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7.44 pm

The Parliamentary Under-Secretary of State for International Development (Mr. Gareth Thomas): May I take this opportunity to congratulate my hon. Friend the Member for Putney (Mr. Colman) on securing this debate. He is an assiduous member of the International Development Committee and is also assiduous in promoting the interests of his constituents and of those who serve his constituents. In that sense, I, too, want to congratulate Professor Khrishna of St. George's hospital, and the team who work with him, on their recent success in identifying how artemisinin works.

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Scientists have been trying to understand that since the 1970s, so the breakthrough of Professor Khrishna's team is particularly significant. As my hon. Friend mentioned, following their breakthrough, the team are now looking at how they can take forward their research to improve the treatment of malaria, to look at other drugs, and to anticipate how resistance to malaria develops.

My hon. Friend alluded to the fact that, despite more than 50 years of malaria control programmes, millions of people, particularly children, still die from it. It kills more than 3,000 children per day—more than 1 million per year—and 90 per cent. of those dying are in Africa. The millennium development goals represent a shared global ambition to address such challenges and to improve the well-being and life chances of the world's poorest citizens. My hon. Friend will know that the sixth of those millennium development goals is that by 2015 we should have halted and begun to reverse the spread of HIV/AIDS and the incidence of malaria and other major diseases. He will also know that the fourth goal contains a target to reduce the under-five mortality rate by two thirds between 1990 and 2015. Alongside the target to reduce maternal mortality, that is the one that is proving hardest to achieve.

On current trends, sub-Saharan Africa will not meet its poverty or its health millennium development goal targets, with deaths from malaria playing a huge part in that. With up to 80 per cent. resistance in some parts of Africa to chloroquine, the most widely available cheap anti-malarial drug, new approaches are needed, and they are needed fast. In addition to the wider use of insecticide-treated bed nets, new approaches to preventing death from malaria may have the single biggest impact in preventing unnecessary deaths. Other big improvements would come from routine immunisation and the introduction of new vaccines, but as my hon. Friend said, a new vaccine for malaria is still many years away. Therefore, new, good quality medicines are needed, which are accessible by poor people at affordable prices.

The Government take that challenge particularly seriously. Following the May 2001 performance and innovation unit report on tackling diseases of poverty, the Prime Minister convened a high-level working group on increasing access to essential medicines in the developing world, which was chaired by the former Secretary of State, my right hon. Friend the Member for Birmingham, Ladywood (Clare Short). Reporting in November 2002, the group recommended that the Government should consider policies to increase the level of UK research and development on essential medicines for poor people in the developing world.

To take that work further forward, my Department has established a dedicated team of officials to work on access to medicines. It is also a key priority for other staff in my Department, not least our international policy department, and crucially, given the focus of my hon. Friend's debate, our research department. Given the obvious interest of other Departments across Whitehall, we work closely on this issue with the Treasury, the Department of Health, the Department of Trade and Industry and the Patent Office.

At a global level, there have been some recent international successes—for example, at the G8 summit in Evian in 2003. As with many diseases that primarily

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affect poor people in developing countries, however, research and development on malaria suffers from more structural problems, as an insufficiently valuable market exists to attract private sector companies to undertake research. Although there is a so-called travellers market for anti-malarials, it is too small to offset the larger investments that are needed to bring a new drug to market: typically, we estimate that an investment of $200 million to $300 million is required to bring new drugs to market.

Clearly, that leaves a variety of public policy options for the Government to adopt to speed up the process of developing new anti-malarial treatments. They range across advocacy on the need for new and better medicines, strongly co-ordinated international strategy and policy on the need for pro-poor research investments, direct investment in research and development, and effective measures to create greater demand for the new drugs so that an incentive is created for the private sector to invest.

My Department already has a portfolio of work supporting malaria research and development. We are prioritising our research efforts as we review our strategy to address the millennium development goals in our new central research strategy, which is due to be announced in the first quarter of this year. Malaria and anti-malarial work will be a focus of that strategy.

We always seek to promote an internationally coherent approach. We were instrumental in establishing the Roll Back Malaria Partnership to secure global steerage. My Department has given the partnership some £48 million over four years, and we have inputs into its strategy in order to develop an effective relationship between the Roll Back Malaria Partnership, the global fund and the World Health Organisation, as well as the other research agencies, academia, private sector groups, foundations and so forth with which the partnership works.

We firmly believe that there should be a strong relationship between poverty-focused control activities and poverty-focused research and development strategies. My hon. Friend mentioned the link between the two.

