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Westminster Hall

Tuesday 27 October 2015

[Geraint Davies in the Chair]

Tropical Diseases

9.30 am

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.

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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.

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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?

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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.”

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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.

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“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 Economistdiscussed 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.

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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

Geraint Davies (in the Chair): Order. Before I call Kate Osamor, if Members restrict their speeches to five or six minutes, we should have time for everyone who wants to speak. There is no formal time limit at this point.

9.54 am

Kate Osamor (Edmonton) (Lab/Co-op): It is a pleasure to serve under your chairmanship, Mr Davies. I thank the hon. Member for Stafford (Jeremy Lefroy) for securing this debate.

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I am glad that we have the opportunity to draw attention to this important issue, about which, as a British-born Nigerian, I feel passionately. According to statistics published by the US Government to coincide with this year’s World Malaria Day, Nigeria has the highest number of malaria casualties worldwide, with an estimated 100 million cases and around 300,000 deaths each year.

The debate is particularly timely given the recent announcement that the roll-out of the world’s first malaria vaccine has been delayed as experts at the World Health Organisation have urged caution. The vaccine requires four doses, and without all four shots children had no overall reduction in severe malaria. That raises important questions about access to healthcare and how less developed countries will be able to administer the four vaccines. It also highlights the disparity in access to healthcare across the world and the more general need to address the issue in order to tackle infectious diseases most effectively. After all, access to healthcare is a human right.

I have been encouraged to see the progress that has been made in tackling malaria. Malaria No More UK states that malaria prevention returns £36 to society for every £1 invested. It is important to note that according to a recent WHO report, carried out jointly with UNICEF, malaria death rates have dropped by 60% since 2000, saving 6 million lives. The number of children under five sleeping under insecticide-treated nets has risen from 2% to 68%. Thirteen countries that had malaria in 2000 no longer have any cases of the disease. That shows that, with funding from the international community, there is hope that malaria, one of the biggest killers at the turn of the millennium, could be eradicated.

Progress must continue to be made. This year alone there have been an estimated 214 million new cases of malaria, with more than 400,000 deaths. Two forms of resistance are threatening to undo the progress that is being made: in south-east Asia, the malaria parasite is able to shrug off the effects of the drug artemisinin; and some mosquitos are becoming resistant to the drugs used to coat the nets. That must be looked into.

Mrs Helen Grant: The hon. Lady is making a really good case. Does she believe that the lack of both adequately trained doctors and health networks is also worrying?

Kate Osamor: That is an important point. We need to invest in the healthcare profession so that this significant and costly disease can be eradicated.

I welcome the fact that the Department for International Development has pledged up to £500 million a year towards tackling malaria. Eliminating malaria is a global effort that involves work from the grass-roots and aid on international and governmental levels. There is still a lot of work to be done and I hope that the UK will continue to lead the way in the fight to end this disease.

9.58 am

Pauline Latham (Mid Derbyshire) (Con): It is a pleasure to serve under your chairmanship for the first time, Mr Davies. I thank my hon. Friend the Member for Stafford (Jeremy Lefroy) for securing this debate on a topic that is very close to my heart. Although I am going to focus on malaria, we must not forget the

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many neglected tropical diseases that my hon. Friend outlined. He and I have worked closely on international development issues for a number of years, as well as in the all-party group on malaria and neglected tropical diseases. We expect to continue that work during this Parliament.

It is clear that the work the UK is doing to tackle malaria is having a huge effect. Through a mixture of UK aid, British business, British-led research and non-governmental organisations, the UK has contributed to reducing the global malaria death rate by 60% since 2000. In the previous Parliament, the UK acted in a number of ways to tackle malaria and other diseases, as my hon. Friend outlined. Our financial and political support for the Global Fund to Fight AIDS, Tuberculosis and Malaria, our support for the Gates Foundation’s efforts to eliminate malaria, our work mapping malaria to establish high-risk areas to focus on, and our bilateral work on helping in-country healthcare systems to respond effectively to malaria and other diseases have all had a real, positive effect.

Although we can be proud of our contribution to tackling malaria and other tropical diseases, we must not become complacent or slow down our efforts. If we do, we risk reversing our momentum. Despite all the progress that has been made, malaria remains a substantial global killer, and women and children still overwhelmingly feel its effects. I could say an awful lot about the fact that women and children are disproportionately affected because they cannot access medicines or get to the clinics easily. Children who do not go to school because they have got malaria have worse life chances than those who go to school all the time.

Given the limited time available, I will focus on the situation in Uganda, a country I have focused on for many years and have a real interest in. Access to medical care to treat malaria and other diseases is poor in areas such as rural northern Uganda. Women and girls are even poorer there. I recently had a meeting with Alison Hall, the founder of Seeds for Development, to discuss the urgent situation in northern Uganda, where there is a major malaria outbreak. Her charity has been on the ground in northern Uganda working with farming communities to help rebuild their lives after the 20-year war with the Lord’s Resistance Army. She has been there for about six years. Three of the districts the charity works in are among those affected by the malaria outbreak. The Department should look immediately at the situation she described to assess whether there is anything we can or should be doing to help.

In the middle of July, Dr Jane Ruth Aceng, the director general of health services in Uganda, admitted that tens of thousands in northern Uganda have recently contracted the disease. Many people cannot afford to travel the long distances required to get to the hospital, and those who do are overwhelming the services due to the outbreak. One hospital—Gulu general hospital in the Gulu district of northern Uganda, which Seeds for Development visited to assess how patients are being treated—padlocks shut its outpatients department at 4 pm, leaves patients outside the door and provides nowhere for them to be treated inside. The charity was also told that St Joseph’s hospital in Kitgum, which is supported by DFID, recorded 125 deaths from malaria between June and August, which is much higher than normal. That is just one hospital, not the true picture.

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Clinics had run out of drugs, and new supplies were taking a long time to arrive. In August, there had not been a delivery of drugs for a month.

We need to look urgently at the situation in northern Uganda to establish the facts and act on them. In particular, I am worried about the lack of access to treated mosquito nets in northern Uganda. We provide financial assistance to the Ugandan Government to provide nets, so why are families in the region not receiving them? I understand that the Ugandan Government stopped its indoor residual spraying of huts programme in 2014. That one act alone will increase the risk of malaria. If the local people get nets, do they know how to use them? Nets often go astray—they are used for fishing and all sorts of other activities—so there has to be an education programme to teach people how to use them. It is very important that women and children sleep under the nets to save their lives. That important issue has been highlighted as among the causes of the current outbreak in northern Uganda.

The UK has a huge amount to be proud of in the way we have taken a lead on combating malaria. We know that the return on investment in tackling malaria is well established and accepted by the Government. However, we alone cannot defeat malaria. It requires a global effort, financially and politically supported by Governments around the world, including those of the countries affected. A lot has been done, but the outbreak in northern Uganda, where hundreds if not thousands have died this year alone, shows that we must not become complacent. I hope the Minister will explain what DFID is doing to help those affected in that region. I understand that DFID acts responsibly in many areas of Uganda, but that area seems to have been neglected, and I would like to know what the Minister can tell us about what is happening.

10.4 am

Mr Virendra Sharma (Ealing, Southall) (Lab): It is a pleasure to serve under your chairmanship, Mr Davies. I congratulate the hon. Member for Stafford (Jeremy Lefroy) on securing this important debate at the right time.

Since I first entered Parliament in 2007, I have been committed to development and healthcare issues. As a boy growing up in India, I saw the debilitating effects of malaria and parasites such as hookworm. Such conditions are not blind; they affect the very poorest in society. Developing nations face a competitive disadvantage. The west and the more developed nations have mostly eradicated such debilitating, but not necessarily life-threatening, diseases, but the countries with the greatest need often lack even the most basic tools for curing neglected tropical diseases.

I was proud to be in New York last month with four of my colleagues here in the Chamber for the global launch of the sustainable development goals. I pledge my support to two goals in particular: goal 3, on health and wellbeing for all people; and goal 5, on achieving gender equality and empowering all women and girls.

The UK currently invests £536 million in eliminating malaria. The Department for International Development has much to be proud of, but neglected tropical disease funding is being reassessed at the end of this year. NTD funding has to be protected and, as the hon. Member

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for Mid Derbyshire (Pauline Latham) said, increased where possible. If there is not a predominantly decent level of health across the globe, how can the world face the challenges of the 21st century? Speaking selfishly, if we meet global malaria targets by 2030, we will not only have saved more than 10 million lives but increased global economic output by $4 trillion. That represents a huge new market for British goods, manufacturing and know-how.

Some 44 million households worldwide, representing more than 150 million people, face catastrophic healthcare costs that can cripple them financially. If we can prevent such cruel, horrible diseases from developing, we can free millions of women and girls from lives of servitude when they have to care for sick and ill family members. They will be able to go to school, receive an education and be fully equipped to participate as full members of our society. The life-changing effect of the drugs we support can be immense, and the cost can be just a few pence. The burden of NTDs and malaria traps so many in a spiral of debt, sickness and poverty. We have much to offer, having gained so much ourselves, but although we have done so much, there is much left to do. I hope that by 2050 people will no longer be trapped in poverty spirals driven by sickness. Hopefully, we will help them to become full members of society.

I support the questions put by the hon. Member for Stafford to the Minister. If the Minister can answer all those questions, it will not only satisfy people but give confidence to wider society that the Government are committed to what they have already paid for.

10.9 am

Fiona Bruce (Congleton) (Con): I congratulate my hon. Friend the Member for Stafford (Jeremy Lefroy) on an excellent speech, not least because of his impressive articulation of so many technical terms, which left many of us in awe. I also acknowledge his equally effective leadership of the all-party parliamentary group on malaria and neglected tropical diseases, which over the previous Parliament and continuing into this one has gathered together many of those involved in research and its practical application, seeking to resolve the challenges that he spoke of and to find solutions to the still deeply concerning impact of malaria and other neglected tropical diseases across the world.

I acknowledge the Department for International Development’s considerable contribution over the past several years and the achievements secured thus far, not least because the constructive partnership working that my hon. Friend mentioned is being so effective in contributing to the improvements that have been made. There is still a long way to go, however. My hon. Friend spoke of the importance of increasing funding for drug discovery, and I want in particular to speak about early-stage drug development funding.

