Tuberculosis

Debate between Nicholas Dakin and Andrew George

Wednesday 27th November 2013 Westminster Hall

[Nic Dakin (Scunthorpe) (Lab)]

Let me start in the past. In 1821, Maria Brontë died of consumption. Two of her daughters died of the disease in infancy and her four older children—Bramwell and his famous sisters, Anne, Emily and Charlotte—also died of it. According to the history books, they became

“ill from dampness and terrible living conditions”.

Consumption, or tuberculosis, is a disease that many people believe belongs to the past. Nothing could be further from the truth. TB kills more people in the world today than any other infectious disease. Every day, 3,800 people die from it. Sunday is world AIDS day, so it is worth remembering that TB is the leading killer of people living with HIV. At least one third of the 35.3 million people living with HIV worldwide are infected with latent TB. People co-infected with TB and HIV are about 30 times more likely to develop active TB disease than people without HIV. Given the devastating synergy that exists between the two infections and the impact that they have on people living in the developing world, it is absolutely vital that resources are stepped up now so that we not only effectively tackle TB-HIV co-infection but ensure that the health-related millennium development goals are achieved. The Department for International Development is about to launch its policy review paper on HIV/AIDS. I hope that it will make clear the importance of linking the approaches to TB and HIV, and that it will have clear commitments to tackle those diseases.

In the UK, we can be tempted to believe that TB no longer poses a threat to public health. There is a widespread belief that the BCG vaccine is effective and that today TB only affects other countries. However, in a connected world of global travel, TB is never far away. That came home to me forcibly when an English student returned from foreign travel with the disease and subsequently infected other students attending the college of which I was principal. Students and staff found dealing with the anti-TB drugs to be an ordeal. For a standard, non-drug-resistant case, the treatment regime can require a six-month course of a cocktail of four drugs. Those “front-line” drugs are more than 40 years old now and have unpleasant side-effects. It was a challenge for me as college principal, working with the local NHS, to get people to take the drugs they had to take. It must be an even bigger challenge to help patients in the developing world who not have access to the type of care and support offered by the NHS.

The stigma attached to the disease here was a barrier to patients accessing treatment. In sub-Saharan Africa, the stigma is even greater. Dr Simon Blankley, a Voluntary Services Overseas chest physician working in Uganda, reported that patients could often be locked away in cupboards or forced to leave their villages, and that health care workers were worried for their own health when TB patients were admitted to wards. TB needs to be tackled in a sustainable way that reassures people and builds community resilience. Dr Blankley was able to use a team of VSO volunteers to provide education and reassurance, and to get TB patients in and around Kampala to complete their eight-month course of treatment. The team’s work drastically increased completion rates. He then expanded the work, adding work on TB to the community health education that was already in place. That sustainable approach can be replicated elsewhere.

Dr Mario Raviglione, director of the global TB programme at the World Health Organisation, said just last month, when he launched the WHO’s global TB report in partnership with the all-party group on global tuberculosis, that

“at the current rate of progress, we will not be rid of TB for over a century.”

The efforts of the global health fund and its partners have made fantastic progress against TB, HIV and malaria, and the Government are to be applauded for their recent pledge of up to £l billion for the fund. However, we need absolute urgency, unremitting determination and co-ordinated effort to tackle TB.

[Andrew George (St Ives) (LD)]

I congratulate the hon. Gentleman on securing this debate. I also warmly applaud the Government on the contribution and the commitment that they have made to the global health fund, which continues the work of the previous Government.

The hon. Gentleman mentioned the HIV position paper, which in fact was published only moments ago. He may be disappointed to note that the Government appear not to be putting quite as much emphasis on ensuring that they make the connection between HIV and TB. Will he insist that the Government continue a commitment to TB REACH and other programmes that address that serious problem?

[Jim Dobbin (in the Chair)]

Order. I suggest that when we have interventions, they are short.