Tuberculosis

Annette Brooke Excerpts

Wednesday 27th November 2013 Westminster Hall

[Annette Brooke (Mid Dorset and North Poole) (LD)]

It is a pleasure to serve under your chairmanship, Mr Dobbin. I congratulate the hon. Member for Scunthorpe (Nic Dakin) on securing the debate. Discussing the link between tuberculosis and HIV/AIDS is particularly pertinent given our proximity to world AIDS day.

I would like primarily to focus on the need to ensure the consistent global provision of cheap, effective, high-quality drugs. I also want briefly to reflect on the past in a slightly different way from other hon. Members. More than 50 years ago, I actually caught TB, just while I was waiting for my BCG vaccination. If the timing had been otherwise, my life would obviously have been rather different. It is important to reflect on the fact that the BCG vaccination is over 90 years old, and it seems incredible that we do not yet have an effective vaccination. I really want to stress that aspect of the problem today.

I was in the sanatorium for seven months and can still remember the awful drugs, which I think are exactly the same as those given today. Day after day, I received injections and the most appalling tasting medicine. To make things slightly better for us young teenagers, we were given a book to read about how TB was treated in this country at the beginning of the 20th century, which was also pretty awful. Things moved on pretty quickly from the time when I was ill, however, and it was not long before the sanatorium was closed down and TB stamped out. That experience drives my interest in tackling worldwide TB.

It seems incredible that, as we have heard, an estimated 1.3 million people died from TB last year. It is most distressing to think that we are still relying on the same drugs for standard TB. We need rapid developments across the range of drugs. As has been mentioned, drug-resistant TB and extreme drug resistant TB also exist, both of which require a cocktail of drugs with horrendous side effects. The duration and difficulty of treatment represents a major challenge to patients completing treatment and therefore being fully cured. I was fortunate enough to go on a trip with the organisation Results UK to a village in Rwanda to meet patients who could not afford the transport to access the slightly more advanced drugs. There is so much more to be done.

We must also look at diagnosis. For the most part, just as when I had TB, the diagnosis is through sputum smear microscopy, which can take months, does not detect drug resistance and is ineffective at diagnosing TB in children and among HIV-positive patients. A new machine, GeneXpert, can detect some forms of drug resistance and can provide an accurate result in two hours. It has been approved by the WHO and rolled out across the world, but it is heavily dependent on local infrastructure. A point-of-care, cheap, easy-to-use diagnostic remains absolutely vital to achieving the quick diagnosis required to reduce transmission.

I, too, congratulate DFID and the Government on making a real commitment to UK aid overseas and, in particular, on topping up the global fund. However, what we are really saying, beyond congratulating the Government, is that much more needs to be done. Every year, 3 million TB patients globally are not officially treated, so we need other countries to add to the contribution we are making. We need to support important programmes such as TB REACH, which other Members have mentioned. We need the maximum provision of high-quality drugs at affordable prices. The Government must use their connections at the highest level to encourage countries to take a harder line on the quality control of drugs.

Global drug provision remains a challenge. The UK needs to increase the number of countries engaged in pooled procurement programmes such as the Global Drug Facility. That will increase demand and draw together a fragmented market, thus helping to ensure a more economically appealing market for manufacturers and suppliers.

Poor health is a driver and a consequence of poverty; we can look back at our history and see that, and we see it today worldwide. The Prime Minister co-chaired a UN high-level panel on the post-2015 framework, which reported earlier this year. Its report revealed that TB case finding and treatment was the most cost-effective intervention measured, returning £30 for every £1 spent. With its record, the UK is in a unique position that enables it to continue giving leadership and to do much more to tackle this big global problem.