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

I move:

That this House:

(1) notes that:

(a) 24 March 2021 is World Tuberculosis (TB) Day, a day to commemorate precious lives lost and recognise the serious impacts COVID-19 is having on TB services globally;

(b) TB remains one of the world's deadliest airborne infectious diseases, killing more than 4,000 people every day, among them 700 children, and close to 15 million people in the last decade;

(c) COVID-19 is exacerbating inequalities, making it difficult to reach people with life-saving TB prevention and treatment;

(d) five to eight years of global progress in the fight against TB is likely to be lost due to disruption of services resulting from COVID-19—1.4 million more people are likely to die from TB in the next five years if urgent action is not taken;

(e) Australia committed to the targets agreed in the Political Declaration of the United Nations High Level Meeting (UNHLM) on TB in 2018; and

(f) the UN Secretary-General's 2020 report found that progress in meeting the UNHLM targets on TB is far too slow to meet the 2022 deadline;

(2) acknowledges that the:

(a) Government's series of announcements of $1.1 billion to support global and regional COVID-19 response and recovery will save millions of lives;

(b) Government pledge of $242 million to the Global Fund to Fight AIDS, Tuberculosis and Malaria (Global Fund) will save millions of lives;

(c) investment of $13.3 million from the Government in 2019 will support antimicrobial resistance and drug-resistant TB research in Pacific island countries;

(d) Government's investment in TB research and development has resulted in the development of a new, 6 months, all-oral TB drug therapy thereby reducing the previous 18-month long treatment for drug resistant TB that consisted of multiple injections and thousands of pills; and

(e) Government's investments in multilateral agencies such as the Global Fund has supported countries' responses to the COVID-19 crisis; and

(3) calls on the Government to increase:

(a) our TB investment in the Asia Pacific region to sustain routine TB services and safeguard the progress made so far; and

(b) investment in TB research and development to meet the commitments made by Australia at the 2018 UHLM on TB.

As the world battles with the COVID-19 pandemic, a silent and unspoken pandemic called tuberculosis continues to rage, killing more than 1.5 million people in 2019 alone, taking total TB deaths to more than 15 million in the last decade. In many countries, the COVID-19 pandemic is exacerbating inequalities and making it even harder to reach people with lifesaving TB prevention and treatment. According to the Stop TB Partnership, this could cause an additional 1.4 million deaths in the next five years if urgent action isn't taken. TB is both preventable and treatable, but the lack of resources is hampering access to the currently available treatments and the development of more effective treatments, diagnostics and vaccines. Global and Australian investments in TB are saving lives. For the first time in 40 years, we have new drugs for the multi-drug-resistant TB that can reduce treatment time from 18 months to six months, which is fantastic, but there's still a lot more that we need to do. We need faster diagnostic tools, shorter treatment regimes, and, most importantly, a more effective TB vaccine. Over the last 12 months, the world has come together to tackle COVID-19. In record time, we've developed effective vaccines, diagnostics and, to a limited extent, treatments. With global collaboration, political leadership and funding commitments, it is possible. We need a similar response to TB.

Incredibly, this year marks the 100th anniversary of the introduction of the current TB vaccine, the BCG vaccine, highlighting the contrast in innovation rates to combat COVID-19 compared to other existing deadly diseases. Countries in our Asia-Pacific region have some of the highest rates of TB infections in the world and account for nearly half of all the cases of drug-resist TB and TB deaths worldwide. According to the Australian Bureau of Statistics, some of those countries are in the top 10 travel destinations for Australians and are major trading partners for Australia. TB has no respect for national borders. The reality is that, with modern travel, TB can be transmitted anywhere in the world in fewer than 24 hours. The distance between our outer Torres Strait islands and the coastal villages of the Western Province of Papua New Guinea, on a boundary to the northern part of my electorate, is fewer than four kilometres. The World Health Organization estimates there are roughly 38,000 TB cases every year in Papua New Guinea, but only 30,000 people are diagnosed for treatment, meaning that about 8,000 are either undiagnosed or unreported. I suggest that those numbers could be even significantly higher.

TB is not a thing of the past or a problem elsewhere. It's very much a problem here and now in Australia. In fact, we had two Border Force officers in the last week or so diagnosed with TB from working up in the Torres Strait area, which is of concern. My own mother was afflicted with TB, and I know the profound impact it had on my family. Although the TB incidence rate in Australian-born cases is low, it's up to seven times higher in Aboriginal and Torres Strait Islanders. Also concerning is a latent TB infection and reservoir of the TB epidemic. People with latent TB do not have symptoms and cannot infect others but can become ill and infectious when their immunity drops. There are an estimated one million latent TB infections, four per cent of our population, in Australia.

