Clean Water and Sanitation (Africa)

Jeremy Lefroy Excerpts

Thursday 21st April 2016 Westminster Hall

[Jeremy Lefroy (Stafford) (Con)]

It is a pleasure to serve under your chairmanship, Mr Percy. I thank the hon. Member for Strangford (Jim Shannon) for securing the debate and for speaking so eloquently, along with my hon. Friend the Member for Mid Derbyshire (Pauline Latham) and the hon. Member for City of Durham (Dr Blackman-Woods).

I will give two examples from my own experience of why this issue is so important. In 1982, I visited for the first time a country that was then a developing country—Peru. I was in the high Andes and visiting a friend of mine, Philip Archer, who was a doctor with a mission there. For the first part of his service—three or four years—he had been a doctor at a health centre. Time after time, the patients who came through his door had diseases that were caused by poor water or lack of water. For his second period of service, he said, “There is no point in my treating the symptoms; I will treat the cause”, so he ended up becoming a public health educator and putting in water systems to help the people of the high Andes.

My second example is perhaps closer to home. My wife ran a public health education programme in northern Tanzania, Kilimanjaro region, for the Evangelical Lutheran Church Northern diocese. As part of the programme, she and her colleagues also saw the problems caused by poor water—not so much on the mountain, where there was plenty of water, although sanitation was sometimes an issue, but on the plains, in particular among the Masai, and elsewhere. She, too, said, “There’s not much point talking to people about health education when they don’t have water, or if they do, they have to walk several kilometres to it.” The problems that that brings have been eloquently described. Collecting water is usually—almost always— done by women or girls. They suffer attacks from wild animals. We heard of people being killed and very badly hurt by crocodiles when collecting water from rivers and, when walking through the bush, by other wild animals. People are also attacked by humans from time to time—they have to cope with all that as well as missing out on their education or livelihood.

With the help of the Rabobank Foundation of the Netherlands, the northern diocese of the Lutheran Church instituted a programme for drilling shallow wells in various villages. In my view that was done in a very sensible manner—I have to say that because my wife was in charge of the project and she is an extremely sensible person, as were her colleagues. They did it under the guidance of the local community, which, first of all, would come to them and say, “Let’s have a shallow well. We really want one.” They then had to show a sign of commitment, so the idea was that the well would be drilled with money from the Rabobank Foundation and other donations, but the villagers would collect the money for the pump. By doing that, they would assume responsibility for the pump and for its maintenance.

By and large, the programme worked well. I shall be going back to Tanzania later this year and I hope to see some of the wells that were drilled up to 20 years ago—or even longer—still in operation and maintained, with the villagers contributing a set amount each month for the pump’s maintenance. Perhaps they will have replaced the pump in that time with the money that they have accumulated.

To me, the programme spoke of a lot of things: first, of the determination of the people themselves. They wanted clean water and could see the impact on their wives and daughters; the women were the loudest in saying, “We want this.” Secondly, these were not massive programmes. This was not a huge project. It involved a few thousand dollars per village and the villagers themselves were able to collect several hundred dollars for the pump. We are therefore talking about small programmes, the impact of which, as we have seen in the International Development Committee, is sometimes overlooked. However, a great deal can be achieved by running a large number of small village and community-based programmes.

At the same time, sanitation was a clear issue. Public health education was the way to convey the importance of good sanitation, and it did not take a lot of money; this was a public health programme that covered several hundred thousand people yet probably cost only a few cents per person per year. People did not have to be given money; once they were told the importance of putting in more modern sanitation and modern toilets, they did so, because they saw how obvious it was. They heard about the consequences of poor sanitation and poor water and did something about it. I will come on to what I would like to ask the Minister at the end, but I am talking now about a relatively modestly funded programme achieving significant results. The educators, who were trained by my wife and her team, would go out into their community, month in, month out, and encourage people to improve the sanitation in their homes and villages.

