Research and development for global health

2.53 pm

Nick Herbert (Arundel and South Downs) (Con): I am grateful to be able to take part in this debate and I will speak briefly. First, I congratulate my hon. Friend the Member for St Ives (Andrew George) on securing the debate.I am very proud to co-chair the all-party group on global tuberculosis, which he and I co-founded with our Labour co-chair, the hon. Member for Ealing, Southall (Mr Sharma). I am also very proud of the report that we have just produced, to which my hon. Friend referred, "Dying for a Cure: Research and Development for Global Health", which covers precisely the issues he has raised in this debate.

May I say in parenthesis that there is much debate about the support provided to all-party groups. Our report simply would not have been possible without our all-party group's first-class secretariat, which is funded by RESULTS UK and other organisations and has enabled our excellent researcher, Matt Oliver, to help with the drafting of the report. That goes to show that not all external support for all-party groups is bad-far from it. Without that support we simply would not have been able to produce the report. It is important that Members speak up for legitimate all-party groups that have important work to do.

I want to focus particularly on tuberculosis, which still kills 1.3 million people a year-quite unnecessarily, given that it is a treatable and curable disease. There is a particular new threat because of drug resistance, which is a serious problem and a concern not just globally but in this country. I commend the Prime Minister's stance on the significance of drug resistance as an issue that this country has to address in future. Our all-party group was reminded of that recently when we travelled to Bucharest in Romania and visited prisons and clinics around the country where TB is prevalent-not just TB but drug-resistant TB. In Romania, as well as in other developing and underdeveloped countries throughout the world where TB is a serious problem, the issue is not just access to drugs, which can of course be corrected by the west making significant interventions through the global health fund and other means to provide drugs where they are available; it is also a problem of availability.

Our report seeks to address the simple fact that there is insufficient availability of diagnostics and treatments for tuberculosis. I have mentioned this in a previous debate on the same issues in this Chamber, but I want to repeat myself because it is important: it is sobering that if TB had resurged in the west, pharmaceutical companies would by now have found the investment required to produce significant new tools for its diagnosis and treatment, as has happened for HIV. Amazing new cures and treatments are available for HIV. Why? Because HIV has been a disease of the west as well as cruelly affecting the developing world.

Although it has made something of a comeback in the west, TB has not been perceived in the same way. It has continued to claim the lives of millions, but only in developing countries, so it has not received the attention. Nor are there the straightforward financial incentives for pharmaceutical companies to develop the necessary tools. There is still no vaccine for TB. People believe that there is, but there is not: the BCG vaccine is partial and relatively ineffective for adults.

The first-line drugs that are used to treat TB were developed decades ago, must be taken over an extended period and are part of the reason why drug-resistant TB is a problem. The diagnostics for TB are old-fashioned and inadequate. All this is not the fault of drugs companies; in a free market they simply do not have the commercial incentive to develop new tools because there would be no market for them to sell to.

Mr O'Brien: I am grateful to my right hon. Friend for giving way to me, particularly on my second intervention in this debate. I have just returned from Papua New Guinea, where, given my interest in malaria, it was impressive to see Oil Search-to refer to his point about delivery-delivering across extremely difficult and hostile territory, in the complete absence of any other form of provision. Multi-drug-resistant tuberculosis was its main challenge. Often, pharmaceutical, distribution and oil and petrochemical companies are becoming part of the solution as they extend their provision, whether that includes GSK considering the pricing of its malaria vaccine or Novartis distributing malaria drugs. Equally, on TB, Oil Search is becoming part of the solution as part of its extended corporate social responsibility, as well as ensuring research and development for non-purchasing-power markets. I thoroughly endorse where my right hon. Friend is taking this debate.

Nick Herbert: I am grateful for my hon. Friend's intervention. I think that corporate social responsibility can be part of the solution, but it will not be a sufficient solution. What we have here is significant market failure. Where there is market failure, there is an imperative for Government intervention. One can still believe in markets-the power of markets, and pharmaceutical companies' freedom to do all the wonderful things that they do-yet understand that where there is market failure, there must be intervention. That is what we need. Given that it can cost about £1 billion to bring such drugs to the market, intervention is necessary, whether in the form of product development partnerships or an adjustment to tax credits for research and development. We make that particular proposal in our report, and I commend it to the Minister. That sort of intervention and Government support for research and development will be essential if we are to beat those diseases.

