UK Response to the Ebola Outbreak in West Africa

Lord Collins of Highbury Excerpts

Thursday 12th March 2015 Lords Chamber

[Lord Collins of Highbury (Lab)]

My Lords, I thank the Minister for repeating the Statement. My thoughts today, and I believe those of all noble Lords, will be with the military healthcare worker who has tested positive for Ebola, wishing her a speedy recovery as she returns to Britain. Our thoughts go also to her family and friends at this stressful time. I understand from the discussion in the other place that the four other personnel who may have come into contact are also being flown home, and we wish them well, too.

As a nation, we can be incredibly proud of the dedication and bravery of the British troops, health workers and charity workers who have travelled to west Africa to tackle Ebola. We on this side continue to support the Government’s efforts to tackle Ebola and get to zero cases as soon as possible. This outbreak has seen 24,000 reported cases and nearly 10,000 deaths. As the Minister said, over 20,000 children are now orphans—vulnerable, traumatised and often stigmatised. However, Professor Chris Whitty, chief scientific adviser to DfID, said:

“There is a high chance that when we look back on this epidemic more people who did not have Ebola will have died as a result of the Ebola epidemic”.

The Government rightly identify defeating Ebola as quickly as possible as the most important step in giving Sierra Leone the best chance of successful reconstruction and development in the long term. It is also right to be planning for that long term now. It is imperative that, once the immediate crisis is over, the eyes of the world do not turn away from that region. In December, the International Development Committee of the other place recommended that DfID convene a global conference in early 2015 to agree a common plan for post-crisis reconstruction in the region. What progress has been made on this recommendation? Also, what is the Minister’s assessment of how well prepared for Ebola the neighbouring countries are? What plans does DfID have to scale up work in Guinea, which today threatens to compromise progress in Sierra Leone and Liberia?

The outbreak has shown the limitations of the global community’s approach to healthcare in developing countries—and, as the Minister said, it has triggered a huge debate on reform of the WHO and whether it is fit for purpose. Will the Minister tell the House what practical steps the department has taken in pressing for a review of the international approach to health emergencies, incorporating the function, structure and funding of the WHO and the role and expectations of major donors? It is the view of the International Development Committee that DfID should not wait until its 2015 multilateral aid review to do this; it believes—in my view, quite rightly—that the urgency of the situation warrants immediate action.

This crisis underscores the importance of investing in a strong system of research and development for global health. As Justine Greening said:

“The development of new technologies is vital if we are to improve the health of the poorest people through better treatment and prevention”.

Will the Minister commit to prioritising within DfID, and promoting among other key donors, the need properly to fund and support research and development for global health? In the development of vaccines and therapeutic drugs, we have a broken market. The cost of bringing forward a drug or vaccine and taking it through the necessary regulatory process means that pharmaceutical companies prefer to focus on diseases in affluent markets rather than diseases such as Ebola and TB which affect the poorest and most vulnerable. Will the Minister support within government the recommendation from the HIV/AIDS APPG that the UK commissions an economic paper to contrast the total costs of developing and purchasing medical tools using the current R&D model with the costs of a delinked model?

The best way to protect against disease is to build a resilient, government-controlled and government-funded health service. Will the Minister tell the House how much bilateral funding the UK will give to support the health sectors of Sierra Leone and Liberia next year to rebuild community trust?

There is a consensus that the global community failed to respond adequately to this outbreak. We need to learn the lessons and ensure that we are better prepared. Does the Minister accept that this reinforces the case for universal healthcare systems, free at the point of access, and that we should use this language in a stand-alone health goal in the forthcoming UN negotiations on the SDGs? Building robust, fair and accessible health systems is ultimately a political decision. Does the Minister agree that we must work with leaders in developing countries and help them generate adequate funding themselves as well as from donors to build better health systems that ensure that no one is left behind?

[Lord Bourne of Aberystwyth]

My Lords, I thank the noble Lord for his general support and for the bilateral approach that we adopt on these occasions.

I shall first update the House on the position of the healthcare worker who is now back in the United Kingdom. Indeed, I think that by now she is in the Royal Free Hospital. Our thoughts are with her and her family and friends. On that flight, there were two other healthcare workers who, I think, are also in the Royal Free Hospital as a precautionary measure. There are two other health workers who are being monitored in Sierra Leone as a precautionary measure, and they may be flown back to the United Kingdom. That is, as I understand it, the current position, and our thoughts are very much with them and their families and friends.

The noble Lord spoke about the need to ensure that the healthcare system in Sierra Leone recovers on the other side of this crisis. Work is under way to ensure that that happens. He referred to loss of life from things other than Ebola, which is the case. We are approaching the rainy season, when malaria will be a threat. Measles vaccination is also vital as are maternity care and so on. There has been loss of life from many other causes, which is why the period of recovery—on the other side of this dreadful disease—is important. It remains the aim to get to zero and that is clearly the right approach, but the other side of this is a recovery phase for the health service and education. Of the £100 million increase in the budget figures—there was mention of £427 million; it is actually up from £325 million —half will be spent on the recovery phase, so that will be going into the healthcare and education sectors to meet the other health problems and emergencies that the noble Lord quite rightly referred to.

The noble Lord also raised the issue of vaccines and the healthcare measures taken via the private sector. Work is under way via GlaxoSmithKline, which has been trialling a vaccine in Liberia. That is going well and trials will be started in Sierra Leone. To that, the Government have committed, I believe, £2 million, which has not been drawn down as yet. As I said, the overall position is one of steady progress. I will not call it a problem—of course, we want zero cases—but the fewer cases there are, the more difficult it becomes in a sense to trial the vaccine on patients. As the noble Lord said, vaccines and trials are clearly important.

The noble Lord spoke of the importance of a universal healthcare system and I certainly agree with that. It is something that we are very focused on. As I think the Statement of my right honourable friend the Secretary of State in another place made clear, our commitment will go on beyond the point where the cases are down to zero. It is a continuing commitment.

Regarding the other two states that the noble Lord mentioned, Liberia has chiefly been getting United States support and Guinea French support. For historical reasons perhaps and reasons of inextricable ties with Sierra Leone, our support has been focused on Sierra Leone, but success is dependent on getting support across all the countries. We are seeking to do that both through collaboration with our partner countries in those two states and through the WHO.

The noble Lord will be aware that the Prime Minister, at the G20 in Brisbane in November last year, spoke about how important it was that we have an early mechanism through the World Health Organization for dealing with health emergencies and being on the front foot. The WHO accepted that in its January meeting and it will carry that forward. We will be watching and continuing to press to make sure that we have that early response because, as the noble Lord rightly identified, it is key to dealing with this sort of crisis.