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Last Updated: Monday, 1 December, 2003, 12:41 GMT
You asked the UK's development minister
UK Development Secretary Hilary Benn answered your questions about global efforts to help fight Aids in a special edition of Talking Point.

  • Transcript


    As the UK's Secretary of State for International Development, Hilary Benn is responsible for Britain's efforts to help fight Aids around the world.

    He has announced that the UK will double its funding for UNAids - the UN body created to tackle Aids - to 6m for 2004.

    Speaking on World Aids Day, he also called for better political leadership, increased funding, and improved co-ordination in the fight against Aids.

    Britain and America, both key donors in the battle against HIV, launched a joint task force on the issue during President Bush's visit to Britain in mid-November.

    But the British government has faced criticism for cutting 100m from aid programmes in middle-income countries - including South Africa, hit hard by Aids - while channelling $544m to Iraq for reconstruction.

    Is Britain and the West doing enough?



    Transcript


    Bridget Kendall:

    Welcome to Talking Point, I'm Bridget Kendall broadcasting on BBC World on television, BBC World Service on radio and BBC News Online on the internet.

    Today, as you may know, is World Aids Day and our guest here in the studio is Britain's International Development Secretary, Hilary Benn.

    Accurate figures are hard to gauge but everyone agrees this is a global epidemic is an urgent crisis that affects us all and a crisis that looks set to get even worse. Some 40 million people around the world are now thought to be infected with HIV - nearly 30 million of them live in sub-Saharan Africa. Yet so far, in developing countries less than half a million people have access to antiretroviral drugs.

    To mark World Aids Day the United Nations has launched a new campaign called, Three by Five. It's aimed at giving 3 million people access to drug treatment by 2005 at a cost of $5.5 billion.

    Here in London today, Hilary Benn has announced Britain will next year double its contribution to the UN fund to fight Aids. He's also called for better political leadership, increased funding and improved co-ordination in the fight against Aids. Mr Benn is here to answer your questions. Welcome Secretary of State.

    This amount that you've announced today - 6 million - doubling the contribution Britain gives to the UN Aids Fund. Can you put that in the context of what Britain spends every year in this battle to fight Aids?


    Hilary Benn:

    Yes, our overall contribution bilaterally - those of the agreements and arrangements we have with individual country governments last year was $270 million. That's an increase of seven times compared with the figure in 1997. We also have committed ourselves to support the global fund which is backing treatment around the country and around the world over the next years up to 2008 to the tune of $280 million.


    Bridget Kendall:

    That's $40 million a year.


    Hilary Benn:

    That's $40 million a year. So we are recognised by UN Aids as being the second largest bilateral donor in the world after the United States and the money that we're giving to UN Aids is to support them in the job that do of co-ordinating all of this effort to make sure that we get the best effect for the money that we're spending.


    Bridget Kendall:

    Everyone says that this crisis is going to get bigger. Are you able to give a commitment that Britain's funding will continue to increase?


    Hilary Benn:

    Well it has certainly increased so far and over the next two years, the UK's overall overseas aid budget is going to rise by just under $1 billion - an extra 320 million available for sub-Saharan Africa and work on HIV/Aids will form a significant part of that growth because this is a problem that we've got to deal with. Not only because of the human catastrophe but because of the economic impact it's having on sub-Saharan Africa and if we don't tackle HIV/Aids then we won't succeed in lifting people out of poverty.


    Bridget Kendall:

    Well let's go to our first caller and see what people would like to ask you Mr. Benn. Our first caller is Ellen McCurley who is Boston in the USA. Ellen what would you like to say?


    Ellen McCurley:

    Good morning, Mr Benn. I've been working in Malawi for the last three years. I run a small project called the Pendulum Project. I went there three years ago and saw vast amounts of suffering - people who were dying and also a lot of children living on the street and children who had lost parents and care givers to Aids.

    One of my concerns is that having worked over in Africa, particularly in Malawi and South Africa, the majority of the response on the ground is small-based community organisations - some of the them very grassroots - and it doesn't seem to me that enough of the money is trickling down to them. I know that countries like yourself and big donors, we need everybody to be involved but I am concerned about how the infrastructure is going to be able to get this type of aid and resources down to people on the ground?


    Bridget Kendall:

    Mr Benn, it sounds like a lot of money but is it really getting to the people who need it?


