Tropical Diseases

Helen Grant Excerpts

Tuesday 27th October 2015 Westminster Hall

[Jeremy Lefroy]

I agree with the hon. Gentleman. DDT was banned for clear, understandable reasons, but it had some severe consequences that resulted in malaria taking a grip in areas where it had almost been eliminated. Even today, when DDT is being used for indoor residual spraying, we are seeing its effectiveness when topically applied and carefully used.

There have been some tremendous advances in cures, notably in the artemisinin combination therapies, which I will come to and which are the subject, in part, of this year’s Nobel prize in physiology or medicine. There has also been the welcome development of new medicines. One of them is coming out of Dundee University, and I am sure other Members will wish to discuss that.

The UK has played a major role in providing the long-term funding. It was less than £100 million a year in 2000, but it now stands at £500 million. That is the direct result of the Chancellor’s pledge, while shadow Chancellor in 2007, to increase funding to tackle malaria to £500 million. It is not simply funding that is essential, however; we need the institutions through which the work can be done. It is pointless for several different nations to all work on their own programmes independently. Overseas development assistance is far too precious a commodity for that, so co-operation was essential from the beginning.

I remember how important the first artemisinin-based cures for malaria were when they came out in the mid- 1990s. At last, there was a cure that was very effective and had limited side effects, unlike chloroquine, which was increasingly ineffective, and Lariam, which was effective, but which, as I found out to my cost, had potentially severe side-effects. At between $10 and $15 a dose, the drug was unaffordable to almost all those who needed it. It needed to be more like $1 a dose at the most.

The Medicines for Malaria Venture was established in 1999 as a product development partnership, with considerable UK support from the Labour Government right from the beginning. Its aim was to take up promising new projects from pharmaceutical companies and help them to fruition, so that effective drugs would be available at a price affordable to the poorest and to developing countries’ health systems. The founders of MMV recognised that developing medicines for malaria was not commercially attractive to companies, as those who most needed the drugs were least able to pay prices that covered the costs of development. There is a big lesson there for our work on tackling antimicrobial resistance. Indeed, I believe that Professor Dame Sally Davies, the chief medical officer, refers to the example of MMV when talking in her book, “The Drugs Don’t Work”, about what we need to do to tackle antimicrobial resistance.

By bringing together Governments including Switzerland, the UK and the US, private foundations such as the Gates Foundation and the Wellcome Trust, pharmaceutical companies, critically including small companies and not just the majors, and researchers, MMV was able to do in co-operation what had not been possible in isolation. Two drugs that have come from that work are: Coartem Dispersible, which is for children and has had more than 250 million doses produced and distributed; and the artesunate injection, which is very effective against severe malaria—possibly more effective than quinine—and has had 35 million doses produced.

A second, larger example of co-operation was the Global Fund to Fight AIDS, Tuberculosis and Malaria, which was also established in the time of the Labour Government in 2002 to concentrate efforts to fight those diseases. The UK, along with the US, France and the Bill & Melinda Gates Foundation, was a prominent supporter of the fund right from its creation. Indeed, the first executive director was a Briton, Dr—now Sir—Richard Feachem. The fund has been responsible for supporting programmes in malaria-endemic countries, including programmes on the mass distribution of insecticide-treated bed nets and the introduction of rapid diagnostic tests.

A third example is the Malaria Vaccine Initiative of PATH, which supports the development of promising malaria vaccines. The most advanced is GlaxoSmithKline’s vaccine, which was developed in Belgium and is called RTS,S. It recently received approval from the European Medicines Agency and will, I hope, become available in the not too distant future.

The progress made in the past 15 years has in large part been down to political will through the millennium development goals and the work of the United Nations and the Governments of the United Kingdom, the United States and other countries increasing long-term funding, with the UK taking a lead alongside the US and the Bill & Melinda Gates Foundation.

[Mrs Helen Grant (Maidstone and The Weald) (Con)]

I congratulate my hon. Friend on securing this debate. Does he agree that the tenacity of malaria means that much more money will have to be spent to beat it? The Gates Foundation estimated that it could cost between $90 billion and $120 billion up to 2020 to deal with it. Does he agree that we must not take our foot off the pedal?

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[Kate Osamor (Edmonton) (Lab/Co-op)]

It is a pleasure to serve under your chairmanship, Mr Davies. I thank the hon. Member for Stafford (Jeremy Lefroy) for securing this debate.

I am glad that we have the opportunity to draw attention to this important issue, about which, as a British-born Nigerian, I feel passionately. According to statistics published by the US Government to coincide with this year’s World Malaria Day, Nigeria has the highest number of malaria casualties worldwide, with an estimated 100 million cases and around 300,000 deaths each year.

The debate is particularly timely given the recent announcement that the roll-out of the world’s first malaria vaccine has been delayed as experts at the World Health Organisation have urged caution. The vaccine requires four doses, and without all four shots children had no overall reduction in severe malaria. That raises important questions about access to healthcare and how less developed countries will be able to administer the four vaccines. It also highlights the disparity in access to healthcare across the world and the more general need to address the issue in order to tackle infectious diseases most effectively. After all, access to healthcare is a human right.