My final point is about the link with disease, which has already been made very clear and is completely uncontroversial. If we look at the diarrheal diseases, in particular, and one or two others that are classified among the neglected tropical diseases—I declare an interest as chair of the all-party group on malaria and neglected tropical diseases, to which my hon. Friend the Member for Mid Derbyshire also contributes hugely—we see that many of these diseases are directly linked to a lack of water or poor water and a lack of hygiene. I know that DFID has made neglected tropical diseases a key part of its programme from 2011 onwards. Indeed, under the previous Labour Government, a significant sum of £50 million was committed, which was raised to £240 million over five years under the coalition Government. It has been shown that there is a huge payback from work on neglected tropical diseases—something like £30 to £40 for every £1 invested.

Will the Minister commit, first, to look at the whole area of water and sanitation and see what more can be done? This is a very basic thing. I saw the impact at first hand 35 years ago, yet we are still talking about it. Let us do more.

Secondly, let us do it in a smart way. There are so many programmes around the world. Water Aid is a fantastic organisation that has contributed to many of them, but there are so many programmes that are not big and which perhaps go under the radar. Let us see how we can support them as a country. We may have to go through a larger organisation to do so, but let us ask how we can do more than we are doing at the moment. Let us not hear colleagues come to us and say, “Well, I’ve got a link in my constituency to a water project in Africa, but I cannot get DFID to support it because it is too small.” Excellent programmes such as Aid Match and Aid Direct have made a real impact in this area, but let us make water programmes a priority; they are ideal and they very much fit into that category of spending.

Thirdly, let us look at how we can support health education programmes, which, again, are often fairly low-key but incredibly effective. They can be run through government, faith groups, Churches and community organisations and are often low-cost, involving amounts of money that do not appear on DFID’s radar. There must be ways of ensuring that these programmes are supported, either though some kind of match funding or direct funding, or even possibly, as we have suggested in our Committee, by making funds available to local DFID offices for support, without people having to go through the centre, with the time and effort that that involves.

Finally, I emphasise again the importance of continuing to support neglected tropical diseases alongside the work on WASH—water, sanitation and hygiene. In fact, WASH projects and NTD projects should go together. Even though providing medicines to schoolchildren to get rid of worms is excellent, there is little point in doing that year after year when those children will get worms back immediately because the water is poor. Let us have the two kinds of projects going hand in hand. As the current programmes come to an end and the Department considers the future funding of neglected tropical diseases, I urge the Minister to consider the huge value for money that those programmes provide.

Thank you for chairing the debate, Mr Percy, and I thank the hon. Member for Strangford for securing it.

Oral Answers to Questions

Jeremy Lefroy Excerpts

Wednesday 16th March 2016 Commons Chamber

[Mr Hurd]

The hon. Gentleman is right to point to the enormous success of the Global Fund in making it easier to access medicines. It is important to note that since 2002 the Global Fund has helped reduce deaths from the big three diseases by 40%—a staggering achievement—but there are still too many people dying unnecessarily from those awful diseases, which is why we look forward to a successful replenishment of that very important fund.

[Jeremy Lefroy (Stafford) (Con)]

The all-party group on malaria, which I chair, is extremely concerned about resistance to anti-malarial drugs in south-east Asia. The Global Fund is doing a great deal of work on that. Can the Minister update the House on the progress of that work?

[Mr Hurd]

I congratulate my hon. Friend on his persistent and tireless work in this area. I was with the senior team at the Global Fund the other day in Geneva to discuss it. I have no doubt about its commitment in the face of that challenge. I hope my hon. Friend takes some pride in the fact that the British Government continue to lead in this area, with the recent refresh of the commitment to spend £500 million a year in the battle against malaria in all its forms.

Oral Answers to Questions

Jeremy Lefroy Excerpts

Wednesday 3rd February 2016 Commons Chamber

[Justine Greening]

My hon. Friend is absolutely right. In fact, when I had the privilege of chairing the UN Security Council last October, the issue we talked about was the need for the international community and the Security Council itself to look at fragile countries before conflict hits and perhaps to have better early warning systems, whether on human rights or any other area, to highlight where we need to do work in advance to keep peace and stability, rather than having the costly after-effects of responding to war.

[Jeremy Lefroy (Stafford) (Con)]

What work is my right hon. Friend doing to ensure that humanitarian aid is joined up with longer-term development aid?