    Hilary Benn:

    Well that is part of the task that we have to work on and that's one of the reasons why in the call for action that we've published today, we talk about the importance of their being one strategy for tackling HIV/Aids in a country, one national commission for agreeing on what the policy is going to be in making it work, and one way of reporting on the ways in which the money is being spent. Because if we all turn up as donors with our enthusiasm and the extra money that there is in the system and ask to have separate conversations with hard-pressed officials in the Ministry of Health or whatever and separate ways of reporting how our particular is being spent, we're not helping developing country governments in making the biggest difference.

    Now Ellen refers to Malawi and last week I met Justin Malewezi who is the vice-president, who has got lead responsibility for tackling HIV/Aids in that country. They are already beginning to think about how they're going to use antiretrovirals in order to keep people alive. But I think Ellen you raise a very important point about making sure that there are the systems and structures in place to make sure that this money makes a difference on the ground. That's why one of the other things that we're doing as a development organisation, as well as supporting work specifically on HIV/Aids, is providing funding to improve health services because you need that infrastructure in place - doctors, nurses, clinics and so on - in particular to make sure that these new drugs which are available now at much lower prices, can make a difference to people's lives.


    Bridget Kendall:

    It's not just in Malawi that there are concerns. We have another caller on the line. This is Anthony Kapemba who is in Lusaka, Zambia and he wants to make a similar point. Anthony what would you like to say to the Secretary of State?


    Anthony Kapemba:

    I have an observation here - the impact of the British aid in our country I think is low and does not reach most of the intended target groups. Looking mostly at community-based programmes which have done very well in our country run by the Catholic Church and then when we look at the programmes we're looking at all-embracing programmes covering things such as counselling, care for affected people - that's treatment of opportunistic diseases, training of medical personnel and their groups. Also care for the families - most of the time these families are child-headed and they are vulnerable with most of them going onto the streets to make ends meet. Now my question is, is the British Government evaluating the impact of this aid and if so, what measures are being taken to redress the situation?


    Hilary Benn:

    Well Anthony, you're right about the importance of making sure that we assess the way in which the money is spent. And that's why part of what we're calling for is one way of reporting so all of this resource that's coming in can make a real difference to people's lives.

    I also agree with you that it's important that we tackle both prevention and treatment and care and dealing with the economic and social impact - continuing to make sure that people have access to clean water and food is part of tackling the HIV/Aids problem. It's also about making sure that there is a live conversation and dialogue between voluntary and community organisations, local communities and governments in the countries affected because that's where the problem is going to be solved on the ground. Our responsibility in the international community is to provide help and support. But it is important that the lead is taken by developing country governments themselves. I think that's a really important principle if we're going to tackle this problem and if there are problems in making sure that the money gets through then people needs to express that view and governments need to respond as they do all over the world.


    Bridget Kendall:

    You talked about having a national programme - you've talked about countries being able to take the lead. We've had this e-mail from Matt Prescott, Oxford, UK who says: Does the UK support countries giving their money to fight Aids to the UN's Global Fund to Fight Aids, TB and Malaria, rather than through bilateral agreements?

    A lot of our aid at the moment is bilateral isn't it and yet we've been hearing from these two callers that they don't feel, in the countries they've been in, that's it has been getting through effectively. Which do you think is more effective - bilateral or global aid?


    Hilary Benn:

    Well the truth is we need to do both and that's precisely what the UK Government does. We have a very significant and growing bilateral programme. We're supporting the global fund which we helped to set up because it's a way of raising additional money - which is what we need if we're really going to make further progress in tackling the problem of HIV/Aids. So the answer is both.


    Bridget Kendall:

    But do you worry that a global fund might need more money for administration which therefore wouldn't trickle down as we're hearing from Ellen in Boston?


    Hilary Benn:

    Well the most important thing is that money is not tied up in administration. That the global fund is really a means of harnessing people's interest, enthusiasm and support - if it can bring additional money to address the problem then it's a good thing. But we have to make sure that the money is then applied in a way that makes the biggest difference on the ground, minimises the burdens that we place on developing country governments and that's why the call for one policy, one organisation, one means of reporting.


    Bridget Kendall:

    I want to read you this e-mail we've from Fred, Malta who says: It is a shame the blame's on the so called rich nations rather than those countries with high Aids incidences themselves. Each country must carry its own burden to fight the disease and not depend on others for food, drugs and money.


    Hilary Benn:

    Well I don't agree with that and I don't think it's a question of blame. Each government has to take responsibility for leading the fight against this problem. What we've seen from experience in Africa is the difference that political leadership can make to reducing the infection rate. Uganda is a very good example of that, where from the president downwards, there's been a very strong push on prevention and Uganda has seen the HIV prevalence rate reducing. And that shows the benefit of political leadership.

