Health: Neglected Tropical Diseases

Lord Collins of Highbury Excerpts

Wednesday 30th January 2013 Lords Chamber

[Lord Collins of Highbury]

My Lords, I, too, thank the noble Baroness, Lady Hayman, for initiating this important debate. Although neglected tropical diseases are the most common infections among the world’s poorest communities, they receive little attention in the media. As we have heard, while they are not always fatal, their effect on individuals and communities can be devastating. They disproportionately affect the world’s poorest and most vulnerable people and are a serious impediment to economic development in many developing nations.

There is no doubt that the coming together of the global health community in January 2012 to plan a new way forward for achieving a world free of these devastating ailments was a historic occasion. The commitment to the control or elimination of 10 NTDs in line with targets set by the World Health Organisation marked the beginning of a new and co-ordinated effort.

As we have heard, the lives of millions of people have improved since the launch of this plan. However, more resources and political will from all Governments will be needed if we are to achieve the WHO’s 2020 goals. The control and elimination of NTDs is feasible through mass drug administration but failure to also address the underlying causes, including the environmental conditions that contribute to their spread, such as clean water, improved sanitation initiatives and vector control, will make this task almost impossible.

The barriers and risks to achieving the WHO targets include: conflicts and the consequent movement of people; population growth; vector or intermediate host control; resistance to medicines and pesticides; expectations overtaking science; inadequate support for research; and, of course, climate change. We still have a world where some 780 million people are without adequate sanitation and safe drinking water; 40% of those without access to improved water sources live in sub-Saharan Africa, where many of the NTDs are prevalent. The biggest challenge is in India, where more than half the country’s population—625 million people—are without basic toilet facilities.

An integrated approach is essential if we are to meet the WHO targets. As we have heard from the noble Earl and my noble friend, there are other risks attached to promoting mass drug administration, including the undermining of already fragile and overstretched healthcare systems and the difficulties involved in relying on volunteers to assist with drug distribution in targeted communities.

However, schemes such as the Bangladesh Ministry of Health and Family Welfare’s Little Doctors programme are shining examples of how education, public health and drugs can be combined effectively. In addition to providing regular treatment, the programme teaches students from upper grades to assist teachers with de-worming days. The Little Doctors also share hygiene and other health messages with their classmates and families to help prevent reinfection.

To ensure that the objectives of the London declaration are delivered, we need clear government strategies. I, too, would like the Minister to explain what action the Government are taking to improving access to clean water and improved sanitation. What steps are being taken to build healthcare capacity and generally to improve public health and education in the target areas?