Health: Neglected Tropical Diseases

Lord Bishop of Derby Excerpts

Wednesday 30th January 2013 Lords Chamber

[The Lord Bishop of Derby]

My Lords, I, too, thank the noble Baroness, Lady Hayman, for securing this debate on a very important topic and, as we have heard, a very neglected one. There are great signs of engagement and creativity, as noble Lords have said, but the statistics and effects are absolutely horrifying. I want to develop the point that has just been made about an integrated and sustainable approach. For medical intervention and investment to be effective—I think the noble Baroness used the term “smart aid”—there has to be an embedding in the local culture. Often, there have been ways of handling these things for many years, and it is not easy for western medicine to come in with all its technology and suddenly change the situation. In fact, an article in the Lancet in March 2012 provided evidence of the hostility to this kind of intervention because people in the local community did not understand it and were threatened by it. The article said that it was important, alongside the medical intervention, to enable what it called “behavioural change” and an “integrated biosocial approach”.

I want to give an example of that and encourage the Minister, and our own investment from this country and the work of the London centre, to take this approach seriously. I declare an interest as a trustee of Christian Aid, and it is good that there are other Christian Aid supporters here. Christian Aid commends what it calls a “community health approach”, which is local, joined-up and sustainable. It has four aims: to respond to local priorities; to integrate the approach to the various diseases and health issues; to develop a local health system; and to involve local people and local resources.

I will give your Lordships an example. A cross-border malaria initiative in Zambia was launched by Christian Aid and a number of partners in July 2010. So far, 100 local people have been identified, engaged and trained up to work as volunteers to enable this integration of the care response and its embedding in the local community. That is the kind of approach that I think we must commend and invest in.

I have two other quick points. Resourcing is crucial. Although it is not the main topic of this debate, I cannot resist reminding noble Lords that before Christmas we debated the issue of tax justice. Much of the wealth that is created in countries where these tropical diseases are prevalent is through tax avoidance schemes and is taken out of the country to where it cannot be taxed to provide local resources for a local response. We need to recognise that that is part of the picture.

Finally, I will say something about vigilance. In the 1960s, sleeping sickness was virtually eradicated in Africa, but by the 1990s, it was beginning to return. There is a frightening pattern in a lot of aid and welfare interventions that almost get there but somehow do not quite integrate and create something sustainable. The problem then creeps back. That is why I commend to the Minister, and ask her to take very seriously, this approach of community health, which is local, sustainable, joined-up and able to build a system so that the approach to neglected tropical diseases will be a lasting and effective one.