Tuberculosis

Alison McGovern Excerpts

Wednesday 27th November 2013 Westminster Hall

[Alison McGovern (Wirral South) (Lab)]

It is a pleasure to serve under your chairmanship, Mr Dobbin. I was going to mention your experience, which I am well aware of. Perhaps you should have spoken in the debate, rather than being in the Chair.

I congratulate my hon. Friend the Member for Scunthorpe (Nic Dakin)on securing such an important debate. The unity that we have heard in the contributions is telling. We often spend our time disagreeing, but today we have not. That should be a message to everybody who cares about this incredibly important issue.

There have been seven excellent contributions to the debate, and I was struck by the amount of personal experience that we have heard. My hon. Friend talked about his experience as a college principal and the stigma of the disease in this country. The right hon. Member for Arundel and South Downs (Nick Herbert) gave a brilliant contribution about his role in the all-party group. He was rightly frustrated about progress and the wildly different standards across the globe, although we are all equally vulnerable to this terrible disease.

My hon. Friend the Member for Easington (Grahame M. Morris) spoke from a mining perspective about his experience and that of his constituents. The hon. Member for Mid Dorset and North Poole (Annette Brooke) spoke personally and directly about her experience of the disease. My right hon. Friend the Member for Rother Valley (Mr Barron) brought his considerable health experience to the debate. The hon. Member for City of Chester (Stephen Mosley) painted a serious and distressing picture of what the disease can mean in places in which people are weak and vulnerable, but also talked about what can be done practically. Finally, my hon. Friend the Member for Ealing, Southall (Mr Sharma) rightly spoke about the picture globally and in the UK, and about his experience in his constituency.

Tuberculosis has cast a long shadow over our country; I can recall my grandparents talking about life alongside people with TB. That shadow led to the bright sunlight of our NHS, which we are proud of. TB preys on the vulnerable, the poor and the weak. I will ask questions of the Minister, but it is worth remembering that, as the hon. Member for City of Chester pointed out, we are talking about putting in place systems to protect people.

TB is a horrible, debilitating disease. To add to the picture drawn by my hon. Friend the Member for Scunthorpe, in our own country TB robbed us of John Keats at age 25 and George Orwell at age 46—think about what those two people might have contributed to our country had they not left us at a young age.

The tragedy of the 1 million deaths from TB each year is the fact that it is a curable disease. As other hon. Members have made clear, we face a growing problem of drug resistance, as well as basic issues about resources and infrastructure; those factors are holding back our ability to cut the persistently high mortality rate for the disease.

TB is not solely a problem in the poorest countries; as my hon. Friend the Member for Ealing, Southall pointed out, it is also a problem here in the UK. Although I am responding to this debate as a shadow International Development Minister, tackling TB demonstrates why we must never see development as some kind of offshore policy issue. Real action to tackle TB diagnosis, treatment, drug resistance and co-morbidities across the developing world will benefit the NHS and public health at home, as well as right across the globe.

I was pleased to serve on the International Development Committee in 2012, when we considered the contribution of the Department for International Development to the Global Fund to Fight AIDS, Tuberculosis and Malaria. At the time, the Committee expressed real concerns about delays to DFID funding for that crucial organisation, which is estimated to have saved as many as 8.7 million lives. I am pleased that Ministers took the Committee’s concerns seriously and that next week the UK will be part of the global health fund replenishment. If we are to eliminate TB globally, the fund requires sustained, guaranteed funding. Will the Minister set out how Britain will make sure that there is more long-term stability for such funding?

Although the global health fund is a vital player and the UK’s contribution to it is extremely welcome, it remains the case that DFID does not currently engage in bilateral funding of programmes related to TB. That is despite the fact that, as has already been mentioned, the UN high-level panel on the post-millennium development goals framework, co-chaired by the Prime Minister himself, found that spending on TB diagnosis, prevention and treatment returns £30 of benefits for every pound spent; that surely satisfies the Government’s demands for value for money. Will the Minister tell us more about how DFID keeps under review its potential for funding TB-specific programmes through bilateral programmes?

Clearly, Britain’s strategy for improving prevention, diagnosis and cure of TB in the poorest countries has to go beyond specific funds—here I develop the point made by the hon. Member for City of Chester—in that it needs to be part of a holistic set of policies to build up functioning, universal health services, the lack of which holds back the fight against tuberculosis. Weak health care systems are thought to be a key reason for the estimated 3 million missed diagnoses of TB and increasing mortality rates from the disease. As I mentioned, our own experience of the disease before the days of the NHS should tell us that, if nothing else does.

In the UK we are right to be proud of the NHS, and we should not be shy about promoting through our development work the benefits of universal health care that is free at the point of use. Curbing a disease such as TB, which is widespread and hits some of the world’s poorest people disproportionately, is simply not going to happen if, when we attempt to do so through health systems, user fees are levied. Put starkly, 27 nations are considered to have a high burden of TB drug resistance. In each of those countries, the average cost of treatment exceeds the annual GDP per capita. If the poorest people cannot afford treatment, they will not receive it.

Britain has a good story to tell in this regard: in 2009, faced with concerns about TB diagnosis at home, the then Government took the decision to remove prescription charges for anyone attending a TB clinic. That should be what we advocate and support in every developing nation we work with that has a high TB incidence. Will the Minister put on the record DFID’s position on providing bilateral support for health care systems where user fees are currently charged? What specific work is being done to ensure that TB treatments are available free of charge in the nations with which DFID has a bilateral relationship? It is important to set out that principle.

Once again, I thank my hon. Friend the Member for Scunthorpe for securing such an important debate and bringing his experience to it. I also thank all right hon. and hon. Members who have contributed today.