PARLIAMENTARY DEBATE
Global Vaccine Access - 13 January 2022 (Commons/Westminster Hall)
Debate Detail
That this House has considered global vaccine access.
It is a pleasure to serve under your chairmanship, Mrs Murray. I thank the Backbench Business Committee for giving us the time for the debate. I thank those Members who are here and those who have given apologies—a number who intended to speak are speaking in the other Backbench Business debate in the Chamber—for their support. I also thank those members of the International Development Committee who are here.
In preparing for the debate, I looked back at the Backbench Business debate focused specifically on covid-19 vaccine access that I secured all the way back in November 2020. It is an odd achievement, but I was the first Member to use the phrase “vaccine nationalism” in the House. On reflection, I am saddened that, more than a year later, we are having a similar debate relating to covid and other vaccine programmes, with a number of issues unresolved.
I will focus the majority of my remarks on covid-19; it is difficult not to. In some respects things have changed considerably in the past 14 months. We now have a number of licensed vaccines in the UK, 90% of over-12s have had at least one jag or jab—whatever you prefer to call it—and more than half are fully boosted. I commend and thank all those who have worked tirelessly to create these vaccines and to ensure that they reached the public and those who need them. However, it has sadly not all been good news.
In November 2020, we were only just hearing about the delta variant spreading in India—a strain that would not enter the UK until February last year. We almost never talk about it now, as in a few short weeks from the end of year, omicron spread throughout the world and entered the UK. It was a stark reminder of something that has been said many times before: we are simply not safe until everyone is safe. While 90% of over-12s in the UK have had at least one vaccine—my own children are part of that number—that falls to 60% of the world overall.
Many countries—it will not surprise Members that it is mainly low-income countries—have hardly any access to covid vaccines. Some 2.3% of those in Nigeria have had a vaccine, 1.4% in Ethiopia, 9.8% in Afghanistan, 5% in Syria, 1.2% in Yemen and only 0.1% in the Democratic Republic of the Congo, to name just a few; I could obviously go on. It is unsurprising that the consequence of this is that new variants emerge elsewhere and spread quickly through those unvaccinated populations, eventually reaching the UK. No borders, physical or otherwise, can prevent that in what is an interconnected world.
That is why we are having this debate. In that previous debate, the Minister responding, the hon. Member for Aldridge-Brownhills (Wendy Morton), told us:
“The UK is proud to be at the forefront of international efforts to develop vaccines, treatments and tests and ensure equitable access for the world’s poorest countries”.—[Official Report, 5 November 2020; Vol. 683, c. 575WH.]
Clearly, the situation has not moved at the pace required. I am sure the Minister will point out that the UK has pledged to donate 100 million vaccines, and that the Government reached their target of donating 30 million of those before Christmas. However, we know that getting vaccines out of the UK is only the first part of the story. We have to think about what happens to those vaccines when they arrive. Organisations on the ground report that vaccines arrive in an ad hoc manner, sometimes with little notice. Too often, they arrive with a limited shelf life, leaving in-country health teams—already overstretched, as health teams all over the world are—scrambling to get doses out to people in time. There is also no requirement currently for donations to be sent with necessary supplies, such as syringes and dilutant in order to administer those doses. Without those, a vaccine in a tube is arguably completely useless.
The United Kingdom donates vaccines that it has purchased and deemed surplus to requirements here in the country. That might suit the Government as a way to marry up vaccinations at home with meeting our commitments abroad, but sadly it leads directly to the position that I have just described, so I ask the Minister to address the following questions. Who decides what donations will be made, and when? What processes are in place to ensure that doses are sent in a timely, regular and predictable fashion? Will the Government commit to end the policy of over-purchasing vaccines and donating the surplus, and will they instead commit to putting a policy in place whereby vaccines are donated in large volumes and in a predictable manner, to allow countries to plan their roll-outs?
Will the Government publish the timelines for expected donations from the UK in the coming months as the UK sends the additional 70 million donations that it has pledged? Will they commit to ensure that donated doses have a minimum 10-week shelf life when they arrive in a country, with the exception of when individual countries have stated that they are prepared to take doses with a shorter shelf life? It is clear that in several of the countries that I have described, there are simply not the internal mechanisms in order to be able to deliver vaccines before they expire. Finally, will the Government commit to donate syringes with the vaccines, to ensure that they can actually be used on arrival and that that is something else for countries not to worry about?
I would be grateful if the Minister could address accounting for the cost of the donations. If doses of vaccine are purchased by a country for use on its own population and are then donated, which is exactly what is happening in the UK, the donations are being accounted for in our official development assistance—ODA—budget. To put it more clearly, the Department for Health and Social Care and the Foreign, Commonwealth and Development Office have budgets. The Department for Health and Social Care is using some of its budget to buy vaccines, and when it cannot use them, the FCDO donates them.
However, the FCDO then gets to say that it has purchased those vaccines from its ODA budget, thus artificially reducing the amount of money left to spend elsewhere. Even more concerning is the fact that the UK Government could account for those doses in the ODA spend at a higher price than they paid for them, thus effectively saving money that was committed elsewhere. I ask the Minister to clarify whether this is indeed her Department’s approach. Will she commit to account for the donations outside the ODA budget? If her Department is not in a position to do so, will she commit to ensure that the donations continue to be accounted for as part of ODA at their actual purchase price?
These are partially problems of oversight as we respond to a global pandemic at speed, but they are related to the problem of the Department for International Development being subsumed into the Foreign Office. They are problems that I warned about when the merger was first proposed, and I secured an urgent question on the merger in June 2020, but here we are, potentially dealing with some of those problems at a time when efficacy is key to successful delivery.
I welcome the fact that there remains a Select Committee dedicated to scrutinising international development work. I have already referred to its Members who are present, and I wholeheartedly commend their work, but it says everything about how the Government are treating international development that when I was preparing for the debate, it was not initially clear which Minister would be answering. That is because there is no longer a Minister responsible for international development. I am delighted to see the Minister for Africa, Latin America and the Caribbean here today, and I look forward to her remarks, but it is not the same as having a Secretary of State or even a named Minister responsible for international development as a portfolio.
