Ebola Outbreak: UK Response

Rory Stewart Excerpts

Thursday 18th July 2019 Written Statements

[The Secretary of State for International Development (Rory Stewart)]

It is nearly a year since the declaration of the tenth Ebola outbreak in the Democratic Republic of the Congo (DRC). This is the second largest Ebola outbreak and the first in a conflict zone. The risks remain very high. And we need—as an international community—to keep a relentless focus on these issues: addressing failings in public health systems, controlling cross-border transmission, working with communities, and getting the basics right on surveillance, tracing, vaccination and treatment.

Since my oral statement to the House on 20 May, the number of cases has continued to grow and despite successes in some areas, new geographic areas have been affected—including Goma in the DRC and across the border in Uganda. Yesterday the World Health Organisation declared this outbreak a public health emergency of international concern. This declaration is highly significant and will bring more focus and instruments to bear on the crisis. The UK has been a major donor since the start. This week we have announced up to an additional £50 million of support to combat the outbreak in the DRC. We have also been pushing hard at meetings of the G7 development ministers, WHO and at the UN for more support from other countries.

The affected part of the DRC has suffered from decades of conflict and under-development, is an opposition stronghold, and there is a deep mistrust of national and international institutions. Despite the best efforts of front-line health workers, the response has struggled to gain trust, and responders have been the direct target of multiple attacks. The outbreak has spread to new health zones in the current two provinces, and several areas that were previously under control are now seeing new cases again. As of 14 July, there have been 2,501 cases, of which 2,407 are confirmed and 94 are probable. In total, there have been 1,668 deaths (1,574 confirmed and 94 probable) and 700 people have recovered. This is the most complex public health emergency in recent history.

For the first time in this outbreak, three cases were confirmed in Uganda in June. This represents the sixth outbreak Uganda has had since 2000. Uganda’s Ministry of Health, with good support from the DRC and significant assistance on preparedness from the UK, reacted swiftly to this long-anticipated outbreak. While Uganda deserves praise for containing these cases, there is no room for complacency, particularly in addressing resources for health facilities where public health systems are weak.

A record number of health zones have now been affected in the DRC. The city of Goma, on the border with Rwanda, has in the last week confirmed its first case. The confirmed case in Goma is a significant development and may increase the risk of further transmission to other areas of the DRC and neighbouring countries. Goma is a significant regional trading and transport hub and we are therefore closely monitoring the situation. We are also asking the WHO to increase its focus on preparedness in the region, particularly in South Sudan and Burundi.

I am thankful for the prompt response by staff at the Ebola treatment centre in Goma, which I visited on my recent trip to the DRC. However, it was clear during my time there that some measures, such as temperature checks at the hospital entrance, are not consistently applied and could be improved. I also visited the Ebola treatment centre in Katwa that has been rebuilt after being burned down in February. This centre seemed to have a good focus on basic procedures and to be making good use of the latest technology, including transparent cubes which allow doctors and families to interact with patients without wearing full protective gear.

I want to once again commend the bravery of the Congolese and international frontline responders who are working incredibly hard to end this outbreak. But they must have adequate support. To ensure a successful response, the UK is committed to supporting the response financially, but also through sending UK-funded experts to the region, including data analysts, response co-ordinators and managers.

The WHO and the UN office for the co-ordination of humanitarian affairs (OCHA) convened a meeting in Geneva on 15 July to focus attention and signal a reset of the response. I was privileged to be able to represent the UK at that meeting, which was timely, as a new strategic response plan (SRP4) covering the next six months of the response will shortly be published.

In Geneva I made clear the UK’s ongoing support to the Government of the DRC and the region more broadly, with a new commitment of up to £50 million for the response in the DRC. So far, UK aid has provided technical experts to eastern DRC, including senior epidemiologists, data scientists and a clinical trials specialist, and previously funded the development of a vaccine, which has helped to contain the outbreak. More than 160,000 doses have been administered to at-risk people in the DRC and neighbouring countries. The vaccine has proved to be over 97% effective and is a vital part of the response in this fragile and complex environment. However, vaccination alone will not end this outbreak, and stronger community ownership is essential. We need to build trust in the response. To end this outbreak people with symptoms of Ebola need to come forward and seek treatment. Effective isolation and treatment will improve their chance of survival and allow the response to follow up quickly and vaccinate those who they have been in contact with.

I also made clear in Geneva that we expect other countries to play a bigger role in the response as a matter of urgency. They need to step up their efforts and funding. The US and UK are the two biggest bilateral donors to the response and although other countries have given some financial support, more is needed. Other countries, particularly francophone countries, which have a presence and history in the region, must support the response with funding, technical expertise and political support.

The UK will also continue to play a leading role in regional preparedness—where we are the largest donor. Events in Uganda demonstrate the value of investing in preparedness activities and health systems strengthening; quick action saves both lives and costs in the long term. Again, other countries should step up their support to avoid a crisis that destabilises the wider region.

The risk of Ebola to the UK population remains very low. Public Health England continues to monitor the situation daily and review the risk assessment on a two-weekly basis. The UK Government continue to work across all Departments to ensure all relevant expertise is brought to bear on tackling this important issue.

[HCWS1756]

First Annual Procurement and Commercial Report

Rory Stewart Excerpts

Thursday 11th July 2019 Written Statements

[The Secretary of State for International Development (Rory Stewart)]

I have today published DFID’s first annual procurement and commercial report. This provides a summary of DFID’s procurement and commercial practice, complementing the information contained in the Department’s annual report and accounts and meeting the commitment made at the time of DFID’s review of supplier practices in October 2017 to place more information in the public domain. I am placing copies of the report in the Libraries of both Houses.

The UK is an acknowledged world leader in the provision of development and humanitarian aid. Our aid budget acts not only in the interests of the world’s poorest, but also in Britain’s long-term national interest.

Our global leadership in development requires continuing efforts to improve value for money, efficiency, innovation and effectiveness.

The report therefore sets out the progress we have made over the last two years in the introduction of commercial reforms to ensure the best value for taxpayers’ money and the maximum benefit for poor and vulnerable people across the world from our programmes. These reforms include the introduction of a comprehensive code of conduct for DFID’s supply partners, strategic relationship management of our strategic partners, greater transparency of costs, fees and overheads in our funding agreements and measures to promote the engagement of small and medium-sized enterprises in our supply chains.

We will continue to improve our commercial practice, publishing a procurement and commercial report each year so that Parliament and the public can assure themselves directly that UK is being used effectively.

[HCWS1712]

Counter-Daesh Update

Rory Stewart Excerpts

Wednesday 3rd July 2019 Commons Chamber

[The Secretary of State for International Development (Rory Stewart)]

With permission, Madam Deputy Speaker, I will update the House on the campaign against Daesh, which recently controlled a third of Iraq and Syria—an area the size of the UK—but which has now lost its final piece of territory in Baghuz, Syria. Its sudden rise and fall—morally troubling, profoundly threatening and almost unprecedented—carries deep lessons and warnings for Britain and indeed the nations of the world.

As recently as 2003, the borders of Syria and Iraq were stable. Secular Arab nationalism appeared to have triumphed over the older forces of tribe and religion. Different religious communities—Yazidi, Shabak, Kakai, Christian, Shi’a and Sunni— continued to live alongside one another as they had for more than a millennium. Iraqis and Syrians had better incomes, education, health systems and infrastructure than most citizens of the developing world.

By 2014, all this had changed, partly because of the Iraq war, partly because of the Arab Spring in Syria, but in great part because of the astonishing rise of Daesh. Just three years after the withdrawal of the coalition in 2011, a movement initially founded by a tattooed, drug-taking video store assistant from Jordan had, following his death, captured Raqqa, Fallujah, Ramadi, Mosul and Palmyra, torn off a third of the territory of Syria and Iraq and created an independent Islamic state of 8 million people. It was a state with endemic poverty and struggling public services defined not just by suicide bombs but by a vicious campaign against religious minorities. Well-established borders between nations were obliterated. A few hundred men routed three divisions of the Iraqi army. Secular nationalism was swept aside by a bizarre religious ideology.

No one in 2005, and very few in 2010, would have predicted the success of that movement. There were, of course, many reasons to fear an insurgency in north-east Syria or Iraq. People felt little loyalty to the lamentable Governments in Damascus and Baghdad, with their anti-Sunni discrimination, corruption and poor provision of services, but there was initially very little reason to believe that people would support Daesh rather than other insurgency groups.

Indeed, Daesh’s imposition of early medieval social codes and horrifying videos of slaughter of fellow Arabs seemed to most Iraqis and Syrians profoundly irrational, culturally inappropriate and deeply unappealing. Its military tactics seemed almost insane. It deliberately picked fights not only with the Syrian and Iraqi regimes, but with Jabhat al-Nusra, the Free Syrian Army, Shi’a communities as a whole, the Iranian Quds Force and the Kurds, who initially tried to stay out of the fight. It finished 2014 by mounting a suicidal attack on Kobane in Syria in the face of over 600 US airstrikes, losing many thousands of fighters and gaining almost no ground.

All of this, which should have been Daesh’s undoing, seemed at times simply to encourage tens of thousands of foreign fighters to join it, and they came not only from very poor countries but from some of the wealthiest countries in the world—from the social democracies of Scandinavia as much as from monarchies, military states, authoritarian regimes and liberal democracies. Part of its success was notoriously connected to social media. It was the first terrorist movement that really flourished on short, often home-made, video clips, on Twitter rants and on Facebook posts from the frontline. It grew far more quickly, and survived far longer, than any diplomat, politician or expert analyst predicted.

The options that seemed available to defeat this kind of movement in 2008 were no longer available in 2016. Eight years earlier—or, in our case, six years earlier—there had been a full-spectrum international counter-insurgency campaign that relied on overwhelming force, huge investments in economic development, 100,000 coalition troops, eight years of coalition training packages and almost $100 billion a year of US expenditure. But that approach ultimately failed to create stability in Iraq and there was no appetite to repeat it in 2016. The US and its allies did not want to deploy troops on the ground in Syria and very few near the frontlines in Iraq, and no one was advocating nation building in the middle of another war.

