Asked by
To ask Her Majesty’s Government, further to the announcement by
the World Health Organisation on 22 March that an estimated 1.4
million fewer people received necessary care for Tuberculosis in
2020 compared with 2019, what they are doing to tackle
Tuberculosis globally.
The Minister of State, Department for the Environment, Food and
Rural Affairs and Foreign, Commonwealth and Development Office
() (Con) [V]
My Lords, the impact of Covid-19 on other global health issues
such as TB is deeply troubling. The UK has a proud legacy of
fighting TB globally. Our current pledge of up to £1.4 billion to
the Global Fund to Fight AIDS, Tuberculosis and Malaria is
tackling all three diseases and helping countries to strengthen
their health systems. We also invest in TB research and
innovation to help people access new TB treatments.
(Con)
My Lords, I thank my noble friend for his Answer. Many people
believe that tuberculosis is a disease of the past. It is in
fact, sadly, a disease of the present, still killing 1.5 million
people a year globally quite unnecessarily. By the time this
World TB Day has ended, there will have been another 4,000
needless losses of life, and 700 of those will be children. No
epidemic in human history has been beaten without a vaccine, yet
there is no effective adult vaccine for tuberculosis. I am
grateful for the many things that the Government are doing to
tackle this disease globally, but will my noble friend assure me
that the Government will remain committed to funding the vital
research and development for the new tools that will help us to
beat this terrible disease by the time of the sustainable
development goal which committed to end it in nine years’ time?
(Con) [V]
My Lords, tackling TB is a crucial part of improving lives. As
the noble Lord says, every death from TB is preventable. That is
why the UK has been a leading donor on TB for many years; we are
consistently among the top three most generous countries. Our
research investments have been transformational and have led to
at least five new diagnostic tools for TB. Although the pandemic
has forced us to take tough decisions, tackling TB remains a
priority and global health remains a top UK ODA priority, as set
out by the Foreign Secretary just a few days ago. We will provide
more information on how we will continue to take a leading role
in due course.
(Lab) [V]
I appreciate what the Minister said about the importance of the
Global Fund. He will well know that any delay in funding would
set a dangerous precedent and undermine the fund’s ability to
disperse those crucial funds. What reassurances can he give about
the full and timely dispersal of the UK pledge to the Global Fund
to Fight AIDS, Tuberculosis and Malaria that keeps to the
original timetable?
(Con) [V]
My Lords, the Global Fund is the principal mechanism that we use
to fight TB in developing countries. We believe that the Global
Fund has a major role to play in the fight against TB. Our
current pledge absolutely reflects this.
(LD) [V]
My Lords, in the context of the deplorable reduction to the aid
budget, how will the Government use their UK leadership through
the G7 and G20 processes to drive international collaboration to
strengthen essential health services and mitigate the secondary
impact of Covid-19, including on TB?
(Con) [V]
My Lords, this is a very significant year for global Britain,
with numerous opportunities for us to demonstrate leadership. The
UK will use its G7 presidency to champion the needs of developing
countries, including, of course, on health generally and on TB in
particular.
(Con) [V]
Is my noble friend the Minister aware that almost a third of the
global population is infected with the TB bacterium but only 5%
to 10% of these will go on to develop active TB? Chief among
those are people with HIV, who may have suppressed immune
systems: for them, preventive therapy is absolutely crucial. That
includes patients here in the UK. Can he tell us what progress is
being made in reaching the target of providing preventive therapy
to the 30 million people most at risk by 2022?
(Con) [V]
My Lords, tackling TB is a crucial part of improving the lives of
vulnerable people, as the noble Lord has said, such as those
living in poverty or with HIV, who are most at risk. While TB
affects mothers and children less than diseases such as malaria
do, 16% of all TB deaths in 2019 were still of children under 15.
For these reasons and many more, tackling TB remains a government
priority.
(Lab)
My Lords, the Minister has stressed that health is a priority for
this Government, so what assessment has been made of the impact
of UK aid cuts on global efforts to build resilient and
responsive health systems to deliver on the sustainable
development goal target to end TB?
(Con) [V]
The pandemic has forced us to take tough decisions, including
temporarily reducing the aid budget. However, global health
remains one of the UK’s top ODA priorities, as set out by the
Foreign Secretary. We will continue to be a global leader on
global health with a major portfolio of investments focusing on
where we can make the biggest possible difference. The current
resource allocation round has not yet concluded, so I am not
able, at this point, to confirm the settlement for global health.
(CB) [V]
My Lords, TB is a contagious and dreadful disease. I know that
because my father died after suffering from TB. He contracted TB
during the 1950s, however, when it was incurable in India.
