PARLIAMENTARY DEBATE
Global Fund to Fight AIDS, Tuberculosis and Malaria - 4 November 2025 (Commons/Westminster Hall)

I beg to move,

That this House has considered Government support for the Global Fund to Fight AIDS, Tuberculosis and Malaria.

It is an honour to serve under your chairship, Mr Dowd. It is 2025, and we find ourselves discussing whether the United Kingdom will continue supporting an organisation that has saved millions of lives. This is an important and timely debate, and it should remind us how much progress we have made, and how much we stand to lose if we step back now.

When I spoke earlier this year about the US cutting funding to the World Health Organisation, I said then, and will repeat today, that global health is not charity; it is security and self-interest. Supporting international health systems does not just save lives overseas; it keeps us safer here at home. Stronger systems abroad mean fewer outbreaks reaching our shores, more stable trading partners and a healthier global economy, which Britain depends on. Investing in the Global Fund to Fight AIDS, Tuberculosis and Malaria is not only the right thing to do morally but the smart thing to do economically and strategically.

I am very much informed by my constituents in Strangford, where local church groups undertake fantastic work to support those in other countries plagued with the likes of malaria, tuberculosis and AIDS. I think specifically of the Ards Elim church in Newtownards in Strangford, which sends groups out every year to support those facing the devastating impact of those diseases. Does the hon. Member agree that more must be done, either by helping to fund their work or working in partnership with them, to ensure that we are doing everything necessary to help them do their bit to help others?

The hon. Member is completely right about the work that voluntary and church groups do on global public health.

I congratulate my hon. Friend on securing this important debate. He mentioned the importance of investing in funds to protect our security. He will know better than anyone that malign-influence powers such as Russia and China are eager to step into the void that we leave when we withdraw our aid. Does he agree that if we do not fund the Global Fund properly, malign powers such as those will step in and shape global health policy in their own image?

I totally agree with my hon. Friend, who sits on the Foreign Affairs Committee; that is an insightful point.

Many of us will remember “It’s a Sin”, Channel 4’s extraordinary drama about the HIV/AIDS crisis in the 1980s. It was joyful and heartbreaking, and it reminded us that behind every statistic was a real person—sons, daughters, friends and partners, all with lives full of love and potential. But HIV today is not a death sentence. Science has done its job. Because of one pill a day, or even a single injection every few months, people can live long and healthy lives. The UN’s 95-95-95 target—that 95% of people living with HIV know their status, that 95% of those are on treatment, and that 95% of those are achieving viral suppression—is within reach, but it will not happen by accident. It requires commitment, funding and global co-operation.

I am delighted that the Prime Minister has chosen to co-host the eighth replenishment of the Global Fund, alongside the Republic of South Africa. I put on record my thanks to my hon. Friend the Member for Gedling (Michael Payne) for working hard over the last year to corral myself and other colleagues to work with the Government to make the case for the Global Fund. Does the hon. Member agree with me that by co-hosting the summit, which is a good thing in itself, we are showing that the UK remains at the forefront of global development, and that doing so in partnership with South Africa exemplifies our commitment to working with other nations to achieve our shared ambitions?

Yes, these are really important summits, and it is important to show international co-operation.

The Global Fund has been central to the progress I have spoken about. It has helped to save millions of lives and allowed millions of babies to be born HIV-free. Yet progress is fragile and without the sustained investment mentioned by the hon. Member for Exeter (Steve Race), the gains made will unravel and history will repeat itself.

The United States AIDS programme—the President’s Emergency Plan for AIDS Relief—launched more than 20 years ago, has saved around 25 million lives. It supports testing, treatment and prevention in more than 50 countries. To show the impact of cuts on these programmes, following funding cuts to that initiative earlier this year, an estimated 120,000 people have died—more than the population of a constituency.

I congratulate my hon. Friend on securing this vital debate and powerfully laying out the success of the Global Fund. Stepping back now and cutting our contribution to the fund, just as the United States is abandoning vaccination programmes altogether, would be devastating for some of the world’s most vulnerable people, and a step back in the progress made. Does my hon. Friend agree that, if the Government do not commit to replenishing the Global Fund sufficiently this year, that not only betrays our extraordinary progress and leadership but, as co-hosts, gives a signal that it is okay for others to do the same?

I completely agree about the importance of demonstrating international leadership on this issue. If international support declines, from us and other countries, an additional 10 million new HIV infections, including up to 880,000 in children, could occur by 2030. Those are preventable deaths—people who could be alive this time next year if we choose differently and maintain funding.

