Covid-19: Vaccinations and Global Public Health
Lord Boateng
To move that this House takes note of (1) the shortage of, and (2) the obstacles to the manufacture and distribution of, COVID-19 vaccinations in the Global South; and of the consequent implications for global public health.
Lord Boateng (Lab)
My Lords, I am grateful for this opportunity to move the Motion standing in my name. Covid has revealed in every aspect of our lives the impact of inequality, has it not? In no case is that inequality greater than in access to vaccines and the means to manufacture them as between the north and south of our world, as well as between countries that have and those that do not—that is, poor and impoverished countries. The facts speak for themselves; I am grateful, as I am sure all noble Lords are, to the House of Lords Library for its research work on this.
The figures revealed are a stark reminder of the problem that we as a world face in relation to Covid and inequality. On 23 August, approximately 32.5% of the world’s population had received at least one dose of a Covid-19 vaccine, while 24.5% were fully vaccinated. That is in the world as a whole. However, only 1.4% of people in low-income countries had received at least one dose. I repeat: 1.4%, as opposed to 32.5%. There are many countries in the world, many of them in Africa—such as Chad, Burkina Faso, the Central African Republic, to name just a few—where the percentage of the population that is vaccinated is less than 1%. That is the reality on the ground. Of course, it presents a threat to us all because an unvaccinated world is a world in which variants that threaten us all are more likely to emerge. So, we have to find a way of addressing this imbalance.
We are also confronted too by the stark reality that, on existing projections, we are faced with a situation in which low-income countries cannot expect to have widespread vaccine access before late 2023. In the UK, we have bought enough vaccine to vaccinate the entire population more than three times over—on some calculations, four times over—and even after boosters have been given and the lower age groups have received their vaccinations, we will still be sitting on 210 million surplus doses. That is the figure that represents the reality of the gap between north and south.
The WHO estimates that some 16.2 billion doses will be needed for 2021-22 to achieve universal vaccination. That means that we are going to have to more than quadruple the world’s pre-Covid capacity to manufacture vaccines. That is the scale of the problem, but there is every reason to believe that, with the right attitude, approach and strategy, and with a willingness now to co-ordinate global action and to put the resources behind that action, the world could in fact meet the challenge. This is not one of those situations in which we can say, “Oh well, it’s all pretty terrible but really there’s nothing much we can do about it, that’s the way of the world”. Actually, it does not have to be the way of the world, because one thing we have learned from Covid is that where there is the concerted will, we can totally transform the picture. We know what has to be done, and what has to be done involves our Government being prepared to take a lead and the world recognising that existing mechanisms simply are not working.
Let us take a look at one of them: COVAX. The COVAX Facility was established—and we should celebrate the fact that it came into being—to create a global procurement mechanism to supply Covid vaccines to all the countries of the world in an equitable and effective way. But I am afraid it simply has not worked, because it was based on the flawed assumption that you could still have business as usual as an approach to the development, manufacture and pricing of vaccines. When I look around the Chamber, the expertise present is indicative of the degree of expertise that is present in this House on a range of issues. On this issue, we all know that, if COVAX is to work, it has to be reformed. It has not just simply to be given more resources; it also has to be geared towards dealing with inequality and not accepting it as a given.
The reality is that COVAX is at risk of failing even the modest, limited targets that it set itself. It looked to allocate just 2.3 billion vaccines by the end of 2022. That would not be enough, anyway, to deal with the scale of the problem that, as your Lordships are aware, exists, but we now face a situation in which it will be able to distribute and disburse less than a quarter of the intended doses on time.
That is hardly a wonder, because in June of this year, the UK received a distribution of vaccines that was greater than that of the entire distribution to the whole of Africa. In one month, June this year, the UK ordered and received 535,000 doses of vaccine from COVAX, and that was more than double the amount given to Africa in that month. How can the Minister justify that? Will he justify that this afternoon, or will the Government at last recognise that, yes, COVAX has got to be reformed? We and other wealthy nations cannot go on taking vaccines out of that pool, and we also need to put more into it. We hope that we will hear from the Minister this afternoon just what the Government are doing about that.
The other issue—again, one on which our nation needs to take a lead—is addressing the obstacles to scaling up manufacture in low-income and middle-income countries. We must be brave and ambitious in this regard, but we must also recognise that the capacity is there in the developing world. Even before Covid, developing country manufacturers were supplying at least 65% of the vaccine needs in all the WHO regions except the Euro region—so the countries of the developing world were already doing it with their existing capacity before Covid. India, China, Brazil, Cuba, Thailand, Senegal, Indonesia and South Africa all have the capacity to produce Covid vaccines. What they need is the additional investment and, significantly, a WTO regime that permits licensing and the sharing of information and encourages the pooling of intellectual property, and a WTO set of regulations to underpin that.
It is not about a free-for-all in which there will be inadequate and insufficient money for R&D in the pharmaceutical industry. That is not what is being proposed. What is being proposed is reform of the WTO. There are initiatives out there from South Africa and India, working together, and, importantly, from the United States. If the United States, which in the past has been at the forefront of restrictive practices in relation to intellectual property, is prepared to take a lead in reform, what is the reason for Her Majesty’s Government being so mealy-mouthed in this respect?
Why have we not taken the opportunity that the much-vaunted freedoms from the EU have given us to say that we will adopt a different negotiating position from the EU on this? Instead, what we have done is to go along with an EU consensus that has in fact been blocking reform within the WTO. I hope that we will get some inkling from the Minister. I do not expect him to reveal all his cards in a debate such as this; that would not be feasible or realistic, but he can at least indicate that we are prepared to join the United States, South Africa, India, and even France, in negotiating wording with the new director-general of the WTO that would give some hope that we will be able to see advances in this area.
There are many other experts in this House who will address this issue and talk about the importance of sharing knowledge and of building on the manufacturing capacity that exists—as I have indicated —in the global south; they will bring their expertise to bear on this. I hope that the Government will utilise the expertise that exists across Whitehall departments to come forward with a policy on this, so that we see the FCDO working with the Department for International Trade and the Department of Health. The Government should be congratulated on the energy of their Vaccines Minister and the strategy that has been brought to bear to meet the demands of our own country, so why can that not now be brought to bear to meet the demands of the world? This is not only a moral imperative but a public health imperative.
There was a great teacher who lived at the time of our Lord in Palestine by the name of Hillel. He said, in relation to self-reliance and solidarity:
“If I am not for myself, who will be for me? But if I am only for myself, what am I?”
This is the importance of recognising our common humanity, our interdependence and the need for solidarity. But he also went on to say, “If not now, when?” That is the importance of action, of getting on with it. Now is the time to demonstrate that solidarity and to make sure that all have access to vaccines for the benefit of all.
Baroness Brinton (LD) [V]
My Lords, I congratulate the noble Lord, Lord Boateng, on securing this important debate, and I agree with every word that he said in his compelling contribution.
I am also grateful to the Association of the British Pharmaceutical Industry for its briefing, updating us on the substantial increase in manufacturing capacity for Covid vaccines. It is worth starting by noting the extraordinary work of our vaccine experts globally, from scientists such as Sarah Gilbert and her team who were working in January 2020, through to the manufacturing companies that have made the most extraordinary steps to provide over 5 billion doses of vaccine to date worldwide, with 41% of the world’s population having had at least one dose. But—and this is the reason for the noble Lord’s important debate today—shockingly, only 1.9% of people in low-income countries have had one dose to date.
The role of Gavi and the World Health Organization in encouraging high-income countries to share doses as soon as possible has been laudable, and those countries, including the UK, that have guaranteed funding to Gavi are also vital. Credit goes to our Government for stepping up to the plate early with those offers. The comments from the noble Lord, Lord Boateng, about the theory of COVAX versus the actual practical attitude of G7 countries were blunt and right, however.
