Debate on Rare and Neglected Tropical Diseases April 3rd 2017
Lord Alton of Liverpool (CB)
My Lords, it is a great pleasure to support my noble friend Lady Hayman and salute her dogged persistence in raising the issue of rare and neglected tropical diseases. In doing so, I should mention that I am a vice-president of the Liverpool School of Tropical Medicine and have been associated with the school in one way or another for the best part of 40 years. I particularly pay tribute to Professor Janet Hemingway, whose brilliant leadership has ensured that the school has maintained its world-class status, and the remarkable Professor David Molyneux, who ranks as one of the foremost global authorities on neglected tropical diseases.
The Liverpool school has been involved with NTDs since its creation in 1898, and has been responsible for many of the ground-breaking discoveries in the field. A school staff member was among the small group who coined the term “NTDs” with the World Health Organization in 2004-05. I should like to use my brief contribution to this evening’s debate to shine a light on the school’s amazing work and to encourage the noble Lord, Lord Bates, to consider what extra assistance might be given.
Let me give the House just some examples of the ground-breaking work in which the Liverpool school has been involved in the past decade. With DfID support, the lymphatic filariasis programme continues to make a real impact on poor people in 12 countries, having assisted ministries of health to deliver 200 million drug doses since 2009. As a result, in Malawi, for instance, transmission of filariasis has stopped. The Liverpool school and the London Centre for Neglected Tropical Diseases have expanded their commitment to those who remain disabled through the disease, recognising the tandem aims of stopping transmission and, as my noble friend Lady Hayman said, reducing chronic disablement. The school has been identifying patients, training surgeons to alleviate this stigmatising male genital disease, and demonstrating the benefits of surgery to those who are disabled.
Secondly, LSTM researchers are at the forefront of new and exciting approaches to mapping neglected tropical diseases using remote sensing technologies, mobile smartphone technologies for detecting NTD cases, patient identification and mapping diseases. I should be grateful if the Minister could tell us what study DfID has made of the use of such technologies.
Thirdly, with support from the Bill and Melinda Gates Foundation, the school has developed the use of the antibiotic doxycycline and, with industrial partners, has developed a new drug ready for clinical trials to treat river blindness and elephantiasis.
Fourthly, the school’s staff are at the forefront of research on insecticide resistance—a major and increasing problem in the fight against malaria, but now also against Zika. This work has major policy impacts in all insect-transmitted diseases. The LSTM is a key policy adviser to the World Health Organization and is working on Zika projects to assist control. Perhaps the Minister could say a word about that too.
Fifthly, the school leads the way in snake-bite research. Snake-bite is a massively underestimated problem globally. I was amazed to be told that at least 100,000 deaths per year are attributable to a condition that often leads to amputation. Africa is in dire need of anti-venoms, as the major manufacturer has ceased production. The LTSM is seeking to develop new products which are multivalent, do not need to be in cold storage and are therefore affordable to those in urgent need. Perhaps the Minister will also comment on that.
Sixthly, researchers are undertaking critical work to improve the use and monitoring of insecticide in India to assist visceral leishmaniasis elimination programmes. VL is a fatal disease if untreated, as we have heard, but effective control of the sand-fly is vital to reduce transmission to some of the poorest people of India, Nepal, Bangladesh and elsewhere.
Seventhly, LSTM researchers are involved in reducing the burden of sleeping sickness in several countries, with cases now at the lowest reported level ever—fewer than 3,000 per year. Perhaps the Minister can tell us how and when we expect to see this reach zero.
To conclude, around 1 billion neglected tropical diseases are treated each year via donated quality drugs to the poorest people most in need at lowest per capita cost of any health intervention. This is often called, “the best buy in public health”, addressing equity, human rights, disability alleviation, and based on effective partnerships and alliances from community to global level. It is crucial work and my noble friend is right to press the Government to build on the progress made since the 2012 London declaration.
Opening remarks by Lord Alton of Liverpool at the round table meeting on
“Countering Violent Extremism in Muslim-Majority Countries: Lessons from Indonesia”, hosted by APPG for International Freedom of Religion or Belief
Tuesday, 4 April 2017, 09:30 – 11:30
We are meeting in the aftermath of a terrible act of violence here in the precincts of Parliament. The topicality of our discussion is also underlined by the recent violence outside Santa Clara church in Bekasi, and the trial of Jakarta’s Governor on Blasphemy charges.