As I said, the all-party parliamentary group has gathered together a number of thinkers at the forefront of this issue, one of whom is Professor Alister Craig from the Liverpool School of Tropical Medicine, who visited us last week. He is a lifelong researcher into the biology of diseases and has several suggestions that could make the funding that goes into this area even

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more effective. I hope the Minister will take those suggestions away. Professor Craig speaks of the weighting system of the research excellence framework, which is a method of addressing the research of British higher education institutions that can impact on the grant funding received. Professor Craig says that the current UK system is well suited to recognising the researching and developing of drugs that have an ultimate commercial home in western markets—that is to say that the cost of their development will be recouped by pharmaceutical companies. In practice, that can mean that the research excellence framework prioritises pure academic and perhaps more theoretical research over more iterative drug development processes. Drug development, particularly at an early stage, can be under-recognised as a result. Framework points can be accrued through the demonstration of excellence in academia more than through a demonstration of excellence in drug development. That is particularly concerning for the development of drugs for NTDs, because it can be seven to 10 years before apparent progress is made, but unless that work is done, no progress will ever be made.

While the system makes sense for the majority of the UK market, where a commercial operator will put in money to turn academic research into a product that ends up on the market, it can be difficult for grant money to get to development stage research into tropical diseases. Such research is often left under-resourced without a commercial developer to inject cash. In the next review of the research excellent framework, is the Minister prepared to consider measures that would allow drug developers to demonstrate the excellence of their research? We could perhaps consider the matter at a future meeting of the APPG, to which Ministers were generous in giving their time in the previous Parliament, so that the issue can be discussed with the experts in this field.

There is a clear disparity in the funding here. Successful research is rightly rewarded with drug development, but the drugs being developed only have a 0.3% chance of turning out to be an effective and available product. Much development work gets us closer to a final answer while not producing a solution or product. That valuable work—we could perhaps call them useful failures—could be better understood by review panels to give it more recognition.

For example, a number of malaria vaccines did not result in in a marketable vaccine, but each new research stage and trial contributed to the accumulation of knowledge and is valuable in the chain of research that will eventually lead to an effective malaria vaccine. If useful failures could be better understood and identified, that would be helpful. However, funding agencies and review panels are often heavily represented by individuals from the academic sphere of pharmaceuticals and less so by those from the development field. The Government have the power to set expectations about the mix of backgrounds on such panels, but will the Minister consider the balance between those from academia and those from product development?

DFID’s funding has been enormously effective over the past few years, but will DFID look particularly at targeting at early-stage NTD drug development? The purpose would be to support long-term development work from groups that have a deep understanding of NTD challenges. Money is put into development, but it

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is often directed, even by DFID, towards picking up drugs that are already at an advanced stage of development, leaving early-stage drugs desperately under-resourced. It is particularly important that Government consider that because private foundations and NGOs often want to invest where they can get the biggest bang for their buck and where they can see an early-course impact.

Research in the UK into tropical diseases has been effective, and research into river blindness, as mentioned by my hon. Friend the Member for Stafford, is a good example. For Members’ information, river blindness is a parasitic infection that is spread through the bites of black flies. It often leads to permanent blindness, and millions of people in central Africa and Latin America are at risk of infection. In some west African communities, 50% of the men over 40 had been blinded by the disease. UK research discovered that the parasitic worms could be stopped by attacking bacteria inside the worm as it was much easier to kill the bacteria than the worm. Millions of people are still benefiting from that discovery, which is a great example of UK research benefiting the lives of many. Such strides take time, however, which is why it is important for us to invest in early-stage drug development to make progress as quickly as possible.

I thank Professor Craig for his engagement with the APPG and for his particularly constructive comments. He says that it is not that the UK is not doing this work, but rather that more could be done. We could do more and could do it even more effectively.

10.18 am

Mark Durkan (Foyle) (SDLP): It is a pleasure to serve under your chairmanship this morning, Mr Davies. Like others, I commend the hon. Member for Stafford (Jeremy Lefroy) on securing this debate and on the helpful way in which he set out the terms of the debate, which was helpful not least because, as the hon. Member for Congleton (Fiona Bruce) said, he covered all the technical terms and jargon, meaning that none of the rest of us has to go over those hurdles. I also pay tribute to the hon. Member for Stafford for his steadfast and sterling work as the chairman of the all-party parliamentary group on malaria and neglected tropical diseases. I try to attend the group’s meetings as often as I can, and I appreciate not only the quality of his work, but the calibre of the evidence and engagement that is brought to the group, which powerfully demonstrates the range of commitment of a number of charities and campaign groups. We have also heard directly from companies, not only about the quality of the work and their research, but about the commitment that they have been prepared to make on things such as price sensitivity. We have also been able to see and hear how important the work of DFID is and about its various partners in the NGO sector, and internationally and multilaterally.

The rate of progress and advance highlighted by the hon. Member for Stafford in his introduction in many ways proves the power of marshalled will when we have multilateral actions and well defined global goals. For some it is fashionable to knock such initiatives, but seeing real success against declared goals should incentivise us to do more and to go further. As the hon. Gentleman said, when we might still be looking at 450,000 or more children dying from malaria and neglected tropical diseases, we clearly need to do more.

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This is a time for renewed commitment, rather than complacency about the challenges. Tackling malaria and neglected tropical diseases will be key to achieving the sustainable development goals, especially the health goal, the realisation of universal health coverage and the reduction in maternal and child mortality. Achievement of the global malaria targets by 2030 will mean more than 10 million lives saved, giving all that added productivity, releasing all that quality of life and increasing economic activity.

The UK should be seen to be prioritising sustainable development goal 3. We should therefore sustain and, I hope, increase the annual investment—£536 million at present—to achieve malaria elimination. The UK’s malaria and reproductive health framework for results will run out this year, so we need a renewed vision and a new plan for the UK’s contribution to global efforts towards elimination.

DFID has the credibility, so it should be seen to ensure that SDG 3 is more articulate about neglected tropical diseases by using its own working indicator on the number of people requiring interventions against neglected tropical diseases by 2030. Furthermore, we should heed the caution of the hon. Gentleman about silo approaches, which are understandable in the face of so many difficult challenges and so many pressures, but it is vital that we do not miss the opportunity to use disease-specific vertical programmes for other diseases and other health challenges to contribute towards the defeat of other diseases. It is therefore important for the UK to continue to fund bilateral, disease-specific programmes if we are to sustain the gains that have been made.

There has already been some discussion of “elimination” or “eradication”. It is important whether we use and how we qualify such terms and the differences between them. The goal is, in essence, one of emancipation. When we achieve elimination or eradication, we will have conquered a disease, with all the ravages that it can bring, including death, disability or diverting the life opportunities of those who have to care for the sufferers—women and children in poor countries are affected in particular. At the same time we will need to remember that malaria and neglected tropical diseases are not only a face of poverty, but a force for poverty, not least in their impact on women and children.

We need to see the whole effort as one of emancipation, creating alternatives for people—not only lives no longer lost, but lives that can be better lived and more fulfillingly expressed through economic contribution and in public life. That is why it is so timely that the hon. Member for Stafford has secured the debate and that is why it is so important that we encourage the Minister and everyone he works with in DFID to do everything that they can.

Geraint Davies (in the Chair): I was hoping to get two speakers in before 10.30 am, but I know that will be rather difficult.

10.25 am

David Mackintosh (Northampton South) (Con): I am grateful to my hon. Friend the Member for Stafford (Jeremy Lefroy) for arranging for the debate and I support his view that this is a critical time for tackling tropical diseases. I will talk specifically about leprosy,

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which, along with the other neglected tropical diseases that we have heard about, is preventable and treatable, although it needs to be caught early to avoid complications, side effects or disfigurement.

Last month I visited Bangladesh and met with workers from the Leprosy Mission and people suffering from the disease. We visited Vasantek, on the outskirts of Dhaka, where I met Soloma Akter, a 58-year-old widow who used to live in Boroalgapa village with her son Azizul Haque, who is a rickshaw puller, and his family. Soloma had dismissed the patch on her left arm as “nothing” when it first appeared. When she developed an ulcer on her right foot, her son took her to the hospital, but the doctors failed to diagnose leprosy. She subsequently lost three toes. A few months before my visit, staff from the Dhaka Leprosy Control Project saw her begging on the street. They recognised her symptoms and brought her to the Vasantek clinic, where she is now receiving treatment. Earlier diagnosis and medical treatment would have helped Soloma to keep her toes. There are many more stories like hers.

I also visited a self-help group in the nearby Bashantek slums, where most people who received early treatment and therefore escaped disability now look out for others with symptoms and bring them to the clinic for treatment. One man who had lost all his fingers and toes spoke passionately through the translator about how he now knew and recognised the signs and had spotted them in three other people, who had since been diagnosed and treated.

Dr Tania Mathias (Twickenham) (Con): I have worked with leprosy in different countries and different continents. Does my hon. Friend agree that disability is 100% preventable and that the UK can lead by ensuring that Governments have proper data collection of every single disability case in leprosy?

David Mackintosh: I agree with my hon. Friend.

I have to confess that that was the first time that I had met people with leprosy, and I was not sure what to expect when I walked into the clinic. I saw people who had lost their toes, sitting with their feet in buckets to clean and hydrate their feet. I was nervous about how I would react, but I wanted to shake their hands to dispel the myth about catching leprosy by touch. But it was fine: my reaction was human, and we all saw how vulnerable these people were, but we also saw the best of humanity—the selflessness of the people caring for them, the local doctors and the people from the Leprosy Mission.

I am pleased that over the past 20 years more than 14 million leprosy patients have been cured throughout the world, and the prevalence rate of the disease has dropped by 90%. Almost all new leprosy cases are now reported from only 14 countries. In order to reach all patients, leprosy treatment, as with treatment of other neglected tropical diseases, needs to be fully integrated into general health services. Education and awareness must remain a priority. As I saw, when people know the signs and symptoms and see the effects, they become advocates for seeking help and themselves help to save many people from similar suffering.

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We also need political commitment in countries with the problem, so that leprosy and other neglected tropical diseases remain a public health priority and so that we break down the age-old stigmas attached to these diseases.

Wendy Morton (Aldridge-Brownhills) (Con): Does my hon. Friend agree that although the global goals give us a greater focus—one of them concerns preventable NTDs and malaria—the focus must now be on all countries buying into the process and into the collection of robust data, which can be shared and used to further the agenda?

David Mackintosh: I agree with my hon. Friend.

The UK Government clearly recognise the importance of neglected tropical diseases. DFID hosted and was a signatory to the London declaration, and it has been championing the issue of neglected tropical diseases on the global stage. In June during the G7 meeting in Germany, the UK Government reiterated their commitment to tackling neglected tropical diseases. The UK needs to commit to continuing to lead on such an important issue and to ensure that at the UN stats meetings, when the indicators are discussed over the next few months, it continues to push for the inclusion of the proposed indicator on neglected tropical diseases, along with discussion of other statistics, as pointed out by hon. Members.

