Tuberculosis

Debate between Lord Herbert of South Downs and David Drew

Thursday 7th June 2018 Commons Chamber

[Nick Herbert]

I strongly agree with the hon. Gentleman that the diseases must be treated together. However, great progress has been made on tackling AIDS, partly because of the tremendous new tools available. By comparison, less progress has been made on tuberculosis. Last year, 1.7 million people died of tuberculosis. That is more than AIDS and malaria combined. The single fact that most people do not realise is that tuberculosis is now the world’s deadliest infectious disease, and it deserves more attention than it gets. Some 10 million people globally are falling ill each year as a result of this disease.

TB was declared a global health emergency by the World Health Organisation 24 years ago. Since then, 54 million people have died. That is not a great advert for the declaration of a global health emergency. Three years ago in New York, the world’s leaders set the sustainable development goals. Target 3.3 was to eliminate these major epidemics in 15 years. At the current trajectory, TB will not be eliminated for 160 years, so another 28 million people will die in the sustainable development goal period alone, costing the world economy $1 trillion cumulatively. Middle and lower-income countries will be the most severely hit, with lower-income countries experiencing a reduction of something like 2% of their GDP.

On top of this, there are new threats. I mentioned that TB strikes when immune systems are compromised, and they can be compromised in new ways, including by the acquisition of diabetes. In Indonesia, TB is striking people with diabetes, which is a growing problem.

Above all—this should concern the House greatly—is the growing risk of drug resistance. TB is the only major drug resistant infection that is transmitted through the air. It is already responsible for one in three deaths worldwide from all forms of drug resistance. Drug resistance generally now kills 700,000 people a year, but Lord O’Neill’s commission, set up by David Cameron, predicted that drug resistance would kill 10 million people a year by 2050, and that those deaths would fall in the west and advanced economies, not just in poor and middle-income ones. That compares with, for instance, 8 million deaths a year from cancer. We are talking about catastrophic loss and catastrophic economic cost, with a cumulative GDP loss of $100 trillion, knocking 2% to 3.5% off global GDP. It is significant that a quarter of those deaths from antimicrobial resistance would be due to tuberculosis, which is already responsible for a third of antimicrobial resistance deaths; that is 200,000 deaths a year.

[Dr David Drew (Stroud) (Lab/Co-op)]

The right hon. Gentleman is making an excellent speech. Will he also accept the connection between TB and conflict? In the parts of the world where TB is rife—including South Sudan, which I know very well—conflict is adding to the complexity for people suffering from disease.

[Nick Herbert]

That is a very interesting point. TB is a disease of poverty. This opportunistic infection will strike if there are no basic health systems and if nutrition and housing are poor, and all those conditions would probably exist in areas of conflict.

Drug-resistant TB is a terrible affliction. It can be dealt with, but even in an advanced healthcare system, it requires a course of treatment in which some 14,000 pills have to be taken. This treatment is appalling, as it can cause patients to become deaf and creates a lot of suffering. Only half of drug-resistant TB patients are successfully treated. In fact, there is a lower survival rate for drug-resistant TB than for lung cancer.