Tackling Infectious Diseases

Patrick Grady Excerpts

Thursday 20th April 2017 Commons Chamber

[Carol Monaghan (Glasgow North West) (SNP)]

I congratulate the hon. Member for Ealing, Southall (Mr Sharma) on securing this debate. He mentioned the three big killers worldwide—HIV, TB and malaria—and I will talk a little about them, too. The hon. Member for Stafford (Jeremy Lefroy) introduced the work on Ebola and Zika. He spoke about the possibility of a new worldwide killer disease, which could have devastating consequences, and how we might react to it. The increased UK Government funding to tackle neglected tropical diseases was mentioned by the hon. Member for Aldridge-Brownhills (Wendy Morton). Although that funding is very welcome, it is probably a drop in the ocean, given what is required to tackle these diseases properly. The hon. Member for Salisbury (John Glen) mentioned the Ebola outbreak, the difficulties in developing vaccines and treatments when there is no economic incentive to do so, and the lack of manufacturing facilities in the UK for such a huge programme.

Vaccination, antimicrobial drugs and improved hygiene mean that infectious diseases are not the massive killer they once were in the UK, but they are still a major health and economic burden for us. In other parts of the world, they are a major killer. We know that HIV and other forms of sexually transmitted infection are rampant just now in sub-Saharan Africa, but even in the UK 100,000 people are living with HIV. The number of cases of genital warts has decreased as a result of the increased use of the human papillomavirus vaccine, but rates of syphilis and gonorrhoea have significantly increased, with many cases being diagnosed late. Those conditions will have huge health implications, even here in the UK.

I wish to discuss the three diseases that the hon. Member for Ealing, Southall, talked about. Malaria is currently threatening half the world’s population, and it claims the life of a child in Africa every minute, so 50 children will have died as a result of Malaria in Africa while this debate has been going on. That is a damning statistic. Tuberculosis has killed more than any other disease in history, and last year it killed 1.8 million people globally—5,000 people every day. TB—the world’s leading killer—is airborne, which makes things difficult as it means it is hugely infectious. It is also increasingly resistant to drugs. TB does not just affect the developing world; we are seeing recurrences of it in major world cities, including London. As the hon. Gentleman mentioned, our response to TB is chronically underfunded, but as he also said, for every $1 invested in TB care, we have a yield of $30, which means there should be an incentive—a moral and economic case—for increasing our efforts.

Alexander Fleming warned in 1945 that micro-organisms could develop resistance to his new antibiotics, and unfortunately that prediction has proven correct. A report published by the World Health Organisation in 2014 said that antibiotic resistance was now a global threat, on a par with other global threats. The inappropriate prescription of antibiotics affects our ability to tackle diseases. I found some statistics about Scotland, and the picture there reflects that in the rest of the UK. In 2014, 55,000—1% of our population—were taking antibiotics at any one time. The problem is that in up to 50% of those cases, antibiotics were unnecessary and the condition would have improved without them. It is essential that we seek to educate people on the use of antibiotics, and that our GPs and others doing the prescribing use them far less.

Resistance is, of course, a natural biological phenomenon, but it is increased by the misuse of medicines and poor infection control. It is a particular concern with regard to antibiotics. Many of the medical advances we have made over recent years—such as organ transplantation and even chemotherapy—need antibiotics to prevent and treat the bacterial infections that such treatments can cause. Without effective antibiotics, even minor surgery and routine operations become high-risk here in the UK.

[Patrick Grady (Glasgow North) (SNP)]

I congratulate the hon. Members who secured the debate and apologise for having been unable to attend it from the start and take part more fully. I agree with a lot of the points my hon. Friend is making. Antimicrobial resistance is hugely important. I do not know whether she is aware of the antibiotic champion scheme, which encourages policy makers, decision makers and others in the professional field to sign up to promote the various steps we can take to tackle antimicrobial resistance. Those steps include completing the course of antibiotics, which is particularly important if people have taken them prophylactically when they have travelled in developing countries, to prevent malaria and so on.

