I beg to move,
That this House has considered the work of the UK in tackling malaria and neglected tropical diseases.
It is a pleasure to serve under your chairmanship, Mr Davies. I refer Members to my declarations in the Register of Members’ Financial Interests. One thing that is not there that I need to declare is that I have been invited to become a trustee of the Liverpool School of Tropical Medicine. That has not yet been ratified, so will not be in the register.
I have secured this debate at a critical time in tackling malaria and neglected tropical diseases, which affect up to 1.4 billion people across the world. Just to explain, neglected tropical diseases include leprosy, lymphatic filariasis, schistosomiasis, soil-transmitted helminths—or worms—leishmaniasis, human African trypanosomiasis and Chagas disease. All those diseases are preventable and treatable using existing treatments, yet they continue to cause death and disability in a way that would simply not be acceptable were they endemic in the United Kingdom. This debate is particularly important as the 2015 Nobel prize in physiology or medicine was awarded this month for work on malaria and neglected tropical diseases. Professor Youyou Tu was awarded the prize for the discovery of artemisinin, which I will come on to later, and Doctor William C. Campbell of Ireland and the USA and Professor Satoshi Omura of Japan were awarded the prize for their discovery of avermectin, which is effective against river blindness, lymphatic filariasis and a growing number of other parasitic diseases.
Over the past decade and a half, the UK has taken a prominent role in the fight against malaria and neglected tropical diseases, and I will set out the great progress made and the challenges that face us if we are to see their elimination. I ask the Minister to consider the future of the UK’s programmes in both areas.
Twenty years ago, we were losing the fight against malaria—I declare an interest, having had it at least four times—and there was widespread resistance to the main drugs used to cure it: chloroquine and sulfadoxine-pyrimethamine. The international will to tackle malaria seemed absent. All of that changed with the adoption of the millennium development goals. MDG 6 targeted malaria, while MDG 4 focused on child mortality. We have to remember that children are the ones who suffer most from malaria, as more children die from malaria than adults. MDG 5 was on maternal health, and pregnant women are particularly at risk of catching and suffering from malaria. The fight against malaria has resulted in a 58% decline between 2000 and 2015 in deaths from malaria globally. The World Health Organisation estimates that that means that 6.2 million deaths from malaria have been averted, primarily among children under five in sub-Saharan Africa.
I congratulate the hon. Gentleman on securing this debate. Does he agree that while significant progress has been made, the fact that 200 million new cases of malaria have been reported this year alone calls into question our legitimate and worthwhile attempt to try to eliminate malaria in the next 15 years?
I entirely agree with the hon. Gentleman. Between 450,000 and 500,000 people—they are mainly children—are dying unnecessarily every year from the disease. How did the tremendous progress—I stress that huge progress has indeed been made—happen? Principally, reliable long-term funding enabled the development and implementation of various interventions, including prevention through insecticide-treated bed nets and the development of vaccines, and diagnosis through the rapid diagnostic tests that enable people, particularly children, to be diagnosed with malaria in the village, rather than having to come to a laboratory in a town when the malaria may be severe.
The hon. Gentleman makes a good point about the progress made and the different ways of making that progress. Does he agree that the earlier regression was partly to do with the mistaken banning of DDT in Africa and elsewhere?
I agree with the hon. Gentleman. DDT was banned for clear, understandable reasons, but it had some severe consequences that resulted in malaria taking a grip in areas where it had almost been eliminated. Even today, when DDT is being used for indoor residual spraying, we are seeing its effectiveness when topically applied and carefully used.
There have been some tremendous advances in cures, notably in the artemisinin combination therapies, which I will come to and which are the subject, in part, of this year’s Nobel prize in physiology or medicine. There has also been the welcome development of new medicines. One of them is coming out of Dundee University, and I am sure other Members will wish to discuss that.
The UK has played a major role in providing the long-term funding. It was less than £100 million a year in 2000, but it now stands at £500 million. That is the direct result of the Chancellor’s pledge, while shadow Chancellor in 2007, to increase funding to tackle malaria to £500 million. It is not simply funding that is essential, however; we need the institutions through which the work can be done. It is pointless for several different nations to all work on their own programmes independently. Overseas development assistance is far too precious a commodity for that, so co-operation was essential from the beginning.
I remember how important the first artemisinin-based cures for malaria were when they came out in the mid- 1990s. At last, there was a cure that was very effective and had limited side effects, unlike chloroquine, which was increasingly ineffective, and Lariam, which was effective, but which, as I found out to my cost, had potentially severe side-effects. At between $10 and $15 a dose, the drug was unaffordable to almost all those who needed it. It needed to be more like $1 a dose at the most.
The Medicines for Malaria Venture was established in 1999 as a product development partnership, with considerable UK support from the Labour Government right from the beginning. Its aim was to take up promising new projects from pharmaceutical companies and help them to fruition, so that effective drugs would be available at a price affordable to the poorest and to developing countries’ health systems. The founders of MMV recognised that developing medicines for malaria was not commercially attractive to companies, as those who most needed the drugs were least able to pay prices that covered the costs of development. There is a big lesson there for our work on tackling antimicrobial resistance. Indeed, I believe that Professor Dame Sally Davies, the chief medical officer, refers to the example of MMV when talking in her book, “The Drugs Don’t Work”, about what we need to do to tackle antimicrobial resistance.
By bringing together Governments including Switzerland, the UK and the US, private foundations such as the Gates Foundation and the Wellcome Trust, pharmaceutical companies, critically including small companies and not just the majors, and researchers, MMV was able to do in co-operation what had not been possible in isolation. Two drugs that have come from that work are: Coartem Dispersible, which is for children and has had more than 250 million doses produced and distributed; and the artesunate injection, which is very effective against severe malaria—possibly more effective than quinine—and has had 35 million doses produced.
