Malaria and Neglected Tropical Diseases

Anne-Marie Trevelyan Excerpts

Tuesday 9th January 2024 Westminster Hall

[The Minister of State, Foreign, Commonwealth and Development Office (Anne-Marie Trevelyan)]

I apologise for the cough—I am apparently enjoying a three-month winter cough, so apologies to all for that. I thank the hon. Member for Glasgow North (Patrick Grady) for securing this important debate and thank the all-party parliamentary group on malaria and neglected tropical diseases for its really thoughtful contributions today and, more importantly, for its long-standing advocacy in this whole arena. I thank all hon. Members for their contributions.

Members will be aware that my right hon. Friend the Member for Sutton Coldfield (Mr Mitchell) is the Minister in FCDO with responsibility for global health. He is unfortunately unable to be here, hence my presence. I am happy to respond; this is an area of both policy and personal interest anyway. When I was the Secretary of State for International Development before the merger, we spent a lot of time on this policy area, so I am pleased to be able to respond on behalf of the Government. If I miss any questions, for which I apologise, I will ensure that my right hon. Friend picks up on them.

On the point made by the shadow Minister, the hon. Member for Hornsey and Wood Green (Catherine West), a number of colleagues touched on the wider question of the UK’s focus on climate change, the impacts more broadly, and how the UK can assist, and is assisting, on the wider question of resilience and adaptation to the changing nature of communities, landscapes and healthcare. All the work that we do has health impacts at its heart. Women and girls are at the centre of every single piece of programming work that the FCDO does, but I will ask my right hon. Friend the Member for Sutton Coldfield to set out a few examples in his reply to help colleagues to see the broader picture, beyond the issue we are discussing today.

As colleagues have pointed out, we are at a critical point for the sustainable development goals. With COP’s focus on the impact of climate change on global health, and with World Neglected Tropical Disease Day at the end of the month, this is a really important opportunity to consider the UK’s role in helping to end those diseases. We know that the covid pandemic has taken a toll in so many ways on the pathway to the 2030 SDGs, and I can safely say that, across the world, we are all focused on trying to get back on track and thinking about how we can do that, using all the tools at our disposal.

As many colleagues have set out, the burden that malaria and NTDs place on so many countries is not geographical; it is about families and people. It is perhaps concentrated in some countries, not only by virtue of their geography and their landscapes, but because of the state of their health systems. As colleagues have said, malaria is still killing a child every minute of every day, and NTDs are causing devastating health, social and economic consequences for more than 1 billion people. We know that they fall most heavily on the poorest and the most marginalised.

In November, my right hon. Friend the Member for Sutton Coldfield set out the Government’s White Paper on development, which has at its heart the principles underpinning the UK’s ongoing contribution towards ending extreme poverty and combating climate change. A key focus of getting the world back on track to meet the 2030 SDGs includes targets to end the epidemic of malaria and NTDs. The White Paper reaffirms our commitment to ending the preventable deaths of mothers, newborns and children under five, which we cannot achieve without a particular focus on malaria. As I have mentioned, however, the White Paper also underlines the importance of helping countries to build health systems by working with them in mutually respectful partnerships and harnessing innovation and new technologies to help them to solve some of these problems.

On malaria, we are at a critical juncture in our fight against the disease. As a number of colleagues have set out, this year’s World Malaria Report showed once again that progress has stalled. We are facing a perfect storm of challenges, including rising drug and insecticide resistance, the climate impacts we have talked about, the spread of urban mosquitoes, conflict and humanitarian crises, rising prices and funding shortfalls. This is, of course, a complex mix to try to get ahead of, but the UK continues to provide global leadership. We will continue to make the limited resources that we have go further and to think about how we can adapt our approaches to fit local contexts more closely, because it is not the same everywhere. How can we help countries to focus in a more targeted way on tackling their most difficult health problems?

