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Global Vaccine Disparities

Volume 718: debated on Wednesday 13 July 2022

[Relevant documents: e-petition 605158, Ensure global and equitable access to vaccines, tests, treatments, and PPE, e-petition 565462, Donate surplus Covid-19 vaccine doses to poorer countries and e-petition 596403, Increase donations of and funding for COVID 19 vaccines to developing countries.]

I beg to move,

That this House has considered disparities in the global distribution of vaccines.

I submitted a request for this morning’s debate because I want to draw attention to the grotesque inequalities in the distribution of vaccines to tackle the covid crisis. When we convene for these debates, often it is to seek more information from the Government or to make a request for changes in policy. Now that there will be a change of Prime Minister and potentially a rearrangement of the Government, including of Ministers responsible for this area in particular, this is a particularly opportune moment to place all the issues on the agenda and hopefully see some change. It is also worth using these debates to record one’s position, because when our children and grandchildren look back in decades to come on the Government’s performance, I think they will ask why we did so little to intervene effectively when there was such a huge scale of human suffering across the globe.

The global vaccine story is one of gross inequality. I heard the Prime Minister when he made the statement that it was greed that brought us the vaccine. It was not greed; it was public money. Very significant public resources went into all the vaccines. However, greed was certainly responsible for the obscene inequality that followed.

Over the last year, the richer an economy was, the more likely that country was to have vaccines. At the top end, it would likely have had far more than it needed, and at the bottom of the scale, many countries had almost none at all. Still today, just under 20% of people across the African continent as a whole are fully vaccinated, and only 16% of people in low-income and poor countries are vaccinated. The Prime Minister has talked about vaccine hesitancy being the main factor accounting for that. That is simply untrue. Studies have shown that there is far more vaccine hesitancy in the United States than in most African countries. However, the way that the giant pharmaceutical corporations—big pharma—and richer countries have behaved has certainly fuelled that scepticism, which should worry us all.

The problem is not simply a lack of solidarity or generosity, although that is shocking in itself. As my hon. Friend the Member for Birmingham, Edgbaston (Preet Kaur Gill), the shadow Minister for international development, recently uncovered, a year ago the Prime Minister promised to share 100 million surplus vaccines with the world’s poorest countries. That is a very small amount, but at least it is something; yet a year later, barely a third have been delivered.

Those are the doses that we had already bought and were otherwise going spare. They would have been thrown away if they had not been distributed, yet they counted against the aid budget. In fact, it gets worse: we charged the aid budget double what the UK was widely reported to have paid for those doses. The Government had charged around £4.50 per dose versus the £2.30 per dose that they paid, as reported by The British Medical Journal. Yesterday, we discovered that over 1 billion doses are believed to have been wasted around the world. That would have been sufficient to vaccinate everyone in the poorer countries.

I commend the right hon. Member for securing a debate on this issue, which has concerned me as well; indeed, it concerns us all across this House. Is he aware that Eswatini, a little country that borders Mozambique and South Africa and one of our Commonwealth family members, was hit hard by coronavirus? I have to say that whenever I raised this matter with the Government, and with the Minister in particular, they did respond. It is a country that I have a particular interest in because of the churches and the missionary groups there, and the Government deserve our thanks.

Does the right hon. Member agree that one of the difficulties—he has already outlined some of them—is that smaller countries have no one to advocate for them internationally? We need to be more proactive in our responsibilities, first to Commonwealth countries and then to those that have no one to advocate for them. I think he is also saying that we need someone to advocate for them and ensure they get the vaccines that are available. We should be doing that.

I thank the hon. Gentleman for his intervention and for his dogged pursuit of the issue in Parliament and with Ministers. There is an issue about the strength of the voices of individual Commonwealth countries, and a real concern about some not being listened to. As a result of that, interventions are not taking place effectively in those countries, but it is invaluable that the hon. Gentleman has consistently raised individual issues with regard to particular countries in which he has an interest through the Christian movement. That adds to the pressure on Government for more effective action, and I am grateful for that.

The situation is worse than just failure to donate at scale. We did not donate as we promised on the scale that we promised, but we also worked to stop others producing the vaccines in their own countries. Around the world, factories offered to produce the vaccines, and one factory in Bangladesh said at the start of the pandemic that it could turn out 600 million doses a year. Compare that to the 35 million doses that the British Government have donated. More than 100 factories around the world could have been safely producing mRNA—messenger ribonucleic acid—vaccines, but were unable to do so because the trade-related aspects of intellectual property rights, or TRIPS, agreement locks that knowledge, which is often publicly produced, behind a wall.

