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Liberal Democrat Fringe - The Health MDGs: What Next?

20 September 2007

Liberal Democrat chair of the International Development Select Committee, Malcolm Bruce, has called for urgent action to achieve the millennium development goals.He was speaking at a Liberal Democrat fringe meeting entitled 'The Health MDGs: What Next?,' organised by The European Alliance Against Malaria, Action for Global Health and Results.

Mr Bruce was joined at the meeting by Carol Maimbolwa from UNITAID, Wendy Graham representing the Partnership for Newborn and Child Health and Dr Dermot Maher from the Stop TB Partnership.

Opening the exchanges, Liberal Democrat MP Malcolm Bruce remarked that while the millennium development goals (MDGs) were a huge help as a reference, the issue was how to coordinate and deliver real results.He emphasised the need for practical solutions in order to achieve the MDGs, highlighting the importance of collective action.

The MDGs were still achievable if action was taken now to meet the 2015 goals, he exclaimed.In her initial remarks, Carol Maimbolwa explained that she was a representing UNITAID, which was a new public health initiative set up by five countries in 2006: UK, Brazil, Norway, France and Chile.

Focusing on MDG No 6 to combat HIV/AIDS, TB, Malaria and other diseases, Ms Maimbolwa outlined the problem of drug resistance, explaining that there was a high demand for second line drugs, which were currently unaffordable, in developing countries. She commended the UK Government for putting the issue of global poverty clearly on the political agenda.She also insisted it was important for the UK Government to encourage, influence and support other donors. Moreover, it was vital for the UK Government to meet the funding commitments which it had made, Ms Maimbolwa asserted.

Turning to the issue of malaria, she explained that it was a preventable disease, yet the leading cause of child mortality in Africa. It was also four more times likely to strike pregnant women, she said. Insecticide nets were a cheap and safe way to prevent the transmission of malaria, she further explained, believing that they had the potential to reduce child mortality rates by up to 20 per cent. For pregnant women, it was possible to administer anti-malarial treatment during pregnancy, Ms Maimbolwa said. She explained that artemisinin-based combination (ACT) therapy provided a very effective way to treat malaria, yet emphasised that it required adequate funding.It was vital to act now in order to tackle malaria and meet the MDG goals by 2015, she said, arguing that it was important to take a holistic approach to treatment management.

Highlighting further problems with diagnostics and infrastructure, Ms Maimbolwa exclaimed that on behalf of all people living with these diseases, she would like to thank the UK Government and all other donors for their help. She advocated for the Global Fund to be replenished and for the air ticket levy to be introduced.

Dr Dermot Maher referred to a document containing plans to reach the TB MDG, explaining that it estimated the impact and cost of reaching this target as well. The Stop TB Partnership was founded in 2000, he said, explaining that it was a global social movement of over 500 partners which shared a common vision of a TB-free world.

Furthermore, Dr Maher observed that TB had plagued humanity for thousands of years and the disease was partly so difficult to tackle because it had evolved alongside humanity.Emphasising the urgent need to tackle the transmission of malaria, he explained that the partnership hoped it would be possible to develop new diagnostic tools, drugs and vaccines. In the case of malaria, he argued that 'cure is the best means of prevention'. Nigerian President Olusegun Obasanjo, Gordon Brown and Bill Gates had drawn up a road map to treat 50 million TB patients, he noted. Moreover, the aspiration was to halve the prevalence of TB deaths 2015 compared to the 1990 baseline, he explained.

He called for an ambitious research agenda, hoping it would be possible for a new safe and affordable vaccine to be developed by 2015.The World Health Organisation produced a Global TB report every year, he said, highlighting that the recent report published in March outlined that 26 million TB patients had been detected and cured over the past decade.The 'good news' was that the epidemic appeared to be slowing, he stated, yet the 'bad news' was that uneven and inequitable access to diagnostics and treatment was still an issue.

Dr Maher emphasised that there were critical shortages of health staff as well. Furthermore, HIV was fuelling the TB epidemic, he stated, asserting that 'turning the tide' of HIV would also help to reduce the prevalence of TB.He explained that multi-drug resistant TB was a problem, highlighting the number of people who had died from extensively drug-resistant tuberculosis (XDR-TB).In order to capitalise on the limited progress which had been made, he insisted that there needed to be more activities on the ground, in addition to more research, especially on new vaccines and diagnostics, he stated.

