PARLIAMENTARY DEBATE
Pandemic Prevention, Preparedness and Response: International Agreement - 17 April 2023 (Commons/Westminster Hall)
Debate Detail
That this House has considered e-petition 614335, relating to an international agreement on pandemic prevention, preparedness and response.
It is a pleasure to serve under your chairmanship today, Mr Sharma. I first want to thank the petitioners for their campaign. The petition has received more than 156,000 signatures, and is therefore something that this House should rightly discuss. The petitioners ask that the Government commit to not signing any international treaty on pandemic prevention and preparedness established by the World Health Organisation unless it is approved through a public referendum.
In their response to the petitioners, back in May 2022, the Government stated:
“To protect lives, the economy and future generations from future pandemics, the UK government supports a new legally-binding instrument to strengthen pandemic prevention, preparedness and response.”
They finished their response with,
“This process of ratification allows scrutiny by elected representatives of both the treaty and any appropriate domestic legislation in accordance with the UK’s constitutional arrangements. The Government does not consider a referendum is necessary, appropriate or in keeping with precedent for such an agreement.”
As I always do when leading a petitions debate, I shall set out my role here today. I lead these debates, not because I have specifically asked to do so, or because I agree with the subject matter, but simply because it is my duty as a member of the Petitions Committee to take a number of debates each Parliament. I want that to be very clear.
In that capacity, I cover a variety of subjects and, as all my Committee colleagues will agree, I am superbly supported by the staff who assist the members of the Petitions Committee. I always believe that the Petitions Committee typifies democracy at its best and am therefore honoured to stand here and debate the views of a percentage of our nation’s people on a specific subject. Today is no different.
I will begin with some information on the World Health Organisation. The WHO was established in 1948 and is the United Nations agency on health. Its headquarters are in Geneva. It has 194 member states grouped into six regions. Its website states that it
“leads global efforts to expand universal health coverage and…coordinates the world’s response to health emergencies.”
One of the WHO’s many success stories is the eradication of smallpox. It has worked in many areas across the globe in sexual and mental health. It has worked towards the eradication of polio. It helps across developing countries with the provision of clean water, and helps against the effects of climate change and earthquakes—the list goes on and on.
A question that I believe should always be asked of any organisation is, “How is it funded?” The WHO gets 20% of its funding from member states as assessed contributions, but 80% then comes from voluntary contributions. That is, again, from member states that wish to give more, but also from the private sector and philanthropists.
What can the WHO do at present, and what does the treaty want to achieve? Through international health regulations, the WHO is alerted to potential events, and can then give guidance to members. There is a legally binding agreement that directs nations on what they need to do in a public health crisis. International health regulations were crafted in 1969 and amended in 2005, and they outline each member’s responsibility. However, these are not really legally binding. From what I understand, the WHO has no real power. Members can choose to ignore what the WHO says. It suggests, rather than tells, a country what it should do. It has no real enforcement powers; all it can do is highlight those countries that do not follow guidance.
Through the treaty, it is now proposed that the WHO would be able to police its powers to motivate a country into doing what its officials believe is necessary. Some countries do not want this to happen, and the petitioners do not want the UK to agree to it without a referendum. Why is that the case? The petitioners believe that those sorts of powers should be sovereign. They do not like the fact that WHO officials are unelected. They do not like the fact that some members pay in more money than others, and could therefore have more influence on decisions. They also feel the same about philanthropists and pharmaceutical companies that make contributions.
Are the petitioners over-concerned? In the treaty there is a change of language from “should” to “must”, but is the WHO only doing its job of protecting our population? There appears to be nothing about lockdowns in the treaty, which that is one of the biggest concerns of the petitioners. The next question is what policing member states would look like. It would probably mean sanctions—services or resources being withheld. Would that only affect the smaller countries? Would that really bother the superpowers? Would it really bother the members that are paying in the most money? Each question leads to another.
That leads me to another part of the petition: maybe a referendum is required. I genuinely do not believe in referenda. I was elected to stand here, educate myself on the various topics that come before this House, and make decisions on my constituents’ behalf. It is a position of privilege, and involves a lot of reading, but that is an important part of the position. Our constituents have their own jobs to do, and therefore do not have the time, nor the ease of access to information, that we have in this place.
There is a push for the WHO to gain policing powers over pandemic responses, and our Government need to seriously look into that, as at least 156,000 people are concerned enough to have signed the petition. They are not alone in their concern. As I have already stated, some countries have said that they will not sign the treaty. Are they right to do so? Whatever our politics may be, we should always be careful when handing over such powers to an organisation that can be influenced by nations other than ours. Questions about whose agenda the WHO takes will be asked, and it should be prepared with answers if they are to quell the concerns of many of the voices speaking on this subject.
In summary, the WHO does some wonderful work. Covid has proved what devastation a pandemic can bring. There will no doubt be another at some point, and we need that global perspective. We are a global community, therefore what happens here can soon have a bearing on a country across the globe. The petitioners are essentially asking whether an unelected organisation should have the power to sanction countries such as the UK if they do not wish to comply. Do we have no real choice but to comply, and should the UK sign up to this treaty without a referendum? I look forward to hearing the position of other Members and the Government.
Part of this argument has been about vaccination. We go back to Dr Wakefield and that appalling piece of chicanery that was the supposed impact of the measles, mumps and rubella vaccine, which has now been completely exposed and discredited. He is now Mr Wakefield and no longer a recognised doctor. Considerable damage was done not just in the UK but across the globe, with large numbers of parents worried about the MMR vaccine and then their children not having it. Suddenly, a disease that had been almost entirely eradicated decades ago—measles—started to spread, with a considerable impact on the health of many children.
We have already discussed how polio has been almost entirely eliminated, and how smallpox appears—one must always be conditional with this—to have been eliminated by vaccination. However, there is the poisonous cesspit of the right-wing conspiracy theorist ecosystem in the United States. I am a huge supporter of our alliance with the US, but within it there is an appalling subculture of those who live by conspiracy theories. The anti-vaccine campaign is one of those, with a detrimental impact on health. That obviously then fed into covid.
We already have international bodies dealing with some issues. With the influenza vaccine, when this year’s variation appears in the southern hemisphere, the international committee then gets together to understand the basic structure, and then informs the vaccine companies in the northern hemisphere. We then all produce that in order to fight it. Very occasionally, the committee gets that wrong, but most of the time it gets it right, which has a huge impact on both the health of individuals and the health service.
This is about international scientific co-operation. The covid vaccine was an exact demonstration of how international co-operation enabled us to produce a vaccine within something like 12 months instead of the normal 10 years. That is a great contribution to health and to stabilising the situation.
There is an argument for referenda on major constitutional issues. For example, it was perfectly right to put the proposal to change the voting system in this country to the public, and the public very sensibly turned that down. By the way, I do not think that anybody should try to change the voting system without a referendum. When the argument about our relationship with the EU could not be resolved here in Parliament, it was perfectly proper to have a referendum, and the people decided on that. We cannot be arguing to have one for every bloomin’ issue, every policy and every treaty. We are signatories to hundreds of treaties around the world.
The point I was making is that we sign trade treaties. We signed up to the World Trade Organisation, which binds us to certain forms of arbitration. We have just signed a treaty with Australia as well. All these treaties bring obligations. That is part of engaging with the world, unless we want to be North Korea and have a policy for hermits.
We have also had reference to major pharmaceutical companies. There are criticisms of them in some other areas, but the mobilisation of their intellectual power and production capacity, in producing a vaccine in record time to stem the tide of covid, was absolutely magnificent. So too was the support from one of the great villains of conspiracy theories, Bill Gates, whose foundation has done a huge amount of work in trying to eliminate tropical diseases, which is often little noticed but has a huge impact on tens of millions of people, especially children, in Africa and other areas.
What we are seeing is overreaction and hysteria, and I would argue that we should give the petition a firm rejection, as I am sure we would do if it ever came to the Floor of the House of Commons. We should support international co-operation for international health.
I also thank the organisation UsforThem, which I have been working with on this and other matters. It is the campaign group that led the calls on behalf of children and young people during the lockdowns, and it is now very concerned about what the WHO’s proposal might mean for the most vulnerable people in our society.
I acknowledge the impulse behind the treaty and the proposals that are before the World Health Organisation. I acknowledge that global threats that defy borders require global co-operation, and it is certainly true to say that this country was not sufficiently prepared for the pandemic when it broke out, but I do not believe that the lack of readiness was due to a lack of international co-operation. Indeed, the degree of international co-operation was astonishing. The lack of readiness was in the ordinary business of contingency planning by the British state—the security of supply of equipment, capacity in the health service, and our ability to support the vulnerable and the isolating. That is where we were not ready.