Instead, the counter-attack on Daesh in Mosul was led by the Iraqi Government. Initially, this did not seem very promising. The Government appeared to lack the capacity and will to restore even the most basic services to communities in Fallujah or Ramadi. They were backed by unreliable Sunni tribal militias and by Iranian-supported Shi’a popular mobilisation forces, which alienated and terrified the local populations. Kurdish Iraqi forces also seemed unwilling to fight Daesh in Mosul. The coalition provided training to Iraqi forces but on a much smaller scale than during the surge. Daesh had laid mines throughout the urban areas and was fighting for every inch of ground.

It is remarkable, therefore, that Daesh was ultimately defeated. This was largely due, on the Syrian side of the border, to the Kurdish-led Syrian Democratic Forces and, on the Iraqi side, to the counter-terrorism force, which at times was enduring casualty rates of almost 40% of its combatants. Iraqi forces regrouped and retook Fallujah, Ramadi and Mosul by early 2017, while the forces in Syria had retaken Raqqa and Deir ez-Zor by 2018.

Whereas during the surge the UK and its allies had been intimately involved in trying to reshape the Iraqi Government and security on the ground, our recent involvement has been less extensive. Rather than on nation building, since 2014 it has focused on £350 million of humanitarian aid in Iraq to provide healthcare, food and shelter. We have provided almost £1 billion to Syria over the last four years, including £40 million in aid to north-east Syria in 2018, which is going towards mine clearance, the immunisation of children, clean water, food and shelter.

This assistance continues. In Syria alone, there are 1.65 million people in need, while over half a million have been forced to flee their homes. Unexploded munitions and mines remain a major issue. In Iraq, 4 million people are returning home having been forced out. Nevertheless, this aid is on a much smaller scale than that which was provided by civilian officials from 2003 to 2011, our embassy and associated staff are much smaller, there are no longer coalition civilian outposts in every province, and the coalition and indeed the Iraqi Government are a long way from being able to take on the task of reconstructing the shattered remains of Mosul.

What lessons can we draw? First, the hundreds of billions of dollars and hundreds of thousands of troops committed by the coalition in Iraq from 2003, and more intensely from 2008, were not sufficient to create a stable civil service, a flourishing and sustainable economy, strong institutions, security, or any of the ingredients of a well- functioning state. This suggests that even the best-resourced foreign intervention may not be able to reconstruct a nation in the context of an insurgency. Secondly, local forces with a light foreign support may be able to achieve far more than people anticipate. Paradoxically, the Iraqi operations may have been effective not despite the lack of support from the west, but because of the lack of support. Operating with much less foreign assistance may have given the Iraqi and Syrian forces far more legitimacy, flexibility, control and sense of responsibility.

Thirdly, the sudden rise and sudden fall of Daesh illustrate the extreme fragility of many contemporary societies. The entire political-economic context was and remains so fluid and so open to exploitation, with so little deep institutional loyalty or resistance, that it was terrifyingly easy for an insurgency group to establish itself on both sides of the border. It may have lost its territory for now, but the underlying conditions remain and could allow insurgents to establish themselves again. Even without holding territory, Daesh remains a significant terrorist threat.

Finally, in a context so inherently unpredictable and unexpected, Britain and its allies need to stand in a state of grace, preparing for the unexpected. We need to keep a close eye on countries that may seem temporarily at peace, continue to invest in the development of countries that may seem no longer to need development and continue to deepen our knowledge of countries that may not seem to be a priority today, while retaining our linguistic expertise and, above all, nurturing our relationships with people in those countries and with potential coalition partners such as the US and France and, in a different context, Germany.

Whether in north-east Nigeria, in Somalia or Libya, in Afghanistan or Mali, the key to our response will never be the amount of money that we invest or the number of troops that we deploy. It will be the depth of our understanding and the care and subtlety with which we respond: our ability to deploy development, defence, intelligence and economic levers, diplomacy and a dozen other tools, rapidly and precisely, not overruling other Governments, but supporting them in the right way at the right time with prudence and economy.

That is why I must close this Daesh statement with deep respect for the courage of our military forces, the skill of our diplomats and the generosity of our development programmes, but above all with deep respect for the people of Syria and Iraq who were in the heart of this fight, who gave their lives, who led this response and who provide us with an example of how we can act as partners with energy, but above all with humility. I commend my statement to the House.

[Dan Carden (Liverpool, Walton) (Lab)]

I thank the Secretary of State for advance sight of his statement. However, while the update is welcome, may I point out that it is only the second statement to be made in the House in the 365 days since 4 July last year, although the Government promised quarterly reports to keep the House updated?

We welcome the destruction of Daesh’s final enclaves in Syria. We know that Daesh is a threat to us all and that it must be defeated wherever it emerges. Just today, news reports have revealed the uncovering of another mass grave in Raqqa; 200 corpses have been found, and it is feared that more will follow. The dead, thought to be victims of Daesh, include bodies found in orange jumpsuits, the kind typically worn by their hostages.

Let me pay tribute to the UK forces who have put their lives on the line and show gratitude—as the Secretary of State did—to the Kurdish forces who have taken such huge risks in leading the fight against Daesh. Will the Secretary of State now reassure the House that the Kurdish community will not be abandoned or left vulnerable to attacks by Syria or Turkey? He mentions Yazidis, Christians, Shi’as and Sunnis in his statement, so will he tell us what he is doing to support the protection of all communities in the region?

There is also the question of the ongoing role of our forces. The 2015 motion that set down the terms for our engagement in Syria to eradicate Daesh’s safe haven in Syria and Iraq was worded in such a way as to avoid an ongoing military conflict in the region. Will the Secretary of State now set out the purpose of our forces, given that their original purpose of defeating Daesh’s safe haven has been achieved? Does he believe that the original mandate has now expired and that therefore a renewed mandate for military action—and clarity on the role of special forces—is required for continued UK engagement in the region?

Let me say a few words about the ongoing conflict in Syria. There remain serious concerns for civilians in Idlib. What steps is the Secretary of State taking to ensure that there are safe corridors for civilians to leave, given that the United Nations has warned that up to 700,000 people could flee Idlib as refugees? Given that dozens of health facilities have been damaged and destroyed in recent months and more than half a million civilians have been unable to access vital medical care, what steps are the Government taking to encourage parties to the conflict to adhere to international humanitarian law and protect civilians?

Last month, I was lucky enough to meet members of a delegation from the Syrian Women’s Political Movement. They spoke about their experiences of being denied their rights to employment, education and medical care and facing sexual and gender-based violence and exploitation. They called for increased women’s representation in peace negotiations and decision-making positions. Will the Secretary of State take this opportunity to respond to their calls?

As for Iraq, does the Secretary of State share the growing international concern about the arbitrary, draconian and legally unsound way in which the Iraqi authorities are conducting trials of alleged jihadist collaborators and the resentment caused among the Sunni community in the country?

What discussions are taking place about the huge number of detained suspected Daesh fighters? More than 55,000 suspected fighters and their families have been detained in Syria and Iraq. Most of them are citizens of those two countries, but overall they come from at least 50 countries. More than 11,000 relatives are being held at the al-Hol camp in north-eastern Syria. Michelle Bachelet, the UN human rights chief, has said that the relatives of suspected fighters should be taken back to their countries of origin. Does the Secretary of State agree with her call?

Let me finally raise the issue of Daesh’s ongoing influence beyond the physical battlefield. The Secretary of State has spoken today about Daesh’s physical territory, but its influence online is an ongoing threat and deeply worrying. What are the Government doing to work with our allies to ensure that action is taken by social media companies so that Daesh cannot find new safe havens online to spread its hatred?

[Rory Stewart]

The shadow Secretary of State has touched on a number of issues, stretching from the Kurdish community to Daesh online. I shall try to deal with them in turn.

What I think is at the heart of the answers to all these questions is that the only way in which we will be able to resolve the problems is through a proper political settlement. Many of the issues raised by the shadow Secretary of State—whether the issue is the minority rights of Yazidis and Christians, or the relationship between Kurds in Syria or Iraq and their national Governments—will have to be resolved in that way. It is very easy to stand at the Dispatch Box and try to talk about an inclusive political settlement, but that is unbelievably difficult to achieve, particularly after eight years of war, deep resentments and a massive militarisation of societies. We see the challenges all the way from Somalia to Yemen, and it will be just as difficult on the Syria-Iraq border, but ultimately that is the only way to resolve these issues, and the more support we can provide for mediators to try to come up with those political solutions, the better off we will all be.

The hon. Gentleman raised a technical and important question about the purpose of British forces. The reason for our forces on the ground was the Iraqi Government’s request for self-defence against Daesh and Syria, and the justification for their continuing presence is to do with the continuing threat posed by Daesh as a terrorist organisation, but not as a territory-holding organisation. I can, however, reassure the House that the nature of our presence is relatively limited. We are talking about airstrikes many of which are not conducted, the planes not being based in the middle east itself, and we are talking about British troops who are predominantly involved in training operations such as counter-IED and first-aid training. Some are based in the Kurdish regions, others in Iraqi bases. We are talking about a few hundred people. This is not the type of operation that we were talking about in relation to Iraq or Afghanistan, and I therefore do not think that a whole new mandate is necessary.

I share the hon. Gentleman’s frustration that a debate on an issue as important as this should be so poorly attended in the House of Commons. I hope that our sense of seriousness as a nation means that the next time such a statement is made, people will engage more in the debate.

Idlib is a source of huge concern. DFID has put £80 million into humanitarian support in Idlib, but it remains true that the populations in Idlib are under a ferocious and brutal attack from the Syrian Government. It remains very difficult to access people within Idlib, and we continue through every mechanism to call on both the Syrian Government and their supporters, including their supporters from Russia, to exercise restraint, but our options have been very limited and we need to do so in a way that does not repeat the mistakes made in the past of laying down red lines that we cannot maintain or raising the hopes of communities in ways that we cannot vindicate or justify.

This brings me to the question of resettlement in Iraq and the 55,000 suspected Daesh fighters and their families and social media. All that is leading up to a much bigger issue: there are clearly some legal issues raised, and there are consular and human rights issues raised, but at the heart of all this has to be the question of Daesh mark 2, or in other words, how we prevent all the same conditions—all the same resentments, all the same abuses, all the same lack of public services and all the same corruption—that led to the emergence of Daesh in its first form back in 2004-5 and its new form of 2011-12 from re-emerging again. We have to work with the Iraqi Government and with those areas of Syria controlled by the Syrian Democratic Forces to ensure that people’s rights are respected, that reconstruction money is going in and above all that Sunni Arabs feel they have a stake in a political settlement, whereas at the moment they often feel deeply excluded by the regimes, by the ethnicity of the regimes and by the sectarian allegiances of the regimes.

