Questions to the Chancellor of the Exchequer     (10/03/05)

G7 Presidency

Paddy Tipping (Sherwood) (Lab): What economic priorities he has set to be achieved during the presidency of the G7.

The Chancellor of the Exchequer (Mr. Gordon Brown): Our aims are: that all countries agree to play their part in maintaining global growth and stability; that structural economic reform is taken forward to increase growth; that, with the reform of the international institutions, we ensure that the world's poorest can share in rising prosperity. Tomorrow, the Commission for Africa will publish its report and the G7 and G8 in Gleneagles will consider it.

Paddy Tipping: Will the Chancellor continue to give Africa a high priority? Ten million people there are co-infected with HIV and TB. Tuberculosis is growing at 4 per cent. and, in parts of the region, only one in three people complete a TB drug programme. Would not investment make a significant difference?

Mr. Brown: My hon. Friend is right and I praise him for his work. Tuberculosis, HIV/AIDS and malaria are the diseases that are responsible for millions of people dying unnecessarily every year. The purpose of creating the global health fund was to ensure the capacity to treat them and the availability of immunisation and vaccinations. That is why it is especially appropriate today, when the scientists' report on malaria is published, that the British Government say that we are prepared not only to contribute towards vaccination for tuberculosis but to join other countries in purchasing and therefore financing an advance purchase mechanism for the new drug that may be a preventative vaccine for malaria. When similar work is done on HIV/AIDS, it will be necessary for the Governments of the richest countries to come together to support vaccination and the preventive work on that, too. That is the best contribution that we can make: not only helping in the short term with bed nets for malaria and vaccination for tuberculosis, but saying that, when those drugs are discovered, we will be behind the first advance purchase scheme in the world whereby the rich countries help the poor.

Questions to the Parliamentary Under-Secretary of State for International Development     (09/03/05)

Africa (Tuberculosis)

Paddy Tipping (Sherwood) (Lab): What support he is giving to programmes to combat tuberculosis in Africa.

The Parliamentary Under-Secretary of State for International Development (Mr. Gareth Thomas): The UK is a key donor to the global fund to fight AIDS, TB and malaria, to which we have pledged some $280 million through to 2008. More than 60 per cent. of global fund grants go to Africa, and some $245 million has been committed for TB. We also fund the global stop TB partnership, support the global TB drug facility and have spent more than £1.5 billion on strengthening health systems, so that better care, including for those with TB, is provided.

Paddy Tipping: Will the Minister accept that there is a serious crisis in Africa, where around 10 million people are co-infected with HIV and TB? TB cases are rising by 4 per cent. a year in Africa, but in parts of the region only one in three have a full course of TB drugs. Will that issue be raised at the G7 summit?

Mr. Thomas: My hon. Friend is right to issue that warning. If TB controls are not strengthened, we estimate that an extra 1 billion people will be infected with TB between now and 2020, that more than 150 million people will get sick, and that some 36 million people will die. G8 countries and EU countries undoubtedly have a role to play in providing more funding for the global fund. We will host the global fund replenishment conference in September, when we will hold discussions with all those countries on further funding.

Michael Fabricant (Lichfield) (Con): Is the Minister aware that every second of every day in the year, someone new is infected with the TB bacillus, which now infects one third of the planet? Given the spread of TB in Africa, does he agree that it is important to eradicate TB in Africa not only for Africans' sake, but because it is in our interests, given the movement of people between Africa and the UK?

Mr. Thomas: I agree with the hon. Gentleman that we must do more to fight TB. We must be aware of the strong links between TB infection and the HIV/AIDS epidemic, which is why my right hon. Friend the Secretary of State announced the doubling of our funding to the global fund last year and why we want to host the global fund replenishment conference in September.

Africa (Multinational Aid)     (09/03/05)

Simon Hughes (Southwark, North and Bermondsey) (LD): If he will make a statement on the proposals for a multinational aid plan for Africa.

The Secretary of State for International Development (Hilary Benn): If Africa is to prosper it needs peace and stability, good governance, a doubling of aid through progress in reaching the United Nations 0.7 per cent. target and through the international finance facility, 100 per cent. multilateral debt relief and fairer trade rules. The Government are pressing for action on all those fronts, and the recommendations from the Commission for Africa will be published on Friday.

Simon Hughes: The Secretary of State will know that colleagues on both sides of the House and I fully support a Government initiative that some have called the new Marshall plan for Africa. Specifically, what role does he expect the United States of America to play, and what role does he expect the European Union and its member states to play?

