Conservative Fringe - Global Health and the MDGs: What Next?

Conservative Shadow Minister for Health & Chair of the All Party Parliamentary Malaria Group, Stephen O’Brien MP, has called for increased and determined efforts to work towards the MDGs. He was chairing and speaking at a Conservative fringe meeting entitled Global Health and the MDGs: What Next? organised by the European Alliance against Malaria, Action for Global Health and Results. Mr O’Brien was joined at the meeting by Geoff Adlide from the Global Alliance for Vaccines and Immunisation (GAVI), Gavin Bryce from Action for Global Health and Dr Aileen Allsop, Vice President for Science Policy at AstraZeneca. 

Mr O’Brien began the meeting by expressing his thanks to the organisers of the event, and made some opening remarks about his recent visit with the Malaria Consortium to Uganda and Mozambique. He commented that it was hard to remain objective about these issues when treatable and preventable diseases such as Malaria and TB continued to be thieves of children’s lives. He acknowledged the work of the LSHTM in working towards marrying science with practical efforts on the ground but noted that in regards to the MDGs, although nations are signed up to them, we are a long way off meeting them. The MDGs relating to health, to be discussed in the meeting, were 4, 5 and 6, relating to reducing child mortality, improving maternal health and combating HIV/AIDS, TB & Malaria. 

Mr O’Brien took the opportunity to outline what the Conservative party has being doing in regards to the MDGs. There was, he said, consensus across the political parties in regards to international development and being a force for good in the world. Conservative party policy is that international development is now a high priority for David Cameron. Andrew Mitchell in particular has said that the Conservatives would play their full part on delivering aspirations but that what was most needed was better use of resources and building capacity. He went on to say that the target of meeting 0.7% of GNI was also George Osborne’s pledge as it was the current governments, with the acknowledgement that other things would have to give for this to happen. 

Mr O’Brien then briefly touched on his visits abroad and recounted how he explained his international trips to his constituents in order that they might see that there is access on the international stage to do the right thing with British money. He outlined some of the projects he saw, which had a variety of donors, and commented on the situation in Uganda in IDP camps and in the flooded areas often making the problem of malaria worse. 

Gavin Bryce from Action for Global Health followed Mr O’Brien and began by introducing the partnership, which began in 2006 with 15 organisations across Europe. They all shared the same joint concern of the lack of progress on the health MDGs. In Brussels and in 5 other European countries they now have offices and the organisations that make up this partnership bring with them extensive experience in the area of health. Mr Bryce went on to remark that what was needed was to look at cross cutting issues such as gender and health systems strengthening. Europe, he said, can and must do more. The MDGs were signed by many nations in a time of great optimism and several of them relate to health. Now in 2007, at the mid way point when we take stock, it is worrying to see that if the pace is not picked up, the MDGs will only be achieved by 2282 and this is not acceptable. If we put this in a UK context he remarked, there would be outrage at people having to wait so long. The NHS in the UK is a key vote winner/loser and is seen as very important. Yet global health events at this Conference you could count on one hand. 

Yet, Mr Bryce said, not all is lost and failure is not inevitable. The MDGs are achievable and he pointed to Action for Global health’s recent report where it talks about how much it will cost to achieve them in the time frame allowed. The total cost would be $27bn, rising to $38bn, per year. However as a percentage of Gross National Income, this is only a minute amount. He acknowledged that the UK does have the commitment to 0.7 % which is good, but there needs to be a greater % on health. Action for Global Health is calling on the government to increase its funding (Official Development Assistance) for global health to 0.1%, as currently it is than half this amount. It is interesting, he remarked, that bonuses paid out to a selected group of businesses men in the city, in one year, total up to more than what is being asked for global health. He also noted the importance of being EU citizens, with the EU being the largest donor.   