We make direct investments in research and development that benefit malaria treatment in several ways. Each year we give some £4 million to the Medical Research Council, in a concordat that prioritises the needs of developing countries in the research selection process. Within the overall MRC portfolio, the focus on basic clinical research that can be used to identify new drug candidates includes malaria.

The Department also has experience of engaging more directly in partnerships with industry to take the kind of research produced by the MRC and turn it into drugs that can be used where they are needed most. Most recently we have formed a partnership with GlaxoSmithKline, the WHO programme on tropical diseases research and Liverpool university to develop a cheap new drug called Lapdap, which my hon. Friend mentioned. To ensure the best possible use of that drug, further research to combine it with another drug to protect against early resistance is being undertaken, managed under an umbrella organisation called the Medicines for Malaria Venture, which my hon. Friend also mentioned and which my Department supports.

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MMV is an important and innovative organisation, which brings together collaborators from the public and private sectors and from foundations to solve the market failure problem that I described earlier. It adopts a new approach to drug development, which creates a virtual process of research and development, and manages intellectual property in favour of developing countries. Since its inception in 1999, it has demonstrated significant progress towards reaching its objective of two new drugs in the next two years. My hon. Friend asked about the resources that my Department is giving to MMV. I can confirm that we are committed to giving it some £5 million over five years.

I mentioned the review of our research strategy; it is worth reminding the House of that. The most expensive phase of drug development is large-scale field trials in humans—phase 3 trials. To raise public finance to support those trials the Government, led by the MRC, are a contributing partner in the new European venture called the European and Developing Countries Clinical Trials Partnership. Launched in mid-2003, the partnership brings together EU member states, developing countries, other donors and the industry. It is one of the main achievements of the European programme for action on HIV, tuberculosis and malaria, and is the largest programme of clinical trials ever targeted on Africa. I think it is a powerful example of the co-operation that can be achieved through the European Union.

Once new drugs are available, it is important to monitor their uptake in target populations. My Department has two programmes that undertake applied and operational research on malaria in African, Asian and Latin American countries. Those focus on making sure that medicines work as they are intended to in real-life situations in developing countries, as well as investigating aspects such as compliance. That is in order to turn the availability of medicines into true access and true health gain in the countries that need it most.

The Government are also using other more indirect methods to stimulate research, such as contributing to the global fund for HIV, TB and malaria. Global funds help to stimulate research by creating a "pull effect". They pull new research into being by guaranteeing larger amounts of finance to procure new medicines when they are developed.

I am sure that my hon. Friend will remember that the Government are implementing the research and development tax credits that were announced in the

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2002 Budget. That special tax relief for companies developing drugs and medicines for TB, malaria and HIV/AIDS applies to all expenditure incurred on or after 22 April last year. As companies make claims when they complete their tax returns, they will have up to 12 months after the end of the accounting period in question to claim the tax credit. We are monitoring how successful the tax credit is in stimulating research and development into drugs for malaria, which obviously helps those most in need—in this case, the poorest in Africa, where malaria is most prevalent.

My hon. Friend alluded to specific issues, such as the prevention and treatment of malaria in the UK. He is right to point out that the NHS does not cover the costs of preventive anti-malarials, impregnated bed nets, sprays or drugs, because the mosquitoes that transmit the disease are not endemic in the UK. A person infected overseas is not, on return, infectious, so there is no public health risk. The NHS does cover the cost of care and treatment for those infected once they are at home. In comparison, the Department of Health pays for hepatitis A, polio, tetanus and typhoid, which are much more infectious when people return.

The Government also take action to try to make people aware of the risks of malaria by providing accurate and up-to-date travel advice. The Foreign and Commonwealth Office has a section on its website for advice "before you go", which includes travel tips and health advice. The health section advises foreign travellers to access the Department of Health website and provides a direct link to the correct site for advice on malaria. That advice provides a list of countries where malaria is endemic, offers guidance on how to protect against malaria and on the value of discussing anti-malarial measures with doctors and encourages people to seek medical attention immediately if they feel feverish while abroad or for up to three months after their return. Travel agencies in the UK are also obliged to give advice to travellers. The Association of British Travel Agents also provides a telephone hotline service. My hon. Friend is right that more needs to be done, as we cannot relax simply because we advise people to take the appropriate precautions. The debate is helpful in stimulating awareness in that respect.

I congratulate my hon. Friend once again on raising this matter. I know that he will continue to return to it in the coming months. I look forward to debating with him and discussing with other interested colleagues what further action we can take to make the treatment of malaria and prevention of its spread more achievable.

Question put and agreed to.


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