Extremist interpretations of Islam motivate radical movements and terrorists throughout the world. While there is no single means to stem radicalisation, unless these interpretations are challenged and undercut, these conflicts will grow. The present narrative of Islam and its radical manifestation that revolve around the Middle East blinds us from two important keys to understand the long term solution.
First, it is a contest of ideas. This contest can’t be won by gunpowder, especially in a digital age and we need to spend much more time thinking about the role of social media in generating hate speech and violent ideology.
Second, instead of focusing only on the problems in the Middle East, we need to focus on finding the long term solution which may lie far away from the centre of problems.
This is where Indonesia stands out in the Muslim world.
With Muslims accounting for roughly 88% of its 260 million people, Indonesia is the world’s third largest democracy with more Muslims than the whole Middle East combined. Its economy is the largest in Southeast Asia and among all Muslim majority countries. As opposed to a caliphate or an Islamic state, constitutional democracy enjoys a broad based support in Indonesia, including from the two largest Muslim organizations with around 100 million members, NU and Muhammadiyah. Indonesia does not have a state religion.
Indonesia’s stronger resistance to radicalism is rooted in its thousands of years of experience with cultural and religious diversity. Peaceful co-existence and cooperation between people with different cultures and religions have been part of its rich history and the glue of the nation with more than 13,000 islands, 1,000 ethnicities, and 700 languages.
As acknowledged by the UK’s Foreign and Commonwealth office in pledged action at the UN Human Rights Council until 2019, advancing freedom of religion or belief – as outlined in Article 18 of the Universal Declaration of Human Rights –to build cohesive communities in which all individuals are equal to manifest their beliefs is a critical element of preventing radicalisation. Breaking-down fear and intolerance towards ‘the other’ by facilitating inter- and intra-faith discussion builds understanding and provides counter narratives to those considering carrying out violence in the name of religion.
Indonesia may well be the counter narrative that the world desperately needs to win this contest of ideas. For Indonesian Muslims, the radical Islam being fueled largely from the Middle East is denigrating Islam, damaging the world, and threatening the peaceful Islam, or what they call the middle path (wasatiyyah) Islam, in Indonesia. They want to stop radicalisation.
Since this war of ideas is a global one, leaders from Indonesia and other countries need to work together to understand the contest – too often violent – and to find the solution. The Indonesian leaders understand that the United Kingdom is a key ally in this.
This visit by the Indonesian delegation, a Christian and Muslim partnership, to the United Kingdom is part of a joint project by Leimena Institute (Indonesia) and Fieldstead and Company (USA) to defeat the extremist religious ideology by consolidating middle path Islam in Indonesia and promoting it to the world, especially among the Muslim majority countries. It is a unique opportunity to work hand-in-hand with a major moderating force in the Muslim world to bring about fundamental reform. It can have a far reaching theological, political, and security impact. It is in the national interest of the United Kingdom and other Western countries to explore the possibility of this global partnership initiative.
Syria -Chemical Weapons April 5th House of Lords
Lord Alton of Liverpool (CB)
My Lords, in welcoming the swift response of Her Majesty’s Government and the reply that the Minister has just given to the Question put by the noble Baroness, Lady Northover, perhaps I might press the Government further on the use of chemical weapons. We have now seen chemical weapons used twice in Syria, but they have also been used, allegedly, in Darfur by the regime of President Omar al-Bashir. We have seen a chemical weapons attack using a toxic nerve agent in an international airport in Kuala Lumpur. Does this not all point to a climate of impunity in which those responsible do not believe that they will be brought to justice? In pursuing the point that the noble Lord, Lord Collins, has just made, will we be pressing also for a referral to the International Criminal Court of all those responsible for war crimes, crimes against humanity and genocide?
Baroness Anelay of St Johns
My thoughts today are very much concentrated on the children and other civilians who suffered yesterday in Idlib. The noble Lord will be aware of my previous answers on this issue, to the effect that in the international field we bring cases before the International Criminal Court when we are able to do so, with the agreement of the Security Council. With regard to Syria, there have been more than two occasions when the regime has been proven to use chemical weapons—there have been three. The proof has been gained by the OCPW-UN Joint Investigative Mechanism, and there are further investigations afoot.
