UN: Sustainable Development Goals

Lord Collins of Highbury Excerpts

Tuesday 16th June 2015 Lords Chamber

[Lord Collins of Highbury (Lab)]

My Lords I, too, thank my noble friend Lord McConnell for initiating this debate and I pay tribute to all those living below the line. Two thousand and fifteen is a critical year for development, with the intergovernmental negotiations finalising work next month ahead of the September summit to determine the global plans for the next 15 years. Like other noble Lords, I ask the Minister: at what stage is the Government’s assessment of the first zero draft, and is she in a position to give a clearer indication of the Government’s negotiating stance?

Like the noble Viscount, the Secretary of State and the Prime Minister have both commented in the past that the number of goals and targets is too many. I would welcome the opportunity to hear from the Minister what she sees as the UK’s priorities within this expansive agenda, and how she intends to galvanise political will on her chosen concerns.

Our commitment to the world’s poorest and most vulnerable is not just morally right; it is in Britain’s national interest. We need global agreement on tax transparency and 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. As my noble friend Lord McConnell said, critical to this will be a strong agreement on finance and resourcing which addresses these structural issues, increasing tax transparency by committing to public country-by-country reporting by multinationals and universal open data formats. It is therefore vital that the UK has a strong presence at the Financing for Development summit next month in Ethiopia. Is the Minister in a position to confirm that the Chancellor of the Exchequer will be attending?

If we are to unlock development the UK must push for a bold and visionary global agreement and in tonight’s debate I once again want to focus on three vital areas—access to healthcare, climate change, and protection of human rights and tackling inequality. Universal health coverage, with access for all without people suffering financial hardship will make countries more resilient to health concerns such as Ebola before they become widespread emergencies. Earlier this month the Secretary of State said in the other place that the Government had strongly advocated universal health coverage. Can the Minister say if this now means the Government will support UHC in the language of the health goal in the SDGs?

As we have heard in the debate, climate change hits the world’s poorest people the hardest as they lack the resilience to cope with drought, flood and food insecurity. Given the clear links between climate change, inequality, poverty and economic development, does the Minister agree that a post-2015 agenda without a stand-alone goal on climate change will undermine the potential of the entire agenda? In advance of the UN conference in Paris on climate change it would be good to hear from the Minister how the Government are co-ordinating their engagement on these two opportunities, the outcomes of which are clearly so dependent on one another.

On human rights I pay tribute to the work of the previous Government in helping change global opinion on the issue of gender-based violence. Last Thursday I pointed out in your Lordships’ House that turning promises into action is vital as, despite many gains, progress across the millennium development goals has been uneven for girls and women. The MDGs did not effectively address the factors that underpin gender inequality. The United Kingdom has pushed for a post-2015 framework with a strong and explicit commitment to gender equality. The Minister in the previous Government, the noble Baroness, Lady Northover, committed the UK to a stand-alone goal geared to achieving gender equality and women’s empowerment. Just as importantly, the noble Baroness also confirmed that there should be rigorous mainstreaming of gender equality concerns across the other priority areas and goals. I would be grateful if the Minister could confirm that this commitment will also be reflected in the Government’s forthcoming negotiating position.

Finally, seven in 10 people live in countries where economic inequality has increased in the past 30 years. Gender inequality is the most persistent form of prejudice but inequalities can also occur across urban-rural divides, or have different ethnic, religious or racial group dimensions. Discrimination on the grounds of disability is also a critical factor fuelling inequality. The all-embracing nature of the zero draft risks prevarication and duplicity, potentially enabling governments to selectively address those goals and targets most aligned to their existing agenda.

This side of the House has been clear where our priorities would be. Tackling inequality and ensuring the attainment of human rights, including the fundamental rights of women and girls, remain at the heart of these agreements, as does, of course, combating climate change. I hope that the Minister is tonight able to match our ambition in this field.

Developing World: Women

Lord Collins of Highbury Excerpts

Thursday 11th June 2015 Lords Chamber

[Lord Collins of Highbury (Lab)]

My Lords, hopefully, your Lordships will consider that I am a man just about to speak. Although I have already had the opportunity to congratulate the Minister from the Dispatch Box on her appointment, for the avoidance of any doubt, I would like to do it again—congratulations. I thank the noble Lord, Lord Loomba, for initiating this debate today and for his strong and powerful commitment to the empowerment of women, in particular his highlighting of the plight of widows. It is only because of his commitment that International Widows Day is celebrated by the United Nations. Like him, my mother’s widowhood has shaped my view of the world.