    But we have a moral obligation to support countries that are dealing with this crisis, particularly where they don't have enough money to fund health care that's needed or to pay for the drugs that are required because we're not going to tackle poverty and therefore we're not going have a safe and secure world if we don't help them meet this crisis.


    Bridget Kendall:

    Our next caller is originally from the Ivory Coast - Nath Zaka - he's here in London at the minute. Nath what would you like to say to the Secretary of State?


    Nath Zaka:

    I think I agree with Mr Hilary Benn regarding his comment on less talk and more action, referring to people who have had a lot of discussion and speeches but not enough action has been done.

    For me to be able to tackle this problem, people need to be accountable - when I say people, that is countries. I think donor countries should be able to ask countries where the disease is prolific or quite high, to come up with individual strategies that can help resolve the issues. If you went to Cuba, for instance, there is a specific approach which is working there. When talking about Aids we should be able to bear in mind the cultural setting of the individual countries. And after the countries are provided with a strategy, then the money available could then be used to support and implement the strategy. I believe that that should be the approach.


    Bridget Kendall:

    What do you think about that - different strategies for different countries?


    Hilary Benn:

    Well the circumstances in each country are different and it's important that we take account of those and obviously developing country governments do the same. But I think it is right and proper that we should be clear that there is an effective means of spending the money, an effective way of getting the help and support and care to the people who actually need it and the people who frankly have the biggest incentive to make sure that that happens are the governments of the countries concerned - their own people, their parliaments, their voluntary and community groups - because it's about their future, their friends, their families - and our job is to support them in a way that enables the biggest difference to happen.

    We need, very importantly, to learn from what succeeds in other countries and apply those lessons because we don't know all of the answers now. But I do believe, despite the scale of the problem, we're in a better position now to do something about HIV/Aids than was the case a decade ago.


    Bridget Kendall:

    This is from Conrad, Kenya who asks: I know there's extensive HIV/Aids awareness information given to Africans but old habits die hard. Africans have to take decisions into their own hands and act appropriately, first by changing their mentality and then their habits.

    Do you think that that is something that a country like Britain could get involved in or does that smack of patronage and you have to be rather careful by sending that message?


    Hilary Benn:

    Well I think we should be honest about the process that countries go through as they come to grips with HIV/Aids. If we think of our own history here in the UK. It was only 15 years ago that the then Secretary of State for Health was approached by his officials - it was Norman Fowler at the time. And they said, Secretary of State I think government ministers have got to start talking about using condoms. Now that was not something that politicians had done before and society here in the UK is much more open about the problem.

    Clearly the availability of treatment has changed people's perception of HIV/Aids - previously lots of people were dying, now treatment allows people's lives to be prolonged very considerably. I think we need to recognise that other countries and cultures need to go through the same process. The important thing is that we're honest about what needs to be done in order first of all to protect people and that's why information and education are so important and then learn the lessons of those who've been through the experience to support others as they too try and confront this great epidemic.


    Bridget Kendall:

    Let's go to our next caller - Michael Fox who is in Ferney-Voltaire, France. Michael what would you like to say?


    Michael Fox:

    I have a question from the point of view of someone who has worked for well over a decade in HIV/Aids prevention and reproductive health in developing countries. The question actually expresses a concern from many people within reproductive health and I'd like to hear Mr Benn's views on it.

    The question is, existing family planning clinics and services are absolutely critical in the struggle against the spread of HIV/Aids as any of us who have worked in the field know, particularly in developing countries and for both women and men. Will DIFD continue to support reproductive health and family planning in its contributions to the fight against Aids?


    Hilary Benn:

    Well Michael the answer is yes. And we've been doing that to a very large degree since 1997 - we've invested 1.5 billion of our overseas aid budget in strengthening health services in the countries with which we work. I agree with you completely about the importance of reproductive health, not least because the work that we are doing already is about giving women the opportunity to have more control over what happens to them and their lives - confidence, information, access to reproductive health services. And so the emphasis that we're putting on HIV/Aids is not at the expense of that work because all our experience tells us we need to do both of those things if we're really going to make a difference in tackling this epidemic.


    Bridget Kendall:

    But you have announced something of a u-turn in British policy recently haven't you - saying that you think that Britain should fund drug treatment more. In the past it has looked far more at questions of broader development. Doesn't that mean that if we're going to put more money into drug treatment - look at the UN campaign started today, they say they need $5 billion in the next couple of years? Surely that means some money has to be taken away from other projects?