The world TB clock is ticking and reminds us of the precious time we are losing and of the promises made to the United Nations high-level meeting on tuberculosis in September 2018, where countries, including Australia, pledged their support to end the TB epidemic. To mark the day, on 24 March, Results Australia is partnering with more than 40 local governments to light up red the town halls and public buildings, an act of solidarity for 1.5 million people who die from TB each year. A few hundred metres from us, Old Parliament House will be lit up to remind people in Canberra that TB is a current issue, and I'm certainly working on a site in my home town in Cairns.

In many countries, including Australia, parliamentarians have shown cross-party support for the issue because we all agree that no-one should die of TB this century. It is a disease that has been neglected for too long. In 2021 it is critical for Australia to lead the fight against TB in the Asia-Pacific region, especially in the backdrop of COVID. (Time expired)

Sharon Bird (Cunningham, Australian Labor Party) Share this | Link to this | Hansard source

Is the motion seconded?

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

I second the motion and will speak to it immediately. I am very pleased to second this motion, noting that 24 March is World Tuberculosis Day, which commemorates the precious lives lost to this disease and recognises the serious impacts that COVID-19 is having on TB services globally. World TB Day is an opportunity to remember the 1.4 million people who have lost their lives to tuberculosis in 2019 alone, reflect on our achievements and acknowledge the need for greater attention for one of the most devastating infectious diseases on the planet. TB remains one the world's deadliest infectious killers. Each day, nearly 4,000 lives are lost to TB and close to 28,000 people fall ill with this utterly preventable and curable disease. Global efforts to combat TB have saved an estimated 63 million lives since 2000. That's extraordinary.

The member for Leichhardt, Warren Entsch, and I as co-chairs of the Australian TB Caucus acknowledge and thank our parliamentary colleagues for their bipartisan support and commitment to raising the profile and advocating for more investment into helping eliminate TB. I want to take the opportunity to acknowledge and thank, especially, the member for Leichhardt, as it was his dedication and lobbying within his own government that helped secure Australia's pledge of $242 million to the Global Fund to Fight AIDS, Tuberculosis and Malaria. This global fund has saved, literally, millions of lives.

Last year demanded that we have a collective focus on the COVID-19 pandemic and the emerging global health crisis. That has pushed the End TB program back and has put it at risk of not meeting the targets we expected. In many countries we're seeing resources for TB redirected to the COVID-19 response, and public demand for TB testing and treatment is also declining. Without urgent action, this has the potential to cause an additional 1.4 million TB related deaths over the next five years.

A tuberculosis epidemic is raging in our nearest neighbour, Papua New Guinea. The country has the highest incidence of TB in the western Pacific region. It is currently experiencing 38,000 new cases a year. Multidrug-resistant TB rates are particularly high and especially so in some recognised hotspots, like Western Province, National Capital District and Gulf Province. Port Moresby General Hospital now has a dedicated ward for TB sufferers. Many of the TB patients in the Port Moresby hospital are young children, with reports that paediatric TB cases now make up more than a quarter of all cases in PNG. This is a tragic state of affairs, and it is crucial that Australia helps its immediate neighbour tackle this epidemic. These diseases are preventable, but what is needed to prevent them is funding. Given the proximity of PNG—I know the member for Leichhardt is acutely aware of the proximity of PNG to his own electorate—and the high prevalence rates in Aboriginal and Torres Strait Islander communities in our Cape York region, Australia has a lot at stake to ensure that our neighbours in PNG are safe and that we are committed to ending TB in that nation as well.

COVID-19 has demonstrated that no-one is safe until everyone is safe. It has also shown us that strong collaboration across countries, political commitment and funding can lead to rapid solutions for major health challenges, and we need a similar response to TB now. The 2021 World TB Day theme is 'The Clock is Ticking', and that reminds us that there is little time to lose if we're to live up to the promises that our leaders made at the United Nations high-level meeting on TB back in September 2018, where Australia pledged its support to end the TB epidemic. The government needs to continue and increase Australia's TB investment in the Asia-Pacific region in order to sustain work already being done there and to safeguard the progress that has been made so far. On behalf of the Australian TB Caucus, we want to thank our partners for organising 2021 World TB Day events, especially Results Australia for hosting the breakfast this year. We will be doing everything we can to eliminate TB. (Time expired)

