Malaria and Neglected Tropical Diseases

Debate between Catherine West and James Sunderland

Tuesday 9th January 2024 Westminster Hall

[Catherine West]

Indeed, and my hon. Friend pre-empts my point about the impact on women and girls. I know that you will be particularly interested, Mrs Harris, in the relevance of tackling what seems to be the disproportionate impact on women and girls, due to various biological, social, economic and cultural factors. Limited financial resources, time constraints, diminished autonomy, and stigma and discrimination create barriers that prevent women from gaining access to timely healthcare, education and employment opportunities. Due to their responsibility for home and family care, they often miss out on crucial treatments. Through close contact with children, women are two to four times more likely to develop trachoma, which is a neglected tropical disease, and are blinded up to four times as often as men.

It was particularly exciting, in the visit mentioned by my hon. Friend the Member for Slough (Mr Dhesi) and the hon. Member for Glasgow North (Patrick Grady), to see old women, who are often neglected in developing countries, receiving crucial treatments and being enabled to feel that they were not a burden on their children. It was particularly special to learn that trachoma has been eliminated in Malawi. The World Health Organisation has signed that off, which is a really exciting development. Sometimes, these things feel very overwhelming, but when we see that trachoma has been eliminated in Malawi, it really is wonderful and encouraging.

The “Ending Preventable Deaths” strategy recognised malaria as a major cause of child deaths, and important tools such as bed nets and intermittent preventive treatment in pregnancy as examples of evidence-based health intervention and best buys. It was also welcome that the strategy recognised the critical importance of clean water, sanitation and hygiene. However, there is no way of ending these epidemics and meeting the sustainable development goals without working to empower and enable women and girls to succeed. I know that is very much at the heart of your work in Parliament, Mrs Harris.

[James Sunderland]

The shadow Minister and I, and many others here, went to Malawi, as we heard earlier, and we share many of the same views on the way forward. In fact, it is quite nice to have cross-party support on such a key issue. We have sought a Commonwealth Heads of Government meeting in Rwanda. Does the shadow Minister agree that it is important for the league tables to be published, so that African nations can take a lead and have responsibility for a particular NTD? In Malawi, we have eliminated trachoma, and I welcome that noma has now been added to the list of approved—if that is the right word—diseases that the WHO is looking at and investing in. Does the shadow Minister agree that empowering African nations and ensuring that the UK can take a lead in thought leadership and education is really important?

[Catherine West]

Indeed, and it has been estimated that 500 million more people, rising to a billion by 2080, could become exposed to chikungunya and dengue, as these diseases spread to new geographies due to warmer climates—a point made by my hon. Friend the Member for Slough. As an example, the impact of flooding in Pakistan has also been mentioned, and in 2022 there was a 900% increase in dengue and a fivefold increase in the number of malaria cases. The Minister might be quite creative and see whether there is money in the climate funds to join up the health inequalities with the climate funding that will eventually become available through the COP28 process.

While countries in the global south will of course carry a disproportionate burden, tropical diseases are now becoming a growing concern in non-endemic countries. Will the Minister update the House on Government efforts to mitigate the impact of climate change on malaria and NTDs, and what steps they are taking to support lower-income countries to address climate-sensitive infectious diseases? Conflict and humanitarian crises are considerable threats to progress. Many countries have seen increases in malaria cases and deaths, and a few experienced malaria epidemics. Ethiopia saw an increase of 1.3 million cases between 2021 and 2022, and political instability in Myanmar led to a surge in cases, from 78,000 in 2019 to 584,000 in 2022, with a knock-on effect in neighbouring Thailand.

Last June, mycetoma services in Sudan were suspended due to a lack of safety, resulting in patients not receiving vital medication. We know that in refugee camps—as I am sure the Minister also knows from visiting refugee or internally-displaced persons camps—there is a particularly high risk of scabies due to overcrowding. Can the Minister reassure us that the UK is working to support countries affected by conflict and other humanitarian crises to ensure the safe delivery of medical supplies, which are the basics?

Despite the difficulties in surmounting the challenges we face, the elimination of these diseases is possible. Both malaria and neglected tropical diseases can be beaten, as we have seen. Azerbaijan, Belize and Tajikistan have been declared malaria-free by the World Health Organisation recently, and 50 countries, including 21 in Africa, have eliminated at least one neglected tropical disease, marking the halfway point toward the target of 100 countries set for 2030. As a result, 600 million fewer people globally require interventions against neglected tropical diseases than in 2010. Bangladesh, supported by the UK and other partners, is the first country in the world to be validated for the elimination of visceral leishmaniasis, which is the very complicated form of the disease that is fatal in over 95% of cases and has devastating impacts, particularly on women.