    Hilary Benn:

    Well it doesn't simply because the UK's overseas aid budget is rising and will increase by just under a 1 billion over the next two years. It is true that we've now said very clearly that treatment is part of what we need to do. And you're right, in the past we did tend to concentrate on basic health services and on prevention. But developing country government themselves are looking at treatment, the price has come down, there's more funding in the system which means that we can make use of it and it is about keeping people alive and maintaining capacity in countries where if we don't do something about this, all of the gains of life expectancy that we've seen in the last one or two generations could be wiped out by HIV/Aids. Because we have a rising overseas aid budget, we can do both of those things and both are required if we're going to make a difference.


    Bridget Kendall:

    Are you saying that in the past Britain's policy was wrong and that it should have funded more drug treatment?


    Hilary Benn:

    No I think that prevention is of course the best way of dealing with the epidemic in the first instance and you need a basic healthcare system. But reflecting on my own experience, when I visited Malawi in November 2001 and met Justin Malewezi previously, he and his colleagues were already beginning to think about ways in which they could use treatment and I confess that influenced me enormously in thinking about what it was we needed to do. And it's not about a competition - it's care or treatment, or treatment or having a stronger health system. We need all of those things if we're going to make a difference. .


    Bridget Kendall:

    Neil Gardner, Cardiff asks: The UK government has recently changed its stance from one that focuses on prevention to one that focuses on treatment. How do you feel about the Vatican's anti-condom battle?


    Hilary Benn:

    Well it is for the Vatican itself to take its own decisions about the advice it gives through the Church. Our view is very clear and we are one of the biggest providers of condoms in the bilateral work that we do around the world is that condoms are a very important form of protection. And therefore, prevention, protection, care, support and treatment all have a part to play and we make our position very clear, others take a different view.


    Bridget Kendall:

    But do you think the Church is wrong in what it's doing?


    Hilary Benn:

    Well it's for the Church to decide on the advice that it gives to its own adherents to the faith. The evidence is very clear that condom use is a very effective way of preventing the spread of HIV/Aids and if we're interested in saving people's lives - which I certainly am and lots of other people are too - then it's important that we give people the information they need and the means that they require in order to prevent infection and to protect themselves.


    Bridget Kendall:

    Of course the big questions is are infections coming down or not and we've had this e-mail from Cleopas Zvidzai who is Harare, Zimbabwe: Globally, can we say that HIV infections are coming down or not? Are the intervention strategies being implemented helping to slow down the spread of HIV and how effective are the current youth programmes?


    Hilary Benn:

    Well the answer is that in some countries infection rates are coming down. I cited the example of Uganda a little earlier in answer to a previous question which shows what can be done with leadership and determination - in other countries the infection rates are rising - that's why it's important that we learn the lessons from those countries from those countries which have had success in reducing the infection rate while we increase our effort, increase resources and increase help that we're giving.


    Bridget Kendall:

    Katie James who is Shropshire here in Britain. Katie, I understand that you're an HIV survivor?


    Katie James:

    Yes that's right. I've been HIV positive for about 10 years and I'm known in the HIV community as a long-term survivor. Although I am living in the UK now I have lived and worked in Africa for many years and I do believe more money should be invested in that continent to help fight Aids.

    But my question relates to what I see is the lack of support for people living with HIV in rural areas in the UK. It's different in the cities and the towns. But when you live in the rural areas such as Shropshire is, things are very different. So my question is, why does this Government not allocate more money to support people living with an HIV diagnosis in rural areas?


    Hilary Benn:

    Well as far as funding for the health service in general is concerned, we've seen very significant increases. I'm just wondering whether this is an issue that you've raised locally with, for example, your primary care trust?


    Katie James:

    I have and I have not had much of a response. I raised it in July first of all. I've had serious problems with the local support group. I raised the question face to face in July at a local PCT. I eventually got an agreement to have a meeting with them in January - it's taken that length of time. In the meantime I've had no support.

    I am in fact dealing with a double-whammy - I'm not only HIV positive, but I've been recently diagnosed with Aids-relating neurological impairment which means that without local support, I get problems with the antiretrovirals. But I have done what I can to try and get this situation sorted out but because I basically have to travel either to Dudley or to Birmingham from Shrewsbury for support.


    Bridget Kendall:

    Thank you Katie. What about this, Mr Benn? Do you think there's a danger of ignoring the problem closer at home because we're so aware of the enormous crisis further afield?


