Ebola: Sierra Leone

Lord Collins of Highbury Excerpts

Tuesday 19th January 2016 Lords Chamber

[Lord Collins of Highbury (Lab)]

My Lords, I have previously acknowledged the Government’s positive response to Ebola on the ground and the significant role of British volunteers, but today our thoughts must of course be with the people of Sierra Leone. Today in the other place, the Secretary of State stressed getting to the point of resilient zero—steady eradication with monitoring and surveillance, working with communities and education. The most important thing is of course a resilient healthcare system. One important element of that involves health education and training. With no postgraduate training, those who want to specialise are forced to leave the country to pursue further education, and many never return. What steps are the Government taking to support Sierra Leone’s health sector recovery plan, especially programmes backed by the royal colleges in this country, to provide continuing professional development for healthcare workers at all levels?

[Baroness Verma]

My Lords, the noble Lord raises some very important issues about the recovery plan. The UK has committed to £54 million in support of President Koroma’s nine-month early recovery and transition plan, which will focus on health, education and social protection—and, of course, economic recovery. We will be standing shoulder to shoulder with our friends in Sierra Leone; we think that that is the right thing to do. The noble Lord is absolutely right that we also need to ensure that, as we gear up to help build resilience, we get others on board to give that support.

HIV and AIDS

Lord Collins of Highbury Excerpts

Monday 18th January 2016 Lords Chamber

[Lord Collins of Highbury (Lab)]

My Lords, I, too, thank the noble Baroness, Lady Barker, for initiating this debate. The APPG report demonstrated progress on access to anti-retroviral therapies. The latest figures released by UNAIDS show that nearly 16 million people now have access compared with fewer than 1 million just 10 years ago. However, 22 million people living with HIV still do not have access to ARTs and an incredible 19 million remain unaware of their status.

Since the report’s publication we have had DfID’s new development strategy and the Government’s strategic defence and security review, which alongside the Autumn Statement pledged significant new funding for global health. These strategies highlight the need for better integration between DfID and the FCO to address human rights abuses and, as noble Lords have pointed out, criminalisation of LGBT groups, which, as the noble Lord, Lord Fowler, said, contributes to access to treatment being denied. Can the Minister outline the process ensuring cross-Whitehall policy coherence so that development needs are not undermined by other political considerations?

SDG objective 3.3 is to end HIV/AIDS, TB and malaria by 2030, and 2016 marks the beginning of the next replenishment phase for the Global Fund. The Global Fund estimates that the combined external funding required to beat the three diseases in line with the SDGs will be $97 billion through to 2019. This will come from affected countries themselves and the countries contributing to the Global Fund, which will need some $13 billion over the period—slightly less than for the last replenishment period. As noble Lords have said, the UK has a proud record on the Global Fund, contributing up to £1 billion over the last replenishment period, making it the third largest contributor.

In addition to the Global Fund commitment, I welcome the Autumn Statement launching the £1 billion Ross fund with the Gates Foundation. The Opposition will hold the Government to account on how that co-operation is working in the months and years ahead. That £1 billion includes a £300 million package on malaria and £115 million to develop new drugs and insecticides for malaria and TB. I welcome that attention given to TB and malaria but, as noble Lords have indicated, the funds do not yet specifically cover new tools for HIV and AIDS, either for treatment or prevention. It is crucial that the Government recognise the importance of new and better tools to prevent and treat HIV to ensure that investments in eliminating the disease are ultimately sustainable and successful.

If the aim of ending AIDS as a public health threat by 2030 is to be achieved, the bulk of the progress must be made in the next five years, as we have heard. The joint UN programme has accepted fast-track targets. These are that 90% of people living with HIV know their status; 90% of those people are accessing treatment; and 90% of those on treatment are virally supressed. That would significantly reduce the number of onward transmissions. Achieving universal access, however, remains a challenge. As my noble friend Lord Cashman said, affordable first-line generic drug treatments are denied to middle-income countries, which are excluded from licensing deals and are forced to buy at inflated prices, making second and third-line ARTs prohibitively expensive. The Global Fund must be allowed to provide critical bridging finance for middle-income countries. We cannot simply pull out and leave Governments to fill the gap when we know that they will not. So will the Minister commit to looking at providing technical support before funding is withdrawn to ensure that programmes do not collapse after withdrawal?