[Sir Michael Fallon (Sevenoaks) (Con)]

On that last point, recognising the considerable caution my right hon. Friend has expressed about the future of Iraq, what more can be done to help promote political reconciliation in the provinces of Anbar and Nineveh and to encourage economic reforms that will enable all the provinces of Iraq to benefit from the stability that our forces have done so much to secure?

[Rory Stewart]

This is of course an issue that my right hon. Friend knows very well indeed. In essence, the only way that we can begin to bring some kind of life and some kind of hope back to areas such as Anbar and Nineveh is by making sure that we have the right combination of economic development, governance and security, which is a pompous way of saying we need to start fixing houses in Fallujah, Ramadi and Mosul. That means clearing mines out of the way, and that means actually physically getting buildings up. This has to be led by the Iraqi Government. There is more we can do in terms of tax incentives, training, support and infrastructure, but that all points to the next consideration, which is of course security. They still remain dangerous areas; there is still a continuing rural insurgency. The way in which that security is addressed—the identity of the Iraqi forces we bring in and their sectarian allegiances—will be very important in regaining the trust of the population. Finally, we must have the right kind of devolution down to the local level so that people feel that the leadership in Mosul, Ramadi or Fallujah genuinely reflects them—reflects them democratically, reflects their identities, reflects their sense of hope—so that those three elements of security, governance and economic development can begin to produce a sense of hope.

[Martin Docherty-Hughes (West Dunbartonshire) (SNP)]

First, may I say as someone whose brother served in Iraq that I am conscious of the sacrifice made by members of the armed forces over the long period in which they have been there? I may not necessarily have agreed with the original direction of travel, but nevertheless the commitment of members of the armed forces is keenly felt by those of us who have family in the armed forces and by those of us on these Benches.

I do not disagree with much of what has been said by the Secretary of State and by the hon. Member for Liverpool, Walton (Dan Carden), who spoke for the official Opposition, but I do wish to raise some issues that have not yet been spoken about. Before doing so, however, let me say that the onus is on us not only in these islands but across western Europe to consider our own history in terms of ethnic and religious tension before we ever believe that we could give some kind of panacea to the peoples of Iraq, and I will also say Kurdistan. I think we should first learn from our own history.

The Secretary of State raised some serious issues about opportunities for moving forward into reconciliation, and even the official Opposition mentioned some of the issues highlighted in some of the camps, and I wish to specifically highlight what was mentioned by Ben Taub in The New Yorker back in December last year:

“Shortly after ten o’clock, three judges in long black robes shuffled into Courtroom 2 and sat at the bench. Suhail Abdullah Sahar, a bald, middle-aged man with a thin, jowly face, sat in the center. There were twenty-one cases on his docket that day, sixteen related to terrorism. He quietly read out a name; a security officer shouted it down the hall to one of his colleagues, who shouted it to the guard, who shouted it into the cell. Out came a young man named Ahmed. A security officer led him to a wooden cage…

‘Sir, I swear, I have never been to Qayyarah,’ Ahmed said.

Sahar was skeptical. ‘I have a written confession here, with your thumbprint on it,’ he said.

‘Sir, I swear, I gave my thumbprint on a blank paper,’ Ahmed replied. ‘And I was tortured by the security services.’…

‘Enough evidence,’ the prosecutor said. ‘I ask for a guilty verdict.’…

Ahmed wept as he was led out of the room. His trial had lasted four and a half minutes.”

I am sure that the Secretary of State recognises that some of the issues in relation to reconciliation are compounded by corruption within the existing infrastructure of the Iraqi Government, notably corruption in Mosul through the limitation of the impact of international aid because of the mayor of Mosul. I was at a meeting yesterday with my hon. Friend the Member for Argyll and Bute (Brendan O’Hara) on Scottish medical professionals trying to get into Mosul as well.

Does the Secretary of State recognise that there is the issue of women and children, specifically those women whose husbands divorce them by telephone and children where husbands abdicated responsibility for them after they joined Daesh? Their ex-wives and children are now being treated as not only second-class citizens but lower than cattle.

Finally, does the Secretary of State recognise the dire need for truth and reconciliation not only in Iraq, but to enable breathing space between the Government of Iraq and the Government of Kurdistan specifically in relation to some of the border issues, which are allowing a possible Daesh resurgence?

[Rory Stewart]

That portrait of a courtroom is of course profoundly shocking, and the hon. Gentleman is right to say that if court proceedings are conducted in that way—in other words, if people feel that their constitutional rights are not being upheld and that their evidence is being extracted by torture to gain a prosecution —that simply provides a really strong reason for there to be more insurgency, as well as that being a flagrant abuse and a flagrantly unjust act. The challenge for us is to think what Britain and other countries can actually do about it. The reality is that we have tended to approach rule of law programmes through focusing on training, so traditionally a judge like that would have been put through a training course; they might even have been flown to the University of Kansas for a couple of weeks to go on a seminar and there would have been a lot of investment in legal books and court procedure. The problem however in that specific case is unlikely to have been simply to do with capacity building; it is much more likely to be about the political context. The key thing is to try to communicate to a sovereign Government in the most respectful way we can through the Ministry of Justice that in the end this kind of approach is, as indeed many Iraqis would acknowledge, self-defeating. Working out how we as Britain or France or Germany or the United States or anyone else can actually get involved right down to the level of that courtroom and a decision made by a judge on the bench remains very tough there, or indeed in 100 other countries in the world.

The question of divorce and the treatment of women is again a subset of a much bigger issue: the ways in which this type of injustice and abuse will continue to fuel resentment going forward into the future, and I look forward perhaps to sitting down with the hon. Gentleman to discuss the issues of the borders on another occasion.

[Dr Julian Lewis (New Forest East) (Con)]

It is always a pleasure to hear my right hon. Friend talking about this subject; although it is a grim subject, the depth of his knowledge is always enlightening, and I would hope that at some stage we might have a debate rather than just an update statement so that we can engage with him more fully. May I therefore raise a couple of points?

First, does my right hon. Friend accept that ultimately the reason Daesh was defeated was that, by seizing and holding territory, it gave up the terrorists’ best weapon: the cloak of invisibility? Secondly, the only thing I found missing from his statement was any reference to that part of Syria that was not fought upon and occupied by the Kurdish-led Syrian Democratic Forces. Can he explain what percentage of the country is occupied by forces other than the Kurdish-led forces? Is not a large percentage of the country occupied by the forces of Assad? Does he now accept what the Government have denied all along: that if we wanted the insurgency in Syria to be defeated, the logical consequence—unacceptable though it seems—was going to be that Assad was at least in part going to win, given the support of his Russian backers?

[Rory Stewart]

These are two important challenges from the distinguished Chairman of the Defence Committee. I shall take the second one, then move on to the first. It is of course true that the vast majority of Syria is now in the hands of Bashar al-Assad’s regime. Looking back in time, we can see that the optimism of the United States and the United Kingdom that Bashar al-Assad would inevitably be defeated, and the red lines that were created by President Obama and others, have not been vindicated in any way at all. In fact, with Russian backing, the Syrian regime has not only retaken the land right the way up to the Euphrates—the edge of the area we are talking about with the SDF—but has pushed south to the Jordanian border and is now pushing up to Idlib, having taken Aleppo and the rural areas around Damascus. The Chairman of the Defence Committee is absolutely correct in his assessment of that. That does not answer the bigger question, which is what Governments such as those of the United Kingdom or the United States will choose to do with the Syrian regime in the future. This returns us to the kinds of challenges that we faced in dealing with, for example, the Shi’a community in southern Iraq under the brutality of Saddam Hussein. How on earth do we balance our humanitarian obligations towards people in horrifying conditions with our sense that we do not wish to operate in the territory of a man who, whatever the sequence of his military successes, remains an unbelievably brutal murderer who is clearly associated with the execution of unarmed prisoners and countless persons through the deployment of chemical weapons? That will remain the key issue for the House to consider over the next months and, indeed, years.

On the first issue, the Chairman of the Defence Committee is also absolutely right. One of the most bizarre, peculiar and ultimately self-defeating parts of Daesh’s campaign was its decision to try to hold territory and, in particular, to try to take on conventional forces. The entire idea of an insurgency or a terrorist organisation is supposed to be that it should drift around like mist or, to take Chairman Mao’s analogy, that it should work and feed off the consent of the local population. Daesh did neither of those things. It attempted to hold territory and, in Kobane, to take on 600 US airstrikes. It attempted to alienate the entire population that it was trying to depend on, through its brutal videos and its incredibly horrifying Islamic social codes. What is extraordinary is not that Daesh was ultimately defeated but that it remained so successful for so long and was able to hold this territory for such an extended period of time.

[Tom Brake (Carshalton and Wallington) (LD)]

On Monday, I met the Iraqi ambassador, and it is clear that the Iraqi authorities are keen for the UK Government, EU countries, the US and Russia to take responsibility for Daesh fighters and their families who might—or might not—have been involved in terrorist activity. Will the UK Government take responsibility for those fighters?

[Rory Stewart]

The position of the UK Government remains that it is more appropriate to prosecute the vast majority of those people in the countries in which their crimes were committed. If those individuals were Daesh fighters, and if they were slaughtering Iraqi and Syrian civilians and committing crimes within that territory, it is perfectly acceptable for them to be prosecuted in that territory, just as it would be for a citizen of any country who committed a crime in somebody else’s country.

[Thangam Debbonaire (Bristol West) (Lab)]

I am grateful to the Secretary of State for his thoughtful responses, but I would like to pick up on two brief things. He mentions unexploded munitions and mines in Syria, and I wonder if he could expand on that and tell us how much of that country is still dangerous to live in for the many people who have been forced to flee their homes. Also, possibly a longer piece of work is about rebuilding the peace and about how this House and Governments relate to countries post conflict. What does he think the role of parliamentarians across this House—across both Houses, in fact—should be in supporting parliamentarians and potential parliamentarians in not-quite-yet democracies in the middle east? What role does he think there might be for us in that peace building?

