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The Parliamentary Under-Secretary of State for Foreign, Commonwealth and Development Affairs (Vicky Ford)
It is an absolute pleasure, Mrs Murray, to serve under your chairmanship.
I start by thanking the hon. Member for Ealing, Southall (Mr Sharma) for securing this debate on this incredibly important topic. I pay tribute to him for his long-standing advocacy for action on TB, including as co-chair of the all-party parliamentary group on global TB. I also thank the other hon. Members for their contributions today. I will try to respond to many of the points that have been raised.
Every year on World TB Day, it is important to reflect on the impact that tuberculosis has on people across the world. We are reminded of the devastating cost of this deadly disease. We are continuing our efforts to combat it, by investing in services worldwide to prevent, test for and treat TB, funding cutting-edge research to fight TB locally, and working to strengthen healthcare across the world and at home. I will set out further details on this work during my speech.
First, however, it is important to understand the scale of the challenge that we face. Despite the fact that TB is preventable and treatable, it continues to have a devastating impact. It is truly shocking that every day more than 4,100 people die from it: mothers and fathers, and sons and daughters. Thousands of families are torn apart daily. TB kills more people each year than malaria and AIDS put together. In Africa, it is the leading killer of people with HIV. And as the Opposition spokeswoman, the hon. Member for West Ham (Ms Brown), pointed out, TB is particularly harmful to women, especially pregnant women, causing complications and increasing both maternal and infant mortality rates.
As hon. Members have pointed out, TB preys on some of the world’s most vulnerable people. The hon. Member for Ealing, Southall mentioned Ukraine. In Ukraine, TB has the potential to add to the horrific impact of Putin’s illegal invasion. Ukraine already had the fourth-highest incidence of TB in Europe and Putin’s war is disrupting medical care, which heightens the risk of the disease spreading. The UK and the rest of the international community will continue to support the Ukrainian Government and people, including with medical supplies. We also welcome the Global Fund’s announcement of an additional $15 million of emergency funding to Ukraine, which will support the continuation of HIV and TB prevention, testing and treatment services. However, I also want to be really clear that the best way to prevent deaths from TB and other diseases in Ukraine is for Russia to stop this illegal war.
As the hon. Gentleman also mentioned, the covid pandemic has continued to take a toll on people’s lives and it has had a knock-on effect on the work to combat TB. In 2020, deaths from tuberculosis increased for the first time in a decade. However, we have also seen an 18% decrease in the number of people being diagnosed with TB, because the pandemic disrupted TB services and people’s ability to seek care.
It is vital that we continue our efforts and work with partners to boost access to essential services, in order to prevent and treat this disease, and that we continue improving global surveillance systems, so that we can detect and respond to outbreaks quickly.
As all the hon. Members who spoke today have mentioned, the World Health Organisation’s TB strategy has set out the global scale of the ambition to end the TB epidemic by 2035. We continue to strive towards that target and have strongly supported work to deliver it. In fact, the UK helped to establish the Global Fund to Fight AIDS, Tuberculosis and Malaria more than 20 years ago. We have remained a strong supporter ever since, contributing more than £4.1 billion to it. The Global Fund has made a huge difference over the past two decades, saving an incredible 44 million lives. It will continue to play an important role and I welcome the focus in its latest investment case on supporting health systems and global health security.
Many Members mentioned reductions to official development assistance. We all know that the economic situation is deeply challenging and that was a very difficult decision to make, but it was also a temporary decision. We are committed to returning to 0.7% as soon as the situation allows, and I remind Members of the positive statements that the Chancellor made about that in his autumn Budget. We remain committed to improving global health, and are looking at our work in a number of areas to ensure the best configuration to deliver our priorities.
International development remains a core priority. It is integrated across the FCDO, including across the country network, and developmental priorities will continue to be embedded in multiple areas. We are reviewing the Global Fund’s recently released investment case and considering what commitment we can make for the seventh replenishment, but I cannot provide details on that now.