The first and most important policy to have in place is one to enable women to be in charge of their own lives and to be decision-makers, not always on the end of a handout or someone’s largesse. The right reverend Prelate gave positive examples of meaningful involvement at local, regional and national level in the allocation of resources and services. If women have control over these things, they will have the confidence to resist and report sexual violence. As my noble friend Lady Kinnock highlighted, there is an increased awareness of sexual violence in wartime due to the significant impact of armed conflicts on civilian populations.

Violence against women as a tool of war remains one of the least prosecuted crimes—we have to do better to ensure action against the perpetrators. However, we must be tough on not only the crime but its causes. We must tackle the underlying problem of lack of empowerment, education and inclusion. As we have heard in this debate, the unanimous adoption of Resolution 1325 on women, peace and security was a landmark decision through which the situation of women in armed conflict was specifically addressed. It called for their participation at all levels of decision-making on conflict resolution and peace-building.

However, we have to recognise that to make real progress, we must ensure the words of the seven Security Council resolutions, recommendation 30 of the Convention on the Elimination of All Forms of Discrimination against Women, the Beijing commitments on women, peace and security, and other initiatives such as the UNGA declaration on ending sexual violence, are translated into practice. They cannot be just words. Turning promises into action is vital as, despite many gains, progress across the millennium development goals has been uneven for girls and women. The MDGs did not effectively address the factors which underpin gender inequality.

The United Kingdom—I am proud to say United Kingdom in the sense that it is not just one Government—has pushed for a post-2015 framework with a strong and explicit commitment to gender equality. Indeed, in response to a Question from my noble friend Lady Kinnock earlier this year, the then Minister, the noble Baroness, Lady Northover, committed the Government to,

“a stand-alone goal geared to achieving gender equality and women’s empowerment”.—[Official Report, 9/3/15; col. 438.]

The noble Baroness also confirmed that there should be “rigorous mainstreaming” of gender equality concerns across other priority areas and goals of the post-2015 agenda. I would be extremely grateful if the Minister repeated that commitment in those strong terms.

Too often women are systemically excluded. Women’s role in peacebuilding should be supported at a local as well as international level. Women’s socioeconomic and political participation is key to resolving and preventing conflict, but also to changing, as we have heard in this debate, the damaging social norms that persist.

Like the noble Baroness, Lady Hodgson, I believe it is essential that we also focus on the other practical steps required for progress, including funding dedicated to WPS; funding to local women’s rights organisations as well as systemic consultation with women to give them a platform to highlight the barriers they face and the solutions; an approach that focuses across the pillars of UN Security Council Resolution 1325; and, as we heard in this debate—more importantly for my noble friend—co-ordination across defence, diplomatic and foreign policy. We need to challenge the root causes and social norms that cause violence against women and girls, and women’s lack of participation.

The 20th anniversary of the Beijing Platform for Action gave world leaders the opportunity to take stock of progress at the national and global level. The conclusions of the Commission on the Status of Women held in March welcomed the progress made towards the full implementation of the Beijing declaration through concerted policy action at the national, regional and global levels. It recognised that this is essential for achieving the unfinished business of the MDGs and for tackling the critical remaining challenges through the post-2015 development agenda.

The UK’s self-assessment concluded that, despite the progress made, discrimination is still prevalent in this country. Globally, many of the seminal achievements of the original 1995 Beijing conference are at risk, as we have heard in the debate, and in not just places of conflict but other areas where cultural shifts affect the rights of women. This is particularly crucial in the area of sexual and reproductive health and rights. We must not allow the clock to be turned back. Women and girls must be free from the fear of violence, coercion or intimidation and have the freedom to choose how many children they want.

The United Kingdom is seen as an important global player in promoting women’s rights. It takes the lead on women, peace and security issues at the UN Security Council and galvanised global action through the Preventing Sexual Violence in Conflict initiative. Like many in this debate, I pay tribute to the last Government for their focus on women and girls in their development work, and their consistent advocacy of women’s rights at the Human Rights Council. I also acknowledge their work in helping change global opinion on the issue of gender-based violence. It is important that we build on this record by using their influence to ensure that the gains of recent years are not lost. It is vital that the UK’s work on Beijing+20 is conducted in co-ordination with preparations for the adoption of a new global development framework. What steps is the Minister’s department taking to ensure that the UK not only defends the gains of the last 20 years but sets out its vision and priorities for the next 20 years of advancement of women’s rights at home and abroad?