[Justine Greening]

The world humanitarian summit is a key opportunity for us to knit these agendas together clearly. At the moment, I would describe the humanitarian system as a hospital that only has an accident and emergency department. From the start of such crises, we need not only to think ahead about how we can deal with the day-to-day challenges that refugees and people affected face, but to begin to build in long-term solutions so that they can get their lives back on track. That is why the issues of jobs in particular, getting children into schools and helping host communities—the communities that host the refugees—to cope are so important.

Ebola: Sierra Leone

Jeremy Lefroy Excerpts

Tuesday 19th January 2016 Commons Chamber

[Justine Greening]

The work that is under way on the ground aims to ensure that the whole framework that we put in place to tackle the major outbreak swings into action again at the local level. That means the isolation of potential Ebola sufferers. It sits alongside ongoing surveillance work, which was how we picked up this case in the first place. We must continue to emphasise the need for safe burials so that this case does not spread more broadly, and work with communities to deliver that.

I mentioned the hospital and treatment centres that provide the isolation units we need to treat Ebola sufferers effectively, and the lab testing. Those things are legacies of the UK’s work with Sierra Leone, which means that it is now better placed to deal with this case. I emphasise that as we go through the contact tracing period and the quarantine period for high-risk contact, it is inevitable that further cases may emerge. That is all part of the steady eradication of Ebola, and getting to what is called “resilient zero”. Unfortunately, we do not expect it suddenly to switch off overnight, which is why we were keen to ensure that some of the underlying processes remained, as well as having the right people and surveillance in place to deal with such situations.

The hon. Gentleman asked about WHO reform and the emergency response, and he is right about that. We must ensure that resourcing is funded internationally, to enable the WHO to put into practice the new strategies it is now developing. The UK was one of the initial contributors to a fund that was set up to do that within the WHO, and we are strongly lobbying other countries to join us.

[Jeremy Lefroy (Stafford) (Con)]

Our thoughts are very much with the people of Sierra Leone. The Secretary of State said last July that the United Kingdom will stay the course until Ebola is defeated. Will she confirm that the UK will stay the course until Sierra Leone, in partnership with its Government, has health systems that are as strong as they need to be to tackle such outbreaks—and indeed all other diseases—in future?

[Justine Greening]

We will certainly stay the course, and my hon. Friend will be aware that part of our work with Sierra Leone over a number of years has been to strengthen healthcare systems. That has been vital for Sierra Leone and in the context of this outbreak, because there was a point at which people were extremely concerned about the potential of the disease to arrive here in the UK. It is not just in Sierra Leone’s interest that we do this work; it is in our interest to have a WHO that is able to respond effectively to international health emergencies.

Global Fund to Fight AIDS, TB and Malaria

Jeremy Lefroy Excerpts

Tuesday 12th January 2016 Westminster Hall

[Jeremy Lefroy (Stafford) (Con)]

I thank my right hon. Friend the Member for Arundel and South Downs (Nick Herbert) for his eloquent speech and for setting out the case so strongly. I declare an interest as a trustee of the Liverpool School of Tropical Medicine, and I have previously done work on artemisinin.

The impact of the Global Fund cannot be underestimated. Since its inauguration, we have seen for malaria alone a reduction in deaths of at least 48%, most of them among children. It is largely through the Global Fund that we have seen the possibility of the mass distribution of insecticide-treated bed nets, which cut in half the chances of children catching malaria. The fund has also supported the use of rapid diagnostic tests, which have made rapid diagnosis possible in rural areas for pretty much the first time. Malaria treatment can therefore begin quickly, before the disease has taken hold.

Five hundred and fifteen million treatments for malaria have been provided, largely of the effective artemisinin-based combination therapies, which were previously much too expensive for most people. The Global Fund has without doubt helped to transform the global malaria situation from one that was becoming out of control in sub-Saharan Africa in the 1990s, to the current situation, where we are speaking with some confidence of elimination—indeed, several countries have become malaria-free.