A second, larger example of co-operation was the Global Fund to Fight AIDS, Tuberculosis and Malaria, which was also established in the time of the Labour Government in 2002 to concentrate efforts to fight those diseases. The UK, along with the US, France and the Bill & Melinda Gates Foundation, was a prominent supporter of the fund right from its creation. Indeed, the first executive director was a Briton, Dr—now Sir—Richard Feachem. The fund has been responsible for supporting programmes in malaria-endemic countries, including programmes on the mass distribution of insecticide-treated bed nets and the introduction of rapid diagnostic tests.
A third example is the Malaria Vaccine Initiative of PATH, which supports the development of promising malaria vaccines. The most advanced is GlaxoSmithKline’s vaccine, which was developed in Belgium and is called RTS,S. It recently received approval from the European Medicines Agency and will, I hope, become available in the not too distant future.
The progress made in the past 15 years has in large part been down to political will through the millennium development goals and the work of the United Nations and the Governments of the United Kingdom, the United States and other countries increasing long-term funding, with the UK taking a lead alongside the US and the Bill & Melinda Gates Foundation.
I congratulate my hon. Friend on securing this debate. Does he agree that the tenacity of malaria means that much more money will have to be spent to beat it? The Gates Foundation estimated that it could cost between $90 billion and $120 billion up to 2020 to deal with it. Does he agree that we must not take our foot off the pedal?
My hon. Friend is exactly right, and we have seen the consequences of taking our foot off the pedal in the past. In Zanzibar, malaria was almost eliminated in the 1950s, but it came back with a vengeance. There was another programme in the 1980s, and the foot was taken off the pedal and it came back with a vengeance. The same has happened in Sudan and many other places, so we must deal with that. I think the figures she quoted are accurate, but if we manage to tackle malaria and get to virtual elimination, it will add more than $4 trillion dollars to world GDP, so it is a hugely important investment to make.
Improving health systems is another reason why we have seen progress in many developing countries, with increasing local funding, although some countries really need to step up to their pledges—for instance, the Abuja declaration of committing 15% of budgets to health, which only a few sub-Saharan countries do at the moment, along with unprecedented co-operation, which I have described. We will need all these and more as we face the challenge of the next 15 years, which is to meet the WHO’s global technical strategy for malaria 2016 to 2030.
On top of that, we face two forms of serious resistance: by the malaria parasite to artemisinin-based combination therapies in the Mekong region in south-east Asia, from where resistance to both chloroquine and sulfadoxine-pyrimethamine started and spread to sub-Saharan Africa, which is why it is vital to get on top of this; and by mosquitoes to the insecticides on bed nets, which are becoming resistant to pyrethroids. We also see serious outbreaks where bed net distribution has failed and health systems are weak. I believe my hon. Friend the Member for Mid Derbyshire (Pauline Latham) is going to describe one such instance later in this debate.
The UK is heavily involved in work to counter both those threats, through the Department for International Development’s work and the global fund supported by DFID in Myanmar, working alongside the Government there, and through the work of the Innovative Vector Control Consortium, based in the Liverpool school, in searching for and testing new insecticides for bed nets. The UK has therefore been at the forefront in so many different ways, whether through funding or research—from the London school, the Liverpool school, Dundee, York, Imperial, Keele and other universities, or from business, NGOs, or, above all, people. There are so many I would like to mention, but I will not because of time constraints, but the UK has fantastic scientists in this field at all levels.
Given the effectiveness of UK support for tackling malaria over the last 15 years, will the Minister undertake to do his utmost to maintain that for the future? I am asking the UK not to increase the level of funding, but to maintain current levels. Reaching £500 million a year is a great achievement and others need to come forward to support the UK in this, not least the countries in which malaria is endemic.
The WHO’s roll back malaria framework states that malaria interventions are very good value for money:
“Immunisation is the only public health intervention that has been shown to be more effective than malaria interventions. Beyond the financial return, investments in fighting malaria will have enormous positive effects on agriculture, education and women’s empowerment. They will also contribute significantly to reductions in poverty and the alleviation of inequality.”
Almost exactly the same can be said about the work on neglected tropical diseases. They affect 1.4 billion people—possibly an underestimate—bringing disability and sometimes death. They have a devastating economic impact, yet treating them is cheap and entirely possible. Co-operation plays a vital role, and host Governments have a vital role to play. Many of these diseases can be treated in parallel through local health systems. It makes sense to work together rather than in silos. We saw that when we visited the NTD control programme in Mkuranga district in Tanzania—I went with two other hon. Members in the all-party group on malaria and neglected tropical diseases—where they were tackling lymphatic filariasis, schistosomiasis, soil-transmitted helminth and trachoma all together. Universities also have a vital role to play. In the case of Mkuranga, an important partner was the schistosomiasis control initiative, based in the UK’s Imperial College London. Other universities are very important partners.
In the private sector, we have seen extraordinarily generous donations of drugs. I will list them because it is important that hon. Members understand the scale. Merck and Co. will donate Mectizan—ivermectin—for onchocerciasis and lymphatic filariasis in Africa for as long as it is needed, with no limit. GSK has already donated nearly 2 billion tablets of albendazole for lymphatic filariasis and will continue until elimination, and has also donated 1 billion per annum to de-worm school-aged children. Johnson & Johnson has donated 200 million tablets of mebendazole a year. Pfizer donated 70 million doses of azithromycin for trachoma in 2012 alone. Novartis has donated drugs for leprosy. Eisai, the Japanese company, has donated 2 billion tablets of Diethylcarbamazine for lymphatic filariasis, and E. Merck has donated 20 million doses of praziquantel a year, going up to 250 million tablets a year from 2016 for schistosomiasis. These are huge figures that will substantially reduce the costs of treatment in countries where those diseases are endemic.