United Nations World Humanitarian Summit

Lord Collins of Highbury Excerpts

Wednesday 2nd December 2015 Lords Chamber

[Baroness Verma]

My Lords, the noble Baroness will be aware from her time as a Minister in the Foreign Office that we work very closely with a range of civil society organisations and other groups, and it is really important that we get the views of everybody, including children. As one of the countries that has often taken the lead on this, we must get other countries and institutions to work closely with us where we feel more can be done. As my noble friend said earlier, we have committed the 0.7% and shown our commitment to it and are dedicated to ensuring that no one—children, women, or girls—is left behind in the discussions.

[Lord Collins of Highbury (Lab)]

My Lords—

[Lord Oates (LD)]

My Lords, last month the UN Secretary-General warned that the scale and cost of humanitarian needs driven by armed conflicts threatened to overwhelm our capacity to respond. Does the Minister agree that the permanent members of the Security Council have an obligation to work jointly to resolve conflicts, rather than using them to serve their own geopolitical ends? Will she ensure that the UK Government lead by example in that respect?

[Baroness Verma]

My Lords, I assure the noble Lord that the UK has led and continues to lead by example. The summit next year will again bring a lot of different actors to the table to discuss these very important issues so that we have a joint, combined response that reaches out to more people.

[Lord Collins of Highbury]

My Lords—

[Lord Soley (Lab)]

Will the Minster consider the United Nations duty to protect, and remind herself that at times non-intervention can cost far more lives than intervention?

[Baroness Verma]

My Lords, we have to do what the UK Government are doing, which is working very closely with our partners, making sure that we are there on the ground when we are needed and providing support where we cannot be present. Generally, I think that we are doing exactly what has been asked of us and we should be proud of the commitment that the UK Government have made.

[Lord Collins of Highbury]

My Lords, third time lucky, I hope. The noble Baroness made the very good point that humanitarian programmes have the potential to make the difference between dependency and development. Will the department and the Government look at examples of this, such as providing refugees with cash rather than in-kind goods so that they can stimulate the local economy and benefit host nations as well as themselves?

[Baroness Verma]

My Lords, as the noble Lord will be aware, these discussions are ongoing. I cannot give precise details of exact discussions with different individuals but, as the noble Lord will also be aware, these things are often done in case-by-case reviews.

Women and Girls: HIV

Lord Collins of Highbury Excerpts

Tuesday 1st December 2015 Lords Chamber

Asked by

[Lord Collins of Highbury]

To ask Her Majesty’s Government how they plan to incorporate HIV as a priority in their work to improve the lives of women and girls, given that HIV is the biggest killer of women of reproductive age globally and of adolescents in Africa.

[The Parliamentary Under-Secretary of State, Department for International Development (Baroness Verma) (Con)]

My Lords, every two minutes an adolescent girl is infected with HIV, which is of course unacceptable. We are therefore proud to be the second largest funder of HIV prevention, care and treatment and have pledged up to £1 billion to the Global Fund. Nearly 60% of the fund’s resources are invested in programmes that reach women and girls.

--- Later in debate ---

[Lord Collins of Highbury (Lab)]

My Lords, one of the most common dangers of mainstreaming an issue is the potential lack of focus. Can the Minister assure the House that any reduction in HIV-specific DfID programming will not result in reduced resourcing or reduced focus on HIV?

[Baroness Verma]

My Lords, yes, I can reassure the noble Lord that integration is at the core of DfID’s approach. Our bilateral programmes work with Governments and civil society to ensure that HIV programmes are delivered within an integrated health service for women, girls and beyond. I am sure the noble Lord will be pleased that, with UK support, we have reached 3.1 million women with services to prevent transmission of HIV to their babies. A lot is going on within the programming.