In fact, we could say that in a crucial respect the UK was prepared. We thought that we knew what we would do in the event of a pandemic. We would introduce targeted isolation and targeted protection of the most vulnerable—the application of personal responsibility, not mass lockdowns, which were not part of the plan—but we threw that plan aside immediately, and we went for exactly what everybody else around the world was doing. Or almost everyone—never forget plucky Sweden.
During covid-19, we had an excess of global collaboration and not enough independence—and certainly not enough parliamentary scrutiny. That is why I am concerned about the treaty and what lies beneath it. The treaty would create, via amendments to international health regulations, the infrastructure and funding to implement changes that are being planned anyway. Those amendments are of greater concern. The proposed new regulations would hardwire into international law and our domestic policy a top-down approach to pandemics and global public health. Yes, we need co-operation and strategic vision, but no, we do not need ever more centralised solutions.
In this country, the top-down approach to covid-19, from the centralised test and trace system to food parcels for the isolated, did not work. What worked best was people taking responsibility for themselves and their neighbours, local government working with civil society, medical leaders exercising their judgment, and public servants at the local level working flexibly and with initiative. What worked was not central control but subsidiarity: decisions being taken as close as possible to the people that they affected.
What we now see is the World Health Organisation setting itself up as responsible not just for identifying pandemics but, crucially, for the worldwide responses to those pandemics. The proposed amendments recognise the WHO as the guiding and co-ordinating authority of international responses to public health emergencies of international concern. Of course, we know the WHO’s unaccountable nature: the director general is appointed through an opaque, non-democratic process, and international pharmaceutical companies have too much power.
The regulations propose the creation of a vast public health surveillance mechanism at public expense; if the WHO itself is anything to go by, that would be substantially funded by the pharmaceutical industry. Crucially, as my hon. Friend the Member for Don Valley said, the regulations propose that the WHO’s existing powers to make recommendations about what countries should do be upgraded from non-binding to binding. That amounts to a vast transfer of power to the WHO.
What would the new regulations enable? They would enable legally binding obligations on countries to mandate financial contributions to fund pandemic-response activities. They could require the surrender of intellectual property in technologies. They could mandate the manufacture and international sharing of vaccines. They could override national safety approval processes for vaccines, gene-based therapies, medical devices and diagnostics.
The WHO’s powers will potentially extend to ordering countries to close borders; to travel restrictions; to the tracing of contacts; to refusal of entry; to forced quarantining; to medical examinations, including requirements for proof of vaccination; and even to the forced medication of individuals. It is not just when a pandemic has already been declared that those powers might be invoked: the WHO claims these powers when there is simply the potential for such an emergency.
As the Chair of the Health and Social Care Committee, I say that we want to be at the heart of scrutinising any future treaty that we negotiated as a member state through the WHO. It would then go through the processes of this House before any ratification took place. Is that not the point of the House of Commons?
I will come to why we absolutely should opt out. I am challenging the proposed regulations and treaty, because they are wholly and fundamentally wrong, and they represent an assault on our freedoms. We should object. I think the suggestion of my hon. Friend the Member for Winchester (Steve Brine) is absolutely right: fundamentally, Parliament needs to exercise its own responsibility and duty to oversee what we are going to do.
My final concern about the proposals is that they set the WHO up as the single source of truth on pandemics and responses to pandemics. There is a legitimate and understandable need to challenge misinformation and disinformation—there is a real danger there—but surely Members should recognise that there is an opposite danger as well, whereby a single supranational agency becomes the sole source of information on what is true. These are the people who said that covid-19 definitely did not come from a lab leak at the Wuhan institute, as now seems likely. These are the people who said that lockdowns would only be short and temporary, rather than lasting the best part of two years, and who said that vaccines stopped transmission, rather than having next to no impact on transmission. They said that vaccines would only be for the vulnerable, rather than everyone—including little babies. They said the vaccines would be voluntary, rather than mandated as they were in many countries, including, very nearly, our own. I do not have confidence in the WHO and its satellites to be the single source of truth on either the science or the response.
I will finish with some observations. As I mentioned, the international health regulations are an existing legal instrument, so they need only a majority of member states at the World Health Assembly in order to come into force. We then have six months to opt out of them. A treaty would require the support of two thirds of member states. I am concerned about the Government’s response to this petition, which said that they
“support a new international legally-binding instrument”.
The Government are therefore in favour of something along the lines of the proposed treaty. They went on to say:
“Not every treaty requires implementing legislation and it is too early to say if that would apply here.”
At the moment, we do not have a commitment from the Government that they would bring the proposals to Parliament, which is very concerning.
Margaret Thatcher warned in a speech in Bruges in 1988 that the UK had not helped to defeat the Soviet Union just to subject itself to a new supranational arrangement: the European Union, as it became. We did subject ourselves to the EU until our current time, and I suggest that we did not leave the EU just to subject ourselves to a new supranational arrangement in the form of the WHO. Some may find that comparison ludicrous, as they find any defence of national sovereignty ludicrous—accept in the case of Scotland. They say that in our interconnected world we need less sovereignty and more co-operation, which means more power for people who sit above the nation states. I say that in the modern world we need nation states more than ever, because only nation states can be accountable to the people, as the WHO is not. Only nation states can temper their policy to the particular circumstances of the people, as the WHO cannot. Only nation states have the legitimacy and agility to adapt to the huge threats and opportunities of our times, as the WHO cannot.
I firmly believe that the treaty and the regulations are another, greater threat to parliamentary sovereignty. It is not clear whether the Government will submit the treaty and the regulations to parliamentary approval, but I believe they should, and I hope the Minister will commit to that today.
I am under no illusions as to why the petition has received such a large number of signatures: because of what has been suggested could be in the treaty. While doing research for this debate, I found a broad range of concerns, some of which are entirely reasonable and others that are completely absurd. On the absurd side, a narrative has been created that the World Health Organisation is a body intent on world domination. Borrowing tropes from conspiracy theories, I found one website referring to the WHO as “globalists” that
“drain our resources, serve our enemies, and continue working to establish a global dictatorship over everyone and everything.”
That sentiment is clearly ludicrous, as is the reference to the WHO being owned by Bill Gates or the Chinese Government.
The reality is far more mundane than the narrative spun. The first key point to remember is that nothing has yet been agreed. The treaty is being negotiated as we speak by, among others, representatives of the United Kingdom. It cannot be viewed as being imposed on us when we are helping to develop it. It is also important to note that it was our Prime Minister at the time who was one of the signatories to the statement of intent to instigate the discussions.
As we have already heard, we can, if we so decide, opt out, so there is no question that this is something that will be done to us. As a sovereign nation we have the opportunity to say no. Given the amount of time that this House has spent debating questions of national sovereignty over the past five or six years, would we do something that would give away sovereignty? There are important principles about parliamentary accountability that we need to bear in mind. It would be unfair to allow some of the wilder conspiracy theories to overshadow legitimate concerns about any potential infringement on our sovereignty and democracy.
On the specifics of the treaty, as I have said already, the key point to note is that it has not been finalised yet, but we do know the broad parameters of negotiations set out in the latest “zero draft” published in February. From that we can see that the guiding mission is:
“to prevent pandemics, save lives, reduce disease burden and protect livelihoods, through strengthening, proactively, the world’s capacities for preventing, preparing for and responding to, and recovery of health systems from, pandemics.”
I would be very surprised if anyone objected to that as a set of guiding principles, but it is reasonable to ask what the definition means in practice, what the procedure is for declaring a pandemic, and what safeguards will be in place to ensure individual liberty and rights are protected.
Those questions and that ambiguity have been seized upon by those who want to undermine global co-operation. They state fears that the treaty will restrict freedom of speech to the extent that dissenters could be imprisoned, that it will impose instruments that impede on our daily life and that it will institute widespread global surveillance without warning and without the consent of world leaders. In other words, some of the hallmarks of totalitarian Governments are to be combined with supercharged lockdown measures, which are all, of course, already in the power of the Government under the Public Health (Control of Disease) Act 1984. Under this treaty, those things will apparently be done without our Government having a say.
If those claims had any basis in fact, we would all be rightly concerned, but they do not stand up to scrutiny. Fact checkers have consistently stated that the WHO would have no capacity to force members to comply with public health measures. A WHO spokesperson said:
“As with all international instruments, any accord, if and when agreed, would be determined by governments themselves, who would take any action while considering their own national laws and regulations.”