Much money has been made available to Gavi for COVAX. The practical problem of sourcing new vaccine manufacturing has proved understandably difficult. That is why the World Health Organization has repeatedly asked high-income countries to donate substantial numbers of doses to low-income countries. We on these Benches urged the Prime Minister to set an example from the United Kingdom in his role as the chair of the G7, but sadly he did not. All that was repeated was the amount of money given to Gavi, which was no use when there was no manufacturing availability. The figure of a 1.9% rate of vaccination in low-income countries is testament to that.
The World Health Organization has rightly said that
“none of us will be safe until everyone is safe.”
That is about overall safety, not just for all people in all countries, but also about the mitigations that we in the UK need to take in our own communities to keep transmission down. I am sorry to say that we are not doing that here in England. This Government have removed all mitigations and that is one of the reasons they are pushing for so many people to have booster jabs—way beyond what is really necessary at the moment. The clinically extremely vulnerable, of whom I am one, are staying at home under the government guidance because we should not be mixing with unvaccinated people. But we must make sure that those who can manage and make changes in their lives—face masks, social distancing and ensuring that spaces they enter are ventilated—play their part as well as government.
I have been watching what has been happening in America. The difference in the numbers of cases, hospitalisations and deaths between states where there are mask mandates and other mitigations and those where there are defiantly no mitigations is truly shocking. Many countries in the global south do not have the resources to provide even these mitigations.
However, there is hope. This month, Covid-19 vaccine manufacturing output will pass the 7.5 billion dose mark, with manufacturers worldwide now producing 1.5 billion doses per month and further continued growth is expected. If there are no major bottlenecks, by June of next year total vaccine production is estimated to reach over 24 billion, by which time vaccine supplies will most likely outstrip global demand.
This is subject, of course, to the emergence of any new variant that is resistant to the currently approved vaccines. There is recent news of the mu variant, which appears to be resistant to the Pfizer vaccine, and worldwide experts are monitoring that and all new variants continuously. We may be relying on our pharmaceutical industry to produce new vaccines for whatever threats are coming down the line. The good news is that G7 countries have sufficient stocks of vaccine doses to vaccinate their own adults and teenagers, and to roll out booster programmes to protect the most at-risk groups—as well as substantially increase the number of doses available to lower and lower-middle-income countries.
There are various things that need to be done, though, and the UK must take the lead on this while we chair the G7. These include stepping up dose sharing, continuing to optimise production, calling for the trade barriers that the noble Lord, Lord Boateng, spoke about to be eliminated, supporting country readiness and driving further innovation. I ask the Minister: what is the current number of doses to be donated from the UK between now and the end of this calendar year? How much will be donated next year? While we chair the G7, it is vital that we lead the way and donate as many doses as we can as soon as we can.
Baroness Sugg (Con)
My Lords, the vaccination effort, here in the UK and in many parts of the world, has been nothing short of incredible, with 5 billion vaccines developed, manufactured and distributed. Of course we must pay tribute to the scientists, health workers and all involved in that but, as the noble Lord, Lord Boateng, set out so powerfully, this incredible success has not been equitable across the world. I am grateful to the noble Lord for giving us the opportunity to debate this today.
I will add a further disturbing statistic to the noble Lord’s: 50% of the world’s vaccine supply has been bought by high-income countries, which account for just 16% of the world’s population. So the vaccine rollout has not been equitable, and indeed has exacerbated existing pre-pandemic inequalities.
The Covid-19 pandemic has impacted every corner of the world and, to avert further public health and economic disaster, we must address this vaccine inequality. It is in our enlightened self-interest to do so, as well as being the correct ethical thing to do. While the UK is gratefully reaping the benefits of a successful vaccination programme, that is not the case in the rest of the world. We know that economic recovery will be longer in poorer economies, compared to advanced ones, and that low-income countries will now face longer-term debt. We will see an increase in poverty and a reduction in spending on health systems. Unless we address this inequality of distribution, we will see the reversal of many of the impressive gains in development we have seen over the last few decades. Achieving the sustainable development goals by 2030 will be well out of reach.
The moral and ethical case for vaccine equity is clear; if that is not enough, so is the case for it being in our enlightened self-interest. It is right that wealthier countries should do more. Immunising many people in just a few countries, while in large parts of the world the virus remains unchecked, will simply allow more variants to emerge in these places. When variants appear, they will end up in the UK, in the end. We can close our borders and try to buy ourselves more time but, at some point, if the variant has sufficient biological advantages, it will spread around the world and into every nation. This is a global problem that must be dealt with globally.
It is clear that more must be done. In the United Kingdom, we have high vaccination rates, relative wealth, the presidency of the G7 and a desire to be a force for good in the world, so we in the UK must do more. We are rightly proud of our involvement in the development of the AstraZeneca vaccine, our early activity and our funding for COVAX. But, as we have heard, COVAX is struggling to deliver its objectives, given the practice of high-income countries such as ours to make deals directly with manufacturers. This has been exacerbated by high-income countries using COVAX for their own vaccinations. As we heard from the noble Lord, Lord Boateng, in June alone the UK received around 539,000 vaccine doses from COVAX—more than double the amount sent to Africa that month. Not much surprises me these days, but I was genuinely taken aback when I heard that. While COVAX is open to higher-income countries, given the supply issues it is facing, we should surely not be using its precious doses in our own country.
As I understand it, the UK has another 27 million doses on offer from COVAX and we are not the only country involved in this activity although, under public pressure, Canada has returned some of the doses it got from COVAX. We are not the only country but, given that we have 27 million additional doses on offer, will my noble friend commit the UK not to take up the option to withdraw any further vaccines from COVAX, so that the vaccines that it has can go to countries with far lower vaccination rates than ours?
I welcome the fact that the Prime Minister put global vaccination on the agenda for the G7 summit in Cornwall, and I would welcome some updates on progress following that. While falling well short of the 11 billion doses that the WHO said are needed, we saw pledges for 870 million doses via COVAX, half of which will be delivered before the end of the year. The UK’s part in this was 100 million doses, with 30 million going before the end of the year. We all know that time is of the essence, so can my noble friend tell me how many of those doses have been delivered and whether we are on track for that 50%?
The G7 summit communiqué also pledged to create the appropriate frameworks to strengthen our collective defences, so I ask what progress has been made on that and whether the task force to which we committed is up and running. The G7 also agreed to “engage constructively” with discussions at the WTO on the intellectual property issue; can my noble friend share an update on that? Finally, will the Government back calls, at the United Nations General Assembly this month, for a global summit to ignite urgent global action to end the pandemic?
I look forward to my noble friend’s contribution at the end, setting out what the UK has done so far. That is not insignificant, but the UK has a responsibility and opportunity to contribute more to end the global pandemic. I hope the Government will do so.
Baroness Lawrence of Clarendon (Lab)
My Lords, I thank my noble friend Lord Boateng for bring us this debate this afternoon. The pandemic in the last 18 months has been devastating around the world, and 18 months down the line we are in a position to address it with the development of the vaccine that has helped us to protect lives.
COVAX was set up to ensure that the Covid vaccine reaches the world’s poorest countries. Its aim is to vaccinate healthcare workers, social care workers and those who are over 65 and high risk within a community. COVAX was created as a global procurement mechanism to distribute vaccine around the world. A recent report on economics intelligence from the Financial Times showed that low-income countries would have only 1.4% of the 5 billion vaccines delivered. This means that they will not be able to vaccinate 60% of their populations by mid-2022. The knock-on effect will plunge these countries into longer term debt. This debt will also spiral out of control, leading to increased poverty and reduced spending on countries’ health systems.
