Warren Entsch (Leichhardt, Liberal Party) Share this | Link to this | Hansard source

I move:

That this House:

(1) notes that:

(a) 24 March is World Tuberculosis Day, and marks the anniversary of German Nobel Laureate Dr Robert Koch's 1882 discovery of the bacterium that causes tuberculosis;

(b) tuberculosis is contagious and airborne, ranking as the world's leading cause of death from a single infectious agent;

(c) in 2015, 1.8 million people died from tuberculosis worldwide and 10.4 million people became sick with the disease, with over 60 per cent of cases occurring in countries in our region;

(d) Papua New Guinea (PNG) has one of the highest rates of tuberculosis infection in the Pacific, with an estimated 33,000 total cases including 2,000 drug-resistant cases, in 2015; and

(e) tuberculosis is:

(i) the leading cause of death among HIV positive people—HIV weakens the immune system and in combination with tuberculosis is lethal, each contributing to the other's progress; and

(ii) considered a preventable and treatable disease, however many current treatment tools—drugs, diagnostics and vaccines—are outdated and ineffective;

(2) recognises:

(a) the impact of the increased support by Australia to combat tuberculosis in PNG, and the need for continued support for prevention and treatment, as well as development of new tools and strategies to combat tuberculosis, consistent with the World Health Organization's 'The End TB Strategy';

(b) current Australian Government funding of health and medical research is helping to bring new medicines and diagnostic tests to market for tuberculosis and other neglected diseases; and

(c) the ongoing support for research and development of new simple and affordable treatment tools for tuberculosis and multidrug-resistant tuberculosis is essential if the goals of 'The End TB Strategy' are to be met;

(3) acknowledges the work of Australia's partners in fighting tuberculosis, including the Burnet Institute and Global Fund, in partnership with the Government of PNG and the Reef and Rainforest Research Centre's 'Treaty Village Resilience Project' in building capacity in villages of the Western Province, to deliver platforms for the delivery of improved health services including tuberculosis prevention and treatment; and

(4) calls on the Australian Government to provide continued funding for tuberculosis prevention and treatment in PNG, and continued funding for the development of improved diagnostics and medications to combat tuberculosis, beyond 2017.

Last week in parliament we commemorated World Tuberculosis Day. There was a great turnout of parliamentary colleagues, diplomats, patient advocates, researchers and the media. I would particularly like to mention Mrs Valda Kereu, a healthcare worker and tuberculosis survivor who travelled a long way to be with us and tell us about the importance of fighting tuberculosis in Papua New Guinea.

Today, as the Australian convenor for the Global TB Caucus and the co-chair of both the Australian Tuberculosis Caucus and the Asia-Pacific Tuberculosis Caucus, I welcome key Australian investment in tuberculosis prevention and treatment in Papua New Guinea and in the development of innovative drugs and diagnostics for tuberculosis and commit to continuing to work towards a TB-free future. The Australian TB Caucus is a cross-party group of 20 parliamentarians focused on securing Australian support for ending TB as a global epidemic. At the most recent count, there were 18 national TB caucuses and a combined membership of 2,300 representatives from 130 countries. That is certainly a powerful potential for global good. I would like to acknowledge my co-chair for the Australian caucus, Matt Thistlethwaite, who is doing a great job. We are working very closely together.

In 2015, tuberculosis killed 1.8 million people, making it the world's greatest infectious disease killer. Tuberculosis has most assuredly not gone away. While we in Australia may have it under control, the Asia-Pacific region bears over 60 per cent of the global burden of tuberculosis. Our nearest northern neighbour, Papua New Guinea, has a high rate of TB infection, and the island of Daru in the Western Province, which borders my electorate, has one of the highest rates of multidrug-resistant tuberculosis in the world.

To highlight the situation in Daru, on a delegation to South Africa in 2015 with RESULTS International, I met Dr Jennifer Furin from Doctors Without Borders. She said:

I have been working with TB for over 20 years. I have worked in prisons in Russia, in Siberia, and many other high-burden countries and in the most difficult of circumstances therefore nothing generally shocks me.

However, I was absolutely shocked and felt despair from what I saw in Daru, which was far worse than what I have ever experienced and the TB burden is horrific. Having said that, what is most despairing is the fact that with the right application this situation can be quite easily addressed.