Hilary Benn: The single most important step that the EU could take would be to agree a new aid target to which its member states are prepared to commit, so that they can help development in Africa and other developing countries around the world. That process has begun in discussions between Development Ministers in the General Affairs and External Relations Council, and Louis Michel, the new Commissioner, will make a proposal. If the United States of America, the other G8 countries and, indeed, all donor countries, accept the argument that a doubling of aid for Africa and other measures are required, they must consider what their contribution will be to creating a different prospect for the next generation in Africa.

Mr. Tom Clarke (Coatbridge and Chryston) (Lab): I thank my right hon. Friend not just for his responses today but for his excellent work in seeking to make poverty history. On HIV/AIDS, will he continue to work with Nelson Mandela and others to ensure that that terrible scourge, which arises from poverty, does indeed become history?

Hilary Benn: I am grateful to my right hon. Friend for raising the matter of HIV and AIDS, not least because today we are co-hosting a conference in London with the French Government, Ambassador Randall Tobias, the US global AIDS co-ordinator, and Peter Piot of UNAIDS. It aims to ensure that the money that we have already raised in the fight against AIDS is used to the best effect so that we can bring care, support, treatment and anti-retroviral drugs to people who are suffering from this terrible epidemic. At the same time, by doubling aid to Africa and increasing aid to other developing countries we can raise the additional finance that we need to turn that expression of the world's support into help for people in the communities where they live. With treatment, more doctors, more nursing, more testing and more counselling we can help to keep more people alive, avoid millions of human tragedies and help to provide an opportunity for developing countries to grow and prosper. Without such an opportunity they will not relieve poverty.

Tom Brake (Carshalton and Wallington) (LD): The success of the Marshall plan for Africa will depend to a great extent on the additional funds from the international finance facility, yet there are great concerns about the way in which it will operate. Louis Michel, the EU Development and Humanitarian Aid Commissioner set out his concerns in a letter to me, in which he said he was anxious about its governance,

"the way its resources would be allocated and spent, and perhaps most importantly, the danger it might pose to aid flows after 2015—when repayments to the IFF would exceed its disbursements"

to developing countries. Does the Secretary of State wish to reconsider his response to me on 15 December 2004, when he said bluntly that he would not consider alternatives to the IFF? Will he agree to liaise with Treasury officials, who are looking at alternatives set out in, for instance, the Landau report?

Hilary Benn: No, I do not take back a single word, because as countries increase their aid programmes to reach the 0.7 per cent. UN target we face a challenge. We now have the timetable that the Chancellor announced last summer. We have 10 years to go until 2015, but we cannot wait until then because it would be too late to raise the necessary finance to deliver increased aid and join the battle against HIV and AIDS, get more children into school, and employ more doctors and nurses. The question for the House and every country is how we raise the additional finance for development today. The international finance facility now has support from France, Germany, Italy and, most significantly in one sense, Sweden, which announced just over a month ago its willingness to participate in the pilot project with GAVI—the Global Alliance for Vaccines and Immunisation—which we think could raise an additional $4 billion and save an extra 5 million lives over the next 10 years. If not the international finance-

Mr. Speaker: Order. May I ask the Minister to keep the answers shorter?

Helen Jackson (Sheffield, Hillsborough) (Lab): I commend my right hon. Friend for the work that he and the Chancellor of the Exchequer have done to promote the international finance facility, and particularly for the fact that it is gaining ground in the European Community. Does he agree that it is the duty of every party in the United Kingdom to come in behind the international finance facility, so that every party and every country in the European Union and the G8 across the world will back it and we can make a real difference during this year?

Hilary Benn: In deference to your strictures, Mr. Speaker, I shall just say that I agree with every word of my hon. Friend.

Questions to the Secretary of State for International Development     (09/03/05)

Millennium Development Goals

Chris McCafferty (Calder Valley) (Lab): If he will make a statement on the millennium development goals review in September 2005 in relation to sexual and reproductive health targets.

The Secretary of State for International Development (Hilary Benn): The millennium project report emphasises the importance of reproductive health and rights if we are to achieve the millennium development goals. Access to reproductive health is identified in the Sachs report as one of the "quick wins" for speeding up efforts to reduce poverty. We are working with others, including the European Union, to ensure that these strong messages on reproductive health are reflected both in the Secretary-General's report due in March and in the summit outcome document.

