Tuberculosis

Debate between Lord Herbert of South Downs and Stephen Doughty

Thursday 7th June 2018 Commons Chamber

[Nick Herbert (Arundel and South Downs) (Con)]

I beg to move,

That this House recognises that tuberculosis (TB) remains the world’s deadliest infectious disease, killing 1.7 million people a year; notes that at the current rate of progress, the world will not reach the Sustainable Development Goal target of ending TB by 2030 for another 160 years; believes that without a major change of pace 28 million people will die needlessly before 2030 at a global economic cost of £700 billion; welcomes the forthcoming UN high-level meeting on TB in New York on 26 September as an unprecedented opportunity to turn the tide against this terrible disease; further notes that the UN General Assembly Resolution encourages all member states to participate in the high-level meeting at the highest possible level, preferably at the level of heads of state and government; and calls on the Government to renew its efforts in the global fight against TB, boost research into new drugs, diagnostics and a vaccine, and for the Prime Minister to attend the UN high-level meeting.

The motion stands in my name and that of the hon. Member for Ealing, Southall (Mr Sharma), and I am grateful to the Backbench Business Committee for allowing us to have this debate on ending tuberculosis.

I believe that this is the first time that this issue has been debated on the Floor of this House for 65 years. Responding to an Adjournment debate in 1952, the Joint Under-Secretary of State for Scotland, Commander T.D. Galbraith, said:

“Tuberculosis is still the major health problem in Scotland…we must press forward…with every weapon that is available to us until the disease, which is said to be preventable, has been eradicated.”—[Official Report, 29 January 1952; Vol. 495, c. 158.]

At that time, people were optimistic because antibiotics had been discovered and put into mass production, housing was improving and there was no longer any reason to believe that tuberculosis would not be beaten. Tuberculosis was the great killer of history. A disease that dates back at least 7,000 years, it has killed 2 billion people in the last two centuries alone. John Bunyan said that TB was

“the captain of all these men of death”.

TB—otherwise known as consumption or the white death—is caused by a tiny bacteria. When it was first identified in 1882, it was still killing one in seven people. Indeed, TB killed more people in the United States in the late 19th century than any other disease. It is a disease that has killed kings, poets and paupers throughout history. Tutankhamun, Edward VI, Cardinal Richelieu, Eleanor Roosevelt, Keats, Chekhov, Emily Brontë, D. H. Lawrence, Orwell and Chopin all died from TB. Of course, the heroines of the operas “La bohème” and “La traviata” notoriously die from tuberculosis. That was expected in that age, which was not so long ago. Millions of others down the ages have suffered from TB—notably, Nelson Mandela, who suffered greatly from it.

With better housing, better nutrition, the discovery of penicillin by Fleming in 1928, and the mass production of antibiotics in the 1940s, it was thought that tuberculosis would be beaten. In 1962, a Nobel laureate virologist said:

“To write about infectious disease is almost to write of something that has passed into history.”

But TB was not eradicated or eliminated at all. It resurged on the back of the AIDS epidemic. TB is a bug carried by a third of the world’s population that can exist in our bodies latently, but strikes when immune systems are compromised.

[Stephen Doughty (Cardiff South and Penarth) (Lab/Co-op)]

I congratulate the right hon. Gentleman on securing this debate. I chair the all-party parliamentary group on HIV and AIDS, and he knows that we very much share his concerns about TB and are pleased to work with his all-party parliamentary group on global tuberculosis. Today, we met the chief executive of the he Global Fund to Fight AIDS, Tuberculosis and Malaria. Does the right hon. Gentleman agree that that organisation is doing excellent work, not least on co-morbidity, as people live with HIV/AIDS and TB? People living with HIV are 30 times more likely to develop active TB, and TB is the leading killer of people with AIDS.

[Nick Herbert]

I strongly agree with the hon. Gentleman that the diseases must be treated together. However, great progress has been made on tackling AIDS, partly because of the tremendous new tools available. By comparison, less progress has been made on tuberculosis. Last year, 1.7 million people died of tuberculosis. That is more than AIDS and malaria combined. The single fact that most people do not realise is that tuberculosis is now the world’s deadliest infectious disease, and it deserves more attention than it gets. Some 10 million people globally are falling ill each year as a result of this disease.

