CONTENTS

politics first | Corridors
September / October 2016 | www.politicsfirst.org.uk
How the north of England’s transport
and local infrastructure is neglected
The importance of overseas development
assistance in tackling malaria
Peter Dowd, Labour MP for Bootle
Even in the age of cyberspace, I expect people do, on
occasion, have to leave their homes. I do. Visiting the
shops, getting to work, visiting family or friends or going
on holiday all require a transport infrastructure, of one
form or other.
Jeremy Lefroy, Chair of the All-Party Parliamentary Group on Malaria
and Neglected Tropical Diseases and Conservative MP for Stafford
Kananga, a city of more than one million people, in the
province of Kasai Centrale, in DR Congo, is not easy
to reach. However, the work which has been done to
control and treat malaria in Kananga and Kasai Centrale
is showing encouraging results in a country which has
the second largest malaria burden in the world.
We all have one thing in common. The
infrastructure is just a stride away. As soon as
people walk out of their house, they step onto
a pavement and therein have become one with
public infrastructure.
Regrettably, however, at that point the
common experience ends. If you live in
London, you become part of a community
which, annually, has significantly more spent
on its infrastructure, including transport, than
other parts of the country. That provides a
comparatively, I emphasise comparatively, good
deal by the standards of other regions. Although,
compared to the historic investment in the
transport infrastructure in, for example, Germany
and France, the UK remains in the foothills.
In England, the nearest rivals to the rail,
road or pedestrians of London are those living
in the North West. In the North East, our fellow
citizens get an even worse deal. We are told
that London, and I acknowledge this, is the
economic powerhouse of the country and needs
the investment. But that becomes a circular
argument as more demands more.
Having set the context, you might ask,
so what? In answer, I would use an example
of a major economic investment underway
in my constituency which highlights a
funding mismatch connected with transport
infrastructure. The constituency I represent has
the Port of Liverpool within it. It is undergoing
major investment, with the building of a new
£300 million container terminal - Liverpool2 –
that will significantly increase the capacity of this
centrally located deep water container port. It is
currently the UK’s primary transatlantic port with
strong connections to other overseas markets
and which, in light of Brexit, surely gives it an
edge. Hopefully, other port-related investments
are in the pipeline.
But regardless of the current private
investment, the transport infrastructure serving
the Port of Liverpool is in need of significant
public investment. The roads are under strain
and the rail port capacity is struggling, to say
the least. So whilst Crossrail 1 has had over
£200 million per rail mile spent on it, one of the
country’s major ports will have just £10 million,
in total, spent on the rail connection over a three
year period and only part of that is taxpayer
money. By contrast, the figure for Crossrail 2 is
likely to reach over £300 million per rail mile.
Network Rail seems incapable of
understanding the importance of rail investment
to the port. Meanwhile, Highways England are
consulting on possible new road investments to
the port. But, will we get any tunnelling on any
new potential route to mitigate the environmental
impact, such as lorries spewing out nitrogen
oxide and fine particles? Crossrail 1 did, so hope
springs eternal.
When major investment by the private sector
in a local economy impacts upon the local
transport infrastructure, it is not unreasonable
to ask for a commitment from government. The
reasonable “ask” which my local community has
of government is simple: it is the commitment
to ensure that the local multi modal transport
infrastructure is of sufficient standard to cope,
preferably in advance of the private investment.
Alas, a forlorn hope in our experience.
In short, there are a number of factors which
militate against the development of a sustainable
transport infrastructure in my constituency, in
particular, and the regions, in general.
Firstly, the current levels of overall investment
in transport infrastructure, compared with some
European rivals, are a drag on both growth and
productivity.
Secondly, combined with the bulk of that
expenditure being significantly regionally
imbalanced and skewed, the ability of many
parts of the country to enhance and maintain
economic grow becomes increasingly
challenging.
Thirdly, where fitful economic growth
does occur, people become sceptical and
disconnected as the deficits in the transport
infrastructure begin to outweigh the benefits of
the patchy growth.
In that context, perhaps the diversions of
cyberspace become even more inviting and
attractive.
The wall charts in the Centre de Sante
Mbumba, just outside Kananga, and rebuilt with
support from UK taxpayers, showed a sharp
decline in malaria cases between 2014 and
2016 since the mass distribution of insecticide
treated bednets. The pharmacy, too, was well
stocked with the most effective anti-malarials,
almost all in date.
The great progress made in cutting deaths
from malaria over the past twenty years is one
of the many reasons why overseas development
assistance is essential. In 1995, up to 2,700,000
people died from malaria, mainly children and
women; in 2015, deaths were estimated at
approximately 438,000 out of a larger global
population.
Almost all of those approximate 438,000
deaths - and those which take place every year -
could have been prevented with the tools which
we already have at our disposal: effective drugs,
insecticide treated bednets, rapid diagnostic
tests and indoor spraying.
That is why the evidence we saw in DR
Congo was encouraging. It is precisely in those
areas which are harder to reach that we need to
concentrate work, if those cases and deaths are
to be prevented.
An increase in ODA has been at the heart of
that work. But there have been many others who
have contributed very large amounts of money.
Foundations such as the Bill and Melinda Gates
Foundation, businesses such as Novartis,
GSK, Sumitomo and Sanofi, and, above all,
the countries in which malaria is, or has been
endemic in, have all contributed substantially.
ODA these days is much smaller than other
flows of money into developing countries. In
2014, it was $135,000 million compared with
private remittances of $583,000 million, inward
investment of $681,000 million and the money
raised by developing countries themselves
through taxation. That is sometimes used as a
reason for saying that ODA is insignificant.
I disagree. The days of very large cash grants
to Governments are largely over. But welltargeted
aid can be combined with resources
from developing country governments and the
private sector to tackle national, regional or
global problems. Malaria is one such example.
Alongside cooperation, we need certainty
and consistency. Research programmes into
new drugs for malaria, TB, HIV/AIDS and against
antimicrobial resistance take years, sometimes a
decade or more, to develop. That is particularly
important where we are seeing serious resistance
developing to existing drugs, as is the case in
South East Asia against the most effective antimalarials
we currently possess.
One example of the benefits of consistency
is the Innovative Vector Control Consortium
programme, based at the Liverpool School of
Tropical Medicine. That is helping to develop
new insecticides to overcome growing
resistance to the pyrethroids used on malaria
bed nets. The programme started more than 10
years ago and the first new effective products
are just starting to be used. Without consistent
funding from a number of donors, it would not
have been possible to make such progress.
We are in the middle of two major calls
for funding. The Global Fund’s replenishment
for 2017-2019 will shortly be concluded.
By the end of this year, countries will also
have made their commitments to the World
Bank’s fund for the poorest countries - the
International Development Association - also
for 2017-2019. Three year funding rounds are
certainly an improvement on fluctuating annual
commitments. But I believe that even longerterm
commitments (10 years or longer) are
needed for the work which involves long-term
research, development and implementation. The
UK’s commitment to invest £500 million per
annum to fight malaria, until 2020, is a welcome
example of providing greater certainty.
The greatest long-term commitment that
can be made is, of course, by Governments
themselves doing what they have pledged to do.
All African Governments, for instance, need to
spend the 15 per cent of their budget on health
as they agreed at Abuja in 2001; and all G7
countries should fulfil their promise to commit
0.7 per cent of Gross National Income to ODA.
Declaration of interests: Jeremy Lefroy is
a member of the International Development
Committee of the House of Commons. He is
also on the Board of the Liverpool School of
Tropical Medicine and the IVCC and chairs the
Board of the Parliamentary Network on the World
Bank and IMF.
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