The idea that we would allow our citizens to be imprisoned by a third party for expressing an opinion on something in this country is absurd. It is just not going to happen. We live in a liberal democracy and I know that Members from across the House are determined to keep it that way. It is those nations that want to undermine western liberal democracies and to create disarray that are pushing the narrative that there is an unaccountable, unelected, global group of people seeking to take control of our lives.
We can both protect our values of freedom and democracy and work more closely with other countries in the face of a global threat. Those two aims can be entirely consistent with one another. Creating a global treaty is an entirely reasonable and responsible course of action. One of the most important messages to emerge from covid-19 was that we need to be better prepared for the next pandemic. We have learned that global co-operation is crucial to success, whether that is by co-ordinating measures to suppress transmission or conducting vaccine roll-outs. It took the world far too long to understand that in a pandemic no one is safe until everyone is safe.
To my mind, the question is much more about whether this Parliament and this Government are up to the task of dealing with another public health emergency in a way that ensures that democratic accountability and public confidence are maintained. As someone who spent many hours dealing with public health regulations during the covid pandemic, I think there is much to be done to improve Parliament’s role. We know that, at times, decisions had to be taken quickly, but far too often covid regulations were debated weeks or even months after they were introduced. As the pandemic progressed, I felt that no effort was being made to ensure that regulations were debated before they came into force. On numerous occasions, there was no objective reason why that needed to be case. Indeed, sometimes the rules were made publicly available on the Government website only minutes before they became law. Trying to obtain clarity about which measures, individually or collectively, were considered likely to lead to an increase or decrease in transmission rates was mission impossible.
When we were able to see the minutes of meetings of the Scientific Advisory Group for Emergencies—in the early stages of the pandemic, we were not—there was often very little correlation between them and the measures being debated. Sometimes, there was no statement in the explanatory memorandum that the measures being put forward in the regulations had even been considered by a scientific adviser. Often, there were no SAGE minutes that stated that these matters had been considered either. Often, what SAGE recommended did not even make it into regulations.
I am sure that many of us can remember the contradictions and the confusion about some of the measures: around why an area was in a particular tier, the lack of clarity about how areas moved in and out of tiers, the decision to close pubs—
Let me return to the question of how the last pandemic was dealt with. There were other examples of decisions being made seemingly without any evidence to back them up—the decision to close pubs at 10 o’clock is a good example—and there was also the lack of coherence about why people were allowed to meet in groups of not more than six and why certain establishments could reopen and some could not. It was a fast-moving and unprecedented situation but, given the draconian nature of the regulations, we needed to be better at parliamentary scrutiny than we were. The release of the WhatsApp messages of the former Health Secretary, the right hon. Member for West Suffolk (Matt Hancock), has certainly given me food for thought. Perhaps not all the decisions were made on a scientific basis.
If we find ourselves amidst another pandemic in which measures that affect people’s daily lives are proposed, this place’s ability to openly scrutinise and question Government on decisions before they are made, as well as its access to the full scientific advice, will be vital. If decisions are taken transparently and—dare I say it—if everyone is seen to be following the rules, we stand a much better chance of maintaining public confidence that the measures are necessary.
There has been a bit of talk about vaccine harms today. I do not want to be seen as unfairly critical of those who have raised those concerns. I understand that sometimes there is a deep desire for a rational explanation for the sudden loss of a loved one. I also believe that we should be able to ask legitimate questions about vaccines: it is perfectly reasonable to debate who should receive a vaccine and how often they should receive it. It is also legitimate to scrutinise Government decisions, particularly ones that impinge on individual liberty. But there is a world of difference between doing that and descending into the dark world of conspiracy theories that suggest that vaccines do more harm than good. That risks pushing people away from potentially life-saving interventions and, over the long term, damaging the public’s perception of the importance of a tool that has been used to eradicate diseases that frequently ruined lives. From smallpox to tuberculosis and polio, vaccines have saved millions of lives over the years. We cannot now abandon the importance of that work because of a few videos on YouTube. We need to be able to challenge and question, of course, but we should not ignore what decades of experience have shown us about the value of vaccinations.
The treaty has nothing to do with Bill Gates, and it is not the first step in creating a world-dominating authoritarian state. I do not believe that it will even impede our sovereignty. It will enable the combined efforts of our brilliant researchers, medics and scientists jointly to tackle the increased threat that we face from pandemics. We achieve far more as a species when we work together. The far bigger risk to our continued existence on this planet is not the so-called great reset, but a descent into paranoia and distrust, such that we avoid using our brightest and best, they end up working in silos, and they do not share their knowledge and efforts collectively. We want to avoid that. From pandemics to climate change and eradicating global poverty, we face many challenges as a species, some of which are existential. If we do not seek to work together to meet those challenges, we will ultimately all be the worse off for it.
The idea behind the treaty is to ensure that there is a more joined-up approach to pandemics in future. There is no question but that the world will face other pandemics and health emergencies in the future. It is clear from covid-19 that countries need to address those threats together.
Covid-19 has affected each and every one of us; no region or country has been spared. According to The BMJ, in less than two years covid-19 infected more than 240 million people, with 5 million lives lost. States agreed that the world must be better prepared to predict, prevent, detect, assess and effectively respond to pandemics in a highly co-ordinated fashion. The covid-19 pandemic has been a stark and painful reminder that nobody is safe until everybody is safe. That means that everyone across the world, no matter how poor or how challenging a nation state is, needs access to safe, affordable and effective vaccines, and to medicines and diagnostics for future pandemics.
So far, so good, but there is a claim that a legally binding WHO pandemic treaty will give the WHO the authority during a pandemic to trump sovereignty and control UK policies, including on lockdowns, school closures and vaccines. If true, that would be a valid concern for every country. Will the Minister reassure my constituents who signed the petition that the treaty is voluntary, that it does not overrule the UK’s ability to legislate for our own pandemic-related policies, and that no UK sovereignty would be ceded at any time to the WHO?
There are also claims that the WHO has continued to develop two international legal instruments intended to have force under international law, with the aim of increasing its own global authority in managing health emergencies, including pandemics. It is claimed that the two instruments work in synergy, with the international health regulations amendments laying out new and specific powers and processes desired by the WHO and its sponsors during health emergencies and extending the context in which such powers can be used, and the treaty providing the terms for the administration, financing and governance of the powers and processes underpinning the enlarged international health regulations.
While the Government have so far expressed support for the treaty and said that they are
“actively shaping its design to ensure it improves how the world prevents, prepares for, and responds to future disease outbreaks of pandemic potential”,
they have made it clear that
“the key will be to ensure the final text is clearly in the UK national interest”.
Negotiations on the draft text continue, including on key international principles such as human rights, sovereignty, transparency and accountability. Will the Minister please confirm and provide assurance to my constituents who signed the petition that no UK Government will sign any legal instrument, treaty or convention that will fundamentally and detrimentally change the relationship between the World Health Organisation and its member states, including the UK?
When a draft treaty is finalised—if ever, as it will need the agreement of nearly 200 countries—it is vital that the why, when, how and what of the treaty and whether it is actually needed are debated, considered and scrutinised by UK elected representatives. Does strengthening global health governance require a treaty? Are there more effective ways to strengthen global health governance after the covid-19 disaster? We must look at those questions. What we must be wary of, however, is conspiracy theories distorting the facts and scaring people. Transparency of debate is therefore needed to squash those conspiracy theories, to provide proper scrutiny, and to put people’s minds at rest.
The pandemic treaty must be viewed in conjunction with the proposed amendments to the international health regulations. As George Santayana said, those who fail to learn the lessons of history are doomed to repeat them. I have some severe worries that the lessons of the last pandemic have not been learned by the WHO itself, and that we are in danger of giving it more powers to enable it to overreach itself and repeat those catastrophic mistakes.
I will start by talking about the WHO itself. As my hon. Friend the Member for Don Valley (Nick Fletcher) pointed out, it was founded in 1948 as a specialised agency of the United Nations responsible for international public health. It consists of 194 member states—basically the whole of the UN membership excluding Lichtenstein and the Holy See. It was based originally on a WHO constitution that is still there today, but that will be fundamentally changed by the two instruments that are in the pipeline following the covid-19 pandemic.
The WHO is domiciled in Geneva and so has special status. Its employees are exempt from tax and they and their families all have diplomatic immunity. It is indeed a supranational body, unelected and unaccountable. I think my constituents would fear that.