Australia and Papua New Guinea have shared goals for increasing TB detection and for treatment completion rates, and we have backed this commitment with financial support. In 2015, Minister Bishop announced additional funding for TB control in Papua New Guinea, taking Australian assistance in the Western Province and the National Capital District to $60 million over seven years. However, this funding concludes in 2017. In the longer term, Australia's commitment to the development of TB services in the Western Province and in Port Moresby will be bolstered by having a stronger national health system and support for locally driven TB control infrastructure.

Helping to drive this on the ground in the treaty villages of the Western Province of Papua New Guinea is the Building Resilience in Treaty Villages project of the Cairns-based Reef and Rainforest Research Centre. The RRRC established another group, INLOC. This is a very interesting exercise on how we are able to get something done, because the biggest problem in the Western Province was providing a platform for the delivery of services. Some years ago, Doctors Without Borders were withdrawn from the area because they could not offer the security necessary for their doctors to provide the service. The whole infrastructure and everything just did not exist, neither was it a secure place, and unfortunately this has resulted in the problem being exacerbated in that area. This was identified by the RRRC and they recruited a most unlikely source, but it has proven to be incredibly successful. In establishing INLOC, they have recruited a group of SAS trainers that have been rotating out of Afghanistan and Iraq.

You may ask the question: why would you get SAS trainers involved in something like this? You have to look at the training of these individuals. We have spent literally millions of dollars training these are people and building their capacity so they are able to build resilience and address governance issues in the countries in which they operate.

In rotating out of these areas of conflict and in coming into Papua New Guinea to establish a ranger program, they have been extraordinarily successful. They have been able to get 52 rangers, 12 of whom are women, and have trained them up in a whole range of skills to build a platform for delivery. With an investment of $1.8 million from the Australian government in 2014, a pilot project was launched in four of the 13 treaty villages. Fifty-two rangers were trained up, as I said, including 12 women, and since then the rangers have used their skills to install more than 1.5 million litres of reliable, clean freshwater storage; to build eight new reinforced capped-and-sealed groundwater wells; to teach sanitation issues to stop the contamination of groundwater; to provide emergency medical assistance on more than 100 occasions; and to complete a top-down refurbishment of Mabaduan village's hospital outpost. I might add that the women are also doing midwifery and they are the first response for any accidents.

All of this is designed to establish a platform for each of these communities that will see delivery of appropriate health services, allowing us to meet the challenge of tuberculosis and other communicable diseases while also giving ownership of the solution to local communities. The pilot has now been extended under a $400,000 commitment in 2016-2017, and I am excited by the potential of this model and how it can be transported into other areas of high disadvantage. The RRRC also saw the need for a philanthropic arm and the RRRC Connect was established. Through Soroptimists International, my good wife Yolonde and Sea Swift in Cairns, they went on a drive for linen, which is desperately needed in these villages. You might wonder why they would need linen. Well, they do not use linen so much for beds or towels; they use it for birthing mats, shawls for children and the elderly; they make nappies out of them; they use it for bandaging wounds; they even make clothing for the children. They had amazing success: in just five weeks they got six shipping containers delivered into these villages; it will make a huge difference to these people.

The pilot is working very well in building resilience and capacity within these communities to assist them in dealing with this scourge. Since 2012, Australia has supported medical research and development into neglected diseases, including TB. Government backing for R&D has had an enormous impact, as new products developed from Australian-supported TB research show. I will mention a few examples: the Cepheid's GeneXpert machine allows TB infection to be confirmed in less than two hours, rather than weeks; the new GeneXpert Omni machine, a portable diagnostics system that will run for eight hours on a solar-rechargeable battery, is the size of a milkshake maker and so very transportable and can be taken into the remotest area for quick diagnosis and treatment; the BPaMZ tablet, currently being trialled through the TB Alliance for standard and drug-resistant tuberculosis, looks very promising. Patients take only four tablets a day for up to six months, instead of up to 20 tablets a day and injections for three years.