There have, of course, been problems. The misuse of funds and tools—such as bed nets—and poorly implemented programmes have hit the headlines. However, the Global Fund has always taken such problems seriously and taken action to remedy them. The question is whether the fund is the best way to tackle these diseases in future, and if so, what it needs to change to become even more effective. I am certain that it has a vital role to play. As my right hon. Friend the Member for Arundel and South Downs said, one of the strongest arguments is that it funds programmes developed by the affected countries themselves. Aid-funded programmes have often been criticised for being the pet projects of the donors without reference to those who are supposed to benefit. The Global Fund takes the opposite approach.

It is important that the Global Fund looks hard at how it operates. I shall mention very briefly four things that it should look at. First, it could do more to ensure that its programmes are fully integrated into the health systems of the countries that it supports and strengthens. I would have much more to say on that, but there is not enough time. I would be very happy to speak to my hon. Friend the Minister about that on another occasion.

Secondly, the global community needs to consider the case either for a separate fund for neglected tropical diseases or for including such diseases in the work of the Global Fund, with increased funding. Diseases such as lymphatic filariasis, soil-transmitted helminths, trachoma and so on—there are 17 of them in total—affect 1.4 billion people on the planet.

Thirdly, the Global Fund needs to report more regularly and more strongly on the work that it does. I was perplexed that the fund did not respond more strongly to adverse reports in the press last year of malaria bed nets being misused. They were indeed being misused, but it was in only a tiny minority of cases. It is vital that corruption and the diversion of funds are investigated and offenders caught, and the Global Fund does that, as it did in Sierra Leone in 2014. At the same time, it needs constantly to point out just how many lives continue to be saved every year as a result of its work across the three diseases. I would like to see quarterly, not annual, reporting.

Fourthly, the Global Fund needs to keep a very close eye on the fight against resistance to antimalarial drugs and the insecticide on bed nets, and allocate money accordingly. The same goes for multi-drug-resistant TB, which my right hon. Friend the Member for Arundel and South Downs mentioned. If not checked, such resistance threatens the substantial gains made over the past 15 years. The importance of the Global Fund to the battle against malaria cannot be overestimated. We were losing that battle but we are now, I hope, on the winning side.

Syria: Madaya

Jeremy Lefroy Excerpts

Monday 11th January 2016 Commons Chamber

[Justine Greening]

The hon. Lady has set out very clearly just how much work the RAF has done and the challenges of carrying out airdrops in this particular situation. DFID and the MOD have never had a closer working relationship in providing humanitarian support to those who most need it around the world. Whether in tackling Ebola, responding to Typhoon Haiyan in the Philippines or saving the lives of people on Mount Sinjar by dropping water, the MOD, and the RAF in particular, have played a critical role, and I have no doubt that they will continue to do so.

[Jeremy Lefroy (Stafford) (Con)]

I thank the hon. Member for Batley and Spen (Jo Cox) for her urgent question and my right hon. Friend the Secretary of State for her answer and all the work she and her Department are doing 24/7. Will she make it a top priority to send food not just to Madaya but to wherever there is the opportunity to do so? Does this not show the importance of the UN system? Whatever its faults—there have been many—it is the only game in town, and the UK must support it in every way possible and encourage our friends, our allies and indeed the whole world community to do the same.

[Justine Greening]

I agree wholeheartedly. It shows that in such circumstances our main leverage is the existence of a rules-based international system. Human rights are universal. It is occasionally argued at the UN that sovereignty is more important than human rights, but human rights do not depend on where someone is; they are universal and apply to people wherever they are, including in Madaya.

Humanitarian Aid: Refugees in Greece and the Balkans

Jeremy Lefroy Excerpts

Tuesday 3rd November 2015 Commons Chamber

[Justine Greening]

The support we provide is very much driven by the needs set out to us by the agencies and non-governmental organisations with which we work. I can confirm to the hon. Gentleman that we have provided tents—for example, in Croatia—and we are playing our role in helping to make sure that when people arrive at reception centres, they are dealt with and processed properly.

As the right hon. Member for Normanton, Pontefract and Castleford (Yvette Cooper) set out, there is a real issue of scale, and Britain cannot solve that on its own. It is worth emphasising to the House that each of the countries where refugees are arriving is leading the response in that country, so it is up to UN agencies and NGOs to work as part of a national response by each country. As I have set out, Britain is also supporting those countries in order to have an adequate response. As the House has heard, there are real challenges, given the scale of the numbers and the flow of refugees who are arriving on European shores.

