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Volume 811: debated on Wednesday 24 March 2021

Private Notice Question

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.

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.

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?

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.

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?

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.

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?

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.

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?

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.

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?

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.

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?

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.

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?

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.

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?

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.

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?

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.

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.

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.

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?

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.