How is the WHO set up? Well, it has something called the World Health Assembly, which meets yearly in Geneva. The WHA is the legislative and supreme decision-making body of the WHO. It elects the secretary general and the executive board and votes on the policy of the WHO. The current chairperson of the World Health Assembly of the WHO is a gentleman by the name of Harsh Vardhan. In 2021, the Indian Medical Association—the Indian version of the BMA, and the largest association of doctors in India—issued a statement objecting to Vardhan, who was endorsing Coronil, a product that was being made in India. The IMA questioned the ethics of the Health Minister—Dr Vardhan was the Health Minister of India at that time—in the release of a fabricated and unscientific product on to the people of India. He has since gone on to become chairperson of the WHA, which will preside over this new treaty, which will sit before every Government in the world. Given that he resigned from the Cabinet in India over that controversy, whyever has he been trusted with greater responsibility? It seems that he has failed upwards, like many at the WHO and the WHA.
The original ideals of the WHO were completely laudable. The WHO is to serve the health of the people, governed by its member states, which will implement health policy in the interests of their people. Under article 3 of the international health regulations—before they are amended—state sovereignty and the rule of law will be respected. People’s self-determination will be fully respected. All human rights, conventions and other Acts that countries have joined up to will be respected. That is protected under article 54 of the original regulations on human rights.
Who is funding the WHO now? It is funded like many of our regulators in the UK: the Medicines and Healthcare Products Regulatory Agency is 86% funded by industry sources, and the Joint Committee on Vaccination and Immunisation, in its members’ personal declarations, declared more than £1 billion of interests in big pharma, the thing it was set up to regulate. That undermines public confidence. The WHO is no longer anything like majority-funded by its member states—the ones it is seeking to control. It is 86% funded by external sources.
I am not sure that my hon. Friend the Member for Winchester (Steve Brine) is correct. The UK is not the second-largest donor, but the third-largest. The second-largest donor after Germany is the Bill and Melinda Gates Foundation, and I think Gavi is the fifth, so if we add those together, they are the biggest donors to the WHO. We have to ask: why are they doing this? They are also the biggest investors in pharmaceuticals and the experimental mRNA technology that proved so profitable for those who proposed and produced it during the last pandemic. Indeed, the WHO said that the contributions of member states to WHO funds
“have been capped and today account for only 16% of WHO’s total budget”,
with
“an increasing share of funding to WHO coming as voluntary contributions where donors direct funding according to their priorities.”
Well, their priorities might well not be the priorities of my constituents in North West Leicestershire, or the electorate in the UK, but he who pays the piper calls the tune.
The WHO is promoting the influence of private-public partnerships. It promotes that on its websites to the point where it is pay to play. Anyone can buy influence at the WHO; it will just cost them money. When it comes to consulting, the WHO’s own internal report—its survey evaluation in its final report on 23 May 2022—said that the various interest groups have more input to WHO policy than the member states. The WHO’s own figures say that the member states only participation was 40% of the input, whereas 60% came from non-member states and 276 stakeholders.
It is clear that there is a strong external influence on the policy of the WHO, an entity whose amendments to the International Health Regulations and the pandemic treaty will come to pass by May 2024 if this House does nothing and does not vote. Doing nothing is not an option: it will not go away.
The WHO’s intermediate study says that the WHO is an international organisation created as a sub-agency of the United Nations for the objective of obtaining the “highest possible level of health” for all people, but at what cost? What cost democracy? What cost to individual freedoms? It is now 80% funded by non-member states, and it is heavily influenced. During the pandemic, it took extra powers, such as the fact that it could define information. It took on a position—and this will be enacted in law, and binding, in those two new instruments —that the WHO has the ability to say what is disinformation.
When anybody says that the science is settled on any issue, I suggest that this House would smell a rat straight away. The science is never settled: it is always open for modification and for new things to be discovered and theses to be refined. The WHO is saying that it will be the arbiter of what the science is, and that cannot be right. It is a bit like someone saying that the market has changed—well, in my experience it never has. That is a huge grab of power. The two instruments—the pandemic treaty and the amendments to the international health regulations—are progressing in parallel.
I am really worried whether colleagues have actually read the treaty, because clearly when we take out the words “not binding” through an amendment, it becomes binding. These are binding treaties: if we do nothing, they are binding—legally binding across all the nations. They bring in an idea called “One Health”, which extends the ability of the director-general of the WHO to call a public health emergency of international concern—which, incidentally, is abbreviated to FAKE. It says that he can bring in these powers on the suspicion or risk of an international incident. It does not even have to be a pathogen affecting humans; it can affect animals. It could be because of the environment or an increase in the levels of carbon dioxide.
I suggest that right hon. and hon. Members read the treaty. It is a massive extension of powers. At the drop of a hat, one man—Mr Tedros—can call for massive powers for the WHO. Not only will he call for them; when he takes the powers, he will decide when the pandemic or emergency is over and when he will give the powers back to this House, where elected representatives are supposed to be representing the interests of our constituents. All that will be suspended.
While we are talking about Mr Tedros, I remind the House that this gentleman will be deciding the fate of the world, because it will be in his gift to declare emergencies. Look at the conduct of the WHO during the recent Ebola outbreak in the Democratic Republic of the Congo, where 83 individuals who were working for the WHO sexually abused local women, including the sexual assault of a 13-year-old girl. It was all covered up. There was a leaked document from the WHO, which would have been in front of Mr Tedros’s committee. A confidential UN report submitted to the WHO last month concluded that the managers’ handling of a case did not violate WHO sexual exploitation policies because the woman concerned was not a beneficiary of WHO aid, as she did not receive any humanitarian support. That is completely unacceptable, if those are the rules of an organisation that will be deciding whether my constituents are locked down for six months or three months, and whether they can go and see their grannies. I do not think it is acceptable.
The proposed new treaties would compress the mandatory reporting time for Governments to report a possible risk to public health to the WHO to 72 hours, and Mr Tedros will make a decision. That is far too little time for any meaningful research to be done on what the real risk is, and it would potentially lead to lots of false alarms and unnecessary disruption. The two proposed instruments seek to take huge powers away from this Parliament and every other Parliament around the world, and they need to be considered very carefully. Sticking our heads in the sand will not do it, and it will not do for my constituents. If we have learned anything from the vote that we had in 2016, it is that people in this country do not want to be ruled by unelected, unaccountable bureaucrats, and there is no one more unaccountable and unelected than people in the WHO. They do not pay tax, and they and their families have immunity from prosecution because they have diplomatic immunity. They are also under the huge financial interests of whoever wishes to fund them.
Many experts are now saying that the two proposed instruments would fundamentally reset the relationship between citizens and sovereign states—not just in this country, but around the whole world. The WHO is an unelected, unaccountable and top-down supranational body, and the treaties would empower its director-general to impose sweeping, legally binding directions on member states. The WHO would have the power to force companies in this country or any other country to manufacture certain medical treatments and to export them to other countries. It would have the power to shut down any business in this country, regardless of what local people think or even what this Parliament thinks.
The proposed treaties would take away all the protections that being in a democracy offers, and they would take away article 3 of the original WHO constitution, which is about respect for human rights and dignity. That would be replaced by a bland statement saying that there will be equity, which means that everyone would be treated equally. It also means that there would be only one solution to any international problem around the world, which would lead to an all-or-nothing situation whereby if the WHO got it right—if I had time, I would go into everything it got wrong in the last pandemic—maybe we would be okay. But if the WHO got it wrong, the whole of humanity would get it wrong. There would be no competition. If there was only one car manufacturer and only one solution, I am not sure it would be the best car that we could ever have. Competition between nations for solutions is a good thing.
I have grave concerns about the two proposed instruments, and about who is running and controlling the WHO. It would be foolish not to see that pharmaceutical giants have huge influence over the direction of the WHO, with their lobbying power. Like many multinational corporations, their size and scale supersedes national Governments, with over 80% of the WHO budget now specified funding, and they have the ability to direct policy. I think it is fair to say that we are drifting away from the WHO’s original and noble ethos of promoting a democratic, holistic approach and co-operation on public health.
The WHO let us down over covid in its response. In January 2020, as has been pointed out, it was still telling us that there was no person-to-person transmission of the virus. That was wrong. It then prescribed lockdowns and mass vaccination during the pandemic, which drove mutations. The pandemic response of the WHO and national Governments should be a cautionary tale about the impact on citizens of handing power to the state. It should certainly not be a template for going further and faster in signing away rights and liberties.
The pandemic response brutally illustrated that the profit-optimised version of the greater good pursued by the WHO often clashes with children’s health. Before I spoke out on 13 December on the risks of the experimental mRNA vaccines, the MHRA was looking to authorise the vaccination of children down to the age of six months in this country. I am very grateful that the Government listened and that we did not do that. Indeed, it was pushed back to people over 50 and, after my speech on 17 March, I am delighted that the Government put it back to only those over 75. In a few months, that is a huge difference from trying to vaccinate everybody. If we were all under one rule, we would be doing exactly the opposite of what this country has individually decided to do.
