There was a very impressive debate in the British House of Commons (Hansard Debates for 26 Jan 2006) yesterday about Health Services in Developing Countries.
Gareth Thomas, Hilary Benn's deputy minister in the Department for International Development, spoke for the Government. He drew attention to the importance of health; and described the UK's approach. This includes:
- increasing finance, in a form that is longer term and more predictable, provided where possible through Government budgets; and working with faith based organisations, NGOs and the private sector;
- dealing with the staffing crisis in many countries;
- improving performance management
- supporting GAVI and the Global Fund
- The International Finance Facility for Immunization
- Stimulating investment by advanced market commitments
- Simplifying the international system.
We have to ensure that those additional funds are spent on the right things and target those most in need. As I said, that aid needs to be long-term and predictable. Only then will countries have the confidence to scale up their health services and invest in the necessary training, and only then will they have confidence that they can recruit and pay for additional staff at the same time as revitalising their health infrastructure. Only when there is that long-term, predictable aid will Finance Ministers and Health Ministers have the confidence and ambition that we want them to have for health care spending in their country.
Mark Simmonds, for the Conservative opposition, expressed his agreement for the Government's approach, including support for the Global Fund and IFFIm. He laid stress on the need to strengthen health systems. He called on the Government to encourage greater availability of generics, and to take steps to increase R&D in new medicines and to ensure that they can be accessed once they have been developed.
This was a good debate: balanced and well informed. There was an interesting focus on the question of staffing, and the role of rich countries in draining trained health professionals from poor countries. (John Barrett MP quotes an interesting statistic that more than half of the additional 18,000 health professionals recruited to the NHS were trained outside the UK and Europe).
I was somewhat bewildered by this call from the Conservative spokesperson:
The Department for International Development needs to do more to encourage the pharmaceutical industry to allow the manufacture of generic drugs for use in the developing world. The former director general of the World Health Organisation's HIV programme suggested the designation of a humanitarian corridor within which leading drug manufacturers would allow rivals to produce drugs at low prices for modest royalties. Does the Department support that suggestion? If not, why not, and if so, what is it is doing to encourage the proposal?
It is not clear that it is in the long term interests of the health of the poor for rich countries to promote generic competition, at least not in all cases. One of the insights of the Advance Markets Commitment work is that we need to make the rewards for companies investing in neglected diseases bigger, not smaller, if we are going to see large quantities of investment in the medicines that are so desparately needed.
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