Nowadays, TB is curable and occurs predominantly in South Asia
and Africa. I am aware that the UK aims to give aid to these
countries mainly for education and skills training, but will the
Government earmark part of the funds to tackle diseases such as
tuberculosis?
(Con) [V]
My Lords, I can confirm that tackling TB remains a priority. As
with all ODA, we are obliged to spend money in the manner that
delivers the best possible results. The noble Lord mentioned his
father’s death, and I am very sorry to hear that. He also
mentioned that TB was treatable, although it is worth pointing
out that we have serious challenges with anti-microbial
resistance. Drug-resistant TB is a real challenge, so we will
have to continue to address that issue as well, and draw
attention to the fact that drug-resistant TB causes, we believe,
a third of all deaths from anti-microbial resistance.
(Con) [V]
My Lords, this past year has seen a huge disruption to the
delivery of vaccinations and medical treatment and care, with TB
being one clear example. Given the increased need for global
health assistance because of Covid-19, surely we should be
stepping up, not stepping back. Do the Government really think it
is right to be cutting life-saving medical UK aid during a global
pandemic?
(Con) [V]
My Lords, we are not stepping back; we are stepping up. In all,
we have committed up to £1.3 billion of ODA to counter the
health, humanitarian and socio-economic impacts of Covid-19 and
to ensure an equitable distribution of vaccines. The UK is
working with countries to ensure that, as far as possible,
essential TB services continue; that TB patients are protected
from Covid-19 infections; and that TB programmes make good
decisions about redeploying their resources to national Covid-19
programmes in a sustainable way. Our funding has supported the
Global Fund’s Covid-19 response mechanism, set up specifically to
help countries keep on track during, and because of, the
pandemic.
(Con)
My Lords, the ODA budget performs a great role in fighting TB and
many other evils across the world. At the same time, the UK
Government have rightly spent billions on a superbly successful
Covid-19 vaccination programme at home, and I congratulate them.
However, when we have completed that work here and excess
vaccines are, hopefully, shared with those countries that need
them across the world, including developing nations that are
otherwise in receipt of ODA, can the Minister reassure us that
the cost of those vaccines will not count towards, or be deducted
from, our aid spending targets?
(Con) [V]
My Lords, my noble friend asks a serious and important question.
I am afraid that it is not one that I can answer right now, but I
will convey it back to the department and my colleagues, and I am
sure that the answer will soon be forthcoming.
(Con) [V]
My Lords, as well as the difficulties for TB care, the pandemic
has led to huge challenges in the delivery of life-saving
contraception. This will be compounded by the plan to cut aid so
significantly. The UK’s flagship family planning programme, WISH,
is at risk and reports at the weekend highlighted that if funding
is removed, we could see up to 2.5 million more unintended
pregnancies and 22,000 maternal deaths. Does the Minister agree
that contraception is one of the most empowering things that we
can do for women globally, and can he please do what he can to
protect this vital programme from closure?
(Con) [V]
My noble friend makes a really important point. It has been the
Government’s view for some time that investing in family planning
is an extraordinarily important way to empower particularly women
and girls in vulnerable communities. There is also a direct link
between empowering women and girls and consequently enabling
families to make decisions for themselves on their own terms in
relation to the size of their families. For many reasons,
investing in family planning has always been a priority, and I
assure my noble friend that it will continue to be.
(Con) [V]
My Lords, I was pleased to hear from the Minister what the
Government are doing. There is a real urgency to tackle this
disease worldwide, not least because we are acutely aware of how
easily disease can spread rapidly across borders. Does my noble
friend have access to any figures regarding the number of TB
cases in the UK in recent years, and whether the disease is on
the increase here? He may have to ask his colleagues in the
Department of Health about this.
(Con) [V]
I am afraid that I cannot give accurate figures, but they do
exist—I have seen them, but I do not want to mislead the House. I
will get back to my noble friend after consulting with the
Department of Health. The numbers are very small, certainly in
comparison with any of the target countries that we focus on
through our ODA.
(Con) [V]
My Lords, does not our success in creating a vaccine for Covid in
very short order suggest that maybe now is the time when, if we
put our shoulders thoroughly to the wheel, we can do the same for
tuberculosis, and that when our aid budget is again increased, a
large lump of the first year allocation to this purpose would
have a great benefit for the world?
(Con) [V]
My noble friend is right. A range of approaches will be critical
in tackling TB in the longer term. We must advance universal
health coverage to ensure that all people with TB have access to
affordable, quality care, and address risk factors for TB, such
as poverty and malnutrition, but clearly a TB vaccine would be a
game changer to prevent TB. Vaccine development research is high
risk, but with potentially gigantic rewards. We will continue
assessing the UK’s contribution to vaccine development as the
pipeline of potential TB vaccine candidates develops.
