Tuberculosis

Lord Lexden Excerpts

Monday 8th December 2014 Grand Committee

[Lord Lexden (Con)]

My Lords, it is a great pleasure to follow the noble Lord, Lord Collins, and to thank him for introducing this debate with great authority and conviction. I shall confine my remarks to tuberculosis.

Historians such as me are under no illusions about the dreadful threat that tuberculosis presents to mankind. Large numbers of people in our country have in the past fallen victim to it. In the 19th century, it was responsible for one in every four deaths in Britain. Our culture has been deeply marked by it. Harrowing accounts of the suffering that it inflicted can be found widely in English literature. It is a significant theme in opera, too, although often in unduly romanticised form.

In human affairs, final victories are hard to achieve over determined enemies of well-being. For a time, we came to believe that Britain had conquered tuberculosis and made it a spectre that belonged firmly in the past, but we now confront this terrible menace once again. Some 9,000 new cases are being diagnosed year by year. The threat to our country’s well-being is heightened by growing resistance to the drugs that are used to treat it. Medical advance is urgently needed to bring new, effective drugs into the service of mankind that can overcome the severe problems created by increasing resistance to the drugs that are currently being prescribed. These drugs were, in most cases, developed decades ago. I understand that only one new drug has been approved by the Food and Drug Administration in the last 50 years.

In Britain, we face a return of an old enemy. The world faces a pandemic. What is happening here surely sharpens our consciousness of the extent of the global threat and of our duty to do all that we can to tackle it, drawing on the highly developed skills and expertise that we possess and pressing for the medical advances on which so much depends. Across the globe, nearly 9 million new cases of tuberculosis occur each year. Well over 1 million people die of tuberculosis annually, part of the estimated 13.7 million who are victims of poverty-related and neglected diseases, to which the noble Lord, Lord Collins, referred. That is why the debate that he has initiated is to be welcomed so greatly. Once again, this afternoon, the noble Lord has demonstrated the deep concern and commitment that he consistently brings to global health issues. I much enjoy working with him on the cross-party basis that is so necessary in this area of policy, which includes combating the prejudice—particularly prejudice against gay people—that sets back progress in too many countries of the world.

Successive Governments in this country deserve the credit that they have been given for the major contributions that they have made to the global campaign to tackle poverty-related and neglected diseases. The significance of our country’s role was underlined in the impressive and authoritative report Dying for a Cure: Research and Development for Global Health, published in July by the All-Party Parliamentary Group on Global Tuberculosis. The report shows that Britain is the world’s second-largest provider of funds for global health research—only the United Sates provides more. The report sums up our record as follows:

“From policies, to levels of funding, to coordination and cooperation, the UK is at the forefront of R&D for global health”.

It is not the least of this Government’s achievements to have kept our country at the forefront of this vital work. The report acknowledges that what the Government have done, and are continuing to do, could have huge implications for global health.

The reason why Britain’s official contribution under successive Governments has been so important, and will remain crucial, has been emphasised by the noble Lord, Lord Collins. Although they often demonstrate deep concern for public welfare, pharmaceutical companies are not charitable undertakings. They invest in developing products where there is a potential for significant financial return, in order to pay for development costs and make a profit. Diseases such as tuberculosis mainly affect poor people, so there is little financial incentive to encourage pharmaceutical investment in research and development, to repeat the point made so effectively by the noble Lord.

It is widely agreed that in this overwhelmingly important sphere of global health the market has failed. The all-party group’s report in July was emphatic. It stated:

“The failure of commercially driven R&D for these diseases is a problem that affects us all”.

Public spending in Britain can help to overcome that failure. The report continues:

“From government departments to academic institutions, we support, fund and conduct outstanding research. Every penny of public funding should be spent as effectively and efficiently as possible. As a nation we excel at research and development, we should do more of it and we should share our expertise with our colleagues and neighbours”.

Against this background, the group recommends that the Department for International Development’s budget should be rebalanced to a certain extent, in order to enhance R&D capacity further in future.

There are many areas of global health in which decisive progress is needed, as the noble Lord, Lord Collins, has made clear. As regards tuberculosis, the search for new and more effective drugs is the highest priority in order to shorten basic treatment and to deal with the bacteria that to an increasing extent are resistant to existing drugs. To that end, DfID should surely consider investing more in drug developers such as the TB Alliance, which are not seeking a financial return. Would there not also be merit in considering a prize fund to encourage TB research and development, along the lines of the Longitude Prize, designed to stimulate diagnostics for microbial resistance?

At the recent global consultation on research for TB elimination conference in Stockholm, a Swedish spokesman said:

“There has been a 45% reduction in TB mortality since 2,000. A great achievement, but not enough. Investments in research and innovations now are crucial to reach the global targets”.

Here in Britain we look to our Government to continue and, if possible, to enhance the contribution that has brought them much well deserved praise. The world will not eliminate tuberculosis until an effective vaccine has been found.