There are also product development partnerships. As well as the Medicines for Malaria Venture and the Malaria Vaccine Initiative, we have the Drugs for Neglected Diseases initiative, which focuses on developing new treatments for the most neglected patients suffering from diseases such as human Africa trypanosomiasis, Chagas disease and lymphatic filariasis, as well as paediatric HIV. Again, the UK has taken a leading role. On top of the £50 million committed by the previous Labour Government, a further £195 million was pledged by the coalition. The UK is also the second largest funder of the Drugs for Neglected Diseases initiative, with £64 million donated, second to Gates, who has given $126 million. The one other donor with more than €20 million of donations is Médecins sans Frontières, which has donated €66 million.
The UK has also played a leading role by hosting the London conference—a big conference that set the path for the next few years; we need to find out where we have got to with that—and the declaration on neglected tropical diseases, an important declaration that I want to quote from:
“Inspired by the World Health Organization’s 2020 Roadmap on NTDs, we believe there is a tremendous opportunity to control or eliminate at least 10 of these devastating diseases by the end of the decade”—
that is just over four years away.
“But no one company, organization or government can do it alone. With the right commitment, coordination and collaboration, the public and private sectors will work together to enable the more than a billion people suffering from NTDs to lead healthier and more productive lives—helping the world's poorest build self-sufficiency.”
I thank the hon. Gentleman for giving me a chance to speak in this debate. Obviously the issue is very important. The number of Members present is an indication of that. I have not yet heard—although I am sure he is coming to it—about the vast contributions that faith groups, churches and missionaries make throughout the world to eliminate poverty and help people to work their farms and so on. Almost every church in my constituency of Strangford has a project to give help directly to an area in Africa, the middle east and the far east. Does he recognise the good work that those churches and faith groups do?
I do indeed. I am most grateful to the hon. Gentleman for that intervention. I recognise the huge amount of work done by faith groups and missions around the world. They often run remote hospitals, which even the state health system cannot afford to maintain. I have seen the work that they do. Indeed, my wife ran a public health education programme for 11 years in Tanzania and saw at first hand the work that was done when she worked for the Lutheran Church there.
I will not go through the London declaration in detail, because I want other hon. Members to speak, but I will quote the final words:
“We believe that, working together, we can meet our goals by 2020 and chart a new course toward health and sustainability among the world’s poorest communities to a stronger, healthier future.”
Real progress has been made in the past few years. To take one example of many highlighted by the Overseas Development Institute last year, Sierra Leone made great strides in preventing four of the five diseases that make up 90% of the world’s NTD burden: onchocerciasis, lymphatic filariasis, soil-transmitted helminth and schistosomiasis. In particular, on schistosomiasis, which can lead to death through liver disease and bladder cancer, 562,000 people in Sierra Leone received preventative treatment in 2009. By 2012, that figure had reached 1.4 million, which was 99% of those needing treatment. We have heard of the tragic trials of Sierra Leone in the past year and a half, but it is important that we also recognise the huge amount of work that Sierra Leoneans have done to treat many of these other diseases.
When my hon. Friend refers to elimination, does he mean the elimination of a disease in human beings or the elimination of the scourge of these diseases from the face of the earth? Have I got that wrong, or is it a combination of the two?
My hon. Friend is absolutely right to raise that distinction. The recent leader article on malaria in The Economist discussed eradication, which is what I believe we have to go for. There are slightly different meanings to elimination and eradication, but whatever it is, we have to aim for what we have seen with smallpox and are approaching with polio, with no one getting these diseases anymore.
Ultimately it is about making sure that human beings cannot catch a disease. Whether we can get rid of a disease from the face of the earth is another matter, because they have a tendency to come back. We have to ensure that we have the tools in place so that if a disease does return when we think it is eliminated, we can deal with it.
I have three questions for the Minister. What progress has been made in investing the additional £195 million committed by the coalition Government to work on neglected tropical diseases? Given the tremendous cost-effectiveness of interventions—we are talking about tackling diseases that affect 1.4 billion people by committing over four years the cost of running an average district general hospital in the UK for just one year—will the Minister look carefully at increasing the UK’s support for NTD work, especially drug discovery and support for programmes that strengthen health systems as they deliver prevention, diagnosis and cure? Finally, will he update us on the progress made on implementing the London declaration? We hosted the conference, so it is important that we take the lead in ensuring that the declaration comes to fruition.
Over the past 15 years great progress has been made on malaria and NTDs. The UK has been a vital part of that work, not just via funding from DFID, but through our scientists, universities, NGOs and voluntary organisations such as the Rotary Foundation, which has done tremendous work on malaria on top of its work on polio, and most certainly through our private pharmaceutical sector, whether in its commitment to research and development in unfashionable areas or in its direct donations of billions of doses of essential drugs. Nevertheless, the job is only half done for malaria, and even less so for NTDs. If the UK remains committed over the coming 15 years, I remain hopeful that we can make substantial progress. I ask the Minister to make that commitment. It is not about specific sums of money, but about an overall approach that recognises how much difference this work makes to billions of people and what an effective use of UK taxpayers’ money it is.
Let me conclude by quoting the leader article in The Economist from 10 October:
“Throughout history, humans and disease have waged a deadly and never-ending war. Today the casualties are chiefly the world’s poorest people. But victory against some of the worst killers is at last within grasp. Seize it.”
It is a pleasure to serve under your chairmanship, Mr Davies. I thank the hon. Member for Stafford (Jeremy Lefroy) for securing this debate.
I am glad that we have the opportunity to draw attention to this important issue, about which, as a British-born Nigerian, I feel passionately. According to statistics published by the US Government to coincide with this year’s World Malaria Day, Nigeria has the highest number of malaria casualties worldwide, with an estimated 100 million cases and around 300,000 deaths each year.
