Neglected Tropical Diseases

Lord Bates Excerpts

Wednesday 11th July 2018 Lords Chamber

[The Minister of State, Department for International Development (Lord Bates) (Con)]

My Lords, I join other noble Lords in paying tribute to the noble Lord, Lord Trees, for securing this debate on NTDs. The noble Lord, Lord Collins, mentioned that he is a veteran of five such debates. I think that I have probably managed three, the last one, last year, introduced by the noble Baroness, Lady Hayman. I also particularly pay tribute to the noble Lord, Lord Trees, for his work as the chair of the advisory group for DfID on zoonosis. I also take the opportunity to commend the work of the APPG on Malaria and Neglected Tropical Diseases, and I am delighted that part of our proceedings have been observed by Jeremy Lefroy, who has done so much to raise the profile of this area and to continue interest in it. I also thank the noble Lord, Lord Kakkar, for his support, including at the global health forum.

It has been a fascinating debate, with a lot of new areas being raised. The noble Lord, Lord Trees, began by reminding us that NTDs are a result of poverty, as well as a cause of poverty. He placed this debate in the context of the sustainable development goals—particularly three, although others are impacted too.

My noble friend Lady Stroud spoke about the impact she had witnessed at first hand in Rwanda. She referred to the work that had been done and the impact it had on children’s education, reminding us of the connectedness of these diseases with other development needs.

The noble Lord, Lord Stone, again reminded us of the incredible work of Imperial College in the schistosomiasis group and the work of Professor Alan Fenwick, which is well regarded in this area.

The noble Baroness, Lady Hayman, is an example of persistence and perseverance in this area, which is not only necessary to tackle neglected tropical diseases but to advance the issue up the agenda of government. She pressed us on that.

The noble Baroness, Lady Warwick, reminded us that women and girls often bear the greatest burden of these diseases. She then went on to highlight a series of technical innovations—such as the example she gave in Mozambique—and called for new ideas.

The noble Baroness, Lady Sheehan, pointed out that none of the progress which has been made would have been possible without collaboration. She said that it would have remained a pipe dream. She also pointed to the important role that data and diagnostics can play in achieving this.

The noble Lord, Lord Collins, reminded us that investing in health systems and the health of populations is one of the most effective ways of correspondingly lifting people out of poverty. Again, he placed that in the context of further work that will be carried out on 24 July at the global disability summit. I am delighted that he is participating in it.

Let me update the House on progress over the past year and then seek to address some of the questions that have been raised. Neglected tropical diseases impact on the most disadvantaged, especially those living in remote areas or areas affected by conflict. They prevent children attending school, as my noble friend Lady Stroud reminded us. Tackling NTDs enables us to ensure that everyone has the opportunity to reach their full potential, a value protected through UK aid and declared, as the noble Lord, Lord Collins, reminded us, through the SDGs, with no one being left behind.

NTDs can result in families falling into poverty as a result of having to sell assets or borrow money to pay for healthcare. Combating these diseases is a development best buy, with the average treatment for a range of commonly occurring NTDs costing between 20 and 50 cents, as the noble Lord, Lord Trees, reminded us.

As the fifth progress report shows, progress is being made. It demonstrates that the number of people needing treatment for an NTD has fallen from almost 2 billion in 2011 to 1.5 billion in 2016, reducing the numbers of people at risk from these diseases. One billion people received treatment for an NTD in 2016. This progress is continuing. Since the report’s publication, the World Health Organization has verified Ghana’s and Nepal’s elimination of blinding trachoma, a fact mentioned by the noble Baroness, Lady Warwick. Guinea worm disease has fallen from 3 million human cases a year in 1986 to just 30 cases in 2017. However, there is more to do.

These are, of course, huge achievements, but hundreds of millions of people remain without the treatment they need. We know the last mile is often the hardest. The World Health Organization has just announced that a case of Guinea worm disease has been found in Angola, a country previously thought to be free from the disease. This is disappointing to us all but I know that globally we will rise to this challenge on the path to its eradication.

