Neglected Tropical Diseases

Baroness Hayman Excerpts

Wednesday 11th July 2018 Lords Chamber

[Baroness Hayman (CB)]

I am a very charitable cause. My Lords, I am delighted to take part in this debate, and I draw the House’s attention to my interests as set out in the register. I congratulate the noble Lord, Lord Trees, on obtaining this debate and on introducing it so effectively and comprehensively. It has become something of an annual parliamentary event. If we look back to last year’s debate, we can see the value of having an annual debate. I start off by congratulating and thanking not only the noble Lord, Lord Trees, but the Minister, the noble Lord, Lord Bates. Last year, those of us who spoke in this debate—many of us are in the Chamber today—gave him not a hard time but an element of harangue because we were coming up to some crucial funding decisions. He took on board everything that we said. He went back to the department—and maybe there was an element of harangue in his conversations with colleagues—and he certainly came up with the goods. I think we ought to record, if not our effectiveness, his effectiveness in ensuring that the DfID commitment to NTDs continued.

As we have heard, that commitment is showing results. When we look at the fifth annual assessment following the London declaration and the published work of Professor Hotez, Professor Molyneux and Professor Fenwick—to whom the noble Lord, Lord Stone, referred—we can see that, particularly in sub-Saharan Africa, and particularly through the mass drug-administration programmes, we are making a real inroad into the diseases that we have described every year in terms of their debilitating effects on individuals and communities and their educational and employment status. We have often said that these are diseases of neglected people, not just neglected diseases.

We also have to recognise that while we have seen successes—I think we can say with some confidence from the academic research that the integrated MDA programmes are highly successful, and of course they are immensely cost effective because of the donations, as has been referred to—there are also areas where success has stalled. Sometimes that is because of conflict and political destabilisation. Last year we discussed the areas of Syria and Iraq, which have seen a rise in NTDs, but also in Venezuela destabilisation has resulted in the rise of Chagas disease, malaria infections and indeed schistosomiasis.

The noble Baroness, Lady Stroud, said correctly that we do not see these diseases in wealthy communities but we see them in wealthy countries. A growing number of NTDs now occur among the poorest living in G20 nations. For example, today 90% of people living with leishmaniasis and Chagas disease, particularly the latter, live in the four leading economies in the western hemisphere—the US, Argentina, Brazil and Mexico—and 99% of those sufferers are denied access to diagnosis and treatment. They are the diseases of the poor but they are not only diseases of the poor living in poor countries. It is very important that we realise that. There are 12 million Americans living with NTDs, particularly in the south.

So we need to look at conflict zones and at the poor in G20 nations. That means we have to continue with the drive for innovation, creativity and new treatments, particularly antihelminthic drugs, and I will bang the drum for vaccines once again. I particularly know about the Texas Children’s Hospital Center for Vaccine Development, which is developing a whole new generation of NTD antipoverty vaccines for Chagas, leishmaniasis, schistosomiasis and hookworm, among others. Many of these vaccines are being developed jointly with manufacturers in disease-endemic countries, and obviously one can see the benefits of that. They are key technologies to ensure the elimination of NTDs.

Talking of vaccines, if I may digress a little, we have to be aware of the dangers of the anti-vax movement. Look at the progress of measles: last year we had 20,000 cases in Europe, and it looks as if we will have more this year. The pernicious effects of the anti-vax movement are already being felt among their own children and children among Europe. What we do not want to see is new vaccines coming in for these diseases being subject to the same sort of scaremongering. That is why it is very important that we take on the anti-vax movement very strongly, otherwise we will quickly erode the gains that we got through MDG 4 and Gavi.

I want to raise a point that I know is of issue particularly to those concerned with leprosy. For very obvious reasons, DfID has had a focus on five diseases and on mass drug administration programmes. In terms of bangs for your buck, one can see exactly why that has happened, but the London declaration went much further than those five diseases. I know that the work of DfID goes much wider than that—for example in the aid match that it has given for leprosy.

It is important that we recognise that many people suffer from not one NTD but several. We must not neglect opportunities to treat the whole person and all their diseases because we are too much in a single disease silo—which of course goes against the whole ethos of universal health coverage, which NTD treatments could be a pathway into.

Can the Minister reassure me that the department will look widely in asking for bids and expressions of interest for NTD work and consider bids that are not necessarily from the five priority areas but particularly involve co-ordination with one of those diseases and a separate disease? It would be nice to know a little more about the Ross fund and what elements of that are going into vaccine and treatment development.

I end by thanking the Minister once again so much for what he did last year.