The hon. Gentleman talked about the UK taking its fair proportion. The reality is that we can be proud of the work the UK is doing to support refugees affected by the Syrian crisis—whether it is the work we are doing in the Mediterranean to save lives, the thousands of people who have been given asylum already, the approach we now have of relocating people from the camps safely and securely, or the kind of support closer to home that I have set out today. No country in Europe is doing more than the UK, and the House should be proud of that.

[Jeremy Lefroy (Stafford) (Con)]

May I thank the right hon. Member for Normanton, Pontefract and Castleford (Yvette Cooper) for asking this urgent question? I entirely agree with the points she made. May I also thank my right hon. Friend the Secretary of State for all the work that she and my hon. Friend the Under-Secretary of State for Refugees are doing? May I, however, urge the Government to engage directly with the Governments of countries which now have refugees? As winter comes, we cannot allow bureaucracy or any other impediment to get in the way of making direct contact to offer our support to the Governments of Greece and the other Balkan countries to ensure that no lives are lost needlessly.

[Justine Greening]

I can assure my hon. Friend that we are doing just that. The problem he sets out is one we commonly face when we are trying to help any refugees, wherever they are. We only have to look at some of the challenges in Lebanon, where many of the refugees are in so-called informal tented settlements. That means that it has been far harder for us to put in place water and sanitation and to get education to the children in some of those camps than it otherwise would have been compared with the work in Jordan, which, broadly speaking, has been more Government-driven from the word go. We are now facing the issue closer to home on our own shores in Europe. I assure my hon. Friend that we are working with those Governments, while also urging our other European partners to step up to the plate, too.

Oral Answers to Questions

Jeremy Lefroy Excerpts

Wednesday 28th October 2015 Commons Chamber

[Justine Greening]

There are two aspects to tackling climate change. The first, of course, is mitigation, and many developed countries such as the UK have significant plans in place to transition to low carbon economies. The second is adaptation, which is the challenge for many developing countries. It is about how they can ensure that they not only adapt to climate change, which often hits them first, but grow sustainably and develop nevertheless.

[Jeremy Lefroy (Stafford) (Con)]

I congratulate the Department on the excellent work it has done with the Nepali Government over many years on the community forestry programme, which has seen forestation increase in Nepal. Are there lessons to learn from that programme for other areas in which the Department operates?

[Justine Greening]

Yes, I think that the key is to work with the grain of human nature and put in place programmes that allow livelihoods to be more successful and profitable, and that can go hand in hand with protecting and preserving the environment. The programme to which my hon. Friend refers is one of a number that the Department has put in place to ensure that reforestation happens.

Tropical Diseases

Jeremy Lefroy Excerpts

Tuesday 27th October 2015 Westminster Hall

[Jeremy Lefroy (Stafford) (Con)]

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.

[Mr Gregory Campbell (East Londonderry) (DUP)]

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?

[Jeremy Lefroy]

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.

[Graham Stringer (Blackley and Broughton) (Lab)]

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?

[Jeremy Lefroy]

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.

[Mrs Helen Grant (Maidstone and The Weald) (Con)]

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?

--- Later in debate ---

[Jeremy Lefroy]

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.”

[Jim Shannon (Strangford) (DUP)]

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?

[Jeremy Lefroy]

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.

[Bob Stewart (Beckenham) (Con)]

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?

[Jeremy Lefroy]

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.

[Bob Stewart]

I am sorry, but my question was really about the distinction between getting rid of a disease from the face of the earth, so that it is never there again and human beings cannot catch it, and dealing with a disease in a human being.

[Jeremy Lefroy]

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.”

[Several hon. Members rose—]

Sustainable Development Goals

Jeremy Lefroy Excerpts

Thursday 10th September 2015 Commons Chamber

[Jeremy Lefroy (Stafford) (Con)]

I refer Members to my entries in the Register of Members’ Financial Interests. I commend the hon. Member for Glenrothes (Peter Grant) on an extremely thoughtful speech, and thank my hon. and learned Friend the Member for Sleaford and North Hykeham (Stephen Phillips) and the hon. Member for Liverpool, West Derby (Stephen Twigg) for their speeches and for proposing this debate. Indeed, I thank all Members who have spoken.

