House debates

Monday, 26 March 2018

Private Members' Business

World Tuberculosis Day

11:42 am

Photo of Warren EntschWarren 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 2016, 1.7 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) large gaps in tuberculosis detection and treatment remain with 4.1 million cases of active tuberculosis that were not diagnosed and treated in 2016, including 600,000 children;

(e) Papua New Guinea (PNG) had one of the highest rates of tuberculosis infection in the Pacific in 2016, with an estimated 35,000 total cases including 2,000 drug-resistant cases, not taking into consideration the large number of cases that go unreported in many regions; and

(f) tuberculosis is:

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

(ii) now linked to non-communicable diseases like diabetes; and

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a preventable and treatable disease, however many current treatment tools—drugs, diagnostics and vaccines—are outdated and ineffective;

(2) recognises:

(a) the funding that Australia is providing to support the testing and treatment of tuberculosis in PNG, including the joint program with the World Bank, is already leading to an initiative to achieve universal testing for tuberculosis in Daru;

(b) the commitment of up to $75 million over five years for Product Development Partnerships in the Indo-Pacific Health Security Initiative to accelerate access to new therapeutics and diagnostics for drug resistant tuberculosis, and malaria and mosquito vector control—an increase in funding to build on the successes of Australia's previous investments;

(c) Australia's three year $220 million pledge to the Global Fund to Fight AIDS, Tuberculosis and Malaria (2017-2019)—a fund that has supported tuberculosis testing and treatment to 17.4 million people since 2002, including over 8.2 million people in the Indo-Pacific region;

(d) that through our endorsement of the Sustainable Development Goals in September 2015, we made a bold commitment to end the tuberculosis epidemic by 2030; and

(e) the scheduling of the first United Nations High-Level Meeting on Tuberculosis in September 2018, which will set out commitments to accelerate action towards ending tuberculosis as an epidemic and provide Australia with an opportunity to showcase the success of our investment in tuberculosis in our region; and

(3) calls on the Australian Government to attend the United Nations High-Level Meeting this year, and commit to increased Australian action and leadership on research and development, prevention, testing and treatment as part of the global effort to eradicate tuberculosis.

Photo of Maria VamvakinouMaria Vamvakinou (Calwell, Australian Labor Party) Share this | | Hansard source

Is the motion seconded?

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

I second the motion.

Photo of Warren EntschWarren Entsch (Leichhardt, Liberal Party) Share this | | Hansard source

TB is a disease that most people thought was in the past or isolated to small pockets of some impoverished countries. It is one of the oldest human diseases and has been identified in Egyptian mummies. My mother was inflicted with TB in the early 1960s and spent a year in the Cairns Base Hospital. Let me assure you: it had a profound effect on my family, especially my younger siblings who didn't see our mother for that full year.

I, for one, also assumed the disease was no longer an issue, but nothing could be further from the truth. The reality is: TB is the largest infectious disease killer in the world. Despite many cases being curable with a six-month treatment regime that costs less than $40, there are still more than 10 million people who contract TB every year, including one million children.

One of the greatest challenges in dealing with TB is the complexity of its treatment. Until recently, to treat a drug-resistant TB patient, there was a requirement for that patient to take up to 25 tablets and have two injections a day for up to two years. There is no question that this would be a challenge for a person living in the most affluent of circumstances; however, imagine the challenge for a patient living in an underdeveloped country without access to potable water.

In Australia, we enjoy a common boundary with Papua New Guinea. The distance between the outer Torres Strait Islands and the coastal villages of PNG's mainland Western province is less than four kilometres. Papua New Guinea is one of the highest burden TB countries in our region with a large number of TB victims living and dying undiagnosed. With the treaty arrangement between Australia and PNG including unrestricted family travel, we're already seeing TB making its presence known in the Torres Strait and in my home town of Cairns. I will also add that one of the highest burdened countries in the world is Indonesia, so we are surrounded by this dreadful disease.