Another report which came out in July stated that 170,000 doses of the Moderna vaccine were at risk of expiring within two weeks. NHS doctors have also reported thousands of Pfizer and Moderna shots being discarded. There are signs that the Government are encouraging the pharmaceutical companies to share their know-how and technology to waive intellectual property, but there are also signs of hoarding of doses by high-income countries. This is said to be caused by the pharmaceutical companies, which have control over the vaccine.
The British Government have announced that they intend to donate 100 million doses, while the US President announced that the US intends to donate 500 million doses of the Covid vaccine to poorer countries in the next year. This was announced at the G7 meeting of world leaders earlier this year. Do the Government understand that the pandemic is not going to wait a year before taking more lives?
The question is: will the Government look to speed up how the vaccines are reaching lower-income countries, as the prediction is that access to the vaccines will not reach those countries until 2023, as my noble friend Lord Boateng said? The G7 countries do not need a surplus; they could make a decision that lower-income countries should receive the vaccines they need now. The Financial Times has talked about vaccines passing their sell-by dates in warehouses, so we know that there is sufficient to vaccinate the world.
Ghana was the first country to receive vaccines from COVAX in February this year. Since then, more than 81 million doses have been delivered to more than 120 countries around the world, including Bangladesh, Brazil, Ethiopia and Fiji, but many African countries are still waiting for the vaccine to reach them.
COVAX is not without its critics; it is said that it is built on an unequal distribution structure. Countries which pay upfront have the option to buy vaccines for up to 50% of their own populations through COVAX. Lower-income countries, financed by advance market commitments, are able to buy for only 20% of their populations. It is morally wrong for rich countries such as the UK to have enough vaccine to vaccinate its population more than three times over, after it has vaccinated the lower age groups and given booster shots in the autumn.
Can COVAX help to end the pandemic that is spreading around the world? This is for not only our Government but world leaders to answer. Speaking on Radio 4 last Sunday morning, the former Prime Minister, Gordon Brown, talked about ordering vaccines and storing doses that are not needed; in some cases, their date has expired. To keep all of us safe, it is important that COVAX has enough vaccine to distribute to all countries:
“No one is safe, unless everyone is safe”—
that is from the World Health Organization.
Lord Oates (LD)
My Lords, I declare my interest as a vice-chair of the APPG on Vaccinations for All, and I thank the secretariat for the briefing they provided to me and other noble Lords. I thank the noble Lord, Lord Boateng, in particular for bringing forward this important debate.
Some months ago, at the beginning of the vaccine programme, Nicky Tyler and her husband, my noble friend Lord Tyler—Paul Tyler—contacted me, because Nicky felt when she got her vaccination that she wanted to be able to donate to people who had not. We worked together to get a facility where people could donate individually to COVAX. As a result of that fundraising effort and with the assistance of the then Lord Speaker and noble Lords from across the House, including the noble Baroness, Lady Lawrence, we managed to raise some funds. We did not raise huge amounts because, unfortunately, the Government and NHS bureaucracy could not get in gear to offer people that chance at point of use, but it was useful revenue none the less.
But all the time the frustration was that we knew that while money was going to be needed, money was not actually the key issue. The key issue was supply. The problem was not only that we in the West, in the UK and other countries, were hoovering up vaccines; we have heard all the statistics. But now we hear—the noble Baroness, Lady Sugg, and the noble Lord, Lord Boateng, cited the figures—that, absolutely disgracefully, we were taking from COVAX as well: 539,000 doses, as has been said. That was more than went to Africa in that month. So, not only did we screw up the way things were supposed to work by all our bilateral deals; we then went and effectively stole from the multilateral vehicle—heads we win, tails you lose. That is not just bad policy; it is morally bankrupt and callously wicked policy. Whoever the Ministers are who signed that up should hang their heads in shame.
It is easy to talk about vaccines in terms of billions of doses and hundreds of thousands taken from COVAX, but the reality is that this is about people. It is about people in these African countries who are not getting vaccinated, who are getting sick, and many of whom are dying. It is utterly wrong, and I hope the Minister will take up the questions from noble Lords and assure us not only that we will not take from the COVAX Facility anymore but that we will return those doses.
The lack of vaccines impacts not only people’s health but the economies of those countries. Shortly before the Recess, I chaired a meeting on behalf of the Royal African Society and the APPG for Africa about the impact of Covid on the tourist and wider economies of Africa. As I mentioned in the debate on Africa yesterday, we heard about the triple whammy on African economies. First, we hoarded vaccines, meaning that their economies could not get back on their feet because people were not vaccinated. We then imposed travel restrictions against them, and then, not content with that, we slashed the aid budget well below what it would have even gone down to under the 0.7% rate.
The Government have to approach this in a way that addresses all these factors, because if we are taking out an estimated $168 billion in tourist income from Africa as a result of the travel restrictions that have been imposed, that impacts health. It impacts people’s lives, and African economies will not recover. We have heard from the noble Lord, Lord Boateng, about the importance of allowing those countries which have the manufacturing facilities to be able to get on and start delivering. That must happen now, and we should be assisting it. On the issue of intellectual property, again, it is completely wrong, at this time of global crisis, that we are denying people access to those vaccines by hanging on to that outdated thing.
I conclude by reinforcing this point: every day that we delay, more people die, more people get sick and more economic damage is done. We have to stop, and start acting with moral responsibility.
Baroness Chalker of Wallasey (Con)
My Lords, as we have heard from previous speakers—particularly the noble Lord, Lord Boateng, in introducing this debate—the shortage of Covid-19 vaccines in the global south is serious but it could be corrected. Many ideas have come forward, but the thing to underline in this debate is that it is a question of different parts of Governments, not just in this country but all over the world, working together with their departments of trade and their technical people to get production in many of the more developed global south countries that could provide vaccines themselves. I will come back to that matter in a moment.
It is 24 years now since my time as an FCO Minister and a development Minister. I have worked with NGOs during that time on the prevention of all sorts of diseases, but in none of them—malaria, HIV/AIDS, tuberculosis and other preventable diseases, including sight loss through trachoma—have we seen such fast development of a solution to the problem we face. We have seen very fast development by some outstanding companies. That development and that knowledge should be shared across the world, not kept to the more developed countries.
It is imperative that we change our developed-nations storage, as I call it, of vaccines, with 27 million doses in this country, plus the Canadians and others, as has been said. Oxford University reported last month that 32.5% of the world’s population had received at least one dose but that only 1.4% of the population of low-income countries had done so, and most of those are in the global south.
I can accept that higher-income countries hedged their bets in the early months of the Covid-19 infection, but surely there is now a case, when we and other higher-income countries have been successful in administering the vaccine—91 million doses of vaccine have been administered to citizens in the UK alone—for us to stimulate and donate more doses, even beyond the pledges made at the G7 meeting and other meetings.
I note that 54 African countries have received about 31 million doses of vaccine through COVAX, and the G7 is now committed to 870 million doses via COVAX, but the real problem seems to be with intellectual property rights. I have a few key questions for my noble friend on that. They concern the waiving of IP rights, both on vaccine production in low-income countries and on distribution. What has happened to the WTO discussions involving the director-general, Ngozi Okonjo-Iweala, about developing a text to give developing countries access, where there is expertise, to vaccine production under the guidance of the established vaccine providers? What is being done about getting the supply of the tested vaccines to low-income countries as soon as possible?
Given that before Covid-19 hit there was economic growth in a number of African countries of up to 6%, probably driven by new technology and mobile telephone usage, we know that these countries are capable of taking up the information provided in the more developed countries and those countries lucky to have well-developed industry. Will the Minister undertake to investigate how, by distributing greater supplies of vaccines to low-income countries and by supplying technology training, we can develop the licensed developers in those countries? By doing so, we could increase the vaccination in low-income countries substantially.