The UK invests in high-performing programmes tackling a range of NTDs. These programmes are delivering results. DfID programmes delivered more than 145 million treatments for NTDs in 2017 and carried out 50,000 surgeries to prevent blindness from trachoma. Asia is making progress towards achieving the elimination of visceral leishmaniasis as a public health problem. We are prioritising the tackling of five high-burden NTDs that we can have the greatest impact on. With our increased investment, we welcome bids that include additional activities to tackle other NTDs included in the London declaration, which identified 10. We have said that we want to focus on five, but I have been persuaded by some of the representations made by noble Lords, particularly on leprosy. I want to see what more can be done there. I received representations from the Leprosy Mission, which I am looking to meet, and Lepra, to see how we can involve leprosy more. Once that meeting is scheduled, I will invite other noble Lords to attend it.

The noble Lord, Lord Trees, focused on rabies. It is a devastating disease. DfID focuses on tackling some of the priority NTDs selected following careful analysis of the disease burden, the value for money and the likely impact of our investment. We welcome the inclusion of other diseases included in the London declaration. We also support the World Health Organization’s NTD efforts, which address an even wider range of NTDs and work to improve health systems in all countries, including those affected by rabies. That is something I will take away.

I am conscious, as officials are now, that noble Lords will be reading the record in a year’s time. I want to do slightly better than I did last year in respect of the questions from the noble Baronesses, Lady Warwick and Lady Sheehan, on the Ross fund. In that context—rather than reading the short response I have from the Box—one of the interesting things about what the noble Baronesses raised on the Ross fund is that we work very closely with the Department of Health and Social Care and we need to co-ordinate a better response there. DExEU has an impact on the relationship with the EU, as does the Department of Health and Social Care. Perhaps the noble Baronesses will allow me to write a more substantive response, which other noble Lords will be copied into.

The noble Baroness, Lady Warwick, also asked what we are doing about technologies. DfID is using smart technologies. An example is trachoma mapping; another is the use of an app to guide medical staff on the dose of drugs and treatments. I know that we are also looking at the use of drone technology, which the noble Baroness also mentioned.

The noble Lord, Lord Stone, asked what we are doing to link water and sanitation work. The UK is committed to supporting people to gain access to water sanitation and hygiene. Since 2015, DfID has provided 27.2 million people with access to clean water or sanitation as part of our commitment to reach an additional 60 million people with water or sanitation between 2016 and 2020.

In passing, I will make a short reference to the Ross fund. We fund research into the development of new drugs and diagnostics for NTDs, as well as operational research. Some £100 million of the Ross fund portfolio, managed by DfID and the Department of Health and Social Care, is allocated to this work, investing in our world-leading research in this area. I also pay tribute the work of Professor Molyneux at the Liverpool School of Tropical Medicine.

Our work on NTDs is one way in which the UK is showing leadership on the global health goal, which will help others. There is a unique public/private partnership. I again pay tribute to the END fund, mentioned by my noble friend Lady Stroud, and the visionary work of Alan McCormick in seeking to advance that particular area. Most of the medicines are donated by pharmaceutical companies. As the noble Lords, Lord Collins and Lord Stone, mentioned, NTDs entered the Guinness book of records in 2017 with the most drugs donated in a 24-hour period. The noble Lord, Lord Trees, was absolutely right to remind us that this must be one of the greatest philanthropic acts in history.

In April 2017, the noble Lord and I attended the NTD summit to mark the fifth anniversary of the London declaration. To mark that conference, we announced an increase in investment to protect more than 200 million people from the pain and disfigurement of NTDs over the next five years. A total of over $800 million was pledged at that conference. The noble Baroness, Lady Hayman, was generous in recognising any small contribution which I may have made to that; I would rather pay tribute to the power of a compelling argument.

There is much more to do in this area, but I assure noble Lords that the UK is meeting our commitments. We must continue to widen the donor base and increase the domestic resources committed to health. We have made considerable progress, but more will need to be done if we are to banish to history the suffering from these dreadful diseases, which we are all committed to do.

House adjourned at 6.30 pm.