Select Committee on International Development Appendices to the Minutes of Evidence


Memorandum submitted by the Parliamentary Office of Science and Technology (POST)


  The White Paper was published in December 2000 and the House of Commons Select Committee on International Development is to hold a short inquiry into the document, seeking oral evidence from the Secretary of State at the end of January 2001. The Parliamentary Office of Science and Technology (POST) has been asked by the Committee to provide comments and questions related to scientific and technological issues raised in the White Paper.

  The issues arising can be divided into four groups:

    —  information and communications technology (ICT)—for example, provision of telephony and internet services to developing countries;

    —  health and poor people—especially improving access to existing essential drugs and vaccines and research into the development of new ones;

    —  intellectual property regimes—for example, their impact on, access to, and cost of medicines; and

    —  environment—in particular addressing the vulnerability of poor countries to global environmental change.


  Distance learning—the White Paper discusses distance learning in Chapter 3, Paragraph 112 and Box 5. In particular, the Prime Minister's initiative on technology in teacher training (known as `Imfundo') is detailed. This is a public/private partnership to employ ICTs to support teacher training and development, particularly in sub-Saharan Africa. While distance learning can allow a wider geographical spread of students to take advantage of teaching resources and tutors, it requires a long term guaranteed investment to buy and maintain expensive equipment, which may be inappropriate in very remote communities and raises issues concerning continuity of funding. Indeed, the Imfundo website states that "education-only projects are unlikely to be sustainable," and suggests that projects should provide commercial as well as education facilities.How does DFID intend to balance the educational and commercial aspects of this initiative and ensure the long term future of its projects?

  The digital divide—Paragraphs 116 to 126 of the White Paper consider the development of communications infrastructure and the use of ICTs. The expanding use of these technologies raises concerns that developing countries may be disadvantaged, although this may seem less urgent compared with priorities in health and education. A number of general recommendations are made in the White Paper, but few specific initiatives are detailed. Some of the issues raised are considered below.

  There is seen to be a lack of legal and regulatory frameworks for telecommunications in developing countries. The White Paper suggests that telecommunications regimes need to be reformed, moving from state run monopolies to competitive markets. There are two requirements for the development of telecommunications: lowering costs and expansion of the network to cover all areas. If a widespread telecommunications network is seen as a necessity for developing countries, to what extent should regulation to ensure universal access supplement market mechanisms? How does DFID intend to encourage this balance?

  Universal access. There is concern over a digital divide within developing countries. The inadequacy of telecommunications infrastructure in many areas rules out use of the telephone, fax or internet (indeed, even electricity may be lacking in some areas). Access is likely to be particularly difficult for those outside cities. For example, more than two thirds of China's population lives in rural areas, but eighty per cent of internet users live in cities. Internet users are also likely to be young and male. Internet use presumes basic literacy (in the developing world, one adult in four is illiterate). It also requires information in local languages. For many in the developing world, residential telecommunications are not affordable, so community access schemes are necessary. What steps is DFID taking to ensure that communal access programmes are available to all, including older people, women and those in rural areas? How is DFID encouraging the development of local information sites in local languages and training so that local people can use them?

  International telecommunications and standards bodies. In the White Paper, the role played by organisations such as the International Telecommunications Union and World Trade Organisation in regulating ICT policy is considered. It is recognised that developing countries need a greater say on these bodies. What specific steps is DFID taking to encourage this?


  (Paragraphs 97-103 and 138-141, Chapter 3).

  These parts of the White Paper identify a number of global health problems affecting developing countries, including HIV/AIDS, malaria, TB, meningitis, pneumonia and diarrhoea. The White Paper reinforces the Government's intention to strengthen international efforts to combat such diseases by:

    —  ensuring that affordable drugs and vaccines are available and establishing the basic health systems needed to distribute medicines in an effective way; and

    —  encouraging the development of new drugs and vaccines (particularly for communicable diseases).

  Improving access to essential drugs—little further detail is given in the White Paper as to how DFID intends to improve access to drugs. Effective medicines already exist for many of the conditions of most concern. The challenge faced by DFID and other funders is to facilitate access to them; for instance, by assisting in their procurement and helping to fund the basic health infrastructures needed to dispense them effectively. The WHO estimates that one-third of the world population (and up to 50 per cent of the population in sub-Saharan Africa) do not have regular access to essential drugs. It is not clear from the White Paper how the UK will address these problems.

  The WHO has a medicines strategy which encourages each country to develop a national drugs policy. This involves setting up a list of essential medicines and developing strategies and systems to ensure that people have access to them. It has identified improving access to anti-malarial and anti-HIV treatments as being major priorities. A major focus of the White Paper is the issue of affordability. One approach here is to involve pharmaceutical companies in drug donation schemes. Other options mentioned in the White Paper (see Section on "Pro-Poor Research", paragraphs 135-141) include public purchase funds, differential pricing, use of tax credits and extending patent periods, although such measures are primarily seen as ways of encouraging the development of new products (see below). Other issues identified by the WHO (but on which the White Paper is largely silent) include:

    —  implementing national drug policies—co-ordination of action by all stakeholders to ensure rational use of drugs by health professionals and consumers;

    —  other aspects of accessibility—(ie apart from affordability) such as security of supply;

    —  quality and safety issues—drugs available to developing countries have often been associated with quality control problems;

    —  shelf-life—inter-agency guidelines for donated drugs stipulate that they should have useful shelf-lives of at least 12 months (although there are some exceptions to this rule); and

    —  disposal of unwanted drugs—(eg after emergencies).