The TRIPS agreement allows huge corporations and their shareholders to profit while preventing us from taking the action that we need to take to protect our own society, as well as people around the world. It is good for the big pharmaceutical companies, and Pfizer predicts $50 billion revenue for its covid vaccine—an anti-viral pill—in 2022 alone. These are the most lucrative drugs in history, and more than one Moderna executive has become a billionaire off its publicly funded and publicly created vaccines, but this situation is bad for us because it has not only created massive inequality, but allowed the virus to go unchecked in many parts of the world, mutating in a way that risks undermining the medicines we already have.

I know how passionate the right hon. Gentleman is about the subject as he supported my Westminster Hall debate on global vaccine access. He is talking powerfully about coronavirus vaccines, but does he agree that there has been a loss of progress on vaccines more generally? A good example is the polio vaccine budget, which the Government have pretty much obliterated. As a result, we are beginning to see wild poliovirus circulating again in some developing parts of the world. It is not just coronavirus; we are failing in our responsibilities on other fronts.

There is a lesson I thought we had learned decades ago, which is that when we have viruses such as this, whether it is polio, covid or others, unless we treat the world, eventually we will become vulnerable again. That is exactly the experience we are going through now. Even with covid, we are going through it again. As we know from information from the past month, a new covid variant has arisen, and from what we hear, that variant is more transmissible than anything we have experienced. On all those issues, unless we have a global strategy to vaccinate the world, unfortunately we will not be able to isolate ourselves from future infections and future tragedies.

Let me return to the issue of the TRIPS waiver, which a number of hon. Members present have raised in various debates. It is worth reminding the House that there was a call from most countries to waive the rules during the pandemic. The tragedy for us was that the British Government were implacably opposed to the waiver. Britain was one of the last countries standing, and only on the last day did Britain sign up to the World Trade Organisation’s very poor compromise on the waiver. I will be frank: I think that is disgraceful. It is disgraceful for a Government of a country that had all the vaccines we needed. The onus was on us to do everything we could to prevent this infection from spreading, and to do all we could to assist poorer countries.

I am grateful to my right hon. Friend for his important contribution to the debate. On the one hand, the Government are currently negotiating a free trade agreement with India. On the other hand, they blocked the proposal from India and South Africa for a TRIPS waiver at the World Trade Organisation. Does my right hon. Friend think that is the right approach to take to the issue of fair distribution of vaccines, and to our relationship with India?

The issue that my hon. Friend raises is something that we have raised before. I commend India and South Africa for the work they did in lobbying so hard to try to get international agreement on the TRIPS waiver. We need to learn some lessons from this period, and one of them is that when the Government act unilaterally in this way, they contaminate future relationships—whether they are over trade or other matters of co-operation. I think that is the anxiety that many of us have. It is a disgrace that we actually sought to prevent others from making the drugs that they needed.

Many countries around the world are shocked at the way they have been treated by this country, and they want to start to do things differently. South Africa has set up an mRNA hub to try to crack this revolutionary technology, which we think can be used not just to prevent severe cases of covid, but potentially to create treatments for a wide range of diseases, such as HIV, malaria and certain types of cancer. The big corporations still refuse to share their know-how, but South Africa has worked out how to make mRNA vaccines and—even better—is sharing this know-how with other countries patent-free. A couple of weeks ago, President Biden’s Administration announced that they would work with the hub to help it. Many European Governments have offered funds, but Britain has done nothing. The Government must support those efforts and protect them from the pressure that will come from the industry. This is a new model of how medicines can be developed, and it deserves our support.

It is not just about covid. I believe that the way we produce medicines is broken. I ask the Minister to talk to Lord Jim O’Neill, who has been trying to get the pharmaceutical corporations to produce the antibiotics that our medical establishment has depended on for many years. He has been trying to engage in a dialogue to change practices within the pharmaceutical industry, but the corporations have done nearly nothing. Look at HIV/AIDs. We now have the means to wipe out HIV through pills that stop transmission. New injectables have just come online. Again, the countries that most need them are being overcharged or shut out of the market altogether. It goes on and on.

