Health: Neglected Tropical Diseases

Lord Chidgey Excerpts

Thursday 6th February 2014 Grand Committee

[Lord Chidgey (LD)]

My Lords, first I must apologise because I have come to this debate with a finely honed speech of just three minutes to find that I actually have four. I could spend that being rude to people, but I shall promise not to. There will be some extra time at the end that noble Lords might want to share among themselves, if they are a bit worried about the length of their speeches. Anyway, here comes my three minutes.

The London declaration in 2012 on neglected tropical diseases set a target for control and eradicating at least 10 of these devastating diseases by 2020. The commitment was to sustain, expand and extend programmes that ensure the supply of drugs and other interventions to help to eradicate these 10 diseases. International donors such as DfID could address this by explicitly targeting NTD programming at the poorest and most marginalised populations. When the Minister replies, I hope that he can comment on that and on what DfID’s role will be.

In the list of NTDs, Guinea worm disease caught my attention because, in my relative youth, I worked for some years in the rainforests and mountains of Guinea in west Africa. Tropical diseases flourished there, but never once did I come across Guinea worm.

As some noble Lords may know, Guinea worm is a parasitic infection contracted by drinking contaminated water containing water fleas harbouring infective Guinea worm larvae. Inside the human’s abdomen, the larvae mate and female worms mature and grow. They grow as long as three feet or more and, after a year of incubation, the worm creates a lesion in the skin and slowly emerges from the host person’s body. The contamination cycle begins when the victims immerse their limbs in water to ease their agonising pain, stimulating the emerging worm to release larvae into the water and begin the cycle all over again. Guinea worms can be removed by winding them around a small stick and manually extracting them in a slow and painful process which can take several weeks.

Through the intervention of the Carter Center and its partners, cases of Guinea worm have been reduced by more than 99.9% since 1986. In 2013, only approximately 150 cases were reported, mainly in South Sudan. Guinea worm disease is on track to be only the second disease in history to be eradicated after smallpox. Sadly, this is only one success.

However, it is worth comparing to the situation with tuberculosis. As far as I am aware, about 20 years ago TB too was believed to be on the point of eradication. I am not a medical man and I am not sure, but that is what I recall. Somehow that initiative was lost and now TB is the second most deadly disease in the world. It is estimated to have killed more people than any other pandemic in history. It is shocking to find that only one new TB drug has been developed in the past 42 years.

Even more troubling is that a signatory to the London declaration on NTDs appears to have effectively abandoned that commitment. According to a recent edition of the Times, AstraZeneca, the UK’s second largest drug company, has confirmed it will no longer carry out early stage research into NTDs, TB and malaria. It will be focusing instead on making products that attract big profits. It seems to be effectively turning its back on the poor.

The NTDs affect the achievement of almost all millennium development goals. There is unquestionably a case for strengthening NTD control and elimination programmes and for the inclusion of NTDs within the health goal in the MDG framework. Do the Government accept this case? In so doing, they would recognise the plight of more than 1.4 billion desperately poor people blighted by NTDs.

Child Poverty

Lord Chidgey Excerpts

Tuesday 26th June 2012 Lords Chamber

[Lord Freud]

My Lords, the level of child poverty has come down since 1998 but the cost has been very high. More worryingly, we are now the second-highest spender on transfers to children and families, spending 3.6% of GNP on it—the figure for France being 3.8%—but we simply do not get enough for our money. We are way down the ranking and that is why we need a new approach. I cannot think of a single reason why quarterly reporting would help that but we are clearly committed to reducing child poverty. We are committed to the targets for 2020 and we need to find new ways of achieving them.

[Lord Chidgey]

As a prelude to the Minister’s consultation with UNICEF, which I think is planned for the autumn, how will the Government explain their plans to address the multidimensional nature of child poverty?

[Lord Freud]

My Lords, one thing on which there has not been enough focus is the importance of behavioural impacts. Income transfers have their place in tackling poverty but they are simply not enough. Behavioural changes are required, and one thing about universal credit is that it brings a change in work incentives, as well as some very precisely targeted income transfers. Vocational education and apprenticeships in this country have just not been adequate, and we have not looked after vulnerable groups—I am thinking of those leaving care and prisoners leaving prison. We need a large number of strategies to tackle this very difficult problem.