It does not take a lot of imagination to see what needs to be done; it simply needs someone to get on with it, and I can think of no one better than my dear friend Ngozi Okonjo-Iweala.
Baroness Bennett of Manor Castle (GP)
My Lords, I thank the noble Lord, Lord Boateng, for securing this debate and his excellent introduction, and I have enjoyed the uniformly excellent contributions to it.
It is worth going back a step and thinking about the nature of the world in which the Covid-19 virus arrived. This is a world of massive, almost unenvisionable inequality. Rich countries have drained $1.52 trillion from the global south since 1960, according to a calculation from the anthropologist, Jason Hickel. I refer to his paper in New Political Economy, which looked at the unequal exchange in the post-colonial era, the rate of which increased dramatically in the neoliberal structural adjustment period imposed on the global south, taking us to the point where Covid arrived. The global north was drawing from the south $2.2 trillion each year through unequal pricing, which is a reflection of unequal power. That has been calculated as being enough to end extreme poverty in the world 15 times over, or it could pay for far more Covid vaccines than we actually need.
At the same time, we have seen destruction of natural worlds and the dumping of plastics and toxic wastes on those nations. We have an economic system—a power imbalance—which sees multinational companies having far more power than entire nations, or even groups of nations.
Then we come to what is happening with Covid vaccines. Here I am particularly pleased to be following the noble Baroness, Lady Chalker of Wallasey, and to pick up on her point about how we are not taking the knowledge of the world and sharing it with the world. Currently, the cost of vaccinating the world is five times what it should be if pharmaceutical companies were not profiteering by charging five times as much as it costs to produce vaccines. These calculations are made by the People’s Vaccine Alliance, which includes the African Alliance, Oxfam and UNAIDS. Pfizer-BioNTech and Moderna have been charging Governments as much as $41 billion above the estimated cost of production of vaccines. To bring this to a national level, Colombia is estimated to have paid $375 million more than the cost price of the vaccines that it has been able to purchase. They are making vaccines for $1.20 a dose; COVAX is paying on average five times that.
There is a huge moral argument here, which many noble Lords have made, for why this should not be allowed to continue, but I know that there are some people in politics who do not acknowledge moral arguments so I shall look briefly at the economic arguments. The economic cost to rich countries of not supplying vaccines could exceed their cost by 10 to 100 times. Essentially, we are shooting ourselves in the foot economically. The noble Lord, Lord Oates, spoke about the impact on economies in the global south, but the damage there will have huge impacts on our economies as well.
Of course, as many noble Lords have noted, no one is safe until everyone is safe. One million new infections occur in the world every day right now.
I have some expertise in the area of biology so I will venture for a second into what that means. Uncontrolled transmission of the virus is what drives mutations of it. Each infection in an individual person produces millions of viruses. Most of those viruses will be identical to the infecting virus dose but some will be mutations. There is then a bottleneck, where that person transmits a small dose of virus from what they have to others. Individually, cases will almost certainly be the same as the original virus, but in some cases they will transmit the mutations. The more infections you have, the more get transmitted.
I will finish by looking at some figures. The New York Times has a very handy table for the number of doses per 100 of population. Here are some rates. In Congo there are 0.1 doses of vaccine per 100 people; in Haiti, 0.4; in Papua New Guinea, 1.5; and in the UK, 138.
Baroness Osamor (Lab)
My Lords, it is a great honour and privilege to participate in this important debate secured by my noble friend Lord Boateng. Coronavirus has taught us that the future is never going to be business as usual and that the virus knows no boundaries either. People all over the global south—Africa in particular—are hungry for change, not charity. That includes harmful, unequal, discriminatory global agreements. A truly global Britain must stop blocking solutions to end the Covid-19 pandemic. They must be available, affordable, suitable to the people we care for and adapted to the place where they live. Imagine trying to keep vaccines cool and effective in blistering temperatures without electricity for refrigeration. People get sick and die needlessly because of these obstructions.
Millions of people are still waiting to benefit from the important medical innovations of the past year and a half. Intellectual property is deepening social and racial injustice across the globe. Shared Covid-19 vaccine know-how to increase global production and supply is needed. Can the Minister tell us whether the Government will support this? Vaccines made in the global south—for example, in Madagascar, Nigeria, Kenya, South Africa, India, Senegal, Zimbabwe, Brazil and so on—could be a game-changer in the Covid-19 response. Lives over profit is not too much to ask—or is it?
Baroness Chakrabarti (Lab)
My Lords, I congratulate my noble friend Lord Boateng on securing time for a discussion of one of the most urgent life and death issues in the world today. As someone who advised him in government on pro-human rights and equality measures over 20 years ago, it is a particular privilege to support him today, as it is to speak in the same debate as my noble friend Lady Lawrence of Clarendon, with whom I have campaigned for so many vital causes over the years.
In my too short time I should like to focus on the immorality and self-destructive illogic of the Government’s current opposition to the vaccine patent TRIPS waiver. To be clear, and to be clear on the record, I believe that the inevitable national and international inquiries, like future generations, will be very harsh judges of this.
Of course, the waiver is, as we have heard, promoted by South Africa and India and supported by half of our Commonwealth, including Pakistan and now Australia. It is advocated by the WHO, the Pope and the United States, with—it would seem—only Germany and the United Kingdom in embarrassing resistance. Forthcoming elections in Germany might even alter the German position.
In answer to a question in your Lordships’ House on 21 July, the noble Lord, Lord Bethell, said:
“It is our strong view that this Government support intellectual property, because it is only through our commitment to intellectual property that we can encourage the kind of massive investment by the private sector … in the first place. For that reason, we remain hesitant about supporting a TRIPS waiver policy.”—[Official Report, 21/07/21; col. 250.]
As a human rights lawyer, I believe in intellectual property as well, but, given that the Oxford/AstraZeneca vaccine was 97% publicly funded, and that it is a similar story for Moderna and Pfizer/BioNTech in the US and Germany, it seems to me that there is a very strong argument that there should have been government-owned patents, or indeed creative commons, in the first place.
Furthermore, like so many of our fundamental freedoms, property is a qualified right at the best of times, and proportionate interference is even more justified in the exceptional circumstances of a pandemic. Ordinary people, businesses and nations have made extraordinary sacrifices of their liberties, livelihoods and lives over the last 18 months—so why weep hot tears for a temporary reduction in the profits of pharmaceutical giants that would only make them more popular and trusted in the future, as a result?
Another argument that is sometimes made against the waiver is that countries in the global south are somehow incapable of safe generics production. It is as if we are advocating a sort of “Breaking Bad” solution, with people mixing vaccines in their basements. That is an insult that verges on the racist. As the noble Baroness, Lady Chalker, suggested, with proper support, know-how sharing and regulation, there is substantial capacity. Indeed, the Serum Institute of India was producing vaccines for export to the West while the bodies of Covid-19 casualties were floating down the Ganges. During that same Indian peak, Teva offered in vain to help with the vaccine effort, and, if we had engaged the TRIPS waiver then, that Israeli company could have begun production to help, as it wanted to do.
Not to share vaccine recipes and know-how free of charge during a deadly pandemic is as obscene as it would be for one of us in your Lordships’ House right now to restrict or charge for advice on emergency exits from this building in the event of a raging fire. While I congratulate the professionals and volunteers of our wonderful NHS on our domestic vaccine rollout—indeed, I encourage anyone and everyone offered to take up their jabs—it is a luxury to be deliberating child vaccinations and booster shots when less than 2% of people in low-income countries have received a single dose. If we want to trade and travel, while protecting ourselves from endless mutations and variants, this vaccine apartheid is positively self-harming, and it must end.
Lord Browne of Ladyton (Lab)
My Lords, I too congratulate my noble friend Lord Boateng on securing this debate. He made an excellent speech in introducing it. From the quality of the contributions thus far, he also appears to have exposed a rich seam of knowledge, wisdom and humanity in your Lordships’ House; we owe him a debt for that.