Katie Allen (Higgins, Liberal Party) Share this | Link to this | Hansard source

I rise in this chamber to support my good friend the member for Leichhardt on his motion to recognise World Tuberculosis Day, to be observed on 24 March, and to commemorate the lives lost from this dreadful disease. TB kills more than 4,000 people every day, among them 700 children. Close to 15 million people have died from TB in the last decade. It remains one of the world's deadliest airborne infectious diseases and the 10th most common cause of death worldwide, but it doesn't have to be. It is both preventable and curable. TB is one of the most common causes of death in many parts of the world, including Sub-Saharan Africa, parts of eastern Europe, South Asia and the Indo-Pacific region. Without an affordable diagnostic test and with the advent of multi-drug-resistant strains, worldwide efforts to curb the prevalence of TB still struggle.

The journal The Lancet Respiratory Medicine published a study in 2018 which contained some chilling predictions. The study found that unless control efforts are stepped up tuberculosis will kill 28 million people between 2015 and 2030 and cost the global economy almost $1 trillion. The investigators based their estimates on a business-as-usual scenario in which progress continues on its present course. They noted that tuberculosis cost the world economy $616 billion from 2000 to 2015 and that economic losses in several countries in Africa and South-East Asia exceeded one per cent of gross domestic product—and we have to put this in context of COVID, where all of the world has pivoted to dealing with that deadly disease. The following 15 years are likely to be even more damaging. India is projected to lose $252 billion, and Lesotho and Mozambique face losing more than three per cent of GDP. The authors predicted that the overall cost of the disease will be $984 billion, almost a third of which will fall on Africa. Add to that the dual health and economic impacts of the recent COVID pandemic, and the negative impact particularly to the developing world is extremely concerning.

While Australia has one of the lowest rates of tuberculosis, unfortunately it is far too common in our Pacific neighbours. We need to show leadership here. According to the World Health Organization, TB kills more people in Papua New Guinea than any other infectious disease. That's quite striking and extremely concerning. Due to the proximity of PNG, we know that this could easily become Australia's next health crisis, and that's why I thank the member for Leichhardt for his wonderful work in this area. He understands that it is particularly relevant to Far North Queensland where we have Indigenous communities more susceptible to TB. Australia's border is only four kilometres from PNG and there is significant travel between our countries in these remote communities—especially prior to COVID and this is expected to resume.

But more than the health security risk of our closest neighbours, we have an international obligation to assist our Pacific neighbours, and I support the Morrison government's Pacific Step-up in this area. We are PNG's biggest partner in response to the rising threat of TB. In pre-COVID times I travelled with the member for Macnamara, who is here in the chamber, to PNG on a parliamentary learning tour with Save the Children, funded by the Gates foundation. While there, we visited clinics that're working to combat multidrug resistant TB and ensure proper screening and early detection. I was able to see firsthand how the assistance the Morrison government is providing to PNG is giving doctors and nurses the tools they need to reduce the recurrence of TB in their communities.

In 2018 Australia committed to the targets agreed upon in the political declaration of the United Nations high-level meeting on TB. In 2020 a UN report found that progress in meeting these targets is currently far too slow to meet the 2022 deadline. This is very concerning. Further, in light of COVID it's possible we're going to lose five to eight years of global progress. More must be done. That is why the Morrison government has announced $1.1 billion of global support, as part of the COVID-19 response and recovery initiative, including a $242 million pledge to the global fund to fight AIDS, TB and malaria, which will contribute to saving millions of lives. This is very important. I know it's a bipartisan supported initiative.

In 2019 the government's $13.3 million pledge of support for antimicrobial resistant and drug-resistant TB research in the Pacific Island countries resulted in the development of a new TB drug therapy that is all oral and avoids having to use multiple injections and thousands of pills. These sorts of initiatives are incredibly important in these developing countries. I commend this motion to the House.

Josh Burns (Macnamara, Australian Labor Party) Share this | Link to this | Hansard source

I am very pleased to join my colleagues and previous speakers in supporting the member for Leichhardt's motion on this really important issue around tuberculosis. The member for Higgins is correct, she and I, and others, travelled to Papua New Guinea in 2019. We went to the Port Moresby General Hospital. We actually went to the children's TB ward in Port Moresby general. While the member for Higgins has spent a career and a lifetime in the medical profession and has spent a lot of time in hospitals, for me it was a visit that I'll never ever forget. Walking in to Port Moresby general was pretty confronting. It was basically the size of a basketball court, with bed after bed after bed of children who had contracted tuberculosis, and many of them drug-resistant tuberculosis. To see the efforts and the struggle that many of them had to go through over time was pretty heartbreaking. Some of those children had been in that ward for almost 12 months. That is a long time to get better. It is a long time to stay in one spot. It is a long journey to recover from this awful disease. I think one of the most devastating parts of tuberculosis is that it is preventable and it is curable. While these young children were forced to stay on this really difficult regime of medical treatment, many children never make it to Port Moresby General Hospital, many children never make it to that level of care and many children never make it.