This is part of a broader narrative—a narrative of the Government stepping back from our commitments to the wider world. I am sure the Minister will say that we are better than other countries in this space, but that is just not good enough when we are stepping back and damaging our historical reputation as world leaders. As we all know, we have cut ODA spending from 0.7% of GDP to 0.5%. It is an action, but not the right kind. Yes, there is a promise to restore spending at some point in the future, but there is no clarity about when that will be. The Chancellor was not as clear as he could have been, and an increase in the future does not help those in need now.
Cutting ODA spending hurts us all. The Minister will know the importance of having soft power on the ground, making friends and being trusted. Cutting spending, programmes and assistance simply does not do that. I have previously spoken in this place about the impact on the British Council. It is the same thing, because such actions break that trust. They destroy our friendships and reduce our power. We cannot be global Britain when the Government choose to step back.
I want to refer briefly to the fact that ODA cuts also hurt us at home. The University of St Andrews in my constituency of North East Fife receives funding for research projects through ODA spending. I have spoken previously about how cuts in that spending have put research projects at that university at risk. I am sure the Minister will say that our scientists have led the way in getting a vaccine in the first place, which is right, but what message does it send about how we value this research when its funding is at risk? Without that funding, will we be prepared for whatever comes next?
While we can improve how we are donating vaccines, this will not be the whole solution. COVAX does not aim to vaccinate whole countries. We will be safe only when countries are able to vaccinate their populations themselves. I have just spoken about the importance of incentivising and paying for research, but it is not contradictory to say that we must also engage with discussions about how low-income countries can manufacture their own vaccines.
The trade-related aspects of intellectual property rights waiver has been on the table for discussion for months. Why are the Government not at least engaging with these discussions? What do the Government plan to do to meet the covid vaccination need without such a waiver? If there is a plan about this, I would be keen to hear it, as donations will simply not be enough.
In a debate about global vaccine access, it would be remiss of me to talk only about covid. While covid has dominated the health agenda for the past two years, other diseases continue to spread. When it comes to routine immunisation services, the UK has a commendable record and is the largest sovereign donor to GAVI, the Vaccine Alliance, but the pandemic has severely put back GAVI’s work.
In 2020 alone, 3 million more children missed out on a measles vaccination than in 2019. Yes, it is vital that low-income countries get urgent access to covid vaccines, but once that is done, we must tackle the backlog of missed immunisations. It is money well spent, as $1 spent on immunisation is estimated to save $21 in healthcare costs, low wages and lost productivity. Put simply, we keep people alive. Will the Minister today commit to maintaining the £1.65 billion donation to GAVI that the Government have committed to between 2021 and 2025?
Having praised our work with GAVI, the UK’s record with other vaccination programmes is sadly less laudable, with a 95% cut in our commitment to the Global Polio Eradication Initiative. The Minister might say that they committed £100 million as planned, but with only £5 million actually delivered, there is no other way to describe this as anything other than a brutal cut that will have a catastrophic impact on the delivery of services. Do we really want to see polio return in the 21st century? Is the legacy of battling covid-19 going to be tens of thousands of people infected with a disease that we were close to eradicating? Will the Minister commit to reinstating this funding as a matter of urgency?
It is very simple. What we have learned in the past two years is that health is a global issue. It is not just right to support worldwide health initiatives, but it benefits us too. When it comes to covid, we have seen that a global pandemic is exactly that: global.
I start by thanking the healthcare workers, NHS staff and volunteers who have helped Britain to have one of the most successful coronavirus vaccination programmes in the world. I also pay tribute to our scientists who have worked to develop coronavirus vaccines, and thank the Government for funding this vaccine development. I was grateful to receive my vaccines at the Kingston Centre and St George’s Hospital in Stafford, and I was delighted to hear that over 2.5 million vaccines were given in the west midlands in December alone. Seeing the vaccine roll-out in my own Stafford constituency has made me passionate about the need for global vaccine access.
Britain has always been at the forefront of global healthcare. The efforts of consecutive British Governments and the generosity of the British public has helped to eliminate many diseases globally. Britain was a founding member of GAVI, the Vaccine Alliance, and this Government are continuing to champion access to vaccines.
As Chair of the International Development Sub-Committee, I welcomed the Independent Commission for Aid Impact’s recent information note on GAVI that highlighted the need to establish worldwide vaccination programmes for dangerous diseases, such as polio, as well as rolling out coronavirus vaccinations. In September, I met with GAVI at its headquarters in Geneva, to discuss the coronavirus vaccine roll-out, and to ensure that the poorest and most marginalised communities in the world are not left behind.
I welcome that Britain is one of the most generous donors to GAVI, pledging £1.65 billion from 2020 to 2025. During the height of the pandemic in June 2020, Britain led the hosting of the GAVI replenishment conference, and I was pleased that fundraising target the was exceeded, with world leaders pledging $8.8 billion. That was a crucial step in tackling the coronavirus pandemic, which, as we know from experience, shows that vaccines do work in protecting us from infectious illnesses.
Polio provides another example of how vaccines can be used to tackle terrible diseases. In 1988, over 70 million people worldwide were infected with polio, and more than 350,000 people developed paralytic polio. The Government’s generous financial support for the Global Polio Eradication Initiative meant that 2018 saw only 33 cases of polio worldwide. That represents millions of people being saved from the perils of polio by one simple vaccine. That is a real example of how vaccination programmes do work, and why we must follow this model and continue to provide global access to vaccines in order to end the coronavirus pandemic.
I repeatedly raised the importance of COVAX with the then Foreign Secretary, my right hon. Friend the Member for Esher and Walton (Dominic Raab), and have done so again with other Foreign Office Ministers, including raising the issue in the Chamber and in International Development Committee evidence sessions. I welcome that Britain took the lead regarding COVAX when hosting the G7 last summer, committing the UK to providing 80 million vaccine doses and helping to secure commitments to COVAX of nearly $10 billion from other developed countries. The Government should be commended for meeting their ambitious target to donate 30 million vaccines to COVAX by the end of 2021.
