Warren Entsch (Leichhardt, Liberal Party) Share 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a preventable and treatable disease, however many current treatment tools—drugs, diagnostics and vaccines—are outdated and ineffective;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.

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