The debate is particularly timely given the recent announcement that the roll-out of the world’s first malaria vaccine has been delayed as experts at the World Health Organisation have urged caution. The vaccine requires four doses, and without all four shots children had no overall reduction in severe malaria. That raises important questions about access to healthcare and how less developed countries will be able to administer the four vaccines. It also highlights the disparity in access to healthcare across the world and the more general need to address the issue in order to tackle infectious diseases most effectively. After all, access to healthcare is a human right.
I have been encouraged to see the progress that has been made in tackling malaria. Malaria No More UK states that malaria prevention returns £36 to society for every £1 invested. It is important to note that according to a recent WHO report, carried out jointly with UNICEF, malaria death rates have dropped by 60% since 2000, saving 6 million lives. The number of children under five sleeping under insecticide-treated nets has risen from 2% to 68%. Thirteen countries that had malaria in 2000 no longer have any cases of the disease. That shows that, with funding from the international community, there is hope that malaria, one of the biggest killers at the turn of the millennium, could be eradicated.
Progress must continue to be made. This year alone there have been an estimated 214 million new cases of malaria, with more than 400,000 deaths. Two forms of resistance are threatening to undo the progress that is being made: in south-east Asia, the malaria parasite is able to shrug off the effects of the drug artemisinin; and some mosquitos are becoming resistant to the drugs used to coat the nets. That must be looked into.
That is an important point. We need to invest in the healthcare profession so that this significant and costly disease can be eradicated.
I welcome the fact that the Department for International Development has pledged up to £500 million a year towards tackling malaria. Eliminating malaria is a global effort that involves work from the grass-roots and aid on international and governmental levels. There is still a lot of work to be done and I hope that the UK will continue to lead the way in the fight to end this disease.
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.
It is a pleasure to serve under your chairmanship, Mr Davies. I congratulate the hon. Member for Stafford (Jeremy Lefroy) on securing this important debate at the right time.
Since I first entered Parliament in 2007, I have been committed to development and healthcare issues. As a boy growing up in India, I saw the debilitating effects of malaria and parasites such as hookworm. Such conditions are not blind; they affect the very poorest in society. Developing nations face a competitive disadvantage. The west and the more developed nations have mostly eradicated such debilitating, but not necessarily life-threatening, diseases, but the countries with the greatest need often lack even the most basic tools for curing neglected tropical diseases.
I was proud to be in New York last month with four of my colleagues here in the Chamber for the global launch of the sustainable development goals. I pledge my support to two goals in particular: goal 3, on health and wellbeing for all people; and goal 5, on achieving gender equality and empowering all women and girls.
The UK currently invests £536 million in eliminating malaria. The Department for International Development has much to be proud of, but neglected tropical disease funding is being reassessed at the end of this year. NTD funding has to be protected and, as the hon. Member for Mid Derbyshire (Pauline Latham) said, increased where possible. If there is not a predominantly decent level of health across the globe, how can the world face the challenges of the 21st century? Speaking selfishly, if we meet global malaria targets by 2030, we will not only have saved more than 10 million lives but increased global economic output by $4 trillion. That represents a huge new market for British goods, manufacturing and know-how.
Some 44 million households worldwide, representing more than 150 million people, face catastrophic healthcare costs that can cripple them financially. If we can prevent such cruel, horrible diseases from developing, we can free millions of women and girls from lives of servitude when they have to care for sick and ill family members. They will be able to go to school, receive an education and be fully equipped to participate as full members of our society. The life-changing effect of the drugs we support can be immense, and the cost can be just a few pence. The burden of NTDs and malaria traps so many in a spiral of debt, sickness and poverty. We have much to offer, having gained so much ourselves, but although we have done so much, there is much left to do. I hope that by 2050 people will no longer be trapped in poverty spirals driven by sickness. Hopefully, we will help them to become full members of society.
I support the questions put by the hon. Member for Stafford to the Minister. If the Minister can answer all those questions, it will not only satisfy people but give confidence to wider society that the Government are committed to what they have already paid for.
I congratulate my hon. Friend the Member for Stafford (Jeremy Lefroy) on an excellent speech, not least because of his impressive articulation of so many technical terms, which left many of us in awe. I also acknowledge his equally effective leadership of the all-party parliamentary group on malaria and neglected tropical diseases, which over the previous Parliament and continuing into this one has gathered together many of those involved in research and its practical application, seeking to resolve the challenges that he spoke of and to find solutions to the still deeply concerning impact of malaria and other neglected tropical diseases across the world.
I acknowledge the Department for International Development’s considerable contribution over the past several years and the achievements secured thus far, not least because the constructive partnership working that my hon. Friend mentioned is being so effective in contributing to the improvements that have been made. There is still a long way to go, however. My hon. Friend spoke of the importance of increasing funding for drug discovery, and I want in particular to speak about early-stage drug development funding.
As I said, the all-party parliamentary group has gathered together a number of thinkers at the forefront of this issue, one of whom is Professor Alister Craig from the Liverpool School of Tropical Medicine, who visited us last week. He is a lifelong researcher into the biology of diseases and has several suggestions that could make the funding that goes into this area even more effective. I hope the Minister will take those suggestions away. Professor Craig speaks of the weighting system of the research excellence framework, which is a method of addressing the research of British higher education institutions that can impact on the grant funding received. Professor Craig says that the current UK system is well suited to recognising the researching and developing of drugs that have an ultimate commercial home in western markets—that is to say that the cost of their development will be recouped by pharmaceutical companies. In practice, that can mean that the research excellence framework prioritises pure academic and perhaps more theoretical research over more iterative drug development processes. Drug development, particularly at an early stage, can be under-recognised as a result. Framework points can be accrued through the demonstration of excellence in academia more than through a demonstration of excellence in drug development. That is particularly concerning for the development of drugs for NTDs, because it can be seven to 10 years before apparent progress is made, but unless that work is done, no progress will ever be made.