International Development Policies

Lord Collins of Highbury Excerpts

Thursday 19th November 2015 Lords Chamber

[Lord Collins of Highbury (Lab)]

My Lords, I will run through what I have to say very quickly. I thank the noble Earl, Lord Sandwich, for initiating this debate, and I congratulate the noble Lord, Lord Barker, on his excellent maiden speech.

The cross-party consensus on 0.7% would have been unthinkable 20 years ago—as evidenced by the noble Lord, Lord Lawson. However, we need to do far more to persuade many of the public. We should make the case every day we can that development changes and saves lives.

Today’s debate is less about how much we spend and more about how we spend it. Can a larger development budget be delivered by an ever-smaller department? As the aid budget rises, so must our ability to control it. That is why the role of the Independent Commission for Aid Impact is so important. I want to focus on its comments on the use of contractors to deliver UK aid. The effectiveness of that aid is reduced, ICAI argues, because of the arm’s-length relationship between DfID and the contractors, and a lack of strategic guidance on their use. However, what ICAI failed to address is the key comparison of the effectiveness of a private sector-led approach to poverty alleviation over a public sector-led one. The use of certain consultants, such as Adam Smith International, inevitably predetermines the policies that are implemented overseas, from privatised water to privatised education. Earlier this year, Global Justice Now published a study stating that the DfID’s funding of private sector health and education projects was driving inequality.

We know that public services can provide better value in developing countries, but in some cases that choice is not being given. This is crucial in ensuring that the needs of the poorest are met and that recipient countries’ ability to become self-reliant is increased. The Ebola crisis highlighted the importance of sustainable public health systems. I urge the Minister to ensure that the department and ICAI give this question the scrutiny that it deserves.

Last year, DfID launched an inquiry into the use of consultants and in its response pointed out that it had tightened procurement controls and ministerial oversight. However, what the department did not do was publish the full results of the inquiry. Will the Minster now agree to do so and advise whether any assessment has been made of the new procedures?

I would also be grateful if the Minister could inform the House of the results of the review of the strategic choices that the department makes in its use of contractors, including when the department should be delivering in-house and when and how it should bring in suppliers.

As my noble friend Lord McConnell noted, with DfID increasingly working in fragile and conflict-affected states requiring complex programmes, the department is more likely to rely on contractors and their local partners. The Prime Minister’s announcement that at least half the UK’s £12 billion aid budget will be spent on supporting fragile states raises even more questions on how this might be managed.

Syrian Refugees

Lord Collins of Highbury Excerpts

Thursday 29th October 2015 Lords Chamber

[Lord Collins of Highbury (Lab)]

My Lords, I, too, thank the noble Lord, Lord Truscott, for initiating this timely debate, especially with international talks resuming in Vienna today and with Iran joining them tomorrow.

The Syria war has killed a quarter of a million people, contributed to the biggest refugee crisis since World War II and become a breeding ground for Islamic State and other extremist groups that threaten not only Syria but its neighbours and all the powers supporting one side or the other. Desperate conditions in the refugee camps are driving more and more to risk their own lives and that of their families to reach Europe.

But, as we have heard others ask, what of the strategy? A June summit resulted in a voluntary agreement to relocate 40,000 asylum seekers from front-line states. August saw the western Balkans emerge as the route from southern to northern Europe. The Vienna summit of regional leaders did little to prevent Hungary and Macedonia unilaterally stopping migrants from crossing their borders. In September, there were two more summits, at which a majority vote finally pushed through the use of mandatory quotas to relocate 160,000 asylum seekers from Greece and Italy to other member states over two years. There were also pledges of more aid for regional responses to the Syrian crisis, particularly in Turkey—the main launch point, as we have heard, for Syrian refugees trying to reach Europe. This month, October, EU leaders backed an action plan to offer Turkey various incentives in return for its co-operation in stemming the numbers of migrants and refugees boarding boats for Europe from its coast. Next month will see the major summit in Valletta, in Malta, which will focus on gaining more co-operation from key origin and transit countries, particularly in Africa. What sort of agreement with the African countries does the Minister hope will come out of Valletta? What incentives and support will be given in return if one is achieved?

