Tuberculosis

Stephen Doughty Excerpts

Thursday 7th June 2018 Commons Chamber

[Nick Herbert (Arundel and South Downs) (Con)]

I beg to move,

That this House recognises that tuberculosis (TB) remains the world’s deadliest infectious disease, killing 1.7 million people a year; notes that at the current rate of progress, the world will not reach the Sustainable Development Goal target of ending TB by 2030 for another 160 years; believes that without a major change of pace 28 million people will die needlessly before 2030 at a global economic cost of £700 billion; welcomes the forthcoming UN high-level meeting on TB in New York on 26 September as an unprecedented opportunity to turn the tide against this terrible disease; further notes that the UN General Assembly Resolution encourages all member states to participate in the high-level meeting at the highest possible level, preferably at the level of heads of state and government; and calls on the Government to renew its efforts in the global fight against TB, boost research into new drugs, diagnostics and a vaccine, and for the Prime Minister to attend the UN high-level meeting.

The motion stands in my name and that of the hon. Member for Ealing, Southall (Mr Sharma), and I am grateful to the Backbench Business Committee for allowing us to have this debate on ending tuberculosis.

I believe that this is the first time that this issue has been debated on the Floor of this House for 65 years. Responding to an Adjournment debate in 1952, the Joint Under-Secretary of State for Scotland, Commander T.D. Galbraith, said:

“Tuberculosis is still the major health problem in Scotland…we must press forward…with every weapon that is available to us until the disease, which is said to be preventable, has been eradicated.”—[Official Report, 29 January 1952; Vol. 495, c. 158.]

At that time, people were optimistic because antibiotics had been discovered and put into mass production, housing was improving and there was no longer any reason to believe that tuberculosis would not be beaten. Tuberculosis was the great killer of history. A disease that dates back at least 7,000 years, it has killed 2 billion people in the last two centuries alone. John Bunyan said that TB was

“the captain of all these men of death”.

TB—otherwise known as consumption or the white death—is caused by a tiny bacteria. When it was first identified in 1882, it was still killing one in seven people. Indeed, TB killed more people in the United States in the late 19th century than any other disease. It is a disease that has killed kings, poets and paupers throughout history. Tutankhamun, Edward VI, Cardinal Richelieu, Eleanor Roosevelt, Keats, Chekhov, Emily Brontë, D. H. Lawrence, Orwell and Chopin all died from TB. Of course, the heroines of the operas “La bohème” and “La traviata” notoriously die from tuberculosis. That was expected in that age, which was not so long ago. Millions of others down the ages have suffered from TB—notably, Nelson Mandela, who suffered greatly from it.

With better housing, better nutrition, the discovery of penicillin by Fleming in 1928, and the mass production of antibiotics in the 1940s, it was thought that tuberculosis would be beaten. In 1962, a Nobel laureate virologist said:

“To write about infectious disease is almost to write of something that has passed into history.”

But TB was not eradicated or eliminated at all. It resurged on the back of the AIDS epidemic. TB is a bug carried by a third of the world’s population that can exist in our bodies latently, but strikes when immune systems are compromised.

[Stephen Doughty (Cardiff South and Penarth) (Lab/Co-op)]

I congratulate the right hon. Gentleman on securing this debate. I chair the all-party parliamentary group on HIV and AIDS, and he knows that we very much share his concerns about TB and are pleased to work with his all-party parliamentary group on global tuberculosis. Today, we met the chief executive of the he Global Fund to Fight AIDS, Tuberculosis and Malaria. Does the right hon. Gentleman agree that that organisation is doing excellent work, not least on co-morbidity, as people live with HIV/AIDS and TB? People living with HIV are 30 times more likely to develop active TB, and TB is the leading killer of people with AIDS.

[Nick Herbert]

I strongly agree with the hon. Gentleman that the diseases must be treated together. However, great progress has been made on tackling AIDS, partly because of the tremendous new tools available. By comparison, less progress has been made on tuberculosis. Last year, 1.7 million people died of tuberculosis. That is more than AIDS and malaria combined. The single fact that most people do not realise is that tuberculosis is now the world’s deadliest infectious disease, and it deserves more attention than it gets. Some 10 million people globally are falling ill each year as a result of this disease.

TB was declared a global health emergency by the World Health Organisation 24 years ago. Since then, 54 million people have died. That is not a great advert for the declaration of a global health emergency. Three years ago in New York, the world’s leaders set the sustainable development goals. Target 3.3 was to eliminate these major epidemics in 15 years. At the current trajectory, TB will not be eliminated for 160 years, so another 28 million people will die in the sustainable development goal period alone, costing the world economy $1 trillion cumulatively. Middle and lower-income countries will be the most severely hit, with lower-income countries experiencing a reduction of something like 2% of their GDP.

On top of this, there are new threats. I mentioned that TB strikes when immune systems are compromised, and they can be compromised in new ways, including by the acquisition of diabetes. In Indonesia, TB is striking people with diabetes, which is a growing problem.

Above all—this should concern the House greatly—is the growing risk of drug resistance. TB is the only major drug resistant infection that is transmitted through the air. It is already responsible for one in three deaths worldwide from all forms of drug resistance. Drug resistance generally now kills 700,000 people a year, but Lord O’Neill’s commission, set up by David Cameron, predicted that drug resistance would kill 10 million people a year by 2050, and that those deaths would fall in the west and advanced economies, not just in poor and middle-income ones. That compares with, for instance, 8 million deaths a year from cancer. We are talking about catastrophic loss and catastrophic economic cost, with a cumulative GDP loss of $100 trillion, knocking 2% to 3.5% off global GDP. It is significant that a quarter of those deaths from antimicrobial resistance would be due to tuberculosis, which is already responsible for a third of antimicrobial resistance deaths; that is 200,000 deaths a year.