Vicky Ford
I thank the hon. Lady for her excellent question. I understand the urgency of getting the details agreed, but, as she knows, there has been a restructuring in the FCDO because of the changing situation that we now face, given the geopolitical impact of Russia’s illegal invasion of Ukraine. It is important that we continually assess how best to use our structures to reflect different global challenges to enable us to deliver for the UK. As I said, we maintain a strong commitment to improving global health, and I understand the importance of getting the numbers agreed. We cannot do everything, but we will get the numbers as soon as possible.
Research was mentioned in the opening speech. The UK is a global leader in the funding of TB research. We continue to support academics and industry to develop the evidence, and new technologies and approaches to diagnose and treat TB. We have been a critical investor in product development partnerships to combat infectious diseases, including TB, for many years. The FCDO has supported the Foundation for Innovative New Diagnostics to develop a new PCR-based technology to test for TB, which is now available in more than 140 countries worldwide, including in the NHS.
Our investment also helped the TB Alliance to develop new combinations of drugs that significantly reduce the severity of side effects and the length of treatment from over 18 months to six months for drug-resistant TB, and even shorter for drug-sensitive TB. UK funding is bringing partners together to solve critical problems. For example, through support to British Investment International, MedAccess, the Clinton Health Access Initiative and Unitaid have secured a lower price for an innovative short-course TB preventive therapy.
As a further demonstration of our commitment to invest in the fight against TB, I am pleased to announce £6 million of funding for TB REACH, which will support piloting innovative ways to hunt down and treat millions of missing TB cases. I am pleased that the US and Canada are also backing that fantastic work; only through joined-up efforts with our partners will we meet our target to eliminate TB. The UK Government are one of the largest bilateral funders of TB research and development globally, and we continue to invest in research and development, including developing new tools and approaches to tackle TB.
The hon. Members for Ealing, Southall and for West Ham spoke about the situation in the UK. With an eye on the global picture, it is important not to lose sight of the challenge that TB presents here in the UK. As in other countries, we see that the disease often affects the most marginalised and vulnerable people. We are investing in early detection and treatment, including genome sequencing, which can help to detect drug resistance and clusters of transmission.
As the hon. Member for Ealing, Southall said, the UK has a TB action plan for England, which will run for five years from 2021 to 2026. It was jointly launched by the UK Health Security Agency and NHS England, and it sets out the work that will support year-on-year reductions in TB incidence in order to move England towards its elimination target. It includes specific actions relating to underserved populations.
Jim Shannon
I thank the Minister for her positive responses; we are greatly encouraged. I do not expect to have an answer today, but will she let us know the number of TB cases in Scotland, Wales and Northern Ireland compared with England?
Vicky Ford
I will get back to the hon. Member with the impact on Northern Ireland. England is one of the few countries that routinely use genome screening for diagnosing and detecting drug resistance and clusters of transmission. The technology was pioneered in the UK and is routinely used in England, Scotland and Wales, but I am not sure about Northern Ireland.
People born outside the UK account for more than 70% of TB notifications, so the UK has a latent TB infection screening programme that detects new migrants with latent inactive TB. That early detection and treatment reduces the chances of a reactivation of the active disease. The Government’s additional £36 billion investment in the health and care system over the next three years will also support TB detection and treatment.
I was born in Northern Ireland, so it was heartening to hear the hon. Member for Strangford (Jim Shannon) speak about the relationship between his constituents and the people of Eswatini and Lesotho—two countries that I visited in, I think, my second week after taking on my current role. It is important that we support smaller countries as well as larger countries, and the Global Fund is working in both Eswatini and Lesotho. I assure the hon. Member that we work globally to tackle the risk factors for TB, including poverty and malnutrition.
To conclude, the UK will continue to work with partners to pioneer scientific breakthroughs, to invest in detection and treatment, and to strengthen health systems globally. That is the only way that we will make tuberculosis a thing of the past.