While we are on the subject of opaque, undemocratic organisations, it is interesting to see what the EU is doing. The EU thinks that we need to strengthen all this. Not only will the WHO be allowed to have a department of misinformation, which will be the arbiter of what the truth is during an emergency, but the EU will adopt exactly the same policy and have its own such department, so that in a pandemic there will be only one version of the truth. That is not very good for science, is it?
The One Health approach is a whole-society approach. The WHO will have the ability to mobilise every aspect of our society. Once it calls those emergencies, it will be able to keep them going. It will have control over absolutely every aspect of our citizens’ lives. This is absolutely massive. There is no more important treaty. Of course, were we to give away such powers—I would never vote to do so—we should have a referendum, because sovereignty belongs to the people. It is not ours to give away; we know that from the referendum in 2016. I hope that the House listens very carefully and reads these documents.
The vast majority of the nation has been busily moving on from the pandemic and the lockdowns, and rightly so, but much analysis of covid and the lockdowns is still ongoing, with the UK covid inquiry beginning to hear evidence in June for its first investigation. As co-chair of the all-party parliamentary group on pandemic response and recovery, I welcome that inquiry, and all other frank, open discussions and analysis of the impact and effects of lockdown, and how policies were originated and formulated.
Our APPG has heard from renowned experts such as Professor Carl Heneghan, Lucy Easthope, Mark Woolhouse, Robert Dingwall, Dr Allyson Pollock, Lord Jonathan Sumption, Kate Nicholls OBE and many more, who have all advocated for evidence-based, proportional measures to prevent avoidable suffering and loss. However, while all that analysis is ongoing, the World Health Organisation is preparing an international treaty on pandemic prevention and preparedness. The treaty seeks to enhance international co-operation, which sounds good in theory, but critics say that in practice it could transfer power away from sovereign and democratically elected nations, and the rights of the individual into the hands of the WHO, an unelected and largely privately funded bureaucracy. That is the nub of it. Who has the oversight? Who is creating the powers? Who has a say in it? That is why people have written to their Members of Parliament and asked for a debate here today. They ask, “Where are those powers going? Who is to remain sovereign? Who will have oversight?” Today, we are here to allay those concerns, to get those issues out in the open, and to head off any issues and ensure that we are not signing away our sovereignty.
Here, for the Minister to address, are just a couple of the issues that my constituents have flagged up. It is those word changes—it is not that countries would have to “consider”, but that they will now “follow”; it is not that these things are non-binding, but that they are binding. My constituents are not some kind of conspiracy theorists. They come to me saying, “You are my Member of Parliament. I want to hear you debate things on the Floor of the House. I want you to be accountable and, if you are not, we will vote you out at the next election. We want to know that we are in control of what is going on.” That is why we are here today. They are concerned about those word changes and what we are doing.
My constituents have other concerns. They remind me—not that I need to be reminded—that it was WHO that went against its own 2019 evidence-based influenza pandemic guidelines. It never advocated lockdowns as a method of controlling respiratory illnesses but, following China’s early lead, it began to champion lockdowns. Look at the U-turns on face coverings: in March 2020, it did not recommend them for healthy people, but the sudden change in the guidance followed despite the apparent lack of any new, high-quality research. In July 2020, BBC’s “Newsnight” suggested that the decision was the direct result of political lobbying.
Before covid-19, WHO had repeatedly overestimated deaths from new infections, diseases and outbreaks. In 2009, for example, it predicted a swine flu death toll of 7.5 million and warned that nearly a third of the entire world population would become infected. That led to knee-jerk over-investment in vaccine contracts, which clawed precious money away from fighting other diseases. In the end, it was concluded that total global mortality was roughly on a par with annual deaths caused by seasonal influenza, nowhere near the original prediction.
Those are the issues that my constituents raise with me—issues of who we are handing control to. As they say, WHO has not covered itself in glory in providing consistent, clear and scientifically sound advice for managing many international disease outbreaks. As we heard from many Members today, the World Health Organisation was set up in the aftermath of the second world war with the aim of providing a high standard of healthcare for all. It approached health in the round, promoting community-based services to address physical, mental and social wellbeing—all admirable reasons for why it was set up.
In recent decades, however, WHO’s focus appears to have narrowed, as private foundations and pharmaceutical companies become an increasingly significant and influential part of WHO’s funding base. Its approach has become more focused on vaccine-based interventions and, most recently, on blunt instruments such as lockdowns, of which we are still analysing the consequences. It is safe to say there was a negative impact on the young.
As Ofsted’s damning 2021 report pointed out, children have fallen well behind in their education and suffered significantly, in particular in their mental health, as a result of lockdowns. Here in the UK, it is estimated that school closures will lead to significantly lower life expectancy and to £40,000 being lost from the lifetime earnings of each individual. Children should never have had to shoulder such an enormous burden, and one that will likely hamper them for the rest of their lives. The lockdowns—those stay-at-home mandates—damaged the economy, but more importantly they drove and will drive many people into poverty, to such an extent that Professor Thomas of the University of Bristol thinks that 2.5 million life years have been lost because of a loss of GDP and those lockdowns. The poverty that we have inflicted on people with lockdowns is incredible.
This petition, calling for a referendum on the treaty, makes it clear that there is growing concern about the expansion of the WHO’s powers and the encroachment on national sovereignty. The UK Government have declared unilaterally that the UK supports a new international legally binding instrument as part of a co-operative and comprehensive approach to pandemic prevention, preparedness and response. Will the Minister explain how that can be the case when Parliament has not yet been allowed to scrutinise those plans?
Although we must not overhype the nature of the threat—I get that—this proposed treaty could, or should, give us all pause for thought. It may not yet be clear how the WHO would legally enforce any of these emergency powers and policies, but there is plenty of potential for its unelected bureaucrats to chip away at our democratic standards. It is therefore vital that we demand robust debate, and an open review of all these plans in Parliament and in public—something that was sorely lacking during covid times.
Our parliamentary system was not really designed to support referendums, so I would be loth to inflict another referendum on the public. However, I agree on the need for parliamentary scrutiny. We need debate and votes in both Houses to ensure that this country lives up to its democratic obligations to its citizens, and to ensure we continue to make our own decisions about how we manage public health threats in this country.
I will start with a question: why are our Government supporting changes to the treaty based on article 19? Article 19 is the compulsion—mandatory—whereas article 21 gives the opportunity to opt in and out. Why would we wish to impose a commitment that we cannot get out of under article 19? When my right hon. Friend the Minister responds, I ask her to embrace the idea, which has already been discussed in the intergovernmental negotiating body—although article 19 is the most comprehensive provision of the WHO constitution under which the instrument could be adopted—that the body is open to confirming whether article 21 could also be an appropriate way of making progress on the treaty.
Article 21 relates to the World Health Assembly’s powers to adopt regulations on a range of technical, health-related matters. Regulations under article 21 would come into force for all member states, except where members reject or make reservations within a specified notice period. In other words, it would be relatively more relaxed than article 19, which would effectively mean this was a mandatory treaty with no option but to comply.
If we think that the only way to deal with pandemics is for all countries across the globe to unite, let us remind ourselves that, if we had our time again, many of us would have said that the Swedes got it right. In a sense, they were the outliers at the time. Under some international mandatory ruling, they would not have been allowed to experiment in the way that they did—to follow their instincts for liberty, freedom and science-based evidence before restricting people from going about their normal business. Why would we want to have a treaty that gave no flexibility to individual countries to decide what was best in their particular circumstances in any given situation? I hope that we can get an answer from the Government on that and about why they are going hell for leather to try to adopt a mandatory treaty.
The extent of concern about this issue has taken many people by surprise. It is symptomatic of people’s loss of trust in Governments and, in particular, in some of the health Departments of Governments. My right hon. Friend the Member for Tatton mentioned in passing that the WHO itself did a complete volte-face. They were supposedly the experts, and they brought forward a document relating to preparedness for a pandemic in November 2019. That document made no reference whatever to many of the measures that were subsequently adopted by the WHO and by Governments across the world. My right hon. Friend referred to the fact that there was no mention even of the word “lockdown”—let alone of the idea that confining people to barracks and preventing them from going about their daily lives would be good for health outcomes. We now know that that has been pretty bad news for people, particularly the younger generation, for whom covid-19 was less of a direct threat to health. As a result of the lockdown measures, younger people have suffered disproportionately and will continue to suffer as they live the rest of their lives. Why should we want to trust the WHO absolutely?
