Between 1.5 and 2 billion people will at any time be suffering from the effects of malaria or tropical diseases such as bilhazia, sleeping sickness, leprosy, leishmaniasis, lymphatic filariasis, worms and at least nine other (collectively known as neglected tropical diseases or NTDs).
Over the past fifteen years, the UK has been among the leaders in tackling these diseases alongside the people and governments of the endemic countries as well as the USA and the Bill and Melinda Gates Foundation. The Millennium Development Goals (MDGs) were very important in focussing attention on them. Whatever their shortcomings in certain other areas, the MDGs certainly galvanised action over health and poverty.
As a result, there has been a substantial decline in deaths, disability and illness from malaria and the NTDs. For instance, deaths from malaria have halved from approximately 1,000,000 to 500,000. Most of the deaths averted have been of young children.
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The impact upon economies is also substantial. It has been estimated that a country experiencing a heavy burden of malaria can expect to see growth reduced by 0.7% pa from that cause alone. While there is no clear proof of the connection yet, it is noteworthy that sub-Saharan African countries which have cut their malaria and NTD burden sharply have also begun to experience some of the highest rates of growth in the world.
But all these diseases are both preventable and treatable. No one should die from them. That is the challenge for the coming years. In Tuesday’s debate, I will be making the case for the UK to continue the fine work of recent years so that we can see the elimination of some of these diseases, and certainly the prevention of so much unnecessary death and disability.
The UK’s leadership has not only been about providing money. Institutions such as the London School of Hygiene and Tropical Medicine, the Liverpool School of Tropical Medicine, York University, Imperial College and Keele University, among others, have done pioneering work.
GSK has helped to develop the first malaria vaccine (RTS,S), which was approved by the European Medicines Agency this year. It has also donated billions of doses of albendazole to fight lymphatic filariasis and to help deworm schoolchildren.
UK charities and non-governmental organisations such as the Malaria Consortium, Sightsavers, the Schistosomiasis Control Initiative (based at Imperial College) and the Leprosy Mission have worked alongside health staff in endemic countries to put in place prevention, rapid diagnosis and cure.
But funding has of course been vital. George Osborne’s committed £500 million pa to fight malaria when he was Shadow Chancellor in 2007. In 2014, as Chancellor, he achieved this. £195 million was also committed to tackling NTDs in 2012-2016, to add to the £50m already pledged by the previous Labour government.
I do not argue that we should expect funding to continue to increase. Other donors need to come forward, as do countries in which these diseases are endemic. Sub-Saharan African countries pledged at Abuja to commit 15% of their budgets to health. Those that have done have made very substantial progress in fighting the diseases, but they are still few in number.
However the UK needs to maintain the support which it has provided. The malaria parasite is beginning to show resistance to the Artemisinin Combination Therapies which have been the front line cures against falciparum malaria for more than a decade. We need to help prevent this resistance from spreading further from South East Asia and to continue to develop new drugs. The mosquito is also developing resistance to the pyrethrum-based insecticides used to spray bed nets, which have been by far the most effective prevention against malaria. Leishmaniasis is returning to war-torn Syria.
Recent history has shown that, if we relax in our struggles with these diseases, they come back quickly. That is why the world needs to push for their elimination, as it did with smallpox and is doing with polio.
The World Health Organisation counts work tackling malaria and NTDs as amongst the most cost effective health interventions of all. But what is much more important is that this work protects and improves the lives of about one quarter of the population of our planet.
Photo credit: Malaria Consortium