I am grateful to my hon. Friend the Member for Stafford for securing the debate and I am pleased to be able to speak and give my support.

Several hon. Members rose

Geraint Davies (in the Chair): Order. I need to call the Front-Bench Members now, as we have half an hour left and three 10-minute speeches to go, but I know that Dr Tania Mathias wanted to speak. Would you like to make a brief point?

10.30 am

Dr Tania Mathias (Twickenham) (Con): Thank you, Mr Davies; I appreciate it. Contrary to some other people, I want to see 21st-century measures, with local medical teams and local Governments taking ownership.

The UK’s legacy is in data collection by the missionaries. In many of the countries in which I worked, that was not done adequately, and that is where the system will break down. Our greatest legacy is the rigour of data collection. I also commend the work of the late, great Colin McDougall, who was a titan in leprosy work. We owe him so much.

Geraint Davies (in the Chair): Mike Kane has indicated that he wants only five minutes, so if you want to speak for a couple of minutes, Dr Mathias, you may.

Dr Mathias indicated dissent.

Geraint Davies (in the Chair): In that case, I call Stuart Blair Donaldson.

10.31 am

Stuart Blair Donaldson (West Aberdeenshire and Kincardine) (SNP): It is a pleasure to serve under your chairmanship, Mr Davies. I thank the hon. Member for Stafford (Jeremy Lefroy) for securing the debate on this important issue.

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It is important to start on the progress made in combating malaria and NTDs. On the basis of reported cases for 2013, 55 countries are on track to reduce their malaria case incidence rates by 75%, in line with World Health Assembly targets for 2015. It is great to see that, in recent years, four countries have been certified by the World Health Organisation director general as having eliminated malaria: the United Arab Emirates, Morocco, Turkmenistan and Armenia. In 2014, 13 countries reported zero cases of malaria within their borders and another six reported fewer than 10 cases. Between 2000 and 2015, incidences of malaria fell by 37% globally and during the same period malaria mortality rates decreased by 60%. An estimated 6.2 million malaria-related deaths have been averted globally since 2000.

That is progress, but there is obviously progress still to be made. According to the latest World Health Organisation estimates released in September 2015, this year will see 214 million cases of malaria and 438,000 deaths. Sub-Saharan Africa continues to carry a disproportionately high share of the global malaria burden: the region is home to 89% of cases and 91% of deaths. Some 15 countries, mainly in sub-Saharan Africa, account for 80% of cases and 78% of deaths. Since 2000, the decline in malaria incidence in those 15 countries has lagged behind that of other countries.

In areas with high malaria transmission, children under five are particularly susceptible to infection, illness and death, with more than two thirds of all malaria deaths occurring in that age group. However, between 2000 and 2015, the under-five malaria death rate fell by 65% globally, translating into an estimated 5.9 million children’s lives saved.

It is often the countries affected by neglected tropical diseases that are increasingly leading the fight to tackle them. In doing so, they are improving coverage rates and making strides towards elimination, with many already achieving elimination goals for individual diseases. In 2014, 126 cases of Guinea worm disease were reported, which is a staggering 99.99% drop since 1986. Only five cases have been reported so far in 2015. Of the 81 countries endemic for lymphatic filariasis, 25 no longer need mass drug administration, including 10 that have successfully eliminated transmission. Fewer than 4,000 new cases of human African trypanosomiasis—also known as sleeping sickness—were reported to the World Health Organisation last year, which is the lowest level in at least 75 years.

According to the UK coalition against neglected tropical diseases—and as the hon. Member for Stafford mentioned—NTDs affect 1.4 billion of the world’s poorest people through mortality, morbidity, disability and stigma. The 10 neglected tropical diseases mentioned in the London declaration of 2012 are reported on each year in the Uniting to Combat NTDs annual report. Its third report was published on 25 June 2015, with its key finding being that increased investment in combating NTDs is hugely economically beneficial for nations afflicted by such illnesses. It is also reassuring to note that more than 5.5 billion tablets have been donated, providing 3.5 billion treatments since the London declaration.

It was good to hear the hon. Member for Northampton South (David Mackintosh) raise leprosy. The report mentioned that leprosy is one of the diseases that is off track, which demonstrates that we need to do more to tackle NTDs and ensure that no NTD is neglected.

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Taken together, the NTDs in the London declaration constitute a disability and mortality burden of the same order of magnitude as HIV/AIDS, tuberculosis or malaria. However, the costs associated with reaching the WHO 2020 targets are relatively modest compared with those big three, and the benefits are enormous, providing a compelling case that the WHO road map is a highly cost-effective initiative, with far-reaching global health, societal and economic impacts.

Combating NTDs would unlock the productive and economic potential of hundreds of millions of people who would otherwise be kept out of work and school. As hon. Members have mentioned, sustainable development goal No. 3 is to ensure healthy lives and promote wellbeing for all at all ages. One of that goal’s targets is, by 2030, to end the epidemics of AIDS, tuberculosis, malaria and neglected tropical diseases and to combat hepatitis, water-borne diseases and other communicable diseases.

The delivery of malaria and NTD interventions is essential to achieving universal health coverage, ensuring healthy lives and promoting wellbeing for those of all ages, particularly the vulnerable and marginalised. It also contributes strongly to reducing child mortality and improving maternal health, and provides the opportunity to treat childhood illnesses such as pneumonia, diarrhoea and acute malnutrition.

It is clear that combating malaria and NDTs will significantly help to achieve the sustainable development goals; indeed, the goals will help to combat malaria and NTDs. With that in mind, it would be great if the Minister told us how the action that DFID is taking to combat malaria and NTDs fits into its wider strategy to achieve the sustainable development goals.

Let me finish by commending the work of the University of Dundee, which the hon. Member for Stafford touched on, in tackling malaria, with the discovery of a new anti-malarial compound in June 2015. The imaginatively named DDD107498 has the potential to treat malaria patients, including those with malaria parasites resistant to current medications, in a single dose and to help to reduce the transmission of the parasite. The compound was identified through a collaboration between the University of Dundee’s drug discovery unit and Medicines for Malaria Venture. The discovery of that new anti-malarial agent, which has shown remarkable potency in multiple stages of the malaria lifecycle, is an exciting prospect in the hunt for viable new treatments. Once again, I thank the hon. Member for Stafford for securing the debate, and I look forward to hearing the Minister’s response to some of the points raised.

10.38 am

Mike Kane (Wythenshawe and Sale East) (Lab): It is a pleasure to serve under your chairmanship, Mr Davies. I, too, thank the hon. Member for Stafford (Jeremy Lefroy) for securing the debate and for his personal leadership in this area. He gave great personal testimony about how the disease has affected him in the past. I, too, went to Tanzania in the early ’90s and was prescribed Lariam while I was helping a friend to set up the first public library in Pemba. I also felt the effects of that terrible drug at that time.

Labour welcomes the sustainable development goals. We are entering a new era in which we hope to eradicate poverty, foster human wellbeing and protect our planet.

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That universal agenda for people in all countries pledges to leave no one behind. We now need to realise its transformational potential. The UK has shown its strong commitment to international development through spending 0.7% of its gross national income on aid and enshrining that spending in law.

I want to talk about sustainable development goal 3, which, as we all know, is about eradicating disease. Although it is only one of 17, and the target only one among 169—I feel sorry for the civil servants who have to understand all those fully—our contribution must demonstrate an integrated approach, as has been said. We must consider the interplay of all dimensions—social, economic and environmental—of sustainable development. We need to expand innovation and research, empower communities, build a skilled workforce and set up strong regulatory frameworks to promote and improve world health systems.

DFID has a strong track record on combating diseases such as malaria and neglected tropical diseases. UK spending on malaria control and prevention was £536 million in 2013-14, and we contributed significantly to the recently announced 60% reduction in malaria mortality since 2000.

According to the World Health Organisation, more than 70 countries are ready to implement national NTD masterplans, which aim to stimulate an increased demand for donated medicines. Since 2006, more than 5 billion anti-parasitic treatments have been delivered. During 2012 and 2013, the pharmaceutical industry donated 2.5 billion treatments—the hon. Member for Stafford made the industry’s contribution clear. Over 800 million people were treated in 2012 alone. DFID has increased its expenditure on combating NTDs to over £250 million. As he said, it takes reliable long-term funding to tackle these diseases.

Global malaria control is one of the great public health success stories of the past 15 years, and our efforts to combat NTDs are on the right track, but we face substantial challenges, such as the spread of resistance to drugs. In addition, we face funding shortfalls for research and development targeted at new diagnostics for, and prevention and treatment of, NTDs. Yet the prevention of deadly diseases is one of the best uses of aid. If global malaria targets are achieved by 2030, it is estimated that more than 10 million lives will be saved and over $4 trillion of additional economic output will be generated.

DFID has great experience in fighting malaria and NTDs, but we can do even more. The UK has excellent resources in the NHS that could be brought to bear in the task of building strong health systems around the world. Following the idea of co-development, the NHS could engage in a mutually beneficial exchange of professionals. As a global employer, the NHS has obligations to support training and healthcare in the countries of origin of our health workers.

DFID should be a strong partner for malaria-affected countries, which will play the most important role in designing effective national strategies, using funds transparently and well, and providing financing from their own domestic resources. Civil society and the private sector also have crucial roles to play. We should encourage new partners to join the global effort, especially

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private contributors. We also need to support multilateral partners such as the Global Fund to Fight AIDS, Tuberculosis and Malaria. It is essential that we continue to support the fund and build on what has been done, particularly the investment in new vaccines, medicines, insecticides and diagnostics.

Tackling NTDs and malaria promises a number of spillover effects, such as greater productivity and growth, reduced worker and child absenteeism, increased equity and women’s empowerment, and improved wellbeing, particularly for vulnerable and marginalised populations. Failure to act could see a resurgence in disease, with increased deaths and lost opportunities for progress and development. The Ebola crisis in west Africa has painfully illustrated the importance of strong public health systems for fighting disease. That lesson applies to our efforts to combat NTDs and malaria.

I thank the hon. Member for Stafford for leading this debate. I also thank hon. Members for their testimony about their time in Tanzania, Uganda, Nigeria, India and Bangladesh, and for the great expertise they have brought to the debate. We need to scale up our efforts to combat malaria and NTDs by investing in research and development, tackling resistance to life-saving medicines and insecticides, and boosting health systems across the world to help to bring an end to these terrible diseases.