Digital Economy Bill – and why we need to be vigilant in combatting gratuitous violence and hatred on the net – March 20th 2017. Parliamentary Debate:
Lord Alton of Liverpool (CB) I support Amendment 25YD in the name of my noble and learned friend, to which she spoke so well earlier on, and the comments of other noble Lords in the debate so far. The problem with coming to this point in legislation, which has proceeded all the way through the other place and is now on Report in your Lordships’ House, on a day when some 174 government amendments have been laid, is that it is very hard to do justice to genuine discussion or indeed scrutiny, which is what this House is supposed to do with these measures. Although I welcome the measured way in which the Minister, the noble Lord, Lord Ashton of Hyde, introduced the amendment today and his assurance that there will be a Green Paper, I was also very taken by my noble and learned friend’s comment about the difficulties there would then subsequently be in having legislation. That is all the more reason not to legislate in haste, lest we end up repenting at leisure. 3.45 pm Secondly, and in parenthesis before I turn to my substantive points, I was struck by what my noble and learned friend said about public opinion on this issue. Although some might think this a very narrow view, polling over the weekend showed significant opposition to the Government’s proposal. Indeed, support for it ranged from 5% to 10% in the ComRes poll. Some 82%, rising to 86% in the case of women, thought that online standards should be the same as those offline or stronger—the point made by the noble Lord, Lord Gordon. Only 4% thought that online standards should be weaker but sadly, as we have heard, that is the ultimate, though probably unintended, consequence of the amendments before your Lordships’ House. I have long had an interest in the subject of children and media safety, after the tragic death in February 1993 of James Bulger, near the constituency in Liverpool which I represented when I was in another place. The 24th anniversary of his murder has just passed. I promoted a cross-party amendment to bring in increased protections for video material. As a result, the Government introduced the amendment, which is now Section 4a of the Video Recordings Act 1984, into this House on 14 June 1994. That section has become known as the “harm test” and I hope noble Lords will indulge me while I quote what was said in this House at the time by Earl Ferrers, who was speaking for the Government: “There may be some works which the board believes would have such a devastating effect on individuals or on society if they were released that there should be the possibility of their being refused a video classification altogether, and the clause leaves the board free to do that. The criteria mean that the British Board of Film Classification must consider who is in fact likely to see a particular video, regardless of the classification, so that if it knows that a particular video is likely to appeal to children and is likely to be seen by them, despite its classification being for an older group, then the board must consider those children as potential viewers. That does not mean that the board must then ban the video altogether. The board will still have discretion on how, or whether, to classify it; but it must bear in mind the effect which it might have on children who may be potential viewers … our amendment goes wider and is not confined to psychological harm or harm only to children. Harm to adults and to society in general can be taken into account”.—[Official Report, 14/6/1994; col. 1592.] Earl Ferrers was right then and those words stand the test again today. This framework has underpinned video regulation since and was adopted into the regulation of video on demand in 2014. It was totally logical that it should be included in this Bill when it was introduced in the other place. In parenthesis, and before saying anything further, I commend the Government for taking on the regulation of pornography on the internet through the Bill. I particularly support what the Minister has been saying about age verification and the effort he has been putting into that issue. Our principal, but not only, concern is the protection of children; hence the emphasis on age verification. However, we should not delude ourselves into believing that this can be enough to meet the significant challenge. The evidence of the damage being done to children and young people through easy access to pornography is deeply disturbing and should give us all pause. Last November, the Justice Minister, Dr Phillip Lee, the Member for Bracknell, said that the internet is, “driving greater access to more worrying imagery online. In the extreme, the sexualisation of youth is manifesting itself in younger conviction ages for rape”. Hopefully, this legislation will make a significant dent in the amount of material seen by children and will lead to a reduction in the concerns that have been so extensively documented over the last couple of years. However, having stepped on this worthy but difficult road, some potholes have appeared, not least whether and how we should regulate what adults see. I am aware that some noble Lords are of the view that it is out there; we do not need to worry about it; it has all been going on for ages; adults should be able to see what they like and we should not interfere. However, we have not taken that view in the offline world, under the Video Recordings Act 1984. One reason for that is that it became abundantly clear that children were accessing gratuitously violent material because adults simply left it lying around. It also