The UK has long been a leader in the fight against malaria. As my right hon. Friend the Member for Aldridge-Brownhills (Wendy Morton) mentioned, we have been the third largest contributor to the Global Fund over its lifetime, investing over £4.5 billion. It has three specific focuses—to eradicate malaria, TB and AIDS—which has enabled it to channel global energies into tackling those diseases. We provided £1 billion towards the seventh replenishment of the fund, and the mission to eradicate those diseases remains absolutely at the heart of the UK Government. The latest investment will help to fund 86 million mosquito nets and 450,000 seasonal malaria chemoprevention treatments, and provide treatment and care for 18 million people. Our funding continues to help drive scientific advancement—for example, the next generation of malaria bed nets, which were developed with funding from the UK and which the Global Fund is now rolling out. We have also long funded the Medicines for Malaria Venture, whose anti-malarial drugs are estimated to have averted nearly 14 million deaths since 2009.

There is further cause for optimism from new vaccines. As colleagues have mentioned, in October the WHO recommended the second ever malaria vaccine, R21. In November, just before Christmas, the first consignment of the RTS,S vaccine was delivered to Cameroon to begin roll-out across Africa. Both vaccines were developed through British scientific expertise, including the long-term commitments that we have seen from GSK, whose RTS,S vaccine has now been given to over 1.5 million children in Ghana, Kenya and Malawi. A further nine countries will receive the vaccine over the next two years, and the UK will continue to support roll-out through our £1.65 billion funding for Gavi and by further funding clinical trials.

Colleagues might not be aware that the UK led the replenishment of Gavi back in 2020, at the height of the covid pandemic, when its funding had never been more urgently needed. Gavi is the organisation that delivers vaccines to many hard-to-reach corners of the globe. It is an incredibly important organisation that is respected and welcomed in pretty much every country in the world. We were proud to bring $8 billion-worth of global commitments to Gavi, despite the challenges that everyone faced during the ongoing covid epidemic. The UK’s commitment was the largest of all those made to that replenishment.

Of course, time goes quickly, and Gavi’s replenishment for next year is coming round again; I know that the UK will continue to provide leadership on that. Gavi is one of the many parts of the machine that enables us to deliver. It does such important work to ensure that, whichever brilliant new technologies brilliant scientists come up with, they get to the places they need to be. That is so important. Indeed, through covid Gavi demonstrated—sadly, more urgently than ever—how effective it can be.

Colleagues have set out the impact of neglected tropical diseases across the globe. We have seen incredible progress, which has been due in part to the UK’s contribution. It is encouraging that 50 countries have eliminated at least one NTD, in line with the WHO’s ambitious target for 100 countries by 2030. Last year saw Iraq, Benin and Mali eliminate trachoma, Ghana eliminate a key strain of sleeping sickness, and Bangladesh and Laos eliminate lymphatic filariasis. In October, Bangladesh became the first country in the world to eliminate visceral leishmaniasis, which would not have happened without long-standing UK support.

Here, again, we face major challenges: climate change threatens to unravel so much of the progress that we have seen, and global funding falls short of what is needed to achieve our overall ambitions. The hon. Member for Slough (Mr Dhesi) highlighted the rise of dengue, which causes real concern and impacts too many places. The UK was pleased to sign the Kigali declaration on neglected tropical diseases at the 2022 CHOGM meeting, and towards that goal we committed to continued investment in research and development. Each signatory makes a unique contribution towards ending NTDs; it is very open and was designed to encourage countries, however small or large, to push on with tackling the challenges.

We are delivering on our commitment with our ongoing funding to the Drugs for Neglected Diseases initiative, or DNDi—I apologise for all the acronyms; there are lots of them—in which we have invested over £80 million so far. Through our and others’ support, DNDi has developed 13 treatments for six deadly diseases, and those are already saving millions of lives. They include a first oral-only treatment for both chronic and acute sleeping sickness, which recently received regulatory approval; a treatment for mycetoma, an infectious flesh-and-bone disease that leads to amputations; new short-course treatments for deadly visceral leishmaniasis, which I mentioned earlier, that can replace treatments with severe side effects and growing drug resistance, which is a continuing challenge in this space; and the first paediatric treatment for Chagas disease, a complex tropical parasitic disease that can result in heart failure.

