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Tuberculosis

Volume 488: debated on Tuesday 24 February 2009

To ask the Secretary of State for International Development what proportion of tuberculosis (TB) patients being cared for in programmes funded by his Department are tested for HIV; and what proportion of HIV patients in such programmes are tested for TB. (256131)

The Department for International Development (DFID) funds TB and HIV programmes through support to global partnerships; such as the Global Fund to Fight AIDS, TB and Malaria (GFATM) and UNITAID, multilateral organisations such as the World Health Organisation, support to countries and support for research. Our funds are often pooled with that of other donors and partner countries. We also support the broader health sector plans of developing country governments through sector wide programming and poverty reduction budget support.

It is difficult to attribute the proportion of TB patients who are also tested for HIV and the proportion of HIV patients tested for TB. However, in a number of countries supported by DFID, the co-ordination of TB and HIV programmes is continuing to improve. The World Health Organisation reports that there has been a substantial improvement in TB-HIV collaboration activities. The provision of HIV testing for TB patients between 2002 and 2006 increased from 21,806 across nine countries in 2002 to 687,174 patients across 112 countries in 2006. Screening for TB among HIV positive people attending HIV care services grew from 194,718 in 2005 to 314,394 people in 2006.

To ask the Secretary of State for International Development what support his Department provides to organisations developing tuberculosis diagnostics for use in developing countries. (256133)

Between 2005 and 2008 the Department for International Development (DFID) provided £5.5 million for the Special Programme for Research and Training on Tropical Diseases (TDR; UNICEF/UNDP/World Bank/WHO) between 2005 and 2008. TDR focuses on accelerating the development of new diagnostics, including for tuberculosis, and identifying those which may be appropriate and useful for developing countries. We are in the first stage of a competition, inviting expressions of interest from organisations involved in product development, which will lead to bids for our research funding. We expect groups working on diagnostics to be among the applicants.

To ask the Secretary of State for International Development with which organisations his Department is working to develop a new vaccine against tuberculosis for use in developing countries. (256134)

The Department for International Development (DFID), along with other donors, supports the Advanced Market Commitment (AMC). This is an innovative funding mechanism, which commits governments to fund an agreed volume of doses at an agreed price if a product is successfully developed. This AMC will be formally implemented in the first half of 2009 and accelerate the introduction and distribution in developing countries of pneumococcal vaccine.

There is significant expectation around the launch of a second AMC. This would potentially be targeted at developing a vaccine for tuberculosis (TB), but there are other critical diseases (such as malaria) that also need to be addressed.

The UK is focused on completing the implementation of the pneumococcal vaccine AMC. Following completion, we plan to reconvene the group of independent international experts (that recommended that the first AMC address pneumococcus) and request that they to make a recommendation for the next AMC.

We are in the first stage of a competition, inviting expressions of interest from organisations involved in product development, which will lead to bids for our research funding. We expect groups working on vaccines to be among the applicants.

To ask the Secretary of State for International Development what steps his Department is taking to ensure that all tuberculosis (TB) patients in developing countries have access to quality TB diagnostic services and treatment. (256218)

The Department for International Development (DFID) supports access to quality TB diagnostic services and treatment through: international organisations and partnerships, countries' TB programmes, and health systems strengthening. We provide core funding to the World Health Organisation (WHO) and to the Stop TB Partnership. We pledged up to £1 billion for 2008-15 to the Global Fund to Fight AIDS, TB and Malaria, and made a long-term commitment to the international drug purchase facility UNITAID starting with €20 million in 2007.

Examples of DFID support to countries' TB programmes include:

In China, funding from DFID and other donors has contributed to increasing detection rates from 30 per cent. in 2002 to over 70 per cent. in 2007; cure rates are now well above 85 per cent. and 1.5 million patients are being successfully treated.

In India, we support the national TB programme which has treated 6.3 million patients and saved 1.1 million lives since 1997.

DFID provides budget support to Pakistan, where case detection rates increased from 13 per cent. in 2002 to 51 per cent. in 2006 and to 69 per cent. in 2007.

To ask the Secretary of State for International Development (1) what assessment his Department has made of the effect of extensively drug-resistant strains of tuberculosis in developing countries on the prospects of fulfilment of the Global Plan to Stop TB; (256219)

(2) what steps his Department is taking to prevent the spread of drug-resistant tuberculosis globally.

The emergence of drug resistant strains of tuberculosis (TB) pose a serious threat to achieving the goals of the Global Plan to Stop TB. The response to drug resistant TB falls far short of what is needed. Much more needs to be done to ensure prompt quality diagnosis and effective treatment.

The Department for International Development (DFID) funds research into new TB drugs, through the Global Alliance for TB Drugs, and also operational research. In 2006 DFID provided an additional £1.6 million to the Stop TB Partnership to address extensively drug-resistant TB (XDR-TB) in South Africa. This was in response to an urgent request from the World Health Organisation (WHO).

Prompt diagnosis and effective treatment is essential to prevent the emergence of drug resistance. DFID supports actions to strengthen TB programmes through international organisations such as the World Health Organisation, global partnerships such as the Global Fund to Fight AIDS, Tuberculosis and Malaria and UNITAID, our support to countries' health systems and our funding for research. By 1 December 2008, global fund-supported programmes had detected and treated 4.6 million additional cases of infectious tuberculosis.