On 15 October 2020, I asked a supplementary question about vaccine equity. Referring to expert warnings—there were many then—that the COVAX initiative offered no guarantee that Covid-19 vaccines would reach the world’s poor, I asked the then Minister for Overseas Territories and Sustainable Development at the FCDO, the noble Baroness, Lady Sugg, whether she was aware that a team of global experts led by Ezekiel J Emanuel, a world-class, distinguished medical ethicist, had proposed a new model ethical framework for global vaccine allocation, dubbed the “fair priority model”, and if so what was the Government’s assessment of it.
In the experts’ words, this framework
“is the best embodiment of the ethical values of limiting harms, benefiting the disadvantaged, and recognizing equal concern … Ultimately, the model offers governments, international organizations, and vaccine producers a practical way to fulfill their pledges to distribute vaccine fairly and equitably”.
Graciously, the noble Baroness restated her belief that
“the right way forward is for the world to come together through the COVAX commitment”.—[Official Report, 15/10/20; col. 1186.]
She offered to look at the fair priority model and come back to me in writing. I am afraid I am still waiting for the promised letter, but there may be a simple explanation for that omission. On 25 November, the noble Baroness, a Minister of ability and admirable integrity, quit after Rishi Sunak announced that foreign aid expenditure would be cut from 0.7% to 0.5% of national income. Interestingly, her former post still exists with all its responsibilities, but is vacant; she is indeed irreplaceable.
I expect that the response to this debate will be that COVAX will deliver, but the truth of the matter is that it is not. We have a situation now in which only 1.9% of people in low-income countries have received at least one dose. Today, CNN reports that only
“330 million doses have been released for delivery to underserved countries through COVAX”,
while the ambition for this year was 1 billion. In August only 12.6 million of the 4.46 billion doses administered globally were in low-income countries. On 4 August, the WHO director-general had to issue a plea for a moratorium on third-dose boosters in high-income countries. These facts prompted the Lancet, for a second time, to add its voice to growing demand for equitable access to vaccines.
As we have heard, the mantra for the Covid pandemic is:
“No one is safe until everyone is safe”—
and with good reason. Unmitigated transmission means rampant viral replication and the likely emergence of new, more transmissible variants that could overcome natural or vaccine-induced immunity. In the words of the Lancet editorial:
“A perverse social experiment would be to allow the virus to continue ripping through low-income and lower-middle-income countries … where people tend to live in close proximity and infection prevention strategies are difficult to implement … while seeing how quickly”
high-income countries
“can redesign vaccines to counter yet another variant that has emerged”
from low and middle-income countries.
“Beyond the moral argument, this approach would make no economic sense”.
Rich countries
“rely on raw materials and intermediate goods”
from low and middle-income countries, and if they
“cannot provide these materials because their populations are dying from COVID-19 or are prevented from working because of lockdowns”
how long do we think we can keep our own economies running?
On 1 September, for similar reasons, Professor Emanuel re-entered the fray too, this time in the company of 80 other leading world figures, who published a letter in the FT. He urged world leaders to convene a global summit during this year’s UNGA to boost vaccine availability. They wrote that
“inequitable access to high-quality vaccines and capacity to administer them is prolonging the pandemic and destabilising economies and societies around the world.”
The briefings we all received for this debate are excellent. They are redolent with evidence of rampant injustice. My noble friend Lord Boateng asked for specific steps to remedy this injustice, as did others. I support them all, but I am struck in my reading by the constant theme from experts that a global pandemic needs a global plan of attack—why did we not think of that ourselves? To boot, it needs one that is developed within an ethical framework, to secure the commitments and actions needed to close the vaccine supply and capacity gaps, to increase countries’ distribution and delivery capabilities and to strengthen health systems and, importantly, our preparedness for the next pandemic.
It appears that not only do we no longer have a specific Minister who holds the responsibilities that the noble Baroness had but we have no comprehensive plan of response to this challenge either. I invite the Minister to urge the Prime Minister to join the call for a global summit during the UNGA and, in the meantime, to study the fair priority model framework, consult its authors and assess its merits and, if he can find the time to do so, to write the letter that I have now been waiting for for coming on a year.
Lord Davies of Brixton (Lab)
My Lords, I join in congratulating my noble friend Lord Boateng on introducing this debate. My mind goes back more than 40 years ago to when we were colleagues together on the Greater London Council. I am pleased to report that he has lost none of his power of advocacy. It was an excellent speech. I will echo one point he made: we know what is to be done. That is the criminal fact. We know the nature of this terrible disease. We know it will not be over until it is over for everyone, including and especially the people in the global south. Of course, we cannot just think of the impact it has on us. There is also the moral imperative to get it right for everyone.
The position has been set out clearly by previous speakers, with compelling arguments. I will echo the comments made by a group of relevant voluntary organisations that we know what is to be done. Will the Government, as a matter of urgency, encourage the redistribution of the vaccine via COVAX, targeting healthcare workers and vulnerable people in low-income countries? Will the Government push the pharmaceutical companies to share their knowledge, particularly, as has been stressed throughout the debate, since so much of that knowledge has been accrued and accumulated through the public sector and public service finance?
Will the Government support South Africa and India to waive the restrictions on intellectual property rights so that production can be ramped up? Will the Government encourage investment in manufacturing capacity in low and middle-income countries? Will the Minister commit the Government to protect the health of our people and to meet the moral imperative of helping others in low-income countries in the global south?
Lord Hussain (LD)
My Lords, I thank noble Lords for allowing me to speak in the gap. I have a particular issue to share with the House. I have just come back from a red-list country, Pakistan. I would like to share my experience. The region I went to is Azad Kashmir, where the majority of the people who are known to be British Pakistanis come from. They keep going back and forth to that area.
You cannot leave this country to go to Pakistan until you are vaccinated and until you have a test proving that you are negative. Of course, once you get there, they test you again. While I was there I witnessed the vaccination programme in the area. It was widely accepted, with people queueing up every day outside vaccination centres. Vaccination is down to school-age children now. People are really encouraging all ages to have the vaccination done.
Also, I have to say something about the local government I saw, with local lockdowns and national lockdowns. My wife and I went to see my elderly in-laws many times—we were in a village—but whenever we wanted to go out for shopping, we were told, “No, there is a lockdown. You can’t go”. So, there is a heavy lockdown in the country. In Azad Kashmir, including in the Mirpur district and the surrounding areas, I did not hear about many deaths from Covid-19, and the hospitals were not full of Covid-19 patients either. That is where the majority of British Pakistanis are travelling to and from.
My experience was also this. Obviously, we could not return without showing a certificate of vaccination and tests. Here, getting from the aeroplane—that is, from the minute the flight landed at the airport—to getting to the hotel, all in London, took nearly seven hours. It was tortuous, and it cost me and my wife £2,300. Yes, we were able to pay, and did pay, but what about those families who have three or four members with them, perhaps elderly relatives or children?
Not only that, let me share my particular experience of when we got to the hotel. Only a few minutes later, a piece of paper came through the door saying, “We do apologise but the hot water doesn’t work in the hotel. We are working on it”. The hot water did not come back for another 18 hours. This is the kind of experience that people are going through. What I am saying is that, if we have to have certain countries on red lists for whatever reason, let us make sure that we force to quarantine in hotels only those who test positive. Otherwise, we are pushing planeloads of people who are not positive into hotels where it costs them a lot of money to go through this tortuous experience.
I beg the Government to look at this from a humanitarian point of view. Please, do something about it. I do not know how long this is going to go on for but it is affecting ordinary people quite a lot.
