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Harriett Baldwin responds to debate on TB


7th June 2018

Harriett Baldwin responds to a debate on tuberculosis (TB) which remains the world’s deadliest infectious disease.

The Minister of State, Department for International Development (Harriett Baldwin)

It is a pleasure to serve under your chairmanship, Madam Deputy Speaker. I, too, thank my right hon. Friend the Member for Arundel and South Downs (Nick Herbert) and the hon. Member for Ealing, Southall (Mr Sharma) for persuading the ​Backbench Business Committee to arrange this very important debate. I thank all Members in the Chamber for contributing to an absolutely excellent debate. They have really shown a commitment to keeping TB high on the agenda.

Most of the questions I have been asked will be covered in my speech but, in response to the specific points raised, I want to add my tribute to the work done on this agenda in Liverpool and in Oxford, which was highlighted by colleagues. I pay tribute to the work done by the hon. Member for Poplar and Limehouse (Jim Fitzpatrick) and others on the subject of road deaths, which has been covered elsewhere. I also pay tribute to the right hon. Member for Kingston and Surbiton (Sir Edward Davey) for bringing to the House’s attention the work of the find and treat teams. Such work is clearly outstanding, and those responsible for funding those teams will have heard that.

We heard excellent contributions from the hon. Member for Liverpool, Riverside (Mrs Ellman), my right hon. Friend the Member for Chesham and Amersham (Dame Cheryl Gillan), the hon. Member for Liverpool, West Derby (Stephen Twigg), my hon. Friend the Member for Banbury (Victoria Prentis), the hon. Member for Poplar and Limehouse, the right hon. Member for Kingston and Surbiton, and the hon. Members for Ipswich (Sandy Martin), for Strangford (Jim Shannon) and for Linlithgow and East Falkirk (Martyn Day). That is testament to the importance of this subject.

I am pleased to say that the UK Government are truly a leading player in global healthy generally. Good health is clearly valuable not only in its own right, but in contributing to the prosperity and stability of developing countries, as well as to the health of people in the UK. As colleagues may know, the UK is in fact the largest funder of GAVI—the Global Alliance for Vaccines and Immunisation. In 2016 alone, that vaccines alliance immunised over 15 million children against vaccine-preventable diseases such as diphtheria and polio, and saved approximately 300,000 through its work that year. Through such programmes, I am proud to say that we have almost eradicated polio and guinea worm worldwide, while typhoid and diphtheria are being tackled and small pox has been eradicated.

However, as colleagues have stated, tuberculosis presents a vast challenge, with 10.4 million people falling ill with, and 1.7 million dying from, TB in 2016 alone. Although the TB death rate dropped by 37% between 2000 and 2016—that success should be applauded—TB is now the world’s leading infectious disease killer. That is why the Department for International Development will provide up to £1.1 billion for the 2017 to 2019 replenishment of the Global Fund to Fight AIDS, Tuberculosis and Malaria.

As colleagues have noted, this year’s high-level meeting at the United Nations General Assembly presents an important opportunity for the world to accelerate global progress in tackling TB and drug resistance. The debate—and, indeed, the letter from 150 colleagues—has shown the importance that this House attaches to the Prime Minister’s attendance at the high-level meeting. The UK will work closely with other member states to negotiate the commitments to be made in the political declaration of the meeting. In fact, I can assure hon. Members that the entire diplomatic network will be engaged in ensuring that the declaration is ambitious, ​including through G7 and G20 discussions. For example, we have already helped to secure specific references to TB in the most recent G20 Health Ministers’ and leaders’ declarations. I cannot personally commit the Prime Minister’s diary at this time, but No. 10 will have heard the voices of parliamentarians this afternoon. I assure Members that, whatever happens, there will be strong, high-level UK representation at the meeting.

Of course, that one meeting is only part of the story. The UK should be rightly proud of the action it has taken to fight TB at home and abroad. At home, there has been a remarkable 40% decline in new cases since 2011. In fact, TB cases in the UK are at their lowest level for 30 years. Most of the recent decline is down to the TB control measures that have been discussed today, and to screening in the 59 high-incidence clinical commissioning group areas. I pay tribute to the excellence of the cross-departmental and cross-country working that has been done as part of this initiative.

Abroad, DFID is a global leader on tackling the TB epidemic, and we do that in three ways. Mainly, we fund increased access to care through our contribution to the global fund. We are the second largest funder, with £162 million of this investment going to tackle TB. That will support the treatment of 800,000 people with TB and accelerate innovation to provide access to new drugs and diagnostic tests. Secondly, we tackle TB through programmes to strengthen health systems in a wide number of countries. We are working with national Governments, particularly in low-income countries, to help people to access high-quality healthcare for all priority health needs, including TB. The prevention, diagnosis, and treatment of TB are underpinned by people having access to good-quality health services. Given that TB is most widespread amongst the poorest, our wider work on reducing poverty and increasing access to services, including efforts to reduce the poverty and vulnerability of populations, also has an impact on this terrible disease.

Thirdly, we fund research into developing new products to combat TB. This is hugely important. We need better and cheaper diagnostics that are available on the spot, including diagnostics that detect drug resistance. Thanks to UK funding, a new test—the GeneXpert test mentioned by the hon. Member for Strangford—has been developed. It reduces the diagnosis time from many days to under four hours, and is now available in 140 countries worldwide. It is also used in the UK, so this is a real, practical example of UK aid funding something that is in our national interest.

Research is also needed to provide shorter drug treatments, which make it easier for people to complete treatment courses and to help themselves, and prevent drug resistance. We provide support to the TB Alliance for this. It has successfully developed paediatric TB drugs and is now working to develop new, faster-acting and more effective TB drugs, including drugs that can be taken by people with HIV. DFID is funding this drive for new drugs and diagnostics as part of the £1 billion Ross Fund portfolio.

Many colleagues have mentioned antimicrobial resistance. Tackling drug-resistant strains of TB, like other forms of antimicrobial resistance, presents a significant challenge to all our work on TB. The disease accounts for one third of all antimicrobial resistance-related deaths worldwide. We are therefore working to prevent, identify ​and treat drug-resistant TB globally. UK support to Gavi for immunisation reduces infections and the need for treatment. The UK’s Fleming Fund is improving laboratory capacity for diagnosis and surveillance of AMR in low-income countries. Our support to the TB Alliance is helping to develop new regimens for treating drug-sensitive and drug-resistant strains of TB. We also fund Unitaid, which aims to triple access to RAID testing for drug-resistant TB, and to reduce prices for drugs to treat TB and drug-resistant TB. The UK Government recognise another challenge: many of those suffering from TB also have HIV; and, as several colleagues mentioned, being HIV positive increases vulnerability to TB. UK aid has helped the global fund to keep 11 million people alive with HIV therapy. DFID prioritises the integration of services to avoid siloed HIV and TB responses through our programmes.

I started with praise for the efforts of my right hon. Friend the Member for Arundel and South Downs in his work on TB globally, and I will end by recognising the significant UK contribution to that agenda. Our universities carry out basic science research, explore how to improve TB services, and work to develop new treatments and vaccines. The UK’s world-leading pharmaceutical companies also contribute by developing new TB treatments and vaccines. The UK is working hard with the global community to achieve progress on the agenda and a successful high-level meeting. We hope that our shared efforts will enable us to achieve the ambitious targets of the WHO’s “End TB Strategy” and the global goals. I thank all hon. Members for discussing this important issue today.

Hansard



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