Neglected Tropical Diseases

Baroness Sheehan Excerpts

Monday 3rd April 2017 Lords Chamber

[Baroness Sheehan (LD)]

My Lords, I add my thanks to those of other noble Lords to the noble Baroness, Lady Hayman, for finally securing this debate. It comes at an opportune moment for me as just last week I visited the headquarters of global health institutions working in the fight against malaria, HIV/AIDS and TB. While none of those is, technically, neglected tropical diseases, there are nevertheless many lessons that we can learn from the global fight against these big three killer diseases. I will pick out just three from among the many challenges.

The first is communicating key messages to affected communities, a point made by the right reverend Prelate the Bishop of St Albans. The other two points were picked up by other noble Lords. The second issue concerns the in-country training of medical practitioners to administer drugs effectively. The noble Baronesses, Lady Chalker and Lady Barker, spoke forcefully on that. Thirdly, we need to recognise that prevention and long-term sustainable control are key to success in tackling NTDs. My noble friend Lady Northover made the point that no resurgence is a key goal if we are to be successful.

I focus on TB as an example. That disease was the scourge of Victorian times in the UK. However, with improved public health, less overcrowding and better nutrition we were able to control it effectively—crucially, without the use of drugs, although, of course, antibiotics helped with the final push. That is the key message I want to get across.

Prevention has to be the first line of defence. Effective prevention needs an integrated holistic approach, starting with disease surveillance to identify hotspots, to enable an effective targeted response. In hotspots, to be effective, the mass administration of drugs must be followed by WASH initiatives—again, the noble Baroness, Lady Chalker, spoke about this—that is, water, sanitation and hygiene initiatives, coupled with vector control and education about local factors that perpetuate the disease. Overarching all this is the need to tackle gender and child inequalities, ensuring that women and children are not left behind, because all too often they are left untreated. They are inadvertently most active in infecting others—women through their role as primary carers and children as they play together.

Why have these diseases been neglected and why are they called neglected tropical diseases? The reason lies in the fact that in general they tend not to be direct killers but instead leave people with disfiguring disabilities, which impact on their schooling, work and economic independence. In 2010, the Global Burden of Disease Study, the precursor to the 2012 London declaration, confirmed that collectively they rank as the most common affliction of the world’s poor, blighting the lives and livelihoods of more than a billion people. If developing countries are to pull themselves out of poverty, these diseases must be eradicated. Eradication, however, will need increased focus on research and development. The Ebola outbreaks in 2014 and the 2015-16 Zika epidemics in the western hemisphere highlighted an almost empty pipeline of new NTD products. I would be very interested to hear the Minister’s response to the Ross fund’s work with respect to NTDs.

The 2012 London declaration will come to an end in 2020. Given that NTDs are an indicator for a number of SDGs, in particular SDGs 1, 3, 6, 10 and 11—I might say what they are later if I have time—what commitment or strategy is planned for post-2020? Could international diplomatic pressure be brought to bear to expand commitment to the London declaration? Lastly, could the Minister and his colleagues in government give some thought to placing NTDs on the G20 agenda given that most NTDs and other poverty-related diseases are also found among the poor in developed countries?