Australia is doing good work. Australia is doing good work in Papua New Guinea and the more the better in this case. I don't think that we should rest on what we've done but continue to partner with our friends and family in Papua New Guinea, in other parts of the Pacific and all across the world to bring an end to this awful, awful disease.

I want to take the rest of my time to also comment on the other looming health challenge that is presenting itself in Papua New Guinea at the moment and that is over the last fortnight we have seen a spike in coronavirus cases in Papua New Guinea. To give you a sense of the scale of the issue—my friend Professor Brendan Crabb, from the Burnet Institute, has written a piece for The Conversation in the last 24 hours going through some of the issues—Papua New Guinea has only conducted 55,000 tests since the start of this pandemic. In Victoria alone, we've conducted over five million tests. That gives you a sense of the scale of the testing that's going on in Papua New Guinea. Seventeen per cent of those 55,000 tests are coming back positive. There is a massive shortage of testing going on, and the percentage of people who are testing positive for the coronavirus is extraordinary. This is far more widespread than what is being reported—and it is on our doorstep.

As we have seen in the UK, Brazil, California and South Africa, where the coronavirus is allowed to spread it then forms mutations. The last thing we want to see on our doorstep is the devastation of the coronavirus in our own backyard, for our friends and family in Papua New Guinea, and another mutation of this virus in numbers that are inconceivable—and, to be frank, we don't even know the full extent of them.

Professor Crabb mention that we have committed to the COVAX program, which is good, but there really is more that we need to do. The remoteness of Papua New Guinea and the remoteness of the population means vaccinating people is a huge logistical challenge. We are already seeing in Australia the difficulty of the logistics of rolling out hundreds of thousands of vaccines. In Papua New Guinea, that difficulty is multiplied tenfold. We need to be providing more PPE to people. We need to make sure the Papua New Guineans are armed with the best and most sophisticated information to help them. Most of all, we need to stand with them and help them through this really difficult time and this awful health crisis.

John Alexander (Bennelong, Liberal Party) Share this | Link to this | Hansard source

I thank the member for Leichhardt for moving this important motion. We used to speak about diseases on rare occasions. A friend getting sick focused our gaze, certainly, but more broadly, barring annual discussions of flu shots or the constant battle to outsmart cancer, there wasn't a society-wide focus on any one disease. Of course, 2020 has up-ended that idea and now disease is the first and last thing we talk about with every conversation. It has taken a deadly disease to bring us out of our stupor. But what we forget is that other diseases with terrible mortality rates are circling the world at any one moment. The difference is that these other pandemics don't happen here; they affect people elsewhere. Many of these pandemics have cures and, in developed countries like ours, only appear in textbooks. But they are out there, they are deadly and they are devastating in countries with less money and poorly managed healthcare facilities.

Tuberculosis is a case in point. Largely cured in Australia, it remains an overlooked threat around the world. As the motion declares, TB remains one of the world's deadliest airborne infectious diseases, killing more than 4,000 people every day. Many more people than Australia has lost to COVID in total are lost to TB every day. The exciting thing about TB is that we can treat it and deprive it of its pandemic status. The world has committed to bring TB under control through the leadership of the UN. Unfortunately, though, as with many health crises that hit undeveloped countries, the actions of the world are so often inferior to the words and ideals of the politicians and diplomats. Australia has a duty to help not just because the Pacific is one of the world's worst-affected areas. Australia's Aboriginal and Torres Strait Islander population continues to record TB rates around six times higher than the Australian-born non-Indigenous population.

I'm proud to say that we are stepping up in Australia, in the region and around the world. Locally we have maintained our record of good TB control, after bringing it to heel in the mid-eighties. Since then we've sustained a low annual TB incidence rate of approximately five or six cases per 100,000 population.