I, too, pay tribute to the support provided to the refugee camps in Jordan, Lebanon and Turkey, but clearly we need to apply pressure on other European countries to increase spending so that the current cuts to the World Food Programme budget are halted. Britain is the biggest donor, but this effort needs to be matched by other EU countries in order to provide adequate financial assistance. Perhaps the Minister can outline what the Government are doing to encourage other donor countries to give their fair share in addressing the refugee crisis.

Finally, as we have heard in the debate, the Prime Minister told the other place in September that the UK will now accept 20,000 Syrian refugees, but over the course of this Parliament. The crisis is getting deeper and deeper. In light of the deteriorating weather conditions in Lebanon, how many refugees do the Government plan to take from the camps before Christmas?

Developing Nations: Technical and Vocational Education

Lord Collins of Highbury Excerpts

Wednesday 21st October 2015 Lords Chamber

Asked by

[Lord Collins of Highbury]

To ask Her Majesty’s Government what steps they are taking to encourage technical and vocational education and training to increase women’s employability in developing nations.

[The Parliamentary Under-Secretary of State, Department for International Development (Baroness Verma) (Con)]

My Lords, good-quality primary and secondary education deliver the highest dividends for poor people, especially girls. The UK Government are supporting 5.3 million girls in school in developing countries, to equip them with the skills for future learning and employment. For example, we are working with Coca-Cola in Nigeria to give 12,600 young women business skills. During 2014 in Nepal, the Employment Fund programme conducted skills training for more than 13,000 young people, of whom 56% were young women.

[Lord Collins of Highbury (Lab)]

I thank the noble Baroness for that response. Following the recent African ministerial conference on this subject in Rwanda, can she say how involved the Government will be in this discourse to promote the involvement of girls and women in technical and vocational education in Africa?

[Baroness Verma]

My Lords, my department, DfID, has bilateral education programmes in 12 African countries where we support the priorities of our partner Governments. As the poorest children are still denied a quality basic education, that is where the majority of our support is focused. In Rwanda, we are the lead education donor and work closely with the German development agency which leads on support for technical and vocational skills.

Sustainable Development Goals

Lord Collins of Highbury Excerpts

Thursday 17th September 2015 Lords Chamber

[Lord Collins of Highbury (Lab)]

My Lords, I, too, want to thank the noble Lord, Lord Chidgey, for initiating this debate and to pay tribute to his work generally on international development.

The year 2015 has been remarkable for international development, with the agreement on global plans for the next 15 years ready for approval by UN heads of states next week. Like my noble friend Lord McConnell, I strongly welcome the agreement and the Government’s part in helping to achieve it. I am proud, too, of our past achievements: the MDGs focused attention on poverty worldwide, galvanised political action and showed that immense progress is possible. As we have heard in the debate today, the agreement on 17 stand-alone goals and 169 targets differs because the framework will apply both to developed and developing nations alike. As my noble friend Lord McConnell said, by leaving no one behind we will be delivering change for all.

Labour’s priorities in delivering the sustainable development goals have been: rights—for women and children, workers, indigenous populations, LGBT groups and disabled people; universal health coverage; and climate change. What does the Minister see as the UK’s priorities within the expansive agenda that we now have? How does she intend to galvanise political will on her chosen concerns?

Making available an annual progress report would ensure that all Governments are fully accountable. They should fully engage with international review processes and set up national accountability systems. As noble Lords have stressed today, parliamentarians play a key role in this process, both at home and abroad. Will the Minister tell us to what extent—how and when—the Government will engage with MPs and Peers of all parties on this new agenda?

I welcome the Government’s push that has delivered an SDG framework with a strong and explicit commitment to gender equality. Sadly, however, as a Guardian headline put it this week:

“20 years on from the UN summit in Beijing, equality remains a … dream”

Critical issues such as maternal health, reproductive rights, sanitation and FGM fall between the remit of a range of UN agencies or between the cracks. MDGs helped focus attention on issues such as pregnancy care and childbirth, such that in the past 25 years maternal mortality has fallen globally by 45%, but developing countries still account for 99% of the deaths, with more than half in sub-Saharan Africa.