Moreover, current funding levels to tackle TB were not sufficient, he said, explaining it was estimated that $56 billion was needed worldwide. The funding shortfall for this year was $1 billion, he stated.Furthermore, more than three quarters of all TB cases around the world occurred in the productive age groups, he pointed out.

Welcoming the launch of the International Health Partnership, Dr Maher said he was pleased that Sir Menzies Campbell had endorsed the need to stop TB, yet insisted that rhetoric had to be turned into reality.

Representing the Partnership for Maternal, Newborn and Child Health, Professor Wendy Graham emphasised that MDG goal No 5 to improve maternal health was the goal which was most 'off-track'.Referring to a particular case which highlighted individual stories hidden behind maternal mortality statistics, Professor Graham outlined the story of a young lady who was pregnant with her fourth child at the age of 25 years.She explained that the need to pay for a caesarean section had plunged the family into debt and the young mother could not afford to pay the hospital fees for the birth of her fourth child. Following a difficult labour, her child was born, yet he died soon afterwards because he was very weak, she went on to say.The mother started experiencing severe abdomen pains a few days after giving birth, though when she was taken to hospital, there was a long delay because the only doctor available was busy in theatre. In the end, the young mother died of heart failure, with the family being billed for £100 treatment at the hospital and £80 for the funeral, which resulted in the family slipping even further into debt, she said.

Professor Graham explained that there were half a million maternal deaths every year, with one every minute and 99 per cent. of them occurring in developing countries. Maternal survival was linked to other MDGs, she emphasised, insisting that it was a developmental issue and not just a health issue.Fifty per cent. of these deaths were concentrated in India, Pakistan, Ethiopia, Nigeria and the DRC, she pointed out, arguing that it was important to catalyse action to reduce the mortality rate. There needed to be a renewed focus on delivery and emergency obstetric care, more health professionals, greater financial resources, robust tracking of accountability and a greater political commitment to addressing this issue, she maintained.

Arguing that it was possible to make rapid progress on this issue, Professor Graham highlighted that there had been a 75 per cent. reduction in maternal mortality between 1926 and 1996 in Scotland. A number of factors such as strengthening the health system and increasing women's education had contributed to this reduction, she said. She advocated a multi-sectoral approach to the problem in developing countries as well. Childbirth was a universal experience and the universality of the experience had the potential to create a global bond, she maintained.

Calling for more research, she suggested that health professional organisations should forge appropriate links with developing countries. She warned that if the MDGs failed to be met, it would be a global collective failure, rather than the responsibility of individual developing countries.

During the question and answer session which followed, one of the members of the audience said that she had lived in Uganda, commenting that many men were taking the insecticidal anti-malarial nets away from women and children.In response, Ms Maimbolwa explained that it had been decided in Zambia that three nets should be provided per family, remarking that in some rural areas men were using anti-malarial nets as fishing nets.

A spokesperson from Oxfam highlighted its campaign to increase in investment in water and sanitation, emphasising that the lack of health professionals in developing countries was a key problem. Agreeing that it was a significant issue, Professor Graham said that the shortfall of midwives was significant with respect to maternal mortality.

Another member of the audience commented that the $1 billion shortfall for TB funding was a 'drop in the ocean' for the European Union. Responding, Mr Bruce said that Britain was performing relatively well in relation to its European counterparts in terms of delivering international development aid, especially when compared to Germany and France.

Regarding a question on the accountability of aid from a representative of Fleishman-Hillard, Mr Bruce explained that the International Development Select Committee compiled an annual report on aid, adding that they were about to focus on a report on maternal health.The select committee was challenging DFID to internalise MDGs in more specific ways, he said. He asserted that the UK taxpayer was willing to donate money towards international development as long as they were sure that targets and desired outcomes were being achieved.

One of the organisers of the event believed that the European Union could do more, emphasising that the European Union was the largest aid donor in the world and had an obligation to ensure that some of this money was being directed towards health.



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