TB was declared a global health emergency by the World Health Organisation 24 years ago. Since then, 54 million people have died. That is not a great advert for the declaration of a global health emergency. Three years ago in New York, the world’s leaders set the sustainable development goals. Target 3.3 was to eliminate these major epidemics in 15 years. At the current trajectory, TB will not be eliminated for 160 years, so another 28 million people will die in the sustainable development goal period alone, costing the world economy $1 trillion cumulatively. Middle and lower-income countries will be the most severely hit, with lower-income countries experiencing a reduction of something like 2% of their GDP.

On top of this, there are new threats. I mentioned that TB strikes when immune systems are compromised, and they can be compromised in new ways, including by the acquisition of diabetes. In Indonesia, TB is striking people with diabetes, which is a growing problem.

Above all—this should concern the House greatly—is the growing risk of drug resistance. TB is the only major drug resistant infection that is transmitted through the air. It is already responsible for one in three deaths worldwide from all forms of drug resistance. Drug resistance generally now kills 700,000 people a year, but Lord O’Neill’s commission, set up by David Cameron, predicted that drug resistance would kill 10 million people a year by 2050, and that those deaths would fall in the west and advanced economies, not just in poor and middle-income ones. That compares with, for instance, 8 million deaths a year from cancer. We are talking about catastrophic loss and catastrophic economic cost, with a cumulative GDP loss of $100 trillion, knocking 2% to 3.5% off global GDP. It is significant that a quarter of those deaths from antimicrobial resistance would be due to tuberculosis, which is already responsible for a third of antimicrobial resistance deaths; that is 200,000 deaths a year.

International Day against Homophobia, Transphobia and Biphobia

Debate between Lord Herbert of South Downs and Stephen Doughty

Thursday 17th May 2018 Commons Chamber

[Nick Herbert (Arundel and South Downs) (Con)]

I congratulate the hon. Member for Hove (Peter Kyle) on securing this debate. I was pleased to support him in my capacity as chair of the all-party group on lesbian, gay, bisexual, and transgender rights, which now has more than 80 members from this House and the other place. It is timely that on International Day against Homophobia, Transphobia and Biphobia we are here talking about the importance of promoting LGBT rights.

We last had this debate—initiated again through the Backbench Business Committee, which I thank for allowing this one—on 26 October. I spoke then about the fact that we were living in two worlds: great progress was being made on LGBT rights in some countries, while in others we were, at best, standing still and, at worst, going backwards. It is important to understand the reason for that. In that debate, I pointed out that, in a short period—16 years—25 countries had passed same-sex marriage legislation. Since then, Australia has become the 26th, following—significantly—a referendum in which a large majority supported the legislation. In so many countries, then, there has been progress on same-sex marriage, yet in others there has been reversal. In Bermuda, where same-sex marriage was introduced under the auspices of its Supreme Court, it has now been reversed by democratic decision and populism in Bermuda. That is a warning to this place not to be complacent about LGBT rights or—for that matter—human rights; we must constantly guard against their reversal.

At the time, I raised the situation in Russia and urged the Government to press the Russian authorities to say what had happened to their investigation into the treatment of gay men in Chechnya, where there had been appalling brutality, torture, arbitrary detention and even killings. What has happened? Recently, the Russian Government flatly denied that their investigation had produced any results—they simply denied that what happened in Chechnya took place. There is a need, therefore, for scrutiny and continuing pressure on those countries to expose what is happening, and we have to be ready to raise these issues at the diplomatic level.

[Stephen Doughty]

I have heard at first hand testimony about Chechnya from activists here in this Parliament. Does the right hon. Gentleman also agree, however, that we need to look at the situation in Northern Ireland? It is obviously not comparable to Chechnya, but does he welcome the efforts of my hon. Friend the Member for St Helens North (Conor McGinn) to bring Northern Ireland into line with the rest of the United Kingdom?

