Neglected Tropical Diseases

Lord Bates Excerpts

Monday 3rd April 2017 Lords Chamber

[The Minister of State, Department for International Development (Lord Bates) (Con)]

My Lords, this has been an excellent debate, with 14 contributions. At the last minute, those were allowed to increase from two to five minutes; I am reliably informed by the Whips that my contribution cannot increase in the same proportion, and therefore I am limited to 12 minutes. There are a number of important issues to cover, but if I can, I will go through this at some pace.

Like the noble Lord, Lord Collins, I can trace the antecedents of raising these issues back a number of years—not quite back to 2013, but to 6 February 2014, when I responded from the Front Bench to the debate in the name of the noble Baroness, Lady Hayman, on this issue. The noble Lord, Rea, is right to say that the noble Baroness, Lady Hayman, deserves a great tribute for ensuring that neglected tropical diseases are not neglected in your Lordships’ House. We thank her for that and commend the work of the very active APPG on Malaria and NTDs, of which she is vice-chair.

NTDs affect 1.6 billion of the world’s poorest people, as the noble Baronesses, Lady Hayman and Lady Northover, reminded us, and they result in disability and have a tremendous impact on people. They cause a great economic burden for people, as the noble Baroness, Lady Sheehan, reminded us, as well as creating stigma and hardship, which were also mentioned.

Reference was made by the noble Baronesses, Lady Hayman and Lady Warwick, and the right reverend Prelate the Bishop of St Albans to the progress that has been made. The number of people at risk from NTDs fell from 2 billion in 2010 to 1.6 billion in 2015. In the 1950s, before programmes started, one in four people over the age of 40 went blind from river blindness in some of the highest endemic areas. Blindness caused in this way has now been virtually eradicated.

The noble Baroness, Lady Northover, who served as a Minister in the department during the coalition Government, reminded us of the visit to the House of Lords by President Carter, who spoke in the Robing Room—an event that I, too, attended. He spoke about Guinea worm eradication. Only three countries reported a total of 25 cases of guinea worm disease in 2016—down from 3 million cases a year when the programme started in 1986. This is well on the way towards the target that has been set and shows what can be achieved in this area.

A number of noble Lords referred to the high-profile London declaration event in 2012, when the UK committed an additional £195 million to tackle these diseases. The UK, along with the US, is a world leader on NTDs. We are meeting our commitments. The UK supports high-performing programmes tackling a range of NTDs, and these programmes are delivering results. DfID programmes delivered more than 136 million treatments for NTDs in 2016. We have supported over 60,000 surgeries to prevent blindness due to trachoma, and over half a million people have been screened for kala-azar, a disease that is invariably fatal if not treated.

Much of our support for the implementation of NTD programmes is through our world-class British institutions. The noble Lords, Lord Stone and Lord Alton, referred to many of these, particularly the Liverpool School of Tropical Medicine, and I pay tribute to the expertise that is to be found there. I am delighted to accept the invitation from the noble Lord, Lord Stone, to meet the SCI group at Imperial and would be very interested to find out more about its work.

Many noble Lords, including the noble Baronesses, Lady Warwick and Lady Barker, referred to the importance of research. This is at the heart of what we do. DfID is committed to spending approximately 3% of its annual budget on research, and of course that also impacts on the NTD process. We also support research into new drugs, diagnostics and better vector control, as well as operational research into the best ways to implement programmes. I very much recognise the point made on vectors by the noble Baroness, Lady Barker, as I do the very important point about prevention made by the noble Baroness, Lady Sheehan. The UK Government have a strong track record of supporting successful product development research through public-private product development partnerships, such as the Drugs for Neglected Diseases initiative and the Foundation for Innovative New Diagnostics.

Tackling NTDs is highly cost effective, as the noble Lord, Lord Stone, reminded us. The average cost of treating one person for a range of commonly occurring NTDs is about 50 US cents. The noble Lord, Lord Alton, described it as a “best buy”, which it very much is. NTDs are an excellent example of a unique public-private partnership: most of the medicines are donated by pharmaceutical companies, which have pledged drugs valued at $17 billion between 2014 and 2020—a point made by the noble Baroness, Lady Masham. Without this very generous support there would be far less progress and considerably higher costs.

A number of noble Lords referred to the London declaration. I am pleased to report that there will be a very high level of representation at the event taking place on 19 April. I do not in any way want to undermine the importance of NTDs, but when we discussed this as a ministerial team, we realised that so many important meetings are taking place this very month: this week on Syria, and in a couple of weeks’ time on Yemen and the wider humanitarian crisis in Africa. However, I will certainly convey to the department and the Secretary of State the importance that your Lordships attach to this initiative and the gathering that will occur on 19 April.