On my visits to Kenya, as trade envoy, I have seen at first hand the difference these COVAX vaccines have made. On my most recent visit in November, I went to the Kenyatta University Hospital and met with Kenyan doctors and healthcare professionals. This hospital in Nairobi works in partnership with the University of Manchester in order to improve healthcare treatments and tackle infectious diseases. The British also developed the Oxford AstraZeneca vaccine, which has helped to save lives and improve the life chances of people living in Kenya; I am pleased this has been replicated across the Commonwealth, with over 2.5 billion doses being used in over 170 countries. At the G7 the Prime Minister said that we need a plan to vaccinate the world. If we want a definitive end to this pandemic, then I agree with him.
One of the reasons for the pernicious spread of coronavirus, and the high global death toll, is the failure of Governments, such as ours, to support the Agreement on Trade-Related Aspects of Intellectual Property Rights waiver, proposed by the Indian and South African Governments last summer, just months before the omicron variant emerged. That was despite India and South Africa proposing, as far back as October 2020, that a waiver of intellectual property rules on covid-19 vaccines, tests and treatments would allow low and middle-income countries to manufacture life-saving tools. Despite most countries, including the United States, supporting the waiver, the UK, the EU and Switzerland all prevented progress.
Action at the time would have led to life-saving covid vaccines, medical equipment and medicines all being produced licence-free. However, more than a year after the start of the global vaccination drive, our Government are still putting hundreds of thousands of lives at risk by not supporting the waiver. The reality is, as we all know, that no one is safe until everyone has access to vaccinations and all nations are immunised.
Sadly, instead of supporting lower and middle-income countries, our Government have actively blocked them from making their own vaccines and have continued to oppose a waiver on intellectual property rights. I would therefore like to hear the Minister respond to the concerns that she and her colleagues are continuing to block solutions to the covid pandemic, given the severity of the crisis affecting both the NHS and the economy as a result of rapidly escalating levels of omicron cases. Denying lower and middle-income countries full, unfettered access to vaccines is incredibly short-sighted and will lead to a situation whereby our own population will remain at risk.
A global disease needs a united, global effort to eradicate it and reduce the risk of further mutations. An intellectual property rights waiver is therefore a vital way to achieve that, and we must follow the lead set by the Biden Administration in supporting that. The Government abolished the Department for International Development. That was extremely short-sighted and regressive, and will ultimately cost many, many lives. What happened was shameful. To put the situation into context, in a six-week period over November and December, the EU, UK and US all received more doses than African countries took stock of in the entire year. That is truly shocking.
I will finish on the point that, despite having already made billions in profit, Pfizer and Moderna continue to refuse to share the new generation of vaccine technology with the World Health Organisation’s mRNA hub in South Africa. That is a major concern, and little appears to have been done since Amnesty International urged Governments, including our own, to deliver 2 billion vaccines to low and middle-income countries before the end of 2021. The continued failure to act will fuel an unprecedented human rights crisis and lead to an untold number of deaths in those countries. We must do more, and the Government have to do a lot better.
I want to report to the House from my privileged position as chair of the British group of the Inter-Parliamentary Union. When we had our first in-person gathering of the Parliaments of the world in Madrid in November, one motion came out top of all of the motions put forward from all the Parliaments in the world. Over several days we were able to come up with a form of words that every single politician from every single Parliament that attended was able to sign up to. I want to share it with the House because it demonstrates the value of the work across Parliaments, and also addresses some of the points that the hon. Lady raised in her opening remarks that would make it difficult for me or perhaps even the Government to support everything that she asked for. If Members look up on the internet the Inter-Parliamentary Union minutes of the meeting, they will find links to the motion. I call upon colleagues to look at that because I do not have enough time to go through all of it.
The motion’s crucial wording is around the issue of the World Trade Organisation. There were German parliamentarians at the IPU who would not have been able to support the TRIPS waiver wording, but parliamentarians did work together and came up with some wording that everyone was happy to endorse. It implores parliamentarians to work with their national Governments to exert a global, collective influence on the World Trade Organisation to eliminate all export restrictions and other trade barriers on covid-19 vaccines and the inputs involved in their production. This issue is so important because, as we heard in the opening remarks, we will not be safe until everyone in the world has been vaccinated. The more parts of the world lag behind us on vaccination rates, the more the virus will be able to mutate.
Extensive covid-19 immunisation is a global public good. Although the Government are doing much good work in this area, I call on them to do even more, because it is so important to our health. It is a development issue; it has never been so obvious to everyone in this country that by helping others around the world, we help ourselves. Let us do it. Please read the motion that we all agreed.
“stain on our global soul”.
The numbers are stark: three quarters of health workers in Africa remain unvaccinated; less than 5% of people in low-income countries have been fully vaccinated. Companies such as Pfizer have made huge profits from their vaccines, but just 1% of its global supply has been delivered to COVAX.
Corporate philanthropy is not going to solve this crisis. We cannot sit back and hope that the pharmaceutical giants will do the right thing; to do so is a death sentence for millions of our fellow human beings. I have to say, in terms of the Government’s performance, that the UK has disgraced itself by voting to block the temporary TRIPS waiver that would put human life above private profit.
As has been said time and again, we live in a global world and we will not be safe from the virus until we are all safe. We know that the more there is transmission anywhere in world, the more likely that new variants will emerge; some will be more virulent, and others may be more lethal than omicron, although hopefully most will be mild.
As campaigning group Global Justice Now has said:
“Until we allow low and middle-income countries to access covid-19 vaccines, we will be trapped in an endless cycle of variants”.
If we want this pandemic to end, we have to stop its global spread—that means vaccinating everybody. The first way to achieve that is for the UK to stop blocking the TRIPS waiver at the WTO; secondly, to encourage UK pharmaceutical companies to share their technology with the World Health Organisation covid technology access pool and the mRNA technology transfer hub in South Africa.