Mr Geoff Adlide, from GAVI , spoke next, introducing the partnership, which started in 1999. It started, he said, because of a recognition that immunisation rates were falling away. It was not designed as a new organisation but an alliance bringing together interested partners to do something that couldn’t be achieved individually. It included multilaterals such as the WHO, the World Bank and UNICEF as well as donor governments such as the UK and Australia, Geoff’s home country, and the governments of developing nations. Finally it also included civil society organisations and members of the vaccine industry. This was in order take a public private interface that had a unique poverty focus, in order to work with industry to bring down the price of vaccines. 

One thing GAVI worked on, Mr Adlide said, was the International Finance Facility Mechanism (IFFM). This was the idea that through capital market bonds being sold to the private sector, money was frontloaded very quickly so that very quickly results could happen rather than money coming at a later date. GAVI also works on new and under used vaccines. It has a number of different funding windows but they are country driven which means the countries themselves make applications for assistance. Programmes can also be incentive based which means that if drugs are sold cheaper than originally anticipated, the difference is given to the countries in question. Mr Adlide noted GAVI’s progress report and highlighted some successes including the price of auto disposal syringes dropping by half. He said that market influence was very important in this regard.

In regards to the MDGs Mr Adlide acknowledged that we were lagging behind, and called for big donors, namely the G8, to follow through with their big commitments with renewed energy around giving aid. Aid effectiveness matters he said, as there needs to be a predictability of money over a long period of time. In terms of what’s next he explained that we are on the edge of an exciting time of new vaccines but often the period between development in the north and distribution in the south is around 15-20 years. GAVI wishes to decrease that. He therefore concluded that

1)       Global Health partnerships show results are possible.

2)       Vaccines are amazingly effective but useless without systems to deliver them.

3)       New vaccines are around the corner.

4)       There is a need to influence markets.

5)       Partnerships are critical across all spheres in order to make progress. 

Dr Aileen Allsop, Vice President for Science Policy at AstraZeneca was the final speaker and she gave her talk around the contributions that industry has and can make towards achieving the MDGs. She pointed out that AstraZeneca, in its work in this area, was not atypical but like many others. There are currently lots of commitments from the commercial section to fight the MDGs with prominent names including Apple, Armani, and American Express. Dr Allsop outlined four exciting areas where industry could contribute:

1)       R&D of new drugs – AstraZeneca for example has a research unit in India for drugs for TB. The company saw they could make a difference there because they had the expertise and it added value to the company more than just financially. AstraZeneca also worked with the Red Cross/Red Crescent in the former Soviet Union again on the issue on TB, learning how to produce, present and work on drugs in a non western context.

2)       Donating drugs.

3)       Working with NGOs and governments to suggest models of infrastructure.

4)       Global advocacy - Dr Allsop said that if major investors can get the governments attention and push forward agendas and make a difference, it makes a big difference if they are influence by and working with developing nations and NGOs. 

Questions were then asked from the floor on whether the Conservative party saw the need to adopt vaccines more quickly in the future. Stephen O’Brien responded that any government should keep the effort going on vaccines and be ready to utilise them quickly once they are ready but at the same time keep a balance by doing other things beside this. He acknowledged the key blockages that happen when drugs are not converted into a means of helping the world’s poorest people. 

The High Commissioner from Namibia commented on the need for knowledge to remain in country and also some of the problems that Namibia had found with drug donations, which weren’t always country drive. Dr Allsop responded that it has been a problem and therefore should go through NGOs on the ground and according to what countries want and how much the health system can support its delivery. 

A further question was asked on whether the panel had considered a European R&D tax credit. Stephen O’Brien replied that from a political approach this could happen with a single market approach. A focus on R & D tax credits here in the UK has not been of huge value but a European wide incentive would make a big difference. 

Chris Whitty, from LSHTM, made a further comment that the situation is not as bleak as we think it is. Partnerships such as GAVI and the Global Fund have meant results are happening. One suggestion to increase interest here in the UK might be to send UK health professionals to Africa for a short period but this is not a long term solution and the bigger problem to address is that of the crisis of the drain of professional health workers from Africa. The chair, Stephen O’Brien, closed the meeting by acknowledging that alliances and partnerships are the key to success in the case of the health MDGs.