Global Fund: AIDS, Tuberculosis and Malaria

Baroness Masham of Ilton Excerpts

Wednesday 4th July 2012 Lords Chamber

[Baroness Masham of Ilton]

My Lords, the worldwide emergence of multidrug-resistant tuberculosis is a major and most important threat to global tuberculosis control. The continued spread of extensively drug-resistant tuberculosis throughout Asia, eastern Europe and southern Africa is an ominous sign. There are two issues regarding multidrug-resistant TB. There is a lack of diagnostic tests, and new diagnostic technologies for detecting drug-resistant TB are now available but are expensive and constrained by round 11 of the grant of the Global Fund. There is lack of access to second-line TB drugs for drug-resistant TB and the Global Fund should invest more in provision of adequate TB drugs. In Africa, 70% of TB patients are co-infected with HIV. A large percentage of TB and HIV cases remain undiagnosed. More proactive routine screening needs to be introduced at all points of care. All receiving countries should account for their funds so there is no malpractice.

Decades of the use of anti-TB drug treatments have resulted in the growth of multidrug-resistant tuberculosis strains. The highest ever prevalence in the world of MDR TB was found in Minsk, Belarus. MDR TB was found in 35.3% of new cases and in 76.5% of those previously treated. In addition, extensively drug-resistant TB was found in 14% of MDR TB cases. This is much higher than the global average. We must not be complacent. I think of the unfortunate 15-year-old girl who died of TB in Birmingham having not been diagnosed by her GP or four different hospitals. She had had TB in 2009 and was struck down again in 2010. I hope lessons will be learnt from this tragic case. Eastern Europe has the highest level of infection, but London has the highest TB rate in any European city. I am pleased that WHO has praised the UK’s Find and Treat service, which uses a mobile X-ray van to screen homeless people and drug addicts in London for TB. I too think that it does a splendid job: its vital work must always be supported.