Some of the DNDi’s incredible work takes place in the UK, where it has over 40 partners across industry and academia. To name but a few, we have the incredible leadership of global companies such as AstraZeneca UK and GSK, which are well known and based across the world, through to some of the smaller developing companies such as BenevolentAI, DeepMind and AMG Consultants. Those smaller companies are using other modern technologies—not pharmaceutical technologies but wider technologies—to think about how we can solve these challenges. It is worth remembering that many UK industry partners threw their technical expertise into the scientific ring when covid-19 hit the world, for instance through the COVID Moonshot work. Continuing to focus on the incredible investments made by our world-leading life sciences, tech and pharma companies is part of the whole solution.

[Catherine West]

The Minister is being very generous in giving way. What assessment has she made of the possibility of promoting more African leadership in manufacturing? Developing really good partnerships may require investment at the beginning, but it could be a very effective way to work. How do we strengthen in-country leadership in Africa while avoiding a top-down approach?

[Anne-Marie Trevelyan]

I said earlier that the Government are focusing not only on how we spend our development budget but on how we invest in and give space to the private sector to use its research and development investment as effectively as possible in areas where there can be global solutions. The shadow Minister raises a really important point, and I spent a lot of time at the World Trade Organisation in 2022 discussing how patents and investment in expensive production facilities can be done more globally. The issue was not resolved at the WTO, but it is at the heart of the conversation, which is, as has been said, about trade. We must understand how to empower the countries that will potentially get the most immediate benefit from production domestically, which will then be able to export to their neighbours, and ensure that investment flows work securely for the pharmaceutical companies that are investing billions of pounds to solve these challenges. We must ensure that production is secure and that the vaccines and other medications reach those they need to. A lot of discussion is going on globally around those issues, and some of our largest pharmaceutical companies are already doing these things around the world. Particularly in South Africa, there has been a real shift in investments, and that country can be a hub from which to export to neighbouring countries. That ongoing area of global policy development sits within the world trade discussions, and it is really important to keep pushing it.

[Jim Shannon]

I and others mentioned the important role that church and charity groups play and the significant voluntary contribution they make. How can the Minister’s Department work alongside them to encourage them and align partnerships so that things can go better?

[Anne-Marie Trevelyan]

The hon. Gentleman raises a really important point. When I visited Malawi a few years ago, I was struck by the fact that almost every Scottish church and school has a relationship with that country. The history goes back to the Scottish explorers of the 19th century, and that fascinating relationship feeds into church and other community groups across Scotland working together to support religious hospitals in Malawi. That really interesting model has been built up over more than 100 years, and those connections continue to grow. I have visited schools in my patch where children want to be involved in these issues and understand them more closely. Strong relationships can be built, and there are some very good organisations—I will come back to the hon. Gentleman because I cannot remember their names—that try to develop links with schools, in particular, to help them understand each other better. We know, as Churches across the world do ecumenically, that that is the best way to share knowledge and develop better understanding.

[Jim Shannon]

The Minister is right to acknowledge the good work that has been done in Malawi. There are 94 churches in my constituency, and I know of only one that is not doing some work in Africa. In particular, the Elim church and the Church Mission Society do work in Malawi, Zimbabwe and Swaziland. I would like to encourage those things, and I am keen to hear how we can do that.

[Anne-Marie Trevelyan]

I will take that away and we can perhaps pick it up more fully.

As colleagues set out, this has been an important and positive debate. The UK plays a long-standing and leading role in the fight against malaria and neglected tropical diseases, both as a leading donor and with our world-leading scientific and research capability, which has focused on this issue for decades. Although, as a global community, we have made incredible progress in the last 20 years, we know that too many countries still face major challenges, not the least of which is the impact of climate change. As colleagues have pointed out, in many countries the most challenging health problems are across boundaries—diseases do not see a line in the sand. As we set out in the development White Paper, we will continue to lead the fight against poverty and climate change, including, very importantly, on global health.

If I have failed to answer any questions, I hope that the Minister of State, Foreign, Commonwealth and Development Office, my right hon. Friend the Member for Sutton Coldfield, will pick up on them. We will continue to seek health solutions, alongside building health systems to help make these diseases history.