The noble Baroness, Lady Barker, referred to the interconnectivity of scientific research with the attempts we are making. That is a point I recall being made by David Nabarro, who is a very strong candidate to be the next director-general of the World Health Organization.

The noble Lord, Lord Rea, the noble Baroness, Lady Sheehan, and my noble friend Lady Chalker raised the importance of WASH. This very much links to what the noble Baroness, Lady Sheehan, said about prevention. WASH is the best form of prevention that we know for NTDs. There is strong cross-sectoral working on this, in particular on increasing access to water and sanitation. My noble friend asked what commitment we have made in this area. We have a very strong manifesto commitment to increase clean water access to 60 million people during the lifetime of this Parliament, which is sustainable development goal 6. That is a major programme which we are working on.

My noble friend also raised the importance of engineers. I am delighted that through the Commonwealth Scholarship Commission we are giving access to many students from sub-Saharan Africa to come and study at our world-class universities and take that expertise back with them.

The noble Viscount, Lord Simon, raised the importance of co-infections. He particularly focused on malaria. The noble Baroness, Lady Masham, referred to TB, and the noble Lord, Lord Collins, referred to collaboration on HIV-TB. We fully understand and stress that these are all very important areas.

A key element is the availability of good quality data and the disaggregation of those data in connection with the SDGs. We want to ensure that programmes collect and analyse data on how we are making progress against targets and disaggregate those data to ensure that we are reaching girls, women and other vulnerable groups—an issue that the noble Lord, Lord Collins, asked us to work on.

The right reverend Prelate the Bishop of St Albans raised the strong partnerships that we have with faith groups. Through our faith partnerships we work very closely with those groups in a number of parts of the world. He talked about Sierra Leone and, in the past week, I have been looking at what the Anglican community is doing in the terrible situation in South Sudan, where the conflict is making the treatment of neglected tropical diseases and the effects of famine incredibly difficult. That is a real manmade tragedy.

We are making efforts to work with other donors, in particular USAID. I take the important points that were made about the USA, with which we are working very closely. The draft budget was prepared by the President and will be turned into a formal budget to be announced in May. It then, of course, has to work its way through Congress. We are looking very closely at his nominee for USAID. The United States, through its private foundations and as a Government, has played a critical role in this and I very much hope we will be able to work with it in the future in delivering this absolute best-buy for development investment.

Our efforts to map the NTDs have helped to determine the geographical distribution of diseases, a point made by the noble Lord, Lord Alton, so that we can target resources where they are most needed. We are now expanding access to treatment. As countries are now able to stop mass drug administration for some diseases, it will be critical to carry out the surveillance necessary to ascertain progress and to ensure that low infection levels are sustained. However, we must not forget that while some countries are reaching that stage, others are only just starting in their efforts to tackle NTDs.

On this point I echo the urging of the noble Baroness, Lady Hayman, in introducing the debate, that there is no question of us regarding this as “steady as she goes” or, in the phrase of the noble Baroness, Lady Barker, taking our foot off the pedal. This is absolutely essential to the sustainable development goals. It is a treatment programme that works and we want it to continue.

The noble Lord, Lord Rea, the right reverend Prelate the Bishop of Peterborough, and the noble Baronesses, Lady Northover and Lady Masham, asked what progress was being made on leprosy. According to the World Health Organization, there were over 210,000 new cases of leprosy reported in 2015. We need to increase progress. In 2016, the World Health Organization launched a global leprosy strategy for 2016-20 and UK aid match is supporting work to improve the lives of people affected by leprosy and other NTDs in Mozambique and other countries.

At the conclusion of my remarks I come back to that very important summit. While the UK across a number of levels—from our great research base to the work that many people have been doing through medical science in this area—is advancing the cause and has made great progress, it is vitally important that we use the occasion and the platform of the World Health Organization joint summit on NTDs on 19 April to ensure that other donors come forward and meet their responsibilities towards eradicating these diseases and meeting the sustainable development goals in these areas.

As to the consequential nature of the SDGs, I have been ticking them off and I think we have covered all 17 of the goals, from partnerships, to conflict in number 16, to eradicating poverty in number 1, to education in number 4, to gender equality in number 5. It is a real point of endorsement as to how the SDGs are rightly a lens through which we judge our progress on this.

I again thank all noble Lords who have contributed to the debate. I shall reflect further on it and feed the messages back to my colleagues at the department as we move forward.

House adjourned at 8.22 pm.