10.45 am

The Minister of State, Department for International Development (Grant Shapps): It is a pleasure to serve under your chairmanship, Mr Davies. I congratulate my hon. Friend the Member for Stafford (Jeremy Lefroy) on securing this debate; I do so out of more than just the usual courtesy, as I also wish to commend him for his tremendous work on the Select Committee on International Development and for his chairmanship of the all-party group on malaria and neglected tropical diseases, which is one of the most effective APPGs in this House. It is well respected, frequently convenes high-quality debates and produces extremely influential reports. His knowledge and expertise have been acknowledged by hon. Members from across the House this morning.

The opening words of the “leave no one behind” pledge—many of us were at the United Nations General Assembly last month where that global promise was signed—are:

“We commit to putting the last first.”

Today’s debate is therefore welcome and timely. Malaria and NTDs affect the poorest of the poor. Every year, neglected tropical diseases affect the lives of over 1 billion people, causing disability, disfigurement, stigma and an estimated half a million deaths, as we have heard. Malaria still kills more than 400,000 people a year, mostly children in Africa.

Since the start of this Parliament I have visited seven different African countries; the hon. Member for Wythenshawe and Sale East (Mike Kane) will be pleased to hear that I have been taking not Lariam but Malarone. My most recent visit was the week before last, to Nigeria—the hon. Member for Edmonton (Kate Osamor) will be interested to hear that—where I discussed these very issues. This morning, I returned from the United Arab Emirates; as the hon. Member for West Aberdeenshire and Kincardine (Stuart Blair Donaldson) mentioned,

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the UAE is one of the latest countries to be declared malaria free, so I had interesting discussions there as well.

My hon. Friend the Member for Mid Derbyshire (Pauline Latham) asked what the UK is doing to tackle the resurgence in malaria—in Uganda in particular, although we must be watchful everywhere. As she will know, DFID has provided a significant amount of support to Uganda to try to reduce malaria. The recent outbreaks are of significant concern, and she is absolutely right to raise them. We are responding.

DFID is supporting the distribution of long-lasting insecticide-treated nets, along with capacity building for healthcare workers for the management of fever, specifically in the 10 most affected districts. We are working in partnership with the World Health Organisation to improve the availability and use of high-quality data for decision making—my hon. Friend the Member for Twickenham (Dr Mathias) rightly raised the subject of data—and, through the UK’s significant contribution to the Global Fund to Fight AIDS, Tuberculosis and Malaria, life-saving anti-malarials are being made available to health facilities across the outbreak areas, as a key strategy for reducing transmission.

We are going further, by building on recent analysis by the WHO. DFID has agreed to fund a study—my hon. Friend will be pleased to hear this, as will the whole House—that will provide robust data on the possible causes of the outbreak, to inform the response and, most importantly, learn valuable lessons that we can then use in future programming as we take further decisions on the issue. I will meet the global fund leaders on 9 November, when I will raise that important issue. Through the strong monitoring mechanisms that we always have in place for our programmes, we will also take a close look at the issue of bed nets. I assure hon. Members that that will be a top priority.

The UK has been at the forefront of delivering progress against malaria and NTDs. By tackling them, we prevent pain, suffering and death, and we help to reduce poverty.

Pauline Latham: I am sorry to go back to the issue of northern Uganda, but will the Minister please tell me what is going to happen about the stock-outs of drugs? Are we going to flood the area with drugs to make sure that the people who need them actually get them? They are not getting them at the moment.

Grant Shapps: As my hon. Friend is aware, we are contributing up to £1 billion over three years—2014 to 2016—to the Global Fund to Fight AIDS, Tuberculosis and Malaria. She has my undertaking that I will raise that specific point when I take part in the meeting on 9 November. In addition, my officials are listening to the debate, and we will endeavour to take the issue forward as speedily as possible. We do not want any delay, and she has my absolute commitment that we will process this as fast as possible.

I would like to make three important points—about resources, results and partnerships. On resources, as hon. Members have discussed, the UK committed an additional £195 million in December 2012 at the London declaration on NTDs. I want to update Members, and particularly my hon. Friend the Member for Stafford, about the declaration. It brought together key leaders from health and development organisations, along with industry partners, and they pledged to tackle the 10 NTDs.

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Its third progress report was launched in London in June, and the DFID Minister of State, my right hon. Friend the Member for New Forest West (Mr Swayne), spoke at the launch. The report indicated the growing number of countries that are meeting their targets.

None the less, there are challenges that threaten our ability to meet WHO road map 2020 targets, and we will all need to step up our efforts to do more. The road map and the London declaration have been game-changing events for NTDs, but the short answer to the questions my hon. Friend the Member for Stafford posed is that, although good progress has been made, there is much more to do. DFID and the British Government will take a lead in making sure that that happens.

At this point, I pay tribute to Members on both sides of the House. In the debate, there has been—almost uniquely, compared with many of our debates—a noticeable degree of cross-Chamber support for the action being taken. That assists the UK in making a full contribution.

We are fulfilling our commitment, and we have expanded our existing NTD programme. As my hon. Friend will be aware, five years ago the UK spent less than £200 million annually on tackling malaria; as has been recognised in the debate, the figure is now well over £500 million. As has been said, tackling such diseases is among the best buys in global health—I had not heard the statistic that £1 brings back £36. Each year, malaria costs the African continent at least $12 billion in lost productivity.

That is why national Government leadership in the endemic countries is critical. The domestic focus in those countries must be on increasing measures to tackle malaria, and Governments must ensure that they put in resources themselves. Ensuring that that happens is a constant battle—a battle I frequently go out and fight to make sure we are all truly sharing the burden. National legislators have an important role to play in making the case for increased health budgets, including for NTDs and malaria. I call on those partners to step up their actions. It is in their countries’ interests to do so, because—quite apart from the very sensible humanitarian reasons—enormous savings can be made.

Let me move on to my second point: results. Just last month, the Secretary of State spoke in the House at the global launch of the report on the malaria millennium development goal target. The report indicated the tremendous progress that has been made, which many Members have mentioned. Since 2000, an estimated 1 billion insecticide-treated bed nets have been distributed in Africa, and malaria mortality has almost halved in just over a decade. That is a huge achievement, and the UK can be proud of her contribution, but there is clearly a lot more to do. One in four children in sub-Saharan Africa still lives in a household without at least one insecticide-treated bed net or other effective protection against mosquitoes, but such things should be the bare minimum.

Mrs Helen Grant: The Minister mentioned the millennium development goals. Is he absolutely confident that the new global goals will be sufficient to continue the progress made under the MDGs, which have obviously done good? Will he and DFID also do everything they can to assist data collection—a subject ably and powerfully raised by my hon. Friend the Member for Twickenham (Dr Mathias)? Without data collection, we will have no measures and we will not be able to make people accountable.

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Grant Shapps: On the latter point, about data collection, I had hoped that I had made myself clear: we absolutely support data collection programmes, and I outlined one specific programme. I will come to my hon. Friend’s point about the new global goals in just a second, because the UK remains committed to bringing down the numbers even further.

Hon. Members will be delighted to learn that, just last week, I approved the purchase of a further 2 million insecticide-protected bed nets for Tanzania, which I visited recently. In addition, there are other programmes that will assist in the battle against these diseases. Energy Africa, a programme I launched in London last Thursday with Kofi Annan—Bob Geldof and others are supporting it—will enable energy to be brought to Africa. That means that it will be possible to provide better medical care, using means such as better refrigeration, for example. That is all an important part of achieving global goal 7.

On global goal 3, yes, everything is there. The UK has been at the forefront of supporting this global goal, with all its sub-targets, including preventing preventable deaths among children and ending epidemics of malaria and NTDs. I am therefore absolutely confident that the UK is right behind the push on that.

To really see an impact, we will need to make Herculean efforts. We need think only of river blindness, which once affected vast swathes of Africa, but which is now almost non-existent, to see what can be achieved.

Earlier this year, former US President Jimmy Carter was at DFID to discuss the guinea worm eradication programme. In 1986, guinea worm disease affected 3.5 million people; last year, there were 126 cases. So far this year, there have been just 15. The reduction is a simply amazing achievement, and we look forward to seeing other NTDs quickly follow the same course.

The Government have a strong track record on supporting successful product development and research, particularly through public-private product development partnerships, and some of the innovations have been discussed this morning.

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There is, however, great concern about the 2020 vision, as my hon. Friend the Member for Stafford mentioned. Earlier this year, the WHO launched its third report on NTDs in London. Former DFID Minister Baroness Northover spoke at the launch. The report set out the financing and targets involved in meeting the WHO road map goals for 2020. It also discussed the progress that has been made. We need to do a lot more if we are to continue to meet those goals, but the Department and the Government are standing very much foursquare behind that.

My third point is about partnerships and collaborating with others to achieve a greater impact. We must, of course, recognise the substantial contribution the pharmaceutical companies have made. Pharmaceuticals have pledged drugs valued at $17.8 billion from 2014 to 2020 to tackle NTDs—a very substantial amount. There is also lots of capacity among health workers, and the NHS was mentioned. Volunteers and others are also supporting the implementation of these programmes. The UK will stay at the forefront of those many developments.

Lastly, we will strive to ensure that the post-2015 agenda has a transformational impact on the lives of the most vulnerable and, in particular, on tackling NTDs and malaria. It is worth noting that the Conservative manifesto—the manifestos of other parties covered similar issues—included a commitment to lead a major new global programme to accelerate the development and deployment of new vaccines, drugs and diagnostics for the world’s deadliest infectious diseases. I can report that that work is ongoing in DFID and throughout the Government so that we can meet that commitment, which I think the whole House will approve of.

Once again, I congratulate my hon. Friend the Member for Stafford on securing the debate. I am aware that there is one question I need to answer in a little more detail, and I will do so in writing.

Motion lapsed (Standing Order No. 10(6)).

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11 am

Rehman Chishti (Gillingham and Rainham) (Con): I beg to move,

That this House has considered Government support for Pakistan.

As chairman of the all-party group on Pakistan, I am grateful for this opportunity to discuss Government support for that country, which has long and deep historic ties with the United Kingdom. Our thoughts are with the people in Pakistan, Afghanistan and parts of India affected by yesterday’s earthquake. I lost 25 relatives, including my grandfather, in the 2005 earthquake in Kashmir. I know what amazing support the UK provided then, and I ask the UK to do all that it can to help Pakistan at this difficult time.

