HIV/AIDS: US Withdrawal from WHO

Question

Asked by

To ask His Majesty’s Government what assessment they have made of the impact of the United States of America’s withdrawal from the World Health Organization on the global treatment of HIV/AIDS.

My Lords, I pay tribute to the noble Lord, Lord Fowler, for the work that he has done on this agenda over very many decades. The UK will continue to work with the World Health Organization, member states and other partners to support the WHO’s ongoing transformation and to strengthen its efficiency, transparency and responsiveness. We are proud of our long-standing support for global health organisations at the core of the response to HIV/AIDS and we continue to support efforts to end AIDS as a public health threat by 2030.

My Lords, I am grateful for that reply. There have been, to date, 40 million deaths from AIDS across the world. Because of the success of efforts over the last years, official predictions were that AIDS could be eliminated as a public health disease by 2030, as the Minister has just said, but that was before the abrupt and recent changes of policy by the American Administration, which have caused havoc across the world. Is it really the Government’s view that the 2030 target is achievable in the new conditions? Do they share the view of most medical experts that the American policies are leading the world backwards, to defeat, in a vital area of public health?

I do not think it has made it any easier, but we stand by our commitment to do this by 2030. There are some things in our favour around medical advances and new treatments, and a willingness of some Governments now to play a part that perhaps they have not been able to in the past. There is no doubt that the situation is now more challenging, but we will work as firmly and with as much energy as we ever have towards this goal, because it is important that we do.

My Lords, tuberculosis is the single biggest cause of death for people with HIV/AIDS, killing 1.25 million people a year. It is the most deadly infectious disease of all. Given the reduction of funding and the dismantling of USAID, and the withdrawal of funding from the WHO, does the Minister share my concern that our ability to conduct ongoing surveillance of this airborne transmissible disease is at risk? Will the Government maintain their programmes to ensure that this disease too can be beaten by 2030?

We are concerned about HIV/AIDS and tuberculosis, malaria and other diseases. The theme of these exchanges today is going to be one of heightened concern about our ability to make the progress that we have an ambition and a responsibility to make. There is no doubt that it has now been made more difficult. The noble Lord asked about the decisions we are making here in the UK. We are not responsible for the decisions that other countries make, but we are responsible for the choices that we take. Although those decisions are currently being made, I find it difficult to envisage a situation where the United Kingdom does not play a leading role in the fight against these diseases.

My Lords, with regard to our approach, this week marks the 10th anniversary of the 0.7% legislation passing this House. I mourn that, because I was naive; I felt that subsequent Governments would honour it. However, we now have the position where the Government will be paying more to private sector landlords in the UK than the entirety of all our support for children with malaria or those born with AIDS. In two years’ time, we will be spending the same level on official development assistance as Viktor Orbán’s Hungary. With all great seriousness, given how far away we will be from that legislation—and the more incredulous government statements saying that when fiscal circumstances arise we will get to it—as the people now in charge of that legislation, will the Government now do the decent thing and repeal it?

Absolutely not. Why would we do that? It is our ambition to regain the 0.7% spend on official development assistance. We have been very clear about that. Why would we repeal that legislation? I find it very difficult that we are spending so much money on housing asylum seekers and migrants in the UK out of our ODA budget. I do not think that is what we should be doing. The previous Government completely lost control of the borders of this country and we have inherited this situation. The Home Office is working hard to get the numbers down and to reduce the spend so that money can be spent where it is needed most. We did make the decision—and it was a difficult one for this Government—to prioritise spending on defence. I do not think I need to explain to noble Lords why we did that. It is a decision I support, and I will be working incredibly hard, with allies and partners, to make sure that the money that we do have is spent wisely, and that we get the best value for money for British taxpayers and the most impact that we can for our partners overseas.

My Lords, last week, I co-hosted on behalf of the Parliamentary Science and Technology Committee a meeting of STOPAIDS in this House. We heard from people from Africa whose ability to access drugs had, in one case, enabled a woman to live to become a grandmother. We heard about the devastating effect, mentioned by the noble Lord, Lord Fowler, of the cuts in USAID, for which we are not responsible. I hope my noble friend the Minister will understand that, to the extent that Britain can continue to play its part in trying to reach the 2030 target, it must use the resources, scarce though they are, to enable this work to continue. We cannot allow the world to go backwards. This needs to be tackled now.

I completely agree. There are encouraging things happening around some of the medical devices and the drugs that can be used now to provide protection against HIV, including devices for which women are in control of their use, because we are seeing an increase in prevalence among women and young girls. There are encouraging things happening, but it would be incredible to stand here and say that the situation that we now find ourselves in is not far more challenging than it has been more recently.

My Lords, taking into account the withdrawal of the United States from the WHO, can the Minister inform the House how we are working with other international partners to fill that void?

It is vital that we do that, and we are doing that. I met the executive director of the WHO earlier this week, and that is something we spoke about in some depth. The noble Earl is absolutely right to encourage the Government to take that approach, and we will be doing so.

My Lords, alongside the withdrawal from the World Health Organization, the Trump Administration are cutting billions of dollars from US universities and research institutes. What assessment have the Government made of the impact on the UK’s research partnerships, and, crucially, in relation to this question, the impact on our shared global health challenges?

There is no doubt that research and development is critical to making progress on this and many other agendas in development. We are working through the impact, as the noble Baroness suggests we should. Clearly, we cannot fill the void, but we can work smarter and more collaboratively, and certainly with our university and research partners it is important that we do so.

My Lords, the Minister seems to suggest that devices and medication are expanding. The problem is that people need to get tested. The impact of the US pulling out is that there are 228,000 fewer tests a day and the supply of things such as condoms and PrEP has ceased in certain programmes. If the Minister wishes the UK to take a lead, as she said at the Dispatch Box, what extra support and resources will be made available if this temporary suspension becomes permanent?

We are working through the impact of the United States’ decision and looking at how we reprioritise our own spending. The noble Lord is absolutely right. Encouragingly, in 2023, approximately 86% of people living with HIV worldwide knew their HIV status. What we do not want to see is that incredible achievement going in the wrong direction. He is right to remind the House of that.