[Rory Stewart]

First, the mines remain an unbelievably serious issue. They are ensuring that not just a lot of agricultural land but much of the urban centres of Fallujah, Ramadi, Mosul, Deir ez-Zor and Raqqa are almost uninhabitable. This is not just a question of the ordnance buried in those buildings. The old city of Mosul is so profoundly damaged that it is almost impossible to understand what we can do to rebuild these places without ceilings falling in on people’s heads. We are talking about many billions of pounds-worth of damage. This brings us to the question of the role that parliamentarians can play, and actually there is one. There is a gloomy analysis of countries such as Iraq, which would have suggested 10 or 12 years ago that there was nothing much we could do, but it is striking that a new generation of leadership is now emerging. The recent visit of the President of Iraq, Barham Salih, shows the emergence of a new, more progressive type of politics in Iraq that wishes to engage with Members of Parliament. That does not mean that we in this House hold the panacea for what is happening in Iraq, in Myanmar or indeed anywhere else, but respectful relationships, partnerships, modelling ways of behaviour and exchanging thoughts with humility about the problems we have, even in this place, dealing with sectarian conflict in Britain or with some of the polarising and divisive effects of our recent referendum here may be useful in dealing with questions on the aftermath of the referendum in Kurdistan.

[Several hon. Members rose—]

--- Later in debate ---

[Rory Stewart]

My hon. Friend has put his finger on the problem. Isis affiliates are now emerging all the way from northern Nigeria to the Philippines, and they are feeding in every case on very similar problems: the lack of legitimacy of the local government; corruption; poor provision of public services; sectarian and tribal conflicts; economic problems, particularly unemployment among young men; fluid borders; and, in cases such as north-east Chad, even catastrophes of climate and the environment. Addressing the root causes that allow this type of insurgent group to flourish involves an enormous development effort, but we are currently about $2.3 trillion a year short of being able to provide the sort of support that could transform the economies all the way from northern Nigeria to the Philippines. What we can do is try to balance our investment with that of other partners in a modest and targeted way. We are now looking much more closely at the work we can do with the French and the United States on the border between Nigeria, Chad, Mali and Niger, but we may have to accept that we cannot control all of the world all of the time, which is why I believe that nimbleness, deep country knowledge, enormous flexibility and enormous energy are going to be required to deal with this over the next 30 to 40 years.

[Jim Shannon (Strangford) (DUP)]

I welcome the Secretary of State’s statement and thank him for his comprehensive update. The defeat of Daesh in Syria is good news, but there have been indications that Daesh is re-establishing in other countries, such as Afghanistan, Nigeria, Algeria and Libya. The recent story in the media about stolen US missiles being in the hands of terrorists in Libya is particularly worrying. As he rightly said, contact and co-operation with other countries is now necessary, but will that be done in Libya, where it is uncertain who is in charge; in northern Nigeria, where Daesh is free to roam; or in Afghanistan, where Daesh is attempting to connect in an area in which it once had influence? It is important to prevent Daesh mark 2 from being established elsewhere.

[Rory Stewart]

The hon. Gentleman puts his finger on the problem, which is that coming up with a comprehensive counter-insurgency strategy simultaneously in Libya, Afghanistan and Nigeria is beyond us. At the height of the counter-insurgency surge in Afghanistan, there were not only over 100,000 troops on the ground, but over 100,000 international civilians and £100 billion a year of expenditure, largely from the US. Those days have now passed, so we are having to respond to such conflicts with a much lighter footprint.

The reality is that the areas where Islamic State has established itself in those three countries are almost entirely outside Government control. They are areas that are inaccessible not only to us, but to soldiers or police from the central capitals. Security must come first, but that security needs to be based on some kind of trust in the regime in the centre. That will be the real problem going forward.

In some ways, ironically, it may turn out to be an exception that Daesh tried to hold territory in Syria and Iraq, because it made them an easier target. Ultimately, their flaw was the attempt to try to hold Deir ez-Zor, Raqqa and Mosul and, in the end, huge courage from Kurdish-led Syrian forces and from the Iraqi army allowed them to retake those areas. However, when Daesh act as an insurgent guerrilla group in remote areas of Afghanistan, Nigeria or Libya, that poses huge demands on Governments that are not actually able to provide intelligence, governance or public services in those areas. A different strategy is necessary, because we are not going to be able to prevent such things from emerging, and we will have to respond quickly with partner Governments when they do.

[Lloyd Russell-Moyle (Brighton, Kemptown) (Lab/Co-op)]

I refer the House to my entry in the Register of Members’ Financial Interests and my trips to north-eastern Syria on the behalf of the Kurdish authorities. I want to ask about the designation of north-eastern Syria and Rojava as a zone under the Counter-Terrorism and Border Security Act 2019. I am informed that the Home Office wants to make it illegal for British citizens to enter the zone but, as someone who visited post-war Afghanistan, the Secretary of State will know the importance of allowing British people to visit such areas to help them rebuild. These people were our allies and helped us, as he described it, to defeat ISIS, and it would be totally self-defeating to make it illegal for British citizens to co-operate with them in the future. Will the Secretary of State hold urgent discussions with the Home Office to ensure that Rojava, north-eastern Syria or Kurdish-controlled Syria—whatever one wants to call it—is not in that designated list?

[Rory Stewart]

The reason why the Home Office has been considering introducing this legislation is that we are looking at ways to try to prevent people from going out to such areas for terrorist activities. It is not primarily intended to prevent humanitarian assistance from going out. One of the legal issues that the Home Office has faced is that, despite having clearly advised that British citizens should not be travelling to such areas in order to prevent them from joining Daesh, we did not have the legal framework in place to make that happen. The proposals that the Home Office has been considering have been designed to target foreign fighters and to exclude people who are going there for humanitarian reasons.

However, I have listened carefully to the concerns, which have also been expressed by a number of international aid agencies, NGOs and others, about the possibility that people going there for good reasons could be caught up with people going there for bad reasons. I am sure the Home Office will have heard the hon. Gentleman’s representations. Indeed, we at DFID have raised similar concerns ourselves.

[Mr Paul Sweeney (Glasgow North East) (Lab/Co-op)]

The Secretary of State’s analysis of the situation was thorough and highlighted the fluid and unstable situation that continues to persist in the region. However, I cannot help but note the cognitive dissonance that seems to exist between his Department and the Home Office, particularly in relation to asylum applications. Some 250 of my constituents are liable to be evicted from their homes, many of whom are Syrians from the region. Will the Secretary of State undertake to write to his counterpart in the Home Office to emphasise the continuing and ongoing danger that the region presents and to stress that sufficient credence should be given to asylum applications, so that asylum seekers are not placed in situations where their lives are threatened?

--- Later in debate ---

[Rory Stewart]

The Home Office is trying to do a very difficult job, and it often does it very well. It is the responsibility of the Home Office to try to have a fair and transparent process for asylum seekers. When processing asylum seekers—even asylum seekers from difficult countries such as Syria, Iraq or Afghanistan—it is extremely important that we verify their stories and ensure that they have legitimate cause to seek asylum. I am sure that the Home Office has heard the hon. Gentleman’s point carefully and will be looking carefully at such cases. However, in my experience, the Home Office takes enormous care and thought, by using people who have deep knowledge of those areas and people who speak the local languages, to ensure that the support that the British Government provide for asylum seekers is genuinely targeted towards the people in most need.

AIDS, Tuberculosis and Malaria

Rory Stewart Excerpts

Monday 1st July 2019 Written Statements

[The Secretary of State for International Development (Rory Stewart)]

I would like to update the House on the UK’s contribution to the sixth replenishment of the Global Fund as announced by my right hon. Friend the Prime Minister (Mrs Theresa May) at the G20 Osaka summit.

The UK pioneered universal health coverage through the establishment of the national health service and we continue to host many of the best medical scientists and practitioners in the world. Good health is a foundation for development; it enables people to go to school, go to work, and contribute to the economy. It is firmly in the UK’s national interest to work with countries to promote good health, to prevent and respond to disease outbreaks, and to contribute to the fight against antimicrobial resistance.

More than 2.5 million people died from AIDS-related illnesses, tuberculosis and malaria in 2017. Every day nearly 1,000 adolescent girls and young women in Africa become infected with HIV. A child still dies of malaria every two minutes. Tuberculosis is still one of the world’s top 10 causes of death. The progress made so far is being threatened by growing drug and insecticide resistance, wavering political will, and the difficulties of meeting the needs of neglected and vulnerable populations.

Tackling these challenges is essential to achieving sustainable development goal 3: ensure healthy lives and promote wellbeing for all at all ages. The UK’s support to the Global Fund is an important contribution towards achieving this goal. I am proud of the UK’s commitment to the sustainable development goals and this July we look forward to setting out our progress through our first voluntary national review. The UK will also support the high-level meeting on universal health coverage at the UN General Assembly in September and host the replenishment of Gavi, the Vaccine Alliance in 2020.

The Global Fund is an extremely successful public-private partnership which was rated as one of the top three performers in the UK’s multilateral development review. This partnership has so far helped to save 27 million lives, reducing deaths from AIDS-related illness, tuberculosis and malaria by one third in the countries where it invests. Joining forces with other donors to negotiate low prices for life saving health technologies, the Global Fund has saved $855 million in procurement over the last five years. It is the leading international financer of the fight against multi-drug resistant tuberculosis, a disease which causes a third of all deaths due to antimicrobial resistance.

I am pleased that the UK will pledge up to £1.4 billion to the sixth replenishment of the Global Fund which will be hosted by France in October. The UK’s investment will help to:

Provide life-saving antiretroviral therapy for more than 3.3 million people living with HIV;

Support treatment and care for 2.3 million people with tuberculosis;

Distribute 92 million mosquito nets to protect children and families from malaria;

Make countries’ health systems stronger, promote global health security and tackle antimicrobial resistance.

I am particularly concerned that the number of malaria cases is at risk of increasing due to growing resistance to our current tools and the potential impacts of population growth and climate change. I have agreed to double the value of private sector contributions to the Global Fund for malaria up to a maximum of £200 million, providing £2 for every £1 contributed by the private sector. This will help us to meet our target to spend £500 million a year on malaria over the five years from 2016-17 to 2020-21. Our previous malaria match funds have so far raised almost £200 million in additional private sector contributions to the Global Fund.

The UK pledge to the previous Global Fund replenishment included, for the first time, a £90 million published performance agreement which set out areas where the Global Fund needed to do even more. I am pleased to report that the Global Fund has performed well against these priorities, including by making significant savings. This has enabled us to release all performance payments on time and in full.