Chris McCafferty: Is my right hon. Friend aware of the millennium project taskforce report on child and maternal health and gender equality? It suggests a new target for universal access to reproductive health care by 2015 to help pull people out of poverty.

Hilary Benn: I am aware of that report. May I pay tribute to the all-party group on population, development and reproductive health, which has published a report, "The Missing Link!", that makes the link between the fight against HIV/AIDS and the importance of sexual and reproductive health? Around the world, 120 million couples do not use contraception, despite their express desire to plan how many children they will have. It is important that we give couples access to information to allow them to determine their own fertility.

Dr. Jenny Tonge (Richmond Park) (LD): I am glad that the Secretary of State appreciates and understands the link between good reproductive health and AIDS, which is such a scourge. He knows that the withdrawal of funds by the United States of America from the United Nations Population Fund has caused the loss of programmes across the developing world and diminished the prevention of AIDS and other diseases in those countries. What will he do to persuade the USA to resume its funding to UNFPA?

Hilary Benn: We have already done the most useful thing that we can do, which was to increase our funding to UNFPA, of which the UK is a strong supporter, by, if I remember rightly, an additional £10 million last year. UNFPA does vital and valuable work, and it deserves support from across the world.

Questions to the Leader of the House     (24/02/05)

Mr. Nigel Evans (Ribble Valley) (Con): The Department of Health announced today that there have been 5,016 cases of HIV. Given the habitual late reporting of that condition, the figure could easily be more than 7,000. In view of the new strain that has developed in New York, which is completely resistant to treatment, never mind cure, may we have an urgent debate to consider the Government's policy towards HIV and the possibility of an effective advertising campaign to warn people of the dangers of contracting it?

Mr. Hain: The hon. Gentleman raises a very important and serious issue. The Secretary of State for Health will want to take careful note of his remarks, and I will ensure that he is aware of them.

Questions to the Chancellor of the Exchequer     (16/12/04)

Poor Countries (Debt)

Ms Christine Russell (City of Chester) (Lab): If he will make a statement on progress towards multilateral debt cancellation for poor countries.

The Chancellor of the Exchequer (Mr. Gordon Brown): Our objective is to match bilateral debt relief by up to 100 per cent., with relief on the debt owed by poor countries to the World Bank and African Development Bank of up to 100 per cent. also to be funded through new commitment from all donors.

Ms Russell: May I thank my right hon. Friend for that encouraging reply? He will be aware that, in common with many other Labour Members, I have hundreds of constituents who communicate with me regularly on matters such as debt relief, and they tell me that they very much welcome and acknowledge the commitment to debt relief that our Government have shown. They have asked me to pass on to my right hon. Friend their earnest wish that Britain, when it assumes the presidency of the G8 and the EU next year, will encourage our colleagues to follow his lead and commit to debt relief.

Mr. Brown: I am grateful to my hon. Friend who, like many hon. Members, is working with the Churches and faith groups to push for debt relief for the poorest countries in the world. In the 1999-2000 period, we persuaded countries to write off 100 per cent. of bilateral debt relief, but we still have to complete the process. That involves writing off the debt owed to the World Bank, the IMF and the African Development Bank. Until now, I had hoped for all-party support in this. Unfortunately, I find that the Conservative party's proposals to cut £35 billion from public expenditure would mean a massive cut in overseas development aid. Again, what sort of Christmas present is that for the third world? The Opposition would cut the Sure Start children's centres, and now we know that they would also cut the overseas development aid.

Tony Baldry (Banbury) (Con): The Chancellor has made it clear that he will pay the UK's share of the remaining concessionary lending debt to the World Bank and the African Development Bank of those countries reaching the heavily indebted poor countries completion point. How much money does he think that that will involve? What indication has he had so far that other donors will be willing to follow the UK's lead? Will this matter be a priority for our G8 presidency?

Mr. Brown: I pay tribute to the hon. Gentleman's work as chairman of the all-party committee. That will be a priority for our presidency. I will talk to the American Administration about it this weekend, and I will meet the IMF and the World Bank to look at practical proposals to allow us to move forward. In the case of debts owed to the IMF, that would be done by use of IMF gold, which would be a bold decision but the right one. I believe that there is increasing support for that from the international community and from the managing director of the IMF. On debts owed to the World Bank, when we tried to act previously we raised a trust fund of something in the order of $3 billion. We have offered to pay off our share—10 per cent.—of the debts owed to the World Bank. I would like other countries to follow. I believe that the different members of the G7 recognise that that has to be done. I am glad that the hon. Gentleman supports our policy, but I ask him please to advise those on the Conservative Front Bench that if they continue to cut overseas development aid in their Budget proposals, they will not be able to finance the debt relief that we are providing. The Conservative party should think again.