With the current PDP program concluding in 2017, I would like to see the government include a renewed commitment to medical R&D in the 2017-18 budget. An appropriate goal for medical research funding would be to increase R&D support to one per cent of the overall aid program, or $60 million, by 2020-21. Within this total, Australia should make a commitment of $15 million a year to the PDP program for the next three years to increase the prospects for new diagnostics and treatments, as well as allow for additional PDP projects, such as work on development of a TB vaccine. The current vaccine is over 100 years old and is totally ineffective. I would also strongly encourage the government to continue to support the rollout of the RRRC's Building Resilience in Treaty Villages program to ensure it can reach all the treaty villages by 2019-2020. It is an outstanding success and is helping local people to beat this scourge in the long term.

Finally, I would like to acknowledge the wonderful support of the key organisations working on tuberculosis like End TB, Results AU, Policy Cures, the TB Alliance, the Burnet Institute, Doctors without Borders, the World Health Organisation and others who have been doing an outstanding job. Most people assume, as I did some years ago, that tuberculosis had been dealt with and was no longer a problem—a bit like polio and other diseases. My mum had tuberculosis when I was a child and spent a year in the hospital, and so I was amazed to realise it was still an issue. It is still an issue and it is something we need to deal with comprehensively. We have an opportunity and we have shown a way forward on this. I certainly commend this motion to the House.

Matt Thistlethwaite (Kingsford Smith, Australian Labor Party, Shadow Parliamentary Secretary for Foreign Affairs) Share this | Link to this | Hansard source

I am pleased to second this motion and I thank the member for Leichhardt for moving it. I also congratulate him on his excellent work and passion for working in this area of eradicating tuberculosis. Last Friday was World Tuberculosis Day: 24 March each year represents the day on which Robert Koch in 1882 discovered the bacteria that causes tuberculosis. Since that discovery there have been numerous attempts at a cure. Mr Koch's discovery was very important for the diagnosis and treatment of tuberculosis. World TB Day should be the day that we discover a cure for tuberculosis—the day we eradicate this terrible disease—but it is not. The reason is that we do not have a cure for tuberculosis; we do not have a workable vaccine. A vaccine was developed a century ago, but is it workable? It does not eradicate multidrug-resistant strains of tuberculosis. As a result, tuberculosis remains the world's deadliest infectious disease. If you want evidence of that, look no further than the front page of today's papers, where the headlines indicate that in Sydney, the capital of New South Wales, we have outbreaks and cases of tuberculosis reported just this week. Late last year a University of Sydney student was misdiagnosed. The doctor thought that he may have had lung cancer and referred him to the RPA for tests associated with cancer. As a result, 10 others were infected with TB because of that misdiagnosis.

I suspect that this person was misdiagnosed because most Australians think that we have eradicated TB; that we have got rid of it; that it was an 18th-, 19th- or 20th-century disease that we got rid of and cured in the 20th century. That is simply not the case. It is the world's deadliest infectious disease. 10.4 million people contracted tuberculosis in 2015, and 1.8 million of those people died as a result. It is the leading killer of people with HIV/AIDS, with one in three HIV-positive people ending up dying because of tuberculosis. The burden of TB is heaviest in our backyard, in our region. Sixty-two per cent of the world's TB cases are found in the Asia-Pacific area. The Western Pacific is one of those areas where the concentration is the most per head of population. In particular, at Australia's doorstep, our nearest neighbour, Papua New Guinea, has the highest rate of TB infection in the Pacific, with 33,000 cases in 2015.

In my previous role in government as the Parliamentary Secretary for Pacific Island Affairs, I travelled to Papua New Guinea, visited the Western Province of Papua New Guinea and opened the Australian-funded tuberculosis clinic in Daru. That was opened in July 2013. It was a $33 million investment by the Australian government in a state-of-the-art, 22-bed isolation clinic and ablutions clinic at the Daru General Hospital. As part of that commitment, we also invested in a sea ambulance. The role of the ambulance was to travel up and down the Fly River to some of the most remote villages in Papua New Guinea to bring people who are suspected of tuberculosis contagion back to the clinic that Labor had funded in the hospital to diagnose them and get them appropriate treatment. I am pleased to say that that clinic is still going. It is still being supported by the Australian government and it is getting results. We have seen a reduction in the number of cases in the Western Province of Papua New Guinea.