[Nick Herbert]

Yes, I strongly agree with the hon. Gentleman, and I am just coming to that point.

Still on the global front, there are other countries where the situation is going backwards. Under state auspices in Indonesia, there are calls for criminalisation and for cures for homosexuality, and raids on private spaces. This is all making public health outreach more difficult, which is interfering with HIV/AIDS programmes. That is of great concern to those campaigning for the relief of HIV infections. In fact, the infection rate in Indonesia has increased fivefold over the past decade. The authorities and parliamentarians in Jakarta are now considering a Bill to criminalise same-sex conduct. I could go on with my list. I could talk about what is happening in China or in Zambia. I know that my hon. Friend the Member for Reigate (Crispin Blunt), should he be called to speak, will talk about what has been happening in Lebanon.

Let us try to look on the bright side. The Government should be commended for the stance that they have taken on these issues. Only recently, the Prime Minister took a very strong stance at the Commonwealth Heads of Government meeting. We still have a situation whereby too many Commonwealth countries—the majority—criminalise homosexual conduct, therefore covering a majority of the population of Commonwealth citizens. The apology that the Prime Minister offered, as well as the willingness to work towards decriminalisation, made a powerful statement.

The Government can do so much. They need to be cognisant of the importance of maintaining pressure. I therefore welcome what the Foreign Secretary said today, when he tweeted:

“Standing up for human rights, including LGBT rights, is an integral part of @foreignoffice work. Societies where people live freely attract world-class talent, business investment & are more stable and prosperous.”

I welcome the work of the Foreign Office in supporting LGBT groups through our diplomatic missions, and through our embassies and high commissions on the ground. Many of our ambassadors and high commissioners do strong work in this area. We need to see more consistency, with more embassies and high commissions offering the support that the best do. That is the message that we should carry to the Foreign Office.

The Government need to be aware that there are domestic issues still to resolve in this country. This is not all about what other countries should do. The hon. Member for Cardiff South and Penarth (Stephen Doughty) mentioned Northern Ireland. It is almost certainly the will of this House that the Marriage (Same Sex Couples) (Northern Ireland) (No.2) Bill passes, and it should be allowed to do so. I understand that it is not the Government who are standing in its way. Hate crime is still a problem in this country, indeed it is increasing, and there are still issues for LGBT asylum seekers. Above all, there are issues for trans people; the consultation on reforming the Gender Recognition Act 2004 should proceed. These are important issues. We have made enormous progress in this country, but there is still work to do.

Global LGBT Rights

Debate between Lord Herbert of South Downs and Stephen Doughty

Thursday 26th October 2017 Commons Chamber

[Nick Herbert (Arundel and South Downs) (Con)]

I beg to move,

That this House has considered global LGBT rights.

I am grateful to the Backbench Business Committee for agreeing to this debate, which was proposed by members of the all-party parliamentary group on global lesbian, gay, bisexual and transgender rights, which I have the honour to chair.

This is a tale of two worlds. In one, as we saw in this House, we have seen the near completion of rights for LGBT people, full recognition in law—with some exceptions, of course, throughout the UK—culminating, four years ago, in the passing of same-sex marriage legislation by overwhelming majorities in this House and the other place. In a 16-year period, 25 countries around the world have passed same-sex marriage legislation, while others have passed legislation recognising civil partnerships. Taiwan became the latest to do so this year. We hope that Australia will follow suit soon, if that is the will of the people. It is noticeable that only Japan among the G7 countries does not have recognition of same-sex marriage. All the other G7 countries now do. Italy has recognition of civil unions.

[Stephen Doughty (Cardiff South and Penarth) (Lab/Co-op)]

I congratulate the right hon. Gentleman on securing this very important debate. He mentioned Australia—I add my support to those campaigning for same-sex marriage there—which is a key member of the Commonwealth. We will be holding the Commonwealth Heads of Government meeting here in the UK. Indeed, this morning I received a card from the Commonwealth Parliamentarians’ Forum, but I was a bit disappointed not to see the specific mention of LGBT+ rights on the agenda for discussion. Does he agree that the meeting of CHOGM and the Commonwealth Parliamentarians’ Forum provides a great opportunity to raise these issues with our Commonwealth partners?