A lot has been said about windfall taxes in recent days. Pharmaceutical companies have made windfall profits, largely derived from public funding. If they do not start sharing their vaccines and technology and start saving lives, I can think of no better circumstance for a windfall tax, with every penny used to fund vaccines around the world. If any Conservative Members are anxious about that, let me just say that it was Rab Butler who introduced a windfall tax 70 years ago this March.
I believe the time to act is now. The Government can do the right thing—they can save lives. If they do not act, their inaction will be, as Gordon Brown said, a stain on our global soul.
I want to take this opportunity to remember my friend, the former Member for Birmingham, Erdington, who made his last speech last Thursday while I was in the Chair. Our thoughts are with his family. He was a wonderful colleague and friend to so many of us, and he was a powerful advocate for international justice and standing up for those who are vulnerable; his last speech was about the settlement of Afghans.
Today, we debate the need for vaccinating the world and protecting people in some of the poorest communities around the world. In that spirit, I want to highlight a number of points. First, we are all incredibly grateful to the NHS and all those who have been involved in the vaccination effort in our country. As we mark the tragic milestone of 150,000 fellow citizens having lost their lives in our country, let us not forget that the battle against covid is not over, as many hon. Members have said. That is why it is important that we recognise both the moral imperative, as has been pointed out already, and the economic imperative. It is in our self-interest, as well as in the interests of the rest of the world, to work to vaccinate the world.
The UN Secretary-General said,
“COVID-19 is menacing the whole of humanity–and so the whole of humanity must fight back.”
Sadly, many Governments across the world have been found wanting, including our own. We have seen the failure to meet the target that has been set to vaccinate sections of the population in different countries. Dr Tedros Adhanom Ghebreyesus, director general of the World Health Organisation, said,
“More than 5.7 billion doses have been administered globally, but only 2% of those have been administered in Africa.”
That is the case in many parts of the world. Former Prime Minister Gordon Brown, who has been quoted today, pointed out the many huge economic benefits that the UK and other countries would gain if we vaccinated the world. That is why it is important in terms of preventing new variants from taking hold and from undermining our economy, our security and our own health, as well as global health, but also getting out of this continuous battle with the pandemic.
We will not be able to end the pandemic if we do not act together. We must remove the barriers and ensure people around the world are vaccinated, backed by resources from our Government. That is why it is important that the Minister addresses the issues that have been raised so far.
The UK Government’s overemphasis on vaccination as the sole plank of infection management is deeply problematic, but even with the vaccine success delivered by Dame Kate Bingham, they have placed all their eggs in the mRNA basket. That is the wrong move. The Valneva vaccine is the only adjuvanted, inactivated whole virus covid-19 vaccine candidate in clinical development in Europe. The UK Government pulled the contract just before the phase three results were published, which demonstrated the vaccine to be highly effective and safe.
In addition, the safety and efficacy of the Valneva vaccine was questioned by the Health Secretary, who said in the House of Commons on 14 September that
“it was also clear to us that the vaccine in question that the company was developing would not get approval by the Medicines and Healthcare Products Regulatory Agency”.—[Official Report, 14 September 2021; Vol. 700, c. 820.]
That statement was untrue and had to subsequently be corrected. We have had the correction, but the company is still awaiting an apology. Importantly for the purposes of the debate, I will focus on the clinical advantages, over solely relying on mRNA. Inactivated vaccines are a well-established, tried-and-tested technology used over the last 100 years to vaccinate billions, including for seasonal flu, hepatitis A, polio and rabies, so the Valneva vaccine could play a vital role in tackling vaccine hesitancy among the general UK population. From a purely public health perspective, its availability and use could help to close the vaccination gap by increasing coverage among those who remain unvaccinated or are hesitant about novel mRNA technologies.
All of this is important, but the great advantage for global vaccine access is that the Valneva vaccine would allow the UK to meet its global humanitarian responsibilities by supplying such vaccines to COVAX, the international vaccine-purchasing agency. The Valneva vaccine does not require the same complex cold-chain infrastructure, making it easier to store, distribute and deploy internationally. Dame Kate Bingham said that the decision to cancel the Valneva contract was “problematic on various counts” and “short-sighted” and, in her lecture on 23 November, she said that it was “inexplicable”. Do the UK Government not get that?
We are deeply lucky to live in a country that can afford and has access to the newest vaccines in sufficient quantities. Millions, indeed billions, of people around the world would beg, borrow or steal to have only the issues that we do. We are always griping about healthcare—the long waits and the crowded surgeries—but we know we are the lucky ones. I am ashamed of the speed of our response to the need for vaccines in other countries. Human Rights Watch estimates that about 75% of covid vaccines have gone to just 10 countries. Vaccines are key to preventing innumerable diseases but, sadly, eradication is often not possible because not enough profit is on offer.
Tuberculosis is a prime example, and I am pleased to declare an interest as chair of the all-party parliamentary group on global tuberculosis. TB was mostly eradicated in this country 50 years ago, although several thousand cases still occur yearly. Across the globe, however, millions of lives are blighted by it. That is because there is no economic impetus to develop a vaccine, but that is what the world needs. Investing in vaccines is cheap in comparison, so let us use this horrific pandemic as a wake-up call that strengthening health systems is cheap compared with what could happen.
In what little time I have available, I want to speak further on fulfilling our international responsibilities. The amazing work of multinational teams of researchers and scientists in British laboratories and, indeed, those everywhere have taken vast strides for humanity in the last two years. The knowledge, though, must be shared—not kept as a trophy, but used to spread health. The World Health Organisation set a target to vaccinate 40% of people in Africa by the end of 2021, but 92 countries missed that target because of lack of access. Sadly, in relation to Nepal, the real impact, despite the warnings of civil society and the requests from Kathmandu, was that no doses came forth when they were required.
The Minister may have prepared commitments to share today, but better than that would be an admission that commitments have not always been met in the past and that action is preferable to fine words.
