Health: Neglected Tropical Diseases

Baroness Northover Excerpts

Wednesday 30th January 2013 Lords Chamber

[Baroness Northover]

My Lords, I thank the noble Baroness, Lady Hayman, for securing this debate and for all her work in this area. Her passionate and expert speech and those of other noble Lords remind us how important it is to tackle the so-called neglected tropical diseases. They blight the lives of more than a billion people, cause disability, disfigurement, stigma and an estimated half a million deaths annually in some of the poorest countries in the world. They cause terrible suffering and perpetuate dire poverty. The noble Baroness, Lady Hayman, spoke of diseases of neglected people. That is a good way of describing them.

Last year, as noble Lords have mentioned, we made a fivefold increase in our commitment to this area and we are maintaining that support to ensure that these diseases and those who suffer from them are neglected no more. This is an area in which some of our outstanding institutions, such as the Liverpool School of Tropical Medicine, the London School of Hygiene and Tropical Medicine and Imperial College, are playing a leading role. Various noble Lords mentioned that the London Centre for Neglected Tropical Disease Research has formally opened this afternoon at the London School, which everybody is extremely pleased to see. The noble Lord, Lord Patel, spoke of the work being done in Dundee and of the importance of public/private partnerships, something which DfID strongly supports and has built into its approach to tackling NTDs.

As the noble Baroness, Lady Hayman, the noble Lord, Lord Sheikh, and others have said, there is partnership across a number of organisations here. The pharmaceutical industry is playing a vital part in this regard. We are also working with the World Health Organisation, the Bill & Melinda Gates Foundation and the US Agency for International Development.

One year on from the London launch, I am grateful to the noble Baroness, Lady Hayman, and others for the tribute that they have paid to the step change that DfID has made in this area. Like the noble Baroness, the noble Lord, Lord Crisp, and others, I pay tribute to my honourable friend Stephen O’Brien, the former Parliamentary Under- Secretary of State for International Development, for his leadership here, as well as to all the others who played their part in the London declaration. I pay tribute, too, to the various organisations, including those led by the noble Baroness, Lady Hayman, and noble Lord, Lord Crisp, who have worked for a long period in this area.

I can assure noble Lords that DfID now expects to reach more than 140 million people who suffer from NTDs by 2015. Since the London declaration, the UK has launched a programme to complete the global mapping of trachoma; agreed a programme to take an integrated approach to tackling NTDs in Nigeria, one of the highest-burden countries in the world; and helped the World Health Organisation strengthen its NTD staffing and improve its co-ordination of the kala-azar programmes in south Asia and east Africa.

Last year, the UK Government offered to increase and extend their support to guinea-worm eradication, provided that others stepped in to help close the financing gap. Noble Lords will be pleased to hear that the Bill & Melinda Gates Foundation, the United Arab Emirates and the Children’s Investment Fund Foundation rallied to this call. The programme now has the funds that it needs to achieve eradication. That will be a stunning achievement. I can assure the noble Baroness, Lady Hayman, that we continually encourage other donors to contribute.

In 2012, fewer than 600 new cases of guinea-worm disease were reported in just four countries, Chad, Ethiopia, Mali and South Sudan—almost half the number of cases in 2011. This trend is very positive, but it is clear that there is no room for complacency. The endemic countries’ health systems and regional security are fragile—noble Lords have made reference to that. The Mali conflict remains a significant threat to the eradication timeline and the success of the global campaign.

Meanwhile, DfID continues to develop and expand the UK’s support for taking NTDs in three distinct but integrated ways. They are: additional support to control elephantiasis, river blindness and bilharzia, building on a number of existing successful partnerships; driving more research—to which the noble Baroness, Lady Hayman, referred—to increase our knowledge of NTDs and improve delivery and effectiveness in addressing them; working on new programmes to help control kala-azar and trachoma, as well as a programme which takes an integrated approach to tackling a range of NTDs in South Sudan. I assure the noble Lord, Lord Rea, that we will include vector control in the design of our work on kala-azar. The noble Lord, Lord Stone, asked about feedback loops. I can assure him that we realise that good monitoring and evaluation are key to this area and we check that treatments get to those who need them. We check to make sure that we are making progress in controlling and eliminating these diseases and are getting best value for money for the funds committed. I seem to recall the noble Lord raising this matter at an APPG meeting that I spoke at and my putting him in touch with DfID. I hope that that takes things further forward.

Expanding our involvement requires a collaborative international effort and response. We are working closely with colleagues, particularly in USAID, the World Bank, WHO and the Bill & Melinda Gates Foundation, to improve mechanisms for tackling these diseases. National Governments are key partners, too, particularly in mass drug administration through schools and communities and in efforts to improve water and sanitation services. We recognise the importance of joining all that up.

In the UK, it has not just been the Government responding to the challenge; there has been a positive response also from organisations, particularly in the private sector. This includes the Children’s Investment Fund Foundation and Geneva Global. I particularly appreciate the all-party parliamentary group’s support for the UK Government’s work on NTDs and for the opportunity that it gave me to speak at the launch of its annual report in November.

Noble Lords will also be pleased to hear that a number of institutions in the UK have formed the UK Coalition against Neglected Tropical Diseases as a collaborative partnership in research, implementation and capacity building. It is at the forefront of the push for integration, especially at the country level with national and other developmental partners.

The NTD community is adjusting to the post-London declaration situation. The WHO annual report makes clear how we have all stepped up and the challenges for tackling NTDs globally from 2013. These challenges include the need for increasing ownership by Governments in the affected countries. National Parliaments have an important role to play here in making the case to Health and Finance Ministers to increase domestic resource provision.

The noble Baroness, Lady Hayman, and others asked about integration of work on NTDs. The noble Baroness asked in particular about integration with the Global Fund. As she knows, the Global Fund in its support for health systems, which has developed over the years, makes a contribution beyond malaria, AIDS and TB. It is vital that all these approaches are integrated—the right reverend Prelate made this point very strongly—so that each element supports the other.

In this regard, I concur with the point made by the noble Earl, Lord Sandwich: mass campaigns need to strengthen and underpin fragile health systems. The right reverend Prelate illustrated that very point. I assure him that drugs for NTDs are delivered by volunteer community health workers, and that that is used to help to strengthen health systems. The noble Earl, Lord Sandwich, the noble Baroness, Lady Hayman, and the noble Lords, Lord Crisp and Lord Collins, referred to water and sanitation as connected issues. Indeed they are, and we are well aware of that. I assure noble Lords that the increase in funding for NTDs is additional to DfID’s existing health, water and sanitation commitments. Integrating with the health system is an important tenet for NTD programmes to help to strengthen that effectiveness and improve sustainability. If we maintain that approach, those diseases can be eradicated, as the noble Lord, Lord Trees, said. We are determined to carry that through—just as we are in sight of eradicating polio, and as we did with smallpox, to which the noble Lord, Lord Patel, referred.

We have grasped a fantastic opportunity here to make a real difference to the lives of those affected by these diseases. In 2013, the task is to finalise remaining programmes, monitor the portfolio closely, continue to promote integration and work with others to expand the donor base and endemic country commitment.

Noble Lords have pointed out that these are diseases of poverty and that we must tackle poverty across the board. They are right, and that is how we view this task. This is indeed about tackling poverty, and we welcome noble Lords’ contribution in this key area.