Global Fund to Fight AIDS, TB and Malaria

Patrick Grady Excerpts

Tuesday 12th January 2016 Westminster Hall

[Patrick Grady (Glasgow North) (SNP)]

It is a pleasure to serve under your chairmanship, Ms Dorries. I congratulate the right hon. Member for Arundel and South Downs (Nick Herbert) on his eloquent opening speech, along with all the chairs of the all-party groups who successfully bid for this debate. Once upon a time I was involved in the campaign for the South Downs national park, and a very beautiful part of the country it is too.

A number of Members have made a lot of excellent points. The importance of the issue to the House is shown by the fact that so many Members wanted to speak. Thanks to your skilful action, Ms Dorries, they have been able to contribute to the debate. I pay tribute to Members for their contributions and for the expertise that they have shown, not least the hon. Member for Stafford (Jeremy Lefroy).

We often hear in Westminster Hall debates, and in political discourse more generally, that any given political change is possible or achievable and all that is lacking is the political will. The Global Fund to Fight AIDS, Tuberculosis and Malaria is a good demonstration of that principle. It was the determination and political will of world leaders to tackle three of the most challenging and infectious diseases of our times, which at that time were killing about 6 million people a year, that led to the establishment of the fund in 2002. As we have heard, in the years since, literally millions of lives have been saved by a massive scaling-up of proven responses and the targeting of funds and resources where they are most needed. The fund is an effective model of co-operation between Governments, the private sector, civil society and affected communities, reaching people in more than 140 countries. As we have heard, it is estimated to have saved more than 17 million lives since it was established.

We have heard about the need for the fund, about the human and societal costs of these diseases, and about the downward spiral that they can bring about for international development. Becoming infected with any of them severely limits the life chances of not only the individual affected but their wider family and community, which can be affected by the loss of income of either the individual or others who have to give up work to take on caring responsibilities. Just as on other issues, it is the poorest and most vulnerable and marginalised in society who are most at risk, with women and girls being disproportionately affected, as is sadly too often the case. The means and opportunity to rid the world of these diseases is there, which is why that ambition is reflected in sustainable development goal 3.3. Because of the challenges I have described, the replenishment of the Global Fund is incredibly important.

As we have heard, last year, for the first time, tuberculosis killed more people than HIV/AIDS. Again, it disproportionately affects the poorest in society, because crowded living conditions, poor ventilation and lack of access to clean water and sanitation all contribute to increased susceptibility. Because it affects people with weakened immune systems, it is one of the biggest killers of people with HIV and AIDS. I was particularly struck by the statistic on the progress that is currently being made on TB: it could easily take between 150 and 200 years to get rid of it, rather than the 15-year ambition that the world has set itself. The need for investment is clear.

Despite being so easily preventable, according to the World Health Organisation, malaria claims the life of a child every two minutes. I was not on the trip that many other Members went on, but in a previous life I spent some time living in Malawi, where I saw how prevalent and debilitating the disease could be. I also saw the challenge of providing relatively simple interventions, such as mosquito nets and prophylactic treatments, given what could sometimes be slightly relaxed attitudes. It seemed to me that in parts of Africa malaria was regarded in the same way that we regard the flu: as a bit of a hassle that some medicine and bed rest will sort out. But, like flu, it is a killer. It has become a catch-all term for all kinds of illnesses. Treating malaria is complex, and investment is needed not just in practical things such as the distribution of nets and treatment, but in education and awareness raising.

[Oliver Colvile]

Does the hon. Gentleman recognise that access to clean water through boreholes and the like is also important?

[Patrick Grady]

Absolutely. I mentioned sanitation in the context of TB, but that is true across a range of health interventions. Improving access to water across the whole of sub-Saharan Africa would go a long way towards tackling not just these diseases but many other challenges. Access to water helps children pay attention in school, for example, so I agree with the hon. Gentleman.

One of the biggest barriers to progress against malaria is drug resistance. If people do not take the complete course of treatment, that helps to build resistance. We must therefore continue to invest in medicine research and development. Providing education and challenging stigma are crucial components in the fight against AIDS. Like TB and malaria, AIDS is an easily preventable disease, yet it continues to have devastating consequences in too many parts of the world. We often hear that HIV is no longer a life sentence in the west—that remarkable achievement is the result of significant investment over many years—but in developing and middle-income countries it remains a killer and, like other diseases, it is a barrier to economic and social progress across society.

The scale of the challenge is clear. I want to echo a number of the questions and points that have been put to the Minister. It would be useful to hear how the Government intend to respond to calls for resources for the fund. What amount are they considering contributing? What timetable have they set for their response? What further opportunities for scrutiny will there be? Will the replenishment be put before us as a statutory instrument? What will the process of disbursement be?

The subject of the cap has been well covered, but I want to re-emphasise some points that have been made. If the Government are prepared to say that they can commit up to £1 billion, the money must be there, so why do they not make those funds available in full? The replenishment request is based on a needs analysis. If the need is not met in full, we risk having an incomplete response, which could cost us and the world more in the long run.

We welcome the announcement of the Ross fund, but it would be useful to know how it will complement the Global Fund’s work. I heard for the first time from the right hon. Member for Arundel and South Downs that it is a three-year programme. I did not find that information elsewhere; perhaps I did not read the correct briefings. It would be useful to know what the plans are after that and how the two funds will complement each other.

A number of Members mentioned the need to tackle the spread of diseases in middle-income countries. The UK Government are free to set their own priorities for their international development programme. They announced that 50% of overseas development aid would be spent on fragile states, but they must recognise the Global Fund’s expertise and the need for it to be able to target funding effectively to prevent backsliding. My hon. Friend the Member for Central Ayrshire (Dr Whitford) made an important point about transitioning middle-income countries from aid. It would be useful if the Government would commit today not to interfere with Global Fund decisions to support programmes in middle-income countries.

Drug resistance is a challenge in tackling all of these diseases. The Minister will be aware of the World Health Organisation meeting in Geneva in March, which will look at reforming global research and development structures and ways of incentivising the production of pharmaceuticals to meet global health need, rather than simply tackling the most lucrative and profitable diseases, for which medicines can be sold. It would be useful to know whether the Government will take part in that conference.

The Global Fund estimates that meeting its next replenishment target could save up to 8 million lives and prevent 300 million new infections. That level of achievement would put us firmly on the path to meeting the SDG eradication target by 2030. However, a failure to resource the fund properly risks reversing progress, increasing drug resistance in new strains and new areas, and ultimately resulting in more unnecessary loss of life. The Government have a chance to show leadership. I look forward to hearing their response.