The Labour party is proud of the UK’s contribution to date in this global effort, and of the legacy of Department for International Development, one of our proudest achievements of the last Labour Government. As part of that commitment, the last Labour Government helped to found the Global Fund in 2002. It is an incredible fund, and we saw the important work it does when visiting Blantyre. The results are staggering, with the malaria incidence rate decreasing from 164 positive cases four years ago to 36 at the time of our visit last autumn.

I know that you want me to wind up, Mrs Harris, but I have one final anecdote. I met Mirriam, an inspiring midwife and primary healthcare provider working in rural Zambia, when she visited the UK Parliament. She said that she encounters disease every day at her health centre, and spoke to me about her harrowing experience of caring for and losing pregnant women and young children with malaria. However, over the past few years the availability of high-quality, inexpensive, rapid diagnostic tests, insecticide-treated bed nets and preventive treatment for pregnant women, all provided by the Global Fund, are transforming how Mirriam and her midwife colleagues diagnose and manage cases of malaria. She also mentioned the important work being done on tuberculosis and HIV.

Many of the tools and medicines we need to beat malaria were also developed here in the UK, and a number of Members have outlined the important connection with our excellence in research—for example, at the University of Dundee, which the hon. Member for Dundee West (Chris Law) mentioned in his speech, and other important UK research institutions. It is important that we listen to what they say about what we need to keep that research going and maintain this country’s leadership in research and development.

We have already talked about the Vaccine Alliance, Unitaid and the Global Fund, so I will not go into the detail. However, we have one specialism that I need to mention: the crucial research into snakebite. Many who may be watching parliamentlive.tv will not be aware that snakebite kills so many people in Africa, or aware of the important work being done at the Liverpool School of Tropical Medicine—I declare an interest as an unpaid trustee there. That work is very special and niche, but it is crucial to keep it going.

I will conclude on the important work that we need to do this month, given that World Neglected Tropical Disease Day is on 30 January. Can the Minister assure me that the UK is doing all it can to support the development of new medicines for neglected tropical diseases and look at re-committing to multi-year funding for product development partnership models? What is her view on manufacturing in Africa? If we look at the map, we see that expensive medicines are produced here in Europe or America and then sent to Africa and so on, so it would be wonderful to see more manufacturing, perhaps through the Serum Institute of India, for example, which did so much important work during covid. What is her thinking about collaborations there that we could lead and push different parties towards? Finally, as 30 January 2024 approaches—World Neglected Tropical Disease Day—the World Health Organisation argues that, for malaria, “business as usual” will simply not be enough. I hope that the Minister agrees that we now need to act, because there is no more time for us to lose.

Immigration and Social Security Co-ordination (EU Withdrawal) Bill

Debate between Catherine West and James Sunderland

Report stage & Report stage: House of Commons
Tuesday 30th June 2020 Commons Chamber

[James Sunderland (Bracknell) (Con)]

I was pleased to contribute on Second Reading of this Bill, and I am pleased to be able to speak now, notwithstanding a sore throat.

In recent weeks, people have told me that the Bill is contentious, but it should be regarded as what it is, not as what others fear it to be. For a start, it allows our country to evolve in the post-Brexit era as we wish it to evolve, and allows us to decide who comes in. For too long, we have seen uncontrolled immigration and a failure to remove those who have accepted our hospitality but sought to do us harm. We have indeed seen lower rates of deportation. Inasmuch as we should be more in control of who arrives on our shores, we should equally be more robust about who leaves. If the process takes more than 28 days, then so be it. I am not therefore convinced by new clauses 3 to 11.

For those who come to the UK and are proud to live here, the opportunities are plentiful. Contrary to what many of our political opponents might think, this is the land of milk and honey for those who are prepared to work hard. Let us look at what is on offer. We will give everyone the same opportunities wherever they come from. Our points-based system will allow us to identify the skills we require. We will protect the rights of EU citizens, and we will protect the long-held rights of Irish citizens to live and work in the UK, so I am mindful of new clause 12.

People have told me that this Bill flies in the face of what has been achieved by so many during the pandemic, particularly in the NHS. Nobody here should need any reminder of the admiration and the awe with which the British people regard these heroes. The Government have rightly agreed to extend the visas of frontline NHS workers, so I am mindful of new clause 35. They have rightly introduced a new NHS visa, offering fast-track entry to the UK for qualified overseas doctors and nurses under more generous terms. The contribution of all public sector employees, public servants and low-paid staff is the stuff of legend, and we will always be grateful.