There have been significant advances in the diagnosis and treatment of TB. The development of the GeneXpert Omni testing device means a sputum sample or mouth swab can be taken and a diagnosis can be confirmed within 60 minutes via a machine no bigger than a milkshake maker. This is a far cry from the previous testing procedures where diagnosis could take up to two months, leaving that delay in treatment. The beauty of the GeneXpert Omni device is that it's solar powered and rechargeable, which makes it amazingly portable.

The stark reality is that with modern travel TB can be transmitted anywhere in the world in less than 24 hours. In fact, the only continent that has not recorded an incident of TB is Antarctica, and that's not because of its environment, it's because of the quarantine arrangements in Antarctica and the very heavy screening. There is a very, very heavy burden of TB on the Inuit population in the north, in the Arctic Circle.

In treatment, the fantastic work of the TB Alliance, under the leadership of Mel Spigelman and his team, means that we are now trialling and treating with patients who have drug-resistant tuberculosis with four tablets a day and no injection. That treatment is for six months. They're also working on a treatment that will see drug-resistant tuberculosis cured with one tablet per day for three months. So there's been amazing progress in recent times with a focus on this. The second major achievement for the TB Alliance has been the development of a world-first oral paediatric TB medicine. This is a game changer for treating children. Up until this point in time there was no drug treatment for children because there was a belief that TB didn't inflict young children, so they had to break existing tablets up and try to guess the amount for treatment. This new one, which is a syrup that children can take orally, is absolutely fantastic.

There has never been a communicable disease that has not been cured by a vaccine. Most of us in Australia, at some stage in our lives, would have received a TB vaccine, and there will be a scar on our upper arm to prove that we've had it. But, I say to you all, don't feel protected. The current TB vaccine, developed in 1921, is absolutely ineffective against any new strains of TB. In fact, it's less effective than a cup full of cold water. It is only effective, in fact, for a small number of children under the age of five. This is an area where we need to focus. I'd like to congratulate James Cook University in Cairns, which has, through the Australian Institute of Tropical Health and Medicine, established a research group led by Professor Louis Schofield that focuses on developing a TB vaccine. No-one should die of TB, a disease that has been neglected for far too long. The disease can be cured but more needs to be done.

According to the World Health Organization's Global tuberculosis report2017, there was an estimated 10.4 million new TB cases in 2016 worldwide. The Asia-Pacific region is home to six countries—India, Indonesia, China, Philippines, Pakistan and Papua New Guinea—that account for 60 per cent of the total worldwide tuberculosis burden. An estimated 1.7 million people died from TB last year, including 400,000 people who were co-affected with HIV. Alarmingly, the report found that underreporting and underdiagnosing of TB cases continued to be a challenge, especially in countries with large unregulated private sectors and weak health systems. Of the estimated 10.4 million new cases, only 6.3 million were detected and officially notified in 2016, leaving a gap of 4.1 million. The report also found that for TB care and prevention investments in low- and middle-income countries fell almost US$2.3 billion short of the US$9.2 billion needed last year. In addition, at least an extra US$1.2 billion per year is required to accelerate the development of new vaccines, diagnoses and medicines.

The United Nations has convened its first ever high-level meeting on tuberculosis due to take place in September this year in New York. The high-level meeting is the biggest and best opportunity to raise the political priority of TB. It is also the most significant political meeting ever held on TB and one I am proud to say that I played a part in making a reality during my three-month secondment to the United Nations last year. This is a golden opportunity for Australia to stand up and be counted and lead the charge in the fight against TB. We are not talking about a disease in a faraway land; TB is already on our doorstep.

In conclusion, I would like to acknowledge the work of an outstanding number of NGOs who have been instrumental in supporting me in my journey on TB advocacy, including the Global TB Caucus, the Global Health Caucus on HIV/AIDS, Tuberculosis and Malaria, RESULTS International Australia, and Stop TB Partnership, just to name a few. I would particularly like to mention and thank Sarah Kirk and Maree Nutt. Without their ongoing support and mentoring, we would never have been able to achieve the outstanding progress we have made to date. I would also like to thank my colleague and dear friend Julie Bishop for her ongoing support in dealing with this horrible scourge. Through her outstanding leadership, Australia is recognised as being at the forefront of tackling this disease.

