Neglected Tropical Diseases

Lord Crisp Excerpts

Monday 1st February 2016 Lords Chamber

[Lord Crisp (CB)]

My Lords, I welcome this debate and the continuing attention that it gives to neglected tropical diseases, at a time when they are becoming more prominent and well known. After all, as my noble friend said, it was only a few years ago that some UK academics coined the phrase, in a masterstroke of marketing. It is very good to see that NTDs are now mentioned in the sustainable development goals, great foundations and indeed great NGOs are tackling them—here I declare an interest as a recently retired chairman of Sightsavers—and there are great efforts in that regard by the UK Government.

This is an area, like much in development, where the UK is a world leader. As an example, DfID funded the mapping of blinding trachoma globally, with Sightsavers as its lead co-ordinating agent. I am delighted to say, although I claim no personal credit, that Sightsavers delivered the mapping on time and on budget. Arguably, this is the largest ever public health mapping exercise, and is now bearing results as we can target the right areas globally to tackle the disease.

My noble friend Lord Trees draws attention to neglected tropical diseases in impairing social and economic development. This is two way—they do not occur in prosperous countries. He mentioned rabies, but trachoma was a major problem in 19th-century Europe. There are strong links between prosperity and these diseases, which are, as has already been mentioned, the diseases of neglected people, who are certainly excluded from prosperity. They impact most heavily on women because they are generally the care givers, and on their children, because they are most likely to come into contact with dirty water. My noble friend also makes a strong point that some things are associated with neglected tropical diseases as a class, not just with individual ones: poverty, dirty water, low levels of education, high birth rates, and much more.

My noble friend Lord Trees references the third report on progress since the 2012 London Declaration on Neglected Tropical Diseases. It points out that there has been pretty good progress: NTDs provide one of the strongest returns on public health investment, and points to the extraordinary levels of partnership here, between the public, private and voluntary sectors, and globally, nationally and locally. It is a terrific example for elsewhere.

However, here is the rub: it is now all about implementation: chasing down—as I suspect President Carter may say to us—the last guinea worm. As the report says,

“Coverage is increasing, but the pace is too slow to meet key milestones”.

We all know what will happen if the pace is slackened or people slow down. It happened with polio a few years ago, when it was eliminated in a number of countries but came back because people did not chase it down to the last moment. The paradox is that catching those last few microbes or worms is very expensive, and it is very important that we keep up the political will here in this country and elsewhere. The biggest risk for many of these diseases is that we do not finish the job properly; that is still an issue, for example, for polio. Like others, therefore, I urge the Government to keep up and even increase their current commitments.

Finally, I have two questions, which relate to the point made by my noble friend Lord Trees about the social and economic impacts, and which largely follow what the noble Baroness, Lady Warwick, and the noble Lord, Lord Bruce, have already said, on integration. We know that successful and sustainable elimination of these diseases will depend on many other developments, including provision of clean water, economic development and the education of adults and children. I therefore ask how the Government, through their wider development programmes, are integrating their support for eliminating NTDs with these wider programmes. I also note that this depends on surveillance and the provision of even basic health systems. How, therefore, are the Government both supporting the development of health systems in the poorest countries in the world and ensuring that these will be able to address NTDs?