Those of us in this House who have long expressed concerns about undue Chinese influence over our lives, and over the freedom of western civilisation, need to take stock and ask ourselves who is in charge of this World Health Organisation. Some people have referred to him by what I think is one of his Christian names, Tedros Adhanom; I will refer to him by his surname, which is Ghebreyesus. He is a former Ethiopian Minister of Health. He was previously a senior figure in the Tigray People’s Liberation Front. Some people here today may remember that many senior members of the Tigray People’s Liberation Front were also members of the Marxist-Leninist League of Tigray. Mr Ghebreyesus won support from Beijing in order to become the director general of the WHO, and China has quite a large control, through him, of the WHO. Margaret Chan, a former WHO director general, said in 2012 that the WHO budget is driven by donor interests. Let us be quite open about it: the Bill Gates Foundation, big pharma and big tech are supplying a lot of the resource to the WHO. They are not covering that up; they are proud of it—indeed, they make a big thing of the fact that more than half of the WHO’s expenditure is now on vaccine programmes rather than other ways of alleviating malnutrition and health problems across the globe.
Has this man—the current director general—got connections with the Bill Gates Foundation and the big funders of the WHO? Yes, he has. He was formerly a member of two of the Gates boards, Gavi and the Global Fund, so he is himself very much in with Gates—with the donors. How can he be trusted to be independent when he owes his continuing position to those donors and also to the support of the Chinese republic?
We may say, “Well, so what? Let the WHO carry on as it has been for many years. It could be an advisory body. Nobody has to listen to it, and we can take it or leave it.” But unfortunately, the developing influence of the WHO is that it now wishes to impose its standards on the whole world. That is why people have become became alerted and signed this petition in very large numbers. They do not wish this country to give up its control over its ability to manage its own affairs when faced with an epidemic or a pandemic. They certainly do not want some body like the WHO, which is wedded to the Chinese version of authoritarian capitalism—authoritarian capitalists—telling people what they can and cannot do: saying that people cannot go about their normal business, live their lives as individuals or, as an old person, meet their relatives, and all the rest.
I am pleased to say that in so far as we were able to, I voted against all those restrictions on freedom. I continue to believe that we made big mistakes in how we addressed the pandemic through lockdowns that were not scientifically based and in respect of which there were no proper cost-benefit analyses. But leave that on one side. The WHO is controlled by people who we would not wish to be in control of our lives. That is why both the United States and our Government are trying to break out of some of the Chinese Government’s controlling influences. But what are we doing about this situation? Why in these circumstances would a rational Government—I still believe that the Government I support are rational—engage in giving an enormous amount of power over our lives to the Chinese and Chinese-influenced and dominated organisations? That seems to be sheer lunacy to me. I hope that in responding to this debate my right hon. Friend will be able to agree on that point. One does not have to do anything other than point out the connections between the director general of the Gates Foundation, the Chinese Government and so on to get people to say, “Gosh. I’m a bit concerned about that.” In our daily lives, we judge companies and organisations on the basis of the people running them. If one looks at the people running the WHO, we should quite rightly ask some serious questions about their behaviour.
A lot more could be said about this treaty, but I am going to finish my remarks by asking the Government to change their approach and listen to the people. This petition was signed by a large number of people. It is not the sort of petition that is presented to someone with a, “Will you sign that?” because in order to sign this petition, people need to apply their mind and get a pretty good understanding of the subject matter. In that respect, although the numbers are well above the minimum threshold to get a debate in this House, the quality of the petition and the arguments within it mean that it is one of the most serious petitions that we have had to debate.
I have here a quote from Richard Horton, the editor-in-chief of The Lancet. He said:
“The allegation that WHO shared responsibility for the pandemic by adopting a policy of appeasement towards China has proven impossible to refute.”
There we have it. The editor-in-chief of no less than The Lancet says that we need to be extremely suspicious of what is going on and what may happen. That is a good credential for the Government to adopt in saying, “We are not going to adopt this WHO treaty under article 19; we are going to examine it more carefully, be much more circumspect, and retain the ability of our own country and our own people to decide these important issues for ourselves.”
The SNP has supported global co-operation and co-ordination throughout the coronavirus pandemic. It is only when the world is safe from covid-19 that any of us are truly safe. Only by working together and embracing global co-operation, not competition, can we tackle global crises such as climate change and pandemics. The covid-19 pandemic has laid bare the importance of strong, global public health infrastructure and how quickly healthcare provision can break down if the basics of medicines, tracking, treatment and other resources are not available. As others have said, international collaboration is the best way to avert and handle future pandemics. The world is not safe until all populations are safeguarded, wherever they are in the world.
I understand the principle behind the petition. I appreciate that people want to be able to hold their Government to account, and we must be able to scrutinise Governments. But there appears to be some misunder-standing around the WHO’s work and how it interacts with Governments. I have done a bit of reading and have listened to the reasons given by those who oppose this potential treaty, and they often have concerns that the WHO would be running health policy for all countries who sign up to it. But those working on drafting the treaty have already included sovereignty as one of its guiding principles and rights. The latest draft of the treaty from 1 February 2023 starts by:
“Reaffirming the principle of sovereignty of States Parties in addressing public health matters, notably pandemic prevention, preparedness, response and health systems recovery”.
There are no proposals to change that, and the healthcare policy, even in a pandemic, would remain entirely a matter for sovereign nations to decide. The World Health Organisation would be able to make recommendations once a global emergency is declared, but they would just be recommendations. Contrary to what others have said, they would be non-binding. The treaty would not require Governments to act on WHO instructions, nor would it require anyone to sacrifice sovereignty. Rather, it would enable Governments to plan together, detect pathogens more quickly, share data more broadly and respond more effectively to the next pandemic.
Those concerned about the impact of the WHO’s involvement are perhaps unaware, or have forgotten, that the UK already implements the WHO’s international health regulations, or IHR. Those regulations provide a framework that defines countries’ rights and obligations in handling public health events and emergencies that have the potential to cross borders. The regulations have been in place in some form since 1969, and the latest regulations have been in operation since 2007, but this has not meant a loss of individual nations’ control over health policy.
On the international stage, the SNP will always support measures to improve global public health. Those include reversing the damaging aid cuts by the UK Government—specifically, in this context, those inflicted on health and wellbeing projects.
Official development assistance has been cut from 0.7% to 0.5% of gross national income, creating a £4.6 billion funding black hole compared with 2019 levels, and health and wellbeing programme funding has been absolutely slashed. As part of their wider international development pattern, the UK Government are cutting funding for conflict resolution projects at a time of renewed war, cutting health and medical funding in the aftermath of a global pandemic, and cutting food programmes during a time of global food insecurity. All of this is morally reprehensible.
It is positive, of course, that the UK Government are supporting the treaty, but it is important to remember that despite the pressing need for a global, collective response to health crises, the UK Government are repeatedly falling short of the mark and reneging on their pledges. It is morally and pragmatically indefensible that the UK Government should continue to actively jeopardise the lives and wellbeing of the world’s poorest and most vulnerable. With the Government maintaining the ODA budget at below 0.7% of GNI, there is no other way to describe what they are doing.
Along with supporting the treaty, the SNP is calling on the UK Government to reinstate the aid budget to 0.7% of GNI as an urgent priority, ensure that aid spending on health programmes and projects around the world is increased to pre-covid-19 pandemic and pre-UK aid cut levels, and ringfence the overseas aid budget for spending abroad, to ensure that the aid budget is not being spent here in the UK on refugee and asylum support. The Government must also establish a much-improved, stand-alone Home Office model that better supports refugees and asylum seekers.
The SNP believes that referenda are essential to establish public consent on issues concerning constitutional make-up and sovereignty, not on every issue that someone might disagree with. The treaty would have absolutely no effect whatever on the UK’s constitutional function and sovereignty, and we are therefore of the firm belief that it does not warrant a referendum.
I was certainly sympathetic when the hon. Member for Devizes (Danny Kruger) lamented the terrible situation whereby the UK might be unable to make its own decisions if it is outvoted by other countries. Imagine! However, as the hon. Member for Winchester (Steve Brine) said, the UK is a leading member of the WHO and a primary architect of the treaty, so that is not what is happening here. If it were, however, what level of hypocrisy would it take to think that this one issue deserves a referendum, but the unresolved issue of Scotland’s independence does not?
The final outcome for consideration on this prospective treaty is expected to be presented to the 77th World Health Assembly in May 2024. Scotland stands ready to play our part in international efforts to collaborate and co-operate—not compete—on pandemic preparedness, awareness responses and collective prevention, so we do not support the petition.
