes that are already there. In general, we do not invent programmes centrally; we support country commitment, civil society and Governments in those countries that are being effective.

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