Lord Purvis of Tweed (LD)
My Lords, I am glad to follow my noble friend’s powerful contribution. I start by commending the noble Lord, Lord Boateng, on securing this debate and introducing it so comprehensively. He set the right tone of fact and passion.
We have heard from all sides of the House the depressing information and the passionate contributions to back it up. I was reflecting on one of those powerful contributions, that of my noble friend Lord Oates, and thought that I have been in the House for eight years but, long before that, it has been a common thread throughout British government policy that we are an upholder of the rules-based international order. The problem with this is that a great number of countries now say that those rules are set by countries that, especially in a time in a crisis, are less interested in an international order than they are in their own internal interest. The rules are out of date and biased towards the developed West. In the 70 years since the rules were developed, the world has never suffered a health emergency such as this pandemic. It had an opportunity to demonstrate that, in the age of sustainable development goals, the response of the richest nations, which set those rules in the first place, could be flexible enough to support the less rich nations and share the enormous burden of the pandemic. That opportunity has been missed.
The chart from Our World in Data by the University of Oxford, included in the Library briefing, showing the vaccine doses administered per 100 people across the globe, is as startling as it is shameful. The OECD tells us that high-income countries, which account for 16% of the global population, had negotiated supply agreements amounting to approximately half the world’s vaccine supply. The opportunity presented itself last year through the establishment of the COVAX scheme, as the noble Lord, Lord Boateng, indicated, for fair global access between countries, regardless of income level. However, a combination of vaccine nationalism and perhaps what some may consider an understandable desire among domestic populations in rich countries to return to normal as soon as possible and release themselves from lockdowns has meant that the negotiated purchase of rich countries to vaccinate their populations many times over has limited the capacity of the COVAX programme to get access to and then distribute those doses. I shall conclude on the most sobering consequences of those actions later.
As the combined charity briefings that we received say—and as the noble Baroness, Lady Sugg, highlighted—the hoarding of doses has only exacerbated the core source of the inequality in vaccine access. Only 1.4% of the 5 billion vaccine doses administered globally to date have gone to low-income countries. The growing number of destroyed doses in the United States is now outstripping some countries’ pulldown from the COVAX scheme. That is a shameful indictment of how we in the richest countries in the world are operating.
Buried in the rather self-congratulatory communiqué of the G7 held in Carbis Bay was an equally sobering detail in paragraph 10 on vaccine production. It stated:
“These include exports from domestic production, with at least 700 million doses exported or to be exported this year, of which almost half have gone or will go to non-G7 countries”.
So of the 700 million doses that the G7 communiqué said had been produced so far, less than half have gone to the non-richest seven countries in the world. That was, again a shocking indictment. Just this week, the relative ease with which two of the richest countries in the world, the UK and Australia, agreed a 4 million-dose swap, when compared with the relative difficulty for African Union members in drawing down already-manufactured doses available, is telling.
The UK approach seems to have been a combination of donation in cash and of surplus doses, as well as the encouragement of manufacturers to share and pool manufacturing. However, for a full year, as my noble friend Lady Brinton said, Members on our Benches have argued that the UK should have led on activating the Doha declaration and the TRIPS waiver mechanisms. We proposed Amendment 75 to the Trade Bill in 2020 so that the Government would activate that, and were supported by the noble Lord, Lord Collins, and others who took part in those discussions. It was a cross-party effort. In the Government’s response to my question about why Canada had activated the mechanisms in March 2020 but the UK chose not to, the Minister replied to me:
“The UK believes that a robust and fair intellectual property system is a key part of the innovation framework that allows economies to grow, while enabling society to benefit from knowledge and ideas.”
However, as the charities’ briefing to us highlighted, the Oxford AstraZeneca vaccine, if it had been openly licensed, as was originally intended by Oxford University, more suppliers would potentially have been producing vaccines to be distributed globally. Instead, the exclusive licence by AstraZeneca for producing the Oxford AstraZeneca vaccine at the Serum Institute of India has meant that there have been major problems with the rollout. Indeed, in some countries it has been halted altogether and others are paying much more, as has been referred to.
Let us not forget that the innovation framework which the Minister referred to in the Trade Bill processes was part-funded by overseas development assistance—so we would not have this innovation for the UK economy if it had not been for the ODA in the first place, and now, most depressingly, as we have heard, we are stripping some of that back. I hope that the Minister can update the House on our position. Are we still acting as a block on the Doha declaration and the TRIPS waiver situation? If the Government gave the reason a year ago, almost to the day, that their situation was preferable, where has been the benefit and where has been the proof that that approach has been better?
What has compounded this—and has also been raised in this debate—has been that at the same time that the UK has not been leading from the front in those areas, it has actively cut development assistance for health systems across many countries. Part of the awful consequences of the unlawful cut of 0.7% to 0.5% has been the reduction in support for health systems to distribute the vaccine, even if those countries were able to get it. Can the Minister confirm that reductions for health system support in developing countries will not be cut next year, as it has been cut this year?
Finally, on the consequences of this, as I highlighted, we have been warning that, without a different approach, there would be consequences. What are some of those consequences? On Wednesday of this week, COVAX slashed its forecast for doses available in 2021 by roughly a quarter. The assumption that was made during the UK hosting of the G7 was “the two billion”. We all saw the Prime Minister talking about “the two billion”. The 1.9 billion has now been reduced to 1.4 billion for the release in 2021, as a consequence of hoarding. The World Health Organization has formally asked for developed countries to delay booster shots as a way of lifting vaccinations to lower-income populations to 40%. Do the Government agree with the WHO’s position? Dr Tedros, Director-General of the WHO, said:
“I will not stay silent when the companies and countries that control the global supply of vaccines think the world’s poor should be satisfied with leftovers.”
However, most shockingly in today’s debate, we have heard that in June, the UK actually drew down 539,000 doses from the COVAX facility itself. Reportedly—I would like the Minister to confirm this—it has options for a further 27 million doses to be drawn down from COVAX. Can the Minister do one thing in response today: confirm that the Government will not do it? It is a clear signal that shows the international rules-based order is working for developed countries. The statistic that Africa as a continent so far has received 100 million doses in its entirety, and we have an option from COVAX just for our country for a drawdown of a quarter of that, surely cannot be acceptable. I hope that the Minister in his response will say that we will not do this.
Lord Collins of Highbury (Lab)
My Lords, as the noble Baroness, Lady Sugg, said, the development of Covid-19 vaccinations has been an incredible scientific achievement that has surpassed almost all expectations of what could be achieved so soon. However, as my noble friend Lord Boateng highlighted in his excellent introduction to this debate, the distribution of vaccinations which has left most of the world without access has been a huge geopolitical failure.
Last month, the Associated Press reported scenes in Kampala of nurses desperate to avert violence as people in Uganda’s capital jostled for the few vaccines that had arrived in the country. The same scenes are being repeated across the global south, where the hopelessness that the UK experienced in 2020 as the virus spread through the country without there being any protection is still playing out.
As Gordon Brown has said, this is in part a result of vaccine nationalism. More than 80% of vaccinations worldwide have ended up in G20 countries and, as a result of over-ordering with no focus on redistribution, around only 2% of people in Africa have been vaccinated. The tragedy is that this hoarding of vaccine will benefit no one. Regardless of how well vaccinated we are in the western world, as all noble Lords have repeated in this debate, if the virus continues to circulate and mutate elsewhere in the world it will remain a threat to us all. The problem also lies with the lack of political leadership and the Government’s unwillingness to step into a vacuum and make a stand. I have no doubt that the Minister will repeat the details of what the UK has done—we have heard it in the debate—in terms of financial contributions, Gavi, the COVAX Facility and CEPI. However, as the noble Baroness, Lady Sugg, said, we should absolutely have been a champion in the world in terms of global vaccination, driving the issue throughout to deal with the suffering that will otherwise continue in the global south. I repeat that we must be aware that if we do not, the virus will continue to pose a danger.