For the avoidance of doubt, immigration is a good thing, and we have built a proud nation on the back of our history, shared values and unrivalled diaspora. I have been honoured to serve alongside so many brilliant foreign and Commonwealth soldiers, but there is a problem here, too. Although this is not directly relevant to this Bill, I urge the Minister to take note. We have recruited many to join our armed services, but the House will know that a small number have slipped through the net by not applying for indefinite leave to remain when they would otherwise have been entitled to do so. Given that some now face particular difficulties in not being British citizens, including crippling NHS bills, I believe it is now time to offer an amnesty to the entitled few who have proudly worn the uniform and borne arms but not become naturalised. Once we have done this, we should then review the crippling visa fees, which remain beyond the reach of most servicemen and women and their young families.

Let us disincentivise those who come here via illegal means, remove those who commit serious crime and place the ruthless people traffickers behind bars, but the quid pro quo is to provide those whom we willingly invite to serve in our armed forces with the security they deserve. It is time that we did the right thing for all of our Commonwealth veterans and fully recognise the sacrifices that they too have made for our great nation.

As for the future of this Bill, I expect it to become law, but inasmuch as it promises a points-based immigration system that mirrors those of other countries in the free world, we need to be careful that it does not become a blunt instrument. The legislation must therefore be flexible and agile enough to respond to the employment market at any given time, particularly in terms of the skills being offered. There will be a need for seasonal labour, and we must be able to attract all those that we need when we need them.

To conclude, as contentious as the Bill might be to some, it is what many have requested for the past four decades, and it is what the Conservative Government have promised. We must also do more to reunite children under the vulnerable children’s scheme, and we therefore need an enduring scheme to be in place by 1 January next year. I am therefore sympathetic towards new clause 29. To be worthy of its pre-eminence, the UK must take back control of its borders.

[Catherine West (Hornsey and Wood Green) (Lab)]

I concur with the point made by the hon. Member for Bracknell (James Sunderland) about armed servicemen and women from the Commonwealth. I hope that the Minister will bear that in mind when the next immigration Bill is introduced, because there are some egregious cases that desperately need to be looked at fairly.

We will not vote for the Bill tonight, mainly because it seems to have been written before the covid crisis. It seems to ignore the fact that we need a new approach to immigration based on solidarity, decent jobs, employment protections and quality public services for all, with all EU citizens guaranteed the right to remain in the UK. Anybody who has been watching “Sitting in Limbo” and following the fantastic work done by the journalist Amelia Gentleman on Windrush will know that it is these sorts of debates that sometimes end up creating systems that cause huge problems for hard-working families.

I wish to speak briefly to some of the amendments and new clauses. First, my right hon. Friend the Member for Normanton, Pontefract and Castleford (Yvette Cooper) has tabled a proposal that emphasises the need for a plan for and provision in the crucial area of social care. We are nowhere near through this pandemic and we desperately need to encourage those working day in, day out in the care sector. Those watching this, perhaps in the course of their duties today, may well feel a bit down and depressed that we are not backing them a little more with this Bill.

Secondly, I wish to talk briefly to the question of care leavers, as addressed by new clause 2. Care leavers face numerous levels of disadvantage. Anyone who has worked in a local authority context will be aware of just how many placements the average child in care goes through. Many children go from home to home, from foster carer to foster carer, into residential care and out again, and into their own flat. Throughout that journey they often lose documents and the phone numbers of their legal advisers. Changes to legal aid mean that they can no longer access legal aid. We then have a very disadvantaged and needy 17-year-old who desperately needs immigration advice when they are about to turn 18. Such are the realities of children’s lives in care. We are talking about a tiny number of individuals. It is the sort of clause that we should all be voting for so that a very small number of people are not left out of the system.

Thirdly, I call new clause 29 the Dubs clause. So many Members from all parties have spoken in favour of it, particularly the hon. Member for North East Bedfordshire (Richard Fuller), who has Yarl’s Wood detention centre in his constituency. Many children are desperate to join family members here in the UK. Many other immigration systems in developed countries have positive family reunion programmes that are quick, that include a system in which people do not have to go in and out of the rules and write to MPs and everything, and that are clear and provide for children who have been torn from their families, mainly by conflict, so that they can get that reunification.