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Harriett Baldwin responds to debate to mark World TB Day

27th March 2019

Harriett Baldwin responds to a debate to mark World TB Day and highlights the efforts to end tuberculosis globally.

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

It is a pleasure to serve under your chairmanship, Sir Christopher. [Interruption.] If only you could stop the noise outside, we would not be quite so distracted. I pay tribute to my right hon. Friend the Member for Arundel and South Downs (Nick Herbert), whose leadership on this issue is absolutely remarkable. Not only does he co-chair the all-party parliamentary group with the hon. Member for Scunthorpe (Nic Dakin), but he shows leadership globally, in the Global TB Caucus. His contribution to the recent Lancet Commission report on building a tuberculosis-free world was also incredibly valuable.

It is a real honour for me to respond to the debate. I wish to pay tribute on the record to my former ministerial colleague, my right hon. Friend the Member for North East Bedfordshire (Alistair Burt), who would have responded to the debate. I assure colleagues that I will pick up where he left off in championing this cause.​
We heard a really passionate case from my right hon. Friend the Member for Arundel and South Downs on why we need not only to mark World TB Day with debates such as today’s, but to keep sustained momentum behind the progress that the world has made. I am always a sunny optimist, and I like to see that progress. Some 53 million lives have been saved since 2000, and there has been a 37% reduction in mortality. We heard from the hon. Member for Poplar and Limehouse (Jim Fitzpatrick) about the progress in the UK and our 2015 strategy. Our wonderful NHS is making tremendous progress, and we are now at a 30-year low, but I acknowledge that there is still more to do, and we have heard powerful speeches arguing that. A range of points were raised, and I will try to address them all in the few moments that are left.

The importance of the work that was done with the declaration cannot be underestimated, because it is a forum where the whole world can come together and make commitments. The UK was proud to lead the work behind the declaration at the UN. The importance of the work on missing cases also cannot be overemphasised. Some of the Global Fund work has supported finding those missing cases. Each missing person can infect another 15 people through not being diagnosed or treated. So far, out of 1.5 million missing cases, 450,000 have been found.

I heard the call from my right hon. Friend the Member for Arundel and South Downs for strong accountability mechanisms. The UN is a very good forum for that. We want to ensure that money is spent on frontline treatment, and that any accountability mechanism adds value by working with the grain of what is already there, making best use of existing mechanisms, and is proportionate.

We should also note that there has been further progress since last year’s debate. We should put on the record the fact that the M72 vaccine seems to be showing promising early results. The UK spends a significant amount—I think it is £12.7 million every year—on research. It is important to co-ordinate research globally, and the World Health Organisation is the right organisation to do that. I assure colleagues that the UK will remain at the forefront as a leader, and that we will take part in the replenishment. I cannot, however, announce exactly how much it will be; obviously, we will wait until October to do that.

The hon. Member for Brighton, Kemptown (Lloyd Russell-Moyle) spoke powerfully about the side-effects and the treatment that he witnessed at first hand in Liberia, and we heard a range of other powerful speeches. I welcome the hon. Member for Nottingham North (Alex Norris) to the Front Bench; he did fantastically in his first outing in that role. I also recognise the call for leadership made by the hon. Member for Liverpool, West Derby (Stephen Twigg) and note the strong links between the work done in Eswatini and the work that the hon. Member for Strangford (Jim Shannon) sees in his constituency in Northern Ireland. I pay tribute to the Scottish research tradition, which goes back 100 years, and to the contribution that the Scottish Government make to this work.

I am not sure how much time I have to sum up, but the UK can be proud of being the third largest donor to the Global Fund, which managed to reach 5 million people in 2017 alone. I do not have the figures for 2018, but that is a significant impact. The Global Fund is also ​very important in terms of research, and of course where we have strong bilateral relationships—particularly in DFID countries—it combines with the work we do to strengthen health systems in those counties. The Global Fund also fits in with DFID’s wider work to reduce poverty and improve access to services in some very hard-to-reach places.

I am proud that the UK is the second largest donor to the current replenishment of the Global Fund. Colleagues have recognised the £1.2 billion that we have contributed since 2017, and we are the first and only country in the world to have enshrined in law our overseas development assistance contribution of 0.7% every year. We will announce our replenishment in October, but we will continue to support the fund in its remarkable and successful work of reducing the burden not only of TB, but—as hon. Members have noted—of HIV and malaria in the world’s poorest countries. The fund is central to efforts to tackle TB, but we need to link that to strengthening health systems in countries where DFID has a strong bilateral programme. We will certainly be playing our part.

We continue our strong tradition, which goes back more than a century, of being involved in research and development as one of the largest funders of tuberculosis research worldwide. Several colleagues spoke about research by drug companies. We are a leading supporter of product development partnerships, which are a mechanism to incentivise the pharmaceutical industry and academia to develop new therapies and diagnostics so that the intellectual property can be fairly distributed. As part of that effort, we are investing £37.5 million in the TB Alliance for the development of new drug regimens, particularly where current treatments are failing because of antimicrobial resistance—a point that was raised several times in this debate.

The challenges that the world still needs to overcome include antimicrobial resistance, ensuring that the most vulnerable and disadvantaged can benefit from care, and the complexities of patients who have both HIV and TB. We have heard the shocking statistic that antimicrobial resistance is now responsible for more than 700,000 deaths a year, of which drug-resistant TB accounts for a third. In response to that challenge, we are leading the work to bring new effective antibiotics to market, funding the development of new treatment combinations for resistant TB, and investing in new ways to rapidly test for drug resistance; it was interesting to hear the anecdote told by the hon. Member for Brighton, Kemptown about the cost of the GeneXpert machine, which is clearly something that we all need to think about. Since 2002, the Global Fund has provided financial support to implement multi-drug-resistant TB diagnosis and treatment in 25 of the 27 most affected countries.

One of the most challenging aspects of TB is the difficulty of finding some of the people affected. If we are to meet our sustainable development goals, we will need to sustain our efforts to find the missing 1.5 million. The likelihood of progression to active TB infection can be reduced if TB is detected and treated early in people who are HIV-positive, so we are actively working on programmes to identify such cases and respond appropriately.

There are clearly a range of challenges, and sustained action will be needed. I welcome the support that colleagues have shown for the international policy dimension, the leadership on research, and the strong bilateral partnerships ​on health, particularly in DFID’s focus countries. It is clear that progress has been made, but that it needs to be stepped up. We have heard the request for the replenishment of the Global Fund and will closely analyse what the UK can do and what other donor countries will be doing.

This debate has been extremely important in highlighting the issue, and I pay tribute again to the all-party group and its chairs for their leadership. I assure my right hon. Friend the Member for Arundel and South Downs that the UK Government will continue, both at the UN and with our allies in DFID’s priority countries and around the world, to step up our impact and resolve the many issues raised today.


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