Much of our aid is indeed aimed at building capacity of developing nations in the ways Mr Rodgers describes. The friends I have working in international aid, whether for charities or DFID, are doing exactly that – work which leaves a legacy and is sustainable without them being there in future.

Mr Rodgers makes some measured comments, acknowleding the dilemma politicians face, but I have to say that most people who tell me ‘charity begins at home’ are really trying to say is that it ends there too. How ever hard things are for us now, we are still one of the world’s wealthiest nations (in spite of our size) and it is in any case in our long term interests to improve conditions in other countries… if we don’t, the consequences come up and bite us at some point down the line.

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‘…vaccination of the poor should be a top priority for the health of the world, but I cannot agree with David that this is a good or useful way of spending our taxpayers’ money.’

So, realistically, how do you propose meeting this ‘top priority’ if not through spending on aid programmes? Yes, these should be sustainable but I’d support Rob’s view that many already are.

The problem with vaccines is that there is not much profit, at least in the short-term, for the companies who develop them to distribute them to poorer countries. These are, remember, private, for-profit companies who are probably not as committed to the long-term benefits for world health as they are to making money.

And those long-term benefits can be both real and economic. I’ve read elsewhere that the eradication of smallpox is estimated to have cost 300 million dollars but to have saved 1000 million dollars PER YEAR – to say nothing of the countless lives it’s saved.

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‘I know this sounds really bad..’ A sadly prophetic opening phrase, Paddy. Unless I misunderstand you, you’re essentially saying we should supply food but not worry ourselves too much about disease. Makes little sense, I’m afraid.

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