Mr. Tom Clarke (Coatbridge and Chryston) (Lab): Does my right hon. Friend agree that the remarkable bilateral and multilateral progress that he has made in respect of debt puts him in a very strong position to encourage developing countries to introduce a strategy where they have mineral resources, such as in the great lakes or even in Angola, so that they can indeed reach the millennium goals and achieve the objectives that he has nobly set?

Mr. Brown: My right hon. Friend has played a prominent part in pushing to ensure that resources are there for the economic development of countries in Africa that have been denied opportunities for too long. That demands a good solution to the trade talks. It also demands that resources be available for education, health and economic development. In the example of Ethiopia, which was the starting country for the Live Aid action 20 years ago, one reason why it has not been able to move forward, and why it has, for example, only 2,000 doctors for 70 million people—a pathetic situation for a country with so many people—is that much of its debt is still owed to the World Bank and the IMF. It is therefore necessary for us to complete the process of debt relief to enable some countries to make the decisions that are right for them. I hope to be able to report progress in the first few months of next year.

Rev. Martin Smyth (Belfast, South) (UUP): We welcome what the Chancellor has been saying. He is offering to pay off 10 per cent. Will that be over a period of years, or is it intended to give a lead to others? Can he give any guidance on who might be the loiterers in coming forward?

Mr. Brown: I am grateful to the hon. Gentleman. We are beginning to persuade people, so I do not think naming and shaming is the right way to move forward in the first few months of our presidency. I believe that we can persuade the countries that need to contribute. The hon. Gentleman asked how the debt relief would be paid. Our 10 per cent. contribution is that we will pay all the interest payments due from the poorest countries to the World Bank for as long as they fall due. We are taking on the burden of the debt, and I hope that other countries can follow that course. The money is set against the overseas aid budget, so all parties would have to make a commitment that they would finance that budget to be able to do it.

Mr. John MacDougall (Central Fife) (Lab): I congratulate my right hon. Friend on his contribution to tackling third world debt. Would he care to comment on the work of the Commission for Africa, which faces significant challenges, particularly in terms of the HIV/AIDS epidemic that is sweeping the country and of the number of orphans left in distressful and unfortunate situations? I believe that the commission is doing an excellent job. Would the Chancellor care to comment on its work?

Mr. Brown: My hon. Friend has taken a big interest in these matters, and he is absolutely right to refer to the 11 million children in Africa who are orphans of mothers and fathers who have died from AIDS. That figure will rise dramatically in the next few years unless something is done. In some countries of Africa, a quarter of the adult population suffer from HIV/AIDS. That is why the measures that we are looking at, including giving £500 million a year from the Department for International Development to finance action on AIDS, are desperately necessary.

We have a meeting in Johannesburg at the beginning of January with the Commission for Africa and we will try to get agreement on a package of measures that could finance action on HIV/AIDS, malaria, tuberculosis and all the killer diseases in Africa. I hope that when we publish the Commission for Africa report we will have all-party agreement that we need to spend the money necessary so that illiteracy can be tackled—110 million children are not going to school today—and so that the 6 million avoidable deaths from killer diseases can be dealt with through prevention and cure.

Questions to the Secretary of State for International Development     (15/12/04)

Africa (Aid)

Dr. Desmond Turner (Brighton, Kemptown) (Lab): What his priorities are for aid expenditure in Africa.

The Secretary of State for International Development (Hilary Benn): The UK will provide over £1 billion in aid to Africa next year. Our priorities are to help build the conditions for development by promoting peace, democracy and economic growth, to help Africa progress towards the millennium development goals with HIV/AIDS, reducing child and maternal mortality and tackling hunger as priorities, and to help build Africa's capacity to develop itself. We will provide substantial assistance to the African Union and to support the recommendations of the Africa Commission.

Dr. Turner: Having also visited Malawi recently, my hon. Friend will be as aware as I am of the appalling difficulties facing health provision in that country due to the sheer lack of human capacity in terms of trained health workers to deliver the goods. What plans does he have to increase the human capacity of countries in Africa such as Malawi? Without extra trained people, all the free or cheap anti-retroviral drugs in the world will not help the massive problem of AIDS in those countries.

