Response to the International Development Committee call for evidence on the Future of UK Aid 

 
Submitted by The Leprosy Mission England and Wales
 

1.0 Introduction
 

This evidence is submitted by The Leprosy Mission England and Wales (TLMEW), and it has not been published before. TLMEW is an international organisation based in the UK which works with people affected by leprosy, other NTDs and disability, via partner organisations in 10 countries in Asia and Africa. Our programmes focus on health system strengthening, research, community-based rehabilitation, advocacy, employment and training, capacity building, stigma reduction and on disaster response and preparedness, including climate change and its impacts on marginalised people.  
 

This evidence responds to the Committee’s invitation to submit written evidence on the following issue: Impact of UK Aid cuts: Impact upon communities in lower income countries, and Impact upon organisations implementing UK ODA programmes. 
 

The evidence will highlight the gaps in the present strategy, challenges with the process and impact of the cuts to the UK Aid budget on the programmes and communities in the countries in which TLMEW works, as well as to the organisation itself.  
 

Overall, the UK Government made catastrophic cuts to the Overseas Development budget that are having a devastating effect on international relations, the world’s most marginalised people and the UK charities that support them.  
 

2.0 Gaps in the present strategy 

The Government’s justification for ODA cuts was to make savings to offset Government debt from the COVID-19 pandemic. The reduction in ODA budget by 0.2% (and the amount already reduced by the shrinking of the economy) is believed to only make a 1% contribution to this debt. However, it is having a devastating impact on the poorest countries in the world at a time when development has already been set back decades by the COVID-19 pandemic. 
 

Although Global Health has been retained in the 7 priorities (global challenges) it seems that this is primarily focused on addressing the pandemic. Although the details of the spending priorities within Global Health have yet to be made public, its lack of focus on the most marginalised is highlighted through significant cuts to Global Health programmes such as ASCEND, meaning millions of pounds of donated drugs for NTDs will now be wasted. A clear illustration that the cuts made have not always considered value for money.  
 

The pandemic’s toll on health systems means that now, more than ever, is the time to increase support for health system strengthening, not cut essential programmes and services aimed at improving the health of the most marginalised. Poor health means less people able to work, a reduced economy, greater inequalities and more likelihood of insecurity.  

It is in the UK’s best interests in terms of trade, health protection and security to ensure reinstatement of its commitment to 0.7%, with significant investment not just in COVID-19 response but in ensuring improved health care and health equity in the Global South.  
 

In order to ensure aid reaches the most marginalised, and the UK fulfils its commitments to the London Declaration, investment needs to be prioritised in diseases that affect the poorest, such as leprosy and other NTDs. This includes a need for research investment in Global Health, which is also a victim of the cuts, affecting not just the Global South but also UK universities. 
 

3.0 Overview of the cuts to TLMEW programmes 
 

3.1 TLMEW and our partners in three countries (Mozambique, Nepal and Bangladesh) have been affected by the funding cuts. This has included forcing a programme to close within 90 days, funding cancelled just before a project was due to start and a significant delay in programme implementation, leaving communities at a loss, Government relationships jeopardised, and staff at risk of redundancy. The total estimated financial impact of all the cuts to our grants and programmes over the next three years is £2,065,687. This will have a significant impact on an organisation with a turnover of under £10 million per annum. 
 

3.2 Such decisions across the sector have put the health, livelihoods and education of millions of people who depend on UK Aid at risk, at a time when the world’s poor are already facing a stark future as a result of the damaging effects of COVID-19. It is also a time when UK Charities are trying to fund emergency COVID-19 related needs in the countries where we work, and every penny is needed to mitigate the impact of the disease on the communities we serve. 
 

3.3 The first of TLMEW’s FCDO projects directly affected by the cuts is Mission Zero Mozambique, a UK Aid Match programme that is aimed at enabling communities to work towards ending leprosy in Mozambique by building and equipping Community Hubs. The Hubs are the centre of services including leprosy awareness, case-finding, medical provision, climate change adaptation, education, livelihood development and wellbeing. The programme was due to start in October 2021, but it has been delayed by six months until after April 2022. FCDO, although stating that this project will eventually be funded, has refused to sign the contract, or agree a start date.  
 

3.4 The second funding cut is for the FOUND project (Fueling Opportunities to end Unemployment for Nepalis with Disabilities) which is a four-year project (2019-2023) granted funding under the FCDO’s Aid Direct Impact Grant scheme. The project aimed to provide 1,375 women and 1,125 men, who are disabled and unemployed, with the skills and training they need to secure employment. However, the project’s budget was cut by 25% in 2020-2021 and in April 2021 it was given 90 days’ notice to close. It is therefore due to close on 30th July 2021. 
 