News of breakthroughs in the science and the race towards vaccines for things such as malaria and HIV are bright spots on what is otherwise a fairly grim global horizon, and designing in access to vaccines will be important as that research advances, too. We are absolutely blessed to live in countries that enable us to access vaccines so efficiently and allow us to get back to some sort of normality, notwithstanding the challenges that health services continue to face.
However, the inequality of access to vaccines is stark. It is now a cliché to say that nobody is safe until everybody is safe, but it is true: inequality of access is inherently unfair, and if that alone does not move people, we know that it undermines getting back to normal in this country. Uneven access to vaccines is not unprecedented: during the H1N1 outbreak in 2009, rich countries again bought up global supplies. Back then, too, self-interest dominated, despite the known risks of not getting a grip globally, and despite the fact that the interface of vaccinated and unvaccinated populations is a recipe for disaster. As others have pointed out, vaccination rates remain dangerously low, despite the fact that vaccine makers worldwide have produced enough to vaccinate the world several times over. Not only are poorer countries left without access but they are more vulnerable due to weaknesses within their health systems, and inherent weaknesses due to other diseases that present challenges.
COVAX is key, but as we know, it has not worked to best effect. It had delivered only 700 million of a planned 2 billion vaccines by the end of last year, and as others have said, three quarters of health workers in Africa have not been vaccinated. Some 16% of the world’s population live in countries that have bought up more than half of vaccine supply, and suggestions that we are choosing between our own populations and those of poorer countries are simply not true. As others have said, it is vital to ensure that the logistics are in place. This really exposes how penny wise and pound foolish the recent cuts to aid have been, leaving health services unable to vaccinate their populations.
The TRIPS waiver, as others have made clear, is an absolute no brainer. As has been beautifully said, this technology should not be kept as a trophy: claims that it would stifle innovation are bunkum. It is hard to see how we do not all benefit from access to this technology, and it is really important that this country does not stand in the way of it.
The emergence of the omicron variant signifies the truly global nature of the coronavirus pandemic. In just a few weeks from the announcement of the first omicron case on 24 November 2021, this variant was running my constituency of Vauxhall ragged, with an estimated one in 20 people in London having covid-19 on 16 December. That is a truly staggering timeline, which proves that tackling this global pandemic requires a global response. Unfortunately, what we have had is a patchwork response divided along national lines: while richer countries have been able to offer at least one dose of a vaccine to 77% of their population, poorer countries have been able to offer the same treatment to just 8%. That is profoundly unjust to some of the poorest people in the world.
We do not know who will be patient zero for the next variant, but we do know that vaccinations will help stop the spread of covid-19 within our society. We also know that in many of the world’s poorer countries, the global HIV pandemic is a serious health problem in society. Although sustainable development goal 3.3 aims to end AIDS by 2030, many countries are struggling to get to grips with the virus, and 1.5 million people acquired HIV in 2020. For those living with HIV, covid-19 can be devastating: those living with HIV are twice as likely to die after being infected with covid-19, and many people with HIV who live in poorer countries cannot get access to the vital treatment or therapy that they need.
The presence of covid-19 within immunocompromised people is not only dangerous to them but can make the pandemic more dangerous for us all. While we do not know where variants will emerge, we do know that the ability of covid-19 to persist longer in the bodies of immunocompromised patients may give it time to evolve and mutate, so tackling covid-19 in the long term may be intrinsically linked to tackling diseases such as HIV. However, rather than a step up in our efforts to tackle HIV, screening in Africa and Asia has dropped by 40% and the UK Government cut funding to UNAIDS by 83%. Will the Minister speak to her colleagues in the Treasury about reversing this cut for UNAIDS so that we can tackle these two deadly viruses together?
Huge public funding went into producing the vaccines. At least 97% of the funding for the AstraZeneca vaccine, for example, has been identified as coming from public funds, taxpayers or charitable trusts. The US Government funded and co-developed the vaccine sold by Moderna. Governments should have insisted that, in exchange for billions of pounds of public funding, vaccine producers must share any successful formula openly. Instead, our Government put the interests of pharmaceutical companies first. Companies such as Pfizer, Moderna and BioNTech make $1,000 every second in profits from covid vaccines. Putting profits first means that less than 6% of people in low-income countries are fully vaccinated. Literally millions of people around the world have died avoidable deaths, and this has created the conditions in which new variants have emerged.
I will touch on what I am afraid is our Government’s shameful role. South Africa and India led the call for a temporary vaccine waiver, allowing technology to be shared. This has now won huge international support from many Governments and from President Biden, yet our Government, along with the Government of Germany, have been leading the opposition, putting profits before lives by blocking the global sharing of vaccine patents that would allow poorer countries to produce their own vaccines. A frankly racist idea, spread by those who make vaccine profits, is that Africa, Asia and Latin America are somehow incapable of making their own vaccines, even if patents were waived, but vaccine experts recently identified more than 100 companies in Africa, Asia and Latin America with the potential to produce mRNA vaccines.
Even if people are not morally outraged by the millions of unnecessary deaths, there is a simple additional reason to back the waiver: no one is safe until everyone is safe. The virus will keep winning if profit is put first. The covid-19 vaccine must be for the global public good—a people’s vaccine, not a vaccine for profit.
It is certainly true that all of us have gained from the researchers who have developed new vaccines, and I pay tribute to the staff of the four national health services across the UK for the speed and skill with which they have delivered them. We have vaccinated almost 80% of adults with a third—or booster—shot, whereas access to even one shot in low-income countries is well below 10%. That simply highlights the inadequate access and inequity across the globe. High-income countries have literally hoovered up the vaccines as they were developed over the last year. That is indefensible. It is very reminiscent of AIDs, when people in Africa who were suffering from HIV or AIDs could not access the treatments that were available in the richer countries.
Last spring—well, actually, the spring before: 2020; I keep forgetting it is a new year—we heard lots of warm words about a global response to a global crisis. That is simply not what we have seen. We have seen that COVAX was established, and that the UK Government gave more than £500 million to it, but they did not give any vaccines until quite late last year. COVAX was meant to procure directly from companies. That never happened. Therefore, COVAX has ended up completely dependent on getting donated doses from wealthy countries that simply did advance procurements. That is the reason COVAX has delivered less than half of the 2 billion doses it was aspiring to deliver last year.