I would like everybody here today to take a few seconds to think about this: humans generally blink every three seconds; every three seconds someone in the world contracts TB. There is one death from TB every three minutes, but it can be absolutely cured, it can be absolutely avoided and I think it's absolutely imperative that we move on this and move on it very, very quickly, because it's a disease that actually drives people further and further into poverty. It usually hits the breadwinner, particularly in developing countries, which makes it impossible for them to work and therefore drives them further and further into poverty. It is so avoidable, but, sadly—as I cough as I am speaking here today—it is the only disease that is delivered airborne, which makes it a real threat. Believe you me, nobody is immune from this, and, unfortunately, because most people assume that this is a disease that has been dealt with, when you present, particularly in First World countries, it is the last thing they look for. By the time they run out of options and look at TB as one of those way-out-there options, the disease is very well advanced. So we need to stamp it out. I also acknowledge my friend and colleague Matt Thistlethwaite for his excellent support as we worked on this together. We are getting real results, and I am very proud to say that.

Photo of Sharon BirdSharon Bird (Cunningham, Australian Labor Party) Share this | | Hansard source

Is the motion seconded?

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

I second the motion and reserve my right to speak.

11:53 am

Photo of Matt ThistlethwaiteMatt Thistlethwaite (Kingsford Smith, Australian Labor Party, Shadow Assistant Minister for Treasury) Share this | | Hansard source

Can I thank the member for Leichhardt for his motion and recognise his lifelong commitment to the eradication of TB and the search for a workable vaccine. On Saturday, the world recognised TB Day—it was the UN-recognised World Tuberculosis Day. TB is often thought of as a 19th century disease, particularly in modern-day Australia—something we got rid of decades ago that doesn't afflict many Australians anymore and is something that still plagues the developing world. But, while Australia has largely won the battle against TB, the broader battle throughout the world continues.

TB is the world's leading cause of death of all infectious diseases. In one year alone, TB will kill approximately 1.7 million people throughout the world. That's almost the equivalent of the population of Perth dying each year from what is a preventable and curable disease. It's sad to think that more than 75 million people will needlessly die from tuberculosis over the course of the next 35 years, and to go with that human cost there's a financial burden as well. It's estimated that $15 trillion will be spent globally on TB care in the next 35 years, unless we find a workable vaccine and coordinate with an international response.

There are also an estimated four million cases of those who are sick with TB but go either undiagnosed or unreported through the health system. TB's also, as we've heard, the leading killer of people living with HIV, being responsible for one in three HIV-related deaths, and it's among the top three causes of death for women of reproductive age.

The Asia-Pacific region, unfortunately, is the epicentre of the public health crisis when it comes to TB. More than 60 per cent of the world's TB cases are located in our region. Drug-resistant TB remains a major issue for several of our neighbours, particularly Papua New Guinea and Indonesia. PNG alone accounts for 60 per cent of our region's drug-resistant TB cases. There are more than 30,000 cases, including 2,000 drug-resistant cases, in PNG today. When I was the Parliamentary Secretary for Pacific Island Affairs I travelled extensively throughout Papua New Guinea, talking to people working in this area and seeing firsthand the great work that Australian aid dollars are doing in trying to prevent TB and treat PNG citizens who are afflicted with tuberculosis. But unfortunately this scourge continues in that developing neighbourhood today, and it's a great shame that we haven't been able to make more significant progress in some of the countries in our neighbourhood, particularly in PNG and Indonesia, with respect to TB.

Australia's bilateral investment in TB has already helped many patients in our region and in our community. However, Australia's funding for PNG still needs to increase in order to address the drug-resistant TB epidemic. The global response to TB has been hampered by the use of old drugs and diagnostics. This makes it challenging to accurately diagnose and treat TB. Current estimates point to a US$1.2 billion gap in financing for TB research and development. New tools and targeted funding will help make a huge impact on the goal to end TB. When you look at the advances that have been made in medical science and research over the course of the last few decades, it is remarkable, given the number of people who are infected with TB each year, the number of people that die from TB each year and the fact that it is preventable, that we haven't been able to find a workable vaccine that can do more to inoculate larger proportions of the world's population against this insidious disease.