For this replenishment I have agreed a £100 million performance agreement with the Global Fund. This sets out the priorities for further improvement: working with Governments to integrate Global Fund programmes into national systems and strengthening these systems to support achievement of universal health coverage; a greater focus on disease prevention; strengthening the focus on the poorest, most vulnerable and marginalised, including women and girls; and antimicrobial resistance and global health security. These are all critical to the Global Fund’s long-term success. Each year my officials will speak with the Global Fund’s senior management to review their progress on these critical areas and make sure that we are working together as effectively as possible.

A successful replenishment will help the Global Fund partnership to save 16 million lives, avert 234 million cases or new infections, and strengthen countries’ health systems to accelerate progress towards universal health coverage. To reach the Global Fund’s ambitious target of at least $14 billion and get the world back on track to end the epidemics of AIDS, tuberculosis and malaria by 2030, as called for in the sustainable development goals, everyone must step up.

We will use our early decision to encourage other donors, new and existing, to make ambitious commitments. Meanwhile our commitment to a new £200 million malaria match fund is an invitation to the private sector to contribute to and play an essential role in delivering the sustainable development goals. Ultimately, though, protecting the health of citizens is the responsibility of national Governments. We expect them to play their part and further increase their public spending on health.

I am aware of the significant degree of interest in this issue from Members across the House, whose advice and support on this issue have been invaluable for the Government. For the convenience of Members, I am depositing a copy of the performance agreement in the Libraries of both Houses.

[HCWS1680]

International Bank for Reconstruction and Development: Contingent Liability

Rory Stewart Excerpts

Thursday 27th June 2019 Written Statements

[The Secretary of State for International Development (Rory Stewart)]

Today I have laid a departmental minute relating to the intention by the Department for International Development (DFID) to create an additional contingent liability of $1,912,245,702.50 with respect to the World Bank’s International Bank for Reconstruction and Development (IBRD). This contingent liability would be in the form of “callable” capital, which is a commitment to make a capital contribution to IBRD in the very unlikely event that the IBRD is unable to meet its financial obligations.

The additional callable capital would permit the United Kingdom to subscribe to the additional shares allocated to it in the 2018 IBRD general and selective capital increases. This would support the United Kingdom’s global influence by allowing it to retain its single seat on the World Bank Board and help enable a modest increase in IBRD support to its clients consistent with our development, prosperity and security priorities.

A call from IBRD from shareholders for this capital is considered very unlikely. IBRD has a triple A credit rating, with a very diversified portfolio of investments across a large number of countries. As of 30 June 2018, it held $43.5 billion in equity and a general reserve of $28.6 billion ¹. If the liability were to be called, provision for any payment will be sought through the normal Supply procedure.

¹ International Bank for Reconstruction and Development (IBRD) management’s discussion and analysis and financial statements, June 30 2018

[HCWS1673]

Sustainable Development Goals: Voluntary National Review

Rory Stewart Excerpts

Wednesday 26th June 2019 Written Statements

[The Secretary of State for International Development (Rory Stewart)]

The Government have today published the United Kingdom’s first voluntary national review of progress towards the sustainable development goals (also known as the global goals). We are proud of what we have achieved but humbled by what we have not. It is not an end in itself but rather has taught us about what we must do better. It balances achievements with shortcomings and, most importantly, outlines next steps.

In September 2015, the 193 member states of the United Nations agreed the Agenda 2030 for sustainable development, including the 17 global goals (the goals). This ambitious agenda sets out the framework through which the world will work together to combat the most pressing challenges of our time, including eradicating extreme poverty, ending hunger, protecting our environment and breaking down gender barriers. These goals apply to all people in all countries, including here in the UK.

The goals are not just about doing more, they are about protecting what we have: protecting the environment, protecting heritage, protecting communities, protecting health and wellbeing, protecting the rights of vulnerable groups, and protecting our planet.

Our voluntary national review sets out the collective efforts of England, Scotland, Wales and Northern Ireland on the goals since their adoption in 2015. It covers domestic and international work across all 17 goals, with a focus on the domestic. It has been produced through collaboration with, and input from, numerous UK Government Departments and the devolved Administrations. Additionally, over 380 organisations from civil society, the private sector and faith groups, as well as many individuals, have been engaged.

While we have made significant progress and have strong foundations on which to build, there is more work to do if we are to meet the ambitious targets by 2030.

Conducting our voluntary national review has further deepened our respect and understanding of the global goals and stiffened our resolve to leave no one behind. I am grateful to all those who contributed to the review. Electronic copies will be placed in the Libraries of both Houses. The review is available at www.gov.uk/ sustainabledevelopmentgoals

[HCWS1660]

Sustainable Development Goals

Rory Stewart Excerpts

Tuesday 11th June 2019 Commons Chamber

[The Secretary of State for International Development (Rory Stewart)]

I beg to move,

That this House has considered the Sustainable Development Goals.

It is a great privilege to speak on the sustainable development goals, and it is a very unusual one for the International Development Secretary because this afternoon I will be speaking about the UK’s performance at home, not abroad. The global goals apply not just to other people’s countries, but to our own. This is a fundamental principle—a fundamental principle about being honest with ourselves, but also about learning some humility and learning, through doing it in our own country, about some of the struggles that other people are going through in their own countries.

We will be reporting in a formal report to the UN after this debate in Parliament, and I hope this debate in Parliament will help inform some of the report we send. This is the result of 350 organisations having contributed so far, with 35 events, 200 case studies and now this parliamentary debate. I really believe that the single guiding principle of the Department for International Development, which is of leaving no one behind, should guide our approach to thinking about Britain.

In presenting my brief remarks to the House, I am reminded of another thing I have learned through this process about dealing with opposite numbers in countries abroad. It is the necessary balance between pointing out problems in our own country and balancing it with our pride in and our optimism about our own country. This would be true for a development Minister in Nepal or in Rwanda. They, too, often feel—as I must, a little bit, at this Dispatch Box—the necessity of balancing talking about the negatives with talking about the things that we are genuinely proud of as a Government.

The starting point is that this is, for all the flaws and all the things we grumble about, a truly extraordinary country. Quite literally and quite technically, this country has never been so healthy and it has never been so educated. Development in this country, if it is compared with development elsewhere in the world, has been quite staggering. In the mid-19th century, life expectancy in this country hovered around 40; it is nearly twice that today. In other words, in the mid-19th century, life expectancy in this country was roughly comparable to that of rural Afghanistan. Even relatively recently, we have seen a halving in infant mortality in this country since 1985. Well within our own lifetimes, we have halved infant mortality.

This is of course true across the world; it is not just Britain. In 1980, 41% of the people in the world were living in extreme poverty. Today, only 9% of the population of the world is living in extreme poverty. For all the criticisms we make, the story across the world is one of progress. In comparing Britain with other countries, it is important to remember that we are not comparing like with like; there is an apples and oranges issue. Here we have a significant issue with relative poverty, but that is quite different from the type of absolute poverty we are talking about in somewhere like eastern Democratic Republic of the Congo.

[Stephen Twigg (Liverpool, West Derby) (Lab/Co-op)]

I welcome the opportunity of today’s debate, and I congratulate the Secretary of State on his appointment. Is he able to confirm that, when the UK makes its submission to the UN, we will make reference to every single one of the goals, targets and indicators for both domestic and international implementation?

[Rory Stewart]

Yes, I am able to confirm that. I hope my distinguished colleague the Chair of the International Development Committee will also feel that we have been quite rigorous and quite tough on ourselves, and have set quite high standards. This is a very open society, and there is no point for us as a Government in trying to hide. The statistics are out there in public, and people can see them from the Office for National Statistics, so we have tried to be as fair and frank as possible about the challenges we face and what we have achieved.

[Kerry McCarthy (Bristol East) (Lab)]

The Secretary of State will know that the UN special rapporteur described the levels of poverty in the UK recently as “systemic” and “tragic”—I think those were the words—and that seems to have been rather glibly dismissed by some of his colleagues. Of the five goals on which the UK is focusing when it comes to the voluntary national review, why is goal 2—ending hunger—not in there when we know that the extent of food poverty, particularly childhood food poverty, in this country is so extreme?

[Rory Stewart]

That is a good challenge, which I think will come up again and again in these debates and in the response to the reviews. We have significant problems in our country—people will refer to, for example, food banks. I recently had a conversation that got to the heart of the matter with a Nigerian pastor who has just begun his ministry in Croydon. He was reflecting on his experience of poverty in Britain and in Nigeria. He said that there was definitely poverty in both contexts, but that it was very different. His brother had just died in hospital in Nigeria because he was unable to access basic healthcare. Of course, in Croydon, he deals with people who have significant problems, particularly with income. He talked about women who are struggling to afford sanitary products and about food banks. However, he also said that it was worth bearing in mind that those people have completely free access to healthcare and education, a water supply and shelter, so we come back time and again to the relationship between absolute and relative poverty.

[Mr Jim Cunningham (Coventry South) (Lab)]

Following on from the point that my hon. Friend the Member for Bristol East (Kerry McCarthy) made, in any city in this country there will be areas where life expectancy is lower than in other parts of that city. We still have disparities in wealth and poverty, particularly in the north, but also in the midlands and the south. There is a lot of work to be done. Although we have a national health service and the third world does not have such things—I agree with the Secretary of State about that and that it is a matter of balance—I hope that the right hon. Gentleman will draw attention at the United Nations to some of the progress we have made.

[Rory Stewart]

That is the right tone in approaching the subject. There is an important fundamental issue: when we think about other people’s countries, we often forget about politics. We often talk as though development in somebody else’s country is simply a matter of experts from the World Bank sitting down with a piece of paper. Yet development in any country is deeply political. People who drive development in other countries are politicians—members of political parties—and there are Oppositions who challenge them. Many of the problems in development—defensiveness, cover-ups, lack of transparency and progress—stem from the fact that we do not understand the politics well enough. The debate is therefore a good way of understanding some of the challenges in, for example, eastern DRC. People might believe that the issue around Ebola is just a technical question of getting the vaccines on the ground, but the basic issue is that the area is controlled by Opposition insurgency groups, which have a big problem with the capital. Politics is at the heart of all that.

For this country, I will move quickly through the global goals, looking at them essentially through the lens of five Ps—people, planet, prosperity, peace and partnership—and trying in every case to give examples of where we are doing well, where we are doing badly and the strengths that we have to build on. Looking at the UK as a whole is well beyond my brain and that of anyone in the House—and I am well aware that there are many experts in the House who know far more about individual areas of domestic policy than I do. I will attempt to present now what we will present to the United Nations as a way of trying to take a snapshot of Britain in 2019.

