Malaria and Neglected Tropical Diseases

Baroness Hayman Excerpts

Thursday 7th July 2022 Lords Chamber

[Baroness Hayman (CB)]

My Lords, I declare my interests as set out in the register and apologise for not doing so when I intervened in a Question earlier. I hope the House will forgive me.

I have been involved in these issues for a long time. I remember the excitement around the London Declaration on NTDs. I very much welcome the speech that the noble Lord, Lord Trees, made, which I thought set out comprehensively the implications of these diseases for some of the poorest people in the world—some of the most neglected people in the world, as the right reverend Prelate said.

The London declaration aimed to enable more than a billion people suffering from NTDs to lead healthier and more productive lives. The link between good health and development is very well understood. We have made a great deal of progress, but we are at a very dangerous point for NTDs and malaria. There is a double challenge. There is the challenge of the post-Covid environment. Covid had a tremendous effect in the poorest countries in the world in diverting resources away from the absolutely basic services given for malaria and NTDs, and we have seen the consequent rises in death, as far as malaria is concerned, and in disability and disfigurement that come from NTDs.

However, as well as the effects of Covid, we have had the effects mentioned by both speakers already of the reduction in ODA, which have been devastating as far as NTDs are concerned. The flagship Ascend programme was cut off completely and in a totally irresponsible way, which ended up with donated medications being thrown away on a horrific scale. If we are to end programmes, there is a way to end them which is sensible and minimises disruption and damage, and we did not do that with the Ascend programme. There are other examples across the board. The RISE leprosy programme in Bangladesh just went, in exactly the same way.

Not to be completely negative, I say that I hope that the Kigali Declaration can bring us back to some focus on NTDs. The Minister, who I know has always been very concerned about these issues and committed to tackling them, endorsed the Kigali Declaration during the summit last month and committed to supporting NTD elimination programmes, recognising that tackling NTDs also helps to reduce poverty, address inequality, strengthen health systems, increase human capital, and build resilient communities. However, I would be very grateful if, when he winds up, he can give us a little of the detail on how the UK intends to act on its CHOGM and Kigali Declaration commitments, and what technical and financial resources it will deploy in support of countries to achieve the WHO 2030 NTD road map, and to partner and collaborate with endemic countries to support action to achieve disease-specific goals while building resilient health systems.

Turning to malaria, I think that the most important message that we can give to the Minister today is on the need for this country’s strong support of the Global Fund. The US has shown the way. We have always been the joint leader on donations to the Global Fund. I hope that this continues. Any reduction in that funding would have long-term consequences. Not only would it imbed and continue the reduction in the progress that we have made in reducing deaths from malaria, it could also have very different consequences. There was a fascinating meeting yesterday with the Medicines for Malaria Venture. One consequence of reducing funding to the Global Fund would be on endemic countries’ access to quality medicines. The shortfalls in the funding of quality medicines might oblige countries to source lower-quality medicines, which are not as effective, and which could have potentially devastating effects. I hope that the Government will look at that potential negative consequence and at the potential positive consequence in supporting the local manufacturing of malaria and NTD medicines, particularly malaria drug production. There are some examples of local manufacturing, but they need support and investment to meet international regulatory standards and WHO prequalification.

I hope that if the Minister cannot reply today he will write to me on whether the Government are considering the positive role they can play in knowledge transfer and supporting capacity-building in-country so that endemic countries can move towards self-sufficiency in the production of these medicines. The UK has been a long-standing leader in the fight against malaria, supporting ground-breaking R&D and the large-scale deployment of tools to tackle the disease. That has been done particularly through generous contributions to the Global Fund.

I shall make one last point. When we were discussing Nigeria the other day, the Minister reassured the House about the priority that the Government give to programmes for women and girls. I hope he will recognise today that those programmes are not just about violence against women and girls. Those who suffer from these diseases most acutely are women and girls. Support for the Global Fund means support for 60% of a programme specifically directed to women and girls. Deaths occur in children under five and pregnant women. NTD infections contribute to maternal mortality and morbidity, poor foetal development, maternal anaemia, maternal mortality, pregnancy complications, infant mortality and low birth weight. They also heavily impact on education and employment opportunities for women and girls. These are important areas, and I hope the Minister will be able to respond positively.