Neglected Tropical Diseases

Baroness Masham of Ilton Excerpts

Monday 3rd April 2017 Lords Chamber

[Baroness Masham of Ilton (CB)]

My Lords, I thank my noble friend Lady Hayman for all she does on this subject. One aim of the declaration is to enhance collaboration and co-ordination on neglected tropical diseases at national and international levels, through public and private multilateral organisations, in order to work more efficiently and effectively together. If so many countries were not ravaged by wars, which produces so many refugees and poverty, there might not be so many health problems.

In 2015 alone, pharmaceutical companies donated an estimated 2.4 billion tablets—enough for 1.5 billion treatments—to prevent and treat NTDs. There is now a global problem with the growing resistance to antibiotics, especially in poor countries, which need more education. I had a very good friend, a Holy Rosary nun, who was a health visitor; she worked in Ethiopia and the Cameroons and told me that it is no good bringing babies into this world if they are to die from disease from contaminated water. She became an expert in sinking wells and providing sanitation.

It is encouraging to hear that South Sudan is soon to be certified free of Guinea worm disease, which thrives in poor areas where there is little sanitation and people bathe in and drink stagnant water. I have visited a leprosy colony on one of the islands, and two babies died in half an hour from malaria when I visited a ward in Mombasa where a friend worked. These people working with NTDs are the unsung heroes. There is much to do, and they need concerted support from Governments and anyone involved.

A neglected disease that is a global danger is tuberculosis, which has not had new drugs for a long time. In 2013-15, there were an estimated 480,000 new cases of multidrug resistant TB in the world. There are substantial differences in the frequency of MDR-TB among countries. In some cases, more severe drug resistance can develop; extensively drug-resistant TB is a more serious form of MDR-TB, caused by bacteria that do not respond to the most effective second line anti-TB drugs, often leaving patients without any further treatment options. Worldwide, only 52% of MDR-TB patients and 28% of XDR-TB patients are successfully treated. Infections that are resistant are much more expensive and take much longer to treat. It is vital that global leadership be provided on matters critical to TB. Ending the TB epidemic by 2030 is among the health targets of the newly adopted sustainable development goals but, unless there is less poverty in the world, that will be difficult to achieve. Also, resistance to a form of HIV treatment, antiretroviral therapy, is increasing around the world. The co-infection of HIV and TB, which are resistant to treatment, is very serious. So many people have been working on vaccines. Like my noble friend Lord Rea, I ask the Minister what hope there is of vaccines for TB, HIV and other diseases.

Health: Ebola

Baroness Masham of Ilton Excerpts

Wednesday 9th March 2016 Lords Chamber

[Baroness Verma]

My Lords, as the noble Lord knows, we are currently undergoing bilateral and multilateral reviews. We will learn from that process where our future funding will go. To take the noble Lord’s point about concentrating on fragile countries, a number of the countries to which the noble Lord referred will be among the 50% that we are targeting in our support for conflict-ridden and fragile states.

[Baroness Masham of Ilton (CB)]

My Lords, could the Minister encourage the Governments of the countries involved with the Ebola virus to teach their populations not to eat bush meat, which can carry the virus?

[Baroness Verma]

My Lords, the noble Baroness raises an important point about causes, but these are lessons that we will learn as we review all the work that we ourselves, other agencies and the Sierra Leone Government have done. We are also undertaking a lot of research in this area, so I thank the noble Baroness for her question.

Ebola: Sierra Leone

Baroness Masham of Ilton Excerpts

Tuesday 19th January 2016 Lords Chamber

[Baroness Verma]

My noble friend is absolutely right. We must of course pay tribute to all those people who put themselves at risk on the front line, including our military personnel and staff of the NHS, among many who have gone there and worked on the ground, putting their own lives at risk. We must also pay tribute to the people of Sierra Leone themselves, who were very much instrumental in being able to restrain this outbreak.

[Baroness Masham of Ilton (CB)]

My Lords, how was it that a swab was taken only after the poor woman died? Surely, diagnosis should have been done when she became ill. Was she not looked after?

Sierra Leone

Baroness Masham of Ilton Excerpts

Monday 29th June 2015 Lords Chamber

[Baroness Masham of Ilton (CB)]

My Lords, I thank my noble friend Lady Hayman for having secured this debate on the catastrophic epidemic and its results in Sierra Leone, one of the countries in west Africa affected by the Ebola virus. With cases of this very infectious condition still appearing, it is clear that the epidemic is far from over. The efforts to end it must not be relaxed.

The medical personnel who have been helping in Sierra Leone rightly have the admiration of many people. It was good news that the nurses who developed Ebola and came back to be treated in the special unit at the Royal Free Hospital recovered, but I take this opportunity to ask how, with all the training that they had had, they became infected. It is important that that is known so that others learn from it. Prevention of infection when working first hand with infected people is vital.

A total of 869 confirmed cases of health worker infections have been reported from Guinea, Liberia and Sierra Leone since the start of the outbreak, with 507 reported deaths. It is said that the initial response by WHO regional staff was slow and poorly targeted, and it has since been heavily criticised as one of the contributory factors in the early expansion stage of the epidemic. It is notable that the WHO Global Outbreak Alert and Response Network, which had such a pivotal role during the SARS outbreak, was mobilised at a late stage after other groups, including Médecins Sans Frontières, had been in action for weeks or months. Even at that point, the WHO concentrated on advisory support rather than mobilising logistics, and clinical and diagnostic support. Several UK agencies, including Public Health England and the Defence Science and Technology Laboratory, were among the European groups to get specialist manpower on the ground at an early stage.

I cannot stress enough how important microbiology and pathology are in combating infection. I think that sometimes the value of their contribution to tackling epidemics is not highlighted enough. At the latest G7 summit, responding to lessons from the Ebola crisis, G7 leaders pledged to help strengthen the world’s ability to prevent, detect and respond to disease outbreaks. I quote from the Society for General Microbiology:

“Emerging zoonitic diseases … pose an increasing global health and economic security threat. Recent outbreaks include Ebola, H1N1 swine flu and severe acute respiratory syndrome … An interdisciplinary ‘One Health’ approach involving human and animal science, health and policy is vital for mitigating this threat”.

There is a huge need for public health improvements. Acute infectious diseases remain the leading causes of mortality, and children under the age of five are disproportionately affected. Since the Ebola outbreak, the impact of malaria has almost certainly increased owing to reduced and/or delayed access to treatment, leading to increased case fatality rates. There is only one paediatrician in the whole of Sierra Leone. Maternal morbidity rates are very high. Over 70% of the population live in poverty and, therefore, the majority of the population’s basic need for food and water is not satisfied. Half the population in Moyamba drink from unsafe water sources. There are few areas with adequate sanitary facilities. One-third of children are stunted; malnutrition is common and under-recognised. During the Ebola outbreak, when the need has been great, the supply of supplementary food has stopped. Thus, unmet nutritional needs of the population have increased.

The current Ebola outbreak is reducing and efforts will continue towards its elimination from the country, but the population will remain at risk of future outbreaks. There is a desperate need for ongoing education. Changes in behaviour such as hand-washing and safe burial practices reduce this risk but the population risk profile has not dramatically altered. There is still a high consumption of bushmeat in Moyamba and other rural areas of the country. I congratulate BBC Media Action on its programme “Kick Ebola out of Sierra Leone”, which it is producing in partnership with Cotton Tree News, broadcast on 40 radio stations across the 14 districts. In recent months, the programme has evolved to focus on concerns about complacency.

I hope the Government will give money to this very poor country. There are successful, rich countries which are getting our support: why not give it to these countries in west Africa?