While the system makes sense for the majority of the UK market, where a commercial operator will put in money to turn academic research into a product that ends up on the market, it can be difficult for grant money to get to development stage research into tropical diseases. Such research is often left under-resourced without a commercial developer to inject cash. In the next review of the research excellent framework, is the Minister prepared to consider measures that would allow drug developers to demonstrate the excellence of their research? We could perhaps consider the matter at a future meeting of the APPG, to which Ministers were generous in giving their time in the previous Parliament, so that the issue can be discussed with the experts in this field.
There is a clear disparity in the funding here. Successful research is rightly rewarded with drug development, but the drugs being developed only have a 0.3% chance of turning out to be an effective and available product. Much development work gets us closer to a final answer while not producing a solution or product. That valuable work—we could perhaps call them useful failures—could be better understood by review panels to give it more recognition.
For example, a number of malaria vaccines did not result in in a marketable vaccine, but each new research stage and trial contributed to the accumulation of knowledge and is valuable in the chain of research that will eventually lead to an effective malaria vaccine. If useful failures could be better understood and identified, that would be helpful. However, funding agencies and review panels are often heavily represented by individuals from the academic sphere of pharmaceuticals and less so by those from the development field. The Government have the power to set expectations about the mix of backgrounds on such panels, but will the Minister consider the balance between those from academia and those from product development?
DFID’s funding has been enormously effective over the past few years, but will DFID look particularly at targeting at early-stage NTD drug development? The purpose would be to support long-term development work from groups that have a deep understanding of NTD challenges. Money is put into development, but it is often directed, even by DFID, towards picking up drugs that are already at an advanced stage of development, leaving early-stage drugs desperately under-resourced. It is particularly important that Government consider that because private foundations and NGOs often want to invest where they can get the biggest bang for their buck and where they can see an early-course impact.
Research in the UK into tropical diseases has been effective, and research into river blindness, as mentioned by my hon. Friend the Member for Stafford, is a good example. For Members’ information, river blindness is a parasitic infection that is spread through the bites of black flies. It often leads to permanent blindness, and millions of people in central Africa and Latin America are at risk of infection. In some west African communities, 50% of the men over 40 had been blinded by the disease. UK research discovered that the parasitic worms could be stopped by attacking bacteria inside the worm as it was much easier to kill the bacteria than the worm. Millions of people are still benefiting from that discovery, which is a great example of UK research benefiting the lives of many. Such strides take time, however, which is why it is important for us to invest in early-stage drug development to make progress as quickly as possible.
I thank Professor Craig for his engagement with the APPG and for his particularly constructive comments. He says that it is not that the UK is not doing this work, but rather that more could be done. We could do more and could do it even more effectively.
It is a pleasure to serve under your chairmanship this morning, Mr Davies. Like others, I commend the hon. Member for Stafford (Jeremy Lefroy) on securing this debate and on the helpful way in which he set out the terms of the debate, which was helpful not least because, as the hon. Member for Congleton (Fiona Bruce) said, he covered all the technical terms and jargon, meaning that none of the rest of us has to go over those hurdles. I also pay tribute to the hon. Member for Stafford for his steadfast and sterling work as the chairman of the all-party parliamentary group on malaria and neglected tropical diseases. I try to attend the group’s meetings as often as I can, and I appreciate not only the quality of his work, but the calibre of the evidence and engagement that is brought to the group, which powerfully demonstrates the range of commitment of a number of charities and campaign groups. We have also heard directly from companies, not only about the quality of the work and their research, but about the commitment that they have been prepared to make on things such as price sensitivity. We have also been able to see and hear how important the work of DFID is and about its various partners in the NGO sector, and internationally and multilaterally.
The rate of progress and advance highlighted by the hon. Member for Stafford in his introduction in many ways proves the power of marshalled will when we have multilateral actions and well defined global goals. For some it is fashionable to knock such initiatives, but seeing real success against declared goals should incentivise us to do more and to go further. As the hon. Gentleman said, when we might still be looking at 450,000 or more children dying from malaria and neglected tropical diseases, we clearly need to do more.
This is a time for renewed commitment, rather than complacency about the challenges. Tackling malaria and neglected tropical diseases will be key to achieving the sustainable development goals, especially the health goal, the realisation of universal health coverage and the reduction in maternal and child mortality. Achievement of the global malaria targets by 2030 will mean more than 10 million lives saved, giving all that added productivity, releasing all that quality of life and increasing economic activity.
The UK should be seen to be prioritising sustainable development goal 3. We should therefore sustain and, I hope, increase the annual investment—£536 million at present—to achieve malaria elimination. The UK’s malaria and reproductive health framework for results will run out this year, so we need a renewed vision and a new plan for the UK’s contribution to global efforts towards elimination.
DFID has the credibility, so it should be seen to ensure that SDG 3 is more articulate about neglected tropical diseases by using its own working indicator on the number of people requiring interventions against neglected tropical diseases by 2030. Furthermore, we should heed the caution of the hon. Gentleman about silo approaches, which are understandable in the face of so many difficult challenges and so many pressures, but it is vital that we do not miss the opportunity to use disease-specific vertical programmes for other diseases and other health challenges to contribute towards the defeat of other diseases. It is therefore important for the UK to continue to fund bilateral, disease-specific programmes if we are to sustain the gains that have been made.
There has already been some discussion of “elimination” or “eradication”. It is important whether we use and how we qualify such terms and the differences between them. The goal is, in essence, one of emancipation. When we achieve elimination or eradication, we will have conquered a disease, with all the ravages that it can bring, including death, disability or diverting the life opportunities of those who have to care for the sufferers—women and children in poor countries are affected in particular. At the same time we will need to remember that malaria and neglected tropical diseases are not only a face of poverty, but a force for poverty, not least in their impact on women and children.