[Carol Monaghan]

I thank my hon. Friend for his intervention. I am an antibiotic champion and I have signed the pledge, but we need more people to not just be aware of that pledge, but take action and follow the steps that it includes.

Inaction on antimicrobial resistance will mean the loss of effective antibiotics, which will undermine our ability to fight infectious diseases, not only in the UK but worldwide. There are many challenges in the current antibiotic funding landscape. The expected returns and associated risks mean that antimicrobials are not competitive with other therapeutic areas. Innovative new antibiotics often have a low price, because society expects antibiotics to be available easily and to be economical, but that low price means that it is not in the interests of the pharmaceutical companies to go ahead and develop new antibiotics. We need to think about that. No new category of anti-TB drug has entered the standard treatment list since 1967—in 50 years—because although TB does occur in major cities around the world, it is still a poor-country disease and there is no economic incentive to provide new treatments. We should be pushing on that from a moral point of view, though, because there is a moral incentive.

When talking about development, we should not underestimate the effects of Brexit. As a couple of hon. Members, particularly the hon. Member for Stafford (Jeremy Lefroy), have said, the EU nationals who work in research and development in the UK’s world-leading centres must have their ability to remain here guaranteed. A large percentage of the staff at the University of Glasgow’s Centre for Virus Research, which is in not my constituency but that of my hon. Friend the Member for Glasgow North (Patrick Grady), are EU nationals—postgraduate and postdoctorate researchers who are doing outstanding work in the field and advancing our knowledge and ability to treat disease.

--- Later in debate ---

[Patrick Grady]

I thank my hon. Friend for giving way again. I had the huge pleasure of visiting the Centre for Virus Research in my constituency just a couple of weeks ago. The staff there undertake world-leading work, so the point she is making about our need to continue to attract the best talent from the European Union is vital. She mentioned the moral case; does she agree that it is also vital that the funds, particularly those that come through the Government’s commitment to the 0.7% aid target, are still available for research? I hope that when the Minister responds, he will be able to reinforce the Government’s commitment to that 0.7% target, unlike some of his colleagues earlier today.

[Carol Monaghan]

I very much agree on the 0.7% target. That figure for aid is as important to tackling infectious diseases as guarantees for the EU nationals who are fighting infectious diseases worldwide.

--- Later in debate ---

[The Parliamentary Under-Secretary of State for International Development (James Wharton)]

What a pleasure it is to speak in this debate. Given recent announcements and national events, it is perhaps the last opportunity I will have to speak in a debate in my current role in the Department for International Development. Whatever happens, my interest in this work will certainly continue, even if my work itself does not, although of course I would like it to continue—it is hardly necessary for me to put that on the record. But it is subject to the will of the people and we will see what takes place.

In that context, let me start by recognising the tone of the debate and the approach taken by so many colleagues of different political persuasions, representing different parties and different parts of our country, to this important subject, and indeed to the range of issues that the Department covers. I have infrequently known an area of policy that has brought together so many people who care passionately about such important global issues, or about which there is so little disagreement or division across party lines. It stands as a testament to the sort of politics that many members of the public wish could be demonstrated more often, with Members bringing forward issues they care about in a constructive way, engaging with Ministers and getting a response that I hope they feel is equally constructive, because together we can make a difference to the lives of countless millions of people in some of the world’s poorest countries facing some of the world’s most challenging circumstances.

I was reminded of that not just this afternoon while listening to the contributions of hon. Members, but earlier this morning when I received a picture message from my sister, who this morning gave birth to Joy Megan Fiske, my new niece, at 10.54 am in North Tees hospital, which is just outside my constituency. It reminded me how lucky we are to have such a good health service, to have it on our doorsteps, and to have all the advantages that living in this society brings. It stands in stark contrast to what I sometimes see when I travel in my ministerial role, given the challenges we have heard so much about today, and with which hon. Members are rightly concerned. Many people across the world do not have the safety and the advantages that we have, and they are, sadly, affected by many different challenges, one of the most significant of which is the topic of this debate: infectious diseases.