My noble friend Lady Prosser referred to the debate on the implementation of the National Action Plan on Women, Peace and Security. What steps is the Minister taking to ensure cross-departmental priority for that action plan? What steps is she taking to ensure that priorities identified go beyond simply a one-term Government and reinforce global initiatives, notably the UN Secretary-General’s seven-point plan on women’s participation in peace-building?

The denial of the rights of women and girls remains the most widespread driver of inequalities in today’s world. Gender-based violence, taking many forms, is a major element of this massive and continuing failure of human rights. Women’s empowerment and the protection of women’s rights are our greatest weapons to prevent discrimination and violence against women and girls.

[Baroness Flather]

I apologise to the noble Lord for suggesting that he might not be a man—I had no intention of doing that—but I think that he is speaking on behalf of the Benches opposite and not actually participating in the debate. However, I always enjoy his contribution, and I thought that it was very good the last time we spoke.

Burma: Rohingya

Lord Collins of Highbury Excerpts

Tuesday 9th June 2015 Lords Chamber

[Baroness Verma]

The noble Baroness is right to address that particular area of concern, but we are working very closely with civil society groups there and DfID is present there, so we are doing a lot on the ground. However, the overall problem needs to be addressed, and we must make sure that there is a collective response in addressing that particular serious issue.

[Lord Collins of Highbury (Lab)]

My Lords, I welcome the noble Baroness to the Front Bench and to her new responsibilities. Can she tell us what discussions the Government have had with Malaysia, Thailand and Indonesia regarding the safety of the Rohingya fleeing Burma?

[Baroness Verma]

First, I thank the noble Lord for his welcome. The issue is absolutely about getting those neighbouring countries to be better supported. We are trying to make more progress on that through our work in DfID and through our dialogue with those countries. It is right and proper that the neighbouring countries take greater responsibility for the refugees fleeing there, and we need to have a dialogue with nations such as Thailand and Malaysia and others in order to be able to respond with the assistance that is desperately needed. By providing food and shelter, we are assisting the refugees in their camps, and we are trying to be as supportive as we can be in this situation, which is becoming dire. Of course, we need to work much harder, and we need to get the neighbouring countries to work harder, towards the comprehensive plan that is so desperately needed.

Millennium Development Goals: Women and Girls

Lord Collins of Highbury Excerpts

Monday 9th March 2015 Lords Chamber

[Baroness Northover]

The Government’s priory is to eliminate the Ebola epidemic in Sierra Leone. We are making extremely good progress, as the noble Baroness will know. We are not there yet, but one of our aims is to reopen the schools. In the mean time, we are seeking to support children who are out of school by distance learning.

[Lord Collins of Highbury (Lab)]

My Lords, very early this morning Radio 4’s “Thought for the Day” mentioned the impact of microfinance in giving women control over their own lives. What action is the Minister’s department taking to ensure that such programmes are supported in what are now described as middle-income countries? What steps are the United Kingdom Government taking to ensure that financial inclusion is properly addressed in the SDGs?

[Baroness Northover]

We have a wide range of programmes supporting financial inclusion. I stress that we need to make sure that in general in the economies of developing countries women have as many opportunities as men at every level.

Gender Equality: Developing Nations

Lord Collins of Highbury Excerpts

Thursday 5th March 2015 Lords Chamber

[Baroness Northover]

Again, I thank my noble friend for her tribute to the work that has been done within DfID. As she has said, last year we had the Girl Summit which focused on both FGM and early and forced marriage. These are clear abuses of girls’ rights. We have already invested significantly in both areas and I trust that that will continue in the future.

[Lord Collins of Highbury (Lab)]

My Lords, will the Minister confirm that in the forthcoming negotiations on the SDGs in New York, the UK will resist attempts to weaken the draft standalone goal on gender equality? Does she share the view that it is vital that it should include strong language on women’s rights and be underpinned by progressive targets that tackle discriminatory social norms?

[Baroness Northover]

I fully agree.