In the region, we're also stepping up. This government is providing over $21 million to the Queensland government to provide services through the national partnership agreement managing Torres Strait and Papua New Guinea cross-border health issues in the Torres Strait Islands, which includes the management of TB. Papua New Guinea remains our most significant bilateral TB investment with over $60 million provided since 2011. Additionally, Australia has committed over $47 million between 2018 to 2022 to the prevention, detection and treatment of TB through the Indo-Pacific health security initiative. But it is on the global front where we can have the greatest impact, as the dollars we contribute here are echoed by others to create an impressive multinational commitment to counter this disease. The government continues to invest in key multilateral, regional and bilateral programs to end the tuberculosis epidemic. At the recent 73rd World Health Assembly, Australia reaffirmed its commitment to ending the TB epidemic globally by 2030, in line with the UN Sustainable Development Goals and the End TB Strategy. To date, Australia has contributed over $830 million to the Global Fund to Fight AIDS, Tuberculosis and Malaria, with a further $242 million pledged across 2020 and 2022. We have also committed $57.7 million to the World Bank's Multi-Donor Trust Fund to support countries' progress towards universal health coverage, including for TB services.

As the motion discusses, next Wednesday is World Tuberculosis Day. We all commemorate the lives lost and commit ourselves to curtailing the future spread of this terrible disease. With COVID slowly coming under control, we must remember that there are other diseases out there that need our attention and need more focus after we have ignored them while fighting COVID. But COVID also remains with us. With resolve and dedication we can come together to fight pandemics and turn them around in a few short years. (Time expired)

Matt Thistlethwaite (Kingsford Smith, Australian Labor Party, Shadow Assistant Minister for the Republic) Share this | Link to this | Hansard source

World Tuberculosis Day is 24 March. Tuberculosis is such a scourge on our community that in this day and age we are still talking about it. Many Australians believe that this disease was eradicated in the 20th century, that we got rid of tuberculosis all around the world, but that's not the case. Tuberculosis is actually a disease that is rampant, and it is particularly rampant in poorer countries. We know that 4,000 people die from tuberculosis every day and that over 60 per cent of the world's TB cases are right here in our backyard in the Asia-Pacific region. Most of these cases are both treatable and preventable. Drug-resistant tuberculosis remains an ongoing public health crisis for our neighbours, particularly our neighbours to the north, Papua New Guinea and Indonesia.

I can recall when Labor was in government, as the parliamentary secretary for the pacific islands, I went to Daru, in the western province of Papua New Guinea, on the Fly River, and opened the new tuberculosis clinic, which was funded by the Gillard government. It's still in operation and still providing that vital service for those communities that live in that rural setting along the Fly River. It also has a boat that travels up and down the river providing outreach services for patients and bringing them back to the clinic for treatment. But more needs to be done. More needs to be done in our region and more needs to be done internationally.

With the serious impacts of COVID-19, we know that broader access to TB services now is harder than it has ever been. We see across our region a common theme of TB and inequality, where a lack of nutrition, poor sanitation and unsafe working environments all contribute to the stark reality of tuberculosis in 2021. The COVID pandemic has seen these inequalities worsen and has raised further barriers to life-saving TB prevention and treatment. Across the world, the poorest households and the most marginalised individuals bear the biggest burden and are at most risk of contracting tuberculosis. Indigenous people suffer TB at a rate 270 times that of non-Indigenous populations. Migrants, the homeless, prisoners and people living with HIV are especially vulnerable to TB. When the poor are vulnerable, they try to access health care to treat their TB. It is no surprise that they become poorer as a result of the financial strain of the treatment required. That medical poverty trap can be seen across those individuals and groups that are particularly vulnerable to tuberculosis. Studies have shown that increasing financial pressure associated with TB treatment has meant patients were more likely to abandon treatment or have the treatment fail or simply, unfortunately, pass away. Aside from the pairing of poverty and TB, TB also leads to a lack of access to adequate health facilities, including fast diagnosis and effective medicines.

We have been talking about trying to get tuberculosis under control for too long, for way too long. It's a primary health concern that is particularly pervasive in our region. The time has come for the world to get together to try and find a workable treatment for tuberculosis. The number of invasive drugs that people used to have to take has been decreasing but, surely, the world can put its mind to developing a workable vaccine for tuberculosis? We have seen how quickly the world has acted in response to COVID-19. Tuberculosis has been around for a much longer time and is much more deadly, particularly in poorer countries throughout the world. It is time that we apply the expertise, the know-how and the willingness that we have shown around a COVID vaccine to the development of a vaccine for tuberculosis, for better treatment and better access to healthcare services, particularly in those poorer countries, most of which, unfortunately, are in our region in the Asia-Pacific.

Sharon Bird (Cunningham, Australian Labor Party) Share this | Link to this | Hansard source

The time allotted for this debate has expired. The debate is adjourned and the resumption of the debate will be made an order of the day for the next sitting.