Health: Neglected Tropical Diseases

Lord Trees Excerpts

Wednesday 30th January 2013 Lords Chamber

[Lord Trees]

My Lords, the debate today is to mark the first anniversary of the London declaration on neglected tropical diseases. I want to celebrate that important initiative and the considerable progress that has been, and is being, made to control and eradicate these diseases. However, I also want to emphasise that we cannot yet be complacent. The job is not finished and there is much to do, even though the way forward is largely clear.

The NTDs are now getting the attention they deserve because they afflict huge numbers of people in the poorest countries of the world—the so-called “bottom billion”. These diseases are inextricably bound with poverty. It contributes to these diseases and these diseases, in turn, contribute to poverty. Their control is an essential step in the achievement of several key millennium development goals. These diseases, which include many with bizarre, exotic and frightening names such as Kala-Azar, Chagas disease, sleeping sickness, elephantiasis and river blindness, are for the most part chronic and persisting infections, which may eventually kill but which in many cases simply—but seriously—disable, disfigure and stigmatise. The effects are pervasive and extensive in the societies in which they occur.

Another of their characteristics is that many can be treated, controlled and even eradicated with tools that we already have. These are the low-hanging fruit of tropical diseases. The costs of making progress are relatively low and the benefits are huge, as has been said by several speakers. It is very much to the credit of the WHO, the Gates Foundation, various NGOs, scientists and healthcare workers throughout the world, and of course, the London declaration, that these diseases are now being tackled in a concerted and coherent way. The contribution of the UK to this global effort is huge. DfID has played a very substantial part, as have many scientists, medics, vets and healthcare workers based in our universities and in our two schools devoted to tropical medicine and public health in Liverpool and London.

Another hugely important factor has been the donation of drugs by major pharmaceutical companies to this programme. Drugs to the value of $2 billion to $3 billion a year are being donated by big pharma; this is an altruistic gesture that is not always fully appreciated. As a vet, it gives me satisfaction that a lot of these drugs were initially developed for the control of worms in animals. A staggering 700 million tablets are administered each year to school children in developing countries to control enteric worms, and that is just one example. All of these efforts have resulted in a substantial reduction in the incidence of infection and disease, and put the goals of controlling and eradicating many—if not most—of the 17 targeted NTDs by 2020 within reach.

However, there is still a need for an estimated $2 billion to sustain this effort to achieve these goals. That is a lot of money. Currently only 0.6% of overseas development assistance for health globally is being allocated to NTDs. Some $2 billion spread over 7 years among the wealthiest nations of the globe, given the huge return, is surely not only a desirable, but also a necessary investment. Fit and healthy people can work to feed themselves, their families and, their populations and they can contribute to the economic and social progress of their countries which in turn reduces conflict and migration.

There is still a need to develop new products and technologies to continue supporting the development of healthcare systems, health services in endemic countries and particularly systems for delivery of drugs to the point of need. We need to ensure clean water supplies and good sanitation. Notwithstanding that, we now have many of the tools we need. It is the appliance of science, the delivery of what we have, that is the major challenge. Given that there are freely available drugs for many of the NTDs, it is a responsibility we all share to apply these tools to achieve the global benefits. If we fail to do that—to satisfactorily deal with the low-hanging fruit—what hope have we to tackle more complex or technical health problems facing the world?