International Development (Official Development Assistance Target) Bill

Lord Collins of Highbury Excerpts

Friday 27th February 2015 Lords Chamber

[Lord Lamont of Lerwick]

My Lords, as my noble friend Lord Lawson has said, these are two amendments aimed at the same target. This issue of accountability and evaluation of the aid programme is very important for several reasons: first, because of the big increase in the amount of aid; and secondly, as the noble Lord, Lord Hollick, said, echoing what was said in the House of Commons, in order to reassure the public that value for money is being preserved.

As the Bill stands, there seems to be a lack of accountability. This is in essence a public relations Bill. It is gesture politics. We all know that the target of 0.7% can be met anyway. The Government have met it. They do not need the Bill. The Bill does not add anything. What the Bill does is send a signal, which some noble Lords have supported; others are more sceptical about the value of the signal. But the Bill by itself does not authorise the expenditure. We still have to have estimates from the House of Commons. They still have to be voted on. The Bill has no sanction. It is an expression of good will, but that is not what Acts of Parliament are for. Of course, the Bill is not legally enforceable either.

We have two ways in which we move on to address the issue of accountability. My noble friend Lord Lawson has resurrected the independent international development office, which was in the original Bill and then removed. It is a bit of a mystery why it was removed but, in consequence, the Government are in a position where they can mark their own homework. They can write a report saying how marvellously they have done.

What I do not understand is why the ICAI is not mentioned in the Bill under the clause on evaluation. When Mr Desmond Swayne was speaking in the House of Commons on 5 December, he referred to the ICAI as,

“this independent mechanism that measures our aid, scrutinises it and ensures that it is of the highest standard. That will also be the body that will establish the independently verified figures”.—[Official Report, Commons, 5/12/14; col. 590.]

He seemed to be implying that the ICAI would do the job of evaluation. If so, why is it not mentioned in the Bill? Of course, it is a very small body. I think it has four commissioners and a small secretariat, so I do not know whether it really is up to the job, although it has a high reputation.

When addressing these sorts of questions in Committee, my noble friend the Minister—slightly in conflict, I think, with what Mr Swayne said—said that she did not feel that,

“tying that function to one particular agency is the answer”,—[Official Report, 6/2/15; col. 995.]

the function being accountability. But surely if you are looking for accountability and whether a programme is effective, it is much better to have one body to have a clear line of demarcation, and it is one body that should be responsible for saying whether there has been any distortion of or alteration in the effectiveness of aid by the great increase in the target. This is a very important amendment indeed.

I hope we might hear from the Labour Front Bench. I know that the Opposition support the Bill, but I am sure that they also support principles of accountability and transparency. It would be very useful to know the view of the Opposition on this amendment.

[Lord Collins of Highbury (Lab)]

I am sorely tempted now, after all this time. Let me reassure my noble friend Lord Hollick that, absolutely, accountability is vital to the Bill. We can be very satisfied that, as we have heard in every debate on every group of amendments, transparency on aid financing and the level of accountability is unique. ICAI has been doing a very good job. The fact that it has produced critical reports in recent times highlights its important role. I want to ensure that we develop its role and defend its responsibilities. I certainly want to ensure that we have a system of accountability that is robust and sustainable. I have every faith in the parliamentary accountability of ICAI through the development committee. That is why I am satisfied, and the party is satisfied, with the level of accountability on value for money and the impact that the spending has. However, for the avoidance of any doubt, if that independence or capability was ever brought into doubt, I assure my noble friend that we would not hesitate to legislate further to ensure that it is sustainable and robust.

[Lord Forsyth of Drumlean]

Before the noble Lord sits down, will he explain, having said how important it is and that he is prepared to legislate in the future, why he would not be prepared to accept his noble friend’s amendment?

[Lord Collins of Highbury]

The simple fact of the matter is that I am satisfied with the current arrangements and that we have a very strong level of accountability. Any amendments proposed at this time are not necessary.

[Baroness Northover]

My Lords, I thank the noble Lord, Lord Collins, for his support. I think that we all agree that independent evaluation of the value for money of our ODA is essential. That is why the Government have significantly strengthened external scrutiny and accountability mechanisms for UK aid, including establishing ICAI. I thank noble Lords for their tributes to it.