As highlighted by the noble Baroness, Lady Brinton, development goals will require effective co-ordination across government departments, devolved Administrations and stakeholders that have a role to play across the different goal areas of the new framework. Success in any one goal area will be dependent on progress in others. Strong co-ordination is particularly relevant for transnational issues such as violence against children, including trafficking, FGM and online sexual exploitation.

For example, as we heard in the debate, implementation of target 16.2 on ending all forms of violence against children will involve a wide range of UK government departments. To successfully implement this target, cross-departmental co-operation will need to be developed—as highlighted by the noble Baroness, Lady Brinton—bringing together both the UK’s domestic and international contributions. Such a model can serve as a blueprint for other areas of SDG implementation. What mechanisms does the Minister envisage to help co-ordination between sectors and stakeholders to ensure ongoing monitoring, and to adapt to changed circumstances?

It is vital that the Government and DfID should continue to play a global leadership role on gender equality, as the noble Baroness, Lady Northover, said. However, to deliver and sustain the necessary change, we need to fully back women on the ground. That is why I support the development by DfID—in partnership with, and implemented by, women’s funds—of a new strategic fund under SDG5 to provide core, flexible and long-term funding to women’s rights organisations. Will the Minister explain how DfID will ensure that all SDG5 target areas are equally and comprehensively addressed in DfID’s work to support women’s rights and gender equality under the strategic vision for girls and women?

Women who are the most affected by poverty have the least access to, and influence over, the decisions being made to tackle it. The Rana Plaza disaster which killed 1,129 people was a stark reminder of the human cost behind cheap fashion in our high streets. Some 3.6 million women work in Bangladesh’s garment industry, most of them in factories similar to the Rana Plaza. Progress has been made, with retailers signing up to legally binding building safety agreements, but Governments need to act, too. Will the Minister take the lead in advocating the change needed to protect the lives of workers around the world, including support for ILO conventions?

Although significant progress was made at Addis Ababa, as we heard, on financing for development—highlighted particularly by the noble Lord, Lord Chidgey—we still need global agreement on tax transparency to ensure that companies pay their tax in-country. We need to support Governments to collect their own taxes to reduce aid dependency and foster good government.

The UK already has a competitive advantage in global health, and the Government must continue this by prioritising SDG 3, on health. The three sub-goals that require particular focus are: target 3.2, to end preventable newborn and under-five deaths; and target 3.3, to end the epidemics of AIDS, tuberculosis, malaria and neglected tropical diseases. I urge the Minister to sustain and, where possible, increase the UK’s £536 million invested annually in malaria to achieve malaria elimination. Most importantly, on this side of the House we believe that the focus should be on universal health coverage, which will make countries resilient to health concerns such as Ebola before they become widespread emergencies.

Climate change hits the world’s poorest people the hardest, as they lack the resilience to cope with drought, flood and food insecurity. Goal 13 acknowledges this and makes clear that failure to properly address the issue will undermine the potential of the entire agenda. As the right reverend Prelate said, the means to deliver will be determined at the UN conference in Paris, but it would be good to hear from the Minister how the Government are co-ordinating their engagement there with the New York agreement, as the outcomes are so clearly dependent on one another.

This side of the House has been clear on our priorities: tackling inequality and the attainment of human rights; universal health coverage; and combatting climate change. I hope that the Minister is able to match our ambition in her response to this debate.

Sub-Saharan Africa: Healthcare

Lord Collins of Highbury Excerpts

Thursday 16th July 2015 Grand Committee

[Lord Collins of Highbury (Lab)]

My Lords, I, too, would like to thank my noble friend Lord Boateng for initiating this debate. It was only a few weeks ago that we had a debate on this subject; nevertheless, I am extremely grateful that my noble friend has raised this issue again because it gives us the opportunity to focus on key priorities as we move forward. As my noble friend and all noble Lords in today’s debate have stressed, the main lessons from this outbreak relate to the strengthening of health systems, increasing the number of primary healthcare staff, improving their training, building scientific capacity in diagnostics and public health laboratories and supporting public health messaging and outreach generally. These are all topics that we touched upon in the last debate but I want to come on to some specific points.

