The Minister of State, Foreign, Commonwealth and Development Office (Lord Ahmad of Wimbledon) (Con)
My Lords, I thank all noble Lords for their, once again, detailed and expert insights in this short but very informed debate. In particular, I thank the noble Lord, Lord Trees, for tabling it and for his long-standing commitment to combating malaria and neglected tropical diseases. I pay tribute to the noble Baroness, Lady Hayman, for her continued focus; her expertise and insight were valuable to me, as they were to the noble Lord, Lord Collins. He and I joined your Lordships’ House at more or less the same time.
As the noble Lord, Lord Trees, reminded us, this debate comes hot on the heels of the successful Kigali Summit on Malaria and Neglected Tropical Diseases, alongside the Commonwealth Heads of Government Meeting. I was pleased to see members of the APPG, including the noble Lord, Lord Purvis, in Kigali and to exchange views with them directly. As he mentioned, the Commonwealth is undoubtedly disproportionately affected by these diseases, and the political will demonstrated at the summit and in the leaders’ communiqué will be key to ending these epidemics.
I agree with the noble Lord, Lord Collins, about the importance of civil society and its role. A few other events were keeping people occupied, but over the last 48 hours I was focused on the delivery of the freedom of religion or belief conference at the QEII, which has just concluded. Civil society representatives were intrinsic and central to the ministerial conference, rather than a separate part of it, and the same needs to apply in every respect of our work.
As noble Lords noted, Commonwealth leaders reaffirmed their commitment to halving cases of malaria in the Commonwealth, and countries affected by malaria made $2.2 billion of commitments to tackle the disease. As noble Lords acknowledged, I was proud to sign on behalf of the UK the Kigali Declaration on NTDs, which will continue the global momentum generated by the UK-led London declaration 10 years ago. The Kigali Declaration commits countries to supporting the delivery of the World Health Organization’s road map on NTDs, a pivotal instrument in our fight to end this epidemic by 2030. I was glad to see the commitments made by Governments, pharmaceutical companies—which the noble Lord, Lord Collins, alluded to—donors and others.
The noble Lord, Lord Purvis, asked about the Commonwealth being off track on the commitment to halve malaria by 2023. There is no hiding from this; it is off track. A large part of this is a result of the impact of Covid; many Commonwealth countries that were on track were impacted. The noble Lord is aware of the challenges of Covid and vaccine distribution, particularly for the most vulnerable. Countries currently on track include Bangladesh, Belize, Malaysia and South Africa. Off-track countries include Nigeria, Mozambique, Uganda and Tanzania, for example. Although overall we are off track as a Commonwealth of 56, the commitment to end the malaria epidemic by 2030 was restated. When I see the focus, uniformity and universality of the commitments, I believe that, rather than pushing targets back, we will see what progress can be made when the Commonwealth meets again. I would be keen to talk to all noble Lords to see what more can be done to meet this commitment.
There is no doubt about the challenges that these epidemics pose: diseases such as Covid-19 place a terrible burden, and the issue of NTDs and malaria add to that. They were there before Covid, are still very much present and affect the poorest, especially women and children.
I assure the noble Baroness, Lady Hayman, that when I alluded to the issue of women and girls, it was not just in the context of issues of sexual violence. I totally agree with the noble Baroness that it is about how we invest, which is why the Government remain committed, for example, to the important issue of girls’ education around the world. In 2020, more than 11 million pregnant women in African countries were exposed to malaria, contributing to more than 800,000 cases of low birth weight, and eight in 10 of those who died of malaria were children aged under five.
Even before Covid, the issue of being off track, which I have just alluded to, was a key challenge for everyone. The pandemic has set us back, but we have rallied to avert the worst-case scenarios, including the World Health Organization recommending the world's first malaria vaccine, as well as advances on other vaccine candidates. The Gambia was declared trachoma free last year, and Rwanda and Uganda heralded the elimination of specific strains of sleeping sickness this year.