There are more than 1 million people of Pakistani background in the United Kingdom. They are the second largest ethnic minority group, and many continue to contribute much to our country, as well as retaining links with family and friends in Pakistan. Pakistan has come a long way in its relatively brief 68-year history, passing an important milestone in 2013 with the first peaceful democratic transition from one Government to another. There is a conviction that a resilient UK-Pakistan relationship is vital to regional and global peace and security. Working together and with key international partners helps to address evolving threats in south Asia. Pakistan has the will, determination and commitment at every level to be a progressive, strong and democratic country at the heart of the international community.

As a country on the front line of the war on terror, Pakistan has faced major challenges and brutal attacks, such as the horrific massacre at the army public school in Peshawar.

Mr Virendra Sharma (Ealing, Southall) (Lab): I thank the hon. Gentleman for allowing me to intervene so early in the debate. I congratulate him on securing it; it is important, given the historical and cultural relationship of Britain and Pakistan. Pakistan has existed for only 68 years, but things have developed. Given what is happening now because of earthquakes and other things, the area needs peace and increased prosperity. The British Government have a responsibility to look into the issues and work with the diaspora here and with the Government of Pakistan.

Rehman Chishti: I thank the hon. Gentleman for his remarks. He has always been a strong friend of Pakistan, wanting to build on the excellent relationship between our two countries. He often highlights the important role of the diaspora. Of course that is right. The United Kingdom has a huge role to play in ensuring that there is prosperity, stability and security throughout the region in south Asia, by working with all countries—India, Pakistan, Bangladesh, Nepal and China. It has a significant role to play in that respect.

I was touching on the horrific attack in Peshawar, in which, sadly, 134 children lost their lives. After many years of attacks that have resulted in the deaths of more than 47,000 civilians and 5,000 armed forces personnel in terrorist-related violence in the past decade, reports show that in the past nine months major terrorist attacks

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have declined by 70%. The UK has always stood shoulder to shoulder with those tackling terrorism and has always been a strong ally of Pakistan. As the Prime Minister said,

“in this battle the friends of Pakistan are friends of Britain; the enemies of Pakistan are enemies of Britain”.

Domestically, Pakistan’s main threat emanates from terrorism and extremism, and there is a direct link between those things and external factors such as conflict in Afghanistan, the unresolved Kashmir dispute and increasing chaos in the middle east.

Imran Hussain (Bradford East) (Lab): This is an important debate and the hon. Gentleman is right to point out that there are more than 1 million people of Pakistani origin in this country. The debate will be important for them. My thoughts and prayers are with those who tragically lost their lives in the earthquake in India, Pakistan and Afghanistan.

Does the hon. Gentleman agree that one issue that remains outstanding in the region, which is in some ways a barrier to peace and prosperity, is the region of Kashmir? Does he agree that there is a need for a peaceful solution to allow the sons and daughters of Kashmir the right to self-determination, and will he call on the Government to encourage both Pakistan and India to have peaceful round-table discussions to promote that?

Rehman Chishti: I pay tribute to the hon. Gentleman for the brilliant work that he does in building the relationship between our two great countries, and for all that he does in his constituency with its large Pakistani diaspora. He touched on an important point about Kashmir; no doubt the Minister and all concerned are aware of United Nations resolution 47 of April 1948, which says that the people of Kashmir should be given a right to self-determination, to determine their own destiny. The resolution includes the words:

“Considering that the continuation of the dispute is likely to endanger international peace and security”.

My response to the hon. Gentleman is that yes, of course, people will say there is a need for bilateral talks between India and Pakistan. However, as we saw in the past year the talks between Foreign Secretaries collapsed, with the Indian authorities withdrawing from them. For talks to continue, two willing parties are needed. At the moment there is no constructive bilateral way forward. The hon. Gentleman is right to say that the international community, including both the United States and the United Kingdom, has a moral obligation with respect to peace and stability in the region to do all that it can to assist in that long, drawn-out issue. I would mention, by way of a declaration, that I was born in Kashmir, so I await a plebiscite for my say, whenever that may come. I think that the international community has a moral obligation with respect to the matter.

Imran Hussain: I thank the hon. Gentleman for his thoughtful response. Will he also comment on the continued breaches and human rights violations in the region, as reported by many international human rights organisations? Will he join me in asking the Government to note that that is perhaps an even more pressing issue at present?

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Human rights violations in the region must end and the international community must do more to assist with that.

Rehman Chishti: The hon. Gentleman is right about respect for the rule of law and human rights. Both the countries in question are signatories to the International Covenant on Civil and Political Rights, so on that basis everything needs to be done to ensure that people’s basic human rights are respected, wherever they are.

It is said that the UK’s supply of advanced conventional armaments to India has the potential to aggravate the growing asymmetry between India and Pakistan, which will lead to a lowering of nuclear thresholds. Some in Pakistan consider the UK’s nuclear stance on Pakistan to be unfair and that the UK’s support for India’s entry into the Nuclear Suppliers Group and perceived pro-India stance on the Missile Technology Control Regime not only undermines Pakistan-UK bilateral relations but also forces Pakistan to adopt measures in the nuclear domain that it considers to be in its national interest but which may be contrary to the UK’s aspiration within the international nuclear paradigm. The UK-Pakistan defence relationship is strong but not regarded as strategic. A move in that direction could develop even stronger relationships.

One of Pakistan’s biggest challenges and largest opportunities is its growing and young population, which is projected by the UN to increase to more than 300 million by 2050. There is an opportunity to reap that demographic dividend, and Pakistan could be the next South Korea by 2050. According to economist Jim O’Neill, Pakistan has the potential to become the world’s 18th largest economy by 2050—almost the same size of the current German economy.

Lord Maude, UK Minister for Trade and Investment, said in the House of Lords in June 2015 that Pakistan presents “too big an opportunity” to miss. Pakistan has one of the world’s fastest growing middle classes, representing 55% of the total population. In the past three years, consumer spending in Pakistan has increased at an average of 26% compared with 7.7% in Asia as a whole. That increase in consumption-driven demand presents an opportunity for British brands to introduce their products and services to the market, as demonstrated by the success of Debenhams.

Pakistan’s strong relationship with the European Union and the US through the GSP plus programme, which the UK strongly supports, is a significant boost to the country’s exports. Since Pakistan was awarded that status by the EU, exports have increased by 21%, and total UK-Pakistan trade increased by 15% in 2013-2014. The China-Pakistan economic corridor in particular has seen 51 agreements signed, totalling $45.6 billion in 2014, in one of China’s largest overseas investments. The mega-projects that will follow can be given vital assistance by British companies through providing services and expertise to maximise the benefits. Encouraged by that, and in recognition of its being one of the best performing frontier capital markets, Pakistan’s credit rating was upgraded this year by Moody’s for the first time since 2008. The UK Export Finance fund has been revised in order to support the work of publicly managed projects, while the overall size of the fund has increased from £200 to £300 million.

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While there is an appetite in the UK to do more business, there are mutual obligations and a moral imperative for Pakistan to reform, including improving the legal process, privatisation, taxation reform and dealing with corruption. Pakistan is rated 127th out of 177 countries on the corruption index. Its controversial and often abused blasphemy laws hinder the country’s international standing, as countries are expected to respect citizens’ human rights and religion freedoms.

Yasmin Qureshi (Bolton South East) (Lab): The hon. Gentleman is right to talk about human rights issues and blasphemy laws. Does he agree that our Government should also look at human rights issues in the rest of south Asia? For example, in India there has been a surge of sectarian violence in the past year or two, which has often been linked with the rise of Hindu nationalism or fascism—whatever we want to call it. In Burma, there have been killings of Rohingya Muslims. Does he think it appropriate for our Government to look at those countries and their human rights records as well?

Rehman Chishti: I thank the hon. Lady for her remarks and pay tribute to her for the brilliant work she does to promote the relationship between Pakistan and the United Kingdom. It was a real pleasure to be on a British Council delegation to Pakistan with her. She probably read the article I read—I urge the Minister to read it too—in the Times of India on 1 May 2015, entitled “US panel: Minorities under attack in India”. The independent panel that reports on religious freedom to the President of the United States, Barack Obama, highlighted human rights issues concerning minorities in India.

Whether the issue is China or the Rohingya community in Burma, human rights should be a key part of our foreign policy wherever abuses occur, as I made clear to the shadow Foreign Secretary in a Queen’s Speech debate on foreign policy. As I said to the hon. Member for Bradford East (Imran Hussain), everyone’s human rights, wherever they are, should be respected by all, and we should do everything we can to ensure that countries respect basic human rights and religious freedoms.

I have often spoken about the need to reform Pakistan’s blasphemy laws. Last year, I wrote a letter, signed by 54 Members of Parliament, to Prime Minister Sharif and the Chief Justice raising concerns about Asia Bibi, a Christian mother of five who was sentenced to death. I am pleased to see that in July, Pakistan’s Supreme Court announced a stay of execution, but there is still much to do to secure her release. Over the summer, the hon. Member for Bolton South East (Yasmin Qureshi) and I visited Pakistan as part of a cross-party delegation. We met senior Government officials and discussed the need to reform blasphemy laws and minority rights. It is fair to say that we sensed a real desire by those senior officials to look at reforming those laws, which are often abused and target Muslims as well as minorities.

Yasmin Qureshi: I concur with the hon. Gentleman. I remember meeting with a Chief Minister in Pakistan and raising the matter of blasphemy laws, as well as the Asia Bibi case.

Rehman Chishti: The hon. Lady not only raised the issue, but used that meeting to provide alternatives of how abuse could be curtailed. I fully support what she

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said about reform, whether it is a question of these cases being dealt with at high courts rather than lower courts or having special prosecutors and special judges. Those discussions took place at every level, and I thank her for her expertise and contributions.

The delegation to Pakistan had the opportunity to learn more about the British Council’s excellent work. Members on the trip visited Islamabad and Lahore to see some of the British Council’s projects in action, including Take a Child to School and the Punjab Education and English Language Initiative, which aims to train 300,000 teachers. The British Council in Pakistan works in all four provinces and has built a network with the scale, skills and influence to deliver transformational change. The council aims to expand its presence and reach tens of millions of people across the entire country by reopening libraries, improving life chances and community engagement through citizenship and sport, empowering women and girls, strengthening skills and expertise in English and UK-Pakistan partnerships in higher education, science and the creative industries.