We need to see the whole effort as one of emancipation, creating alternatives for people—not only lives no longer lost, but lives that can be better lived and more fulfillingly expressed through economic contribution and in public life. That is why it is so timely that the hon. Member for Stafford has secured the debate and that is why it is so important that we encourage the Minister and everyone he works with in DFID to do everything that they can.
I am grateful to my hon. Friend the Member for Stafford (Jeremy Lefroy) for arranging for the debate and I support his view that this is a critical time for tackling tropical diseases. I will talk specifically about leprosy, which, along with the other neglected tropical diseases that we have heard about, is preventable and treatable, although it needs to be caught early to avoid complications, side effects or disfigurement.
Last month I visited Bangladesh and met with workers from the Leprosy Mission and people suffering from the disease. We visited Vasantek, on the outskirts of Dhaka, where I met Soloma Akter, a 58-year-old widow who used to live in Boroalgapa village with her son Azizul Haque, who is a rickshaw puller, and his family. Soloma had dismissed the patch on her left arm as “nothing” when it first appeared. When she developed an ulcer on her right foot, her son took her to the hospital, but the doctors failed to diagnose leprosy. She subsequently lost three toes. A few months before my visit, staff from the Dhaka Leprosy Control Project saw her begging on the street. They recognised her symptoms and brought her to the Vasantek clinic, where she is now receiving treatment. Earlier diagnosis and medical treatment would have helped Soloma to keep her toes. There are many more stories like hers.
I also visited a self-help group in the nearby Bashantek slums, where most people who received early treatment and therefore escaped disability now look out for others with symptoms and bring them to the clinic for treatment. One man who had lost all his fingers and toes spoke passionately through the translator about how he now knew and recognised the signs and had spotted them in three other people, who had since been diagnosed and treated.
I have worked with leprosy in different countries and different continents. Does my hon. Friend agree that disability is 100% preventable and that the UK can lead by ensuring that Governments have proper data collection of every single disability case in leprosy?
I agree with my hon. Friend.
I have to confess that that was the first time that I had met people with leprosy, and I was not sure what to expect when I walked into the clinic. I saw people who had lost their toes, sitting with their feet in buckets to clean and hydrate their feet. I was nervous about how I would react, but I wanted to shake their hands to dispel the myth about catching leprosy by touch. But it was fine: my reaction was human, and we all saw how vulnerable these people were, but we also saw the best of humanity—the selflessness of the people caring for them, the local doctors and the people from the Leprosy Mission.
I am pleased that over the past 20 years more than 14 million leprosy patients have been cured throughout the world, and the prevalence rate of the disease has dropped by 90%. Almost all new leprosy cases are now reported from only 14 countries. In order to reach all patients, leprosy treatment, as with treatment of other neglected tropical diseases, needs to be fully integrated into general health services. Education and awareness must remain a priority. As I saw, when people know the signs and symptoms and see the effects, they become advocates for seeking help and themselves help to save many people from similar suffering.
We also need political commitment in countries with the problem, so that leprosy and other neglected tropical diseases remain a public health priority and so that we break down the age-old stigmas attached to these diseases.
Does my hon. Friend agree that although the global goals give us a greater focus—one of them concerns preventable NTDs and malaria—the focus must now be on all countries buying into the process and into the collection of robust data, which can be shared and used to further the agenda?
I agree with my hon. Friend.
The UK Government clearly recognise the importance of neglected tropical diseases. DFID hosted and was a signatory to the London declaration, and it has been championing the issue of neglected tropical diseases on the global stage. In June during the G7 meeting in Germany, the UK Government reiterated their commitment to tackling neglected tropical diseases. The UK needs to commit to continuing to lead on such an important issue and to ensure that at the UN stats meetings, when the indicators are discussed over the next few months, it continues to push for the inclusion of the proposed indicator on neglected tropical diseases, along with discussion of other statistics, as pointed out by hon. Members.
I am grateful to my hon. Friend the Member for Stafford for securing the debate and I am pleased to be able to speak and give my support.
Thank you, Mr Davies; I appreciate it. Contrary to some other people, I want to see 21st-century measures, with local medical teams and local Governments taking ownership.
The UK’s legacy is in data collection by the missionaries. In many of the countries in which I worked, that was not done adequately, and that is where the system will break down. Our greatest legacy is the rigour of data collection. I also commend the work of the late, great Colin McDougall, who was a titan in leprosy work. We owe him so much.
It is a pleasure to serve under your chairmanship, Mr Davies. I thank the hon. Member for Stafford (Jeremy Lefroy) for securing the debate on this important issue.
It is important to start on the progress made in combating malaria and NTDs. On the basis of reported cases for 2013, 55 countries are on track to reduce their malaria case incidence rates by 75%, in line with World Health Assembly targets for 2015. It is great to see that, in recent years, four countries have been certified by the World Health Organisation director general as having eliminated malaria: the United Arab Emirates, Morocco, Turkmenistan and Armenia. In 2014, 13 countries reported zero cases of malaria within their borders and another six reported fewer than 10 cases. Between 2000 and 2015, incidences of malaria fell by 37% globally and during the same period malaria mortality rates decreased by 60%. An estimated 6.2 million malaria-related deaths have been averted globally since 2000.
That is progress, but there is obviously progress still to be made. According to the latest World Health Organisation estimates released in September 2015, this year will see 214 million cases of malaria and 438,000 deaths. Sub-Saharan Africa continues to carry a disproportionately high share of the global malaria burden: the region is home to 89% of cases and 91% of deaths. Some 15 countries, mainly in sub-Saharan Africa, account for 80% of cases and 78% of deaths. Since 2000, the decline in malaria incidence in those 15 countries has lagged behind that of other countries.