We have an industry committed to making huge amounts of money, but not to making and sharing the medicines that humanity needs. We have to change that, and conversations are happening across the world about how to do it—except here, where the Government’s commitment to shareholder return appears sacrosanct and is prioritised above saving lives and reducing human suffering. My warning is this: it is not only ethically obscene; it is bad for us, too. It means that the British taxpayer is getting a terrible return on their investment in new medicines, that the NHS is overpaying for medicines such as covid vaccines, and that we are not developing the medicines we need to prevent the next health epidemic.

There are huge healthcare disparities, because many people still lack adequate public, universal healthcare systems. Sadly, however, the UK Government, like the World Bank, is still pushing a deeply inadequate private, market-based healthcare model in many countries. It is telling that some of the hospitals that were supported with British development funds refused to treat covid-19 patients in the first wave of the pandemic. Many died, and many were left destitute by this model. It is time for the Government to stop pushing that failed model and start helping to build national health services for all.

Let me come to the specific requests for the Government. A coalition of different organisations, which includes Just Treatment, Global Justice Now, Oxfam, STOPAIDS and many others, is calling on the Government to demonstrate support for the World Health Organisation’s mRNA technology hub initiatives. The hubs will help to end the covid-19 pandemic for all by increasing manufacturing capacity for treatments and technologies.

More broadly, the hubs will support self-reliance, independence and health equity in lower income countries. They will ensure that we are adequately prepared for the next pandemic. The UK Government must provide financial support to the hubs and ensure that pharmaceutical companies share their manufacturing know-how and refrain from undermining the success of the hubs with intellectual property barriers.

As the new Administration is formed under a new Prime Minister, will the Minister, first, now back the coalition’s request that the Government use their influence to encourage Pfizer, Moderna and BioNTech to share their technology and know-how, and urge companies to remove intellectual property barriers to the production of mRNA products and related technologies? Specifically, the UK Government should call on Moderna to revoke the patents they hold in South Africa and prevent other pharmaceutical companies from similarly undermining the work of the new mRNA hubs.

Secondly, will the Government make a public commitment to support and finance the €92 million that mRNA hubs need to fund the initiative over the next five years? Some 59% has been raised so far from other countries, but not this country.

Thirdly, will the UK stop blocking the trade-related aspects of intellectual property rights waiver at the World Trade Organisation? Will the Government ensure that the TRIPS waiver has a minimal duration of five years and includes all forms of intellectual property, including medical tools beyond vaccines, treatments, and diagnostics?

I hope that, with a change of Prime Minister and Administration, there is a window of opportunity for the Government to think again on the vital issue of how to prevent the loss of life and human suffering that has taken place on a global scale, which we have done so little to assist in tackling.

I expect the Minister will repeat the Government’s response to the petition that was lodged on this issue by many members of the general public, restate the various contributions and donations that have been made and compare us to others. The reality is that the financial contributions do not go anywhere near what is necessary. More importantly, the issue that must be addressed is the blocking of the local production in lower income countries of the means by which we can tackle the pandemic. If it is not, that will be a stain on this Administration.

It is a pleasure, as always, to serve under your chairmanship, Mr Hollobone. I am grateful to the right hon. Member for Hayes and Harlington (John McDonnell) for securing this debate and to all hon. Members who have contributed. I will try to respond to some of the right hon. Gentleman’s points.

According to recent research by Imperial College London, the global roll-out of covid vaccines has averted up to 20 million deaths, but progress has been uneven. Hon. Members are absolutely right to want the global roll-out to go further and faster, because too many people remain unvaccinated, particularly in lower income countries and marginalised communities and among those in the grip of humanitarian crises.

The Government’s priority is to end the acute phase of the pandemic by ensuring that those most at risk are fully vaccinated and enabling societies to live with covid. Everyone in this House and throughout the country can be proud of the role the UK has played in developing and rolling out covid vaccinations. UK scientific excellence and co-operation has made a huge contribution to collective knowledge about the virus, including how to treat it and vaccinate against it. Professor Dame Sarah Gilbert and her team created and developed the game-changing Oxford-AstraZeneca vaccine, backed by the UK Government. The Government also backed research into several other successful vaccines that were produced at unprecedented speed, including through our £250 million support to the Coalition for Epidemic Preparedness Innovations, otherwise known as CEPI.

We have also played a big role in the global vaccine roll-out, which has been the fastest ever against a single disease. Furthermore, we are a founder and one of the largest donors to COVAX, with our commitment of £548 million to its advance market commitment. That has helped COVAX to deliver more than 1.5 billion vaccine doses to 146 countries and territories worldwide, including 87 low and middle-income countries.

