Tuberculosis

Jim Shannon Excerpts

Thursday 7th June 2018 Commons Chamber

[Nick Herbert]

That is a very interesting point. TB is a disease of poverty. This opportunistic infection will strike if there are no basic health systems and if nutrition and housing are poor, and all those conditions would probably exist in areas of conflict.

Drug-resistant TB is a terrible affliction. It can be dealt with, but even in an advanced healthcare system, it requires a course of treatment in which some 14,000 pills have to be taken. This treatment is appalling, as it can cause patients to become deaf and creates a lot of suffering. Only half of drug-resistant TB patients are successfully treated. In fact, there is a lower survival rate for drug-resistant TB than for lung cancer.

[Jim Shannon (Strangford) (DUP)]

Just to step back, the right hon. Gentleman mentioned diabetes. In this country, we can change our lifestyles as we have access to lots of food and other things to reduce diabetes, but people in third-world countries where TB and diabetes are rampant do not have the same choice. Does the right hon. Gentleman agree that this complicates issues?

[Nick Herbert]

I do agree. There is a growing list of reasons why we should act, and that is one of them.

--- Later in debate ---

[Jim Shannon (Strangford) (DUP)]

I am last but hopefully not least.

I thank the right hon. Member for Arundel and South Downs (Nick Herbert) for setting the scene so well. I think that his speech gave us all an appetite for the debate, but he also challenged us in the House to do better. I thank other Members for their contributions as well; they have been much appreciated.

Most diagnoses are still made with the use of a technology pioneered in the 19th century that relies on laboratory infrastructures and several weeks of culture to determine drug resistance. In the weak health systems to which many Members have referred, where so much of the global TB burden is concentrated, the consequences are catastrophic. That is the issue for me and, I think, for others who have spoken today. The hon. Member for Ipswich (Sandy Martin) was right to refer to what has been done on the UK mainland, but I want to focus on what is happening in the rest of the world, where TB is rampant and can be catastrophic in terms of the lives that are lost and the lives that are affected.

The drug regime that is used to treat TB was developed in the 1950s. It is cheap and can cure the disease, but it is no match for drug resistance. People who suffer from drug-resistant strains of TB must currently undergo up to two years of treatment, swallowing thousands of tablets and having painful injections that lead to the most severe side effects and may ultimately not cure the disease. We also have no effective adult vaccine for TB.

The BCG vaccine that many Members will have received as infants offers protection against only the most severe forms of childhood TB. Although it is worth while, it does not do what vaccines are usually so good at: preventing disease for life and interrupting the chain of transmission. If we want to talk about the eradication of any disease, whether TB or HIV, we must invest in vaccines research. A Member who is no longer in the Chamber mentioned that to the right hon. Member for Arundel and South Downs in an intervention.

If new tools are to become available to us in seven years, we must invest. Currently, we are not doing so. Funding for TB research has consistently fallen short of 50% of the estimated annual need. We must address that issue as well, and I look to the Minister for a response. She is always very forthcoming, and I know that she will take our views on board. Unless that funding shortfall is addressed with great urgency, we have no hope of ever achieving the sustainable development goal to which our Government signed up three years ago.

It should be noted that the UK Government have done a great deal in this regard and currently rank as the second largest funder of global health research. Let us give some credit to our Government, to the Department and to the Minister for what has been done. The Government’s work, the product development partnerships and the researchers working on TB, HIV, malaria and other diseases should be celebrated. We have led by example—I wish that others could follow that example—but the funding gap for TB persists, and we will never close it unless concrete pledges are made. It would be a shame for the UN high-level meeting to pass with just another set of empty promises that have no impact on the people most affected by TB.

The Treatment Action Group estimates that if countries pledged to devote just 0.1% of their overall gross domestic expenditure on research to TB research and development, the R&D funding gap would be closed. That is a goal for which I am sure other countries could aim. People watching this debate could say, “Let’s do that.” If other countries did that along with us, we could do something significant very quickly. In terms of the average over the past five years, the UK Government have already been hitting the target, but many other countries continue to invest far less than their fair share, and without them, we will not achieve the sustainable development goal.

The UK has established itself as a leader on TB research, in respect of both funding and our fantastic research institutions in the public and private sectors. That is a very good example of the two sectors working together for the benefit of a great many people. The UN high-level meeting gives us an opportunity to demonstrate our leadership and to bring other funders to the table to talk about how we, as a community, might close the funding gap in a way that is fair and does not place an undue burden either on countries that are already investing significantly or on those that are simply unable to afford it. Will the Minister and her Department commit themselves to working with partner countries to develop concrete, fair-share funding targets for closing the research funding gap at the high-level meeting?

Let me end by saying something about co-ordination. As we work with partners to increase investments in TB research, it is essential for those investments to be well targeted and co-ordinated so that they can have an impact on patients’ lives as quickly as possible. I do not think that that is currently the case. The first two new drugs that became available for the treatment of TB were developed in isolation, which necessitated years of additional research to see how they could be safely and effectively integrated into existing regimens. That is something we should consider. The new diagnostic test, GeneXpert, which promised to revolutionise the diagnosis of TB, remains inaccessible to most. That is another shortcoming, which is due in no small part to the lack of operational and implementation research that would tell us how to use the tool most efficiently. We need to address that as well.

The UK Government have demonstrated the ability and willingness to convene partners and co-ordinate research funding, particularly in the field of antimicrobial resistance, of which TB is such a major part. Most recently, the Government supported the launch of the G20 AMR research and development collaboration hub, which has been a really good step in the right direction, providing an innovative new model through which research investments by countries from across the G20 and the world can be effectively co-ordinated to ensure patients have equitable access to innovation as quickly as possible.

In conclusion, I urge the Minister to work with partners through the G20 AMR R&D collaboration hub, which is a great idea that could really do things and move us in the right direction. The consensus from everyone who has contributed today, on both sides of the House, is that we want this to happen. We want the hub to make TB one of its priority pathogens and to begin work to co-ordinate TB R&D investments. I thank the right hon. Member for Arundel and South Downs for securing the debate. I am happy to have contributed and to support both him and the energy of the House in its desire to make things better for those who cannot do it for themselves.