ICAI has a key role to play in evaluating the department’s work, and I emphasise that it is likely in practice to be the main body through which this part of the Bill is delivered—I agree here with my right honourable friend Desmond Swayne. However, we do not agree that tying the function of independent verification entirely to one particular organisation, and enshrining that organisation in statute, is the right step to take. We do not want to limit the current range of scrutiny options that are available.

ICAI is an independent scrutiny body that reports not to the DfID Secretary of State but to Parliament through the International Development Select Committee. The IDC has a specific sub-committee which is responsible for overseeing the work of ICAI, approving ICAI’s work plan and taking evidence in public hearings following the publication of each ICAI report. It holds an inquiry into ICAI’s annual report. Noble Lords have emphasised their respect for what ICAI is doing.

The Bill asks that the Secretary of State include in each DfID annual report a statement as to how he or she has complied with the duty to ensure that there is independent verification of development assistance. As I have said, it is likely that that would be done for ICAI. The annual report is subject to scrutiny by both the National Audit Office and the IDC. Clause 5 of the Bill thus ensures that the Secretary of State will be answerable, including to Parliament, through the IDC, on whether his or her choice was of an independent and suitable body. It also allows transparent reporting on the full range of independent evaluations, and allows for scrutiny of whether the spread of arrangements in place effectively examines value for money. We believe that Clause 5 strengthens the current framework in such a way that adds value, increases accountability for programmes and projects and ensures that the value for money of our work is independently evaluated, but it does not enshrine a new body in law.

The whole thrust of this Parliament’s policy has been to bear down on the creation—

International Development (Official Development Assistance Target) Bill

Lord Collins of Highbury Excerpts

Friday 6th February 2015 Lords Chamber

[Lord Forsyth of Drumlean]

I apologise if my noble friend thought I was referring to her. I was referring to the Opposition.

[Lord Collins of Highbury (Lab)]

That does not make it better.

[Baroness Northover]

Being somewhat short, I could not see who was over there and who my noble friend might have been addressing.

Obviously I take very seriously what my noble friends have put forward. I emphasise that the commitment to invest 0.7% of GNI in ODA is an international commitment that is reported to and monitored by the Development Assistance Committee of the OECD. The UK reports on this basis to the DAC, allowing comparison across donors. To aim at an alternative ODA target for the United Kingdom based on GDP would not only lead to multiple definitions, but create confusion. It would also undermine our intention to fulfil our international commitments. This is an international target; it would reduce our credibility and moral weight that our commitment to the 0.7% target carries with our international partners—I have encountered widespread support for the move to the 0.7% target that we have taken—which would limit our ability to press other donors to meet their obligations, for example, to the Global Fund, which my noble friend Lord Fowler mentioned. This would not be helpful or in the spirit of our commitment to the world’s poorest. Gross national income became the preferred measure of measuring a country’s wealth in 1993.

Ebola

Lord Collins of Highbury Excerpts

Wednesday 4th February 2015 Lords Chamber

Asked by

[Lord Collins of Highbury]

To ask Her Majesty’s Government what recent progress they have made on tackling Ebola in West Africa.

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

My Lords, the United Kingdom is leading the international response to the Ebola crisis in Sierra Leone. It is clear that this strategy is working. There are signs that the infection rate is falling in Sierra Leone. This is real progress and a cause for cautious optimism that we can beat this disease. We remain focused on defeating the outbreak completely.

[Lord Collins of Highbury (Lab)]

My Lords, just before Christmas, Professor Chris Whitty, chief scientific adviser to DfID, said in evidence to the Public Accounts Committee in the other place:

“There is a high chance that when we look back on this epidemic more people who did not have Ebola will have died as a result of the Ebola epidemic”.

Does the Minister agree that this reinforces the case for universal healthcare systems, free at the point of access, and that we should use this language in a stand-alone health goal in the forthcoming UN negotiations to replace the MDGs?

[Baroness Northover]

It is clear that there have been problems with other diseases in the affected areas, as people have not come forward for treatment, so the noble Lord is absolutely right. It is extremely important that in the future we take forward the strengthening of their health provision—that is clearly necessary. It is essential when the new SDGs are agreed that health is there, underpinning what happens in terms of human development.

