Mike Freelander (Macarthur, Australian Labor Party) Share this | Hansard source

I would like to congratulate Mr Entsch, the member for Leichhardt, and Mr Thistlethwaite, the member for Kingsford Smith, on their very passionate exposition of what is an extremely important cause and healthcare issue throughout the world. As already mentioned, last Friday was World Tuberculosis Day, a momentous occasion for modern medicine, marking the day that Dr Robert Koch announced his discovery of the bacterium Mycobacterium tuberculosis. Subsequently, this led to the discovery of other related organisms, such as M. bovis, the cause of bovine tuberculosis, and M. leprae, the course of leprosy. The CDC in Atlanta estimates that tuberculosis has infected up to one-third of the world's population and that an estimated 480,000 people worldwide develop multi-drug resistant tuberculosis every year.

Names that tuberculosis has been called in the past include names like consumption, phthisis, scrofula, Pott's disease, the white plague, galloping consumption and wasting pneumonia—all names for one of the most devastating infectious diseases the world has known. Tuberculosis has been present, as far as we can tell, for over 5,000 years. Many well-known people have died from tuberculosis, including Eleanor Roosevelt; Vivien Leigh; Frederic Chopin; Andrew Jackson, the American President; George Orwell; Louis Braille; Jane Austen; Emily Bronte; John Keats and Mohammed Ali Jinnah, the founder of Pakistan. Nelson Mandela developed tuberculosis during his captivity, but was, thankfully, cured.

There is not a person in this building whose family has not been affected by tuberculosis. It has been a scourge around the world for many years. In my own family, my grandfather lost his hearing because of treatment for tuberculosis with streptomycin. My wife's stepfather had a pneumonectomy to remove half of one lung to treat tuberculosis in the 1930s. My cousin Alex Griffiths moved from Sydney to the Gold Coast for the warmer climate to recover from tuberculosis. He started feeding the birds in his backyard, and this eventually became the Currumbin bird sanctuary that many of us remember from our childhood.

Prior to the Second World War, treatment consisted mainly of bed rest, good nutrition and, sometimes, surgery. Treatment with antibiotics, initially streptomycin, started in 1945, but it soon became obvious that antibiotic resistance was rapidly developing. The advent of triple therapy, using such drugs as isoniazid, cyclocerine, para-aminosalicylic acid and rifampicin, rapidly lead to cures and it seemed that tuberculosis would disappear. I have a textbook in my own library from my days as a medical student entitled Tuberculosis: the end of the scourge. This was written in the 1970s. The Pathology Museum in the old anatomy building at Sydney University was thought to be the last place where we could see pathological examples of tuberculosis. Sadly, the cure has not come. We continue to search for long-term answers for what is an international plague.

BCG immunisation was developed almost 100 years ago. This was thought to be the advent of a cure. Whilst it has had some limited effect, it is by no means a cure. There is some evidence that BCG immunisation can prevent the more severe manifestations of tuberculosis in young children, such as tuberculous meningitis, but it does not cure and, certainly, in terms of population health, it has not had a major significant effect. Many of the millions of people infected with tuberculosis live in Southeast Asia. With the rise in multi-resistant forms of tuberculosis and the advent of HIV, there is an extremely large reservoir of infectious people that have proven difficult to treat. To our near north in Papua New Guinea already we have a conduit for multi-resistant tuberculosis to enter Australia across the Torres Strait. There is an increasing global concern about the risks of this wave of widespread tuberculosis infection to our near north.

I have seen cases and treated cases of tuberculosis in children in my own electorate in my own hospital practice. Whilst these cases are sporadic, it does not require a great leap of thought to consider what a devastating effect more widespread tuberculosis disease could cause. Drug treatment of multiple drugs causes side effects and requires multiple tablets to be taken every day for a number of months. Even in Australia amongst my own patients I have found compliance to be very poor in spite of regular health checks and regular follow-ups at the chest clinic at nearby Liverpool Hospital. Around the world, many people with tuberculosis remain poorly educated, live in poverty and have limited access to health care. Treatment objectives have aimed to develop a regime that requires fewer tablets over shorter periods of time and with fewer side effects. However, the holy grail remains a vaccination that is effective, safe and offers long-term protection.

We are lucky that we have organisations such as Policy Cures, led by the pocket dynamo Dr Mary Moran, that, together with many other organisations, such as MSF, where my daughter works, can lead the way in development of a vaccine. I hope one day to see a time when tuberculosis will only be seen as the specimens in the Pathology Museum and there will been no more active cases of tuberculosis throughout the world. It is very gratifying that, in a bipartisan way, we can work to develop a cure for tuberculosis. This will require funding and a unified approach. As some countries become more isolationist, Australia will need to lead the way in processes to develop an effective vaccine and work to improve it. (Time expired)

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