Beside the human cost, tuberculosis in general and, in particular, drug-resistant tuberculosis, places an extraordinary economic burden on communities. It traps people in poverty. It is estimated that TB will rob the poorest countries of an estimated $1 trillion to $3 trillion over the next 10 years. The World Bank estimates that that loss of productivity attributed to TB is four to seven per cent of some countries' GDP. A failure to specifically address drug-resistant TB will result in major long-term human and economic costs and may ultimately pose a major threat to regional development and security.

In recent times Australian governments of all persuasions—coalition and Labor governments—have supported ensuring that we are working to roll out drugs, particularly across the Pacific, to reduce the rates of infection. We have done this predominantly through Australia investing in The Global Fund. I am pleased to see that the current coalition government increased the investment in The Global Fund at the last replenishment round by 10 per cent. Australia's commitment will go from $200 million to $220 million. That is because of the work of people like Warren and the TB caucus that we have established here in the parliament, and the fact that 87 members and senators signed the Barcelona Declaration calling for greater action on tuberculosis.

We had a forum last week where we spoke to people who work in this area. Despite the fact that Australia has increased its commitment globally to fighting TB, they did point out that in their view where Australia has fallen down, if you like, in recent years is in our commitment to funding research and to trying to find and develop better drugs and, ultimately, a vaccine to deal with this. Australia's commitment through the Department of Foreign Affairs and Trade into funding research and development has been patchy. In some years we fund it and in others we do not. If the world is going to be serious about eradicating TB we really need to get onto a path of consistent funding so that the necessary researchers can do their work and develop the drugs that will ultimately lead to a workable vaccine for tuberculosis.

It can be done. When you think about the fact that we have been able to eradicate diseases like smallpox and polio, it has been because governments have said, 'We are going to get serious about this and invest in the research to develop the drugs to do it.' It is amazing, given the number of people that tuberculosis has killed through the centuries and continues to kill today, that we have not worked enough to fund research to develop a vaccine to cure this insidious disease.

I thank all the members and senators who have been involved in the TB caucus. I am pleased to work with the member for Leichhardt on this. Again I thank RESULTS Australia, the Burnet Institute, Medecins Sans Frontieres and Doctors Without Borders for their commitment to eradicating TB.

Trevor Evans (Brisbane, Liberal Party) Share this | Link to this | Hansard source

I wish to rise in support of this motion by the member for Leichhardt and I also acknowledge the words just then from the member for Kingsford Smith. I have spoken previously in this House about tuberculosis. I mentioned how Australia is a sanctuary in more ways than one, considering the diseases and illnesses wreaking havoc on people and societies much closer than you would think—a mere three-hour flight from my constituency in Brisbane. This motion marks World Tuberculosis Day, which notes the anniversary of German Nobel Laureate Dr Robert Koch's 1882 discovery of the bacterium that causes TB. World TB Day is an opportunity for people to continue to raise awareness of the plight of those suffering. It is an opportunity for us to refocus our efforts and initiatives and to educate others about TB, because, as the member for Leichhardt said in his speech, many Australians would be surprised to hear that tuberculosis is still a major problem in the world, and indeed, right on our doorstep.

Despite generally declining worldwide rates of infections and deaths because of TB, it does remain a stubborn and deadly challenge locally, especially in the Asia-Pacific region right on our doorstep. The previous speaker, the member for Kingsford Smith, mentioned the link between TB and HIV/AIDS. In fact, TB today kills more people than HIV/AIDS and malaria combined, because those are diseases on which more significant progress has been made in both prevention and treatment. Worldwide, TB is today taking about 1.5 million lives every year, with a further 10 million new cases of infection every year. Almost all of these are in developing countries, and about half—in fact, probably more than half—are occurring in countries in our region.

Last week, as the member for Kingsford Smith mentioned, members of this parliament met with stakeholders including the executive director of the research group Policy Cures, Dr Mary Moran, to talk about policies addressing TB. She stressed that the best approach requires four equally important aspects: research, development, procurement and on-the-ground delivery.

