My Lords, I begin by thanking all those who have helped draft this Bill. I specifically highlight the contributions of all the cross-sectoral stakeholders who took part in the round table I hosted last year. I will also single out Jen Mills at the Legislation Office, who was instrumental in shaping the Bill into a deliverable form, alongside Pete Kennedy for his work on the legal grounding. I also thank Dr Paul-Enguerrand Fady at the Centre for Long-Term Resilience, who conceived of this Bill, has been advocating for it since he joined my office in 2021 and continues to support it; and a succession of British Society for Antimicrobial Chemotherapy interns who have helped me to this point. It is a great pleasure to see so many noble Lords here; I thank you all.
I will start by explaining the motivation and rationale behind bringing forward the Bill. It aims to curtail the general sale and subsequent spread on to human bodies and into the environment of consumer products intended for human use that contain biocides. Noble Lords will hear me repeat this phrase, “consumer products intended for human use” several times today. It is an important phrase to convey the narrow scope of the targeted and well-evidenced policy interventions contained in the Bill.
For the purpose of the Bill, biocides are chemicals that have an antimicrobial effect—they kill bacteria and other micro-organisms. It may strike members of the public tuning into this debate as strange to want to spare bacteria; after all, the public have been told for many years that “killing 99.9% of bacteria” is a desirable feature of many products. Your Lordships will probably see an advert today saying just that, but this could not be more wrong. It is high time we reclaimed the narrative around bacteria on our bodies, in our bodies and in our environments.
I will be clear about one thing: the Bill does not, in any way, shape or form restrict the ability of qualified medical professionals to provide medicines to patients in need. It also in no way impacts on veterinary treatments or products for animals. It concerns consumer products intended for human use and only those. There are very valid use cases for biocide-containing products, such as mouthwashes with chlorhexidine sold by a qualified pharmacist to patients suffering from mouth ulcers; octenidine-containing soaps prescribed by dermatologists to patients suffering from a range of skin conditions; silver-impregnated dressings for wound care; and more. I reiterate that the passage of the Bill into law would have no effect whatever on the use of these products in medicine. My aim is to protect the ongoing functioning of these products in medicine by curtailing their commercial availability and overuse.
We are behind the times when it comes to regulating biocides in consumer products intended for human use. In 2016, almost a decade ago, the United States Food and Drug Administration banned 19 biocides from hand soaps and handwashes. Why? Very simply, in the words of one FDA official:
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“There’s no data demonstrating that these drugs provide additional protection from diseases and infections”.
This official went on to say that
“some data suggests that antibacterial ingredients may do more harm than good over the long-term”.
This is a key point to which I will return.
The FDA has continued its campaign to educate Americans on the non-superiority of biocide-containing consumer products. As recently as last month, it published a press release titled “Skip the Antibacterial Soap; Use Plain Soap and Water”. It did this because a decade later, despite all the follow-up studies commissioned by the industry, the fact remains, as the FDA states,
“there isn’t sufficient evidence to show that over-the-counter … antibacterial soaps are better at preventing illness than washing with plain soap and water”.
The FDA chose to limit the scope of its advice to soaps—I have not. Antibacterial hand sanitisers, mouthwashes and oral products are also in the scope of the Bill. As an article published today in the Daily Mirror, coinciding with this Second Reading, outlines, biocides are found in many consumer products intended for human use, and members of the public are often unwittingly purchasing and using these products, with potentially negative effects.
It is widely recognised that there is no advantage in these biocides being present in soaps. Noble Lords may wonder whether that is the full extent of my grievance— it is not. I have worked closely with the Women’s Environmental Network—often known as WEN—which runs the brilliant Environmenstrual campaign. As a politician, feminism is one of my first politics. I was horrified when WEN highlighted to me that period products are being laced with silver and sold to women on the basis that periods make them smell bad. This is an example of the pernicious kind of advertising that underpins the sale of many biocide-containing products intended for human use. Consumers are shamed and made to feel dirty for having normal, natural microbiomes or carrying out normal bodily functions such as sweating or menstruating.
Swedish government research has shown that up to 90% of the silver in treated articles for reusable menstrual products flows out into waterways after only 10 washes. This is a pointless and dangerous use of biocides that is spreading fast into clothing products often marketed as high-tech, desirable and expensive—a trend that urgently needs to be addressed.
The use of biocides leads to a rise in resistance to biocides—a form of antimicrobial resistance, or AMR. Added to commercial use undermining the medical use of the same biocides is the threat of cross-resistance. That is when exposure to one antimicrobial, such as the biocide in mouthwash, leads to resistance to a different antimicrobial, such as the antibiotic of last resort for a critically ill patient. There is a detailed case study on this, which I prepared with Dr Fady and Dr Katy Stokes, in the briefing paper for the Bill. It is available on the BSAC website if noble Lords would like more information.