***

Nick Herbert: Will my right hon. Friend give way?

Mr Duncan: I have only three lines of my speech left, but since it is my right hon. Friend, I will.

Nick Herbert: I am grateful. I welcome everything that my right hon. Friend has said, the commitment that DFID has shown to this area and his undertaking that the Department will look carefully at the report. Does he think, in the overall scheme of things, that the global response to these diseases, many of which are pandemics, is equal to the task? It has taken an enormous global effort in other respects to tackle these diseases, such as with the establishment of the global fund. Only one TB drug has been approved by the Food and Drug Administration in the past 50 years. It was developed by Janssen Pharmaceuticals, by doctors who were not authorised to take it forward because they knew it would not be commercial. Finally, the company allowed the drug. Unless there is a step change in the response in the developing world to this problem, I wonder whether we will deal with it.

Mr Duncan: I agree with my right hon. Friend. We had a passionate debate on TB just a few months ago, in which he spoke on a subject on which he commands the House. The scale of the activity is not yet equal to the task, and it needs to be. That is why I urge all developed countries to match the 0.7% commitment that we have made. We, having taken the lead, should be followed by others. We can be proud that we are in the lead, and if others did what we did, we might well be up to the scale of the task that he illustrated. On that purposeful note, I say that we are committed to maintaining our record of funding high quality, high impact research and to putting that knowledge into use, so that we all, in the work we do, can save many thousands, if not millions, of lives. 

A full transcript of the debate can be read here: http://www.publications.parliament.uk/pa/cm201415/cmhansrd/cm140708/halltext/140708h0001.htm#14070893000001

The APPG Report - Dying for a cure: Research and development for global health - can be read here: http://www.appg-tb.org.uk/images/reports/Dying%20for%20a%20Cure%20-%20Research%20and%20Development%20for%20Global%20Health.pdf  

Nick's last speech on TB can be read here: http://www.nickherbert.com/media_centre.php/658/tuberculosis 

2.53 pm

Nick Herbert (Arundel and South Downs) (Con): I am grateful to be able to take part in this debate and I will speak briefly. First, I congratulate my hon. Friend the Member for St Ives (Andrew George) on securing the debate.I am very proud to co-chair the all-party group on global tuberculosis, which he and I co-founded with our Labour co-chair, the hon. Member for Ealing, Southall (Mr Sharma). I am also very proud of the report that we have just produced, to which my hon. Friend referred, "Dying for a Cure: Research and Development for Global Health", which covers precisely the issues he has raised in this debate.

May I say in parenthesis that there is much debate about the support provided to all-party groups. Our report simply would not have been possible without our all-party group's first-class secretariat, which is funded by RESULTS UK and other organisations and has enabled our excellent researcher, Matt Oliver, to help with the drafting of the report. That goes to show that not all external support for all-party groups is bad-far from it. Without that support we simply would not have been able to produce the report. It is important that Members speak up for legitimate all-party groups that have important work to do.

I want to focus particularly on tuberculosis, which still kills 1.3 million people a year-quite unnecessarily, given that it is a treatable and curable disease. There is a particular new threat because of drug resistance, which is a serious problem and a concern not just globally but in this country. I commend the Prime Minister's stance on the significance of drug resistance as an issue that this country has to address in future. Our all-party group was reminded of that recently when we travelled to Bucharest in Romania and visited prisons and clinics around the country where TB is prevalent-not just TB but drug-resistant TB. In Romania, as well as in other developing and underdeveloped countries throughout the world where TB is a serious problem, the issue is not just access to drugs, which can of course be corrected by the west making significant interventions through the global health fund and other means to provide drugs where they are available; it is also a problem of availability.

Our report seeks to address the simple fact that there is insufficient availability of diagnostics and treatments for tuberculosis. I have mentioned this in a previous debate on the same issues in this Chamber, but I want to repeat myself because it is important: it is sobering that if TB had resurged in the west, pharmaceutical companies would by now have found the investment required to produce significant new tools for its diagnosis and treatment, as has happened for HIV. Amazing new cures and treatments are available for HIV. Why? Because HIV has been a disease of the west as well as cruelly affecting the developing world.