In areas with high malaria transmission, children under five are particularly susceptible to infection, illness and death, with more than two thirds of all malaria deaths occurring in that age group. However, between 2000 and 2015, the under-five malaria death rate fell by 65% globally, translating into an estimated 5.9 million children’s lives saved.
It is often the countries affected by neglected tropical diseases that are increasingly leading the fight to tackle them. In doing so, they are improving coverage rates and making strides towards elimination, with many already achieving elimination goals for individual diseases. In 2014, 126 cases of Guinea worm disease were reported, which is a staggering 99.99% drop since 1986. Only five cases have been reported so far in 2015. Of the 81 countries endemic for lymphatic filariasis, 25 no longer need mass drug administration, including 10 that have successfully eliminated transmission. Fewer than 4,000 new cases of human African trypanosomiasis—also known as sleeping sickness—were reported to the World Health Organisation last year, which is the lowest level in at least 75 years.
According to the UK coalition against neglected tropical diseases—and as the hon. Member for Stafford mentioned—NTDs affect 1.4 billion of the world’s poorest people through mortality, morbidity, disability and stigma. The 10 neglected tropical diseases mentioned in the London declaration of 2012 are reported on each year in the Uniting to Combat NTDs annual report. Its third report was published on 25 June 2015, with its key finding being that increased investment in combating NTDs is hugely economically beneficial for nations afflicted by such illnesses. It is also reassuring to note that more than 5.5 billion tablets have been donated, providing 3.5 billion treatments since the London declaration.
It was good to hear the hon. Member for Northampton South (David Mackintosh) raise leprosy. The report mentioned that leprosy is one of the diseases that is off track, which demonstrates that we need to do more to tackle NTDs and ensure that no NTD is neglected.
Taken together, the NTDs in the London declaration constitute a disability and mortality burden of the same order of magnitude as HIV/AIDS, tuberculosis or malaria. However, the costs associated with reaching the WHO 2020 targets are relatively modest compared with those big three, and the benefits are enormous, providing a compelling case that the WHO road map is a highly cost-effective initiative, with far-reaching global health, societal and economic impacts.
Combating NTDs would unlock the productive and economic potential of hundreds of millions of people who would otherwise be kept out of work and school. As hon. Members have mentioned, sustainable development goal No. 3 is to ensure healthy lives and promote wellbeing for all at all ages. One of that goal’s targets is, by 2030, to end the epidemics of AIDS, tuberculosis, malaria and neglected tropical diseases and to combat hepatitis, water-borne diseases and other communicable diseases.
The delivery of malaria and NTD interventions is essential to achieving universal health coverage, ensuring healthy lives and promoting wellbeing for those of all ages, particularly the vulnerable and marginalised. It also contributes strongly to reducing child mortality and improving maternal health, and provides the opportunity to treat childhood illnesses such as pneumonia, diarrhoea and acute malnutrition.
It is clear that combating malaria and NDTs will significantly help to achieve the sustainable development goals; indeed, the goals will help to combat malaria and NTDs. With that in mind, it would be great if the Minister told us how the action that DFID is taking to combat malaria and NTDs fits into its wider strategy to achieve the sustainable development goals.
Let me finish by commending the work of the University of Dundee, which the hon. Member for Stafford touched on, in tackling malaria, with the discovery of a new anti-malarial compound in June 2015. The imaginatively named DDD107498 has the potential to treat malaria patients, including those with malaria parasites resistant to current medications, in a single dose and to help to reduce the transmission of the parasite. The compound was identified through a collaboration between the University of Dundee’s drug discovery unit and Medicines for Malaria Venture. The discovery of that new anti-malarial agent, which has shown remarkable potency in multiple stages of the malaria lifecycle, is an exciting prospect in the hunt for viable new treatments. Once again, I thank the hon. Member for Stafford for securing the debate, and I look forward to hearing the Minister’s response to some of the points raised.
It is a pleasure to serve under your chairmanship, Mr Davies. I, too, thank the hon. Member for Stafford (Jeremy Lefroy) for securing the debate and for his personal leadership in this area. He gave great personal testimony about how the disease has affected him in the past. I, too, went to Tanzania in the early ’90s and was prescribed Lariam while I was helping a friend to set up the first public library in Pemba. I also felt the effects of that terrible drug at that time.
Labour welcomes the sustainable development goals. We are entering a new era in which we hope to eradicate poverty, foster human wellbeing and protect our planet. That universal agenda for people in all countries pledges to leave no one behind. We now need to realise its transformational potential. The UK has shown its strong commitment to international development through spending 0.7% of its gross national income on aid and enshrining that spending in law.
I want to talk about sustainable development goal 3, which, as we all know, is about eradicating disease. Although it is only one of 17, and the target only one among 169—I feel sorry for the civil servants who have to understand all those fully—our contribution must demonstrate an integrated approach, as has been said. We must consider the interplay of all dimensions—social, economic and environmental—of sustainable development. We need to expand innovation and research, empower communities, build a skilled workforce and set up strong regulatory frameworks to promote and improve world health systems.
DFID has a strong track record on combating diseases such as malaria and neglected tropical diseases. UK spending on malaria control and prevention was £536 million in 2013-14, and we contributed significantly to the recently announced 60% reduction in malaria mortality since 2000.
According to the World Health Organisation, more than 70 countries are ready to implement national NTD masterplans, which aim to stimulate an increased demand for donated medicines. Since 2006, more than 5 billion anti-parasitic treatments have been delivered. During 2012 and 2013, the pharmaceutical industry donated 2.5 billion treatments—the hon. Member for Stafford made the industry’s contribution clear. Over 800 million people were treated in 2012 alone. DFID has increased its expenditure on combating NTDs to over £250 million. As he said, it takes reliable long-term funding to tackle these diseases.