The covid pandemic has been one of the most surreal and seismic global events of our lifetimes, with 212,000 people having died as a result of it in the United Kingdom and our economy having been directly hit to the tune of £250 billion of gross value added. The social impacts on everything from our children’s lost learning to NHS waiting lists will be felt for years to come. The extent of the damage that the pandemic caused was not inevitable. The UK was badly unprepared. NHS waiting lists were at record levels even before the pandemic hit. We had staff shortages of 100,000 in our health service and 112,000 vacancies in social care.
In 2016, the outcome of Exercise Cygnus informed the Government that the NHS would not be able to cope with a flu pandemic; yet they still reduced the stock of PPE and the number of beds. Too many people have paid for that decision with their lives, particularly in care homes across our country as untested patients were ferried from hospitals to homes. Then of course there are the billions of public money wasted on unusable PPE, the chaotic shuffling in and out of lockdowns from a Government that could not get a grip, and at the end of it, the UK’s abject position as the worst hit economy in the G7.
After 12 years of Tory complacency, the next Labour Government will never leave our country with such a soft underbelly. The next Labour Government will deliver a new 10-year plan for the NHS, including one of the biggest expansions of the NHS workforce in history, doubling the number of medical school places to 15,000 a year, training more GPs, nurses and health visitors each year, and harnessing life sciences and technology to reduce preventable illness.
While it might feel like the pandemic is over now, the threat is not. That is what today’s debate is about. Far from a once-in-100-years event, many natural biological threats have emerged in recent years, including severe acute respiratory syndrome, avian flu, middle east respiratory syndrome, Ebola and monkeypox. Climate change and globalisation mean that natural biological threats are becoming more common, and it is not only biological threats that we must prepare for. Advances in gene editing mean that virologists can more easily modify viruses to be deadlier and spread more quickly, increasing the security risk posed by bioweapons and bioterrorism. Will the Minister comment on our concern that the biological weapons convention currently remains very weak, with little funding and only four staff, compared with the 500 staff for the chemical weapons convention?
Pandemic preparedness must therefore be taken seriously as a matter of national security. Future threats could be far deadlier than covid-19. During the first wave of coronavirus, 1% of infected individuals died, compared with 80% during the west African Ebola epidemic. The lesson of the pandemic was that no one is safe until everyone is safe, and that global health is local health, so global co-operation on pandemic preparedness and biological threats clearly needs to be strengthened. That is why the Opposition absolutely support the principle of a legally binding WHO treaty that sets the standard for all countries to contribute to global health security. Our country was set back not just once but three times by new, dangerous covid variants that originated overseas. We are stronger together than trying to firefight such crises alone.
The WHO is the primary UN agency for international public health. In its history of over 70 years, it has contributed to the eradication of smallpox, helped to immunise millions of children against preventable diseases such as tuberculosis and measles, and is supporting the near eradication of wild polio. Currently the WHO is responding to 55 graded emergencies around the world. Last year, it supported member states in response to 75 different health emergencies. More than 339 million people are now in need of direct humanitarian assistance, and in those countries affected by fragility and conflict we are seeing 80% of the world’s major epidemics.
The principles laid out in the zero draft text on pandemic preparedness are a strong foundation from which to begin to respond to some of those crises. The text on strengthening global health systems and universal health coverage, on international transparency and on the sharing of technology, diagnostics, vaccines and knowhow echoes what Opposition Members said consistently during the pandemic. It is through multilateral efforts, strengthened through international law, that we can ensure that the response to the next pandemic is faster and more effective, and does not leave other countries behind.
I know that the hon. Member for North West Leicestershire (Andrew Bridgen) has been calling for this debate for some time and that he has reservations. It is important that we have this debate and show that there is no shadowy conspiracy. I am afraid that the reality is much more mundane than that. I note his claims that a treaty will
“hand over…powers to an unelected…supranational body”,
even despite the fact that it would still have to be ratified by the United Kingdom and there is over a year of negotiations to go. I point out to him that the very first statement in the zero draft text reaffirms
“the principle of sovereignty of States Parties”.
Moreover, it states that the implementation of the regulations
“shall be with full respect for the dignity, human rights and fundamental freedoms of persons”.
Of course, the draft text makes no reference to vaccine mandates, lockdowns or any such draconian policies. If the hon. Gentleman reads it, he will see that the draft treaty is primarily about transparency, fostering international co-operation and strengthening global health systems, in recognition of the catastrophic impact of the pandemic on developing countries. It is on the face of the text.
As I have said, the negotiations operate on the principle that nothing is agreed until everything is agreed. That is a really important principle to hold on to. In over a year’s time, there will be a two-thirds vote of WHO members and then, ultimately, it will be for us to ratify and enact those policies as we interpret them. It is really important that we recognise that.
Far from there being a conspiracy, this process is built on the very basis of international co-operation, which is essential for tackling transnational threats. As a country, we have a proud history of supporting the international system, using our influence and expertise to set common standards and bring parties together to achieve more than they can achieve alone. If we can use the WHO to support basic universal healthcare around the world, infectious diseases are less likely to spread and fuel global pandemics. Of course, that is in our national interest, too.
As I have said, pandemic preparedness is a matter of national security. Last year, in a debate on global vaccine access, I warned that striving for vaccine equity is not only a moral imperative but a matter of national interest. Yet those lessons have not yet been translated into action. Today, just 27% of people in low-income countries have received a first dose of a covid vaccine, demonstrating the terrible divide in coverage between richer countries and the global south. This Government have paid homage to the need to address that in words and announcements, but in truth their record has been dire. It includes a damaging departmental merger of the Department for International Development and the Foreign and Commonwealth Office at the height of the global crisis; repeated aid cuts to the very programmes designed to keep us and others safe; and consistently not keeping promises made to poorer countries.
Nobody expected the UK to retreat from the world stage at a time like that, or for it to vandalise its own relationships, expertise and capacity. The message it sent out to our partners and allies has been received loud and clear: they know who they can trust to show up in an international crisis and who they cannot. The irony is that those decisions harmed us as much as anyone. Vital research programmes to track new covid variants were slashed by 70%, pulling the plug on many programmes mid-project and causing years of research to go to waste. Programmes to treat tropical diseases were cut by a shocking 95%, leaving millions of people vulnerable and risking the wastage of over 270 million doses of life-saving drugs. The UK’s contribution to the Global Polio Eradication Initiative was cut by 95% for at least five years—last summer, polio resurfaced in the UK for the first time in 40 years.
Now, as our Government divert the development budget to prop up their failing asylum system, eight of South Sudan’s 10 state-run hospitals have lost their funding this month, putting them on the brink of collapse. Can the Minister explain what assessment she has made of the impact of that decision? Can she say when the refreshed global health framework will be published, and how it will draw lessons from the last three years?
The divide exposed by the pandemic was stark. At a time when millions in the global south were in greatest need, the international system failed them. The Government’s charity model of aid did not share vaccines equitably or effectively, leaving millions unprotected and the poorest countries paying the highest price. The UK’s own promises illustrate that point. At the G7 in 2021, the former Prime Minister, the right hon. Member for Uxbridge and South Ruislip (Boris Johnson), promised to donate 100 million surplus vaccine doses within a year. A year later, barely a third were delivered, the aid budget was raided to do it, and the UK effectively profiteered at poor countries’ expense.
Earlier this month, provisional spending figures for 2022 were revealed, and a further £225 million was charged against the aid budget for vaccines we had spare— effectively making a £330 million cut to the budget. Can the Minister provide a breakdown of the number of doses that were shared directly with developing countries, and through COVAX, by make and pricing, last year? How many doses were shared in total? What steps did she take to minimise the cost to the aid budget, bearing in mind that those surplus doses would have been incinerated if they were not used? How many vaccines were priced at the maximum possible of $6.66?
There is a different way—a way that does not merely give people crumbs from our table. Labour’s new model for development will be based not on charity, but on solidarity and long-term development planning. Our comprehensive plan to ramp up global vaccine manufacturing—set out in 2021—is the blueprint for the change we need to see. The pandemic revealed a fundamental problem: namely, that the world has more capability to invent and develop vaccines than it has to manufacture and distribute them on a global scale. While donating our surplus vaccine doses to poor countries was the right thing to do, in practice it has been slow, inefficient, and, in this Government’s case, used as a cover to make further stealth cuts to our aid budget at poor countries’ expense.
Developing countries should not have to wait for handouts at the back of the queue. The next Labour Government will strengthen global health systems, using the NHS as a model. We will help to establish an international mechanism to rapidly produce and distribute vaccines, to share technology, knowledge and skills, and to build the infrastructure the world needs to deliver it. We need a global effort to develop viable, orally active vaccines in solid dose form, building on the innovative work carried out by a number of pharmaceutical companies. That historic breakthrough would include the prospect of a vaccine delivery system that does not rely on needles and could lead to less need for trained vaccinators, increasing take up and negating cold chain storage, meaning fewer doses would expire before they could be used.