I have been encouraged to see the progress that has been made in tackling malaria. Malaria No More UK states that malaria prevention returns £36 to society for every £1 invested. It is important to note that according to a recent WHO report, carried out jointly with UNICEF, malaria death rates have dropped by 60% since 2000, saving 6 million lives. The number of children under five sleeping under insecticide-treated nets has risen from 2% to 68%. Thirteen countries that had malaria in 2000 no longer have any cases of the disease. That shows that, with funding from the international community, there is hope that malaria, one of the biggest killers at the turn of the millennium, could be eradicated.

Progress must continue to be made. This year alone there have been an estimated 214 million new cases of malaria, with more than 400,000 deaths. Two forms of resistance are threatening to undo the progress that is being made: in south-east Asia, the malaria parasite is able to shrug off the effects of the drug artemisinin; and some mosquitos are becoming resistant to the drugs used to coat the nets. That must be looked into.

[Mrs Helen Grant]

The hon. Lady is making a really good case. Does she believe that the lack of both adequately trained doctors and health networks is also worrying?

[Kate Osamor]

That is an important point. We need to invest in the healthcare profession so that this significant and costly disease can be eradicated.

I welcome the fact that the Department for International Development has pledged up to £500 million a year towards tackling malaria. Eliminating malaria is a global effort that involves work from the grass-roots and aid on international and governmental levels. There is still a lot of work to be done and I hope that the UK will continue to lead the way in the fight to end this disease.

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[Grant Shapps]

As my hon. Friend is aware, we are contributing up to £1 billion over three years—2014 to 2016—to the Global Fund to Fight AIDS, Tuberculosis and Malaria. She has my undertaking that I will raise that specific point when I take part in the meeting on 9 November. In addition, my officials are listening to the debate, and we will endeavour to take the issue forward as speedily as possible. We do not want any delay, and she has my absolute commitment that we will process this as fast as possible.

I would like to make three important points—about resources, results and partnerships. On resources, as hon. Members have discussed, the UK committed an additional £195 million in December 2012 at the London declaration on NTDs. I want to update Members, and particularly my hon. Friend the Member for Stafford, about the declaration. It brought together key leaders from health and development organisations, along with industry partners, and they pledged to tackle the 10 NTDs. Its third progress report was launched in London in June, and the DFID Minister of State, my right hon. Friend the Member for New Forest West (Mr Swayne), spoke at the launch. The report indicated the growing number of countries that are meeting their targets.

None the less, there are challenges that threaten our ability to meet WHO road map 2020 targets, and we will all need to step up our efforts to do more. The road map and the London declaration have been game-changing events for NTDs, but the short answer to the questions my hon. Friend the Member for Stafford posed is that, although good progress has been made, there is much more to do. DFID and the British Government will take a lead in making sure that that happens.

At this point, I pay tribute to Members on both sides of the House. In the debate, there has been—almost uniquely, compared with many of our debates—a noticeable degree of cross-Chamber support for the action being taken. That assists the UK in making a full contribution.

We are fulfilling our commitment, and we have expanded our existing NTD programme. As my hon. Friend will be aware, five years ago the UK spent less than £200 million annually on tackling malaria; as has been recognised in the debate, the figure is now well over £500 million. As has been said, tackling such diseases is among the best buys in global health—I had not heard the statistic that £1 brings back £36. Each year, malaria costs the African continent at least $12 billion in lost productivity.

That is why national Government leadership in the endemic countries is critical. The domestic focus in those countries must be on increasing measures to tackle malaria, and Governments must ensure that they put in resources themselves. Ensuring that that happens is a constant battle—a battle I frequently go out and fight to make sure we are all truly sharing the burden. National legislators have an important role to play in making the case for increased health budgets, including for NTDs and malaria. I call on those partners to step up their actions. It is in their countries’ interests to do so, because—quite apart from the very sensible humanitarian reasons—enormous savings can be made.

Let me move on to my second point: results. Just last month, the Secretary of State spoke in the House at the global launch of the report on the malaria millennium development goal target. The report indicated the tremendous progress that has been made, which many Members have mentioned. Since 2000, an estimated 1 billion insecticide-treated bed nets have been distributed in Africa, and malaria mortality has almost halved in just over a decade. That is a huge achievement, and the UK can be proud of her contribution, but there is clearly a lot more to do. One in four children in sub-Saharan Africa still lives in a household without at least one insecticide-treated bed net or other effective protection against mosquitoes, but such things should be the bare minimum.

[Mrs Helen Grant]

The Minister mentioned the millennium development goals. Is he absolutely confident that the new global goals will be sufficient to continue the progress made under the MDGs, which have obviously done good? Will he and DFID also do everything they can to assist data collection—a subject ably and powerfully raised by my hon. Friend the Member for Twickenham (Dr Mathias)? Without data collection, we will have no measures and we will not be able to make people accountable.