Hilary Benn: My hon. Friend makes a very important point about a country where, over the past 10 years, average life expectancy has fallen from 48 years to 39 and where there is a public health emergency. On 3 December, I announced a new programme worth £100 million that we have developed with the Government of Malawi. It will increase salaries for doctors and nurses by 50 per cent. and in part is aimed at helping to recruit the 800 or so qualified nurses living in Malawi who do not currently work in the health service. The programme will also increase Malawi's total aid budget by 30 per cent. and train more doctors and nurses. In the meantime, to fill some of the very many vacancies in the Malawian health service, it will pay for volunteer doctors and nurses to go to that country, and they will start arriving over the next six months. Ours is a very practical programme and we are able to pay for it because we have a rising aid budget in Africa.

Mr. Alan Duncan (Rutland and Melton) (Con): Because of the scale of poverty in Africa, and because aid resources are obviously limited, priorities have to be set. However, it appears that the Copenhagen consensus, with a team of eminent economists, chose a set of priorities different from those just outlined by the Secretary of State. The Copenhagen economists said that the top three priorities were the need to stop the spread of HIV/AIDS, the need to combat malnutrition and hunger, and the need to encourage freer and fairer trade. On what academic basis has the right hon. Gentleman's Department reached such a different conclusion?

Hilary Benn: I do not agree that we have reached a different conclusion, because we are working on all three of those matters. The hon. Gentleman will be only too well aware that, in 1997, the UK was spending £38 million a year through its development programme in the fight against HIV/AIDS and to promote reproductive and sexual health. Next year, and in the two years after that, Britain will put £500 million a year into the fight against HIV/AIDS and to promote reproductive and sexual health. By any measure, that is a very substantial increase and it is due to the fact that we have a rising aid programme. We are doing all the things that the Copenhagen consensus outlined in its document, but we are also investing—unapologetically—in improving health and education. If we do not improve the health services, it will be very difficult to get treatment to people suffering from HIV/AIDS.

Mr. Duncan: Let us assume for a moment that we accept the Secretary of State's priorities. If he accepts the need for prioritisation such as he has described when determining how our aid budget is allocated, why is he happy to give a quarter of our total aid budget to the EU, which spends only half of its funds on tackling poverty in the poorest countries? If the Government want to apply their poverty-reduction criteria effectively, how can they justify the diversion of a quarter of the aid that they give through a channel that applies completely different criteria?

Hilary Benn: First, as my hon. Friend the Minister made clear in answer to the first question this afternoon, there has been a real process of reform in the European Union, which I welcome but which needs to continue. Secondly, I hope that the hon. Gentleman will join me in supporting the Government's push to get the arguments that he has just advanced heard better in the European Union, because it is unacceptable that a falling proportion of the EU's development budget is spent on the poorest countries in the world, including in Africa. All of us need to work hard to increase that proportion, because the need is greatest in those countries and we need to ensure that all our resources, including those that go via the EU—

Mr. Duncan indicated assent.

Hilary Benn: The hon. Gentleman agrees with me; I am grateful for his support.

Questions to the Secretary of State for Education and Skills     (02/12/04)

International Development

Ms Sally Keeble (Northampton, North) (Lab): What steps he is taking to promote the understanding of international development in schools.

The Secretary of State for Education and Skills (Mr. Charles Clarke): On 15 November this year, I launched the Department for Education and Skills international strategy, called "Putting the world in world-class education". It makes clear my Department's aim to ensure a strong international dimension across our education system, which we intend to achieve by building on the good work already being done in many schools by the British Council, the Department for International Development and voluntary organisations. We have also developed the Global Gateway, which is a new international website to allow schools across the world to engage in creative partnerships and develop mutual understanding.

Ms Keeble: I am grateful to my right hon. Friend for that answer. Will he join me in congratulating the 25 schools in my constituency that have been studying the plight of HIV/AIDS orphans in Kenya and preparing Christmas parcels of toys and school equipment for them? Will he join me in paying tribute to Kappa Packaging, the local firm that made the boxes, and to DHL, which is flying all 1,800 of them to Kenya? Does he agree that such work done by schools and backed by businesses is the way to build the kind of understanding that we need in future to tackle international problems?