[Nick Herbert]

I strongly agree with the hon. Gentleman. It is important not least because of the health and equality issues that are raised, which he will know in his capacity as chair of the all-party group on HIV/AIDS. I will come on to CHOGM shortly.

There is another world, too. I am talking about a world in which 75 countries criminalise same-sex activity between consenting adults. That covers 2.9 billion people. Some 40% of the world’s population live in these jurisdictions, which means that more than 400 million people live under laws that punish same-sex activity, and punish it with the death penalty. Our all-party group was keen to secure this debate now because of the events in a number of countries last month, during the conference recess. What happened was a matter of grave concern.

In Azerbaijan, during the last two weeks of September, organised police raids led to mass arrests of perceived gay and bi men as well as trans women in the capital, Baku. The authorities claim that the arrests were made as part of a crackdown on prostitution, but activists and the victims’ lawyers claim that LGBT people were specifically targeted. While in detention, victims report being subjected to beatings, electric shock torture, forced medical examinations and other degrading treatment and ill-treatment. The majority of the detainees were charged with disobeying police orders, which is an administrative offence, and sentenced to between five and 20 days in custody. The country’s own Ministry of Internal Affairs stated that 83 people were detained in total.

The ambassador of the Republic of Azerbaijan noted that we were calling this debate and wrote to me this week. Let me quote what he says:

“I can reassure you that this was not a concerted effort to crack down on the LGBT community, but rather a police action to stop solicitation of sexual services in downtown Baku following complaints from local residents. It may be that some within the local police force acted over-zealously and exceeded their mandate. As soon as the appropriate authorities were made aware of this the police operation was stopped and all those detained were released.

I would like to reiterate that the Azerbaijani constitution guarantees all forms of freedom of expression. Same-sex sexual activity for both men and women has been decriminalised in Azerbaijan since September 1st 2000.”

That does not deal properly with the situation. Local groups have reported that, since the initial raids, the authorities continue to intimidate and harass people whom they perceive to be LGBT. It is very important that this House, and I hope the Government, send a very clear message to the Azerbaijani Government that that kind of oppression is unacceptable in the eyes of the global community.

This House heard an urgent question earlier this year about the terrible situation in Chechnya, with arbitrary arrests and the illegal detention and torture of LGBT people. That continues to take place as part of a wider crackdown on human rights, despite the protests that have been made to the Russian authorities.

In Egypt, more than 50 people have been arrested in response to the flying of rainbow flags at a pop concert in Cairo on 22 September. That act alone resulted in arrests. The victims stand accused of debauchery, inciting debauchery, promoting sexual deviance and belonging to a banned group—charges that carry up to 15 years in prison. Many have already been sentenced. Victims report being subject to beatings, sexual harassment and forced anal examinations while in detention.

Although same-sex conduct is not explicitly prohibited in Egypt, the Egyptian Parliament is now debating criminalising homosexuality with a proposed punishment of up to 15 years in prison. What are Her Majesty’s Government saying to the Egyptian authorities and Government about this terrible abuse of gay people for committing what we in this country would regard as no crime at all, but simply the freedom of expression of flying a flag? I was struck by a message sent to me by a young gay man living in Egypt who attended that concert. He said:

“I can hear those consistent steps. Coming closer. Fear. Is it happening? Fear. Are they coming for me?...This has been the most common stream of thoughts during the past weeks in Cairo. The thought of being arrested would not leave my mind ever since the recent escalation of the state in its crackdown on the LGBTQs in Egypt. Fear that has, more or less, accompanied me for a life time as a gay man in Egypt. It is heartbreaking to wake up everyday to a new chapter of fighting for your right to exist, just to be.”

These are not isolated cases. Attacks on freedom of expression and association of LGBT people are wide- spread in other countries. State action, in turn, licenses discrimination at best, violence at worse and a climate of fear under which LGBT people have to live.