A lot of work is going into research and development for a workable vaccine at the moment, but unfortunately we haven't been able to come up with something that is practical and workable. The member for Leichhardt's also pointed out that when someone contracts TB the treatment regime and regimen in terms of the number of tablets that people have historically had to take is quite remarkable and often outrageous, and it impinges on that person's quality of life for many years. One of the major drivers of TB today is that treatments are so tough. To cure standard TB, patients have to take 4,000 pills over the course of six months, and people with drug-resistant TB suffer 18 months of treatment—a total of 14,000 pills in a six-month period and in some cases daily injections. As the member for Leichhardt's mentioned, advances are being made, and that is bringing down the number of pills that people have to take, But for many in the developing world the cost of those medicines is prohibitive, and they're still on these very arduous and burdensome treatment regimens. And when you're talking about developing nations, where access to potable water, to sewage, to electricity and to transport can be a challenge for many, taking 4,000 pills over the course of six months is in itself a challenge. And people forget. They don't take the treatments and they relapse, or they think they've cured themselves of the illness and they pass it on to others. In addition, the emergence of drug-resistant strains of TB means even longer treatment times, much higher costs to treat and even more troubling side effects.

It's clear that we need new drugs, diagnostics and vaccines, and Australia has made significant investments in research and development to help turn the tide to fight TB. Australia can be proud of our global health research and development investment. It benefits both our region and its growing prosperity and Australia's own health security. Our investment in the product development partnership TB Alliance has also led to shorter treatment duration for drug-resistant TB. But we still need to seek to do better to target the overall TB investment and leverage if thorough policy is going to result at a national and international level.

For the first time, the United Nations will host a high-level meeting on TB in September in New York. This meeting is the most significant of its kind to be held on TB. It will result in a political declaration on TB endorsed by the heads of state, which will then form the basis of a global TB response. This meeting will also provide Australia with an opportunity to highlight the success of our regional investment and efforts to combat tuberculosis.

This motion, which I'm proud to speak on, calls on the government to do more in terms of investments in research and development, in innovation, for the cure for this disease and for a workable vaccine, but it also calls on the government to participate in this meeting that will occur in New York through the UN later in the year. This will be a very, very important meeting and an opportunity for Australia and the world to show leadership on this issue that afflicts so many in our region. As we pointed out earlier, TB is preventable, and it is curable with the right investment, the right diagnostics and the right vaccines and drugs becoming available.

We also need to work even harder to support the development of new tools and strategies to combat and ultimately end the scourge of tuberculosis and make sure that it does become—as we all imagine it is and perceive that it is—a 19th century illness. We need to make sure that we work together as a global community to properly fund the research and development of a workable vaccine, a cure, and to finally eradicate tuberculosis.

I also wish to thank those very, very dedicated people who've worked in this industry around infectious disease and its spread for many, many years—in particular, the Global TB Caucus, which I, the member for Leichhardt, and others in this parliament are very proud to be part of; RESULTS Australia and the work that they do; and of course the Stop TB Partnership, which does wonderful work in this area. I commend this motion to the parliament.

12:02 pm

Photo of Chris CrewtherChris Crewther (Dunkley, Liberal Party) Share this | | Hansard source

As a proud member of the Australian parliament tuberculosis caucus, I want to raise my voice as well in support of this motion. Tomorrow morning, my parliamentary colleagues and I will join together at the World TB Day breakfast to throw our renewed support behind the efforts to eradicate tuberculosis worldwide.

TB is a serious infectious disease and, despite many people having little to no awareness about TB in Australia, the disease has an incredible reach worldwide and especially so in our own region. TB is recognised as a major obstacle in our quest to raise the base level of health in the Indo-Pacific region, which boasts the unfortunate status of having more than half of the TB cases and also the majority of the multidrug-resistant TB cases worldwide. If that is not enough of a reason to act on TB, the sheer proximity of tuberculosis to our borders, four kilometres away in Papua New Guinea, should prompt concern in those who may have found themselves unaware of this conversation.