became clear that what we see influences our behaviour, whether we are children or adults. The advertising industry certainly believes that what we see influences us. I looked at figures for advertising over the weekend. In the last 12 months, more than £5 billion was spent on TV advertising—a record amount. Taking UK advertising expenditure as a whole, in 2016 it increased by 7.5% to £20 billion, and internet ad spend increased by 17.3% to £8.6 billion. What we see affects what we eat and wear, how we spend our money and how we behave. What is true for the advertising industry is manifestly true for these other influences too. Indeed, Parliament has rightly rejected a disinterested, laissez-faire approach to the online world of video on demand, as is evident in the Communications Act 2003. We have had to say that some material simply is not appropriate, even behind age verification, with the harm test being a consideration in what the British Board of Film Classification will classify. The Government are saying that nothing will change with their Amendments 25H, 25W and 25YC: what is illegal offline is, and will remain, illegal online. Yes, but only up to a point. For instance, we are saying, “Don’t possess explicit animated images of children, but it is okay for a website to supply this to you if it is behind age verification as it does not meet the definition of extreme pornography”. We are telling retailers that they cannot supply an unclassified video work without committing an offence, but that if they are a website the regulator will not bother them unless the work is unclassified because it contains extreme pornography. Extreme pornography is a very narrow definition of very violent pornography. It is a much narrower category than prohibited material, against which the law is enforced offline and against which the Digital Economy Bill currently suggests that the regulator should enforce the law. Violent pornography will be caught via the extreme pornography offence only if it is life threatening or likely to result in not just injury but serious injury to specifically named body parts—as we have heard from my noble friend Lady Howe—clarifying that serious injury to other body parts would not be caught, as she mentioned. Rejecting the current prohibited material standard would also mean making space for sexually violent material that would not fall within one of the criminal offences but which the BBFC would not classify, “in line with the objective of preventing non-trivial harm risks to potential viewers and, through their behaviour, to society”. I understand that some may say that even with these amendments the provision of an age verification regulator with the power to enforce the law online would be beneficial to the extent that it means extreme pornography would be caught. For me, however, and I suspect much of the country, the presenting issue is quite different. We are at Report stage of a Bill that has completed all its stages in the Commons and almost all its stages here. These issues should have been more widely aired and these amendments should have been considered in the House of Commons and in depth in Committee in both Houses. There should be a public debate about the changes the Government are proposing and how they will impact on other media standards, which they inevitably will over the longer term. Unless there is evidence that there is no detrimental impact, the definition of extreme pornographic material will revert to that originally used for prohibited material and the ability to provide all this material via age verification with impunity will be removed. Amendment 25YD would give us all time for reflection and to review what the evidence says on the impact of violent pornography on women, and whether the Government have got the regulatory framework right. Twenty-four years ago, I was talking about concerns arising from violent videos. Technology and accessibility to media have changed dramatically over that time but human nature has not. The same principles of harm to children, adults and the wider society need to be weighed and confronted. It was this House that introduced the harm test in 1994 and it is this House that should now ask the Government to reflect further, which is precisely what my noble and learned friend’s amendment seeks to do.
Lord Alton of Liverpool My Lords, I supports the amendment proposed by the noble Baronesses, Lady Jones and Lady Janke, but also the remarks of my noble friend Lady Howe. I want to ask the Minister, when he comes to reply, about an issue that I raised in your Lordships’ House previously, and that is the issue of suicide sites on the internet. It concerns me that young people can be encouraged to visit those sites and take their own lives. I attended a school prize giving in a north-west school, and the headmaster told me, when I arrived, how a child in that school had taken their own life only the day before. As noble Lords can imagine, that was a terrible tragedy not only for the family but for the whole school, and it certainly changed the atmosphere on that occasion. That child had been visiting one of the suicide sites on the internet, and the headmaster discovered that several other children had been doing the same. It can be revenge porn or the kind of trolling to which the noble Baroness referred, the harassment of young women in particular, or the whipping up of xenophobia, racism or anti-Semitism, and it is right that there should be a code of practice, and we should get on with it. I hope that the Minister will tell us more about the Green Paper, what the framework will be for it and when we are going to start to seriously look at these issues