The Department for International Development is investing some £320 million this year in Pakistan in one of its largest programmes. Pakistan was DFID’s third largest bilateral programme in 2014-15, and if progress continues, it could become DFID’s largest such programme in 2015-16. The greatest priorities for the UK as an international development donor to Pakistan are education, women and children, creating jobs and supporting economic growth, strengthening democracy and governance, building peace and stability in conflict-affected areas, and providing humanitarian assistance through life-saving support to people affected by conflict and natural disasters.

There are ways we can further our relations with Pakistan. In particular, I would like the Minister to consider the following issues. Will he ensure that every possible assistance is offered to Pakistan in the light of the earthquake, to assist the country at this difficult hour? There is a clear relationship between the number of direct flights to a country and an increase in trade. However, since 2008, British Airways has suspended its six weekly Heathrow flights. Will the Minister look at that? The Government’s travel advice has been raised as an issue. Will the Minister look at that and the process for reviewing it, in line with the improving security situation in Pakistan?

The Government have a target of increasing bilateral trade to £3 billion by 2015. Will the Minister present an update on plans to increase trade relations, including plans for trade delegations to Pakistan? With the bulk of trade focused on the goods sector, what can he say about the scope to develop trading links across the service sector? Around 10,000 Pakistani students are studying in the UK. However, changes to student visas were raised when we visited Pakistan as a delegation. Will the Minister provide an update on the situation?

On security, Pakistan is on the front line of the battle with terrorism and would appreciate assistance through GSM—global system for mobile communications—intelligence gathering and technology, such as biometric scanners and night goggles, to monitor the Afghan border more effectively.

I come to my last specific point for the Minister. In a recent joint statement with Prime Minister Sharif, President Obama said that US engagement with Pakistan, one of the largest Muslim democracies in the world, should be

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comprehensive and multi-dimensional to reflect the global challenges of the 21st century. Is that what the United Kingdom is trying to achieve with Pakistan in its long, strategic relationship with the country?

In conclusion, Pakistan still has many challenges, but it is determined to become a safe and prosperous nation at the heart of the international community. With our mutual shared history, our very large Pakistani-origin diaspora and our deep, strong, multi-dimensional relationship based on mutual trust, respect and understanding, our relationship can go from strength to strength by working together to tackle the global challenges facing the international community. I know that the Minister has recently visited Karachi and seen the many opportunities that the country offers. I thank him for the brilliant work that he does in building our two countries’ excellent relationship, and I look forward to hearing from him on this matter.

Geraint Davies (in the Chair): I call the Minister, who will have to speak quickly.

11.21 am

The Parliamentary Under-Secretary of State for Foreign and Commonwealth Affairs (Mr Tobias Ellwood): Thank you, Mr Davies; it is a real pleasure to respond to this debate, and I congratulate my hon. Friend the Member for Gillingham and Rainham (Rehman Chishti) on securing it. He spoke with such passion, flair, understanding and expertise on this matter, and in such detail, that he has managed to give me limited time in which to respond. However, such is his enthusiasm for making sure that these matters are discussed in the House that it is fully understandable that he has eaten a little into my time to reply. I will do my best to respond to some of the matters that he has raised, and as usual, I will write to him in the normal manner if there are points that I cannot reply to now. I commend him and other hon. Members for the work they have done in the House.

My hon. Friend began, as I should as well, by offering our condolences, understanding and sympathies to all those affected by the horrific earthquake that has taken place in Afghanistan, but which has rippled right across the region. He asked what Britain is doing. Naturally, we stand ready to give support—we have had no formal request yet, but we stand by, ready to help our friend and ally.

My hon. Friend mentioned the important role of the enormous diaspora that we have in this country, which strengthens our cultural relationships and the understanding of our country, which is very important indeed. I am pleased that he also paid tribute to the British Council, not least the delegation that I had the opportunity to meet recently on a visit to the country. I was very proud to meet those British Council representatives and to hear about the work they are doing to strengthen this important bilateral relationship. I had the opportunity to visit not only Karachi, but Islamabad last month. I saw at first hand how Britain is working very closely with Pakistan on three key areas: security, which my hon. Friend raised, the economy and governance. Before trying to answer his questions, I will cover—in the time available—some thoughts on those three key areas.

First, as my hon. Friend implied, security across Pakistan has improved dramatically. There really was an understanding—almost a wake-up call—following

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the disastrous attack that killed so many children in the Peshawar public school. The British Government are very much playing our part. We are training Pakistani police and promoting work with prosecutors and the judiciary to investigate, prosecute and sentence terrorist suspects in line with international human rights standards. We have made an awful lot of progress, and I hope that continues.

Secondly, on the economy, the improved security is helping to drive economic growth. It is making the country more attractive. An International Monetary Fund programme has helped to stabilise the economy since the fiscal and balance of payments crisis two years ago. However, more work is needed if we are to increase the country’s growth to the 7% to 8% needed to reduce poverty. We continue to encourage Pakistan to address the energy crisis, tackle corruption and undertake further privatisations, which are needed to boost the economy. We are supporting businesses that want to trade more with Pakistan, where the opportunities, from energy to infrastructure, are clear, as I discovered on my visit. I hope to return to Pakistan, not least to Karachi, in the near future with my own trade delegation. Indeed, I have invited and encouraged the Mayor of London, who is familiar with working with megacities, to provide assistance in making sure that Karachi works towards being a gateway to the region.

Thirdly, on governance, the advances made in security and prosperity cannot be sustained without good governance, and democracy in Pakistan has shallow roots, as we have heard. We are helping to build on that and sharing our experience to cement accountable governance, credible elections and civilian transitions. The Department for International Development, which my hon. Friend mentioned a number of times, has one of the largest bilateral aid programmes and is helping Pakistan to improve healthcare, education and the provision of humanitarian assistance. UK aid has benefited over 6 million primary school children, ensured that over 1 million more births involved medical professionals and helped over 4 million flood victims.

My hon. Friend mentioned Kashmir, which is obviously a very sensitive subject. He is familiar with our long-standing position in the UK—that it is for India and Pakistan to find a lasting solution to the situation in Kashmir which takes into account the wishes of the Kashmiri people. It is not for the UK to prescribe a solution or indeed, to mediate, but we very much encourage both sides to maintain their positive dialogue and to work towards a solution.

In the limited time remaining, I will try as best as I can to answer the series of questions that my hon. Friend asked. As I mentioned, on the earthquake, we stand ready to give support. We will continue to have discussions with British Airways. The time is now ripe for those flights to be reviewed and reinstalled. I hope that will be the case, pending the security requirements

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that we and the airline need. On travel advice, we want to make things as trouble-free as possible. There are over 1 million visits and movements every year. There is a requirement, occasionally, for us to review travel advice to specific areas. We are quite careful to make sure that we articulate that travel advice on our website.

On bilateral trade, we have the target of £3 billion. I hope we can persevere towards that. My hon. Friend is right to emphasise the fact that the British Government now underwrites and guarantees business opportunities. The money has increased from £200 million to £300 million, which I think is excellent news. That is an indication of how we want to meet the target and to encourage not only businesses that are already there to grow, but new businesses to consider Pakistan as a place to open up and do business.

My hon. Friend mentioned the 70th anniversary in 2017. I very much hope that that is something we can work towards, and it is wise to flag that up now, to ensure that we can mark that important landmark in Pakistan’s history.

On visas, my hon. Friend will be aware of the robust requirement for us to have a thorough visa system in place. However, we want to make sure that we can attract the brightest and best students from around the world and that they are able to come here on legitimate courses, so we very much want to work with Pakistan on that front. On terrorism, I hear what he said about the requests. We will certainly look at that. We have a very strong relationship that is growing ever stronger with regard to helping Pakistan on counter-terrorism.

My hon. Friend spoke of the opportunities for the country to grow and to become the South Korea of the future.

Rehman Chishti: Will the Minister give way?

Mr Ellwood: I have 30 seconds left, so I hope it is a short intervention.

Rehman Chishti: Will the Minister join me in welcoming the high commissioner of Pakistan to our debate and in commending him for the brilliant work he does to build the relationship between our two countries?

Mr Ellwood: That intervention was absolutely deserved. I look forward to meeting the high commissioner in the very near future—I think we have a meeting planned either today or tomorrow—and we are always happy to have the opportunity to meet.

This has been a short debate, but it has articulated the importance of this bilateral relationship and the opportunities for us to work together on security, the economy and governance.

Motion lapsed (Standing Order No. 10(6)).

11.30 am

Sitting suspended.

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Met Office

[Mr Gary Streeter in the Chair]

2.30 pm

Mr Ben Bradshaw (Exeter) (Lab): I beg to move,

That this House has considered the BBC’s relationship with the Met Office.

The Met Office and the BBC are two of the United Kingdom’s most respected and successful public institutions. The first is our national weather forecaster, owned by the public, and the second is our national broadcaster, also owned by the public; they both have a reach and reputation that go far beyond these shores.

The BBC is a global broadcaster, with a justified reputation for quality, accuracy and impartiality. Our Met Office is independently assessed and widely recognised as the best in the world. Both the BBC and the Met Office earn millions of pounds for UK plc; for example, our Met Office provides weather forecasts for most of the world’s civilian airlines, keeping our flights safe and helping them to plan the most efficient routes. The Met Office does more than just forecast weather. It provides expert advice on a host of hazards, including flooding, air quality, space weather and volcanic ash, and is the world’s leading repository of expertise on climate change.

The BBC and the Met Office are also two of the world’s oldest organisations of their kind. The Met Office was set up by the Government in 1854 to establish meteorology as a science and, initially, to provide weather forecasts to protect the safety of ships and their crews at sea. The BBC first broadcast a radio weather bulletin in 1922 using data from the Met Office, a relationship that has prospered to the present day. The weather men and women we see regularly on our TV screens are fully qualified meteorological scientists, often employed not by the BBC, but by the Met Office. They work round the clock using their scientific expertise and broadcasting skills to communicate vital information to the public. Many of them, across the generations, have become household names. Radio 4’s shipping forecast, again provided by the Met Office, is an iconic part of our national life.

It was with some consternation that I heard back in August that the BBC was planning to end its 90-year-plus relationship with the Met Office. I should say at this stage that the Met Office is in my constituency. Indeed, I helped to secure its transfer to Exeter from Bracknell in the early noughties, and we in Exeter are immensely proud to host it. However, my main motivation for seeking this debate is not the potential impact on my constituency. The current contract with the BBC earns the Met Office about £3 million out of a turnover of £220 million a year. The Met Office has said that any impact on income or jobs from the BBC terminating the contract would be minimal. No, my main reason for raising my concerns and seeking this debate is primarily the wider national interest.