Tuberculosis, often called a Victorian superbug, is on the rise again, with cases in England up 13% last year. Globally, it remains one of the leading infectious killers. It is largely preventable, treatable, and curable in the vast majority of cases, yet is too often neglected. Malaria is a microscopic parasite, spread by something as small as a mosquito, that continues to kill half a million people a year. There is a saying, “If you think you are too small to make a difference, you have never spent the night in a tent with a mosquito.” We know what works: mosquito nets, repellents, rapid tests and education. The challenge is not the science but the access. The tools exist but too many communities cannot afford or reach them.

When it comes to global public health,

“Nobody wins unless everybody wins.”

Those are not my words but Bruce Springsteen’s. They apply just as much to global health as they do to any other struggle. If we allow international health systems to weaken and turn our backs on collaboration, we are failing not only others but ourselves. Every time we strengthen a health system abroad, we strengthen Britain’s safety at home. We reduce the risk of the next pandemic reaching our shores, protect supply chains, stabilise economies and open new opportunities for trade and innovation.

If we invest now, we can cement the UK’s reputation as a global leader in health innovation, not just through our laboratories and universities, but through partnerships such as the Global Fund that translate research into real-world impact. British expertise in vaccine development, diagnostics and data science already help to shape programmes that have saved lives across the world. Continued investment allows us to share knowledge, strengthen health systems and, in doing so, build influence and resilience that benefit the UK and our global partners.

We also need to be honest about the wider picture. The UK’s official development assistance budget has already been reduced from 0.7% to 0.5% of national income. The Government are now reducing it further, to around 0.3% by 2027. The Fleming Fund, which monitors and helps to tackle antimicrobial resistance, has been scaled back, and the UK’s contribution to Gavi, the Vaccine Alliance has fallen from about £1.65 billion to £1.25 billion for the next funding cycle, which is a real-terms reduction of roughly 40%.

Taken together, those decisions risk sending a message that Britain is retreating from its proud record of global health leadership. If we are serious about being a world leader in science, public health and international development, maintaining our commitment to the Global Fund is one of the clearest and most effective ways to show it. A rushed transition from global aid to self-financing, forced by rapid funding reductions, will result in direct harm through reduced healthcare, stock-outs of essential medicines and untimely deaths. When this is done in the context of infectious disease, the long-term cost will rise in exchange for short-term savings.

My hon. Friend talks about infectious disease. The cost of the malaria vaccine is now thought to be just under $5 a dose, which is amazing purchasing power. By contrast, the UK, under the last Government, who are not represented here today, was spending 29% of UK aid on in-country donor costs—that is, on hotel accommodation. Does he think this money could be better spent?

Order. Just before the hon. Gentleman responds, I remind Members that the Minister will speak at quarter past 4. The Minister is entitled to 15 minutes. I know other Members wish to speak; however, that is the way we must operate. I remind the hon. Member of that.

I thank my hon. Friend for his intervention, and I am finishing up now, Mr Dowd.

Britain has always punched above its weight when it comes to science, health and compassion. We helped to eradicate smallpox. We led on vaccine distribution. We have the knowledge, compassion and credibility to lead again, if we choose to. During the covid-19 pandemic, we all waited for the science to catch up—for a vaccine and for hope. When it finally arrived, the world changed overnight. With HIV, TB and malaria, we do not have to wait. The science is already there. The treatments already exist. What is missing is the political will and the funding.

It is a pleasure to serve under your chairship, Mr Dowd. I will be brief, as I appreciate there is not much time left.

I wanted to speak in today’s debate because, as a public health consultant who has worked in international development for 20 years, I have watched the Global Fund and have not always been its greatest fan, I have to say. It has employed funding through vertical programmes for AIDS, TB and malaria.

However, I stand corrected—politicians do not say that very often, but I do. I have seen the great work that the Global Fund has done. I have understood how it has taken a large amount of donor funding and put it to excellent use, resulting in serious reductions in three major infectious disease scourges of our time, including malaria, which 21 countries are now free of, thanks in major part to the Global Fund.

It is not just about the three major diseases that the Global Fund works on; it is about health systems strengthening, which is where it has won my heart. It now understands that we cannot just have vertical health programmes to address those three major scourges; we have to invest in systems strengthening.

I thank my friend who secured this debate, the hon. Member for Winchester (Dr Chambers). He talked about the Fleming Fund. As it comes to a close, we can address antimicrobial resistance through the Global Fund’s work on systems strengthening.

I will conclude by talking about the UK pledge coming up imminently. In 2022, we pledged £1 billion. I am incredibly proud of the leadership the United Kingdom has shown in global health, and I very much hope—as has been alluded to, with regard to our co-hosting in South Africa—that we continue to show that leadership.