The UK Government promised 100 million doses in June 2021 at the G7—80 million to COVAX, and 20 million bilaterally. Less than a quarter of that has actually been delivered to COVAX. We are at the beginning of 2022. The 100 million is meant to be delivered by this coming June, which means 9.1 million per month to COVAX and a total of 11.5 million if we include any bilateral donations. The UK needs to radically step up donations of doses. That is the acute response, because that can be done in the short term. The UK has enough excess that it could carry out its third doses—and for many vulnerable patients, fourth doses, which I have had myself, as an immunocompromised person—and still accelerate the donation of doses to more than meet its target by June.
The problem is that wealthy countries think they can protect their own populations purely by vaccinating them. Omicron shows that that simply is not true. When we have large parts of the world, particularly in the global south, with low access to vaccines, that will generate high spread, and therefore more mutations—eventually, there will be new variants. Some of those variants may be as infectious as omicron—as transmissible and as good at escaping either natural immunity or previous vaccination—but may turn out to be much more severe. The fairy story that, inevitably, a virus is committed to becoming milder, is something that we are not in a position to count on.
We still, right now, two years into this crisis, need a global response. I therefore call on the Government to accelerate their donations, using the excess that we have. However, those must be predictable and in collaboration with the low-income countries that are receiving them. They also must have a decent shelf life.
We heard of Ministers having to visit their ports, every day, in case something had arrived. They had to keep stopping their own programmes because, suddenly, they got a delivery with a few weeks left on it. That is disrespectful to countries that do not have the health infrastructure that we have across the UK. It is critical to include consumables such as syringes and needles. It is also important to try to support the wider covid-19 responses.
Anyone looking at the WHO data will notice the incredibly low levels of covid—supposedly—in Africa. Africa does not have low levels; it has low levels of access to tests which means that cases are not being registered. We should not be using the doses as part of the already-reduced ODA budget, and certainly not charging more than the UK Government have paid for them.
That is the short-term approach, but the medium-term approach is to massively increase global production. The problem is that the TRIPS waiver has been being discussed for basically over a year. We would be in a totally different position if that had been moved on at the beginning. The UK is one of a dwindling number of countries that is blocking it. Over 130 countries now support it.
It is important to recognise that most of the leading covid-19 vaccines have been developed with public funding, either from university settings, which are largely publicly funded, or through the huge injection of funding made by the UK, US and EU Governments, and others. We touched on polio. The fact is that Salk did not patent his vaccine, Alexander Fleming did not patent penicillin and Röntgen did not patent X-rays, because they saw them as part of the global good.
As well as getting rid of the blockage of intellectual property rights and patents, it is important that there is proper sharing of data and technology transfer. Médecins Sans Frontières has identified 100 companies across Africa, Asia and Latin America that are certified by the European Medicines Agency, the United States Food and Drug Administration or the WHO for good manufacturing practice. To imply that it is not possible to produce vaccines to high qualities in the global south is frankly insulting.
The technology of messenger RNA vaccines holds hope for action against many tropical diseases in the future, such as TB, malaria and others. Sharing that technology now is not just about dealing with covid-19. It opens up the ability to tackle the scourges of infectious diseases that many countries face.
The UK should be increasing production of vaccines, to become a net exporter, instead of an importer. It is inexplicable why the UK Government pulled funding from the Valneva production site in Livingstone, when the trial data was about to be published. That vaccine was successfully developed using a traditional whole-virus approach, and people who were unwilling to take the messenger RNA vaccines may have been willing to receive the Valneva vaccine. It has not yet been trialled, but because it uses a whole-virus approach, it may provide a broader reaction that remains viable even when other variants arrive.
In comparison to delta, which had four mutations on the spike protein, omicron has 32 mutations. It is a totally different shape. Therefore, sadly with the AstraZeneca vaccine, the key no longer fits the lock. Pfizer does, but it wanes. We need to have broader vaccines so that we might be a bit more resistant to variants in the future.
The Government must maintain their support for routine vaccination. That means honouring the replenishment commitments to GAVI, because routine vaccinations have suffered due to the disruption of the pandemic. The UK has always been a leading funder of vaccination, and it must not pull back now. We must also think about future pandemics. The replenishment of the Coalition for Epidemic Preparedness Innovations is coming up this year. The UK needs to commit to that.
We are all talking about the humanitarian and the moral need to support people in poorer countries to have the access we have had, but on top of the lives lost and the huge, multi-trillion economic hit to the world, it is important that we recognise that this was a global challenge. The international community has failed, so far. If we cannot get our act together now in facing this, that does not give great hope for that other challenge—the climate crisis.
From the very start of the pandemic, Labour and I have been clear that achieving global vaccine equity is a moral and economic imperative, yet the Government have failed time and again to answer the calls from our partners abroad, and the result is a catastrophic disparity between the countries that have and the countries that have not.
The facts speak for themselves. In the west, 70% of adults have received a vaccination, but many people in the world’s poorest areas are yet to receive a single dose. Nowhere is the covid divide clearer to see than in Africa, a continent in which immunisation rates in many countries are below even 1%, and three in four healthcare workers are yet to receive a single dose. The EU, the UK and the US received more doses in the last weeks of 2021 than African countries received all year.
From our own struggles with the pandemic, we know how desperately important it is to get jabs into arms, and of course we encourage everyone to get vaccinated; it is the way that we beat this virus. Yet why is it that when it comes to the rest of the world, last year we lagged behind the EU, the US, France, Germany, Italy and Canada in the number of doses donated to low and middle-income countries? I know that the new Foreign Secretary is perhaps a bit distracted at the moment with her own leadership ambitions, but seriously, is this global Britain? The world is right to wonder why this Government have fallen so far behind. Although Britain could be once counted upon to be a dependable and trusted leader on the world stage, our reputation has been tarnished by the Government’s failure to heed warnings about the virus mutating in less vaccinated regions and to take decisive action.