The scale of the challenge the global community faces is extraordinarily significant. In 2015, 10.4 million people fell ill with TB, and there were 1.4 million deaths. There were 212 million cases of malaria, with over 400,000 deaths. Some 2 million people were infected with HIV, and there were around 37 million people living with HIV and an estimated 1.1 million deaths from AIDS-related diseases. Neglected tropical diseases—a subject on which my hon. Friend the Member for Stafford (Jeremy Lefroy), like others, has been a passionate advocate and on which he spoke with great knowledge—affected 1.6 billion of the world’s poorest people, causing disability, disfigurement and stigma, with an estimated 170,000 deaths.

As hon. Members recognised—they spoke about this in some detail—the situation is exacerbated by the global health threat of antimicrobial resistance, which is as real a threat to us here in the UK as it is to so many millions across the world. Antimicrobial resistance will lead to the greater spread of infections, longer illnesses, higher mortality, increased costs and greater economic impact from infectious diseases. It is a global challenge, and we all have a role in tackling it and an obligation to do so.

On that note, I would particularly like to congratulate the hon. Member for Ealing, Southall (Mr Sharma), who has done sterling work in this area. I have enjoyed attending all-party group meetings with him, and I have enjoyed the constructive relationship we have had. He spoke with a great depth of knowledge and understanding about the scale of the challenges we face and about the need to continually develop and innovate and to ensure we do everything we can to find the solutions of the future. He spoke of his concerns about antimicrobial resistance, and he referred to a meeting he and I recently attended at which that very issue was explored at some length, particularly in the context of TB.

I also congratulate my hon. Friend the Member for Stafford, although he has had to leave the Chamber for reasons that are perhaps related to other commitments. He has been a passionate advocate on these issues. He has been an excellent Member of Parliament, not just for his constituency but in terms of the topics he has pursued. He has been a great help to me in my role, as I try to take forward the portfolio for which I am responsible in DFID. He is a global leader in this area; he knows a great deal about that about which he speaks, and it is always a pleasure to listen to him.

Similarly, the sterling work of my hon. Friend the Member for Aldridge-Brownhills (Wendy Morton) on the Select Committee is always helpful and constructive, if sometimes a little challenging—but, then, that is what she is there to do. That work makes a real difference in helping the Department to shape policies in the spirit of the cross-party co-operation I spoke about earlier and to ensure that we get the maximum value and benefit from the money we spend. That is incredibly important as we continue to make the case for a global Britain and for the work we do to help some of the world’s poorest. That work makes a real contribution, and I congratulate my hon. Friend and look forward to working with her in the future.

I also congratulate, and recognise the comments of, my hon. Friend the Member for Salisbury (John Glen). As ever, he was a passionate advocate for his constituency. He was able effortlessly—or at least with the appearance of effortless delivery—to weave constituency interests into an international debate, and he made some very good and valid points about ensuring that we use the assets we have to the best and maximum effect and utility to make a difference to some of the world’s poorest and to retain our position as world leader in some of the areas of research about which he spoke. I thank him for his contribution, which was useful, and I look forward to continuing our discussions after the next seven weeks are over.

I also recognise the comments of the hon. Member for Glasgow North West (Carol Monaghan), I thank her for her contribution. She spoke with great knowledge and insight about a wide range of topics, many of which hon. Members have taken an interest in over months, if not years, in this Parliament, and I am sure they will take an interest in them into the future. I hope to touch on many of those issues as I make my specific comments about some of the issues that have been raised in the debate.

Finally, I thank the hon. Member for Hornsey and Wood Green (Catherine West) who again demonstrated an understanding of the importance of the matters we are here to discuss. As always, she asked questions that were carefully calibrated to elicit the most helpful, useful and constructive responses. I always endeavour to respond to questions, even where I cannot answer them, and I will of course try to respond in my comments to some of the issues she raised.

