AIDS, Tuberculosis and Malaria

Baroness Barker Excerpts

Thursday 11th December 2014 Lords Chamber

[Baroness Barker (LD)]

My Lords, I, too, want to thank the noble Lord, Lord Fowler, for today’s debate. It is an opportunity to thank this Government for their continuing commitment—a commitment started by the previous Labour Government—to funding for international aid. In times of austerity, there are those cheap political point-scorers who will say that international aid is a luxury which we cannot afford. They could not be more wrong. As today’s report on anti-microbial resistance shows, health issues are now global, and investment in the health of people in countries around the globe is an act of self-preservation for people here, too. Any political party that says it will cut foreign aid is not acting in the best interests of its own citizens.

That said, tackling these three big issues is very complicated. We have all sorts of different actors: academics, national Governments, researchers, scientists and not least the people themselves. By far the agents with the biggest impact are the global funders: the UK and the United States Governments are the biggest contributors to them. They have the most profound impact on what happens to everybody else.

I, too, want to echo the points that have been made by a number of speakers about the Global Fund’s current strategy towards middle-income countries. It is right that the Global Fund has gone through a process of refining its funding models. It is important that it should fund work in countries in ways which are compatible with the development of proper national health systems in those countries, including basic health systems, such as access to clean water. However, it is an unfortunate reality that, having gone at such a pace, the Global Fund is withdrawing funding from middle-income countries, such as Ukraine and Vietnam. It is having a devastating impact on those countries, not least on their marginal communities.

I want to echo what was said by the noble Lords, Lord Cashman and Lord Lexden: it is groups within those countries that can have the biggest impact on their own Governments. I would therefore encourage the noble Baroness to commit to working with civil society groups to achieve that. I say that because of the searing experience I had of standing in a top AIDS clinic in New Delhi watching a line of women queuing up for their HIV and TB treatments. They were among the most powerless people I have ever seen. Recognising that they are in the position that they are in through absolutely no fault of their own makes a compelling case not to abandon them, just because they live in a country the economy of which is increasing.

I am proud to be part of the group that produced the Access Denied report. It covers a number of matters in tremendous detail, not least the matters of intellectual property rights and TRIPS agreements. I am not going to talk about that in great depth today, but I would welcome the opportunity to do so some other time. The Global Fund, as noble Lords have said, is an important player when it comes to research. Underlying the whole of the work to deal with these diseases is the issue of research, funding for basic research, funding for translational research, and funding for new medicines. We had the experience in India of talking to generic manufacturers who explained to us, as the commercial people that they are, that there was no market for paediatric formulations for HIV. That makes it even more important that Governments and funds, such as the Global Fund, continue to make the sorts of structural investment over a long term which enables other people to maximise their efforts.

Noble Lords will know that in the last 50 years there have been no new drugs for TB. There have been loads of new drugs for allergies and so on, because they are diseases of the west and there is a market. In the case of drugs for TB, there largely is not a market. It is therefore really important that the Global Fund continues to fund research.

In answering the Question asked by the noble Lord, Lord Collins, on 1 December, the Minister made some remarks about the funding of research which have caused some alarm among the lobby groups and civil society groups that work in this area. Will she commit to meet a cross-party group from both Houses along with some of those groups so that we can talk about that?

I think that we all understand that, now more than ever, there is cause to be efficient and effective in the way in which resources are deployed, but there are some decisions that we need to take, not just for the present moment but for years to come, which will, I hope, bind future Governments. As the noble Lord, Lord Fowler, epitomises in his work, this is something for the long haul. Things that are for the long haul require exceptional political commitment. Will the noble Baroness make that commitment so that we can all rest safe in the knowledge that the investment which has been made over the last 30 years will not be lost?