There have been significant improvements in healthcare even relatively recently. For example, stillbirths in this country have reduced by 18.8% since 2010. However, on the negative side, we need to do a great deal more on particular forms of cancer, on heart attacks and on stroke, where we do not achieve the results of some comparator developed countries. We have a strength to build on—the NHS, which is a truly remarkable organisation. It is very difficult to think of equivalents elsewhere in the world that have that key point of being free at the point of access. There are countries that have done better than us on cancer survival rates where healthcare is bankrupting for a family. It can mean the destruction of a family and the absence of health insurance can drive people to the wall.

We have reached the extraordinary stage where nearly half our population now goes to university compared with only 3% when my mother went to university. That is a big change since my mother was young. However, we can do much more in education. We are not doing as well as we can on basic numeracy and literacy and technical education compared with some of our comparators. We are also perhaps not thinking hard enough about the effect that robotics and AI will have on the world of work. Hundreds of thousands of people are at risk of losing their jobs to new technologies and we need to have bursaries for people in mid-life to retrain for a new world of work. However, to come back to the basic point of building on strengths, in our country, as hon. Members will have heard again and again from the Dispatch Box, 85% of children are in good or outstanding schools.

We have heard about equality, on which we have very significant challenges. In addition to the question raised by the hon. Member for Bristol East (Kerry McCarthy), there are other areas in this country that we do not talk about enough—for example, the elderly poor. This area can genuinely be shocking. I feel that in my constituency if I see an 88-year-old woman looking after a 92-year-old doubly incontinent man, having to wake up every two hours through the night. That is a genuinely shocking thing.

I sometimes feel, coming back from Nepal or the Congo, that our family and community support structures for the elderly are not necessarily what they are in some other, much poorer developing countries. On the other hand, on the positive side, we can point out that in this country income inequality has, unusually among advanced countries, declined.

On the planet, there is a balance between three things. Yes, we are very proud that we have gone 300 hours without coal-fired power and that we have reduced our carbon emissions more than many comparable advanced countries, but nobody can get around the fact that we are facing a huge climate planet emergency. There is an enormous amount to do and there is simply no point being complacent or talking about our achievements in the past. There is a huge amount more that Britain can be doing on technology and research and development. For example, to stop China building another 300 gigawatt coal-fired power station, we should be developing solar technology, light spectrum technology and solar film to drive down the marginal costs. That is why, as the Secretary of State for DFID, I want to double the amount we spend within our budget on climate and the environment.

On prosperity, we are leading the world in certain sectors. We are doing very, very well in financial services and technology—I have been astonished by some of the robotics and AI companies I have seen recently—but we have a big problem with productivity. There is a big challenge in northern England in particular, where we really need to get infrastructure on the ground. We have not yet unleashed the potential that could come from, for example, properly connecting Newcastle, Carlisle and Glasgow, or properly connecting Leeds and Manchester, which is the huge opportunity.

There are, however, strengths we can build on. The most obvious is that, if one looks at the elections in the 1970s, the great issue in this country was of course unemployment. With all the challenges we have in our country, the achievements on employment have been quite remarkable. In particular, compared with 2015, 700,000 more people with disabilities are now in employment. There has also been a slight reduction—not a big enough reduction, but a slight reduction in that period—in the gender pay gap.

On peace—the penultimate issue on which we are measuring ourselves—crime has been falling. At the same time, however, we have a serious problem around knife crime. We have an enormous amount to learn from Glasgow’s public health approach to knife crime. We have lost only two soldiers on active service since 2014. We live in a much more peaceful world in relation to Britain’s activities overseas. That would have been almost unimaginable for a Minister to say from this Dispatch Box at any time, probably, in the past millennium—if this Dispatch Box had been around for a millennium.

Finally, on partnership, this country has an incredible voluntary sector and an astonishing civil society. We all feel that in all of our constituencies—I feel that in my constituency, as all hon. Members will in theirs—but we are still not harnessing it properly. Amazing community schemes on community land trusts, community broadband and community planning are not being properly reinforced and followed up.

There are a lot of things that we could address. In recent meetings, for example, people have pointed out that if your mother lives in Middlesbrough and you live in London, could we not have a situation whereby somebody whose mother lives in London while they live in Middlesbrough visited your mother while you visited their mother? A lot of people would like to do that sort of thing, but as a society we are simply not good enough at tapping that kind of voluntary energy and bringing it together.

Given that I am often accused of being too gentle with those on the Opposition Benches, I am going to provoke them by saying that there is an example of partnership from which we can learn. I am going to pick possibly the most unpopular subject for those on the Opposition Benches: the privatised water industry. The extraordinary thing about the privatised water industry since 1980 is that by privatising water we have brought in £78 billion of investment that would not have otherwise come in. Water quality in this country is now at 99.6% and we are five times less likely to have an outage on our water. That is at a cost to the person of £1 a day for your water, in and out—an extraordinary achievement.

[Mr Jim Cunningham]

I think the right hon. Gentleman was watching Margaret Thatcher’s speech on privatisation last night and is trying to imitate her here today.

[Rory Stewart]

That is the greatest compliment I could receive as a leadership candidate in this House—thank you very much.

In conclusion, we in this country, as all parties and all nations, have together achieved an incredible amount over the last 100 years. In my constituency, when my predecessor’s predecessor, Willie Whitelaw, was the Member of Parliament for Penrith and The Border, a third of my constituents had no indoor lavatories and a third had no mains electricity in their homes. We have moved completely away from that world since the second world war. We are in a very different world but it should not be one of complacency; it should be a world of us all working together to make things much better. The biggest challenge in this country, as I will indicate in my foreword to the UN, is adult social care.

I began with the thesis that one of the problems in development is politics. If the House wants a classic example of the way in which a good, technocratic solution to a problem in this country has been hampered by politics, just as good solutions are hampered in other countries by politics, take adult social care. There have been dozens of White Papers and Green Papers over decades, royal commissions in and out and parties in and out proposing solutions, and we still do not have the solution in place. What I shall be saying is that we need to show some humility. We need to learn from this. We need to reach across the House and work with other parties to solve the great unfinished revolution of our society, which began with the NHS dealing with people who are ill but did not properly deal with the vulnerable, the frail and the elderly. If we can tap that together, Britain can go back to the world not arrogant, preening or presenting itself as a model to the world, but presenting itself as a partner with the world.

[Kerry McCarthy]

The Secretary of State is giving a characteristically thoughtful speech. I do not want to cast any doubt on what he is saying—I agree about the need to cross party boundaries when we try to find solutions to these issues—but I wonder whether it is really possible for him to do it from the Department for International Development, as opposed to, say, the Cabinet Office, leading on the domestic delivery of the sustainable development goals. Will he say a bit about how he can persuade his perhaps less thoughtful colleagues to come to the table?

[Rory Stewart]

The hon. Lady has put her finger on a very important point. In the end, it is all very well setting these kinds of goals, wearing the kind of badge that I am wearing and signing up to the things that we believe in, but this is about leadership right the way through Government. It is about people sharing a vision of the kind of world we want to live in and of what sustainable development means, feeling in our bones and sinews the connection between our contribution to poverty and the environment and how cities, communities, clean water, clean air, gender equality, productivity and employment all come together not only to provide a society that we are proud of, but perhaps above all—as Britain continues as a partner with the world—a world that we can be proud of: a world that is greener, fairer, more united.

International Development

Rory Stewart Excerpts

Monday 10th June 2019 Ministerial Corrections

[Liz Twist (Blaydon) (Lab)]

T3. For the past 25 years, the UK has rightly been committed to ensuring that aid spending is untied from commercial interests. How does the Secretary of State explain the ONE Campaign’s research that found that almost £475 million of UK aid was still effectively tied?

[Rory Stewart]

We are very clear that we do not tie aid spending. There may be situations in which it is beneficial. For example, we have just put £70 million into British universities to find a universal cure for snake bites. That is a very good example of how we can solve a global public health problem through investment in British universities, but that is not tied aid; it is because British research and development, particularly the Liverpool School of Tropical Medicine, is the leader in this area.

[Official Report, 6 June 2019, Vol. 661, c. 268.]

Letter of correction from the Secretary of State for International Development:

Errors have been identified in the response I gave to the hon. Member for Blaydon (Liz Twist).

The correct response should have been:

[Rory Stewart]

We are very clear that we do not tie aid spending. There may be situations in which it is beneficial. For example, we have put more than £70 million into research, including with British universities, to develop new drugs, such as a universal cure for snake bites. That is a very good example of how we can solve a global public health problem through investment in British universities, but that is not tied aid; it is because British research and development, such as at the Liverpool School of Tropical Medicine, is a leader in this area.

Ebola Outbreak: DRC

Rory Stewart Excerpts

Monday 20th May 2019 Commons Chamber

[The Secretary of State for International Development (Rory Stewart)]

Ebola is back—this time in the eastern DRC. This is the largest outbreak in the country’s history, the second largest in the world and the first in a conflict zone. So far, 1,209 people have died, and we must do much more to grip the situation. It is not a simple question of virus control. If it were, we could simply repeat what we were able, at huge cost and risk, to do in Sierra Leone and Liberia, and even to some extent what the DRC Government and the World Health Organisation were able to do in Équateur and western DRC over the first six months of last year—that is, to get out into village after village, identify all the cases, trace all their contacts and the contacts of those contacts, and contain the outbreak through preventing further chains of transmission. But this situation is not like that.

This outbreak is in North Kivu, which is the centre of a conflict and is dominated by dozens of separate armed groups, largely outside Government control. Such groups have begun to attack and kill health workers, meaning that key international experts have had to be withdrawn from the epicentre of the virus. The decision not to allow this province to participate in the recent elections—partly on the grounds that it was an Ebola area—has fuelled suspicion that Ebola is a fabrication developed by hostile political forces. As a result, communities are reluctant to come forward when they have symptoms, to change burial practices or to accept the highly effective trial vaccine. The Congolese army and Government, which have successfully contained nine previous Ebola outbreaks over the last 45 years, are struggling to operate in the epicentre of this outbreak, as are the UN peacekeepers and the WHO. Although this area is dangerous and difficult to access, it is not sparsely populated. The epicentre of the outbreak is Butembo, which has a population of 1 million people, and the surrounding areas contain almost 18 million people.