International Development (Official Development Assistance Target) Bill

Lord Collins of Highbury Excerpts

Friday 23rd January 2015 Lords Chamber

[Lord Collins of Highbury (Lab)]

My Lords, I, too, congratulate the noble Lord, Lord Purvis, on bringing forward the Bill, and Michael Moore on introducing it in the other place. It is vital that we debate these issues and have a full and frank exchange of opinions. As the noble Baroness, Lady Jenkin, and my noble friends said, it is worth remembering that the provisions of the Bill featured in all three party manifestos and in the coalition agreement. All sides of this House passionately support the legislation. I also welcome the noble Lord, Lord Fox, to the House and congratulate him on his excellent maiden speech, which made the points that are at the heart of the matter.

For many here today, the Bill marks a point in a journey that can be traced back through the establishment of the Department for International Development by the incoming Labour government in 1997 and the adoption of the target by the Government back in 1974. It is a long journey, as many noble Lords have pointed out. I congratulate my noble friend Lord Judd on being on that journey all the way. He has been a fantastic advocate for the past 45 years.

As we have heard, the Bill will be a catalyst to action by other countries as, this year, the world agrees the sustainable development goals and how we can end global poverty over the next 15 years. For me, development is about tackling the imbalance of power—politically, economically and socially. Labour’s vision for development tackles that imbalance by expanding freedoms as well as signing cheques, measuring success by the change that we make, not the cash that we put in.

Too often, people say that there is a choice between the interests of rich countries and of those in the developing world, but improving tax fairness benefits both the developed and the developing world. All of us, rich or poor, will be affected by climate change. It might seem that the powerful and the powerless live in different worlds, but it is one planet and we need to change how it is run. Our global contract with the developing countries needs to reflect that.

As many noble Lords have said in this debate, passing the Bill means that the question becomes less about how much we spend and more about how we spend it. As the noble Lord, Lord Shipley, highlighted, it is right to ask whether a larger development budget can be delivered by an ever smaller department. There are real worries that, in a bid to cut costs, the department has kept the bureaucracy but is losing some expertise and, with that, the ability to lead.

Your Lordships’ Economic Affairs Committee questioned the effectiveness of the target, saying that,

“the speed of the planned increase risks reducing the quality, value for money and accountability of the aid programme”,

as we have heard in this debate. I do not see the primary point of DfID as simply distributing aid; rather, it is to help to change the world by redistributing power, as my noble friend Lord Judd said. As the aid budget rises, so must our ability to control it. That is why Labour strongly supports the Independent Commission for Aid Impact. Value for money should mean maximising the impact that we make. When a budget as important as this is ring-fenced, there is a fiscal responsibility and a moral duty to deliver as much change as possible for the money that we invest, and the sort of value for money is crucial.

As my noble friend Lady Kinnock said, aid and development work; development changes and saves lives. Life expectancy is rising while preventable deaths are falling. More children are in school while fewer mothers die in childbirth. Literacy is storming ahead while polio is mostly in retreat. This is all in part because of aid and international development efforts across the world.

As, again, we have heard in this debate, development is also in Britain’s best interests. Britain invests in development to prevent extreme poverty, climate change and conflict. Retreating from that responsibility one way or another will still carry a cost, as the noble Lord, Lord Steel, said. The way to eliminate that cost is to tackle it at source. The UK would be immeasurably better off growing and trading with a strong global economy, with a sustainable climate, supportive Governments and secure borders. That is what British development helps to achieve. Tackling the big global issues can save us billions in the future.

I strongly agree with the sentiments of the noble Baroness, Lady Jenkin: I do not believe that this House should impede the progress of the Bill by further amendment. There is an opportunity for us to put this on the statute book, and we should not miss it. This is a very small Bill on just a few sheets of paper. It will save hundreds of thousands of lives of people that we will never meet and whose names we will never know. In years to come, we will look back with a real sense of pride on what we are achieving together today.

Developing World: Maternal and Neonatal Mortality

Lord Collins of Highbury Excerpts

Thursday 15th January 2015 Lords Chamber

[Lord Collins of Highbury (Lab)]

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

As we have heard, the UN estimates that over the past two decades the under-five mortality rate has almost halved; and the number of deaths of children under five is being reduced faster than at any time in the past two decades, partly due to increased access to vaccination against deadly childhood diseases. As we have heard, the number of women dying in pregnancy and childbirth has also been cut by almost half in the same period.