Over my short time as a member of parliament, I have had a number of meetings with a great organisation called RESULTS International Australia to discuss these very important issues. I have a deep affinity for the people in the Asia-Pacific region as someone who has been fortunate enough to visit most of its countries and most of our nearest neighbours. I have seen the very big difference that targeted Australian aid is making for the benefit of humanity in our region. It is why I am proud to have become a member of the Global TB Caucus. I want to congratulate the member for Leichhardt, Warren Entsch, for his longstanding leadership in this area, and for helping and encouraging me to become involved. Not only have I joined the Global TB Caucus, I have also signed the Barcelona Declaration. It is the founding document of the Global TB Caucus, designed to raise the profile of this issue amongst world leaders and advocate for action.

I am also very happy to reiterate this government's commitment of $220 million in aid to the global fund to fight AIDS, tuberculosis and malaria. I thank the previous speaker, the member for Kingsford Smith, for his acknowledgement of our 10 per cent increase in funding in that area. More Australians deserve to know how Australia's funding is one of the global cornerstones in the fight to eradicate TB. It is on top of the approximately $64 million that Australia has contributed specifically in bilateral support to some of our close neighbours in this area, in countries like Papua New Guinea and Kiribati. Australia is playing a leadership role here, and I want to congratulate our foreign minister, Julie Bishop, for delivering compassionate and meaningful foreign aid leadership. Australia has a strong legacy of aid in the Asia-Pacific region and we are continuing to build on that legacy and history today.

But more needs to be done. A greater investment in diagnostics, better drugs and vaccines are our only true hope for eradicating TB. I look forward to working with groups like RESULTS International Australia, the TB Caucus and my colleagues in the chamber today to continue to advocate for more support in this area. I commend the motion to the House.

Mike Freelander (Macarthur, Australian Labor Party) Share this | Link to 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)

Jane Prentice (Ryan, Liberal Party, Assistant Minister for Social Services and Disability Services) Share this | Link to this | Hansard source

Last Friday, 24 March, was World Tuberculosis Day, as designated by the World Health Organization. This annual event marks the anniversary of the 1882 discovery of the bacterium that causes tuberculosis by German Nobel Laureate Dr Robert Koch. It is an important initiative which acknowledges that a very preventable, treatable disease still claims the lives of up to 1.5 million people every year. I rise to speak on this motion today and to thank the member for Leichhardt for bringing this issue to the attention of the parliament. And I thank my colleagues on both sides of this chamber for their support.

Tuberculosis has been all but eradicated in developed countries. However, it remains a major global health problem in most developing countries. In 2015, more than 10.4 million people worldwide contracted this disease, which was known also as consumption in the early 19th century. The Asia-Pacific region, Australia's local neighbourhood, has more than half of the global tuberculosis cases. Our closest neighbour, Papua New Guinea, experiences one of the highest rates of this highly contagious and airborne disease in the Pacific. In 2015, Papua New Guinea was struck with an estimated 33,000 cases of tuberculosis. To put that into perspective, that is equivalent to the population of Gladstone in Queensland.

Treatment of this disease is not without challenges, especially for those who live in remote regions like Papua New Guinea. The standard short course TB therapy is six months in length. This involves 28 pills each week. However, for patients with drug-resistance TB treatment is considerably longer—20 pills a day plus injections for three years. Currently, more than one-third of the world's population is infected—five to 10 per cent of whom become sick or infectious at some time during their life. The case for early prevention and targeted strategies is very strong, as infectious sufferers, on average, will infect between 10 and 15 others each year, contributing to the pandemic nature of this disease.

We know a person may be infected with TB bacilli in the dormant stage for many years, ultimately having active symptoms when their immune system is weakened. Unfortunately, even with the aid of modern medicines and technology, not all cases can be successfully treated. Two thousand cases of drug resistant TB were recorded for 2015 in Papua New Guinea alone. Only last year there was an outbreak of drug resistant cases on Daru, near the PNG-Australia border. The situation in Daru was so dire that, with 160 reported cases, the TB ward in the island's hospital was at capacity, meaning that some could not be saved. This very concerning position means that there are strains of TB which are resistant to all of the major anti-TB drugs we currently have at our disposal.