[Patrick Grady]

Several Members have asked about the future commitment to the 0.7% aid budget target. As the Minister has said, the 2015 legislation was passed on the basis of cross-party consensus. Does he share my hope that that cross-party consensus continues into the next election and that all parties’ manifestos will contain a commitment to the 0.7% target?

[James Wharton]

The hon. Gentleman knows very well that I am delighted to see cross-party consensus on any policy that the Government—whoever they may be, although I rather hope they will be of my party political colour following the next seven weeks of campaigning—might look to bring forward. I hope and trust that there will be cross-party consensus because I am sure that we will be doing the right thing.

Let me remind the House—not that it needs reminding—of the significant record of achievement and work in this area that we have demonstrated collectively in the UK over recent years. The UK pledged £1.1 billion towards the fifth replenishment of the global fund, including a commitment to double private sector contributions to tackling malaria up to a maximum of £200 million, making a real difference in key areas that affect the lives of countless millions of people—I mentioned the huge numbers of individuals affected. The UK is one of the leading nations in tackling some of the diseases that have the most devastating effect on some of the world’s poorest.

The UK will continue to use its position as one of the world’s leading aid donors to challenge, change and reform the aid system, with our pledge to secure a demanding new £90 million performance agreement designed to push the already high-performing global fund to deliver even more. We do not just contribute to these organisations and make a difference through the money that we spend; we push them to reform and to be efficient, and we offer and share with them our expertise. That is something of which we should all be proud.

In November 2016, the Department for International Development launched its first ever research review highlighting Britain’s global leadership in this field. The review set out how the UK will focus 3% of its budget per year over the next four years on research and innovation to help address the great global challenges of the 21st century. That 3% of our budget will be invested in high-quality, high-impact research. In addition, we will invest £357 million to fund research into infectious diseases through the Ross fund portfolio. This means that we are spending over £1.5 billion on research over the next four years, cementing and reinforcing the UK’s place as a leading country in this field and delivering real change in some of the areas that hon. Members spoke about. UK-funded research is saving lives and changing lives all over the world. We have supported fast new tests for detecting tuberculosis, child-friendly malaria drugs now used in more than 50 countries, and a new rotavirus vaccine for preventing life-threatening diarrhoeal disease in infants. We are making a real difference to people who need this support most.

We are also a leader in neglected tropical diseases, which a number of hon. Members commented on. This week marked the fifth anniversary of the landmark London summit on NTDs and the high-level summit on NTDs in Geneva. At that summit, the UK made a clear commitment to continued investment that is both ambitious and focused on outcomes. We will invest £360 million in implementation programmes to treat and eliminate neglected tropical diseases between 2017-18 and 2021-22. That funding will provide 1 billion treatments for people in developing countries. We have played a leading role in tackling NTDs through our commitment to UK aid, through our leading NGOs, through our pharmaceutical companies’ generous donations, and through our world-class universities and researchers all working together. Since 2009, UK aid—working, for example, with GlaxoSmithKline and the Liverpool School of Tropical Medicine—has provided 217 million people with treatment against lymphatic filariasis. I apologise for my pronunciation; despite my mother’s best intentions and desires, I did not make it to medical school. However, I do recognise the impact that much of this can have.

This week the UK also announced that we are investing in pioneering research to drive the development of drugs and diagnostics against neglected tropical diseases, including £48 million for the Drugs for NTDs initiative, £30 million for the Foundation for Innovative New Diagnostics, and £10 million for the Coalition for Operational Research on NTDs. That is making a difference.

Bill Gates said this week:

“UK aid and Britain’s world-leading research institutions are playing a major role in protecting the world’s poorest people from neglected tropical diseases and enabling them to live healthier, more prosperous lives…With our foundation, I am proud to partner with the UK on global health”.

The UK is leading on AMR, NTDs and global health challenges. We are making a real difference and all hon. Members should be proud of that.