  Research—the White Paper identifies a need for "pro-poor research" to encourage the development of new drugs and vaccines. Specific priorities identified for such research include communicable diseases, especially HIV/AIDS, malaria and TB. One of the main issues raised by such research is that of commercial incentives. While governments can fund fundamental research, it is commercial companies that have the manufacturing and marketing skills needed to turn such research into new products. Drugs and vaccines aimed specifically at conditions affecting developing countries are often commercially unattractive; mechanisms thus need to be found to provide incentives for companies to develop such products. The White Paper acknowledges this and notes a number of different approaches including:

    —  public purchase funds, where governments guarantee to buy vaccines for developing countries at a fixed price from any company that develops an effective new product. This raises the question of how DFID will encourage strict criteria to be agreed regarding the safety/efficacy of any new product;

    —  differential pricing, where drugs/vaccines are sold more cheaply in developing than in developed countries. How will DFID ensure that such schemes are not subject to profiteering? and

    —  extending the period of patent protection to allow companies to make profits on drugs and vaccines targeted at developing markets over a longer time period. A potential issue here that is not discussed in the White Paper is defining which products should qualify for this treatment.

  Other areas relevant to research but which are not covered in the White Paper include:

    —  clinical trials in developing countries. There is a perception that clinical trials conducted in developing countries do not always match the ethical standards required in developed countries;

    —  identification of emerging diseases (eg Ebola)—this is particularly relevant given the time-scale required (10-15 years) to develop and market new drugs and vaccines; and

    —  One of the biggest practical obstacles in using current vaccines and drugs is the need to keep many of them refrigerated; this makes their use particularly difficult in (for instance) sub-Saharan Africa. There may be scope for more research into improving existing drug and vaccine formulations to make them more robust for use in developing countries.


  (Paragraphs 142-149, Chapter 3)

  The White Paper identifies a number of concerns that developing countries have voiced over the WTO Agreement on Trade-Related Aspects of Intellectual Property Rights (TRIPs). A particular concern is that patenting regimes may restrict access to/increase the cost of essential drugs (eg if they do not permit the import of the cheapest legitimate source of a product, such as a generic drug). Another is that the TRIPs Agreement does not cover traditional knowledge or access to indigenous genetic resources. DFID proposes the establishment of a UK Commission on Intellectual Property Rights to consider such issues and report back to the Secretary of State for International Development. More details of the workings of the Commission could be requested, such as its membership, who and how it will consult and when it will report.

  The WHO has also expressed concern that trade agreements might restrict access to essential medicines. It is concerned that drugs should not be treated merely as yet another commodity, and that access to them is part of a broader right to health care. When setting up IPR systems, a balance must thus be struck between protecting the interests of the patent holder and protecting public health. To this end, the WHO are monitoring the impact of the WTO TRIPS Agreement on drug prices, technology transfer, and levels of resources available for research and development into tropical diseases. It is not clear from the White Paper how the proposed UK Commission will interact with the WHO monitoring.


  Clean technology—Chapter 6 of the White Paper refers to the need to promote the development and uptake of cleaner technology. The question arises whether DFID sees this in terms solely of reducing the release of pollutants to the environment from production processes. The discussion in Paras 261-263 appears to suggest this. However, this topic can be viewed more broadly, in terms of increasing the productivity of resources, and ensuring that products are designed to be inherently less damaging throughout their lifecycle (the cradle to grave approach). POST published a report on this topic in April 2000, and further information is available on request. The White Paper does not make clear how DFID intends to promote life cycle thinking in cleaner technology, rather than just cleaner process technology.

  Value of the Environment—Paragraphs 258-259 refer to the environment as having value to people only in terms of benefits to humans (eg protecting people from ultraviolet rays, purifying air and water, and providing resources). While these ecosystem services are real, the environment is of value to people all over the world for a variety of other non-instrumental reasons. Cultures, expressed through religion and ethics, for instance, place a less materialistic value on the environment. Similarly, the environment is of value to science in providing understanding of the workings of the earth. Finally, the 1981 UN Charter on Wildlife expressly recognises that "all life warrants respect regardless of its usefulness to Man". To what extent does DFID acknowledge the non-instrumental value of the environment, and what actions does it intend to take to recognise this alongside the instrumental values?

  Global Environmental Change—The White Paper states that developing countries are the most vulnerable to global environmental change, but does not address the means by which such vulnerability could be reduced. Research has pointed to a number of features of developing countries that make them especially vulnerable to global environmental change. In particular vulnerability increases as the capacity to adapt to the changes ("resilience") decreases. This relates to the extent to which countries have access to technology, robust institutional arrangements for emergency response, and financing and insurance. The differences in the scale of the consequences of the impacts of Hurricane Mitch on Central America and the southern USA in March 1998 illustrated the extent to which vulnerability and resilience are related to socio-economic conditions. How far does DFID recognise these issues, and what action will it take to address the issue of reducing vulnerability (ie increasing the capacity to adapt) to global environmental change?

Parliamentary Office of Science and Technology

January 2001

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