Tuberculosis

Debate between Lord Herbert of South Downs and Gregory Campbell

Wednesday 27th November 2013 Westminster Hall

[Nick Herbert (Arundel and South Downs) (Con)]

I congratulate the hon. Member for Scunthorpe (Nic Dakin) on securing this debate. I am delighted to be taking part in it, particularly as I have resumed the co-chairmanship of the all-party group on global tuberculosis, now that I am free to do so. It is, quite properly, a cross-party co-chairmanship, which reflects growing concern in the House about what is often a “Cinderella” disease—one that is not talked about as much as some other diseases that are still claiming lives today.

We are, properly, concerned about the terrible tragedy in the Philippines and the loss of thousands of lives and we are, properly, marking world AIDS day on Sunday and the millions of lives that have been claimed by that disease. There is a strong overlap, as the hon. Gentleman pointed out, between HIV and tuberculosis, which many still believe is essentially a disease of the past. Indeed, before I became involved in this movement, I thought so too. In the 19th century, tuberculosis—consumption—was regarded sometimes even as a romantic disease, as featured in many operas of that era, yet one in four people in Europe were dying of consumption at that time. It was only with the advent of modern medicine—antibiotics—and the west’s attack on poverty in the late 19th and early 20th century that the disease was brought under control.

There are some sobering observations to make about the rate at which TB—which, as the hon. Gentleman said, has now resurged here, as a disease of the present—is being tackled, compared with the rate at which the west dealt with it in that era. At the current level of progress that the west in making in dealing with a disease that is still claiming 1.3 million lives a year—unnecessarily, because in the main it is easily and cheaply curable—we will have to rapidly step up the efforts that are being made, because the incidence of this disease is currently declining by 2% a year. If we continue at this rate, it will take more than a whole lifetime—a whole generation—and it will be more than 100 years before we tackle this disease properly and get it under control. That will mean that millions of lives will needlessly be lost.

On top of that, there is a growing threat—one that now amounts to a serious issue for this country as well—of drug-resistant TB, the emergence of which is entirely a reflection of the ancient way in which we treat this disease. Were it not for the fact that people with TB require lengthy treatment with antibiotics, because the drug regimens are old-fashioned and no new drugs have been developed, and were it not for the prevalence of counterfeit drugs and the inadequacy of health regimes, drug-resistant TB might not have developed with such ferocity. However, it is now a serious matter of concern, and not just in developing countries, where people unlucky enough to be diagnosed with drug-resistant TB—and few are—almost always face a death sentence. Acquiring drug-resistant TB in a developed country with an advanced health system would still require an expensive and extremely painful course of treatment over months and years.

[Mr Gregory Campbell (East Londonderry) (DUP)]

While the right hon. Gentleman is elaborating on the complications that follow diagnosis, does he agree that there is a shocking compounding of the problem worldwide, because in some countries lung cancer is being diagnosed to a considerable degree in people who are subsequently diagnosed with TB?

[Nick Herbert]

The hon. Gentleman raises an interesting point. The starting position has been that we need the means to diagnose this disease.

Let us face up to the fact that if the resurgence of this disease had been in the west, it would already have been tackled by now. The pharmaceutical companies would have had a commercial interest in developing better diagnostics and tools, better drugs and, indeed, a vaccine. Another common misconception is that a vaccine is available to deal with TB, but only the BCG vaccine exists, and that is generally ineffective for most forms of TB and works for children for a limited time. Had this disease resurged in the west, by now we would already have these things, but we do not, because the drug companies did not have a commercial interest in developing them, essentially because the disease was found in developing countries without the economies or the wherewithal to pay for these new tools.

There can be no better example of the necessity for intervention by wealthy western Governments, who have the resources to ensure that such a disease can be tackled, not just in the interests of ensuring that lives can be saved—there is a profound moral reason to tackle this anyway—but in the west’s interests in securing the economic development of high-burden countries that are afflicted with this disease, which is a tremendous brake on economic development. Of course, TB is a disease that knows no borders, and with migration, and so on, we face the prospect of it resurging in our country. We have higher rates of TB in this country now—although they are low by comparison with high-burden countries in the rest of the world—than in the rest of Europe. We have failed to reduce rates in the past 10 years, as compared with the United States, for example, which has got on top of the problem. This is a pressing public health issue in this country.

There are lots of reasons for western Governments to be concerned about this issue. Therefore, I strongly endorse what my hon. Friend the Member for St Ives (Andrew George) said about the UK Government’s recent commitment, which has not been sufficiently noticed, to replenish the global health fund. That is a fantastic commitment, not just because of the absolute sums pledged to the global health fund—which is an effective means of tackling TB and is responsible for 80% of the funding for TB programmes across the world—but because it sends a powerful message, ahead of the replenishment summit next Monday, to other potential donor countries about the value of stepping up our efforts at this time.

The west faces a choice. We have the opportunity, with the potential emergence of new treatments, diagnostics, and so on, to get on top of this disease. If we relax our efforts and fall victim to the idea that, at a time of austerity, the west might pull back from some commitments that it is making, our efforts to tackle TB would go into reverse. This is an important moment to step up to the plate. Britain has done so admirably. I commend the work of the Secretary of State for International Development and Ministers in making that commitment, and I encourage other countries to do the same.