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Column Number: 003
European Standing
Committee B
Wednesday 16 July 2003
[Mr. John McWilliam in the Chair]
Action on the Three
Major Communicable Diseases
[Relevant Document: European Union Document No. 7115/03.]
2.8 pm
The Parliamentary Under-Secretary of State for International Development (Mr. Gareth Thomas): Mr. McWilliam, it is a privilege to serve under your chairmanship for the first time in my current ministerial capacity. Given the massed ranks in front of me, I am particularly appreciative of the fact that a Celt is watching over the Committee. I am grateful for the opportunity to discuss the issues reflected in the European Commission programme for action on HIV/AIDS, malaria and tuberculosis. The programme is wide-ranging; it encompasses action across the development, trade and research agendas. It will make a huge contribution to global efforts to improve health and reduce poverty.
The programme guides accelerated European Commission action throughout three broad areas. It links country efforts to reduce the impact of the three diseases with wider European Union and global action to increase affordability of key pharmaceuticals and to scale up research and development of new generations of health commodities, such as vaccines and drugs. The programme of action should be seen as part of a scaled-up international effort.
The first programme area is an attempt to increase the impact of proven, effective interventions by rolling out, on an unprecedented scale, a massively increased level of investment in education and training, in behaviour change programmes, in improving access to sexual health services, in providing impregnated bed nets and in expanding new, effective approaches to tuberculosis treatment.
Much recent attention has focused on AIDS and the imperative to increase access to antiretroviral drug treatment. However, we must not lose sight of the availability of effective and often low-cost interventions to prevent and/or treat TB and malaria.
Secondly, we must try to increase the affordability of key pharmaceuticals. That requires action on trade and intellectual property. The agenda has been driven by pressure to increase access to antiretroviral treatment, but the principles will also apply to new generations of high-cost TB and malaria drugs.
Thirdly, we should step up efforts to encourage the research and development of specific global public goods such as new knowledge, new drugs, diagnostic treatments and vaccines, which are all necessary to meet current and future challenges. The standard drugs for treating TB are 50 years old; the only vaccine is some 100 years old. The programme proposes to build more effective and collaborative research efforts
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across the European Union, and to provide greater investment in building the research capacity of developing countries.
To be blunt, progress in implementing the programme has been mixed; there has been limited achievement in increasing impact at country level. The prioritisation of policy has not yet been matched by appropriate shifts in resources. For example, health aid only accounts for 3.3 per cent. of total European Commission development aid. European Commission spending on social infrastructure is rising slowly; there have been some significant increases recently. The proposed regulation on poverty diseases will provide a threefold increase in resources directed at those issues. Significant European Commission funds are being channelled through the global fund to fight AIDS, TB and malaria, which can be expected to have a major impact.
The work on affordability has been productive. The discussions on trade-related aspects of intellectual property rights and public health at the World Trade Organisation have led to an acceptance that public health concerns can override patents, and that countries can issue compulsory licences in emergency public health situations. There has been progress on untying European Commission aid and on studying the impact of tariffs on drug prices. The research framework programmes have allocated substantial funds to work on the three diseases. That work includes the establishment of a partnership to provide a single voice for the European Union research effort. That is very much a long-term agenda, but it promises a more collaborative approach.
The European Commission has undoubtedly helped to shape international agendas. It has made a substantial contribution to the establishment of the global fund to fight HIV/AIDS, TB and malaria and to the work of other relevant international health partnerships, such as the Global Alliance for Vaccines and Immunisation and the international AIDS vaccine initiative. The European Commission has engaged in a wide range of activities, and we must be aware of the risk of overstretch. In particular, the Commission needs to avoid duplication of the work of the World Health Organisation and other agencies.
The document that we are debating is a progress report. There are no legal or procedural matters of concern, and the Government welcome the update. Its approach is broadly in line with that of the United Kingdom. We continue to work closely with the European Commission on a range of agendas, including the efforts to shape the global fund and to improve access to medicines. The Secretary of State for International Development is in Paris today discussing those issues.
There remain challenges ahead in each of the three areas of work that the programme flags up: first, to demonstrate further early impact at the country level, and to make the most effective and best use of the available, increased resources; secondly, to put into practice the differential pricing concept and gain wider support from the pharmaceutical sector for that agenda; and finally, to use appropriate incentives to
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stimulate research and development into the three diseases.
The Chairman: We now have until eight minutes past 3 o'clock for questions, when I shall call the Minister to move the motion, if questions last that long.
Mr. Andrew Robathan (Blaby): Mr. McWilliam, it is a delight to be here under your illustrious chairmanship. This document addresses a serious issue on which there is little blue water between us—if I can use that term. Does the Minister think that the European Union is doing enough to match the US$15 billion pledge by the United States to the world fight against AIDS?
Mr. Thomas: With respect, I think it is red water that lies between us. I do not want to take the Committee down a partisan route, but I shall flag up the differences between our attitude and that of the Conservative Government to development spending.
On the hon. Gentleman's specific question about whether the European Union is doing enough, we must treat with caution what has been said about the American contribution to the global fund, and acknowledge that, although President Bush has committed up to a £1 billion for the global fund, ultimately the decisions remain in the hands of the congressional appropriation committees. We must watch carefully to see how much they allocate in practice. The European Union has allocated more than half the money that has been pledged to the global fund. The United Kingdom has allocated some $200 million at the outset of the global fund—the period from 2002 to 2006. Most recently, we allocated a further $80 million for the two years beyond the initial period.
Mr. Kelvin Hopkins (Luton, North): I am pleased to see my hon. Friend the Minister in his place, and I congratulate him on his promotion. This is my first opportunity to congratulate him formally.
Concern has been expressed in this Committee and elsewhere in the Department for International Development that providing aid through the European Union is inefficient, and much less efficient than providing it through our Government and possibly through others. Will the Minister comment on whether we could do some things better at a national level, rather than pursue them through the EU?
Mr. Thomas: We have to have a twin-track approach. I acknowledge my hon. Friend's long-standing interest in these issues. He is right to suggest that my Department and the Government more generally have had concerns about the way in which European Commission aid is distributed. We welcome the reforms that have been implemented, especially the speeding up of aid distribution. It is fair to say that further work needs to be done to ensure that aid is allocated in the most effective fashion.
Significant progress has been made: for example, there is greater devolved responsibility to European Commission delegations in countries. As I have said, the rate of dishing out funding has been stepped up.
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However, my hon. Friend is right to acknowledge that there is work to do. The Government shall continue to press for the European Commission to modernise its procedures.
Mr. Robathan: I am delighted about that. Although the Minister has tried to make this a partisan issue, I do not think that it is—at least, I hope it is not. Can the Minister explain how the large proportion of EU aid spent in Poland and other accession countries contributes to what is possibly the worst health crisis facing the world, namely HIV/AIDS in southern Africa?
Mr. Thomas: The hon. Gentleman should recognise that the aid that the European Commission gave Poland was intended to help it in its accession to the Commission. As it has made progress, the aid will inevitably decrease, and I hope that there will be a greater focus of European Commission aid on low-income countries. That was one of the key messages that we wanted to get across to the Commission.
Mr. Hopkins: The European Scrutiny Committee has asked the Committee a number of questions. I shall draw attention to one or two of them, and ask my hon. Friend the Minister to elaborate on them a little. First, the European Scrutiny Committee asks why the programme has been so slow to have an impact, and asks what lessons have been, or should have been, learned.
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