The historic relationship between the Met Office and the BBC and of each organisation with the Government has been and, in my view, remains integral to national resilience and emergency planning and even, in times or arenas of conflict, to national security. The Met Office provides information to a whole host of customers and

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organisations, including commercial businesses, transport bodies, farmers, seafarers, sports organisations, local government, the NHS and the general public. If we think about it, there is almost no aspect of our lives that is not somehow impacted by the weather. Timely, accurate weather information and forecasting is vital in normal times, but during extreme weather events or at times of national emergency it can be a matter of life and death.

That is why the Met Office is embedded in our civil contingency systems. I remember, as a Minister, attending emergency meetings of the civil contingencies secretariat, COBRA, during severe flooding and the foot-and-mouth and bird flu crises, when the in-time input from Met Office staff was absolutely critical in informing the Government’s response. Communicating severe warnings quickly and accurately through our main broadcaster is vital to enable businesses, public bodies and the wider public to plan and respond.

The BBC has said in response to questions from me that it intends to continue to use the Met Office’s severe weather warnings in its broadcasts, and that is extremely welcome. But what the BBC has not done is explain how it will ensure that those warnings are consistent with its general weather forecasting if they are sourced from a different provider.

Britain’s geographical position on the edge of the European continent and facing the Atlantic makes our weather very difficult to predict. Accurately forecasting the exact route of the deep depressions or storms that are responsible for most of the gales and flooding we experience is particularly tricky. The Met Office has an unparalleled reputation in getting these forecasts right. In fact, the World Meteorological Organisation says the Met Office’s forecasts are consistently the most accurate in the world. But if the BBC goes ahead with its plans, the severe weather warnings from the Met Office could still be broadcast by the BBC but might be inconsistent with or even contradict the BBC’s general weather forecasts.

Accurate and consistent messaging is absolutely essential in weather-related emergencies. Ten years ago, America suffered its worst ever death toll in a natural disaster when Hurricane Katrina devastated New Orleans. Much of the subsequent blame for the high death toll centred on the inconsistent and contradictory weather warnings, which sowed uncertainty and confusion in the area about the need to evacuate. I know our civil contingencies secretariat is extremely concerned about the BBC’s proposals and the potential for mixed messages.

In response to parliamentary questions I have been assured by Ministers that arrangements will be put in place to address those concerns. The BBC has issued similar assurances to the Met Office, but we have not been provided with an explanation as to how that can be done so I would be grateful if the Minister would do so in his response. I wonder whether the Minister shares my concern that we could be facing a situation in which the public will receive and act on information provided through the BBC that is different from that provided to the Government itself and the emergency services by the Met Office. The long-standing and respected environment editor of The Independent, Mike McCarthy, said of the BBC’s proposal to drop the Met Office:

“It may suit the Corporation’s bottom line, or its image of itself as a trendy broadcaster: but the commercial interests of the BBC are not the same as the interests of the nation, and this decision is a nonsense which needs to be reversed.”

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I have a parallel concern about the effectiveness of our armed services. The Met Office, which until recently came under the umbrella of the Ministry of Defence, provides regular weather information to our military at home and abroad. Met Office staff in military uniform are currently embedded within our armed services in Afghanistan and Oman. Those armed services will also have access to the BBC’s global weather forecasting, so there is a danger that the information they receive officially from the Met Office could be inconsistent with that provided by the BBC over the normal media, hampering operational safety and effectiveness.

Then there is the further potential vulnerability, in the event of a more serious conflict, war or massive cyber-attack, of our national broadcaster being dependent on a private or foreign weather forecaster. I should be grateful if the Minister would say whether the Government have made any assessment of the impact of the BBC’s proposal on national resilience and security.

I would also like the Minister to tell us whether there have been any discussions across the Government about value for money if the BBC contracts weather services from abroad or from a private company. At the moment, the public pay through the licence fee for the BBC’s weather services, but the public, or the Government, also receive the income as the Met Office is publicly owned. If the BBC goes down its proposed route, the public will in effect be paying twice: first to the Met Office for its work and again to a foreign-owned or private weather provider via the BBC licence fee.

As the Minister well knows, the BBC is about to embark on its 10-year charter renegotiation and renewal. This is the chance for the BBC to agree its size, its scope and its strategy within the financial envelope provided by the licence fee. Given the financial constraints on the corporation because of the funding levels already announced by the Government, there is widespread consensus that the BBC will have to do less if it is to protect quality. However, in a briefing provided to me in response to my concerns about the BBC decision, the BBC says that it wants

“to enhance our position as the leading destination for weather information with ambitions to be the best provider of weather information in the UK and the world.”

We already have the world’s best provider of weather information. It is called the Met Office. This feels like another example of the BBC trying to do everything and grow its empire, rather than doing what its director-general, Tony Hall, says it should be doing, which is “partnering with others”. On the eve of charter review, the BBC is planning to sign a new 10-year contract with a foreign or private weather provider, pre-empting charter review and shutting the public completely out of the process. Does the Minister not agree that it would be far better for the BBC to consider and decide this as part of charter renewal? That would also give it and the relevant Departments the chance to review and address the concerns that I and the Met Office have been raising.

That leads me, finally, to the process. The decision by the BBC was not consulted on and was announced not in any formal way, but in the form of a leak to The Sunday Times. That is unsatisfactory in itself, but it is completely clear from the correspondence that I have received from Ministers and from the answers to my

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parliamentary questions that Ministers and Departments were kept in the dark over this. The BBC treated it as a narrow commercial decision, with no regard whatever to the wider national and governmental interests. Could the Minister please confirm that he and other Ministers were not consulted on the announcement before the BBC made it? Could he also tell me what subsequent conversations he has had with colleagues in the Department for Business, Innovation and Skills, the MOD, the Department for Environment, Food and Rural Affairs, the civil contingencies office and the other interested Departments and agencies about the potential impact of the BBC’s plans on national resilience and security?

The Met Office website offers a public weather media service that will be made available free at the point of use to all public service broadcasters. That package of information includes weather forecasts, warnings, observations, guidance, scripts and services provided under licence and tailored for the broadcast media, so I am also concerned that the BBC has in effect tendered for services that, at least in part, are available to it free of charge through that service. I recognise that the actual content of any tender is commercially confidential, but I none the less request the Minister to reassure himself that the option to satisfy the BBC requirement through the public weather media service was fully explored before the decision to tender was taken. If it was not, there are serious questions about the process and its ability to deliver value for money. My concern is that the BBC has pursued a narrow commercial tender without fully considering its responsibilities to UK resilience and public safety and value for money. That might explain why it is having such trouble explaining how it is going to address the concerns that it now recognises are real, but if the BBC cannot explain that, it is very important that the Government do.

This episode seems to me to be a classic example of a large organisation—in this case, the BBC—taking a decision without thinking through the wider implications. If it had bothered to consult or even seek others’ views, it might have come to a different conclusion. Now that the wider implications and problems have been pointed out to it, it is frantically trying to reassure us that the potential problems can be resolved, but without explaining how. I hope very much that, in the light of this debate, the BBC will pause this process and see the merit of rolling it forward into charter renewal, so that it can fully explore the potential problems with this plan and consider its weather forecasting contract as part of its overall strategy and reach.

However, the responsibility of Government goes much wider than this. The Government have overall responsibility for national security, emergency planning and managing crises and contingencies. So far, I have not been reassured by what Ministers and their Departments have said on this. I therefore hope that, in his response, the Minister can address those concerns or, failing that, go away and consult his colleagues in BIS, the MOD, the civil contingencies office and elsewhere and provide the detailed reassurances and explanations that I am seeking.

2.44 pm

Kevin Foster (Torbay) (Con): It is a genuine pleasure to serve under your chairmanship for the first time in Westminster Hall, Mr Streeter. I thank the right hon. Member for Exeter (Mr Bradshaw) for securing the

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debate. It is directly relevant to my constituency, which is not a million miles away, and to your constituency of South West Devon. We will almost certainly have constituents directly affected by this decision. However, although there is a link between Torbay and south Devon’s economy and the location of the Met Office, my focus, like that of the preceding speech, will be on the overall impact of the decision and what it could mean for our country.

It is safe to say that anyone who represents a coastal community knows the absolute importance of an accurate weather forecast and of that being disseminated to the public more widely. It is not the person who has a large shipping operation who relies on the BBC shipping forecast. It is the person deciding whether to go out in their own small boat the next morning. It is the person going to the beach. It is the person who might take their family to the coast. For each of them, it is critical that they can easily get hold of an accurate weather forecast. I see here my hon. Friend the Member for South East Cornwall (Mrs Murray), whose area has a large fishing industry. I have the bay, but I do not have Brixham. That is in the constituency of my hon. Friend the Member for Totnes (Dr Wollaston), but there is certainly a fishing community in Torquay that goes through Torbay, and all rely on being able to have accurate forecasts, with many using the BBC to supply them.

What speaks to me about the importance of the weather is this. We all remember the iconic hanging tracks at Dawlish. Had those winds been true east rather than slightly to the south-east, that storm would have hit Paignton directly, causing a very severe impact. That is why, for me, the relationship between the Met Office and the BBC is crucial.

The BBC has a reputation for gold-standard accuracy in its weather forecasts—perhaps with the exception of Michael Fish not quite seeing the hurricane that was on its way. Therefore, it is vital that it also has the accuracy of the Met Office’s gold standard of weather information and forecasting. The right hon. Member for Exeter was right to talk about potential conflicts between Met Office severe weather warnings, which again are the gold standard for keeping people away from harm, and another provider advising of a slightly different outcome in the weather. It is hard to see how an organisation that has been accurately forecasting Britain’s weather for nearly 170 years will be bested by any other organisation suddenly picking up this contract for the BBC.

It is vital that we look at the need for a resilient source of weather information, as the right hon. Gentleman said, for the military, for our civil authorities and for Government itself. We need to look at everything from energy security to potential issues with our agricultural sector. Many things will depend on knowing the weather and being able to provide what support we can by having had notice well in advance of what the weather conditions are likely to be.

For me, what shows the importance of the weather to Government decisions and planning is that we banned weather forecasts during world war two, because that was seen as such useful information to the enemy that we did not want them to have it. Seventy years later, it is still a vital part of Government planning. It is not just about whether we will get wet when going out for a walk, but about planning services—planning when power stations will need to be brought on to supply, and

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planning when staff may need to be on standby for everything from snow and ice to flood and wind. Ensuring that we can maintain a resilient and durable Met Office is crucial to the way we run our country.