Finally, we need a binding, enforceable investment and trade agreement among all participating countries to govern the co-ordination of supplies and the financing of production, to prevent hoarding of materials and equipment, and to centrally manage the production and distribution process for maximum efficiency and output in the wake of a pandemic being declared. I am pleased to see that this draft treaty offers a strong starting point. Technology transfer and the open sharing of vaccines, science, technology and knowledge through the trade-related intellectual property rights waiver would help ensure everyone can access vaccines, diagnostics and therapeutics, and that no one is left behind.
I would be grateful if the Minister could set out the Government's approach to negotiations, particularly on the matters of intellectual property waivers, increased local production capacity and conditions on public funding for research. Future international initiatives need to be followed in letter and in spirit. Does the Minister recognise the importance of an accountability framework to ensure the accord’s success, and will she and her officials be pushing for that in talks? Separately, does she acknowledge the continued importance of action to address the debt crisis in low-income countries, which is clearly diverting resources away from public services and health systems? What does she see as the UK’s role in helping to unlock relief for countries in debt distress and bring creditors to the table?
Negotiating an effective international treaty on pandemic preparedness is an historic task, but, if we can achieve it, it will save hundreds of thousands of lives in the years to come, provide the foundation of a sustained global economic recovery and give us and our partners the freedom and confidence to plan for the future. Labour has a comprehensive plan to strengthen Britain’s health security, to end the 13 years of sticking-plaster politics under this Government and to return Britain to the international stage as a trusted development partner.
As covid-19 clearly demonstrated, it is in all our interests to invest in global health. The world was ill-prepared for the pandemic, which killed millions, wiped billions off the global economy and undid years of progress on our development goals. The three years since covid struck have been a wake-up call for the whole world. They have highlighted the importance of strong, resilient and inclusive health systems and have made clear that we need a co-ordinated approach across our work on human health, animal health and the environment. Covid also shone a spotlight on the need for agreed international protocols, so that information is shared in a timely fashion. It underlined how important it is that vaccines, treatments and tests are available to all who need them.
In short, we need collective international action, co-operation and mutual accountability to protect future generations from the catastrophic impacts of pandemics. Finding the best ways to manage communities of all economic strengths and resilient shapes and sizes is, of course, one critical part of that. That is why the UK is working with G7 partners and others to catalyse international efforts to try to help countries of all shapes and sizes to be better prepared.
As part of this, the former Prime Minister, my right hon. Friend the Member for Uxbridge and South Ruislip (Boris Johnson), joined other world leaders in 2021 in calling for a new international instrument to strengthen pandemic prevention, preparedness and response. All 194 WHO member states agreed by consensus to draft and negotiate a new pandemic instrument. There was a clear view that this could transform global health security and deliver the changes necessary to withstand health threats, for example, by making sure that the world has fit-for-purpose agreements in place for data-sharing and surveillance, to be able to help slow or contain the spread of disease and to support a speedy and effective response.
In November 2021, together with the other members of the World Health Organisation, the UK agreed to establish an intergovernmental body to draft and negotiate the new pandemic instrument, with a target date of May 2024.
To answer my hon. Friend the Member for Christchurch (Sir Christopher Chope), that is being negotiated with a view to adoption under article 19 of the WHO constitution, but without prejudice to considering adoption under article 21 as negotiations progress, if that was to be the preferred decision of all member states in the consensus decision that they hope to reach.
The article 19 route would not negate the ability of each member state to accept it through their own national constitutional processes, which is a really important part of the question that I will refer to further. Whether agreed under article 19 or 21, both will be legally binding as a matter of international law.
As part of our wider efforts to improve global health security through strengthening international law, the UK is participating in parallel negotiations to update the international health regulations: the technical public health framework, which a number of colleagues referred to, that requires countries to report and respond to potential cross-border health threats.
Over the next year, UK officials will shape and negotiate a text with other WHO members to ensure that it delivers on our priorities. Those will include: working towards faster and more equitable access to affordable vaccines, treatments and tests; strengthening collaboration on scientific research and development, including clinical trials and data sharing; improving collaboration and co-ordination across the human, animal and environment health sectors to try to control threats from zoonotic diseases among those other threats that we know are out there; and building strong health systems to support populations to access the health services they need during and after a pandemic.
We are already demonstrating global leadership in those priority areas. Through our multilateral and bilateral investments, we are helping low and middle-income countries to develop resilient systems and services. For example, we trained more than 600 health workers in Côte d’Ivoire to strengthen surveillance, reached over 53,000 people in Cameroon through outreach campaigns led by civil society partners and substantially increased response times to reported public health events in Mali.
Through our “One Health” approach, we are working to monitor and control the spread of diseases between humans, animals and the environment. We supported Cameroon to carry out a simulation exercise that tested and refined plans to deal with disease outbreaks of zoonotic origin, including monkeypox. Meanwhile, our investments in research and development are increasing equitable access to vaccines, drugs and diagnostics. With UK support, the Medicines for Malaria Venture has developed and rolled out more than 13 new anti-malarials. To date, those medicines have saved an estimated 2.7 million lives.
In all of this, we are working in strong partnership with academic institutions, the private sector and other organisations. The Coalition for Epidemic Preparedness Innovations—CEPI, as it is known—is a great example of that partnership work, helping to ensure that medical innovations are affordable and accessible to those in need. The Foreign, Commonwealth and Development Office has committed £230 million to CEPI to support the development of vaccines for covid-19, which includes the covid-19 vaccine candidate developed by the University of Oxford and AstraZeneca, with support from the Department of Health and Social Care’s UK vaccine network. As we have seen, the Oxford-AstraZeneca covid-19 vaccine has saved lives worldwide.
The UK has been a global leader, working with CEPI, Gavi and the WHO to ensure that our scientific leaders can help tackle health crises. As Secretary of State for International Development back in early 2020, I was proud to lead the fundraising for Gavi and COVAX to ensure that vaccines—once, we hoped, they were found—could be delivered as quickly as possible through the incredible networks that organisations such as Gavi have to reach across the globe. When covid hit, it was clear, however, that stronger collective international action, co-operation and mutual accountability will be needed if we are to tackle to tackle more effectively the global health threats of the future. Sadly, as colleagues as have said, we know that we need to be prepared for them.
I will try to tackle some of the concerns about the proposed instrument that are raised and highlighted in the petition. First, I would like to be clear that no text has yet been agreed. The process of drafting and negotiating it is ongoing, and we certainly do not expect the text to be agreed before May next year. It is a member state-led process, with member states negotiating the treaty, not the WHO. The WHO secretariat is supporting the process; it is a technical and bureaucratic system.
Colleagues have mentioned changes to the international health regulations, which are an important legal framework intended to prevent, protect against, control and provide a public health response to the international spread of disease commensurate with the public health risk involved. Indeed, it also helps to avoid unnecessary interference with international trade flows, so economies continue to be as strong as they can be under such pressures.
The UK and other WHO member states adopted the current version of the IHRs in 2005. They came into force in UK law in 2007. Negotiations on targeted amendments are looking to improve the framework in the light of the covid-19 lessons learnt. To be clear, the UK is right at the heart of those negotiations. We will work for good outcomes for the UK and for all member states, which we wish to work with and support.
Having personally spent many hours in various international negotiating fora in recent years, I know absolutely that the UK, with its voice, expertise and wisdom, and our trusted partner status with so many other member states in the UN family, is respected and listened to. Discussions continue with our officials and health experts and various other teams from across Government and, together with the leadership that we bring, that should ensure confidence in those discussions.
To conclude, we must ensure that future pandemics—which I fear that we or our children may have to tackle—will not come with the same devastating cost as covid-19. We have the opportunity now to make real and lasting improvements to the way in which the international community prepares for, prevents and indeed responds to global health threats. The UK’s voice, our scientific leadership and the strength of our democratic processes will ensure that our vision for global health planning and pandemic preparedness is at the heart of any new treaty to protect the most vulnerable.
I thank the Minister for her comments and her assurances. Sovereignty has been hard fought for in this country, and the Government will see that it is not something that we want to hand over lightly.
I genuinely believe that this debate has been a good one. I hope that the Independent Panel for Pandemic Preparedness and Response will look at the wonderful work Hansard does to put the debate out there and that it will realise there is an awful lot of concern. We all want to protect people across the globe; how we do it is the important part.
I thank all Members for taking part. I also thank you, Ms McDonagh, for your work as Chair.
Question put and agreed to.
Resolved,
That this House has considered e-petition 614335, relating to an international agreement on pandemic prevention, preparedness and response.
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