To help to address the supply shortages last year, we used our presidency of the G7 to make a collective commitment to provide 870 million doses to poorer countries by the end of 2022. Collectively, the G7 has exceeded that commitment by making more than 1 billion doses available. Nationally, we have donated more than 85 million doses to nearly 40 countries and made a further 15 million available. We have done all we can to meet our commitment to share 100 million doses. In 2021, the UK donated 30.8 million doses of the AstraZeneca vaccine, all of which were charged at cost. The OECD Development Assistance Committee will issue guidelines on the reporting of vaccine donations in 2022 later this year.

Through this immense collaborative effort, the world now has enough vaccine supply to enable countries to meet their immunisation goals; indeed, global vaccine supply now far outstrips demand. The key challenge is ensuring that developing countries can effectively administer the vaccines they have. We are working with the covid-19 vaccine delivery partnership and other international partners to tackle delivery bottlenecks and improve vaccine uptake to ensure that covid-19 vaccines reach the most vulnerable. Since January, the vaccine delivery partnership has accelerated progress towards national vaccination targets in more than half of the 34 countries with the lowest vaccination rates, with a strong focus on priority groups.

Community confidence and easy access are critical to successful roll-outs. We are using our development budget to encourage uptake and improve delivery. For example, our Nigeria health programme is supporting delivery and using evidence to build vaccine confidence in five of the poorest states. We have also provided £20 million to the Hygiene and Behaviour Change Coalition, which builds vaccine confidence through community engagement, working with health workers, religious leaders and other influential and trusted voices.

Just as the UK’s scientists and Government made a huge contribution to the first wave of vaccines, we are now working with partners such as COVAX and CEPI to ensure affordable and effective second-generation vaccines and make them available to low and middle-income countries, so that the world can respond rapidly to any new variant of concern. As part of this work, CEPI is supporting the Cambridge-based company DIOSynVax to develop a new pan-coronavirus vaccine to offer broader protection.

This year, we hosted the global pandemic preparedness summit, which raised more than £1.2 billion for CEPI’s work, including a UK Government pledge of £160 million. That money will fund the development of vaccines against new health threats—including possible new covid variants—in 100 days from any outbreak.

Rolling out covid vaccines puts huge pressure on weak and overstretched systems, so we are working with COVAX, the WHO, UNICEF and other partners to support countries in developing sustainable approaches to managing covid and other diseases. For the long-term control of the virus, it is critical to integrate covid-19 vaccination tests and treatments into primary healthcare systems, supported by strong and resilient health systems. The UK Government use our development budget to support countries to strengthen their health systems and work towards universal health coverage. We are also a leading supporter of Gavi’s work on restoring and strengthening immunisation and health systems for the 2.7 million children in the poorest countries who missed out on vaccinations in 2020 because the pandemic prevented them from getting their jabs.

Covid-19 has caused more than 6.3 million reported deaths, and the WHO estimates that there have been up to 15 million excess deaths in total around the world. It has had hard, far-reaching economic, social and health consequences, so stopping the next potential pandemic is vital. That will require a concerted and co-ordinated international effort. In addition to our investment in CEPI, the UK Government have pledged £25 million to a new World Bank-hosted fund for pandemic prevention, preparedness and response. That will help to ensure more equitable access to vaccines, tests and treatments when a future threat to global health emerges.

On TRIPS, the UK Government continue to recognise the importance of the intellectual property system in incentivising innovation, research and the development of new medicines, vaccines and medical technologies. We welcome the consensus-based outcome on the TRIPS agreement reached at the WTO ministerial conference. We believe that decision will make it easier for developed countries to choose to export life-saving covid vaccines while preserving the incentive that intellectual property rights provide to invest in innovation.

The Minister will soon run out of time, so will she address the issue of support for the WHO’s strategy of rolling out hubs? Will the Government think again?

I am grateful to the right hon. Gentleman for putting his case forward, but I have been clear about the UK’s position.

The global vaccine roll-out is pivotal to ending the acute phase of the pandemic and transitioning to living with covid. The points that have been made about delivery and distribution are live issues, and we are working hard with our international partners to resolve them. The Government are also investing in the development of second-generation vaccines, pandemic preparedness and the strengthening of global health systems. That comprehensive approach is the only way to strengthen global resilience to covid and other future health threats.

Question put and agreed to.


That this House has considered disparities in the global distribution of vaccines.

Sitting suspended.