We are very encouraged by the progress of fast-tracked approaches to vaccine development for COVID-19. Several vaccine candidates have demonstrated very promising results in clinical trials, with one recently approved for use in the UK (Pfizer/BioNTech). Interim results for another candidate, developed by Oxford University and AstraZeneca, are also very encouraging and this vaccine is part of a portfolio of candidates funded by the UK-backed Coalition for Epidemic Preparedness Innovations (CEPI). We will need multiple safe and effective vaccines to control the pandemic in a range of populations and settings. CEPI is playing a vital role in enabling global access to successful vaccine candidates, especially in poorer countries.

Vaccine research for many global health challenges, including HIV/AIDS and tuberculosis, is expensive, complex and high risk. The encouraging results on COVID-19 vaccines demonstrate the importance of international collaboration and having trials in multiple settings. It also highlights the need to address manufacturing capacity, accessibility and affordability at the same time as development of the vaccine, to ensure rapid access for poorer countries. The UK has been clear in its commitment to international collaboration in development and access to COVID-19 vaccines, as demonstrated by our significant financial commitments to CEPI and Gavi the Vaccine Alliance which are both under the COVAX facility.

It is still too early to establish the impact of COVID-19 on the spread of antimicrobial resistance. The UK is supporting countries to respond to the pandemic, maintain essential health services, including diagnosis and treatment of infectious diseases like TB, and to strengthen health systems to combat antimicrobial resistance. This includes our investments in WHO, Global Fund and Gavi as well as bilateral support to country health systems.

The FCDO funds research programmes to promote the development of new diagnostics, medicines and vaccines. For TB and multidrug-resistant-TB, this includes our support to the Foundation for Innovative New Diagnostics (FIND). With our support, FIND have developed five new diagnostic tests for TB, now approved by WHO and being rolled out in over 27 countries. FCDO also funds UNITAID, which aims to triple access to rapid testing for MDR-TB, and to reduce MDR-TB drug prices.

We knew from previous health emergencies that COVID-19 would disrupt health services for diseases like TB. As the Stop TB Partnership's assessment highlights, TB case notifications have decreased this year, due in part to TB laboratory capacity being diverted to COVID-19 testing.

The UK has pledged over £1 billion of aid to fight COVID-19. We are working with organisations we fund to adapt their TB activities in light of COVID-19. For example, the Global Fund to Fight AIDS, TB and Malaria is supporting countries to detect TB in a way that avoids individuals gathering in one place. The Global Fund is also helping countries procure additional diagnostic machines to ensure adequate testing capacity for TB. The UK has pledged up to £1.4 billion to the Global Fund to 2022.

The UK Government also supports developing countries to make their domestic health systems, including their TB programmes, stronger and more resilient.

The UK is a proud supporter of the Global Fund to Fight AIDS, TB and Malaria. We are the second largest donor to the Sixth Replenishment, pledging up to £1.4 billion for 2020 - 2022 to fight HIV, TB, and malaria and support health systems, contributing to achievement of universal health coverage and Sustainable Development Goal 3 of “Good Health for All”. We support the Global Fund’s swift action to allow countries to re-programme or use savings from their current grants, and their rapid creation of the COVID-19 Response Mechanism (C19RM), which together have created up to £1 billion of flexibility for countries to respond to COVID-19 and its impacts on HIV, TB, malaria, and health systems.

This Government has already pledged up to £764 million of UK aid on responding to COVID-19 and we are taking our leadership role in global health very seriously. We are using UK aid to its full effect to counter the health, humanitarian, and economic risks and impact of this pandemic in the developing world. We will continue to consider all options for our future support.

DFID invests in the Global Fund to Fight AIDS, TB and Malaria as the principal mechanism to combat TB. The UK is currently the second largest investor in the Global Fund, pledging £1.4 billion to the 6^th Replenishment (2020 – 2022) and £1.2 billion for the 5^th Replenishment (2017-2019).

As our investment in the Global Fund has increased our bilateral programmes have decreased. Bilateral spending on TB control in 2018, which we publish by calendar year, was £1,862,966.

We also fund research on TB, including to develop more effective diagnostics and treatment, programmes to support countries to strengthen their health systems. Additionally, we significantly invest into health multilaterals such as the World Health Organisation and Unitaid, which provide technical leadership on tackling TB and strengthening health systems, support the introduction of new drugs for drug-resistant TB and the development of paediatric TB medicines for children in some of the world’s poorest countries.

Data on UK aid expenditure is published each year and can be accessed from the link below:

https://www.gov.uk/government/statistics/statistics-on-international-development-final-uk-aid-spend-2018