Lords Debate on Neglected Tropical Diseases April 2017

To ask Her Majesty’s Government what is their assessment of progress made in combating neglected tropical diseases since the London Declaration made in January 2012.

My Lords, tonight’s debate has been an extremely movable feast in terms of dates, times and length of speeches. However, at last, we are here and I am delighted to introduce a debate which has become, over the past five years, a standing item in the parliamentary calendar. I am extremely grateful to colleagues here tonight for their commitment to a subject which, before the London declaration of 2012, was very much a minority interest even among those who focused on health in the developing world.

Tonight I hope that we can do two things. First, that we can look back and record achievements in combating the 18 bacterial, viral and parasitic diseases brigaded in the WHO’s category of neglected tropical diseases affecting more than 1 billion people in 149 countries across the world, and that we can also look forward and recognise the major challenges that remain if we are to meet the targets set in 2012 in the WHO’s 2020 NTD road map and in the London declaration of the same year.

I know that colleagues are well aware of the toll that these diseases take on individuals and on human and economic development in the countries in which they live. These diseases result not only in half a million deaths each year; they also cause chronic disability, stigma and long-term ill health. They affect children’s development and pregnancy outcomes. They are the diseases of poverty and in themselves they perpetuate that poverty. As Margaret Chan, the director of the WHO, put it in that organisation’s latest report:

“NTDs thrive under conditions of poverty and filth. They tend to cluster together in places where housing is sub-standard, drinking water is unsafe, sanitation is poor, access to healthcare is limited or non-existent, and insect vectors are constant household and agricultural companions”.

Unsurprisingly, we think of NTDs primarily as diseases of the developing world, and that of course is where they take their highest toll. But poverty is not confined to those who live in poor countries, and cases of NTDs are found among the poor of even the wealthiest countries. In North America, there has been the emergence of Chagas disease in several southern states. In Europe, between 2007 and 2015 we saw outbreaks of chikungunya in Italy, France and Spain, of dengue in Portugal, of leishmaniasis in Greece and of schistosomiasis in Corsica.

The causes of these cases of emergence and re-emergence are not only poverty, but climate change and mass human migrations linked to the hundreds and thousands of people fleeing conflicts in Libya, Syria and Iraq. In Syria cutaneous leishmaniasis has reached hyper-epidemic proportions due to breakdowns in health systems and a lack of access to essential medicine, with tens of thousands of new cases annually. There is a real danger of introducing ?or reintroducing NTDs endemic to the Middle East and north Africa to Europe and beyond. All this highlights the global challenge of NTDs and emphasises the need to make progress in tackling these diseases of poverty in our interconnected world if we are to achieve the “ensuring healthy lives for all” sustainable development goal.

 

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