We find many parts of our society blissfully unaware of the continued existence and threat of TB, with it relegated to being a thing of the past, a historical killer, seemingly eradicated, along with many of the other diseases or illnesses that characterised our past. The reality is that, in 2016, 10.4 million people fell ill with TB, and 1.7 million people died from it. People with HIV are at even more risk, with TB being the leading killer for those living with HIV. TB is very much still out there, and many Australians are somewhat sheltered from the devastation that it can leave behind. I am proud, though, of Australia's support in addressing the threat of TB, and I urge the support of my colleagues for continuing to do so.

Last year, in 2017, I had the opportunity to travel with the Pacific Friends of the Global Fund, to look at our work in tackling TB, malaria and HIV in Myanmar and Thailand. I saw firsthand the benefit of our funding to tackle TB. Despite achieving and maintaining one of the lowest rates of TB incidence in the world, it is important for Australia to support research and development into better tools to fight TB in Australia, our region and abroad. Since 2011, Australia has committed $60 million to comprehensively support TB control in PNG alone. We are partnering with PNG and the World Bank to address drug-resistant TB. Just last year, we pledged $220 million for the fifth replenishment of the Global Fund to Fight AIDS, TB and Malaria.

To examine the funding and support to end TB from another perspective, there are additional reasons for action on TB globally, and for our involvement. To allay the concerns of those who urge lower aid funding overseas, it is in our own interest to act on the threat of TB. Growing immigration levels, for example, have seen a recent rise in new cases of TB from higher burden countries. With Australia's population predicted to rise by over 10 million people by 2056, it is important that future immigration policies can adequately detect and control TB in new arrivals and allow for ongoing monitoring. These risks can be responded to with a pre-emptive approach as well. By working to lessen the spread of TB worldwide, we address and reinforce our own health security in Australia.

It can always be argued that there should be more done to address global health risks, but I am proud that Australia continues to advocate for increased global attention to TB, especially in the Indo-Pacific region, and I am proud that, in response to my esteemed colleague's motion, Australia will be strongly represented at the high-level meeting of the UN General Assembly on ending TB. Continuation of Australia's high standard of diagnosis and treatment relies on current TB control infrastructure being continued and improved, including new diagnostics, treatment and vaccinations. I join with the member for Leichhardt on this in calling for increased Australian action and leadership on research and development, prevention, testing and treatment. Saturday may have marked the 136th anniversary of the discovery of the bacterium that causes TB, but we are undoubtedly closer to its eradication than we were 136 years ago.

12:07 pm

Photo of Sharon ClaydonSharon Claydon (Newcastle, Australian Labor Party) Share this | | Hansard source

I'm very pleased to contribute to this motion recognising World Tuberculosis Day 2018, which was held on the weekend to raise awareness of the devastating health, social, and economic consequences of tuberculosis. The theme this year is 'Wanted: leaders for a TB-free world'. It urges people across the social and political spectrum to do what they can to lead the change in their part of the world.

I'd like to thank the member for Leichhardt for moving the motion. He's been a longstanding and passionate advocate for bringing an end to this disease, and he's done a fantastic job, as has the co-chair of the Australian parliamentary TB caucus, the member for Kingsford Smith, Matt Thistlethwaite. The TB caucus, of which I'm also a member, brings together federal parliamentarians to develop strategies and raise awareness of TB, with a focus on its impact in our own region. It's just one of a global network of parliamentary groups in the Global TB Caucus.

Tuberculosis is a diabolical disease, caused by exposure to bacteria from an infected person. It usually attacks the lungs, but it can also spread to other parts of the body. Symptoms include extreme cough, chest pain, coughing up blood, sweats, chills and fever. It's still the top infectious killer globally, with more than 10 million cases in 2015 alone. Of these cases, 1.4 million people lost their lives. If left untreated, half of those who are infected will die. While there are some treatments for TB, they are lengthy and incredibly burdensome to patients, taking more than a year to complete. For a range of reasons, many people just aren't able to complete the treatment course, and there's a growing problem with the strains of the disease that don't respond to antibiotics at all.

