Tropical Diseases

Pauline Latham Excerpts

Tuesday 27th October 2015 Westminster Hall

[Pauline Latham (Mid Derbyshire) (Con)]

It is a pleasure to serve under your chairmanship for the first time, Mr Davies. I thank my hon. Friend the Member for Stafford (Jeremy Lefroy) for securing this debate on a topic that is very close to my heart. Although I am going to focus on malaria, we must not forget the many neglected tropical diseases that my hon. Friend outlined. He and I have worked closely on international development issues for a number of years, as well as in the all-party group on malaria and neglected tropical diseases. We expect to continue that work during this Parliament.

It is clear that the work the UK is doing to tackle malaria is having a huge effect. Through a mixture of UK aid, British business, British-led research and non-governmental organisations, the UK has contributed to reducing the global malaria death rate by 60% since 2000. In the previous Parliament, the UK acted in a number of ways to tackle malaria and other diseases, as my hon. Friend outlined. Our financial and political support for the Global Fund to Fight AIDS, Tuberculosis and Malaria, our support for the Gates Foundation’s efforts to eliminate malaria, our work mapping malaria to establish high-risk areas to focus on, and our bilateral work on helping in-country healthcare systems to respond effectively to malaria and other diseases have all had a real, positive effect.

Although we can be proud of our contribution to tackling malaria and other tropical diseases, we must not become complacent or slow down our efforts. If we do, we risk reversing our momentum. Despite all the progress that has been made, malaria remains a substantial global killer, and women and children still overwhelmingly feel its effects. I could say an awful lot about the fact that women and children are disproportionately affected because they cannot access medicines or get to the clinics easily. Children who do not go to school because they have got malaria have worse life chances than those who go to school all the time.

Given the limited time available, I will focus on the situation in Uganda, a country I have focused on for many years and have a real interest in. Access to medical care to treat malaria and other diseases is poor in areas such as rural northern Uganda. Women and girls are even poorer there. I recently had a meeting with Alison Hall, the founder of Seeds for Development, to discuss the urgent situation in northern Uganda, where there is a major malaria outbreak. Her charity has been on the ground in northern Uganda working with farming communities to help rebuild their lives after the 20-year war with the Lord’s Resistance Army. She has been there for about six years. Three of the districts the charity works in are among those affected by the malaria outbreak. The Department should look immediately at the situation she described to assess whether there is anything we can or should be doing to help.

In the middle of July, Dr Jane Ruth Aceng, the director general of health services in Uganda, admitted that tens of thousands in northern Uganda have recently contracted the disease. Many people cannot afford to travel the long distances required to get to the hospital, and those who do are overwhelming the services due to the outbreak. One hospital—Gulu general hospital in the Gulu district of northern Uganda, which Seeds for Development visited to assess how patients are being treated—padlocks shut its outpatients department at 4 pm, leaves patients outside the door and provides nowhere for them to be treated inside. The charity was also told that St Joseph’s hospital in Kitgum, which is supported by DFID, recorded 125 deaths from malaria between June and August, which is much higher than normal. That is just one hospital, not the true picture. Clinics had run out of drugs, and new supplies were taking a long time to arrive. In August, there had not been a delivery of drugs for a month.

We need to look urgently at the situation in northern Uganda to establish the facts and act on them. In particular, I am worried about the lack of access to treated mosquito nets in northern Uganda. We provide financial assistance to the Ugandan Government to provide nets, so why are families in the region not receiving them? I understand that the Ugandan Government stopped its indoor residual spraying of huts programme in 2014. That one act alone will increase the risk of malaria. If the local people get nets, do they know how to use them? Nets often go astray—they are used for fishing and all sorts of other activities—so there has to be an education programme to teach people how to use them. It is very important that women and children sleep under the nets to save their lives. That important issue has been highlighted as among the causes of the current outbreak in northern Uganda.

