Global Health (Research and Development)

Debate between Lord Herbert of South Downs and Alan Duncan

Tuesday 8th July 2014 Westminster Hall

[Mr Duncan]

We will, of course, write to the right hon. Gentleman, as requested, with our thoughts and views on his proposal. I have no doubt that officials will be happy to discuss with him, in person, what he thinks should be done, should he so wish it.

DFID is also utilising research and development techniques to understand better the environment in which we operate and it is working out how we can anticipate future trends. One example is in antimicrobial resistance, which has been mentioned today—a future threat on which the UK Government are taking a leadership role globally. DFID is supporting an initiative to track drug resistance to malaria in south-east Asia as it potentially spreads through the region and, critically, towards Africa. That will help target new antimalarial drugs, the development of which is also being supported by DFID.

Research alone will not alleviate poverty, which is why DFID also invests heavily into putting research into practice. Our programme, Research into Results, which is designed to convert theory into practice, is a perfect example of that. In my recent visit to Edinburgh university, I saw the good work being done in setting up small-scale businesses able to take the best research ideas coming out of universities and get them into widespread use. So many of the development challenges we face today rely on solutions from research, and solving many of the challenges we will face tomorrow will rely on the research and development investments that we make today.

[Nick Herbert]

Will my right hon. Friend give way?

[Mr Duncan]

I have only three lines of my speech left, but since it is my right hon. Friend, I will.

[Nick Herbert]

I am grateful. I welcome everything that my right hon. Friend has said, the commitment that DFID has shown to this area and his undertaking that the Department will look carefully at the report. Does he think, in the overall scheme of things, that the global response to these diseases, many of which are pandemics, is equal to the task? It has taken an enormous global effort in other respects to tackle these diseases, such as with the establishment of the global fund. Only one TB drug has been approved by the Food and Drug Administration in the past 50 years. It was developed by Janssen Pharmaceuticals, by doctors who were not authorised to take it forward because they knew it would not be commercial. Finally, the company allowed the drug. Unless there is a step change in the response in the developing world to this problem, I wonder whether we will deal with it.

[Mr Duncan]

I agree with my right hon. Friend. We had a passionate debate on TB just a few months ago, in which he spoke on a subject on which he commands the House. The scale of the activity is not yet equal to the task, and it needs to be. That is why I urge all developed countries to match the 0.7% commitment that we have made. We, having taken the lead, should be followed by others. We can be proud that we are in the lead, and if others did what we did, we might well be up to the scale of the task that he illustrated. On that purposeful note, I say that we are committed to maintaining our record of funding high quality, high impact research and to putting that knowledge into use, so that we all, in the work we do, can save many thousands, if not millions, of lives.

Tuberculosis

Debate between Lord Herbert of South Downs and Alan Duncan

Wednesday 27th November 2013 Westminster Hall

[Mr Duncan]

The hon. Gentleman has raised a serious point. If he will bear with me, I will come to the issue of South Africa in just a moment. As he and the right hon. Member for Neath (Mr Hain) said, the issue is obvious and compelling, and has to be addressed.

In spite of tough times, the broad picture for the UK is that we are delivering on our promise to spend 0.7% of gross national income on development. This year we will become the first G8 nation ever to do so. We are clear about our responsibility to deliver aid that is transparent, that delivers value for money and that produces the best results for the world’s poorest people. Our support to the Global Fund to Fight AIDS, Tuberculosis and Malaria helps to do just that. Between 2002 and 2012, the global health fund supported the detection and treatment of 9.7 million cases of TB.

To respond to the continuity point raised by the hon. Member for Wirral South (Alison McGovern), who spoke from the Opposition Front Bench, last month the UK Government committed up to £1 billion over the next three years, which is enough to save a life every three minutes. The global health fund allocates 18% of its funds to TB, which equates to £180 million of UK development funding specifically for that disease. Improving basic TB control is critical to prevent the further spread of TB, and includes early detection and diagnosis of people with the illness, ensuring that they get the right treatment and care, and checking that their families and other close contacts do not also have active TB. Also important is the reporting of cases, so that health authorities can better monitor them and improve their services.

Let me turn to the work we are doing through our country bilateral support programmes. DFID is working closely with the Government of South Africa to expand the quality and access of public sector services, including TB control, and is increasing the speed with which new TB drugs are registered. In conjunction with the World Bank, DFID is also engaged in a new partnership with the private sector in South Africa. The partnership has been set up to increase public-private collaboration to reduce the high incidence of TB specifically in miners and in the communities around them. We will continue to focus on that important target group, to which the hon. Member for Easington (Grahame M. Morris) referred. In India, DFID is working with Indian pharmaceutical manufacturers to improve the price and security of supply for high-quality drugs for resistant TB and new low-cost diagnostic products.