According to all our expert analysis here, the current disease profile poses only a low to negligible risk to the United Kingdom, so this statement should not be a cause for panic here at home. However, this outbreak is potentially devastating for the region. It could spread easily to neighbouring provinces and even to neighbouring countries. I commend all those—both in the Congolese Government and the international community—who are working in very difficult situations to bring this disease under control. My predecessor, the current Defence Secretary, paid tribute to Dr Richard Valery Mouzoko Kiboung, who was killed in an attack by an armed group on 19 April while working on the frontline for the WHO’s Ebola response. I am sure the whole House will join me in expressing our deepest condolences to the family, friends and colleagues of Dr Richard and to all those who have lost loved ones as a result of this outbreak.

We now need to grip this situation and ensure that the disease is contained. As Members can imagine, this has been my key priority in the emergency field since I was appointed to this role just over two weeks ago. I spent the weekend in discussions with UN humanitarian co-ordinator Sir Mark Lowcock and with the Director General of the WHO, Dr Tedros, who has personally paid eight visits to the affected area so far. I have also spoken about the response to the Deputy Secretary-General of the UN, Amina Mohammed. I am pleased to see that there has been a real step-up in terms of the UN staff on the ground regarding co-ordination and the seniority of those staff, particularly in places such as Butembo. Both the Health Secretary and the Foreign Secretary have been supporting this agenda in meetings over the past four days—the G7 health ministry meeting and the WHO meetings in Geneva.

I have convened a meeting with a number of international experts in the field, including Brigadier Kevin Beaton, who helped to lead the UK military response in Sierra Leone and Liberia, and the chief medical adviser to the UK Government. I have concluded, on the basis of their advice, that we need to provide more money immediately, not only to support the frontline response—the health workers—but to support the vaccination strategy and to put more of our expert staff on the ground into the response. This is not just about recruiting doctors. We need people who understand and can work with the DRC Government, the military and even the opposition forces in order to create the space for us to work. We need people who know the UN system well so that they can drive and shape the UN response.

These people need to be not in London but on the ground, because they need to be able to learn and adapt very quickly as the disease spreads. We are already deploying epidemiologists through our public health rapid support teams, in partnership with the Department of Health and Social Care. I am also now considering deploying officials with specialities in information management, adaptive management, anthropology and strategic communications. It is, however, important for us all to understand that this is not a problem that the international community can solve from a distance. This is a political and security crisis as much as a health crisis, and the response must, in the end, be driven by local health workers and leaders.

There are some positive signs. DFID has been a key player in developing a new experimental vaccine for Ebola that is proving highly effective. Over 119,000 doses have been administered in eastern DRC—an achievement that has probably saved thousands of lives. Modelling from Yale suggests that the use of the vaccine has reduced the geographic spread of Ebola by nearly 70%. This is not just about statistics. It is about, for example, Danielle, a 42-day-old baby in eastern Congo who survived Ebola last week thanks to the inspiring work of community volunteers, themselves Ebola survivors, and frontline health workers, supported by UK Aid.

Of course, we cannot do this alone. It needs grip and urgency, but it also needs humility. One of the reasons I have been talking in detail about this issue to Mark Green, my US opposite number, is not only that we share the US’s analysis but that the Americans will inevitably be major players in this response in terms of finance and expertise, as indeed they were in the Liberia Ebola outbreak. We need many more international donors to match our financial contributions and to sustain the international and local health operations in the field. That is why the UK has just hosted an event specifically on Ebola to build support for the response in the World Health Assembly in Geneva. It is also why I have agreed that my colleague, the Africa Minister, should visit eastern DRC immediately.

This is a very dangerous situation where the Ebola virus is only one ingredient in a crisis that is fuelled by politics, community suspicion and armed violence. We need to act fast and we need to act generously. But above all, we need the right people on the ground who are completely on top of the situation and able to come up with quick solutions and to guide us in keeping up the support for—and, yes, sometimes the pressure on—the UN system, on non-governmental organisation, on opposition politicians and on the Government of the DRC to get this done. The stakes are very high. I will keep the House updated on our response.

[Dan Carden (Liverpool, Walton) (Lab)]

I thank the Secretary of State for advance sight of his statement and for its comprehensive nature. I would like to start by joining him in commending all those who are working to fight this outbreak, honouring Dr Richard Kiboung, who was killed last month, and expressing our deepest sympathies to all those who have lost their lives to the latest Ebola outbreak in the DRC.

The death toll currently exceeds 1,000 people, and as the number of confirmed cases continues to rise, this deadly and cruel virus is certain to claim more lives in the days and weeks to come. The World Health Organisation has said it is unlikely that the virus will be contained, so its spread into neighbouring countries is not only possible but likely. This assessment from the WHO means that the world must act fast to prevent catastrophic outcomes, given the speed with which Ebola can contaminate and kill. David Miliband, who recently visited the region, confirmed that

“the Ebola outbreak is getting worse, not better, despite a proven vaccine and treatment.”

Through the Department for International Development, the UK is already playing its role in the response and making a difference on the ground, as it has done in previous outbreaks. Real credit is due to DFID’s staff and all responders for their tireless work and commitment. I am pleased to hear that the Secretary of State is discussing further action that DFID can take with other donor countries. Every day is crucial, and getting the response right is imperative. It is not simply a matter of issuing more money or resources. Given the complex security context laid out by the Secretary of State, a more hands-on and strategic approach is urgently needed.

It has been widely reported that one of the major barriers to delivering the necessary response is the breakdown of trust between the affected community and those trying to lead the response. A quarter of people in the region believe that the Ebola virus does not exist, and a third think that it was fabricated for financial gain. Foreigners have been accused of bringing Ebola to the DRC, and armed groups have stormed health centres and killed staff members.

Medical humanitarian agencies, such as Médecins sans Frontières, that have the expertise and experience to fight Ebola are being forced to suspend activities in the face of threats of further violent attacks. As a result, people are left untreated, vaccines are not administered, and the majority of Ebola-related deaths are now occurring within the community rather than health clinics. Lack of infection control and safe burials only speeds up the spread of the virus. In April, the country recorded its highest number of cases since the outbreak began, and we can expect this month’s caseload to be higher. Transmission is occurring in highly populated areas where health systems are weak and hundreds of armed groups operate.

What specific steps is the Secretary of State taking to ensure that all agencies prioritise working with the Congolese community in their response? What urgent steps is he taking to gain the trust of the Congolese community? Can he tell us more about his discussions on supporting efforts to stop the current rumour mill of misinformation and secure negotiated access to the affected population?

What more can the Secretary of State do to reduce the problematic dependence on armed escorts and military involvement in the implementation of humanitarian activities? Agencies active on the ground report a major difficulty being that actors involved in the Ebola response are the very same actors who have played a long-standing role in the ongoing conflict in the region. Can he give an assurance that he will uphold the principles laid out in the Inter-Agency Standing Committee guidelines, which state that military and civil defence assets should only ever be employed by humanitarian agencies as a last resort? Crucially, while we want to see everything done to get this emergency situation under control, does he agree that prevention is better than emergency response and that we must provide long-term support to ensure that the DRC can build appropriate public health systems for the future?

[Rory Stewart]

I thank the hon. Gentleman for his moving and well-informed response to the statement; it is clearly very well informed by some of the actors on the ground. I will reply specifically to two of his questions.

On stepping up co-ordination, an assistant secretary-general of the UN is now operating out of Butembo with a broader co-ordination role for the different UN agencies. We have reached out to opposition leaders, who yesterday made the first in a series of statements to communities to encourage them to come forward to report cases. This is really important because those opposition leaders were at least complicit passively in allowing the rumours to spread that Ebola was somehow an invention of the Government, so there has been a very important shift. We want to thank those opposition leaders for coming forward and making those statements, and we would encourage them to make more such statements. Clearly, the Ebola response should not be politicised and should not be caught up in people’s disagreements with this particular Government in Kinshasa.

On the military-security relationship, the hon. Gentleman is absolutely right that we should be using military personnel only as a last resort, but it is very difficult situation. Nearly 200 separate insurgencies are taking place in the DRC—in particular, the Allied Democratic Forces and the Mai-Mai groups, which are operating in North Kivu and the surrounding areas—which, as we have said, have killed a doctor, mounted at least two attacks on Médecins sans Frontières facilities and attacked up to 40 other health facilities. With these kinds of problems, and when we are protecting our health workers not just from the risk of getting Ebola itself—health workers are of course among the individuals most at risk of contracting Ebola—but literally protecting them from being shot or attacked, it is understandable that in certain cases we have to work either with UN troops or the army of the DRC to address this outbreak.

We need to be very realistic about what this whole situation means. Part of that is resilience and, absolutely, investment in the public health facilities in the DRC. However, we should remember that the DRC Government have dealt with nine previous outbreaks. In fact, Ebola is named after a river in the DRC, and it was first discovered because of an outbreak in the DRC. The Congolese army and the DRC Government actually have a huge amount of experience in dealing with this. Their failure to grip it here is specifically about the conflict in North Kivu, rather than necessarily about their having the skills and experience to deal with it.

Finally, we need to invest in resilience in the neighbouring countries to make sure that were the disease—God forbid— to move into Uganda, Burundi or Rwanda, we have the proper response in place to contain it in each of them.

[Mrs Pauline Latham (Mid Derbyshire) (Con)]

Last time I was in Uganda, I was shown the preparations that were being made in case Ebola did come across the border, but I did not feel they were adequate enough. There was one bed, as part of a health facility, which just had a curtain around it. Will my right hon. Friend explain what we are doing to help, because this will not respect the border of a country and it will cross? Will the Secretary of State explain exactly what we are doing to help the countries bordering the DRC to stop it spreading into their country?

[Rory Stewart]

The answer is that we have much more experience now than we did 10 years ago of dealing with this, particularly because of the experience in Sierra Leone and Liberia. That means partly that we are giving money to agencies such as Oxfam so that it can provide its own experts in the field and support to the WHO both in resilience preparedness and in work with the public health authorities in those countries. We know what we are doing; we have the skills; and we know how to run a good technical Ebola clinic. I am very concerned to hear this news from Uganda and I am very happy to look at the individual case, but we certainly can do much better than that and we generally are doing much better than that.

[Douglas Chapman (Dunfermline and West Fife) (SNP)]

May I thank the Secretary of State for pre-sight of his oral statement? Thanks are due in no small measure to those who are already working on the ground. That point was made by the Opposition Front Bencher, the hon. Member for Liverpool, Walton (Dan Carden), and indeed by the Secretary of State.