I, too, have previously acknowledged the Government’s incredibly positive response to Ebola on the ground and the incredibly significant role of British volunteers and their bravery. In the previous debate I mentioned how much I appreciated the Government recognising their courage with a medal.

As we have heard from my noble friend, over decades Sierra Leone has had insufficient investment in its health systems. Universal health coverage can make countries more resilient to health concerns such as Ebola before they become widespread emergencies, as highlighted by my noble friend. I therefore welcome the clear commitment given in recent debates by Ministers—the noble Baroness in particular—to support universal health coverage, free at the point of access, in the language of the health goal in the SDGs. I welcome their commitment to this in the forthcoming New York negotiations in September.

Like the noble Baroness, Lady Northover, I think that we are extremely lucky to have someone like Professor Chris Whitty and I have attended many of his briefings about the crisis. In recent briefings he particularly stressed the impact of Ebola on other diseases. That is one of the key lessons for us to focus on. It is clear, as my noble friend Lord Giddens said, that gains made against malaria are at risk as health systems are pushed to breaking point and people avoid using them because they fear contracting Ebola. Many children have missed out on routine vaccination services since 2014. Modelling by the Johns Hopkins Bloomberg School of Public Health on the long-term impact of Ebola on routine immunisation suggested that as many as 1 million children could miss out on measles vaccinations as a result of the knock-on impact of Ebola.

One of the big issues affecting immunisation has been trust in the health service, another issue touched upon in today’s debate. Rumours circulating in the region have falsely claimed that childhood vaccines, such as those protecting against measles, pneumonia and diarrhoea, could be linked to Ebola. Tackling that misinformation is key. This has dealt a severe blow to immunisation coverage, with parents refusing to allow their children to be immunised against common but potentially fatal conditions, leaving hundreds of thousands of children at risk. Additionally, as we have heard from all noble Lords, hundreds of health workers in the three countries were among the 10,000 people who lost their lives to Ebola during the crisis and many were forced to abandon their posts as the epidemic took hold. As the three countries begin their return to normality, there is now a severe shortage of trained health workers to administer vaccines, let alone carry out other primary care work.

In her written response following the recent debate, which I managed to get this afternoon and which was quite helpful, the Minister outlined the immediate steps that were taken to reinstate basic healthcare as safely as possible. Picking up on the point made by the noble Baroness, Lady Northover, could the Minister set out for us today the longer- term strategy to develop more resilient and sustainable health services, particularly in Sierra Leone? What steps have been taken by the department to support the Government of Sierra Leone in developing a comprehensive strategy aimed at supporting communities to recover from the crisis and to put the country back on track to meet all the development targets that it has? Can the Minister tell the Committee whether the department, in considering the lessons of the outbreak, has examined the impact of previous changes to funding commitments to Sierra Leone? In doing so, can she tell us whether the department has reversed or rethought any planned funding cuts?

One other clear lesson on the outbreak highlighted by my noble friend Lord Boateng has been the role of community engagement—another issue that we touched on in the previous debate. I welcome the noble Baroness’s written response in relation to this, particularly on the Social Mobilisation Action Consortium, which brought together BBC Media Action, Centres for Disease Control, GOAL and Restless Development, all funded by DfID. In the debate I touched on the issue raised by the noble Baroness, Lady Northover, about the lessons in terms of FGM. I am disappointed with the written response on that. I know—I share the concern of the noble Baroness, Lady Northover—that there are huge cultural issues but if we were able to address the issue and raise awareness during such a difficult period, surely we need to ensure that we continue with that and not back away from it.

It is important that we ensure this work continues and is extended to enable civil society organisations to work with communities, to hold meetings, to brief village chiefs and, as my noble friend said, to work with religious leaders not only on basic health issues but on the importance of immunising children. We also need to ensure that there are enough trained health workers to provide the vaccines to the children.