In 1993, the gravity of the situation was recognised by the World Health Organization, which declared TB a global health emergency. In 2015, it released the End TB Strategy, which aims to reduce TB deaths by 95 per cent and to cut new cases by 90 per cent between 2015—which I remind us was three years ago—and 2035. In 2017, goal 3 of the United Nations Sustainable Development Goals set a 2030 date for eradication, and I believe we can get there. We're now at a critical juncture, with an enormous number of game-changing advances before us or just around the corner. Defeating TB means giving patients and health systems better and simpler tools. We must invest in new technologies and innovation to deliver shorter, more effective treatments. We need to move from the old TB wards and isolation rooms, with the need for refrigeration and injections and the onerous treatment regimes, into some space that is simpler, with faster tests, and safe, effective tablets that can be taken at home. We also need an effective vaccine.

While Australia has one of the lowest TB rates in the world, we mustn't think it's not our problem. In fact, TB remains a critical issue in our country, with 60 per cent of cases occurring on our doorstep, in the Asia-Pacific region. As this motion outlines, Papua New Guinea has one of the highest rates in the Pacific, with an estimated 33,000 cases. Some great work has been done in PNG to fight the disease, including the treaty village resilience project, in which the Burnet Institute and the global fund worked in partnership with the PNG government and the Reef and Rainforest Research Centre to build capacity for improved health services in the Western Province villages. But we cannot drop the ball now. The Australian government absolutely must provide continued funding for tuberculosis prevention and treatment in PNG, and continued funding for the development of improved diagnostics and medicines to combat TB into the future.

This year, 2018, is going to be critical in the global fight to end TB, not least because of the United Nations high-level meeting in September. Heads of state from around the world will gather in New York City to discuss and commit to the actions that will be needed to eradicate TB—and Australia must do its share. Now is the time to reaffirm our commitment to the global fight against TB and to redouble our efforts to end this damaging scourge.

12:12 pm

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

Designated by the World Health Organization as World Tuberculosis Day, on 24 March every year we seek to continue to raise awareness of TB. It is an important initiative that acknowledges that a very preventable and very treatable disease still claims the lives of up to 1.5 million people every year. I rise to speak on this motion today, and I thank the member for Leichhardt for bringing this issue to the attention of the parliament.

Tuberculosis, also known as consumption, has been all but eradicated in developed countries. Sadly, this disease remains a major problem in most developing countries. The harsh reality is that tuberculosis remains one of the top 10 causes of death worldwide, with 10.4 million people falling ill with TB in 2016, and 1.7 million dying from the disease. In that same year, one million children became ill with TB, with the tragic result of 250,000 of their young lives ending. Significantly, on Australia's doorstep, within our local neighbourhood, the Asia-Pacific region has more than half of all global tuberculosis cases. Papua New Guinea experiences one of the highest rates of this highly contagious and airborne disease in the Pacific. In 2015, PNG was struck by an estimated 33,000 cases of tuberculosis. To put that into perspective, that is the equivalent of the population of the city of Gladstone, in Queensland.

Currently, more than one-quarter of the world's population is infected with latent TB, five to 10 per cent of whom become sick or infectious at some time in their life. For sufferers of TB, who are often living in impoverished, isolated locations, treatment of this disease is not without challenges. The standard short-course TB therapy is six months in length and involves 28 pills a week. For those patients who have drug-resistant TB, treatment is considerably longer: 20 pills a day, plus injections, for three years.

The case for early prevention and targeted strategies is very strong, as infectious suffers will, on average, infect between 10 and 15 others each year, contributing to the pandemic nature of this disease. We know that a person may be infected with TB 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; 2,000 cases of drug-resistant TB were recorded in 2015 in Papua New Guinea. An outbreak of drug-resistant cases on Daru, near the PNG-Australian border, in 2016 demonstrates the real threat of this disease to Australia. This very concerning position means that there are strains of TB that are resistant to all of the major anti-TB drugs that we currently have available.

The prevalence of multidrug-resistant tuberculosis continues to increase worldwide: 490,000 cases in 2016 alone. The World Health Organization's End TB strategy was endorsed by all member states at the 2014 World Health Assembly and aims to end the tuberculosis epidemic by 2030, 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 regimen that is the first to treat both drug-sensitive and multidrug-resistant TB. This new treatment has the potential to shorten and simplify TB therapy and reduce the cost of treating multidrug-resistant TB by up to nine per cent. There is some hope for sufferers in nearby PNG, and I would like to place on record my appreciation and recognition of the work undertaken by the YWAM Medical Ships. They continue their fight by helping to improve access to diagnosis and treatment in PNG's more isolated areas.