The prevalence of multi-drug resistant tuberculosis continues to increase worldwide. The World Health Organization's End TB Strategy was endorsed by all member states at the 2014 World Health Assembly. It aims to end the tuberculosis epidemic by 2035, with full elimination by 2050. In 2015, the Australian government announced a $30 million investment over three years that will help bring new diagnostic tests and drugs to market to tackle the threats of TB and malaria. As part of this announcement, the TB Alliance received $10 million over three years to support late-stage clinical trials of new TB treatments. These include the phase 3 trial of a new drug regime which is the first to treat both drug sensitive and multi-drug resistant TB. This new treatment has the potential to shorten and simplify TB therapy and reduce the cost of treating multi-drug resistant TB by up to 90 per cent.

However, there is hope, and I will take this moment to recognise YWAM Medical Ships, which have joined the fight by helping to improve access to diagnosis and treatment in PNG's rural and remote areas. YWAM Medical Ships have continued to provide health services to villagers and health workers in very remote parts of PNG. The Australian government is continuing to work toward combating the challenge of tuberculosis in the region and to work toward the need for discovery, development and rapid uptake of new tools, interventions and strategies to achieve this goal. I would like to place on record my recognition and acknowledgement of the work being undertaken by the likes of the Burnet Institute and the Global Fund, in partnership with the PNG government and the Reef and Rainforest Research Centre. To continue the fight against tuberculosis, I call on the Australian government to ensure funding is committed to prevent and treat this insidious disease in Papua New Guinea. I commend this motion to the House.

Sharon Claydon (Newcastle, Australian Labor Party) Share this | Link to this | Hansard source

It is with real pleasure that I rise to speak on the member for Leichhardt's motion on tuberculosis today, noting—as others before me have—that last Friday was in fact World Tuberculosis Day. I thank the member for Leichhardt for bringing this motion forward, because it is vital that we keep this issue absolutely front and centre on our agenda. I am very proud member of the parliamentary TB caucus, which the member for Leichhardt and the Labor member for Kingsford Smith, Matt Thistlethwaite, do an excellent job of co-chairing. The TB caucus aims to play an active role in keeping TB on our agenda, supporting the eradication of this disease in our region and, in doing so, helping secure support and expertise and identifying opportunities for action and engagement. I would also like to recognise up-front the work of the Pacific Friends of the Global Fund and RESULTS International (Australia), who work alongside caucus members from all sides of parliament, and volunteers across the nation.

Domestically we have made some terrific strides in addressing this terrible disease. We heard some of the history of the disease in Australia previously. We now have fewer than one thousand cases per year, I understand, thanks to the improved conditions in both screening and the effective use of antibiotics. But today's news—that we have another 10 new contractions of drug-resistant TB in Australia—means that we must never be complacent, and indeed we have to be forever vigilant. Regretfully, the situation is a lot worse in a whole lot of other countries, and, in fact, despite many medical advances, we know tuberculosis is still claiming 1.8 million lives globally, with an estimated 30,000 new contractions each and every day.

Our neighbours in the Asia-Pacific region are especially vulnerable, with people living in very crowded conditions, with low levels of sanitation and high rates of malnutrition. It has been estimated that Asia-Pacific countries comprise more than 60 per cent of the global TB cases. The best outcomes are achieved when patients see their medical practitioner every day. Something like that is very impractical, if not impossible, in many of the regions, where doctors are few and far between. Treatments are long and difficult, with patients needing to take around 700 tablets over a six-month course. Failure to take the correct and full course is often leading to drug-resistant forms of the disease, and the treatment for these forms is even more onerous, requiring daily injections in addition to ever-increasing numbers of tablets.

In the Pacific, Papua New Guinea has one of the highest rates of infection, with around 33,000 cases in 2015, of which 2,000 were drug resistant. The Australian government is providing funding and support to reduce the health and economic impacts of TB in our region, in many respects achieving some great results, and is to be congratulated for that. In PNG's Daru General Hospital, the support around the purpose-built 22-bed TB ward, vital diagnostic equipment and expert staff that have been provided has meant that the proportion of people staying on for treatment has risen from 40 per cent in 2011 to 97 per cent last year. That is remarkable by anyone's measure. We are now at a critical juncture, with an enormous number of game-changing advances before us or just around the corner.