Last week I met with Dr Seth Berkley of Gavi, the Vaccine Alliance. Unfortunately I could not attend the briefing organised by the noble Baroness, Lady Northover, but I was able to meet him separately. He made clear that as the initial Ebola epidemic recedes we face a race against time to prevent outbreaks of other dangerous diseases by ensuring that children receive the vaccines they need to protect them. That is a key element of restoring trust. Rebuilding trust among parents and carers is critical, as is ensuring that they are provided with the services they need to protect their children.

Sierra Leone

Lord Collins of Highbury Excerpts

Monday 29th June 2015 Lords Chamber

[Lord Collins of Highbury (Lab)]

My Lords, I, too, thank the noble Baroness, Lady Hayman, for initiating this important debate.

The Government’s response to Ebola has been positive, providing more than £200 million for treatment, facilities, expediting NHS staff who have heroically volunteered, helping to finance trials, and developing new treatments and vaccines for Ebola. The role of the volunteers has been significant, and I, too, very much welcome the Government’s decision to provide a new medal that will recognise their bravery and hard work.

Sierra Leone is one of the poorest countries in the world and had one of the most fragile health systems. Over decades, it has had insufficient investment in infrastructure, the healthcare workforce, the health information system, and medical supplies and equipment. Therefore, has the department, in considering the lessons of the outbreak, reversed or rethought any planned funding cuts to Sierra Leone?

Universal health coverage can make countries more resilient to health concerns such as Ebola before they become widespread emergencies. I therefore welcome the clear commitment given by Ministers in the House in recent debates to support universal health coverage, free at the point of access, in the language of the health goals in the forthcoming negotiations over the SDGs.

Last week, I attended a meeting with Professor Chris Whitty, chief scientific adviser to DfID. A key part of the discussion was the impact of Ebola on other diseases, highlighted by the noble Baroness, Lady Hayman. It is clear that the gains made against malaria, for example, are at risk as health systems are pushed to breaking point and people avoid using them because they fear contracting Ebola. As we have also heard, many children have missed out on routine vaccination services, and since 2014 measles outbreaks have been reported in the country, mostly among children under five. I, too, welcome the commencement of mass vaccination programmes, including those for measles and polio for children under five, which are going into all districts and should benefit more than 1.3 million children. However, what steps have been taken to ensure that we are offering other health services alongside the strategies for containing and eliminating the Ebola virus in Sierra Leone?

According to Save the Children, nearly half the population of Sierra Leone is under the age of 18, and the impact of the Ebola crisis on their lives now and on their future opportunities has been far-reaching: no school, loss of family members and friends to the virus, and changing roles and responsibilities in the home and community. What steps has the department taken to support the Government of Sierra Leone in developing a comprehensive strategy aimed at getting the country back on track to meet development targets?

As we have heard in the debate, building the economy is another critical factor. The impacts of the Ebola crisis are likely to linger well into the future, and economic recovery will hinge on understanding which sectors and groups need the most support to get back on their feet, as highlighted by my noble friend Lord Giddens. Private sector investment is critical, and it is good to see the CDC leading the way on this. However, when supporting the private sector, prioritising those industries that provide much-needed infrastructure to the health system, such as communications and energy providers, is important.

One other clear lesson highlighted by the noble Baroness, Lady Hayman, has been the vital role of community engagement, which all too often has been regarded as a soft and relatively non-technical add-on to medical interventions; the noble Lord, Lord Crisp, also highlighted this. The Social Mobilisation Action Consortium brought together BBC Media Action, Centers for Disease Control, FOCUS 1000, GOAL and Restless Development, all funded by DfID. Through working with young volunteers, community and religious leaders and partner radio stations covering every district in the country, it has achieved tangible behaviour change around safe burials, early treatment and the social acceptance of Ebola survivors. I urge the Minister to take the opportunity of this community engagement infrastructure and the large-scale behaviour change achieved in this crisis to address other issues such as child marriage, teenage pregnancy and female genital mutilation.

If we are to stop this threat, we must continue to support the Government of Sierra Leone to develop their capacity, address corruption and ensure that they have the technical and administrative support to work effectively.