With 1,600 cases and almost 1,200 deaths, the outbreak in the DRC is the second largest in history. It has a 67% fatality rate 10 months after it began, and the case numbers are still rising and escalating as we speak. As we know, the disease disproportionately affects women, in 55% of cases, and children, in 28% of cases. The International Federation of Red Cross and Red Crescent Societies has warned that it may have to scale back operations dramatically in the DRC because of underfunding and some of the security issues that the Secretary of State mentioned in his statement.

I have two questions for the Secretary of State. First, on vaccines, he might remember that my hon. Friend the Member for Central Ayrshire (Dr Whitford) noted in a recent article for The BMJ that

“modern air travel means it is not possible to ignore infectious diseases that occur ‘far away’ as of no concern here”.

Does he agree that vaccines are a key weapon in the fight against this disease, at home and abroad, and if so, what steps is his Department taking to combat the disinformation about vaccines worldwide? I think that problem is bigger than what we are dealing with today.

Secondly, during the west Africa epidemic of 2014 to 2016, funerals were a major source of Ebola transmission, causing almost 80% of infections in Sierra Leone. What steps is the Department taking to ensure that safe and speedy burials are provided across the worst affected areas?

[Rory Stewart]

There are three issues. First, I absolutely agree that we need to work very closely with everyone, including all Members of this House, to combat the very dangerous lies about vaccines. Vaccines are absolutely vital. They have transformed life expectancy around the world. We cannot allow conspiracy theories about vaccines to lead to unnecessary deaths.

Secondly, in eastern DRC, there are two types of vaccines available: one developed by Merck, and one developed by Johnson & Johnson. The trials of the Merck vaccine were very successful in Guinea. We are beginning to roll out the Johnson & Johnson vaccine. There is an issue with how long it takes to make these vaccines; because they still have to be biologically incubated through an egg, it can take between six and 12 months to create the vaccines. Pushing towards 350,000 over the next six months will therefore require enormous drive and effort.

Finally, on burial practices, we must ensure that we are anthropologically sensitive. Family members want to be able to see their loved ones before they bury them, so we have to bring them in wearing hazmat suits and ensure that they see the chlorine spraying of the body. In certain cases, in addition to wrapping the body, we need a clear site so that they can see the face, so that some of the rumours that have been going around about organ harvesting can be dealt with directly. In eastern DRC, this is about reassuring not only the family, but the broader community.

[John Howell (Henley) (Con)]

One of the big problems is that that part of the world is characterised by a large number of refugees, due to the inherent instability of the region. How will my right hon. Friend tackle Ebola among refugees to ensure that it does not spread to other countries?

[Rory Stewart]

My hon. Friend is absolutely right. The ongoing conflict in eastern DRC, which has been going on for decades, involves Congolese citizens moving in large numbers into neighbouring countries, and some of the insurgent groups, such as the Allied Democratic Forces, are citizens of other countries—a lot of people originally born in Uganda and Rwanda are now fighting in eastern DRC. That means we need to deal with the situation in two ways. We need to think about those people returning to their host countries, but we also need to think about vaccinating within the camps for refugees and internally displaced people. Our aim will be to try to do a complete vaccination of those camps and communities.

[Kevin Brennan (Cardiff West) (Lab)]

My constituent Ben Thomas came to talk to me about this on Saturday. The combination of this terrible disease, in an area with 18 million people dominated by separate groups, as the Secretary of State described, out of Government control, with the conspiracy theories, reads like the nightmarish script of some disaster movie. How sure is he that the risk of this spreading and eventually coming to the UK is negligible, and what is he doing with other Departments to ensure that we are ready for such a possibility?

[Rory Stewart]

That, of course, is the central question. Our colleagues in public health conduct an analysis on a real-time basis and publish every two weeks their view of the risk to the United Kingdom. They publish the risk of vectors of transmission that they are aware of. They look at the fact that eastern DRC is a relatively remote area, with no direct flights to the United Kingdom, and there is a very limited number of people from the diaspora community of eastern DRC in Britain. However, if Ebola continues to spread, that fortnightly update will change. The current negligible risk could move up, which is why we need to watch this very closely. If it were to move to Uganda, two factors would come into play. Uganda has a better public health system, so it should be able to trace contact to contact and contain Ebola more rapidly, but there is the risk of the direct flights to the United Kingdom, so we need to keep the House updated very closely on that. At the moment, I think their assessment is correct. However, should the situation change, our assessment will need to change.

[Jeremy Lefroy (Stafford) (Con)]

I thank my right hon. Friend the Secretary of State and the Opposition spokesman, the hon. Member for Liverpool, Walton (Dan Carden), for their very measured and detailed statements and replies. May I ask the Secretary of State about the situation in Goma? As far as we know, there are no cases in Goma at the moment, but it is a very large population centre. It seems, from the information I have, that it is not well prepared. Should the disease reach Goma, that could have extremely dangerous consequences. Goma is home to large numbers of refugees, as my hon. Friend the Member for Henley (John Howell) pointed out.

[Rory Stewart]

In terms of the worst-case scenarios we are looking at, Goma is a very serious situation. Butembo, as I explained to the House, has a population of 1 million. Goma is far larger. It is a considerable urban settlement and a major trading port right across to Rwanda. It would not be possible to vaccinate everybody in Goma. There are simply more millions of people than we have vaccines to insert. It is therefore very, very important that we contain the outbreak by ring-vaccination around the area of Butembo. If it moves to Goma, we will have to move to a totally different stage of response, so we must do all we can to prevent that happening.

[Nick Smith (Blaenau Gwent) (Lab)]

I thank the Secretary of State for his statement, which was very helpful. I understand that in Sierra Leone’s most recent Ebola outbreak nearly 10% of that country’s health professionals were killed. This disease can therefore have a huge impact on a country. The Secretary of State talked about much distrust surrounding this outbreak. Will he say more about what is being done to raise awareness and emphasise the impact of Ebola, so we can contain it?

--- Later in debate ---

[Rory Stewart]

There are two main lessons from Sierra Leone. The first is communication—in particular, making sure that anybody who is sick comes forward to report it and that they report their contacts honestly. We had a situation recently in eastern DRC where a baby was reported, but nobody traced the fact that the grandmother of the baby had actually had the disease. Contact tracing and reporting is essential. The second relates to safe burial practices and understanding very clearly the risks involved.

In terms of health workers, the big change from Sierra Leone is the vaccine. One of the great achievements that this Department has played a major role in is the final development of an Ebola vaccine, which, so far, has been very effective—over 90% effective. We are now vaccinating all health workers in the area as a matter of course, so that anyone who is in contact with a patient is vaccinated. That should make a huge difference to the transmission of the disease, because in Sierra Leone and Liberia it moved through health workers. The problem at the moment is traditional health workers, who are reluctant to come forward.

[Alex Chalk (Cheltenham) (Con)]

For intervention to be decisive, clinical experts will have to be deployed at pace and at scale. Will the Secretary of State indicate what discussions he is having with our international counterparts to ensure that such resources, as are required from us and our allies, are deployed as quickly as possible?

[Rory Stewart]

From discussions in the Department, we have agreed a scale-up of the UK response. We have laid out the additional UK experts who want to go into the field. I have spoken to Mark Green, the administrator of the United States Agency for International Development. A retired US admiral who led their response in Liberia has just been out in the field in eastern DRC and has returned to Washington. I hope that a colleague will be able to meet him in Washington this coming week. The third thing is making sure, with Dr Tedros and Mark Lowcock from the WHO and the United Nations Office for the Co-ordination of Humanitarian Affairs, that we get the right UN experts in the field. My hon. Friend is absolutely right: more expertise, more quickly and closer the epicentre is the key.

[Tom Brake (Carshalton and Wallington) (LD)]

I welcome the Secretary of State to his new role. He is perhaps that rare animal—a Minister who is respected on both sides of the House—so I wish him well. He will know that in 2014, the Ebola outbreak was classified as a public health emergency of international concern, as was the Zika outbreak in 2016. I assume that he is monitoring that. At what point does he think we might reach that stage, and what additional resources would that bring to tackle the outbreak?

[Rory Stewart]

That is a very good, technical question. Let me take the two responses in reverse order. First, we do not believe that the declaration would make a dramatic difference to the resources that we are able to deploy. In fact, we have just signed off on very significant additional resources. For various security reasons, I feel that we cannot talk about the exact sum, but we are putting much more resource into this operation. Secondly, we are monitoring this issue and the entire meeting last week was around that. It is an active question for the discussion currently taking place at the World Health Assembly, and we will keep the House updated on the declaration of the emergency.

[Jamie Stone (Caithness, Sutherland and Easter Ross) (LD)]

I congratulate the Secretary of State on taking up his role; the introduction of a Scot always helps matters in sensible decision making. My question is simple: in terms of mobilising all our forces and getting the vaccine on tap as quickly as possible, are we making the maximum use of one of our strengths, which is British academia? One thinks of Oxford, Cambridge, Glasgow, Edinburgh and Manchester, where we have some tremendous medical specialists.

[Rory Stewart]

The answer is yes. British academics are playing a very major role, but a lot of the Merck development has included not just British but American and Canadian academics. The point is well made. We are very proud in DFID that the quest for a universal snakebite vaccine, for example, will be led through the Liverpool School of Tropical Medicine and funded entirely with DFID money. That is an example of where I, as a Scot, would very much like to take this Department.

IBRD Loan to Jordan: Contingent Liability

Rory Stewart Excerpts

Wednesday 8th May 2019 Written Statements

[The Secretary of State for International Development (Rory Stewart)]

I have today laid a departmental minute setting out DFID’s intention to guarantee a portion of a forthcoming development policy loan from the International Bank for Reconstruction and Development (IBRD)-arm of the World Bank to Jordan.

This would create a contingent liability of the US dollar equivalent of £332 million (based on current interest and exchange rates), in respect of the World Bank Group. There remain strong incentives for Jordan to avoid entering into arrears as doing so would lead to the IBRD not agreeing any new lending, and not providing any lending agreed under existing loans.

In the event that a default did occur, and the guarantee is called, the UK would still provide compensation to the World Bank, in proportion to the UK’s guaranteed share of the overall IBRD loan. If this liability is called, provision for any DFID payment would be sought through the normal procedure.

[HCWS1542]