The millennium development goals have, by and large, been a success. Having lived in Tanzania throughout the 1990s, I saw what was happening in their absence. Malaria—I chair the all-party group on malaria and neglected tropical diseases—was taking a greater toll on people’s lives towards the end of the 1990s than at the beginning of that decade. The same can be said about many other diseases, but the introduction of the millennium development goals led to institutions such as the global fund and the Gates Foundation investing in tackling them. As a result, in the next few weeks we will hear about the tremendous progress made in cutting deaths from malaria by half, saving millions of lives over the past 15 years. Those lives would not have been saved but for the millennium development goals. Let us remember how much has been done through the MDGs.

The SDGs are of course far more ambitious, and I recognise that that raises some problems. The Sermon on the Mount is an incredibly ambitious statement. Every time I read it, I first realise how far I fall short, but at the same time it inspires me to go on to do better. It is the same with the SDGs. Every year, we should pick them up in debates such as this one. We will say, “Yes, we have made progress”, but they will also inspire us to do much better. I hope that the SDGs will do that in each member state that signs up to them. We must not lose ground against the millennium development goals or we will lose heart, as we will if the SDGs are simply not met and, for instance, we go backwards on infectious diseases.

I will mention four SDGs. On goal 3, on healthy lives, I want to echo the point made by the hon. Member for Glasgow North (Patrick Grady) about the need to take a long-term approach. I believe that we must look at incredible challenges, such as the challenge of anti-microbial resistance to drugs, which means that we need to look at the global goods in which we must invest in order to develop antibiotics. That is not a three or a five-year funding programme, but a 20-year funding programme.

When the Select Committee went to Nepal earlier this year, we saw the great results of DFID’s long-term work on afforestation. We must do more on that great long-term project. On goal 3, we must also do much more on the integration of healthcare systems, rather than having the silo mentality that there has been in the past, although it is starting to break down.

Goal 8, on sustained, inclusive and sustainable growth, is absolutely crucial. My hon. Friend the Member for Mid Derbyshire (Pauline Latham) has already mentioned it with specific reference to tourism. Hilton reckons that 70 million jobs may be created globally through tourism in the next 10 years. That will bring very good, high-value employment to countries that need it. We need full, productive employment and decent work for all.

Last night, I had a meeting with a great friend who works in Uganda and the Congo. Mainly as a result of his and his colleagues’ work, although with some support from DFID, he now works with 24,000 farmers in the Democratic Republic of the Congo, one of the poorest countries on earth. They have introduced a cocoa business that now brings tens of millions of dollars into the country and provides livelihoods for tens of thousands of people. That has been developed over the past few years, showing what can be done in the most incredibly difficult and challenging situations.

Goal 13 is on combating climate change and its impact. I had the privilege of walking with my daughter in the Swiss Alps a couple of weeks ago. I walked in the same mountains 35 years ago, when I worked in Switzerland. The glaciers are now less than half what they were then. That is on our doorstep in Switzerland; it is not Kilimanjaro, where I lived for 11 years and could see the glacier almost shrinking before my eyes. Climate change is a reality and, as the hon. Member for Glenrothes said, it is affecting countries such as Bangladesh right now.

Hon. Members have already referred to goal 16, on peaceful and inclusive societies. Without peace and inclusion and without greater equality within societies, we will not see development. I have just mentioned the Congo, and it is rare that there is development in the absence of peace; it takes much more effort.

I again want to mention Tanzania, where I had the pleasure to live. With the exception of the short war with Uganda, it has by and large been at peace since independence in 1961. Very few Tanzanians seek refuge elsewhere, because they want to stay in Tanzania, which is a peaceful and largely well-governed country. It is a poor country, but people want to stay there. Goal 16 is therefore absolutely crucial.

I again thank hon. Members for giving us the opportunity to discuss the SDGs today, but we must revisit them in detail every year so that we can be challenged and see where we have fallen short.