It is vital that the Australian government reaffirms its commitment to eradicating the disease in our region and continues supporting the World Health Organization's End TB Strategy, which is a blueprint to help countries reduce TB incidence by 80 per cent. Defeating TB means giving patients, practitioners and health systems better and simpler tools. It means investing in new technologies and innovation to deliver shorter, more effective treatments. It means moving from the TB wards, isolation rooms, injections and yearlong treatments to simple, fast, safe and effective means of treatment that can be done at home. It means supporting efforts to develop an effective vaccine. We also need to ensure that there is greater connectivity between those involved in TB research, product development and on-the-ground program delivery. There is no time to waste. I commend this motion to the House.

Steve Irons (Swan, Liberal Party) Share this | Link to this | Hansard source

I rise today in support of the motion on tuberculosis put forward by the member for Leichhardt, and acknowledge his long and persistent passion for this particular issue. Friday was World Tuberculosis Day, and the World Health Organization is reporting that last year 10.4 million people fell ill with tuberculosis. 2017 is the second year of a two-year Unite to End TB campaign, and the World Health Organization is placing emphasis on an effort to 'leave no one behind', which will include efforts to address stigma and discrimination.

Closer to home, in WA, the Western Australia Tuberculosis Control Program is housed at the Anita Clayton Centre. This program manages tuberculosis in WA and offers a statewide public health service that operates as a resource centre and clinic. This program provides a range of services as well as the diagnosis, treatment and case management of tuberculosis. The program provides surveillance and prevention of tuberculosis, with active screening of high-risk groups, and diagnosis and treatment of latent tuberculosis infection. The program also looks after tuberculosis infection control by providing, in healthcare settings, advice and assistance on tuberculosis. The program also looks after the development, implementation and review of policy relevant to tuberculosis management and control, which is important, because tuberculosis is the world's leading cause of death from a single infectious agent. In 2015, 1.8 million people worldwide died from tuberculosis and 10.4 million people became sick with the disease.

The member for Leichhardt's motion makes an interesting point. It says that Papua New Guinea has one of the highest rates of tuberculosis infection in the Pacific, with an estimated 33,000 total cases, including 2,000 drug-resistant cases in 2015. In 2009 I was on the Committee on Health and Ageing when we did a report on health in the South Pacific. I would like to quickly relate to you a story about that visit. When were in the South Pacific we met a woman from Rockingham in Western Australia who ran the only clinic on Saibai Island. She shared with us some experiences and stories of PNG nationals who had crossed the short stretch of water by canoe to get to the clinic. One such national had been trying for four months to get into the clinic on Saibai Island. Eventually, on the day he had his scheduled visit, he collapsed in the waiting room. They revived him and sent him down to Thursday Island the next day for treatment, where he died. He had been waiting for four months to get in and due to a lack of resources and funding he could not. The causes of his death were HIV and tuberculosis.

Tuberculosis is an infection primarily in the lungs caused by a bacterium called Mycobacterium tuberculosis. It is spread from person to person by breathing infected air during close contact. The most common symptoms of tuberculosis are fatigue, fever, weight loss, coughing and night sweats. When the immune system of a patient with dormant tuberculosis is weakened it can become active or reactive and cause infection in the lungs or other parts of the body. As such, people with HIV-AIDS are at a high risk of developing the disease, due to lower immunity, like that man I just spoke about.

Tuberculosis is a leading cause of death worldwide. With the considerable movements of people between the Top End of Australia and the South Pacific, many of which have been part of the culture for many years, this is an area that we must be mindful of and cannot neglect. Another example occurred at the time we were running part of this inquiry in Cairns. A woman who was found to have drug-resistant tuberculosis was put into an isolation ward in Cairns Hospital, where her term of stay was predicted to be two years. Tuberculosis is a global health problem in which Australia has a responsibility and the capacity to make a difference. Australia has been successful in treating it at home. However, Australians are not immune to future outbreaks of tuberculosis and we must have appropriate policies in place to deal with this.