3.5 The third project impacted by the cuts to the UK Aid is RISE (Recognised, Identified, Seen, Empowered), a four-year project (2020-2024) for which the funding of just over £1,000,000 was cancelled in April 2021. The target of the RISE project was to reach a total of 9,373 direct beneficiaries; slum residents in the city of Dhaka, Bangladesh, who are affected by leprosy and disability and to deliver healthcare and social services to this population comprising of 3,229 men, 3,685 women, 1,144 boys and 1,315 girls. The project aimed to increase access of people affected by leprosy in the slums to curative Multi-Drug Therapy for leprosy and complication management services and for their households to acquire an improved understanding of nutrition and menstrual hygiene and to adopt healthier practices.  
 

4.0 The impact of the cuts on our programmes and the communities we serve: 
 

4.1 The project preceding Mission Zero Mozambique is currently working with over 100 people who are living in communities affected by leprosy. These are communities which the new Aid Match project hoped to reach when it commenced in October 2021. Funding for the existing project will end on 31 August 2021 and since Mission Zero has now been delayed by six months there is a danger that communities will not receive any support in the gap between the end of the previous project and the start of Mission Zero. The delay, without finding other funding, will directly affect and could stop altogether our work with these communities, impacting on their access to services for leprosy awareness, medical provision, education and wellbeing. This leads to reputational damage for our partners in Mozambique. It also means that TLMEW, if unable to find alternative funding sources will need to use its reserves in the interim to retain essential trained staff. Moreover, the expectations of field staff and communities involved in project design who were told the project would start in October have been let down. Building trust, credibility and relationships is a lengthy process; something that will be challenging to rebuild. 
 

4.2 The cuts to the FOUND programme in Nepal, amounting to just under £1,000,000, have a multi-layered impact as explained below:  
 

Enrolments: our target was to enroll 2,625 disabled people onto the project and, so far, we have enrolled 661. Existing beneficiaries have the support of an Employment Counsellor to help them become work ready and a Business Development Officer to liaise directly with employers and to offer self-employment advice. This support will now cease, and no further beneficiaries will be enrolled. 
 

Decent paid work opportunities: we aimed to secure formal or self-employment for 1,500 disabled people. To date, 162 people have secured employment (27 in formal work, 30 in on-the-job training leading to formal work and 105 into self-employment). Without the support of the project, it is highly possible that the 27 people in formal employment will not remain in their jobs, 30 people will have to leave their on-the-job training, and the 105 people who have just started self-employment may see their businesses fail. As a result, their income levels will decrease considerably which, in the difficult times of the COVID-19 pandemic, and its new, devastating wave currently affecting Nepal, will be catastrophic. 
 

Working with employers: 34 employers have signed up to the Disability Confident Employer Scheme (DCES) and 32 of these have offered work to disabled people. This scheme has a steering committee with local and national government representatives and the long-term aim is for it to be adopted nationally throughout Nepal. It takes considerable time for a scheme such as this to become embedded, allowing for sufficient monitoring and adapting where necessary. The funding cuts mean that this scheme will not be able to continue and as a result, inclusive recruitment will become less of a priority for employers. 
 

Staffing: at least 14 members of TLM Nepal staff will be made redundant. Other staff will be moved to the Country Office, increasing the budget considerably. Their positions will only be tenable if other funding sources are found. As there are other NGOs in Nepal with UK Aid funded projects that are also affected by the cuts, it is unlikely that it will be easy for staff to find alternative employment.  
 

Infrastructure: three Employment Centres have been set up with furniture, IT equipment and disability access. These will have to close before achieving most of the targeted outputs, meaning that the capital expenditure to date does not represent value for money.
 

Organisational reputation: a considerable amount of time and effort was used to gain approval for the project from local and national government. Additionally, as there have not been any similar projects delivered in Nepal, it was initially difficult to convince partners and stakeholders of its potential effectiveness. Closing the project when all this groundwork has been completed, but the benefits not yet realised, will significantly affect the professional reputation of The Leprosy Mission within Nepal. This means that when the funding situation is more favourable, it will be difficult to re-establish the relationships needed to get further projects off the ground. 

