I shall talk tomorrow about mental ill health.  Mental illness and heart diseases alone account for almost 70 percent of lost economic output. Mental and neuro-psychiatic disorders like dementia and stroke are the largest source of burden of disease globally. Over 90% of the 24 million people suffering from schizophrenia live in low and middle-income countries, but less than half of them receive treatment, even in developed countries.

Countless millions go untreated and suffer misery and poverty, despite the availability of effective interventions and affordable delivery. A decade of reports calling for political action has been widely ignored. I was disappointed that mental health was scarcely given a mention at the UN meeting; it was not on the agenda and the final communiqué had barely 3 passing mentions.

We can guess why these disorders were ignored. The problems of stigma and mistreatment are similar to the experience of those with stigmatizing infectious diseases like HIV, and in some instances there are serious abuses of human rights. But we now have evidence based knowledge of effective treatments and delivery systems that can be adapted to meet the needs of different cultures. Indeed the best community based mental health systems have much to teach the developed world about recovery and social integration. Nevertheless, an enormous gap in treatment persists throughout world, particularly in the least developed countries. The time for global action has come and I hope our Government will begin to support the push for global action on mental health.

In many ways this goes to the heart of the problem in Afghanistan and some other developing country’s. It may be a long time ago but when John Reid was Secretary of State for defence he expressed the hope that UK troops would leave Afghanistan without firing a shot. A naive but genuine hope said in the knowledge that troops were being sent under the UN to provide stability for the government that would allow development to take place. The UN was emphasising the importance of rights for woman not just because the organisation believed it was right but because the evidence was very strong that without women’s rights development was far less likely to happen.

The problem for NGO’s is that they are inevitably challenging the power base of groups who oppose development and who maintain power by enforcing the status quo. So health care that improves the position of woman poses a political challenge. Sadly in this situation NGO’s are inevitably part of the political process. In the early days of the Afghan conflict with the UN forces the Taliban and others decided to target volunteers , civil servants, teachers and others so John Reid’s optimistic hope that UK troops would leave without firing a shot failed. This problem is not unique to Afghanistan – it is more starkly reported in te UK because our troops are under fire but it is happening in other countries where those supporting development are in conflict with those who feel threatened by that development.

The report received a lot of publicity last year in this country and overseas and will be of interest to all those concerned with contagious diseases especially TB, HIV, Malaria, Influenza. It also deals with the interaction between many of the international and intergovernmental organisations dealing with disease.

http://www.parliament.uk/parliamentary_committees/lords_press_notices/pn210708igo.cfm

Meanwhile I have been very frustrated because the Liaison Committee which decides what select committees should exist and in what form met and agreed that the Intergovernmental Committee should not continue in its present form and quite possible not continue at all! This would be a serious mistake in my view and in the view of many members of the House who believe we need a committee to look at the way your money is spent on intergovernmental organisations. The following brief debate on the Liaison Committees report gives an example of that in the form of the cost to the UK of peacekeeping operations.

Billions of pounds are spent by the UK- quite rightly in my opinion – on the UN, the World bank, the IMF and others but we do not give sufficient attention to the effectiveness of this investment. Follow this link to read my contribution to the argument and watch this space for further developments! I will return to this.

http://www.publications.parliament.uk/pa/ld200708/ldhansrd/text/80716-0002.htm#08071684000007