Mr. Clarke: I very strongly commend the schools and organisations supporting the Kenya project in my hon. Friend's constituency. She has described that work to me, and it is genuinely impressive and exciting. Such work with Kenya fits absolutely with the Commission for Africa and the Government's focus, through our G8 presidency, on promoting Africa and how we can work together in so many ways. Education is the key to contesting HIV/AIDS in sub-Saharan Africa, and the kind of work in Northampton that my hon. Friend can happily represent is inspirational.

Questions to the Chancellor of the Exchequer     (11/11/04)

International Development

Sir Nicholas Winterton (Macclesfield) (Con): What recent discussions he has had with Cabinet colleagues regarding levels of public spending on international development in 2004-05.

The Chancellor of the Exchequer (Mr. Gordon Brown): Following discussions with Cabinet colleagues, I announced in the spending review that total UK official development assistance will increase from £4 billion this year to almost £6.5 billion by 2007-08, and ODA as a proportion of national income will increase from 0.34 to 0.47 per cent. in 2007-08

Sir Nicholas Winterton: Members on both sides of the House recognise the Chancellor of the Exchequer's commitment to international development, international aid and, ultimately, to achieving the United Nations target of spending 0.7 per cent. of national wealth on development aid, but does he accept that the Department for International Development spends aid very much more effectively in the poorest and most needy countries than does the European Union, which often concentrates on political objectives in neighbouring countries? Will he therefore ensure that a greater percentage of our aid is bilateral and decided by this country and given to the poorest and most needy nations?

Mr. Brown: We have of course increased bilateral aid and will continue to do so. However, multilateral aid has an important role, whether that is when nations come together through the World Bank, the International Monetary Fund, the African Development Bank or the European Union's aid programmes. We should not reject the idea that the European Union should do work in this area, but ensure that the European aid programme is reformed. I hope that the hon. Gentleman and I share a common objective on that. We have made proposals for the reform of the budget and we have a new Commission, so I hope that we can achieve such reform. I would hope that that would especially benefit the countries about which he is most interested: the countries of the British Commonwealth in which 70 million children still do not have schooling. We could make a huge impact on that situation in the next few years.

Mr. Win Griffiths (Bridgend) (Lab): When my right hon. Friend is at meetings with the G8 or other Chancellors in the European Union, will he ensure that a lot of the spending will be focused on dealing with the problem of HIV/AIDS? Unless we can stop that scourge, teachers and other professionals will not be available to ensure that our millennium goal of making sure that primary education is accessible to all children can be achieved.

Mr. Brown: My hon. Friend takes a huge interest in such matters. There are 40 million people who live with HIV/AIDS and 20 million people have died of AIDS. In sub-Saharan Africa, as he knows, 25 million people are living with AIDS and 3 million children have AIDS. That tragedy can be dealt with. Of the £1.5 billion that the UK will spend on tackling HIV/AIDS over the next three years, at least £50 million will be dedicated to helping children who have been made vulnerable by what has happened to their parents, and that will be spent especially in Africa. I met the head of the Global Fund to Fight AIDS, Tuberculosis and Malaria only a few days ago. He has a programme that would enable him to spend substantially more to deal with the problem, but the issue is the resources that are available to him for what is acknowledged as an effective programme. That is why we need measures such as the international finance facility.

Sir Patrick Cormack (South Staffordshire) (Con): Is the Chancellor confident that sufficient contingency plans are in place so that when the odious, tyrannical Mugabe regime comes to an end, there will be proper aid to put that country back on its feet?

Mr. Brown: It is a common cause among the parties that, if aid goes directly to organisations in civil society that deal with problems, and thus sometimes bypasses Governments, it is to the benefit of people who were previously denied bilateral aid given between Governments. Civil organisations in Africa are increasingly receiving help directly from the World Bank or Governments, and I think that that will continue. We provide help to Zimbabwe where there is famine and disease, but the unfortunate thing is that its Government are not doing what they should, which is why change is needed in that country.

Chris McCafferty (Calder Valley) (Lab): My right hon. Friend will be aware of the importance of access to sexual and reproductive health education and services to achieving the millennium development goals and helping people out of poverty. Will he assure the House that, when he discusses financial considerations for overseas development, and especially the millennium development goals, he will examine carefully the proportion of money that he is giving to fund sexual and reproductive health services abroad?

Mr. Brown: I am grateful to my hon. Friend, who has taken an interest in these matters. The International Development Secretary has been doing a great deal of work on the matter and I talked to him about it only a few days ago. Much more of our increased aid budget is being spent on health generally and the specific services about which she talks.

