Global Fund to Fight AIDS, Tuberculosis and Malaria

Baroness Northover Excerpts

Tuesday 3rd December 2013 Lords Chamber

[Lord Avebury]

To ask Her Majesty’s Government what contribution the United Kingdom will make to the fourth replenishment of the Global Fund to Fight AIDS, Tuberculosis and Malaria.

[Baroness Northover (LD)]

As World AIDS Day reminded us, we have made great strides in our fight against AIDS, malaria and TB, but more still needs to be done. In 2011, AIDS killed 1.7 million people and TB killed 1.4 million people. In 2010, malaria killed 660,000 people. That is why the UK has pledged £1 billion to the global fund, provided that our contribution does not exceed 10% of the replenishment value.

[Lord Avebury (LD)]

My Lords, it was great that DfID was able to say recently that it had met most of the targets that were forecast in the 2011 paper Towards Zero Infections. However, will the new contribution enable the global fund to reduce the number of new infections among women by half a million, as was scheduled in the 2011 paper, to make a step change in prevention and to reduce further the cost of treatment?

[Baroness Northover]

My noble friend is right that the international effort directed through the global fund has had stunning achievements. The rate of new HIV infections among women and girls has declined. The pace of the decline is not as fast as we would wish it to be and that is something that the UK is putting renewed effort into, as will the global fund. Clearly, the focus on prevention will particularly benefit women. There has been far greater coverage of the population as a result of the global fund’s efforts and stunning reductions in the cost of, for example, HIV treatment. In 2000, treating a patient cost about $10,000 a year and that has now dropped to $125 per patient.

[Lord McConnell of Glenscorrodale (Lab)]

My Lords, the work of the global fund and the continuing UK commitment to it are to be welcomed, as that work is very important. However, I think that a new dimension is developing, particularly in sub-Saharan Africa, concerning the teenagers and young adults who were born with HIV/AIDS and who have survived due to the quality and quantity of those medical interventions but are now facing the prospect of relationships, marriage and having children as they move into adulthood. Either through the global fund or perhaps directly, might the UK Government pioneer some schemes to assist those young people with the advice and counselling that will be required to help them through that transition?

[Baroness Northover]

The noble Lord is right that a generation affected by HIV is growing up. He will also know that a lot of work has gone into trying to make sure that there is no mother-to-child transmission of the disease, and that is very important for these young people. The global fund is well aware that there is a young population whose needs it has to address.

[Lord Fowler (Con)]

I wonder whether my noble friend saw the BBC “Panorama” programme on the global fund last night, with the best tabloid title “Where’s Our Aid Money Gone?”. Over the past 18 months, I have been to more than a dozen countries looking at the HIV position. Is my noble friend aware that, without the help of the global fund and the President’s fund in the United States, the world would be in a desperate position, with escalating disease? Although there have been exceptions, overwhelmingly this money has been well spent and has resulted in millions of lives being saved. Would it not be nice if “Panorama” reported that?

[Baroness Northover]

My noble friend is absolutely right. Cambodia, for example, which was highlighted in the programme, has seen an 80% decline in malaria deaths, a 45% fall in TB and a 50% decline in HIV cases. I pay tribute to what my noble friend has done to highlight the challenge of HIV/AIDS and to his fight for the global fund, which has been transformative in this area.

[Baroness Masham of Ilton (CB)]

My Lords, does the Minister agree that it is in the interests of the world to prevent these conditions? I congratulate the UK on what it has done, but will the noble Baroness encourage other countries to do more?

[Baroness Northover]

The noble Baroness is right in terms of the impact. Yesterday, President Obama pledged $5 billion to the global fund. The US has said that it does not wish to contribute more than one-third to the fund. In other words, it wants to bring in other partners. Other countries, including Canada and the Nordic countries, have put in money and are coming forward in an encouraging fashion.

[Lord Collins of Highbury (Lab)]

My Lords, having identified TB-HIV as a strategic priority and the global fund as the lead provider for dealing with the TB epidemic and TB-HIV co-infection, will the noble Baroness tell us whether the department will follow the global fund in mandating that all HIV programming in high-burden TB and HIV countries includes specific strategies to reduce TB and TB-HIV incidence?

--- Later in debate ---

[Baroness Northover]

As the noble Lord knows, the two things go closely together. I will have to look carefully at what his question implied. Of course, both the global fund and DfID are well aware of that interrelationship. Where you have patients suffering from TB, especially when it is multidrug resistant TB, you often have HIV going alongside, so the two are being tackled together. I will need to look at the noble Lord’s question to see whether there is something in it that I did not understand.

[Baroness Hayman (CB)]

My Lords, I echo the remarks of the noble Lord, Lord Fowler, about the enormous benefits that the global fund has brought to international health and its commitment to transparency and to dealing with these issues when they arise. I declare my interest in malaria and neglected tropical diseases. Will Her Majesty’s Government encourage the global fund to look at partnership working and integrating programmes, particularly on maternal and child health and neglected tropical diseases, as part of the post-2015 commitment to strengthening health systems and doing that from the bottom up rather than the top down?

[Baroness Northover]

The noble Baroness is absolutely right. The global fund has had an effect across all those areas and I pay tribute to her work on neglected tropical diseases. DfID has been strongly supportive of that. There are a number of areas where obviously the work of the global fund is complementary. If you look at its aim to raise $15 billion, at the moment $37 billion across this whole area is coming from the developing countries, supporting the kind of work that the noble Baroness is talking about.