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Volume 821: debated on Monday 25 April 2022


Asked by

To ask Her Majesty’s Government what steps they are taking to tackle malaria globally; and what assessment they have made of the findings of the World Health Organization’s World Malaria Report 2021, published on 6 December 2021, in particular that after years of steady progress towards elimination, malaria cases and deaths are rising.

My Lords, I beg leave to ask the Question standing in my name on the Order Paper and, in doing so, declare my interest as chair of the charity Malaria No More UK.

My Lords, first, I acknowledge and congratulate my noble friend on assuming the role of chair of Malaria No More UK, a charity we worked very closely with in the run-up to CHOGM in 2018. Turning to the specifics of the Question, the World Health Organization’s 2021 World Malaria Report notes that the Covid-19 pandemic contributed to an estimated 6% increase in malaria cases and a 12% increase in malaria deaths in 2020. The UK remains a very strong supporter of the Global Fund to Fight AIDS, Tuberculosis and Malaria, providing £4.1 billion to date. We also invest in research to help people to access new malaria treatments and diagnostics and support countries to strengthen their health systems.

My Lords, today is World Malaria Day. It is possible to end malaria within this generation, but we need continued UK leadership to do so, so I thank my noble friend the Minister for that Answer. My noble friend mentioned the Global Fund; does he agree that it is one of the most effective and best value for money investments we can make with UK aid? This year will see the Global Fund replenishment. Can my noble friend give me any reassurance that the UK will make an ambitious pledge, as the United States has just done, to help get progress back on track?

My Lords, as I have said, the United Kingdom has invested £4.1 billion in the Global Fund to date and during the last replenishment. My noble friend is correct: the Global Fund’s investment case for the seventh replenishment has been presented to the Government. We are looking at this and reviewing our support in line with our published approaches to health systems and our commitment to strengthen work to end preventable deaths. We will announce our commitment in the near future.

My Lords, may I put the question in another way? In the last replenishment of the Global Fund, we were the third biggest contributor. We have been its founder and strongest supporter, and what we need now is an early and strong pledge to show leadership. Will the Minister confirm that “global Britain”—as the Government put it—will keep its leadership position in support of the Global Fund?

My Lords, the noble Lord mentioned our commitment and our support and leadership. Whether we are second or third, depending on which criteria are used, we remain very much committed to the Global Fund. As I said, I cannot pre-empt the announcement that we will make about the current replenishment because that decision is being finalised, but I can reassure the noble Lord and your Lordships’ House that we remain very much committed to fighting malaria and to the Global Fund.

My Lords, I was in Washington last week, and I met the US representative and board member of the Global Fund. She stressed to me very clearly that the Biden Administration’s earmark of $6 billion is part of the American approach of matching up to 30% as a percentage cap of the remainder of the contributions. So, if the UK cuts its support for the Global Fund, that will automatically cut American support, which would be devastating and a tragedy. The Americans have earmarked the funds—why can the British Government not state that they will not cut support for this crucial fund? It is over a number of years and the Government say they want to return to 0.7%, so why do they not make that announcement now?

My Lords, I appreciate that the noble Lord is tempting me to make a specific commitment, but as I said already, I cannot give a commitment in terms of the actual amount. I can again reassure the noble Lord that we are committed to the fund. I agree, as my noble friend has illustrated and the noble Lord knows well himself, on the real impact the Global Fund has had in tackling malaria. Regrettably and tragically, the Covid-19 pandemic has seen a rise in cases—though not to pre-pandemic levels. Frankly, there has been a real challenge, particularly looking at young children and pregnant mothers, with the rise of cases of malaria, and these are preventable deaths. That is why we remain committed to fighting malaria.

My Lords, I draw attention to my interests in the register. The Minister is quite right to point out what has gone backwards during Covid in terms of malaria, but today there have been extremely promising results from the Jenner Institute in terms of the new R21 vaccine. Does the Minister agree with me that our investment in science is equally important and bore huge results in terms of Covid? Will the investment case for the Global Fund look at the possibilities of reversing that decline in progress through the new vaccine?

My Lords, again, I pay tribute to the noble Baroness’s work on this issue, but I share her commitment on the importance of the vaccine. She will be aware of recent trials that have taken place, including the World Health Organization’s approval of specific vaccines in key pilot countries. We are looking at that very closely. She is also right to point out the R21 vaccine being developed by the Jenner Institute in Oxford. As part of our focus on vaccines, I am also pleased that it now has an association with the Serum Institute to look at upscaling manufacturing of that vaccine once it has been tested. We are looking at working very closely with both those institutes.

My Lords, malaria deaths have risen year on year to the highest level in nearly a decade: 627,000 lives were lost to malaria in 2020. Could the Minister ensure that funding to the overseas aid budget is restored to 0.7% of GNI and that there is a successful seventh replenishment of the Global Fund? Could he indicate today when that announcement about the seventh replenishment will be made?

The noble Baroness is right to make the point about the increases in deaths from malaria. We did see a real reduction from the estimated 896,000 to around 560,000 in 2015, but we have seen a rise in cases under Covid, so I accept that point. As I said earlier, I cannot give a commitment on the amount, but it will be during the course of this year, as we look to the deadline of the seventh replenishment, to ensure we make a sizeable contribution that reflects our continuing commitment to fighting malaria around the world.

My Lords, is it not imperative that, at this year’s summit, Commonwealth countries renew the commitment that they gave in 2018 to reduce malaria by half?

My Lords, as the Minister of State for the Commonwealth, I am working closely with our colleagues in Rwanda. Certainly, the United Kingdom was and is the biggest Commonwealth donor in fighting malaria, and we will be working closely with Rwanda to ensure this remains on the agenda for CHOGM in June.

My Lords, I am sure the noble Lord saw the encouraging report by Adrian Hill in the Times today about the vaccine trials. One of the things he said was that if the vaccine trial is successful, as it seems to be, it will cost a mere $3 per person to vaccinate the African population. That would require $600 million per year. Is the Minister aware of the cost of this scheme? Are the Government going to come forward with a response?

My Lords, the noble Lord is of course right to point out the impact of malaria, particularly on Africa. Indeed, when you look at the statistics, they are very stark: 95% of cases and 96% of deaths from malaria are on the African continent. I have not read the specific article, but I am aware of the support and the issue of having effective costs. I think the real progress will be made through the World Health Organization and ensuring that vaccines are made available to all those who need them at a cost which is acceptable, reasonable and sensible for those who require them.

My Lords, in October 2021, the WHO recommended the first malaria vaccine for children living in areas of high to moderate risk of malaria. The demand for the RTS,S malaria vaccine is estimated to be far greater than supply over the next few years. What is the FCDO doing to speed up equitable access to the vaccine?

The specific vaccine that the noble Baroness refers to, the RTS,S malaria vaccine, is one of those which has just gone through the World Health Organization’s approval process. This was based on trials in three countries, I believe: Ghana, Kenya and Malawi. Some 800,000 children received that vaccine. The conclusions of that—this is why it is important to continue research on the vaccines, which we are certainly committed to—is that the vaccine supply is limited and there are costs, as was pointed out just now by the noble Lord, to ensuring equitable access. The noble Baroness is right to point this out and, as I said earlier, we will work with the World Health Organization on equitable and fair access to the vaccines once they are scaled up. We should be encouraged that the Covid experience, through partnerships such as those with the Serum Institute, lends itself to a proper scaling up of the vaccines once those initial trials have been proven.