Although it has made something of a comeback in the west, TB has not been perceived in the same way. It has continued to claim the lives of millions, but only in developing countries, so it has not received the attention. Nor are there the straightforward financial incentives for pharmaceutical companies to develop the necessary tools. There is still no vaccine for TB. People believe that there is, but there is not: the BCG vaccine is partial and relatively ineffective for adults.

The first-line drugs that are used to treat TB were developed decades ago, must be taken over an extended period and are part of the reason why drug-resistant TB is a problem. The diagnostics for TB are old-fashioned and inadequate. All this is not the fault of drugs companies; in a free market they simply do not have the commercial incentive to develop new tools because there would be no market for them to sell to.

Mr O'Brien: I am grateful to my right hon. Friend for giving way to me, particularly on my second intervention in this debate. I have just returned from Papua New Guinea, where, given my interest in malaria, it was impressive to see Oil Search-to refer to his point about delivery-delivering across extremely difficult and hostile territory, in the complete absence of any other form of provision. Multi-drug-resistant tuberculosis was its main challenge. Often, pharmaceutical, distribution and oil and petrochemical companies are becoming part of the solution as they extend their provision, whether that includes GSK considering the pricing of its malaria vaccine or Novartis distributing malaria drugs. Equally, on TB, Oil Search is becoming part of the solution as part of its extended corporate social responsibility, as well as ensuring research and development for non-purchasing-power markets. I thoroughly endorse where my right hon. Friend is taking this debate.

Nick Herbert: I am grateful for my hon. Friend's intervention. I think that corporate social responsibility can be part of the solution, but it will not be a sufficient solution. What we have here is significant market failure. Where there is market failure, there is an imperative for Government intervention. One can still believe in markets-the power of markets, and pharmaceutical companies' freedom to do all the wonderful things that they do-yet understand that where there is market failure, there must be intervention. That is what we need. Given that it can cost about £1 billion to bring such drugs to the market, intervention is necessary, whether in the form of product development partnerships or an adjustment to tax credits for research and development. We make that particular proposal in our report, and I commend it to the Minister. That sort of intervention and Government support for research and development will be essential if we are to beat those diseases.

***

Nick Herbert: Will my right hon. Friend give way?

Mr Duncan: I have only three lines of my speech left, but since it is my right hon. Friend, I will.

Nick Herbert: I am grateful. I welcome everything that my right hon. Friend has said, the commitment that DFID has shown to this area and his undertaking that the Department will look carefully at the report. Does he think, in the overall scheme of things, that the global response to these diseases, many of which are pandemics, is equal to the task? It has taken an enormous global effort in other respects to tackle these diseases, such as with the establishment of the global fund. Only one TB drug has been approved by the Food and Drug Administration in the past 50 years. It was developed by Janssen Pharmaceuticals, by doctors who were not authorised to take it forward because they knew it would not be commercial. Finally, the company allowed the drug. Unless there is a step change in the response in the developing world to this problem, I wonder whether we will deal with it.

Mr Duncan: I agree with my right hon. Friend. We had a passionate debate on TB just a few months ago, in which he spoke on a subject on which he commands the House. The scale of the activity is not yet equal to the task, and it needs to be. That is why I urge all developed countries to match the 0.7% commitment that we have made. We, having taken the lead, should be followed by others. We can be proud that we are in the lead, and if others did what we did, we might well be up to the scale of the task that he illustrated. On that purposeful note, I say that we are committed to maintaining our record of funding high quality, high impact research and to putting that knowledge into use, so that we all, in the work we do, can save many thousands, if not millions, of lives. 

A full transcript of the debate can be read here: http://www.publications.parliament.uk/pa/cm201415/cmhansrd/cm140708/halltext/140708h0001.htm#14070893000001

The APPG Report - Dying for a cure: Research and development for global health - can be read here: http://www.appg-tb.org.uk/images/reports/Dying%20for%20a%20Cure%20-%20Research%20and%20Development%20for%20Global%20Health.pdf  

Nick's last speech on TB can be read here: http://www.nickherbert.com/media_centre.php/658/tuberculosis