When a new project starts, beneficiaries are given hope. Disabled people, especially disabled women, already face multiple barriers to employment and the effects of the COVID-19 pandemic magnify these. Cutting the funding to the FOUND project takes away hope from our beneficiaries. 
 

4.3 The cancellation of funding for the RISE project in Bangladesh has impacted communities, staff, organisational reputation and planning, and has resulted in missed opportunities to prevent illness and disability amongst the most vulnerable in society. Furthermore, there is a huge cost to potential project beneficiaries in the field in terms of the missed opportunity to make an impact in the lives of 9,373 people living in poverty in the slums of Dhaka. 

More specifically, 2,802 vulnerable people have now lost the opportunity to improve their incomes; 2,900 will no longer receive support to improve the nutritional quality of their diets, receive empowerment to attain rights and entitlements, and in the case of women and girls, improve their menstrual hygiene and reproductive health. Training programmes to help 949 Government and NGO workers to effectively diagnose and support people affected by leprosy will no longer happen, and behaviour change communication messaging proposed to make 168,185 residents of the slum aware of the signs and symptoms of leprosy has also been cancelled. As a result, we anticipate that several hundred people with leprosy who would have been identified through project outreaches will experience a delayed diagnosis and an increased chance of developing complications leading to permanent disability. 
 

5.0 Challenges of the process 
 

5.1 TLMEW was informed of the cuts to our current UK Aid Direct project (FOUND) via a webinar on 30th April 2021. Upon hearing this news, along with all other NGO representatives in the webinar, we were so shocked we were unable to think through essential questions in the time allowed. We would have been better prepared to ask essential questions had we been informed beforehand in writing and then a discussion meeting set up with FCDO for questions, as happened with the cancellation of the RISE project. We have confidence in our ability to achieve the planned outcome and outputs of the FOUND project and will be seeking funding for it to continue. However, having a very short timescale in which to develop the closure budget meant that it was extremely difficult to plan for a responsible exit within the 90 days limit imposed by FCDO. This was also compounded by the fact the news was delivered just before a bank holiday weekend, giving us a day less to prepare the budget. Queries around the budget that needed further clarification from FCDO meant the 2-week time limit for budget submission was in reality reduced to a few days, once answers were received. Mannion Daniels have been extremely supportive throughout the process, pushing FCDO to make timely decisions regarding budget approval and without this, it is unlikely that we would have been able to produce a closure budget that enables us to provide the best service to our beneficiaries and staff during this very challenging period within the time allowed.  
 

5.2 The RISE project proposal was first submitted to FCDO in 2019 and provisionally accepted in early 2020. Delays were initially announced in 2020 and then the funding was cancelled altogether in April 2021. The delays and uncertainty made organisational planning difficult as the situation in the field is dynamic and documents had to be repeatedly revised. Staff recruitment plans were disrupted with resulting financial losses, and staff and stakeholders invested considerable time and effort in developing and revising this project at the cost of missing other opportunities and conducting other important work. There were also unquantifiable losses in terms of vulnerable communities losing their confidence in the organisation, which has the potential to affect ongoing relationships and credibility. 
 

6.0 Conclusion  
 

Overall, the massive delays and cuts to our programmes have had and will continue to have devastating impacts on people whom we serve in some of the most underprivileged areas of the world. Our programmes are in line with the FCDO priorities in reaching out to those ‘left-behind’ within the most marginalised and neglected communities. Yet, these huge cuts and delays leave our organisation and programmes deeply and irreversibly damaged. What is more, FCDO’s refusal to sign the contract for our latest UK Aid Match project makes planning difficult, leaving partnerships with communities and national governments in limbo. It also calls into question whether FDCO intends to keep its commitment to the UK public and fulfil its promise to match their donations. 
 

FCDO and TLMEW both have downward accountability to the stakeholders involved in these programmes which should not be underestimated. TLMEW will be seeking alternative funding sources, but the ability to secure the total amount required to offset all these cuts in the present funding environment seems unlikely. Recent UK Aid cuts have broken the strong relationship of trust that NGOs previously had with DFID and are destroying the UK Government’s reputation overseas. FCDO’s funding cuts to the world’s most vulnerable people shows that the UK has turned its back on those most in need, in the time of a global pandemic and ahead of global events such as G7 and COP26, hosted by the UK.  

Evidence submitted on 28th May 2021.  

For further information: Please contact Lidis Garbovan,  
Policy Advisor at The Leprosy Mission England and Wales, 
Email address: Lidisg@tlmew.org.uk. 

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