In June 2013, the Russia Duma unanimously adopted, and President Putin signed, a nationwide law banning the distribution of propaganda for non-traditional sexual relations—often the excuse for measures that discriminate against LGBT people. Since the introduction of that Russian law, 14 countries have considered similar legislation in eastern Europe, central Asia and Africa.

Nigeria’s Same Sex Marriage (Prohibition) Act 2013 criminalises the formation, operation and support of gay clubs, societies and organisations, with sentences of up to 10 years’ imprisonment. Uganda’s Parliament passed a similar act—the Anti-Homosexuality Act 2014 —which would have prohibited the promotion of homosexuality by individuals and organisations, incurring penalties of up to seven years’ imprisonment. That has now been revoked, but Uganda’s Pride had to be cancelled this year as a consequence of the actions of the state and the police, who were absolutely determined that that expression should not take place.

It is sometimes suggested that the UK may be guilty of some kind of neo-colonialism by seeking to impose our views on countries in the same way as we did in the past. It is true that 40 of the 53 member states of the Commonwealth criminalised same-sex activity using legislation inherited from the British empire. I would argue that our history gives us a special responsibility to atone for the measures that we introduced, and to act. That view is shared by the Prime Minister, who—I am delighted to say—said last week at the PinkNews awards that, on the world stage, the Government are

“standing up for LGBT rights, and challenging at the highest level those governments which allow or inflict discrimination or abuse. The anti-LGBT laws which remain in some Commonwealth countries are a legacy of Britain’s Colonial past, so the UK government has a special responsibility to help change hearts and minds. We will ensure these important issues are discussed at the Commonwealth Heads of Government Meeting, which we are hosting in London next April.”

That is immensely welcome.

Only this week, the Commonwealth Equality Network of activists and non-governmental organisations is meeting in Malta to discuss how to reverse the oppression of gay people in too many Commonwealth countries. The stand that the Prime Minister has taken and the Government will take at CHOGM next year is very important. After all, what many of these countries are doing is in breach of the Commonwealth charter itself. Indeed, outside the Commonwealth, every country has signed up to the United Nations declaration of human rights—rights that guarantee liberty, freedom of expression and freedom from torture and oppression. That is why it is so important that we continue to support campaigns run by United Nations institutions, such as the Free & Equal campaign, as well as other multinational initiatives, such as the Equal Rights Coalition, which was launched last year with UK Government support. It now incorporates 29 Governments, who co-operate and share information, but it needs the continuing and active support of the UK Government.

I would argue that the UK Government, who have done a great deal in this area, can do much more, and I welcome the Prime Minister’s commitment to a high-level challenge. The all-party parliamentary group produced a report last year and made a number of specific recommendations on what the Government could do. First, they could adopt a cross-departmental strategy to ensure that all parts of the Government are co-ordinated and take the necessary steps, so that they can take a stance and promote the values that we in this country think are important. There are multiple actors—the Department for International Development, the Foreign Office, the Department of Health and the Home Office—and it is important that they are co-ordinated. I welcome the presence here of the Minister for Equalities, my right hon. Friend the Member for Bognor Regis and Littlehampton (Nick Gibb); he is a Minister in a domestic UK Department, but I nevertheless recognise his cross-cutting responsibility for these issues, and that co-ordination is important.

Secondly—this is perhaps one of the most important things of all—there is the funding that can be provided for LGBT activist groups on the ground. These are vulnerable, fragile groups, which are run by very brave activists in countries across sub-Saharan Africa, in Russia and in other countries that we have discussed and will discuss. They need support, and the support they can be given—yes, by private individuals and foundations, but also by the British Government—is immensely important. It is important that those funding streams that can be directed through British high commissions and embassies are maintained.

Thirdly, we should ensure that safe routes are given to people who flee persecution—particularly when they are applying for asylum—in the way that was done in countries such as Canada and other European countries in relation to the LGBT people who were so egregiously persecuted in Chechnya.