I accept that the Government do not direct the BBC in its contracting. It is right that the corporation has a level of independence. It would be strange for us to stand in this House one day demanding that it is completely independent of Government and then the next day demand that the Government take various decisions for it. That said, it is concerning that this decision was taken purely on a fairly narrow set of criteria. I, too, would be interested to hear the Minister’s remarks on what consultation was done, given that ultimately the BBC is not a service that anyone can choose to receive. If someone has a television, they have to pay for it under the law, and in fact they are still branded a criminal if they do not pay the licence fee that goes towards it, so I would certainly be interested to hear what consultations were done.

I hope that the BBC will take a close look at the impact of the decision. My concern, as a constituency Member, is for my constituents who will be affected, particularly as such an iconic employer brings quality jobs into Devon that will benefit the community in the long term. I agree with the suggestion from the right hon. Member for Exeter that the BBC should pause this issue during the charter review, in which we debate the whole relationship between the Government and the BBC—between the state and the public broadcaster. I would be interested to hear the Minister’s thoughts and comments. As I said, we cannot say one day that the BBC should be independent and the next that it should do whatever we direct it to do.

We need to know that the gold standard of weather forecasting is available; we do not want a standard that blows with the wind. I hope that the BBC will look again at this opportunity to keep its historic link with the Met Office.

2.50 pm

John Nicolson (East Dunbartonshire) (SNP): It is a pleasure to serve under your chairmanship, Mr Streeter. The Scottish National party Government Minister Humza Yousaf once observed that there are two seasons in Glasgow: taps oan and taps aff. To translate for those who are hard of Scots, that means removing one’s upper garments, or keeping one’s upper garments on. Of course, as everybody knows, the colder and wetter it gets in Glasgow, the more clothing people remove. My constituency is the second-wettest in the United Kingdom, just missing out on the top spot to Cardiff.

Although people from Scotland joke and vent their frustrations about the unpredictable weather that we experience throughout the day, accurate weather forecasting is essential to the country. The landscape and natural environment of Scotland are one reason why detailed weather forecasting is so important. Tourists from all over the world come to marvel at Scotland’s natural beauty, climb our mountains, trek in our glens or explore our cities. They need to know the weather in advance to ensure that they dress appropriately and are adequately prepared. Our country’s winter sport industry is worth nearly £30 million to the economy each year, so hotels and ski resorts also need to have detailed weather forecasts so that they can plan accurately.

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In addition, Scotland is home to large shipping, fishing and seafaring communities, who need to be fully briefed on what lies out in the seas to ensure their safety. Those are three of many obvious examples of why weather forecasting makes a huge impact on life in Scotland. It is intrinsically linked to the safety of our people and the prosperity of our economy. People rely on the Met Office.

There are, surely, two key questions that need to be addressed when debating the relationship between the Met Office and the BBC, and the divorce that is taking place. What were the reasons for ending the contract with the Met Office? Will the ending of the contract improve the weather forecasting service for the people of these countries? A BBC spokesperson has stated that during the bid process for the weather forecasting contract, the BBC sought to

“make sure we secure both the best possible service and value for money for the licence fee payer.”

That, of course, is always foremost in any BBC manager’s thought process. Although that is to be expected, can both be prioritised simultaneously or has value for money taken precedence?

There has been some misinformation about the cost of the Met Office to the BBC; reports in the press have stated that the Met Office charges the BBC £30 million a year. In fact, that is the total commercial revenue of the Met Office from a wide range of customers for the whole year. Only a small percentage of that comes from services to the BBC, with presenters being paid at market rate. The Met Office is seen as providing the most accurate predictions for UK weather underpinned by significant research capability and strong infrastructure. It is regarded as a world leader in the field, and provides services in the United Kingdom and around the world.

Many have argued that the BBC’s decision to end its contract with the Met Office has been taken purely for commercial reasons. Dr Grant Allen, an atmospheric physicist at the University of Manchester and a leading expert in the field, has said:

“In my opinion, the BBC’s decision was taken on cost and not on predictive skill. We could get less accurate weather forecasts than before through the BBC, and that is sad news.”

Moreover, the timing of the divorce could not be worse. The Met Office has recently invested £97 million in a supercomputer 13 times more powerful than its previous system, which will increase the accuracy of its forecasting. As part of the new forecasting abilities, the Met Office says that it wants to include the probability of certain weather types. A forecast would give the temperature and a 20% chance of rain, for example—again, vital to my constituents, although our assumption is that there is 100% chance of rain every day for the next year. Such probabilities are available on the Met Office website, and many people are used to using them on smartphone apps. We understand, although this has not been confirmed by the BBC, that the BBC does not want that new service, regardless of how useful it would be to licence fee payers.

If the BBC has opted to end its contract with the Met Office simply to reduce costs and replace it with a service that is not as detailed or accurate, that is worrying and clearly goes against the BBC’s public service broadcasting remit. The BBC is responsible for providing

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services to inform its audience—services that would not always otherwise be provided where commercial interests are at the fore. Detailed, accurate weather forecasts fall into that category, and attempts to dumb down in order to reduce costs would do a disservice to audiences across the United Kingdom.

On a broader level, the UK has a leading position in the world for atmospheric science, which is the result of sustained institutional support for the science. Questions must be asked about how the end of the BBC contract will affect the Met Office and its ability to deliver. Will investment in the Met Office suffer as a result? Will the change have knock-on effects on the Met Office’s numerous roles outwith the BBC? Will it ultimately affect the future of domestic weather forecasting throughout the country?

The two companies widely reported to be in the final bidding for the contract are a Dutch firm called MeteoGroup and the commercial branch of New Zealand’s meteorological service, MetraWeather. Both must now come under scrutiny. Whichever is selected, we must be assured that it will deliver the high-quality, detailed and accurate weather forecasting required for the BBC and audiences. MeteoGroup is already used by the London Evening Standard and provides services at the Sheringham Shoal offshore wind farm. MetraWeather has attempted to make weather forecasting more interactive during TV bulletins in the Netherlands. Those are, however, small-scale endeavours compared with the scope of the task ahead of them if they are to replace the Met Office working for the BBC.

As Professor Ellie Highwood, joint head of the University of Reading department of meteorology, has said:

“Without any details about the BBC’s new arrangements, it is too early to say how this decision will impact the quality of weather forecasts to the general public”.

She does not welcome the developments. It is now the BBC’s responsibility to award the contract to whichever provider will offer the best weather forecasting service to the public. I strongly hope that it is awarded on the basis of quality of service, rather than as a cost-cutting procedure. At the end of this process, I expect the BBC to show full transparency and detail why the contract with the Met Office was ended and why a new contract was awarded to a different supplier.

In conclusion, I find myself agreeing with the right hon. Member for Exeter (Mr Bradshaw) that the Met Office is part of the family silver. Expelling it from our TV screens seems an unnecessary, destructive step, which has been inadequately explained and unwelcome.

2.59 pm

Chi Onwurah (Newcastle upon Tyne Central) (Lab): It is a pleasure to serve under your chairmanship, Mr Streeter. This is the third time in less than 24 hours that the Minister and I have been opposite one another. Yesterday evening he tried to incite me to intervene, although, as the Speaker rightly pointed out, it was against parliamentary procedure—not exactly fair play.

John Nicolson: Or cricket.

Chi Onwurah: No, it was not cricket. I was obliged to remain silent, but I intend to make up for that today. I congratulate my right hon. Friend the Member for

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Exeter (Mr Bradshaw) on securing this important debate and on his impressive opening speech. He speaks with experience and authority, as a local MP and a previous Minister.

The Minister for Culture and the Digital Economy (Mr Edward Vaizey): He was a Secretary of State.

Chi Onwurah: And as a previous Secretary of State. He knows his subject comprehensively. I am sure that the Minister will extend my right hon. Friend the courtesy of answering all his questions as fully as possible.

As my right hon. Friend said in his introduction, the Met Office is a respected and successful institution. He touched briefly on the origins of what is now known as the Met Office. Those origins reflect many supremely British characteristics: naval power, trade, exploration, science and eccentricity. The Met Office was first founded as the Meteorological Department of the Board of Trade by Robert FitzRoy, who is most famous for being the captain of HMS Beagle, the ship that carried Charles Darwin on his famous voyage. More than 160 years ago, this House roared with laughter when a Member suggested that we might, one day, predict the weather in advance. FitzRoy led an interesting and troubled life, but pressed on in the face of scepticism about weather reporting. Today, his vision of a public forecasting service, funded by the Government for the benefit of all, has endured.

The modern Met Office is respected the world over and has an important place at the heart of the nation’s contingency planning and our culture. Indeed, the hon. Member for East Dunbartonshire (John Nicolson) emphasised its role in the heart of Scotland’s culture. We all like to poke fun at weather forecasters for getting it wrong, but the fact is that the Met Office is critical to our military security and civil planning. Its shipping forecasts make the jobs of those at sea a little safer, as the hon. Member for Torbay (Kevin Foster) rightly emphasised. Its global research links enhance our understanding of how the weather and climate affect our economy and way of life, and its parliamentary advice makes us all—at least, those of us who make use of it—a little wiser.

I hope the Minister will assure us that the Met Office is not on the Government’s list of public sector targets. In fact, I hope that he and his colleagues will go further and champion its work and the unique role it plays. Perhaps, they might even recognise the value that such public sector institutions play in our society and economy. As my right hon. Friend the Member for Exeter said, this decision is not the end of the Met Office—far from it. It does so much more than providing the BBC with weather forecasts. In fact, its data will still drive those forecasts. The decision raises questions about the strategic relationship between the BBC and the weather provider. The police and the military will continue to rely on the Met Office for advice, while the public may receive different information. My right hon. Friend cited international examples that raise serious questions about this approach. Is the Minister concerned about that and has he discussed it with the BBC?

Many in the Conservative party believe that the BBC needs to be clipped, either because of misplaced ideas that it crowds out competitors or because of perceived bias. I find it difficult to divorce this decision and this

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debate from the wider context of the charter renewal process and the sustained attack that the BBC is coming under from the Government and their friends. The BBC is under immense pressure at the moment to prove to the Government and the wider public that it is efficient and good value for money. Obviously we are all in favour of value for money, but what matters is how we define value and over what period of time. Even if we accept that there is no risk to the national interest—which I have yet to be convinced of, although I will listen closely to the Minister—I am not persuaded that the cheapest option is always the best.

3.5 pm

Sitting suspended for Divisions in the House.