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Covid-19: Vaccination in Developing Countries

Volume 816: debated on Thursday 2 December 2021


Asked by

To ask Her Majesty’s Government what steps they are taking to support COVID-19 vaccination programmes in developing countries following the emergence of the Omicron variant.

My Lords, the new variant omicron is showing us yet again that no one is safe until everyone is safe. Global vaccination continues to be vital for our defences against the pandemic and we are committed to making sure that people in the poorest countries get vaccines. We are a leading supporter of COVAX, which has delivered over 483 million vaccines to low and middle-income countries. This will rise to 1.8 billion doses by mid-2022.

I thank the Minister for his reply. I am slightly confused because I am hearing very different stats coming out. Affinity said yesterday that we have in fact delivered to developing countries only 11% of the vaccines we have promised, so I wonder when the remaining 89% might be delivered. Is the Minister aware that the Anglican Communion is working hard with local leaders in grass-roots churches right across Africa and parts of Asia on overcoming vaccine hesitation? Would he and his colleagues be willing to meet some of our team to see how we can roll these programmes out faster?

I thank the right reverend Prelate for his question. I do not recognise those particular stats, but I can give him some others which perhaps may reassure him. As I said earlier, the UK is one of the largest donors to the COVAX advance market commitment, which supports access to Covid-19 vaccines for up to 92 low and middle-income countries, 46 of which are in Africa. Our commitment of £548 million will support the COVAX AMC to deliver up to 1.8 billion doses to those countries in early 2022. We have already delivered 16 million doses through COVAX and directly to recipient countries, of which over 6 million have been delivered to 14 countries in Africa. Some 5.8 million doses are with COVAX and are in the process of being allocated and delivered and a further 9 million will be delivered to COVAX in the coming weeks, direct from AstraZeneca. Countries receiving those doses include Kenya, Nigeria and Mozambique.

I apologise for my long answer but, as the right reverend Prelate mentioned, many factors contribute to the slow vaccine rollout and one of those is vaccine hesitancy. I pay tribute to the Church for the extensive work it does on both Covid and other diseases, in particular in Africa, and of course we would be more than happy to meet and talk about this.

My Lords, this is a real north-south issue. On Monday, the noble Lord, Lord Goldsmith, told me that the UK did not have a stockpile of vaccine doses and the supply chain is managed carefully to ensure that donated vaccines are able to be used by recipient countries. So, can the Minister explain today why hundreds of thousands of vaccine doses reached their expiry date and have been destroyed rather than distributed to countries that need them? Will he also reflect on what Gordon Brown said: is it true that the UK has 33 million vaccine doses that we could immediately deliver to the rest of the world without impacting our own vaccine programme?

I do not know the answer to the noble Lord’s second question. As regards the expiry date issue, decisions on donations are driven by the availability of vaccines from domestic supply. Once the Health Secretary is confident that vaccines are available to donate directly to partners, the Foreign Secretary prioritises how they are shared. Obviously, avoiding vaccine expiry and wastage is a UK core objective, determining when and where we share or deploy doses, and we strive to observe WHO guidelines on that. No vaccines will be shared without an agreement with recipients that there is sufficient time for distribution and deployment before expiry. To expand a little: obviously, it would be much more sensible to manufacture in Africa, and the UK is working with the new Partnership for African Vaccine Manufacturing to develop its road map for African vaccine manufacturing over the next year.

My Lords, I welcome the Minister to his position; it is the first time I have been able to do so. But does he not understand that at the very time our Government are asking our health networks to work together for a third jab, the Government’s cuts to health networks in developing countries—40% at a minimum, wiping out programmes across many countries—are inhibiting the distribution of the first and second jabs to those countries? The Independent Commission for Aid Impact said that this was a direct impact on the world’s ability to vaccinate. Can the Government at the very least review and reverse the shameful cuts to the health networks for the very people who need them most at this time?

