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Global Health Policies

Volume 827: debated on Monday 30 January 2023


Asked by

To ask His Majesty’s Government what steps they will take to promote the global health policies specified in their strategy for international development, published on 16 May 2022, at the United Nations High-level meeting on universal health coverage in September.

My Lords, we are advocating for a joined-up agenda across the high-level meetings on universal health coverage, tuberculosis and pandemic preparedness and response. Working through the UN General Assembly and the World Health Organization, and with our partners, we are promoting a co-ordinated approach that strengthens health systems to achieve universal health coverage, improve global health security and end preventable deaths of mothers, babies and children.

My Lords, the latter part of the Minister’s Answer is precisely what this Question about, because the high-level meeting is an opportunity to make progress on ending preventable deaths and strengthening health systems, both of which are key priorities of the Government. However, that will be achieved only if we have global leadership and global leaders supporting it. One way to build momentum would be for the United Kingdom to provide leadership and signal now that either the Prime Minister or the Foreign Secretary will attend. Can the Minister commit to that now?

My Lords, I think I would cause some concern to the diary secretaries of the Prime Minister and the Foreign Secretary if I were to do that. However, I take the point that the noble Lord has raised: in any international forum, it is important that we see senior leadership and senior members of His Majesty’s Government representing the United Kingdom’s interests. I pay tribute to the noble Lord’s work on issues of nutrition, et cetera. I am sure he will agree that we have continued to stand firm on issues such as vaccinations, therapeutics and diagnostics—that is the Government’s approach, which I believe is the right approach. We also underline that with strong support, including for the Global Fund and in areas such as Gavi, to ensure that issues of health and vaccination are kept at the forefront of the discussions within international health structures.

My Lords, my friends at Age International have reminded me that access to healthcare in developing countries is even more difficult for older people, who are more vulnerable. The number of older people in developing countries is increasing rapidly. That is all acknowledged in the paper that the FCDO has produced. So what will the Minister do to ensure that the UN high-level meeting takes account specifically of the needs of older people?

My Lords, there are many vulnerable groups across developing nations who need our assistance—that is why global health structures are important. Our approach has been to target specific levels of support to different communities to ensure workable solutions on the ground. For example, we work with partner Governments and multilateral partners to strengthen health systems for all, including the elders. We are increasing support for women giving birth in health facilities; for example, in Nepal, that has risen from 9% in 2001 to 80% in 2022, specifically for young mothers. We are working in Nigeria to help a large uplift in support for vulnerable communities there. We are also adopting new technologies to ensure that we can deliver healthcare; we have a telemedicine pilot for reaching remote communities, including elders, in Brazil. Those are just some examples, and I will be happy to discuss with the noble Lord other examples of what we do across the globe.

My Lords, do we not need to recognise also how things have changed—particularly with HIV and AIDS, where the position has changed from there being no cure or any way of dealing with them to, today, it being perfectly possible to deal with them effectively? Is it therefore not totally distressing to find that the latest figures show that 658,000 deaths last year were AIDS-related and that these included around 250,000 women and 100,000 children under 14? Are those figures not disgraceful, and are they not a further explanation to us of what needs to be done in international co-operation to try to expand care for this terrible pandemic, which has done so much damage over the years?

My Lords, first, I pay tribute to my noble friend’s work in this area. I agree with him: tackling issues such as AIDS has changed from many years ago to where we are today; it is preventable and there are cures available. We need to work with our international partners and—coming back to the point raised by the noble Lord, Lord Collins, about the importance of international health architecture—to ensure that those most vulnerable communities get the support they need. That was why I was delighted that we committed a further £1 billion to the Global Fund, which, as my noble friend knows, is focused, among other things, on AIDS. We need to work on specific outcomes on the ground, particularly for young women and, again, on preventable deaths—there are babies who die of AIDS, and this can be avoided.

My Lords, I very much welcome both the Government’s leadership and the money they are putting in through the Global Fund. But my noble friend will know that one of the key elements of reducing maternal deaths, neonatal deaths and perinatal deaths is education—education, education, education—particularly for young girls and women. Without this, we will fail. Can my noble friend the Minister say what we are doing to try to improve this particular aspect through the Global Fund as well?

My Lords, I thank my noble friend for raising that important issue. The UK Government’s strategy for international development highlights our commitment to work towards preventable deaths for mothers, babies and children. Within that, we are building strong health systems. There are also important issues of sexual and reproductive health that need to be addressed, as well as good nutrition—a point the noble Lord, Lord Collins, has often raised. We also need to invest in research and innovation. We are doing all the above and, yes, investing in education as well. Our policy over many years, which I know all noble Lords support, has been education for every girl around the world irrespective; and quality education is a key part of that.

My Lords, the strategy for international development, published on 16 May 2022, states categorically that funding for women and girls will be restored to pre-cuts levels. Two days later, on 18 May 2022, the Foreign Secretary told the International Development Committee in the Commons that this meant

“£745 million, which is the same as what it was in 2019-20. That is restored immediately”

in 2022-23. That was an unequivocal promise to women and girls in support. Can the Minister repeat that that promise is being upheld?

My Lords, as the noble Lord is aware, we have not yet announced our full settlement in terms of our ODA for the next two years.

I meant this current year and next year. That is why I can assure the noble Lord that within the scope of the decisions being made, the issue of girls and women is a key priority, and rightly so.

My Lords, does the Minister feel at all inhibited in calls for his international leadership by the fact that our own health system is failing in so many ways? In particular, we are drawing in nurses and doctors from countries that need them much more than we do.

My Lords, the noble Baroness raises a point about health recruitment. We are committed to working with the likes of the World Health Organization, which is governed by a strict UK practice for international recruitment, including a ban on direct recruitment for countries that the World Health Organization deems to have the weakest health systems. I agree with the noble Baroness, notwithstanding what I have just said, We work with particular countries to ensure that those who are recruited from those countries have an opportunity to return. For example, in India, we are looking at the opportunity to take advantage of studying medicine in the UK and working within the NHS in the UK; but within the scope of that, after the practical and academic experience, the individuals can return to healthcare in India. These are the innovative ways in which we need to work with other countries to ensure that we get the kind of universal healthcare coverage that is required.

The noble Lord, Lord Fowler, gave the figures for AIDS. Does my noble friend not agree that a similar number of people are dying every year from malaria? Most of them are children, and most of them are in Africa. What prospects of real progress can he hold out for us in that context?

My Lords, partly, I can answer in exactly the same way as I answered the noble Lord, Lord Fowler. The Global Fund, as my noble friend will be aware, targets three specific areas: HIV, tuberculosis and malaria. The United Kingdom has committed £1 billion for 2022-25.