The Australian government is continuing to work towards combating the challenge of TB in the region and the need for discovery, development and rapid uptake of new tools, intervention and strategies to achieve this goal. To continue the fight against tuberculosis, I call on the Australian government to ensure that funding is committed to prevent and treat this insidious disease, particularly in Papua New Guinea, and I commend the motion to the House.

12:17 pm

Photo of Maria VamvakinouMaria Vamvakinou (Calwell, Australian Labor Party) Share this | | Hansard source

Milton House in Flinders Lane, Melbourne, is today notably known for its magnificent Art Nouveau architecture. But when built in 1901 it was a private hospital, equipped with a free X-ray service provided by the federal government to assist in the fight for the elimination of tuberculosis. On Saturday, March 24, World Tuberculosis Day was commemorated, and the theme of this year's World Tuberculosis Day is 'Wanted: leaders for a TB-free world'. This will of course allow for a focus on building an international commitment to end TB.

Almost 100 years after Milton House was built in 1901, tuberculosis is still an issue in Australia—not so much in our own country, but it certainly is a major health concern for us internationally. So I want to thank the member for Leichhardt for raising this very important issue, and I'm very pleased to be speaking to it. This year, 2018, marks the beginning of this commitment to world leadership—so much so that in September the heads of state who will gather in New York at the United Nations will do so to conduct the first ever high-level meeting on tuberculosis. The aim is to fast-track the international community's efforts to end tuberculosis.

In 2016 TB was one of the top 10 causes of death worldwide, causing some 1.8 million deaths, including 0.5 million people with associated HIV complications. It is the leading cause of death from a single infectious agent. There were an estimated 10.4 million new TB cases worldwide in 2016, of which 1,500 were in Australia, just 29 of which included an HIV-positive diagnosis and 53 of which involved multidrug-resistant TB.

In 2016, 1.67 million people died from TB, and, of those, 48 were Australian. So we can compare our efforts, in not having to deal with high levels of TB, with those of the rest of the world. One area in particular—the countries in our neighbourhood, such as India, Indonesia, China, the Philippines and Pakistan—accounts for 56 per cent of people living with TB. Although TB is curable and preventable, it is transmitted very easily, so it's very important that we all work together—the developing world, the developed world and the international community—in order to stem the possible spread of TB and ensure that everyone globally has access to treatment. Thirty countries are assessed as having a high TB burden by the World Health Organization. These account for 80 per cent of all TB cases, Of these countries, our nearest neighbour, Papua New Guinea, had the fifth lowest success rate for treatment. The WHO also reports that, in 2016, PNG had the seventh highest incidence of TB per 100,000 in population.

From 2006 to 2017, happily, the funding levels for TB prevention, diagnosis and treatment have doubled from US$3.3 billion to US$6.9 billion. Many high-TB-burdened countries rely heavily on international sources of funding in order to manage TB in their countries. Papua New Guinea, Indonesia, the Philippines, Myanmar, Cambodia, Vietnam, Pakistan and Bangladesh rely heavily on global funding to meet more than 70 per cent of their strategies for ending TB.

Funding provided by Australia for PNG in the health program specifically includes up to $609.1 million over the period 2012 to 2018. And, according to DFAT, the program provides funding to partners working in various areas, including the detection, diagnosis and treatment of TB. In 2016, the Australian government recommitted to continue its aid contribution to PNG in order to tackle TB. The Torres Strait Cross Border Health Issues Committee meeting in April 2017, of which Australia was a part, identified several remaining challenges for ending TB in our region. These were lack of human resources; poor understanding and implementation of the basic principles of the treatment short course; and a weak laboratory capacity in Papua New Guinea. Our efforts in our region are commendable. They need to continue until such time as the world is free of TB.

Photo of Sharon BirdSharon Bird (Cunningham, Australian Labor Party) Share 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.