Global Fund to Fight AIDS, TB and Malaria

Jeremy Lefroy Excerpts

Tuesday 12th January 2016 Westminster Hall

[Jeremy Lefroy (Stafford) (Con)]

I thank my right hon. Friend the Member for Arundel and South Downs (Nick Herbert) for his eloquent speech and for setting out the case so strongly. I declare an interest as a trustee of the Liverpool School of Tropical Medicine, and I have previously done work on artemisinin.

The impact of the Global Fund cannot be underestimated. Since its inauguration, we have seen for malaria alone a reduction in deaths of at least 48%, most of them among children. It is largely through the Global Fund that we have seen the possibility of the mass distribution of insecticide-treated bed nets, which cut in half the chances of children catching malaria. The fund has also supported the use of rapid diagnostic tests, which have made rapid diagnosis possible in rural areas for pretty much the first time. Malaria treatment can therefore begin quickly, before the disease has taken hold.

Five hundred and fifteen million treatments for malaria have been provided, largely of the effective artemisinin-based combination therapies, which were previously much too expensive for most people. The Global Fund has without doubt helped to transform the global malaria situation from one that was becoming out of control in sub-Saharan Africa in the 1990s, to the current situation, where we are speaking with some confidence of elimination—indeed, several countries have become malaria-free.

There have, of course, been problems. The misuse of funds and tools—such as bed nets—and poorly implemented programmes have hit the headlines. However, the Global Fund has always taken such problems seriously and taken action to remedy them. The question is whether the fund is the best way to tackle these diseases in future, and if so, what it needs to change to become even more effective. I am certain that it has a vital role to play. As my right hon. Friend the Member for Arundel and South Downs said, one of the strongest arguments is that it funds programmes developed by the affected countries themselves. Aid-funded programmes have often been criticised for being the pet projects of the donors without reference to those who are supposed to benefit. The Global Fund takes the opposite approach.

It is important that the Global Fund looks hard at how it operates. I shall mention very briefly four things that it should look at. First, it could do more to ensure that its programmes are fully integrated into the health systems of the countries that it supports and strengthens. I would have much more to say on that, but there is not enough time. I would be very happy to speak to my hon. Friend the Minister about that on another occasion.

Secondly, the global community needs to consider the case either for a separate fund for neglected tropical diseases or for including such diseases in the work of the Global Fund, with increased funding. Diseases such as lymphatic filariasis, soil-transmitted helminths, trachoma and so on—there are 17 of them in total—affect 1.4 billion people on the planet.

Thirdly, the Global Fund needs to report more regularly and more strongly on the work that it does. I was perplexed that the fund did not respond more strongly to adverse reports in the press last year of malaria bed nets being misused. They were indeed being misused, but it was in only a tiny minority of cases. It is vital that corruption and the diversion of funds are investigated and offenders caught, and the Global Fund does that, as it did in Sierra Leone in 2014. At the same time, it needs constantly to point out just how many lives continue to be saved every year as a result of its work across the three diseases. I would like to see quarterly, not annual, reporting.

Fourthly, the Global Fund needs to keep a very close eye on the fight against resistance to antimalarial drugs and the insecticide on bed nets, and allocate money accordingly. The same goes for multi-drug-resistant TB, which my right hon. Friend the Member for Arundel and South Downs mentioned. If not checked, such resistance threatens the substantial gains made over the past 15 years. The importance of the Global Fund to the battle against malaria cannot be overestimated. We were losing that battle but we are now, I hope, on the winning side.