On the issue of specific deliverables raised by the noble Lords, Lord Trees and Lord Collins, and the noble Baroness, Lady Hayman, I agree that we need to be specific in what we can do. One of the important elements, to put a bit of detail on this, is that the UK will invest quite specifically in research and innovation in new drugs and diagnostics, through world-leading product development partnerships. These will include specific research on NTDs and other diseases of poverty.
Several noble Lords raised the issue of drugs being thrown away by programmes, and I will look into this in more detail. From a general perspective, while there were no reported cases of donated drugs being destroyed or thrown away, figures are being used in media reports, so I will follow this up. If noble Lords know of any specific countries or issues that can be traced back to particular programmes, it would be helpful to have that information.
Picking up several of the points raised by the right reverend Prelate, we remain very much committed to global health, and our recently published international development strategy focuses on this. Saving lives, particularly those of mothers, newborns and under-fives, while making essential health services available to all, is a top priority for the UK. We have detailed our commitments and plans in our new IDS, as well as in position papers last year on health systems strengthening and ending preventable deaths.
Strong, resilient and inclusive health systems are of course crucial here and we will continue to invest in programmes to strengthen these, to help ensure that tools for preventing and treating malaria and NTDs are readily available to all who need them. I agree again with the noble Baroness that, by investing early in R&D and prevention, we can save money but, most importantly, we can save lives.
The focus on stronger health systems is the bedrock of our efforts to improve global health, and in this respect I agree with the noble Lord, Lord Trees, that it really is the basis for continued wellbeing. It is a strategic decision to focus on the sustainable systems and essential services required to address all causes of ill-health—a point made by the noble Lord, Lord Collins.
In some cases, this focus has also meant reducing our investments in directly delivering services, but here we have worked with national programmes and partners to prioritise and complete programme activities where possible, and to co-ordinate the handover of activities to others. We continue to invest in key multilaterals and research, alongside helping to build strong health systems overall.
All noble Lords referred to the Global Fund. This year also marks the seventh replenishment of the Global Fund, which remains an essential partner in the fight against HIV, TB and malaria, as well as in strengthening health systems and supporting pandemic preparedness. As all noble Lords acknowledged, the UK is a co-founder and long-standing contributor to the Global Fund, having provided more than £4 billion in funding to date, and we are reviewing the investment case for the seventh replenishment in line with our new strategy and global health position papers. I reassure noble Lords that we will make a significant financial and leadership contribution to the Global Fund.
The noble Lord, Lord Collins, talked about needing to make sure we get the commitment. What more should I say? I am still here. In all seriousness, this is important to me; it is something I have focused on. There is nothing on which I disagree with noble Lords in relation to the importance of this fund and its contribution. We are focused on making sure that our leadership is sustained. The noble Lord spoke about supporting others, including the United States. If we can continue to focus on this, we can look ultimately again at saving lives.
Along with other institutions, we have funded Gavi and UNITAID. The Global Fund has also played a critical role in piloting the malaria vaccine. We will continue to support the Global Fund and Gavi to maximise the vaccine’s impact by helping countries plan their rollouts, alongside other proven malaria interventions. That is an important point about logistics on the ground.
On R&D, the UK continues to invest. I can assure the noble Baroness, Lady Hayman, and the noble Lord, Lord Collins, of our recognition of the importance of technology transfer. We will continue to put our scientific expertise to work for global health and development challenges in this respect, focused on NTDs. Our investments have led to the world’s first child-friendly antimalarial drug, which is estimated to have saved over a million lives. We have also funded trials, with the result published in the Lancet, of a novel type of bed net that kills mosquitoes resistant to traditional insecticides. This net reduced the prevalence of malaria by 43% in the first year of use.
The point on ODA is well made. I have always been candid and clear: when you cut funding on ODA, which we have done, that will have an impact, but ensuring prevention is a key focus. The Government’s commitment to 0.7% remains.
I am grateful to all noble Lords who have contributed. Our long-standing commitment endures. As the noble Lord, Lord Trees, said, health ultimately creates wealth. Our objective should be ensuring that countries improve not only their health services but their livelihoods. The collective will demonstrated in Kigali should be the impetus to do so much more.