World Tuberculosis Day can also serve as a reminder of the importance of vaccinations. The coalition government bought in the No Jab, No Pay policy where parents whose children were not vaccinated and who did not have a valid medical exemption or were not on a catch-up schedule by a certain date would start incurring a debt for child care payments that they would have to repay. Since the policy was announced in the May budget we have seen a huge lift in immunisation rates across the country. As of November last year a further 187,695 children were up to date with their immunisations. This shows that parents are increasingly recognising the value and importance of immunisation. I commend this motion and again thank the member for Leichhardt and other members in this place who have spoken on this particular issue.

Emma Husar (Lindsay, Australian Labor Party) Share this | Link to this | Hansard source

I rise to speak on the motion put forward by the member for Leichhardt concerning World Tuberculosis Day, on Friday. I think the member for putting forward this incredibly important and comprehensive motion. As my colleagues the member for Newcastle has already pointed out, tuberculosis continues to be a major cause of illness, death and misery around the world. While TB has largely been well managed and kept at bay in Australia, we exist in a region that continues to struggle with this infectious disease. In fact, nearly two-thirds of all cases of TB diagnosed worldwide in 2015 were in the South-East Asia and Western Pacific regions, so our nearest and dearest neighbours are still very much suffering with this disease.

It is estimated that there are roughly one million people with TB in China and in Indonesia. In our region the total estimate sits at roughly 6,330,000 people affected across South-East Asia and the Western Pacific. As we all know, the disease can be easily managed; however, in poverty-stricken communities diagnosis and treatment can be extremely difficult and the disease's effect debilitating. Once TB has been contracted and if the body's immune system is unable to fight it off it typically attacks the lungs; however, it can affect a person's lymph nodes, bones, kidneys and the brain. TB is most deadly in communities that have poor access to health care and in people who have compromised immune systems—commonly, kids under five, older people and those with other illnesses.

As the motion correctly points out, Australians should be proud of the work we are doing to assist our neighbours to prevent and treat tuberculosis. It forms a large part of our Health for Development Strategy, which draws on close to half a billion dollars of our foreign aid budget to combat health threats across the world by increasing the capacities of our partner countries' health systems; improving sanitation, hygiene and nutrition; and investing in health research and development. When it comes to tuberculosis we know that some of the conventional medicines are no longer effective in resistant strains of the disease, causing additional problems and, in higher incidence areas, additional pressure on their health and hospital systems. So our support in funding medical research that aims to bring new medicines diagnostic tests to affected areas is crucial to managing the disease.

It perfectly illustrates the value of our foreign aid program. This money is being used to combat a terrible infectious disease right on our doorstep. It is leading to hundreds of thousands, if not millions, of better outcomes in our region and across the world—across the world over time. It is a good example of how foreign aid spending keeps Australians safe. It is another reminder of the importance of medical research and more broadly the importance of backing in our scientific community and the invaluable work they do. Tuberculosis has only been managed as well as it has been in most regions of the world because government put faith in their medical researchers and their medical practitioners.

It is worth noting that even in this country it is something we need to continue to work on so that uninformed, misguided, ignorant and dangerous people cannot hijack good sense and the public debate in order to steer people away from preventative health medicine and good health. We have recently seen Senator Hanson of the One Nation party question the efficacy of preventative vaccines. We have seen her pedal the uneducated nonsense that vaccines might cause autism and the like. As the mother of a child with special needs—one on the autism spectrum—I find that assertion quite ugly, frankly, and also hazardous to our community. I am glad her uneducated ramblings were called out for what they were: factually incorrect and just dangerous. But these views are not isolated just to Senator Pauline Hanson and we have a lot of work to do to back in our scientific and medical research communities and ensure we are doing all we can to encourage and promote preventative health care.

The substantive issue of tuberculosis in the motion before us specifically mentions the important work we are doing in PNG. As I mentioned before, there are 33,000 cases of TB in Papua New Guinea alone—just on our doorstep. The Australian government is working very closely with the PNG government and the World Health Organization to develop new strategies to combat this disease, which is a particular burden on the PNG community. As the motion states, it is particularly important to acknowledge our global partners in this fight and thank them for their work in this space. I again support this motion and call on the government to provide continued funding for tuberculosis prevention and treatment in Papua New Guinea and continue funding for the development of improved diagnostics and medications to combat tuberculosis beyond 2017.

Debate adjourned.