World TB Day

Lloyd Russell-Moyle Excerpts

Wednesday 27th March 2019 Westminster Hall

[Lloyd Russell-Moyle (Brighton, Kemptown) (Lab/Co-op)]

I thank the right hon. Member for Arundel and South Downs (Nick Herbert) for securing this important debate. Many things have been said already; I will come on to the topic of my trip with RESULTS UK, on which I was accompanied by my hon. Friend the Member for Liverpool, West Derby (Stephen Twigg) and which appears in my entry in the Register of Members’ Financial Interests.

During my introduction to this speech, one person has died from TB. Some 18 seconds will pass until another person dies from TB somewhere around the world. In the UK alone, someone will be infected with TB every two hours, and in 2016 there were more than 6,000 cases in the UK. However, very few people die from TB in the UK, because treatment is available. The real challenge is that 99% of tuberculosis deaths occur in developing countries. As we have heard, it is a disease of poverty. That is partly because of TB’s intersection with other major issues, and particularly with compounding health conditions. It remains one of the biggest causes of death worldwide.

The sustainable development goals say that we should try to tackle this condition in the next period, but at the current rate, we will have to wait 160 years to eradicate TB and save 28 million lives. Those lives will be lost if we do not pick up the pace. Working to end tuberculosis means that we must engage with civil society and communities, and in particular work with high-risk groups and other people who are especially vulnerable. Most importantly, we must ensure there are universal, free-to-access health services, which are the best way—almost the only way—of tackling TB.

In 2017, my hon. Friend the Member for Liverpool, West Derby and I went to Liberia to examine its response to tuberculosis, particularly drug-resistant tuberculosis, which now accounts for a third of all tuberculosis deaths. Let us be clear: there is a treatment for drug-resistant tuberculosis, but the side effects are gruelling. It is a two-year course of medicine, with a success rate of only 50%. A person is likely to experience chronic nausea, psychosis, and painful blistering on almost all of their limbs, which they may scratch, causing further infection. They face the permanent loss of hearing in one ear, or maybe both, and after enduring that treatment they still only have a 50% chance of survival. The real problem is that the side effects of those drugs are so awful—reading out that list does not show how awful they are. If a person is experiencing psychosis, painful blisters all over their body and nausea, they are unlikely to complete their course of treatment, and that was the case for the vast majority of people we saw. They are sent back out into the community for the disease to spread.

We also saw a GeneXpert machine being used to test samples taken from people who came into hospital. The machine can be used instead of a microscope to examine a sample to see whether a person is drug resistant, and they can be treated immediately. The problem is that the machine costs $20 per person to use. Although it was in use in Monrovia, the capital, when we went out to the county hospitals we saw that it was rarely, if ever, used. We saw the machine packed away in a cupboard, not plugged in and not being used, because $20 per test is too high a cost. Instead of using the machine, those hospitals would do a traditional microscope test—through which it is not possible to tell whether someone has drug resistance—work out that a person had TB, give them the normal drug and send them back into the community for a few weeks. If there was no improvement, the person would be brought back in for the GeneXpert machine test. The problem is that over that time, drug resistance has spread, family members have got it and the cost has increased. Without early detection and treatment, more people will have to undergo the two-year regime that I have described. More people will drop out, and more people will suffer needlessly.

Drug-resistant TB is a battle, and if it is lost in the developing world, it is only a matter of time before drug resistance reaches these shores. We will suffer, and we will struggle to deal with it just as much, because no British person will willingly suffer those side effects. We need immediate action on pharmaceutical development to find decent drugs that do not cause such side effects, but we also need to nip the problem in the bud. As we have heard, the UK has been one of the biggest backers of the Global Fund, but it needs replenishment, and it needs it now. I hope the Minister will commit to redoubling the UK’s funding.

In 2015, among people in whom non-drug resistant tuberculosis was detected, reported and treated, 80% were successfully cured. This fight can be won, but we must reach out to those vulnerable groups, fund research and ensure that everyone can access good, universal healthcare that is free at the point of delivery to eradicate this condition once and for all.