Questions to the Secretary of State for International Development     (10/11/04)

Medical Training (Africa)

Tim Loughton (East Worthing and Shoreham) (Con): What support his Department has provided for the training of (a) doctors and (b) nurses in Africa in each of the last five years.

The Secretary of State for International Development (Hilary Benn): DFID has provided £560 million over the past five years to support health services development in Africa, including the training of nurses and doctors. Of that, an estimated 5 to 20 per cent., depending on the country, is spent on developing the capacity of the work force.

Tim Loughton: I warmly welcome those figures. One of the things that struck me most when I visited Ethiopia two years ago was being told that there are more Ethiopian doctors in Chicago than in the whole of Ethiopia. That pattern is replicated throughout Africa. In places such as Ghana and Zimbabwe, 70 per cent. of doctors leave within five years of graduation. It is right that we should contribute towards the training of health professionals but crazy that we should then poach them; that is still happening in this country through private agencies. Can the Secretary of State apply his mind to thinking more imaginatively about improving terms and conditions, perhaps as part of the aid budget, to ensure that doctors and nurses stay in their home countries, where they are needed most?

Hilary Benn: The hon. Gentleman is right. We have the code of practice in place and my right hon. Friend the Secretary of State for Health is looking at how we can strengthen it. Individuals make decisions to leave countries to seek employment in other parts of the world, but the hon. Gentleman has put his finger on the real issue. How can we do something, working with developing-country Governments, to make it less likely that people will take their skills and expertise away from the country of their birth and travel to other parts of the world? It is about pay, opportunities for continuing professional development, working conditions, the extent to which they will have access to the drugs that they have been trained to use but which may not be available in the communities in which they are placed, accommodation, and whether their children can be educated if they work in rural areas. When I was in Ghana earlier this year, I had exactly that discussion with the head of the Ghanaian health service. His mind was almost exclusively focused on what could be done in Ghana to reduce the factors that push health workers out of that country.

Tony Worthington (Clydebank and Milngavie) (Lab): The Secretary of State knows that this is an immense problem. As more money goes in to HIV/AIDS and reproductive health, it simply will not be possible to improve health services unless we improve the supply of nurses and doctors. There is no sign of any international effort to tackle that issue. Staff are emigrating; staff are themselves dying from HIV/AIDS and there is a totally unsatisfactory secondary and tertiary health system. Perhaps there should be a World Health Organisation-led effort to deal with the problem of the capacity of health services through human resources in Africa.

Hilary Benn: At its last gathering, the World Health Assembly passed a resolution asking the WHO to look at that very question and will report back next time. It included the proposal for an international code. Quite what that might say and how it would be enforced I cannot say.

AIDS is having a devastating impact not only on the countries themselves but on the capacity of their health services. That is why we are working with the Government of Malawi, for example, to try to double their health capacity over the next six years. The vacancy rates in Malawi are running at 64 per cent. for nurses, 91 per cent. for obstetricians and gynaecologists and 85 per cent. for surgeons. There are 10 districts in Malawi with no Ministry of Health doctor whatever. That is the scale of the challenge, and we are considering a programme that will include external recruitment, to try to sustain the capacity of the Malawian health service.

Mr. Julian Brazier (Canterbury) (Con): Everything that the Secretary of State has said on this issue is welcome, but the fact remains that we are still pillaging doctors and nurses from countries that are desperately short of them; a figure even worse than those that he cited is the 97 per cent. shortfall of nurses in Uganda. Will he ask the Secretary of State for Health to take action, not just to tighten the code of practice, but to ban the NHS from taking staff, through private sector agencies, from the countries with the greatest shortfall of medical and nursing staff?

Hilary Benn: The code of practice says very clearly that there will not be active recruitment. The really difficult question, if we are honest, is this; if an individual from a developing country who is a nurse or a doctor chooses to seek employment in the United Kingdom or the United States of America, is it right to have a law that says that they cannot be employed in any capacity in the health service in our country? The individual would say, "What about my right?" Linking back to the earlier question about remittances, one thing that encourages people to seek employment in another country is that they can earn a higher salary so that they can send back money to help sustain their families. One must be aware of the two sides of the argument. The purpose of the code of practice is to prevent active recruitment, and my right hon. Friend the Health Secretary is investigating what more we can do to deal with the problem.

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