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Sustainable Development Goals: HIV

Volume 767: debated on Tuesday 1 December 2015


Asked by

To ask Her Majesty’s Government, in order to help achieve the Sustainable Development Goals, how they plan to invest in key populations in middle-income countries where it is expected that by 2020, 70 per cent of people living with HIV will live.

My Lords, the UK is proud to be the second largest international funder of HIV prevention, care and treatment. We have pledged up to £1 billion to the Global Fund and £9 million to support key population groups through the Robert Carr civil society Networks Fund. The UK’s support to the Global Fund will prevent approximately 8.4 million new malaria, HIV and TB infections.

I thank the Minister for that Answer. Today is World AIDS Day. AIDS is the biggest killer of women of reproductive age. AIDS is the second-biggest killer of adolescents. In 2014, 1.2 million people died of an HIV/AIDS-related illness. There are 36.9 million people living with HIV, and most people living with HIV are in middle-income countries. Therefore, it is vital that when addressing the possible withdrawal of programmes and funding from middle-income countries, the Government look at indicators other than the blunt instrument of GNI.

My Lords, I reassure the noble Lord that approximately 50% of Global Fund resources are directed to middle-income countries. We use our seat on its board to encourage it to focus on key populations, as the noble Lord is aware. As middle-income countries graduate from aid, we work with the Global Fund, UNAIDS, national Governments and civil society to encourage stronger national responses and greater domestic resource mobilisation.

My Lords, there are 36 million people around the world living with HIV, yet WHO estimates that half of them are untested and undiagnosed. Is not the reason why people do not come forward the prejudice against them and the criminal law against gay people and lesbians in so many countries? Given that so many of these countries are inside the Commonwealth, should not the British Government take the lead in campaigning against such injustice?

My Lords, my noble friend raises a really important point. Stigma and discrimination drive key affected populations underground. At the recent CHOGM talks in Malta, we very much had that conversation. I reassure my noble friend that we spend £6 million a year on research programmes–including understanding how social drivers increase HIV infection—and on supporting people in those countries.

My Lords, 35 out of 121 low-income and middle-income countries have increased their spend on AIDS by more than 100%, with all domestic spending on AIDS amounting to some 60% of the total. Does the Minister agree that this confirms the long-standing role of communities in addressing the epidemic in the years ahead, and the critical importance of investing in a strong community health presence to broaden the reach of their services? Can she assure us that these vital services will not be threatened by DfID’s planned withdrawal of budget support?

I need to reassure noble Lords that there is no withdrawal of budget support. However, we do need to ensure that the support we are giving is to those people who are in most need and are unable to self-finance. The low-income, high-burden countries need our support the most but we continue to work in middle-income countries. So there is no withdrawal—just smarter, more focused delivery of services.

Is not the criminalisation of homosexuality simply incompatible with the Commonwealth charter, which all its members have signed up to?

My noble friend is of course right: universal rights must apply to all people. That is one of the key messages we must keep reinforcing, whether at Commonwealth level or outside the Commonwealth.

My Lords, how will the money be targeted to help women who become widows through this appalling disease so that they are not left to become destitute and poverty-stricken?

My Lords, the noble Lord knows that the UK Government have put women and girls at the heart of all their development assistance work. We know that women are disproportionately affected by not just HIV/AIDS but a number of other complex issues. In the programmes we are working through at country level, we are therefore focusing on ensuring that, as the SDGs rightly say, no one—no one—is left behind.

My Lords, is the Minister aware that there are now many thousands of AIDS orphans, particularly in Africa? They frequently find that other family members take their parental possessions, and they are destitute. Do the British Government have any programmes in Africa to support such children?

My Lords, this is a really important question. On a recent visit to Zambia, I saw some of those orphaned children being taken care of predominantly by grandparents, particularly grandmothers. We found that, through programmes such as social cash transfer programmes, we are helping to keep children in school and receive an education. However, that does not really respond to the wider issue of ensuring that those children are supported throughout their childhood, and we work very closely with a number of NGOs on the ground to ensure that children have access to good healthcare and education.

My Lords, does the Minister agree that these questions are rather predicated on the notion that HIV will remain a fatal illness? Does she not agree that one of the key issues is to improve research into retroviruses and viruses such as HIV, for which, in time, there is every chance of finding effective cures?

The noble Lord is right that we should look for zero HIV infection, but while we are working towards that—investing and researching—we still of course have the wider issues to comprehend.