The noble Lord will appreciate that I cannot commit the Government to all those things, but I can tell him a bit about some of the things we are doing, which I hope will reassure him a little. He will also understand that this is not necessarily my specialist subject so I ask him to bear with me. We have deployed UK emergency medical teams to 11 African countries to provide training and clinical advice. We have also deployed a UK public health rapid support team to provide specialist technical assistance to public health agencies in Nigeria, the Gambia, Tunisia and the Africa Centres for Disease Control and Prevention. We are continuing to provide technical support to build genomic sequencing and country capability through the UK’s new variant assessment platform, including in African countries. We are doing a lot.

My Lords, when the Government responded last year to our Select Committee’s report on UK relations with sub-Saharan Africa, they stated that

“we are investing up to £20 million in the African Union’s ‘Africa anti-COVID 19 fund’”.

In the light of omicron, can my noble friend update the House on investment in that fund and whether it has been affected in any way by our cuts to overseas development assistance?

I am pleased to be able to give my noble friend a good answer: the £20 million contribution to the African Union’s Covid-19 response fund was not affected by the ODA cuts. The first contribution of £5 million was disbursed in July 2020 when the Foreign, Commonwealth and Development Office and the African Union agreed an MoU. The remaining £15 million was disbursed in March 2021, so the money was disbursed in full.

My Lords, the World Health Organization has said that developing countries urgently need not only vaccines but health- care workers to deliver them. Yet developed countries continue to rely on healthcare workers’ migration to deliver their own services. The Nursing and Midwifery Council data shows that the number of nurses coming to work in the UK from overseas has increased significantly. In the last year, the increase has been 225% from Africa, meaning that 3,503 nurses have joined the NMC registry, driven largely by four countries—Nigeria, Ghana, Zimbabwe and Kenya. These nurses are extremely welcome; however, can the Minister explain the Government’s commitment not only to share vaccines but to ensure that there are healthcare workers to deliver jabs into arms in developing countries? Is investment through overseas aid in training and retaining healthcare workers part of future plans?

I thank the noble Baroness for her question, and it is an incredibly important one. Clearly, one of the factors of slow vaccine rollout is a lack of ability to distribute and administer. The UK Government are preparing a cross-departmental support offer to multiple sub-Saharan African countries, including: scientist-to-scientist conversations to provide technical advice to Governments; genomic sequencing and variant assessment support; medical and technical personnel surge response; and in-kind donations of PPE and other medical supplies. I also go back to the answer I gave to the noble Lord earlier about sending emergency medical teams to 11 African countries and the fact that we have deployed a UK public health rapid support team to provide specialist technical assistance.

My Lords, does the Minister recognise the deep sense of anger and betrayal in southern Africa over the rich world’s handling of the omicron variant? Is the response of economy-crippling travel restrictions and doubling down on vaccine boosters, when many in southern Africa have not been able to get even their first shots, not only deeply immoral but utterly counterproductive in encouraging countries to be transparent in the future and preventing new variants emerging, both of which are crucial if we are to get off this Covid treadmill?

My Lords, I think, actually, the first duty of a Government is to protect their own population. I do not regard that as deeply immoral. However, I agree that there is clearly inequity between the rich and the less well-developed parts of the world. With regard to the travel bans, we are putting in place a lot of economic support for Africa, as I have already detailed to some extent. There are other aspects of it as well, such as debt relief, and we will continue with that support. On the travel ban itself, we acted fast, in line with many other western countries.

My Lords, given the global agreement from the scientific community that Covid-19 badly affects older adults and those with obesity and underlying health issues in particular, I found the decision to use millions of doses of vaccines on children under 16—who are not really at risk—here and in Europe and elsewhere most odd. This was not supported by the JCVI or the Royal College of Paediatrics and Child Health. Nevertheless, does my noble friend the Minister agree that to divert future millions of doses for the use of adults across the third world and other countries with a minimal uptake would be a more positive move towards protecting them and addressing the catastrophic effects of this deadly virus?

I thank my noble friend for her question. I think I have already explained and outlined the extensive efforts the UK is making as regards exporting vaccines. I am afraid I am not qualified to comment on the advisability or otherwise of vaccinating particular cohorts of the population. That, as I am sure my noble friend will appreciate, is significantly beyond my brief.