With the COVAX facility falling short of its pledges last year by over a billion doses and revising down its forecast for 2021-22 by 25%, as well as revelations that many vaccine producers not only failed to prioritise deliveries to COVAX but violated their contractual obligations, now is the time for outward-looking nations to redouble their efforts to vaccinate the world. This is not a question of trying to achieve the impossible, nor is it a choice between jabs at home or jabs abroad. We have the expertise, the technology, the resources and the production capacity, so what is stopping us?
First, there has been a shameful level of mismanagement. It is an absolute scandal that despite repeated promises by the Government to distribute surplus vaccines, more than 600,000 doses of the AstraZeneca vaccine had to be destroyed after passing their expiry date in August last year. In the same month, it emerged that the UK had taken 500,000 doses from COVAX that were meant for poorer countries. What on earth was going on? The reality of the global vaccination effort is that the increasing reliance on ad hoc donations from high-income countries to fill the gaps has meant vaccines arriving in countries late, with little notice and limited shelf lives. That makes it impossible for people in those countries to plan vaccination campaigns and increase absorptive capacity so that they can get those jabs into arms.
I note that of the 30 million doses that the UK pledged to donate last year, only a third had been delivered by November, with the Government leaving it until the absolute last minute to fulfil their promise. Life-saving health interventions must not be treated like essay deadlines. We must do better and give countries adequate notice, with transparent and ambitious timelines, as well as a good level of shelf life on doses when they arrive.
Striving for vaccine equity is not only a moral imperative, but wholly in Britain’s best interests. We know from painful experience that viruses evolve and mutate. Our country’s heroic efforts in the fight against covid have been seriously set back not once, but twice, with the emergence of the more transmissible delta and omicron variants. Neither of those variants originated in the UK, but once they arrived here they quickly swept the country. That is why it is so important that our fight against covid is global.
We know, with great sadness, that another strain of this deadly virus will emerge if we continue down our current path. That is why it is unbelievable that the Government cut by 70% research programmes that track variants. As Gordon Brown so rightly pointed out:
“The grim truth remains that until no one anywhere lives in fear, then everyone everywhere will have to live in fear.”
Simply put, the current pandemic is not something that we can booster our way out of. As the emergence of omicron has shown us, as soon as a booster is administered in the west, another strain of the virus may mutate elsewhere, most often in the fertile breeding grounds where vaccinations are difficult to access.
We must remember that striving for global access to vaccines also makes economic sense. Covid is not just a health emergency but an economic emergency, and instead of being preoccupied with how much global vaccination would cost, we would be better served by considering how much it would save.
Will the Minister therefore confirm how much it costs us per dose to procure vaccines, and will she tell us at what price doses are currently being accounted for on the Government ledgers? Does she agree that donations to low and middle-income countries should not be counted towards the 0.5% ODA target? The sooner we can put an end to the health crisis, the sooner we can put an end to the economic crisis. Only when we can confidently say that the pandemic is over will global supply chains be able to adjust, our economy recover and businesses have the confidence to invest and thrive.
As the managing director of the International Monetary Fund put it, the costs of ensuring global vaccine equity would be
“dwarfed by the outsized benefits”,
with economies likely to see
“the highest return on public investment in modern history.”
This is not rocket science. It is the common sense that Opposition Members have been pleading with the Government to adopt since the pandemic first began.
If the Government are serious about global Britain, they also need to be serious about global health. If we are to have any chance of stamping out this virus once and for all, we need to work with national Governments to ensure that those with the greatest need can access vaccines, regardless of their location or the depth of their pockets. Labour has led the way on this issue, setting out the steps that the Government should take. I encourage the Minister to look at the 10-point plan that the former shadow International Trade Secretary, my right hon. Friend the Member for Islington South and Finsbury (Emily Thornberry), and I laid out in May last year.
In particular, I urge the Government to show global leadership by working with other Governments to negotiate a temporary patent waiver with the World Trade Organisation to allow developing countries to speed up their own vaccine production. The UK is out on a limb on this now. The majority of countries around the world have expressed support for the TRIPS waiver. It is backed by hundreds of human rights lawyers, IP scholars, civil society organisations, economists, medical experts, scientists, most Commonwealth countries and the First Ministers for Scotland and for Wales, as well as by India, South Africa, New Zealand, Australia and the US. Only the UK, Switzerland and the European Union are still blocking this. There are more than 100 manufacturers across Africa, Asia and Latin America with the potential to produce mRNA vaccines. Let us give them the tools to manufacture more of the vaccine and get the world jabbed as soon as we can.
Finally, I urge the Government to leverage the UK’s world-leading expertise and work in close co-operation with national healthcare providers and trusted partners on the ground to ensure that systems are in place to allow vaccines to be distributed in an efficient and swift manner. After all, there is little point in turbocharging global vaccine production if those vaccines cannot be distributed to the people who desperately need them.
As we enter the new year, the Government have an opportunity to finally do the right thing. As a proud, outward-looking nation, we simply cannot continue down our current path, looking on as spectators while the world suffers vaccine apartheid. To do so would be not only grossly unjust, but catastrophic to the UK’s interests—our reputation, the world economy and our security.
The Government must commit here today, without qualification, to taking the urgent steps that Labour, Gordon Brown and so many more have urged all along: to look beyond our borders, recognise our mutual common interests and do the right thing. Let us make 2022 the year that we close the great covid gap and do our part to vaccinate the world.
It is now almost two years since the start of the pandemic. We have seen extraordinary and unprecedented progress in so many areas, but too many people across the world remain unvaccinated and vulnerable to the virus, particularly in lower-income countries and in the most marginalised communities.
[Mr Philip Hollobone in the Chair]
Our G7 and UN Security Council presidencies last year drove an important international response on vaccine access. It included a G7 agreement to share and finance at least 1 billion doses for developing countries by June this year. Furthermore, last month, within days of becoming aware of the omicron variant, we convened G7 Ministers to agree a co-ordinated response. On 30 December, the Foreign Secretary announced £105 million in UK aid to help vulnerable countries respond to the omicron variant, including support to scale up testing, improve access to oxygen and provide communities with hygiene advice.
