Neglected Tropical Diseases

Baroness Barker Excerpts

Monday 3rd April 2017 Lords Chamber

[Baroness Barker (LD)]

My Lords, I thank the noble Baroness, Lady Hayman, not just for today’s debate but for the succession of world-leading scientists who she and Jeremy Lefroy bring into Parliament week after week so that some of us can begin to understand the complex science about which we are speaking tonight. Having listened to those scientists for over a year, I now understand that we are talking about three main types of disease when we talk about neglected tropical diseases. Those caused by worms and flukes are largely treated by very simple population management methods. Those which are vector-borne are much more complicated and need treatment in hospital; malaria is the classic example. The third group is made up of the very highly contagious epidemics which hit a population with a much more profound effect than they would do here when that population is, as noble Lords have said, living in poverty and without access to basic medicine.

The approaches to all three of these disease groups are quite distinct, and the hazards that they pose are quite different. They are also all happening, worryingly, against the background of multidrug resistance, for example for TB and malaria, which is probably the equivalent of climate change in medicine and something that we should be very focused on and frightened of. But a very important point is that the same institutions and scientists that work on drug resistance mechanisms are the same scientists who work on the mechanism behind NTDs. So the science is interconnected, and I want to talk about maintaining that science base.

Other noble Lords have spoken about the heritage that we have from our colonial past in the schools of tropical medicine in London and Liverpool, and it is time that we repaid what we took from the world, by ensuring that those institutions continue to work to provide the basic science to support pharmaceutical companies to take forward new compounds into development and clinical trials and on towards new medicines. In that, international funding from Governments, including for example from DfID, is really important. It does two different things: humanitarian aid, which is very important, but also funding for long-term scientific and medical development. That is the stuff which the public do not really see and which is therefore much more vulnerable to cuts. I hope the Minister might be able to assure the House that DfID will continue to play its leading role in humanitarian funding but will also not take its foot off the pedal in terms of funding the scientific research.

Other noble Lords have spoken about the fact that it is always the marginalised people in these countries who suffer the most, but I want to raise one other issue with the Minister. The disengagement from global health by the USA under the Trump Administration will have a huge impact on in-country programmes, particularly in Africa, where many institutions such as hospitals and universities are very dependent on American support for funding both their staff and the equipment and buildings. In Ethiopia, for example, the whole of the medical school expansion programme is funded from the USA via the World Bank. It remains to be seen whether organisations such as the Bill & Melinda Gates Foundation, the Carter Center and the Clinton Foundation can step up and fill that gap. US government institutions such as the CDC and American universities such as Johns Hopkins, we think, may also be forced to stand back.

It is really important when we are trying to deal with outbreaks of these diseases around the world that there is a standing body of people in countries who have the scientific expertise to bring about a response. Will DfID perhaps switch its funding, in light of the Americans’ withdrawal of funding from certain sexual and reproductive health programmes, to ensure that funding for those programmes continues? Will the Government also press the Trump Administration, who have less objection to work on NTDs, to place some of the money that they have withdrawn from the other programmes into programmes supporting the science and treatment of neglected tropical diseases?