Global malaria control is one of the great public health success stories of the past 15 years, and our efforts to combat NTDs are on the right track, but we face substantial challenges, such as the spread of resistance to drugs. In addition, we face funding shortfalls for research and development targeted at new diagnostics for, and prevention and treatment of, NTDs. Yet the prevention of deadly diseases is one of the best uses of aid. If global malaria targets are achieved by 2030, it is estimated that more than 10 million lives will be saved and over $4 trillion of additional economic output will be generated.
DFID has great experience in fighting malaria and NTDs, but we can do even more. The UK has excellent resources in the NHS that could be brought to bear in the task of building strong health systems around the world. Following the idea of co-development, the NHS could engage in a mutually beneficial exchange of professionals. As a global employer, the NHS has obligations to support training and healthcare in the countries of origin of our health workers.
DFID should be a strong partner for malaria-affected countries, which will play the most important role in designing effective national strategies, using funds transparently and well, and providing financing from their own domestic resources. Civil society and the private sector also have crucial roles to play. We should encourage new partners to join the global effort, especially private contributors. We also need to support multilateral partners such as the Global Fund to Fight AIDS, Tuberculosis and Malaria. It is essential that we continue to support the fund and build on what has been done, particularly the investment in new vaccines, medicines, insecticides and diagnostics.
Tackling NTDs and malaria promises a number of spillover effects, such as greater productivity and growth, reduced worker and child absenteeism, increased equity and women’s empowerment, and improved wellbeing, particularly for vulnerable and marginalised populations. Failure to act could see a resurgence in disease, with increased deaths and lost opportunities for progress and development. The Ebola crisis in west Africa has painfully illustrated the importance of strong public health systems for fighting disease. That lesson applies to our efforts to combat NTDs and malaria.
I thank the hon. Member for Stafford for leading this debate. I also thank hon. Members for their testimony about their time in Tanzania, Uganda, Nigeria, India and Bangladesh, and for the great expertise they have brought to the debate. We need to scale up our efforts to combat malaria and NTDs by investing in research and development, tackling resistance to life-saving medicines and insecticides, and boosting health systems across the world to help to bring an end to these terrible diseases.
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.
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.
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.
The Minister mentioned the millennium development goals. Is he absolutely confident that the new global goals will be sufficient to continue the progress made under the MDGs, which have obviously done good? Will he and DFID also do everything they can to assist data collection—a subject ably and powerfully raised by my hon. Friend the Member for Twickenham (Dr Mathias)? Without data collection, we will have no measures and we will not be able to make people accountable.
On the latter point, about data collection, I had hoped that I had made myself clear: we absolutely support data collection programmes, and I outlined one specific programme. I will come to my hon. Friend’s point about the new global goals in just a second, because the UK remains committed to bringing down the numbers even further.
Hon. Members will be delighted to learn that, just last week, I approved the purchase of a further 2 million insecticide-protected bed nets for Tanzania, which I visited recently. In addition, there are other programmes that will assist in the battle against these diseases. Energy Africa, a programme I launched in London last Thursday with Kofi Annan—Bob Geldof and others are supporting it—will enable energy to be brought to Africa. That means that it will be possible to provide better medical care, using means such as better refrigeration, for example. That is all an important part of achieving global goal 7.
On global goal 3, yes, everything is there. The UK has been at the forefront of supporting this global goal, with all its sub-targets, including preventing preventable deaths among children and ending epidemics of malaria and NTDs. I am therefore absolutely confident that the UK is right behind the push on that.
To really see an impact, we will need to make Herculean efforts. We need think only of river blindness, which once affected vast swathes of Africa, but which is now almost non-existent, to see what can be achieved.
Earlier this year, former US President Jimmy Carter was at DFID to discuss the guinea worm eradication programme. In 1986, guinea worm disease affected 3.5 million people; last year, there were 126 cases. So far this year, there have been just 15. The reduction is a simply amazing achievement, and we look forward to seeing other NTDs quickly follow the same course.
The Government have a strong track record on supporting successful product development and research, particularly through public-private product development partnerships, and some of the innovations have been discussed this morning.
There is, however, great concern about the 2020 vision, as my hon. Friend the Member for Stafford mentioned. Earlier this year, the WHO launched its third report on NTDs in London. Former DFID Minister Baroness Northover spoke at the launch. The report set out the financing and targets involved in meeting the WHO road map goals for 2020. It also discussed the progress that has been made. We need to do a lot more if we are to continue to meet those goals, but the Department and the Government are standing very much foursquare behind that.
My third point is about partnerships and collaborating with others to achieve a greater impact. We must, of course, recognise the substantial contribution the pharmaceutical companies have made. Pharmaceuticals have pledged drugs valued at $17.8 billion from 2014 to 2020 to tackle NTDs—a very substantial amount. There is also lots of capacity among health workers, and the NHS was mentioned. Volunteers and others are also supporting the implementation of these programmes. The UK will stay at the forefront of those many developments.
Lastly, we will strive to ensure that the post-2015 agenda has a transformational impact on the lives of the most vulnerable and, in particular, on tackling NTDs and malaria. It is worth noting that the Conservative manifesto—the manifestos of other parties covered similar issues—included a commitment to lead a major new global programme to accelerate the development and deployment of new vaccines, drugs and diagnostics for the world’s deadliest infectious diseases. I can report that that work is ongoing in DFID and throughout the Government so that we can meet that commitment, which I think the whole House will approve of.
Once again, I congratulate my hon. Friend the Member for Stafford on securing the debate. I am aware that there is one question I need to answer in a little more detail, and I will do so in writing.
Motion lapsed (Standing Order No. 10(6)).