Neglected Tropical Diseases

Lord Stone of Blackheath Excerpts

Wednesday 11th July 2018 Lords Chamber

[Lord Stone of Blackheath (Lab)]

My Lords, it is really an honour to be involved in this debate with those of your Lordships who are great experts and involved in the long-term effective work of relieving millions of people the world over, particularly children, from suffering from these diseases. We, as a nation, can be proud of the work that we are doing.

I am no expert but I know particularly about the work of the Schistosomiasis Control Initiative at Imperial College. I declare an interest as a past member of its advisory board. One reason that I was taken on is that I can pronounce schistosomiasis and the drug that controls it, praziquantel. I am not surprised that these diseases are neglected, as no one can pronounce their names. Schistosomiasis affects 200 million people, primarily in sub-Saharan Africa, and very few people know about it but we do. The latest figures from the World Health Organization suggest that over 70 million people received treatment in 2016. Our own SCI, supported by the British Government since 2010, has delivered over 40% of Schistosomiasis treatment globally—thank you, the Government.

What I do know about is quality control and systems. SCI has rigorous monitoring and evaluation processes in place to ensure that it is able to track closely the treatment numbers. This also allows for the identification of areas where the prevalence and intensity of the infection are not being reduced at the expected rate, and enables those Governments to be supported to take corrective action. Due to the complex epidemiology of schistosomiasis, in which the parasite is able to multiply many thousands of times in the snail intermediate host, continued progress will require a sustained effort, as the fifth progress report says. SCI and other organisations are committed to reaching the World Health Organization targets for schistosomiasis but also to ensuring that the disease-specific NTD interventions support the health systems of endemic countries and therefore the broad sustainable development goals. In addition, there is an issue with water and sanitation. Work on that needs to be accelerated so that we progress the targets for NTDs.

If I have any expertise, it is in linking business with good works. Arup, the global business of designers, planners and engineers, is currently involved in a number of projects related to sanitation and new and emerging water-quality issues worldwide. It has a strong global water-skilled network of staff, with specialisations covering all aspects of the water cycle. These staff work with ecologists in an interdisciplinary manner, which allows them to develop solutions based on holistic whole-systems thinking, and they feel that they may be able to view the problem and the potential solutions from a slightly different angle. What are Her Majesty’s Government considering doing to link investments made by DfID with these organisations to promote improved water and sanitation and strengthening systems?

My mentor in all this, who has already been mentioned, is Professor Alan Fenwick, the founder of SCI, who is now an adviser to the Global Schistosomiasis Alliance—GSA—which brings together donors, implementation organisations and country programme managers to assist in the development and implementation of country plans for the control and elimination of schistosomiasis country by country. He and others are concerned that the member states of the World Health Organization passed a World Health Assembly resolution in 2012 identifying schistosomiasis as a disease that could be eliminated. The resolution called on the World Health Organization to prepare guidance for member states towards the elimination of transmission, to establish procedures for the confirmation of the interruption of transmission and to support countries with post-elimination surveillance to prevent reintroduction of transmission. Six years later, there is still a lack of guidance from the World Health Organization on the treatment strategies needed to fulfil the resolution. How can Her Majesty’s Government support the World Health Organization to develop that guidance?

On a positive note, Wendy Harrison, who now leads the SCI team, reports that last year NTDs entered the Guinness book of records with the world’s largest mobilisation of donated drugs: the delivery in 2016 of more than 200 million doses, which arrived in distribution sites in six countries in one 24-hour period. One of the drugs that I mentioned that treats schistosomiasis, which has been generously donated by Merck, is praziquantel. Donations of praziquantel more than doubled from 72 million tablets in 2014 to 183 million tablets in 2016, but those donations still covered only about one-third of the 563 million tablets needed. How will Her Majesty’s Government support the market for praziquantel to reach the full number of tablets required?

Finally, to celebrate the UK’s innovation, entrepreneurialism and care in these times, and linked to our work, I was yesterday on your Lordships’ Terrace with Patricia Carter a director of Howad Ltd, which produces incognito insect repellent. She smiled at the fact that as we were talking, a bus crossed Westminster Bridge with an advert for incognito. The company has won a Queen’s Award for Enterprise in Sustainable Development for its product, which protects people from mosquitoes and other biting insects at home and overseas. We should be proud of that, as a country. Due to our work and expertise, here is an example of a small UK company protecting people against neglected tropical diseases and exporting to 22 countries. It also donates 10% of its profits to charities. On that note, I am now going to donate the four minutes that I have not used to the noble Baroness, Lady Hayman.