Select Committee on Science and Technology Written Evidence

Memorandum by the Department for International Development (DFID)


  1.  Infectious diseases are a major threat to global health, prosperity, social stability and security. Infectious diseases account for more than 40 per cent of the global disease burden, causing millions of deaths in the world each year.

  2.  Globalization has had a number of major effects, as people, money and goods have become more mobile. The consequence of rapid and wide scale population movement is a global opportunity for disease; a reality dramatically underscored by the AIDS pandemic, the spread of antimicrobial drug resistance and the recent swift spread of severe acute respiratory syndrome (SARS).

  3.  Globalization also provides significant opportunities to harness new information and technologies to share skills and knowledge, leading to better ways to tackle new challenges leading to improved health outcomes.

  4.  The Department for International Development (DFID) is committed to international poverty reduction and recognizes that the health and well-being of the world's poor requires international action. DFID is working hard to strengthen the international effort to combat diseases of the poor, with a greater focus on communicable diseases, including the development of new drugs and vaccines and improving the effectiveness of national health systems.

  5.  This international effort is underpinned by national and global surveillance that tracks disease trends and identifies new infectious disease threats and outbreaks. This information acts as the critical foundation for designing effective national and global strategies to tackle diseases, management of resources and systems, developing new tools such as drugs and vaccines, monitoring control measures ad shaping public opinion.


  6.  DFID works in partnership with developing country governments and key international institutions, including WHO, UNAIDS, UNFPA and the World Bank to tackle infectious diseases.

  7.  WHO, in its role as the world's leading technical agency on health, has an essential part to play in setting norms and standards at a global level, and helping its member states to tackle the major burdens of disease, whatever their cause, and to strengthen their health capacities and infrastructures.

  8.  DFID, Department of Health (DH) and Foreign and Commonwealth Office (FCO) share an interest in shaping a strong WHO, recognizing its potential in support of both national and international health. The Departments engage collectively with WHO on strategic and technical levels, as the world's leading health agency has a major contribution to make in promoting health, development and poverty reduction. The agenda to tackle poverty was established during Dr Bruntland's term as Director General of WHO (1998-2003) and more recently re-emphasised by the Director General nominee, Dr J W Lee, who states that "we (WHO) must focus our work on these global commitments (to the MDGs) to sustaining development and eliminating poverty". WHO is a key agency with which the UK, through DFID, engages to support our joint objectives.

  9.  On a technical level, WHO has developed surveillance systems for infectious diseases and continues to support pandemic preparedness. The Global Outbreak Alert and Response Network is a collaboration of existing institutions and networks, coordinated by WHO, pooling human and technical resources for the rapid identification, confirmation and response to outbreaks of international importance.

  10.  WHO's global alert and response activities and the Global Outbreak Alert and Response Network represent a major pillar of global health security aimed at the detection, verification and containment of epidemics. In the event of an intentional release of a biological agent, these activities would be vital for effective international containment efforts.

  11.  WHO takes a lead role in establishing the International Health Regulations (IHR) to address serious diseases that have potential for cross border spread. Revisions to the regulations have been made in accordance with the epidemiology of infectious diseases and by the growth of international travel and trade.

  12.  DFID has contributed significant financial and technical support to international partnerships, such as the Global Fund to fight AIDS (200 million US dollars over five years), TB and Malaria (GFATM), Roll Back Malaria (RBM), Global Alliance for Vaccines (GAVI) and STOP TB. DFID has also funded public private partnerships to generate new public goods in health for developing countries, such as drugs, microbicides, diagnostics and vaccines, for example our £14 million contribution to the International AIDS Vaccine Initiative. Through effective global action, we are on the verge of eradicating the unnecessary death and suffering due to one disease, polio.

  13.  Access to medicines is central to achieving health outcomes. DFID is working on a range of mechanisms to improve affordability of medicines, improving health systems delivery and fair trade rules. DFID has worked closely with DH on access to medicines—Lord Hunt was on the UK High Level working group and we have been working closely with them at official level to take the agenda forward with other stakeholders. The UK Government is engaged in negotiations through the World Trade Organization (WTO) on trade-related aspects of intellectual property rights (TRIPS) and Public Health, revolving around developing countries with insufficient manufacturing capacity and their inability to make use of the compulsory licensing flexibilities in TRIPS to meet their public health needs.


  14.  DFID is actively engaged with Department of Health in critical areas of international health. DFID supports the Government's strategy "Getting Ahead of the Curve". This sets out to:

    —  describe the scope and nature of the threat posed by infectious disease to the health of the population of England;

    —  and establish the priorities for action to combat the present, as well as possible future, threat posed by infectious disease.

  15.  The strategy recognizes that UK health and global health are inextricably linked and in order to safeguard UK health, international action and cooperation is required. DFID welcomes the opportunity to contribute to the strategy and will continue to play a role in its implementation. However, the nature of our engagement will need to take account of the following context. Our objective and strategies for working to improve the health of populations in developing countries are to meet development objectives in those countries. It would be contrary to the International Development Act (2002) for the UK government to engage in these countries to primarily safeguard UK health.

  16.  DFID would, however, value closer opportunities for aligning UK and international agendas. The UK's influence internationally is as much related to the quality of our domestic policies as to the quality and scale of our policy dialogue with our country and donor partners. There are areas of domestic policy development where we may be seen to be promoting different policies at home than with our development partners. For example, the UNGASS Declaration of Commitment is a key document providing a blueprint for the global response to HIV/AIDS. DFID strongly endorses this. All countries are asked to provide an annual response outlining the activities they have undertaken to fulfil their commitments. This year, 2003, will see the first substantial report on achievement of baseline objectives, and a full day of this year's General Assembly will be devoted to this. The UK Government has not submitted it's contribution to the report. It is difficult for us to emphasise the importance with our development partners where we are not contributing.

  17.  There are disease specific examples of cooperation. The Strategy recognizes tuberculosis as an infectious disease priority. DFID has been invited to participate in the UK national panel on tuberculosis, which will convene following the development of the new action plan to address tuberculosis.

  18.  More people are dying of TB in the world today than at any other time in history. In the UK, progress made in reducing tuberculosis in boroughs of London has been difficult to sustain, emphasising the importance of a cross boundary response. In response to the global threat of tuberculosis (92 per cent of cases and deaths occur in low income and lower middle income countries) the international community needs to adopt a similar cross boundary approach by providing increased resources, improved surveillance and more support for the global programmes aimed at controlling TB.


  19.  Public Health Laboratory Service (PHLS) Specialist agencies, and its Communicable Disease Surveillance Centre, provide expertise in informing policy, in co-ordinating surveillance activities and in the investigation of outbreaks and epidemics. The Communicable Disease Surveillance Centre (CDSC) is responsible for surveillance, sharing information in this country and across the world.

  20.  DFID recognize the importance of a new National Infection Control and Health Protection Agency combining the existing functions of the Public Health Laboratory Service and three other national bodies (the National Radiological Protection Board, the Centre for Applied Microbiology and Research, and the National Focus for Chemical Incidents) to provide an integrated approach to protecting the health of the public against infectious diseases as well as chemical and radiological hazards.

  21.  Technical skills within the National Health Service are part of an international resource pool that builds capacity within developing countries. Examples include the support to health systems and management skills in Bolivia and public health expertise to address Ebola in Uganda.

April 2003

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