In 2022, I was the first to raise the issue of cross-resistance in this place in over a quarter of a century. That such a pernicious issue has been discussed only nine times across both Chambers since its first mention in 1973 shows that we are not taking cross-resistance seriously. But health authorities in this country are aware of the risk, with scientists at the UKHSA describing biocide resistance as
“a new scourge of the infectious disease world”
because of the problem of cross-resistance.
Thanks in large part to the determined, concentrated work of Dame Sally Davies, many Members of your Lordships’ House will have at least heard of antimicrobial resistance. Perhaps noble Lords read the large article in the Observer this month. But the real urgency and scale of this problem has not yet really struck in government, in the corridors or departments of the Civil Service, or among the general public. Every 11 seconds, someone falls ill with a resistant infection. Every three minutes, someone in the world dies from AMR. By the time we finish this Second Reading in about 90 minutes, there will have been 30 deaths from AMR globally. The British charity Nesta said in 2019 that that was the first year in which
“we’ll all know someone with a drug-resistant infection”.
Whether that is an untreatable recurrent urinary tract infection, a recalcitrant diabetic foot ulcer, or simply a chest infection that does not respond to the first round of antibiotics, it is almost certain that Nesta’s analysis was correct.
Beyond undermining our antibiotics, the widespread availability of biocide-containing consumer products for human use poses another threat: microbiotoxicity. That is a fancy way of saying damage to the human microbiome—the community of microorganisms living on and inside us. We are increasingly starting to understand the importance of these microorganisms in health and disease. In the Mental Health Bill, I spoke about the gut-brain axis and our slowly dawning understanding of the importance of the microbiome in mental illness.
Impact on other bodily systems is also becoming clearer. Research has shown, for example, that wiping out the oral microbiome with chlorhexidine mouthwashes risks increasing blood pressure, which has consequences for the risk of heart disease.
Alongside brilliant scientists and clinicians, I recently published a letter to the editor in the Journal of Infection calling for the recognition of the human microbiome as an organ system. I would be happy to circulate this to any noble Lords interested.
I should address the environmental angle. The unimpeded flow of biocides into our waterways is undoubtedly a bad thing. As was confirmed to me this week at a meeting of the Pharma Pollution Hub, a new and exciting initiative engaging with this crucial issue, we have yet to be able to model exactly how all the various chemicals mixing together in our waterways and water are affecting our environment. This is known as the “cocktail effect” and entails complex dynamics and interrelationships that are extremely difficult to quantify. A fundamental truth, however, is that the fewer chemicals and biocides there are in our waterways—I would add microplastics—the less they can interact and exert their effects on our aquatic species, our entire ecosystems and, of course, ultimately, our bodies.
If for no other reason than the precautionary principle, to which the previous Government committed us through the Environment Act, I hope noble Lords can see the sense in the Bill trying to curtail the amount of biocides ending up in our environment. I will postpone to another day comments on the soil microbiomes that are crucial to our food security. I have not run through the clauses and mechanisms of the Bill because the excellent Library briefing does that very clearly and I wanted to take some time to set out what are still not widely familiar scientific principles.
I thank the noble and learned Lord, Lord Thomas of Cwmgiedd, for taking part in this debate at my request. I apologise for possibly messing up his Friday. The Bill seeks to take what I believe is a novel approach to product regulation and I particularly value his thoughts on the approach taken, although it is based on the model from several other Bills.
We have what is known colourfully as a whack-a-mole problem when it comes to chemicals regulation. A novel chemical is produced, tested by the manufacturer in the ways it chooses, then put on to the market. As problems emerge, campaigners speak out, companies resist, and, usually decades later, that single chemical is eventually banned. A new chemical, possibly similar, often worse in its impacts, is then devised, and we go back through the same cycle. We have seen this with PFAS, the forever chemicals that are of such public concern. The Bill seeks to set us on a new path—to modestly and practically start to tackle the exceeding of the planetary boundaries for novel entities that has turned our rivers, seas and environments into such a dangerous cocktail of substances.
I say to the Minister that we are, of course, debating this Bill while the Product Regulation and Metrology Bill is going through your Lordships’ House, so there is an opportunity for the Government to pick this up holus-bolus and incorporate it into that Bill. I live in hope.
Finally, I often say that the first duty of the state is to ensure the health of its citizens. My vision of the Green Party is that we are a party of public health—of one health. Although the Bill embodies many of the principles we in the Green Party uphold, it is absolutely not a partisan Bill. It is in everyone’s best interest to prevent harm to human health and to the health of our environment. I beg to move.