I put on record that a potential 15% cut to that £1 billion would result in 220,000 fewer lives saved; 270,000 fewer people provided with antiretroviral treatment; 240,000 fewer people provided with tuberculosis treatment and care; and 20 million fewer people having access to mosquito nets, which provide much needed protection to children and families from this absolutely terrible disease.

We have led the way in global health and we have been a systems leader. Do not get me wrong: this is not simply about funding—but a strong pledge by the UK at this eighth replenishment will absolutely signal that the UK remains dedicated to global health, and how important it is to our health systems as well as to the rest of the world.

It is a pleasure to serve under your chairmanship, Mr Dowd. I am grateful to the hon. Member for Winchester (Dr Chambers) for securing this debate. I pay tribute to his work on global health as secretary to the all-party parliamentary group on antimicrobial resistance and as a member of the APPG on maternity. I am also grateful for the efforts of so many here who have dedicated themselves to the fight against HIV/AIDS, TB and malaria for years. I am thankful for the contribution of every hon. Member, including the thoughtful and passionate speech from my hon. Friend the Member for Worthing West (Dr Cooper). I will do my best to address the points that have been raised in the time I have.

I know that hon. Members will be aware of this Government’s commitment to the mission of the Global Fund. Indeed, we can all be proud that the United Kingdom helped to establish the Global Fund back in 2002. The UK is the fund’s third largest investor, contributing £5.5 billion so far. Members should be in no doubt that this Government value our ongoing partnership with the Global Fund; it is essential to maintaining and accelerating progress in global health.

It is hard to overstate the importance of the Global Fund in transforming the fight against these diseases. Since 2002, with support from the UK and many others, the Global Fund partnership has helped to save 70 million lives and reduce deaths from AIDS, TB and malaria by 63%—that is remarkable. Importantly, the Global Fund has helped to build more resilient and sustainable health systems that help us to fight AIDS, TB and malaria, and it helps countries to support and improve the health of their populations more broadly, from addressing the threat of antimicrobial resistance to making progress on preventing new diseases from becoming epidemics, or even pandemics.

Yet our work is far from done. Tragically, every passing minute, a child under the age of five dies of malaria. Notwithstanding all the progress that we have made, tuberculosis remains the world’s deadliest infectious disease. Nearly 14 million children are growing up without one or both of their parents—lost to AIDS-related causes, mostly in sub-Saharan Africa. Sibu Sibaca from South Africa spent her childhood caring for her parents, until AIDS took them from her when she was just 16. Her adult life is devoted to making the case for action to ensure that others do not have to go through this, and she spoke so powerfully alongside my right hon. Friend the Foreign Secretary at the United Nations General Assembly in New York, and at a reception co-hosted with South Africa’s Foreign Minister in London a few weeks ago. My hon. Friend the Member for Exeter (Steve Race) has spoken about the importance of co-operation, and of course he is right.

Wherever we can, we are making the case for how the Global Fund can continue to be a powerful solution multiplier—pooling investments, making economies of scale and maximising our collective impact. Let me take this opportunity to shine a light on how cutting-edge advancements are changing what is possible now. Take Lenacapavir, a twice-yearly injectable that could be a game changer in the fight against HIV. Thanks to partners, including Unitaid, a recent landmark deal will bring it to market at $40 per person. That is a staggering drop from the original price of over $28,000. Thanks to the Global Fund, 2 million doses will be distributed to people in low and middle-income countries over the next two years, saving lives and giving people a chance at a better future.

The final replenishment summit in Johannesburg on 21 November matters immensely, and we are proud to be working in partnership with the Government of South Africa to make it happen. We celebrate all that we have achieved through the Global Fund in its 23 years so far, and we focus on what comes next: raising billions for the fight against AIDS, TB and malaria, with public and private investors working together; backing countries’ ambitions to invest more in health; harnessing private sector expertise, including world-class UK science to make the most of the latest innovations and improve access to medicines; and committing to work together in new ways to support countries on their path to self-reliance, and to reshape the global health architecture for the future. That is how we make sure our efforts add up to more than the sum of their parts so that the Global Fund can continue its lifesaving, life-changing work around the world.

I want to build on what other hon. Members have said by underlining what we stand to gain if we continue to make progress in the months and years ahead. As the hon. Members for Strangford (Jim Shannon) and for Winchester said, there will be more children growing up with their parents, more parents spared the heartbreak of burying a child, more families spared from devastating loss, more communities able to thrive and more economies able to prosper. That is what people everywhere want to see. I am not foolish enough to attempt to match the poetry of Bruce Springsteen, but we will keep working until people everywhere feel the benefits of better health in our lives.

Question put and agreed to.