I congratulate Nick Herbert and my hon. Friend Mr Sharma on bringing this debate to the Floor of the House, and I thank every Member who has spoken for bringing so much knowledge and passion to the debate, especially my hon. Friend Mrs Ellman, who spoke about the University of Liverpool and the Liverpool School of Tropical Medicine, which lead on research here in the UK. I also pay special thanks to Lucy Drescher and Janika Hauser from RESULTS UK for producing parliamentary briefings for the debate and providing the research that went into my speech.
The forthcoming United Nations high-level meeting on TB offers a truly unprecedented opportunity to transform the fight against TB, so today’s debate could not have been called at a more significant moment to discuss TB. I join my hon. Friend Stephen Twigg, Dame Cheryl Gillan, Victoria Prentis, Sir Edward Davey and the 150 Members from across the House who are calling on the Prime Minister to confirm her intention to attend the meeting personally in September.
Some 10.4 million people are infected with TB. In 2017, 1.7 million people died of TB—almost 5,000 a day. In the time allocated for this debate, 582 people will lose their lives to a curable disease—that is perhaps the most outrageous fact of all. TB is curable, and has been for more than 50 years. Every death from TB can be, and should have been, avoided. The global response against TB has been one of failure: not a failure of those doctors, nurses, scientists and civil society groups who have been working tirelessly in a system stacked against them, but a failure of political will.
Two years ago I visited Zambia with RESULTS UK and met with doctors who spoke of the horror of needing to prescribe drugs they knew to be toxic and potentially ineffective despite years of treatment, in the knowledge that there is simply no alternative. Those on the treatment whom I met spoke of the pain of side-effects, the stigma, and the feeling of hopelessness. Those who successfully make it through the treatment bear lifelong mental scars.
I want to put on record that I welcome the work that the Minister and the Department are already doing in the global response to TB. In the debate we heard my hon. Friend Stephen Doughty and Nick Herbert speak positively of the impact of UK aid on communities most affected by TB through investment in the Global Fund to Fight AIDS, Tuberculosis and Malaria and through strengthening of public health services, but the consistent funding shortfall for TB programmes has had catastrophic consequences. Some 3.8 million people go undiagnosed each year, and global treatment outcomes are nowhere near what they could be. When the Government signed up to the sustainable development goals the UK signed up to the commitment to be at the forefront of their delivery, but projections show that at the current rate of progress there is little likelihood of ending TB by 2030 and that that will not be met for more than 150 years.
Last year’s World Health Organisation global TB report stated that there is a $2.1 billion funding shortfall for the diagnosis and treatment of TB drug susceptibility alone, and funding for drug-resistant TB services will need to double before 2020 to be in line with the WHO global plan to end TB. The global plan estimates that the annual investment needed for TB is $9.2 billion a year, rising to $12.3 billion a year in 2020. With a single course of MDR-TB treatment costing 10 times more than drug-sensitive treatment, the global cost of ending TB will skyrocket unless action is taken now. The UK’s investment in TB continues to be dwarfed by our investments in HIV and malaria. I have no criticism of the UK investing in strengthening HIV maternal and child health systems, but sadly, antimicrobial resistance continues to exclude TB programming.
I must add that despite TB being the world’s deadliest infectious disease, 17 of the Department’s priority countries are classified as high-burden countries, but DFID currently has no dedicated TB programmes and offers no direct bilateral investments, and often bilateral funding is dependent on country requests. Does the Department have a plan in place for addressing TB in its own priority countries? Many high-burden countries can and should invest more in their national TB programmes.
Another central theme of today’s debate is the need for TB research and development. Sadly, in the absence of adequate funding for TB programmes, drug resistance has emerged and spread, rendering a curable disease increasingly difficult to treat. The UK’s investment in TB research and development is already transforming lives second to none on the global stage. New diagnostic tools will allow us to diagnose people more quickly and accurately; new drugs and paediatric formulations are improving treatment outcomes. None the less, data collected from the Treatment Action Group show that global funding for TB research and development falls consistently short of 50% of the annual funding need. I therefore join my hon. Friend Jim Fitzpatrick and Jim Shannon in asking the Minister whether DFID will commit to working with global partners to ensure concrete steps are taken at the UN high-level meeting to close the TB research funding gap and to ensure that funding is appropriately co-ordinated so that affected communities can access the products of such innovation as easily and quickly as possible.
If we are to talk seriously of ending TB before 2030, we will need to diagnose and treat a cumulative total of 40 million people before 2022. The WHO’s “End TB Strategy” shows that we will only reach the SDG 3 target if new tools to prevent, diagnose and treat TB are made accessible to affected communities before 2025. With just seven years left, we have a long way to go. The UK has an opportunity to use the high-level meeting to lead on the global challenge—ultimately, by demanding and effecting change to deliver on the SDGs.
I therefore ask the Minister: does the Department have plans for fairer national targets to be discussed or developed at the UN high-level meeting? I join Victoria Prentis in asking the Minister to commit to DFID improving cross-departmental working to ensure these targets are delivered. I know that the Minister literally embodies cross-departmental work, so I hope that will make it easy for her to do so.
In conclusion, I hope that the Prime Minister will attend the UN high-level meeting in earnest, first, to demonstrate the UK’s commitment to ending TB and, secondly, to convene partners at the UN to demand a meaningful political declaration that will effect change. It would be a tragedy if all that came out of the UN high-level meeting was another political declaration full of empty promises. Let the current trend be a warning to the Government: we cannot let our successors stand at these Dispatch Boxes years from now to have the very same debate once again.