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Monday, 20 August 2018
Page: 7843


Dr FREELANDER (Macarthur) (11:43): I commend this motion to the House. I thank the member for Leichhardt for his undying efforts to make sure that tuberculosis is removed from the medical literature as soon as possible. In my time as a medical student, I was given a textbook to read. It's called The Conquest of Tuberculosis, because we thought, when I was a medical student, that we would not have to deal anymore with tuberculosis. It's by Selman Waksman, a microbiologist who actually received the Nobel Prize for developing the streptomycin group, or the aminoglycoside group, of antibiotics that were used in the treatment of tuberculosis. It was thought that this would lead to the eradication of tuberculosis around the world.

We know that tuberculosis has been present in our communities since prehistoric times. Egyptian mummies have even been found with evidence of tuberculosis. It's been called many names over the years: consumption, galloping consumption, scrofula—a whole list of names. We seem to be in this revolving cycle of appearing to be able to eradicate this disease, but the disease, in the end, wins. Not this time, I think. I think that we have the resources to be able to remove tuberculosis from modern day texts on infectious diseases if we try hard enough, but it requires a lot of effort. The tuberculosis organism is a very clever one. It's able to lie dormant for many years after primary infection and may not become apparent for decades after an initial illness, the so-called primary infection. Secondary tuberculosis can present many decades later in a whole variety of infections, from bone infections to other organ infections, and can present in many ways. The organism itself is able to develop resistance to the antibiotics that are being used. We now have to use triple therapy. We're already seeing some resistance to these therapies in developing countries, where tuberculosis can be a major issue, killing over 1½ million people in 2016.

During a recent trip to Thailand and Myanmar with the Global Fund, it was apparent to me why we were having such difficulty in eradicating tuberculosis. We went to a tuberculosis clinic in Myanmar and saw the patients, often with very active tuberculosis, sitting around in the general waiting areas. Many of them came from outlying villages and many of them were transient workers on construction projects. They would not return for ongoing follow-up and would continue to spread the disease in the country. It is very difficult in a country with very few medical resources to continue with the contact tracing, contact screening and treatment.

The basic tools for diagnosis are no different, really, from when I was a medical student over 40 years ago. We are very poor in developing new technologies that are able to screen and treat people very quickly. The Holy Grail of treatment of tuberculosis will depend on vaccination development, and this will require a lot of resources, which are already being put in place by organisations like the Global Fund and the Bill & Melinda Gates Foundation. Australia must play its part. As has already been mentioned, we have a gateway for multi-drug resistant tuberculosis to enter Australia: from South-East Asia to Papua New Guinea, across the Torres Strait and on to northern Australia. This is a very important issue and one that we must investigate and fund properly.

The member for Leichhardt's motion is very comprehensive in its request to the government, but this is a matter that is now most urgent. We have the tools and the abilities, but we must make sure that Australia plays its part, together with many other countries, such as the United States, Japan, the United Kingdom, France and Germany, who are all investing their resources in trying to finally eradicate tuberculosis. I don't want to see another textbook like this published in my lifetime. I want us to truly make an end for tuberculosis.