Global Health (Research and Development)

Frank Dobson Excerpts

Tuesday 8th July 2014 Westminster Hall

[Frank Dobson (Holborn and St Pancras) (Lab)]

I congratulate the hon. Member for St Ives (Andrew George) on securing the debate. I have the privilege of representing probably the biggest concentration of biomedical research institutions in this country and in Europe, if not in the whole world. I must declare an interest as a member of the court of the London School of Hygiene and Tropical Medicine, and as a governor of the Royal Veterinary College—I believe I was originally the Privy Council governor.

The role of the London School of Hygiene and Tropical Medicine in this matter is obvious, because of its remarkable record of more than a century. It has tended to draw on home-grown talent, but it increasingly attracts people of worldwide distinction to do their research there. A splendid example of that is the present director, Peter Piot, who in the 1970s played a major role in identifying Ebola, and in the 1980s in helping to combat HIV/AIDS in Africa.

The reason for the inclusion of the Royal Veterinary College may not be quite so obvious, but the institution has done a great deal of work on the health of animals, particularly farm animals, in developing countries. That work has focused on improving those animals’ resistance to disease and thus helping to counter poverty, malnutrition and poor health. In more recent years, the college has put a huge amount of effort into zoonotics, which concerns the possible transfer of diseases from one species to another, and particularly from various other species to ourselves. The Royal Veterinary College has developed an expertise in avian flu that is unrivalled anywhere in the world.

Recently, Professor Dirk Pfeiffer and Dr Guillaume Fournié, in collaboration with the London School of Hygiene and Tropical Medicine and the university of Queensland, have started on a project on the zoonotics of poultry in Bangladesh. Professors Javier Guitian and Jonathan Rushton have started to do some immensely important work on brucellosis, also in collaboration with the London School of Hygiene and Tropical Medicine, in west and central Africa. Together with Professor Eric Fèvre of the university of Liverpool and in collaboration with the universities of Edinburgh, Nottingham and Nairobi, Professor Rushton has been doing a lot of work on zoonoses in livestock in Kenya. All that is soundly based research, in the field, with practical application.

If there were outbreaks of diseases caused by zoonotics, the poorest and least healthy people in the world would suffer most, but we too would suffer. Having looked at Professor Pfeiffer’s work, I have come to the conclusion that although we hear a lot of talk about weapons of mass destruction, both nuclear and chemical, in terms of worldwide death the most likely weapon of mass destruction is going to be an infected chicken. We must take the matter extremely seriously.

Along with Birkbeck college, the Institute of Neurology and the School of Pharmacy at University college London are doing important work in this sphere, and they are soon to be joined by the Crick Institute. He takes a lot of stick, but I must say that the institute will be there because of the drive of the previous Prime Minister, my right hon. Friend the Member for Kirkcaldy and Cowdenbeath (Mr Brown), who battled through all the bureaucracy that was obstructing it and used his authority as Prime Minister to secure the site and the funding. It is to the credit of the current Government that they took up that baton. We must keep up and extend our research in this sphere, particularly university and public funding.

The question then arises—it has already been mentioned and I am sure it will be mentioned by others—as to whether such work will be worth while for drug companies. It will not. It is no good pretending: in certain circumstances it will not be worth their while, so we must find a worldwide mechanism to find the funds and create the practical application worldwide. The G7 and the G20 need to turn their attention to this issue. They are very good at globalising capital flows, but they need to be concentrating on globalising medical flows. Perhaps we could link the two together with a worldwide Robin Hood tax on financial transactions, but not just for the money.

We need well-organised, practical projects, the best example of which was the World Health Organisation’s commitment to eliminate smallpox. Edward Jenner did his work in 1798; the last person to be treated for smallpox that was caught in the wild was treated by my late good friend, Professor Richard Madeley, who was subsequently at Nottingham university and treated a child in Bangladesh 200 years after Jenner first did his work. We clearly have to ensure that technology transfer speeds up. We do not want it to take 200 years—we do not want it to take 200 weeks. When things are discovered that work and will improve people’s health worldwide, we need the world institutions to put in place a mechanism that will ensure that everyone gets the treatment, not just us privileged folk in the developed countries.