What did the Government do? What have we seen? The noble Lord, Lord Purvis, set out exactly some of the horrible contradictions which I hope the Minister will respond to. What did we do? It took almost six months for the Government to begin donating the promised surplus doses of vaccines to low-income countries, and there has been no effort to speed up the process. Ahead of the G7 summit, Labour called for a serious commitment to vaccinate the world, but leaders at it managed to pledge only 9% of the 11 billion doses the world needs. What is required is a credible plan, backed by the necessary resources from the world’s wealthiest countries, as my noble friends have said in this debate. Labour laid out a 10-point plan which we put to the Government. We wrote to government Ministers. It is a strategy which could help transform global vaccine production to produce and distribute enough coronavirus vaccines for the whole world. It included proposals to build on the audit work already undertaken by CEPI, launch a global procurement programme for essential supplies and agree a comprehensive plan to transfer the expertise, knowledge and skills required to start vaccine production at new facilities around the world. This is the exact ambition we need from the Government to overcome the shortage in the global south.
We also need to see that the Government are alert to the ongoing blockages which are preventing distribution and manufacture in the global south. In sub-Saharan Africa in particular, limited manufacturing capacity has meant that it is especially vulnerable to supply-chain disturbances, and we must be alert to these disturbances and be in constant dialogue with the political leaders in the global south so that we can address and overcome these obstacles.
In addition, we need to look at the long term, accept that Covid is likely to stay and plan for future vaccination cycles. This means building up strong and resilient healthcare systems. The noble Lords, Lord Purvis and Lord Oates, highlighted that, instead of building up those systems, we have cut—cut support to those incredibly vulnerable countries and undermined those health systems. I have spoken a lot in this Chamber about the cuts to the nutrition programme, the foundation blocks to make vaccines effective, by 80%. Women and children are suffering. I hope, as the noble Lord, Lord Purvis, has asked, that the Minister will respond that those cuts will be restored, as soon as possible.
The pandemic is not over. For much of the global south, the worst may not yet have passed. It is in everyone’s interest that we address the blockages and disruptions that are preventing the delivery of vaccinations to low-income nations, but we must accept that there are systematic political issues behind those shortages, too.
We are fortunate. The UK is in a fortunate position to have access to sufficient vaccines for our entire adult population, but the most effective way to protect our population is to pass on any surplus doses remaining, not taking it down from the COVAX facility, as the noble Lord, Lord Purvis, said, which should be redistributing. I hope again that the Minister responds positively to the questions of the noble Lord, Lord Purvis.
I conclude with the words of the noble Baroness, Lady Sugg: addressing the shortage of vaccinations in the global South is not only the morally right thing to do—it is in our self-interest to do it. It is in our country’s self-interest and the people of this country’s self-interest. It is the only course of action that will protect us from this virus again causing the destruction and suffering we have seen in the past 18 months. I look forward to the Minister’s response.
Lord Parkinson of Whitley Bay (Con)
My Lords, I thank the noble Lord, Lord Boateng, for tabling this debate and all the noble Lords who have taken part. It has been urgent and passionate, but focused. As the noble Lord, Lord Browne, put it, it has demonstrated the
“rich seam of knowledge, wisdom and humanity in your Lordships’ House”.
It has been almost 19 months since the first cases of Covid-19 were reported, and nine months since widespread international vaccination programmes began. Yet, as noble Lords have rightly said today, too many people remain unvaccinated, particularly in the global south.
The rapid spread of the delta variant illustrates what we have known from the very beginning, and what the noble Baroness, Lady Lawrence, and others echoed today: nobody is safe until everyone is safe. Worldwide vaccination is essential to beat the pandemic, and UK science and diplomacy have been pivotal to the progress made so far. From the outset, Her Majesty’s Government have advocated rapid and equitable access to vaccines, and we have helped to drive the global response including, as noble Lords noted, by hosting the Global Vaccine Summit and through our presidencies of the G7 and the UN Security Council. We have been a champion for global action in this important area.
We have worked closely with our partners to design, fund and implement the COVAX Facility, which is an unprecedented initiative led by the World Health Organization, Gavi, or the global vaccine alliance, and the Coalition for Epidemic Preparedness Innovations, or CEPI. COVAX has brought together 191 countries to fund, develop, manufacture and deliver Covid vaccines, particularly to the global south. Its advanced market commitment is focused on providing safe and effective vaccines to up to 92 low-income and middle-income countries. From Benin to Zambia, from Bangladesh to Timor-Leste, it is delivering vaccines across the world.
It was launched at the Global Vaccine Summit that we hosted in June last year. The UK was among its founding donors and our total commitment of £548 million is among the largest from any donor. Thanks to our leadership at the UN General Assembly and our match-funding campaign, we helped to mobilise an additional $1 billion for COVAX from other donors by the end of 2021. The noble Lord, Lord Boateng, rightly talked about resources that have been made available—our work has helped to mobilise the resources that have been made available so far. By leading this early funding drive, we gave COVAX the purchasing power it needed to secure its first deals with manufacturers, which locked in the supply of internationally approved vaccines.
The first COVAX shots—vaccines from the University of Oxford and AstraZeneca—were delivered to Cote d’Ivoire and Ghana in March this year, just four months after the first vaccination in the UK: an historically unprecedented speed. From a standing start in June last year, COVAX has now delivered more than 230 million vaccine doses to 139 countries and territories, including 87 low and middle-income countries.
Manufacturing vaccines at scale is difficult, even for experienced companies. Delays in production have slowed progress, a frustrating fact that has rightly been echoed throughout today’s debate. However, the COVAX vaccine rollout is now poised to accelerate, with new funding, supply agreements and donation commitments in place which will provide 1.8 billion vaccines to low-and middle-income countries for early 2022. This will protect millions of front-line healthcare workers and other vulnerable people.
It is right to draw attention—as the noble Lord, Lord Boateng, and others have—to the discrepancy between the number of vaccines available in the UK and elsewhere in the world. The first duty of the Government, just as it is for all Governments around the world, is to ensure that we have sufficient vaccine supply for our own domestic rollout. I am sure that noble Lords would not disagree with that. We are ensuring that we have sufficient future supply for the UK’s needs alongside meeting our G7 commitments.
Alongside this, as noble Lords have said today, making vaccines available globally not only helps address the coronavirus pandemic in developing countries and is the morally right thing to do, but it will also reduce the threat posed by vaccine-resistant variants which are emerging and could pose a threat to us all. As my noble friend Lady Sugg put it, it is in our enlightened self-interest as a force for good in the world. Through our participation in COVAX and by sharing vaccines bilaterally, the UK is therefore also championing the need for access for all countries.
At the G7 leaders’ summit in Cornwall, the UK committed to sharing 100 million Covid-19 vaccine doses within 12 months, including 30 million by the end of this year. Of these, 80% will go to COVAX to accelerate support to countries in need. My noble friend Lady Sugg and others asked how many had been delivered so far. To date, the UK has delivered over 9 million doses—ahead of our target for the end of September—of which half are helping to meet the urgent need for vaccines in countries across Africa, south-east Asia and the Caribbean. UK donations are already helping to immunise health workers and those most vulnerable to serious illness from Covid, and to protect health systems. Our 100 million doses are part of the broader G7 promise to finance and donate a billion safe and effective vaccines worldwide by June next year.
My noble friend Lady Sugg and many others asked about the taking of vaccines from COVAX for UK use. As well as being one of the largest donors to COVAX, the UK was one of the earliest. That is pertinent here, because the UK opted into procuring the Pfizer vaccine through COVAX at a time when that was the only vaccine demonstrated to be effective and approved by the UK regulator. COVAX subsequently decided, after consulting those participating, to procure only a small amount of the Pfizer vaccine because it is, as noble Lords will know, difficult for many countries deploy, given the challenge of establishing the very cold temperatures at which it needs to be stored in the delivery chain. Our early funding to COVAX gave it the purchasing power it needed to secure deals with manufacturers to supply internationally approved vaccines for low and middle-income countries.