Last year, we also worked with a wide range of partners to design and fund the COVAX facility, with the participation of over 191 countries and territories, including up to 92 developing countries. Yes, COVAX faced constraints in 2021, but supply has increased rapidly, and the facility has delivered to 86 low and middle-income countries. We were a founder and, with our commitment of £548 million, we were one of the largest donors. The UK continues to support vaccinations through its contribution to the World Bank’s African Vaccine Acquisition Trust scheme. We have also pledged funding for developing covid-19 treatments and rapid diagnostic tests, and we have deployed emergency medical teams.
The UK has also committed to sharing 100 million vaccine doses. We have donated over 30 million doses so far, meeting our goal for 2021, and UK donations have helped to immunise health workers and those most vulnerable to covid-19.
The spokesperson for the Scottish National party, the hon. Member for Central Ayrshire (Dr Whitford), seemed to believe that the UK holds a stockpile of covid-19 vaccines. That is not the case; the UK does not stockpile covid-19 vaccines. We manage our supply chain very carefully, ensuring that vaccine doses are used and have an impact as quickly as possible, either in the UK or beyond. A number of Members spoke about vaccines that may have gone to developing countries, but were too close to their use-by dates. Right now, vaccines that are delivered by COVAX are delivered in consultation with countries that are ready and able to begin an immediate roll-out, and they are distributed in line with the World Health Organisation’s equitable allocation framework. For bilateral donations, we have sought assurance that recipients have the capacity to roll out that quantity of doses in line with their national vaccination programmes, ahead of their expiry dates.
Supply is increasing, but it needs to be sustained and consistent, so that countries can plan and implement their immunisation campaigns. A capacity to deliver vaccines quickly is now a priority of our focus. A new inter-agency global co-ordinator for delivery has been appointed to focus on in-country delivery, and several countries, such as Mozambique, Rwanda and South Africa, have already administered most of the vaccines they have received so far. Yesterday, I spoke to our team in Ghana, where right now they are vaccinating half a million people every day, and even using drones to deliver vaccines to the hardest-to-reach communities. It is a truly remarkable effort, and we donated over a million vaccines to Ghana before Christmas as part of that work.
Although our vaccine donations make a difference and are a critical source of short-term supply, I recognise that dose sharing alone will not vaccinate the world. That is why the UK also backs the Oxford-AstraZeneca model of voluntary licensing to expand the production of affordable vaccines. About 2.5 billion Oxford-AZ doses have been delivered at cost to more than 170 countries, and about two thirds of those have gone to low-income and lower middle-income countries.
In addition, last year we announced a quarter of a million pounds for the Coalition for Epidemic Preparedness Innovations in order to accelerate the collaborative development of vaccines against new diseases, including covid-19. CEPI is also providing funding to other UK institutions for the development of vaccines against other diseases, such as Lassa fever, Marburg virus disease and middle east respiratory syndrome. In March this year, the UK will host the global pandemic preparedness summit, which will mobilise resources for CEPI’s five-year strategic goal to reduce the time it takes to develop vaccines against new threats, including new covid variants.
The right hon. Member for Hayes and Harlington (John McDonnell), the hon. Members for Stockport (Navendu Mishra) and for Belfast South (Claire Hanna) and others called for an intellectual property rights waiver, but that is not the solution. There is a serious risk that a TRIPS waiver could undermine the intellectual property framework that helped to produce covid-19 vaccines, and could disincentivise future research and development investment.
On manufacturing, we are also providing technical support to develop business cases for Biovac to manufacture vaccines in South Africa, to Institut Pasteur in Dakar, Senegal and to the Moroccan Government. This technical support is helping to catalyse the investment that will see those vaccines produced on the African continent this year. We are also engaging with the new Partnership for African Vaccine Manufacturing. Focusing on supporting manufacturing on the continent of Africa is absolutely one of my key priorities. However, vaccine supply must be matched by the capacity of health systems to deliver them. We have been working to support and strengthen health systems in some of the most vulnerable countries, and we recently launched the “Health Systems Strengthening” position paper, which sets out our determination to do more on building overall capacity. As my hon. Friend the Member for Stafford (Theo Clarke) and others point out, Gavi, the Vaccine Alliance is really important, and we continue to be a leading supporter. Our commitment of £1.65 billion over five years will help to vaccinate 300 million more children against preventable disease and improve health system resilience against future pandemics.
Let us think first about what we have agreed on. We are very proud of those who are involved in the development of vaccines, and those in our NHS who are involved in the supply and delivery of vaccines within the UK. We are also all proud of the UK’s previous record as a global leader in international development.
However, our differences of opinion, which became clear in the Minister’s concluding remarks, are about whether the UK is doing enough, whether it should be doing more and how it should be doing it. In relation to the TRIPS waiver, I absolutely get the intellectual property considerations, but why do 130 countries feel differently from the UK in that regard?
I say to the hon. Member for West Worcestershire (Harriett Baldwin) that I looked at the IPU bits, and unfortunately it felt a little bit like COP26; where we have got to is the equivalent of moving from “phase out” to “phase down”, and there is clearly more to be done there. On Valneva, which the hon. Members for Kirkcaldy and Cowdenbeath (Neale Hanvey) and for Central Ayrshire (Dr Whitford) raised, if we can develop a vaccine that does not have those storage requirements, I do not know why we are not looking at that.
There was a degree of disquiet on this side of the Chamber when the Minister talked about donations. I saw somebody on Twitter say, in response to the debate, that our current approach is a bit like clearing the pantry of food that is about to expire, donating it to a food bank and feeling like a philanthropist.
Finally, there were lots of stats in the debate, and I thank the Members who raised them. As we have seen over the past few days, statistics are loved ones—they are people.
Motion lapsed (Standing Order No. 10(6)).
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