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[Michael Connarty (Linlithgow and East Falkirk) (Lab)]

I declare an interest: I went numerous times with Results UK to see its work on the GAVI fund and other matters. I thank the hon. Member for St Ives (Andrew George) and his co-chair for outlining the problem that we face in R and D for global health. An estimated 13.7 million people die every year from or in connection with a group of diseases known as poverty-related and neglected diseases, including TB, HIV, malaria, dengue fever, yellow fever and many others.

As has been said, there has been a market failure in developing drugs, diagnostics and vaccines for diseases that predominantly impact low and middle-income countries. Significant improvements could therefore be made, as the co-chair of the all-party group said, in co-ordination, financing and the policies of public sector donors. The World Health Organisation has been the focus of efforts to develop a globally binding convention on R and D for nearly a decade, but has not made much progress. Progress has been dishearteningly slow, and given the figures that I just quoted, every year that passes without globally co-ordinated efforts to remedy the R and D market failure results in the unnecessary loss of millions of lives. However, despite that massive figure, we do not seem to get any progress.

One of the core proposals is for countries to contribute a fixed percentage of GDP to R and D for global health, as we have done with international development generally, in recognition that such diseases represent a threat to global human, social and economic development, just as the matters on which the Department for International Development focuses its contributions do. The percentage called for is 0.1% of GDP, which could be spent bilaterally or contributed to a central fund that would apportion money for key projects and programmes to develop the new drugs, diagnostics and vaccines that are missing.

What are the challenges of reaching such a consensus? Among donors, there is a general reluctance to support a global R and D convention; the push for it is coming from developing countries. The countries that conduct the majority of research and host the biggest pharmaceutical companies want to maintain their sovereignty over their research programmes. Countries have competed over scientific research for centuries, and it is important to developed economies. Many Governments even direct money from their aid agencies directly to domestic research only. The UK can be proud that it does not do this, meaning that DFID’s contributions and aid are spent on the best research, wherever it is carried out. Nonetheless, co-ordination of funding and priorities is extremely important to ensure that there is no unnecessary duplication between research in different countries. I see the sense in that, but of course it is not how the capitalist market works.

Why should the UK back such reforms? First, they are ultimately in our own self-interest and that of other developed countries; I always like to appeal to self-interest when a Conservative Government are in power. We will not eliminate TB or HIV unless we find quick, safe and effective cures for those diseases. They have a small but significant presence in the UK: HIV treatments alone, for example, cost the NHS more than £630 million every single year.

[Frank Dobson]

Is it not also the case that in order to protect blood products and blood transfusions, this country has been spending the best part of £1 billion for the same reason?

[Michael Connarty]

I know that when my right hon. Friend, a former Health Secretary, speaks, he tells only the truth, so I accept that £1 billion figure. It is a frightening sum, and it could be used in other ways. If we return to a situation in which TB and HIV are essentially untreatable, the cost of handling those diseases in the UK could become more costly than investing in finding further cures.

The second reason is that UK academic institutions are some of the best in the world, as my right hon. Friend the former Health Secretary outlined. It would therefore lead to more money, not less, being devoted to UK research establishments. Thirdly, the reform process could lay the foundation for new mechanisms and new systems of developing drugs, diagnostics and vaccines that would otherwise never be brought to market under the competitive capitalist system. The co-chair of the all-party group mentioned antibiotics, which have recently been brought to our attention. A global convention could implement new approaches and prevent microbial resistance, which has been discussed by the Government and the Chief Medical Officer.

Fourth, as a major funder of global health programmes and with their stated 0.7% commitment, the UK Government must acknowledge the enormous benefits of accelerating progress against HIV, TB and other diseases. From treating diseases, we could turn to preventing them. In Cambodia, Kenya and Rwanda, I have seen the cost of treating diseases once they have caught hold in a country. Driving those diseases back will result in savings for country health programmes, improved health and educational outcomes for children, increased work productivity for adults and overall reduced dependency on preventive foreign aid, which is the model that we want. We want to raise people out of complete dependency so they can generate their own futures.

A WHO convention, bringing new money and new resolve to global health R and D, is the best way to develop a new intervention that will accelerate our progress against global diseases. I have a question for the Minister, although I must apologise for the fact that I cannot remain in the Chamber for his reply, as I will be trying to speak in the debate on the Modern Slavery Bill, with which I have been engaged for the last couple of years. Will DFID and the UK Government commit to supporting a WHO convention on R and D in 2016 and lead the world towards the eradication of some of mankind’s deadliest diseases?