These practical points lead to questions posed by the noble Baroness, Lady Lawrence, and others, about donating vaccines with short shelf lives. We agree that adequate shelf life is important for all vaccines supplied to all countries. We are aiming for all donated and dose-shared vaccines to have a minimum of two months of shelf life, in line with Gavi and COVAX guidance. The partner Governments are free to refuse donations if they are concerned about expiry dates. They are working to ensure the rapid rollout of shared doses to priority groups, including people who need a second dose, and to prevent wastage. The WHO EUL vaccines are approved with a six-month expiry date at present, which may be reviewed by the WHO depending on emerging stability data.
The noble Baroness also asked what we are doing to speed up vaccine access and to tackle the problem of sell-by dates. We are working through the governing boards to ensure that Gavi and World Bank funding is available for in-country delivery and that it is approved and dispersed in a timely manner. We are also supporting COVAX to become less reliant on India-based manufacturers and to diversify its portfolio to manage risk.
The noble Baroness, Lady Brinton, asked another practical question about new variants that may evade vaccine immunity. If such a variant emerges, it should be possible for manufacturers to update vaccines to protect against it, but this means scaling up vaccine manufacturing and rolling out vaccines as quickly and widely as possible. In addition, as more people get vaccinated, we expect virus circulation to decrease. This will lead to fewer mutations, but of course we must track those mutations and variants closely to detect them, and that means carrying out genomic sequencing globally and sharing data.
The noble Baroness, Lady Bennett of Manor Castle, referred to the UK’s role in the development of the AstraZeneca vaccine. So much of what we have been debating today would not have been possible without the extraordinary work of our scientists. The UK’s scientific excellence and co-operation has enhanced collective knowledge about the virus and led to pivotal breakthroughs. The Government’s role in supporting AstraZeneca is well known and we are proud of the helping hand that we gave. The advance there has become an extraordinary gift to global vaccination efforts. More than 1 billion doses have already been delivered at cost, with no profit, with around two-thirds of them going to lower-income and middle-income countries. That has saved countless lives across the globe.
We also supported wider international collaboration to develop vaccines. In March last year the Prime Minister announced £250 million of funding for CEPI to accelerate vaccine development against global threats including Covid-19. CEPI has supported 11 vaccine candidates, including the approved Moderna vaccine, as well as Novavax, which has showed positive results in clinical trials. The UK will host a replenishment conference to raise funds for CEPI’s crucial work on vaccine development in March next year, helping it to realise the aim of making vaccines against new health threats, including new Covid variants, in just 100 days.
In addition to our support for vaccines, the UK is a world leader in viral genomic sequencing, which will be important for the reasons I outlined in response to the question from the noble Baroness, Lady Brinton. This has proved crucial in identifying the emergence of new variants and will be essential to ensuring that the vaccines remain effective. Public Health England is already working with seven countries and the Africa Centres for Disease Control to build their capacity in genomic sequencing.
A number of noble Lords raised the issue of manufacturing. The rollout of vaccines has raised important questions about TRIPS, the agreement on trade-related aspects of intellectual property rights, which the noble Baroness, Lady Chakrabarti, and others focused on in particular. We have engaged in discussions on intellectual property and a possible TRIPS waiver at the WTO and we will continue to engage constructively with the US and other WTO members, as the noble Lord, Lord Boateng, and others urged. We have not yet, however, seen conclusive evidence indicating that the removal of intellectual property protections would lead to the scaling up of production or the improvement of the supply of Covid-19 products, including vaccines. At this point we remain unconvinced on how beneficial a waiver would be.
As a practical point, any negotiations at the WTO on a waiver would need unanimous support, which could take a long time. While we will continue to engage in IP discussions and review the merits of any proposals submitted to the TRIPS council, we must also continue to push ahead with pragmatic action now, including voluntary licensing and technology transfer agreements for vaccines, support for COVAX, as I outlined, and solutions to production bottlenecks and supply chain issues. The UK is also co-sponsoring the Ottawa group’s trade and health initiative. This aims to increase co-operation among WTO members, keep medical supply chains open and lower trade barriers, getting vital supplies, including vaccines, to those who need them most.
The voluntary licensing approach taken by the team at Oxford and AstraZeneca has had our full support, as has their collaboration with the Serum Institute of India to scale up manufacturing for global supply. We welcome the work of the new Partnerships for African Vaccine Manufacturing, which is developing its road map to manufacture vaccines in Africa and engaging to identify opportunities for partnerships. We have provided technical support to Biovac, a vaccine company in South Africa, to develop an investment case, which helped secure financing to produce Covid vaccines there. We are giving similar support to the Institut Pasteur in Dakar, to companies in Senegal and to the Government of Morocco.
Noble Lords also focused on questions of distribution, and we recognise that distribution, particularly in hard-to-reach locations, is a critical challenge in many countries. Investment in delivery is vital in getting jabs into people’s arms. Multilateral development banks are playing a central role in funding health systems to deliver vaccines, treatment and testing while maintaining other essential services, and the UK has led engagement with multilateral banks to strengthen co-ordination with COVAX and speed up the processes for applications and release of funds. The FCDO is also working with UNICEF and other humanitarian partners to ensure that planning and finance are in place to address the challenges of distribution in difficult environments.
It is extremely difficult for charities and healthcare workers safely to provide jabs to people living in conflict zones, so the UK used its presidency of the UN Security Council in February to secure unanimous support for a resolution calling for ceasefires in conflict zones to enable vaccine delivery. We continue to work with our international partners to monitor and support the implementation of that important resolution.
Lord Purvis of Tweed (LD)
I am not sure whether the Minister will be coming back to the UK and COVAX. He has been asked very specific questions: to confirm whether in fact the UK drew down 539,000 doses in June and whether we have in fact negotiated options for a further 27 million doses. He was asked whether the Government will confirm that they will not draw down those 27 million doses.
Lord Parkinson of Whitley Bay (Con)
I cannot confirm that number, but I outlined that we drew down some of the Pfizer vaccine for the practical reasons that I gave—the difficulty of distributing and using those doses—with the agreement of those taking part. I fear I cannot give the commitment that the noble Lord asked for today, but I will certainly take his questions and those from other noble Lords back to the Vaccine Taskforce and will ensure that all noble Lords who have taken part in the debate get the answer to that.
The goal to which we and our G7 partners have committed—to vaccinate the world in 2022—is a monumental one. Much has been achieved already but, as today’s debate has powerfully underlined, we know that there is much more to do. The points noble Lords have raised today, particularly on manufacturing and distribution, are significant issues, which the UK is working with our partners to tackle.
International collaboration remains the key to ending this global pandemic, and we will continue to work with our international partners through the autumn, including at UNGA, the G7 and the G20, to support the G7 commitment to vaccinate the world in 2022. The international community must work together to get vaccines to those who need them around the world, and Her Majesty’s Government are determined to do all we can to ensure that that happens.
Lord Boateng (Lab)
My Lords, it is late and we have had an outstanding debate. It has been a rich debate; there has been compassion, knowledge and passion, undergirded by broad experience—experience of campaigning around human rights, experience of activism around social justice, and ministerial experience—on all sides of this House.
I hope the Minister got a sense that the House spoke with one voice, and that one voice was clear. There is, as the Minister himself has said, much more to be done. This House expects more to be done, and we intend to make sure that it is. I can say only a huge thank you to all those who have contributed, but also to all those who have come and stayed—on all sides—to hear these arguments and to indicate their support for what has to be done.