    Hilary Benn:

    No, I hope there is isn't a danger of doing that and that's why I referred in general to the significant increase there has been in spending on the NHS. Now obviously decisions have to be taken at local level about how that is allocated and I hope that the meeting that you referred to that's going to place next month, will help to resolve the particular needs that you've got.

    But if we compare our situation here in general with the situation in a very large number of developing countries around the world, the scale of the epidemic there, the impact that it's having is enormous and we need to work on both. But it's important that we give more support to those people because we won't improve their lives, we won't enable them to go on living and we won't tackle poverty if we don't tackle HIV/Aids.


    Bridget Kendall:

    Let's go Cora Richards in Roseau, Dominica. Cora what would you like to say?


    Cora Richards:

    I would like to ask the Minister what level of funding has been contributed to the Caribbean in particular which would include Latin America and the eastern Caribbean - Jamaica, Barbados, Dominica - seeing as we have been tagged as second in the incidence of Aids after sub-Saharan Africa?

    I also want to ask Mr Benn if he feels that sufficient importance has been placed on the fight against Aids in less developed countries versus the aid that has been poured into Iraq to the level of $540 million I understand? Does he feel that sufficient attention is being paid to Aids in these less developed countries, some of which are former British colonies?


    Hilary Benn:

    Well we've got programmes running in a number of countries with which we work, including in the Caribbean and including in Latin America. But I will say very frankly that one of the objectives we have as an international development organisation over the next two years is to increase the proportion of the aid which we give to the very poorest countries of the world. That's part of the reason for a shift in the direction of the poorest countries from the so-called middle income countries. And the reason, if you look back over the last 10 years, there was more aid being given across the world and in that intervening period, the amount of aid has declined and the share going to the poorest countries of the world has also declined. And therefore we've taken a very conscious decision as a major donor, to shift more of our resources to the poorest countries because that's where we think we can make the biggest difference.


    Bridget Kendall:

    What about the Iraq point? We've had this e-mail from Ephanye in Nigeria, who asks: Why do the British and American governments dissipate so much money and human life in Iraq while most nations are ravaging in abject poverty, Aids, malaria, tuberculosis?

    Has money that might have been going to Aids been diverted to help with reconstruction in Iraq?


    Hilary Benn:

    Well the reason we're putting a lot of money into the reconstruction of Iraq is because of the terrible suffering of the Iraqi people over the last 30 years. Thirty years ago, Iraq's GDP per head was the same as Portugal. Iraq is now a low income country. So it's classified as one of the poor countries of the world. It's important that we give support now to improve the life of ordinary Iraqis.

    Most of the money has come from central contingencies across government from DIFD's own contingency. Some we have reallocated from middle income country budgets. But we've also had to make the change because I intend that we should focus more of our money on the poorest countries of the world and I don't apologise for that because it's what the figures show is needed and it's also where we can make the biggest difference.


    Bridget Kendall:

    Here's an e-mail from Ian Rasmussen in Liverpool, UK: Could Britain exert more influence through the Commonwealth to encourage African leaders to show a statesman-like attitude towards Aids?


    Hilary Benn:

    Well Aids will certainly be one of the topics that we're discussing at the Commonwealth Heads of Government meeting in Abuja this weekend to which I will be going. We published to Call for Action today because it is an expression of our commitment to do more. But in the end this has to be an international response. We play our part but we want to encourage other people to do the same and as I say I am sure it will figure prominently in the talks that we will have over the weekend.


    Bridget Kendall:

    But do you think that people should have cause for concern that reconstruction in Iraq, if it goes on for a long time, could take money away from this?


    Hilary Benn:

    I don't think we should have cause for concern that we are supporting the reconstruction of Iraq because the Iraqi people deserve all the help that they can get after the nightmare that they've experienced and the hundreds of thousands of lives that have been lost - people murdered by Saddam. That's why it's important that we give the help now. If we can get it right now, the politics and the reconstruction, then Iraq with its oil wealth should have a prosperous future.


    Bridget Kendall:

    And I'm afraid that's all we've got time for today. My thanks to our guest Hilary Benn, Britain's International Development Secretary. And of course my thanks to all of you who've taken part in the programme. Don't forget you can keep sending your e-mails to talkingpoint@bbc.co.uk and do take a look at our special Aids website at www.bbcnews.com/aids where you can watch or listen to this programme again, add your comments and read reports on HIV/Aids from around the world. But for now from me, Bridget Kendall and the rest of the team here at Talking Point, goodbye.




  • SEE ALSO:
    Profile of Hilary Benn
    06 Oct 03  |  Politics


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