However, as we heard from the noble Baroness, Lady Hayman, this progress has not been even because women, adolescents and children from poor and marginalised communities are being left behind. Noble Lords have referred to the fact that nearly 800 women die every day in pregnancy and childbirth, and HIV/AIDS remains the leading cause of death for women aged between 15 and 44.

With little control over their lives, millions of adolescent girls are forced into early marriage, putting them at risk of complications from pregnancy and HIV at a young age. Faced with an unintended pregnancy, many women and girls resort to unsafe abortion, which accounts for 13% of all maternal deaths; and for every woman who dies, 20 others suffer illness, injury or disability.

As we have heard, mothers and babies face the greatest risks in sub-Saharan Africa, which accounts for 62% of all maternal deaths, followed by south Asia, with 24%. As the noble Lord, Lord Patel, said, two countries account for one-third of all maternal deaths: India, with 17%, and Nigeria, with 14%. It is worth repeating these statistics, because those are countries that we now consider middle-income countries, which do not need development support. But inequality there is growing rather than diminishing.

The noble Baroness, Lady Hayman, highlighted the maternal mortality ratio, showing the highest discrepancy of all health indicators—the gap between high and low-income settings. Sierra Leone has been mentioned: it is estimated to have the highest MMR, at 1,100 per 100,000 live births—and as we have heard, this estimate is from 2013, before the Ebola epidemic. There is emerging evidence that as a result of the Ebola epidemic more maternal deaths are occurring, both as a result of the virus and as a result of lack of availability of routine care, with the focus on care for patients with Ebola and the collapse of existing health systems—which were, as we have heard, incredibly weak already. I do not know how many noble Lords heard the BBC’s excellent report yesterday highlighting the additional risks to healthcare workers treating pregnant women with Ebola. It was a shocking story.

We have heard about millennium development goal 5a, to reduce maternal mortality by 75% between 1990 and 2015: 11 countries are “on track” to meet it, 63 countries are “making progress”, and 13 are “not on track”. Factors associated with making progress include leadership, working in partnership, using evidence, and being innovative and able to adapt using both long and short-term strategies.

Maternal and newborn health are closely linked. As we have heard, motherless children are up to 10 times more likely to die within two years of their mother’s death. More than 6 million children under five died last year, primarily from complications of prematurity and birth, pneumonia, malaria and diarrhoea, with under-nutrition a major factor. The survival rate of the most vulnerable children—newborns—is improving too slowly: 44% of deaths under the age of five occur in the first month.

As we have heard, nearly all maternal, child and newborn deaths are preventable. Strong health systems, with sufficient skilled health workers and reliable supplies of affordable essential commodities, medicines and vaccines, providing equitable access to universal health care, are critical. Proven strategies to improve maternal and newborn health include increasing access to quality care in pregnancy and childbirth, including emergency obstetric and newborn care, reproductive healthcare and information, family planning services and, most importantly, safe abortion.

Poor nutrition is an underlying factor in almost half of all child deaths under the age of five. The UK Government are a leader in the fight against hunger and under-nutrition, but can the Minister assure the House that all bilateral maternal and child health programmes include a strong nutrition component? The next Labour Government will put universal health coverage at the heart of the global development agenda. Universal health coverage affirms the right of every person to have the opportunity for the highest standard of health, without suffering financial hardship or poverty as a result. It does not just help improve health outcomes, but would help reduce inequality and stop 100 million people a year falling into poverty. Health and economic development are interdependent. Healthy populations are more productive.

It is clear from this and other recent debates in this Chamber that universal healthcare will make countries more resilient to humanitarian disasters and outbreaks of disease. The ability of Nigeria, which has a relatively strong healthcare system, to contain and beat the Ebola virus this year sharply contrasts with the experience of Sierra Leone and Liberia, whose health systems were weak. Universal healthcare is a clear and quantifiable goal. Will the Minister commit the Government to it in considering the language of the health goal in the SDGs when negotiations start in New York next week? What is her department doing to ensure that the next development framework is ambitious and trans- formational to end all preventable, maternal, child and newborn deaths?

As we have heard from my noble friend Lady Kinnock, addressing the underlying causes of ill health and mortality is also critical. As we heard from the right reverend Prelate the Bishop of Derby, this means investing in women’s empowerment, girls’ education, preventing gender-based violence and ensuring access to clean water and sanitation. Will the Minister highlight what the UK Government are planning and doing to address these underlying causes?