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Global Fund to Fight AIDS, Tuberculosis and Malaria

Volume 794: debated on Monday 3 December 2018


Asked by

To ask Her Majesty’s Government what assessment they have made of the results achieved in saving lives by the Global Fund to Fight AIDS, Tuberculosis and Malaria.

My Lords, the Global Fund to Fight AIDS, Tuberculosis and Malaria has helped to save 27 million lives since 2002. Deaths caused by the three diseases have been reduced by one-third in countries where the Global Fund invests. Despite impressive progress, however, there are significant challenges which require us to go beyond “business as usual” to achieve the 2030 targets.

I thank the Minister for his Answer. Successive UK Governments should be proud of the role this country has played in the Global Fund, which has a huge effect, not just by keeping millions of people alive, but also on the search for new medicines and vaccines. What do the Government intend to do to support the Global Fund in its upcoming sixth replenishment?

The noble Baroness is right. This is an area where we can be proud cross-party of the commitment that has been made since the fund was started in the early 2000s. Successive Governments have committed to this, and the UK is now a leading force in this whole area. We are coming up to a crucial moment with the sixth replenishment of the Global Fund, which will take place next year. The investment case will be presented to potential donors in New Delhi in February and then it will be important for all countries to step up to the plate. The UK’s position—I am absolutely confident of this without prejudging it—will continue to be one of leadership and commitment, because it is working.

My Lords, does the Minister agree that it is vital we maintain our commitment to the Global Fund and encourage other partners to do so if we are to achieve our ambition of zero HIV diagnoses by the year 2030 in line with the sustainable development goals?

That is absolutely right. On the sustainable development goals to which all 193 nations are signed up, goal 3.3 is the specific commitment. If it is going to be met, nations will have to step up and put more funds on the table to ensure people get the treatments that are needed. In 2017, those diseases killed approximately 2.6 million people, so we are a long way off 2030. We have the technologies, but we need to make sure the resources are there so that they are delivered.

My Lords, there is another commitment to which the Government are a party and that is the commitment made at the Commonwealth Heads of Government Meeting to halve malaria in the Commonwealth by 2023. The Global Fund has been absolutely crucial so far in the enormous achievements that we have made against malaria but, as the Minister said in his Answer to the Question, the achievements are in jeopardy if we do not go forward. Can he be even more positive about both the Government’s commitment to the sixth replenishment round and to persuading other Governments to meet their commitments too?

I think that that is one reason we were party to the high-level meeting in the margins of the UN General Assembly in September, which sought to gather some momentum behind this issue. There are other challenges with malaria, which the noble Baroness, as someone who has championed this cause over many years in this House, will know, and they include antimicrobial resistance and insecticide resistance. The challenges, particularly in relation to malaria, are getting more difficult, and that is why we need the resources.

My Lords, can my noble friend tell us what plans the Government have to improve access to HIV treatment for children? Globally, only 52% of children living with HIV have access to antiretrovirals and, tragically, half of those without treatment will die before their second birthday. There will soon be a high-level discussion on scaling up early HIV diagnosis and treatment for children. Will the Government be sending a delegate to it?

I cannot give an answer on that point, but I am very happy to write to my noble friend. He is absolutely right. We believe that this issue will be addressed in the investment case. It is also touched upon in the political declaration that accompanied the UN General Assembly high-level meeting. However, I will certainly write to him on the specifics of the issue and I thank him for raising it.

My Lords, as many low-income countries graduate to middle-income countries, that could have a disproportionate effect on women and girls in particular where programmes require ongoing funding. Is DfID working with the Global Fund to ensure that transition policies are complementary and that no one is left behind?

The noble Lord is right. Some middle-income countries, such as China, India and Indonesia, show the highest incidence of TB. The highest incidence of HIV/AIDS is to be found in South Africa, with an increasing number of instances in the countries of central and eastern Europe due to drug-related infections, so this has to be part of the overall effort. The noble Lord and I have often talked about the fact that the SDGs are very important because they focus on eradicating the disease rather than focusing on a particular geographic area.

My Lords, how has the Global Fund contributed to reducing the transfer of HIV/AIDS from mother to infant, and what progress has been made with regard to reducing maternal transfer?

I do not have a specific answer to that, so perhaps I may deal with it in my written response to my noble friend Lord Black.

My Lords, further to the question from the noble Baroness, Lady Hayman, about malaria, my noble friend will be aware that malaria mortality has halved in this century, which is a remarkable achievement. Seventy per cent of that reduction was due to a surprisingly low-tech innovation—namely, the insecticide-treated bed net, although, as my noble friend said, resistance is becoming a problem. Is he aware of research that is going on to improve the efficacy of insecticide-treated bed nets, and is this something that the British Government support?

I am aware of the research. Precisely because of the insecticide and antimicrobial resistance that I mentioned, this issue will be addressed in our antimicrobial resistance strategy, which will be refreshed next year. However, I know that my noble friend takes a close interest in this technology, and I would be grateful if he would keep us informed of any initiatives or new ventures that he is aware of.