Neglected Tropical Diseases

Baroness Sheehan Excerpts

Wednesday 11th July 2018 Lords Chamber

[Baroness Sheehan (LD)]

My Lords, I too add my congratulations to the noble Lord, Lord Trees, on bringing this debate to your Lordships’ House, and thank him for his very thorough introduction to the huge global health burden that NTDs pose for developing countries. I will keep my remarks short, as it is not every day that the England football team has an opportunity to secure a place in the World Cup final.

The success of the London declaration in bringing together the partners necessary to deliver a holistic attack on 10 NTDs is documented quite thoroughly in its fifth progress report. Let us be clear—and other noble Lords have emphasised this point. Without collaboration among stakeholders, including Governments, donors, civil society—particularly the private sector—and academia, this record of achievement would have remained a pipe dream. What a catalogue of progress it documents.

Let me pick out a couple of highlights. Lymphatic filariasis—I am not sure whether I said that correctly—is no longer a public health concern in 10 countries, and Guinea worm disease is poised for eradication, with only four cases reported by WHO from 1 January to the end of May this year. When the eradication programme began in 1986, there were 3.5 million cases worldwide. That is a real testimony of what determined leadership from an individual such as President Carter can achieve.

Can I ask the Minister about DfID’s approach to leprosy? The Leprosy Mission’s briefing informs me that DfID currently does not include leprosy as a priority NTD. Can the Minister elaborate on why that is the case, particularly in light of the fact that multi-drug therapy is available free of charge through the WHO and is a very effective cure for all types of leprosy?

The fifth progress report on the London declaration makes it clear that it is the poorest of the poor in developing countries who continue to be disproportionately affected by NTDs. The noble Baroness, Lady Hayman, is quite correct when she says that poor people in developed countries are also facing attack from NTDs. It is clear that those living in closest proximity to dirty water and soil are worst affected. Clearly, prevention is the first line of defence in ridding the world of these diseases of the poor, and WASH initiatives are key to prevention. I hope the Minister agrees with me that, if we are to sustain the progress made to date, basic principles of clean water, sanitation and hygiene, in collaboration with in-country organisations, must underpin all DfID NTD partnership programmes.

On data, in the Parliamentary Office of Science and Technology report of May 2017 entitled Global Health Inequalities, we are told that, although more people have access to essential health services now than at any time in history, profound health inequalities persist—that is, differences in health status between different population groups such as age or socio-economic status. To overcome health inequalities and meet the 13 targets of SDG 3, which is to ensure healthy lives and provide well-being to all at all ages, it is essential that we have access to good-quality data. Yet it seems that good data, although gathered at distribution points, are nevertheless not captured further up the report chain. For example, the November 2016 report from Uniting to Combat Neglected Tropical Diseases, Neglected Tropical Diseases: Women and Girls in Focus, makes the point that current WHO reporting forms include sex-disaggregated data, collected at the point of distribution. However, these are not reported up when the data are aggregated, which is a lost opportunity for action. It is important to understand where these data are lost, so that the integrity of information can be restored. Maybe we can bypass human error through smart technologies, as outlined by the noble Baroness, Lady Warwick of Undercliffe—that would be a way to move forward on this. Nevertheless, will the Minister undertake to follow up with WHO on this point, and will he undertake to write to me if and when he receives a response?

In its briefing for this debate, the British Society for Immunology quite rightly draws our attention to the importance of immunological research in developing new drugs, vaccines and diagnostics for NTDs. However, it goes on to say that, since the London declaration was signed, research progress has been slow. The importance of vaccines and new drugs in the face of rising antimicrobial resistance is self-evident. Let me focus on the importance of rapid point-of-care diagnostics, which need little skill to operate. This is as an area where huge opportunities exist, and with good payback. At present, seven of the 10 NTDs in the London declaration lack essential rapid point-of-care diagnostic tools. Yet government agencies have demonstrated that, with the correct support, they are able to very quickly develop medical products for other diseases, such as the rapid antigen diagnostic test for Ebola. Will the Minister make inquiries as to why this success, in collaboration with industry and clinicians, cannot be replicated for the NTDs listed in the London declaration? I believe that this is a clear case of where there is a will, there is a way. The British Society for Immunology certainly thinks so.

My final question to the Minister is about the Ross fund, about which we still know very little. In preparing for this debate, I reread last year’s debate and was surprised to find that there had been five speakers—namely my noble friend Lady Northover, the noble Baronesses, Lady Hayman and Lady Chalker, the noble Lord, Lord Collins of Highbury, and myself—who asked for more details on the role of the Ross fund in delivering UK aid to NTDs. It may be churlish of me to say, but I note that the Minister did not address these questions in his response last time. I hope that he will take the opportunity today to do so, or, if time does not permit, will he undertake to write to me and others who are interested with a response?