Co-infection has been covered thoroughly today. Many countries have made considerable progress in addressing the combined epidemic of TB and HIV. However, there were still 320,000 deaths from HIV-associated TB in 2012. DFID is supporting improved co-ordination and collaboration between TB and HIV services jointly. As part of our commitment to the global health fund, we are pushing it to do more to prevent, diagnose and treat TB and HIV co-infection.

The UK Government are very concerned about the spread of drug-resistant TB, which probably results from the improper use of antibiotics. A patient who develops active disease with a drug-resistant TB strain can transmit that form of TB to other individuals, which threatens the whole global response to TB. Drug resistance increases the cost of treatment and makes it more difficult to ensure that effective treatment is accessible to the poorest. We support efforts to tackle drug-resistant TB through our support to UNITAID, the global health fund and research.

The UK has a strong record of supporting research and development for effective treatments, diagnostics and vaccines. We support a number of product development partnerships that bring together a range of public, private and community organisations. They are designed to develop and deliver new products more rapidly and more cheaply than either the public or private sectors can do alone.

I should mention TB REACH, to which four or five hon. Members referred. The issue is not as straightforward as any of us in public policy would like. We have reviewed the external mid-term evaluation of TB REACH, and the findings suggest that it has successfully funded pilot projects and innovative approaches, which we applaud. The question is whether it will be able to roll them out effectively in the long term and on an adequate scale. We propose that DFID officials should meet the executive director of the Stop TB Partnership to discuss how the global health fund can better support the expansion of proven TB REACH projects. It is important the TB REACH implementers co-ordinate more closely with national TB control programmes—again, that was raised today—and are part of national planning processes. That is crucial to secure longer-term support.

[Nick Herbert]

I am grateful to the Minister for responding to our points about TB REACH. Does he accept that although it will no doubt be worth having a dialogue with the global health fund about supporting proven TB REACH projects, further projects will rely on the continued funding of that programme? As my hon. Friend the Member for City of Chester (Stephen Mosley) effectively said, TB REACH funds projects that the global health fund will not fund because they are unproven. TB REACH allows innovation on the ground in such projects. Will the Minister reflect on that and consider my request for a meeting to discuss the TB REACH programme before a final decision is taken about its funding?

[Mr Duncan]

I certainly undertake to consider that, but obviously, as I am on my feet at the moment, I cannot give a commitment. We provide core funding to the Stop TB Partnership, some of which is used to support TB REACH continuously. I understand exactly what my right hon. Friend is saying, and I hope that the meeting to which I have referred can explore that point in more detail and address his concerns conclusively.

DFID has also supported the Foundation for Innovative and New Diagnostics—FIND—to develop a rapid molecular test, GeneXpert, to which reference has been made. It can be used by health care workers with minimal training and laboratory facilities. The test is associated with a 40% improvement in case detection rates and can provide test results within two hours. Working through the Stop TB Partnership and UNITAID, the Department has supported the policy development and distribution of GeneXpert, which is available in 29 countries. In August, DFID announced support to nine public-private partnerships, including FIND, the TB Alliance and Aeras. Those partnerships will help to fund crucial work on developing new and more effective tools to prevent, diagnose and treat TB.

We cannot shelter the UK from what is happening around the world. In 2011, nearly 9,000 cases of TB were reported in the UK. More than 6,000 of them were in people born outside the UK. The patterns must be analysed, followed and fully understood. A cross-government approach is also essential. Public Health England has made TB one of its priorities and is working to oversee a stronger national approach.

Resistance to all antimicrobials—the drugs used to prevent and treat bacterial, fungal, viral and some parasitic infections in humans and animals—is increasing, but of greatest concern is the rapid increase in bacterial resistance to antibiotics, including those used to treat TB. In September, the Government published a new five-year antimicrobial resistance strategy, which sets out actions to slow the development and spread of anti- microbial resistance, including strengthened international collaboration. That is why DFID will continue to work with the Department of Health and others to provide national and international policy leadership. We must play our part in ensuring co-ordinated action to tackle TB at home and abroad.

In conclusion, significant progress has been made since 1995 in controlling TB, with more than 56 million cases treated and 22 million lives saved. That progress has been rooted in improved partnership, policy, innovation, and national and international leadership. We have grounds for optimism, but we are not complacent about the significant challenges ahead, in which the UK will continue to play its full part.