The UK has a huge amount to be proud of in the way we have taken a lead on combating malaria. We know that the return on investment in tackling malaria is well established and accepted by the Government. However, we alone cannot defeat malaria. It requires a global effort, financially and politically supported by Governments around the world, including those of the countries affected. A lot has been done, but the outbreak in northern Uganda, where hundreds if not thousands have died this year alone, shows that we must not become complacent. I hope the Minister will explain what DFID is doing to help those affected in that region. I understand that DFID acts responsibly in many areas of Uganda, but that area seems to have been neglected, and I would like to know what the Minister can tell us about what is happening.

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[The Minister of State, Department for International Development (Grant Shapps)]

It is a pleasure to serve under your chairmanship, Mr Davies. I congratulate my hon. Friend the Member for Stafford (Jeremy Lefroy) on securing this debate; I do so out of more than just the usual courtesy, as I also wish to commend him for his tremendous work on the Select Committee on International Development and for his chairmanship of the all-party group on malaria and neglected tropical diseases, which is one of the most effective APPGs in this House. It is well respected, frequently convenes high-quality debates and produces extremely influential reports. His knowledge and expertise have been acknowledged by hon. Members from across the House this morning.

The opening words of the “leave no one behind” pledge—many of us were at the United Nations General Assembly last month where that global promise was signed—are:

“We commit to putting the last first.”

Today’s debate is therefore welcome and timely. Malaria and NTDs affect the poorest of the poor. Every year, neglected tropical diseases affect the lives of over 1 billion people, causing disability, disfigurement, stigma and an estimated half a million deaths, as we have heard. Malaria still kills more than 400,000 people a year, mostly children in Africa.

Since the start of this Parliament I have visited seven different African countries; the hon. Member for Wythenshawe and Sale East (Mike Kane) will be pleased to hear that I have been taking not Lariam but Malarone. My most recent visit was the week before last, to Nigeria—the hon. Member for Edmonton (Kate Osamor) will be interested to hear that—where I discussed these very issues. This morning, I returned from the United Arab Emirates; as the hon. Member for West Aberdeenshire and Kincardine (Stuart Blair Donaldson) mentioned, the UAE is one of the latest countries to be declared malaria free, so I had interesting discussions there as well.

My hon. Friend the Member for Mid Derbyshire (Pauline Latham) asked what the UK is doing to tackle the resurgence in malaria—in Uganda in particular, although we must be watchful everywhere. As she will know, DFID has provided a significant amount of support to Uganda to try to reduce malaria. The recent outbreaks are of significant concern, and she is absolutely right to raise them. We are responding.

DFID is supporting the distribution of long-lasting insecticide-treated nets, along with capacity building for healthcare workers for the management of fever, specifically in the 10 most affected districts. We are working in partnership with the World Health Organisation to improve the availability and use of high-quality data for decision making—my hon. Friend the Member for Twickenham (Dr Mathias) rightly raised the subject of data—and, through the UK’s significant contribution to the Global Fund to Fight AIDS, Tuberculosis and Malaria, life-saving anti-malarials are being made available to health facilities across the outbreak areas, as a key strategy for reducing transmission.

We are going further, by building on recent analysis by the WHO. DFID has agreed to fund a study—my hon. Friend will be pleased to hear this, as will the whole House—that will provide robust data on the possible causes of the outbreak, to inform the response and, most importantly, learn valuable lessons that we can then use in future programming as we take further decisions on the issue. I will meet the global fund leaders on 9 November, when I will raise that important issue. Through the strong monitoring mechanisms that we always have in place for our programmes, we will also take a close look at the issue of bed nets. I assure hon. Members that that will be a top priority.

The UK has been at the forefront of delivering progress against malaria and NTDs. By tackling them, we prevent pain, suffering and death, and we help to reduce poverty.

[Pauline Latham]

I am sorry to go back to the issue of northern Uganda, but will the Minister please tell me what is going to happen about the stock-outs of drugs? Are we going to flood the area with drugs to make sure that the people who need them actually get them? They are not getting them at the moment.

[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.