Westminster Hall

Thursday 15th May 2025 Westminster Hall

Thursday 15 May 2025

[Christine Jardine in the Chair]

Accountability for Daesh Crimes

Thursday 15th May 2025 Westminster Hall

JOINT COMMITTEE ON HUMAN RIGHTS

Select Committee statement

13:30

[Christine Jardine (in the Chair)]

We begin with the Select Committee statement. Tom Gordon will speak on the publication of the Joint Committee on Human Rights’ second report of the Session “Accountability for Daesh crimes” for up to 10 minutes, during which no interventions may be taken. At the conclusion of the statement, I will call Members to put questions on the subject of the statement and call Tom Gordon to respond to these in turn. Questions should be brief, and Members may only ask one question each. I remind Members that they should bob if they wished to be called to ask a question.

[Tom Gordon (Harrogate and Knaresborough) (LD)]

It is an honour to serve under your chairmanship, Ms Jardine, and a privilege to speak on this important statement on the Joint Committee on Human Rights report “Accountability for Daesh crimes”. The report represents the shared conclusions of a cross-party group of parliamentarians from both Houses, a rare show of unanimity in one of the most disturbing human rights failures of our time.

Let us begin with the facts. Between 2014 and 2017, Daesh—also known as Islamic State—waged a campaign of brutal violence and terror across Syria and Iraq. They targeted ethnic and religious minorities, including Christians, Muslims and particularly the Yazidi people, with a clear intent to destroy them as a group. Thousands of Yazidis were executed. Women and girls were abducted, raped, sold and enslaved, and many remain unaccounted for. Children were indoctrinated or taken for use as child soldiers. These were not isolated atrocities. They were systematic and intentional. They were acts of genocide, crimes against humanity and war crimes.

In 2023, the UK Government formally recognised that Daesh had committed genocide against the Yazidi people. That recognition matters, but recognition without justice is not enough. The uncomfortable truth is that nearly 3,000 women and girls were taken by Daesh and that, while a number of UK nationals were involved in these crimes and some have since returned to this country, not a single one of them has been prosecuted in the UK for international crimes such as genocide. Only around 32 returnees have been prosecuted for terrorism-related offences. Although it is welcome that those prosecutions have taken place, they fall short of the accountability that the scale and the nature of these crimes demands.

Let me be blunt: it is a stain on the UK’s human rights record that we have not prosecuted a single individual for some of these crimes, despite having the legal tools and the moral obligation to do so. Other countries have stepped up; in Germany, several Daish perpetrators have been successfully prosecuted for war crimes and genocide. There is no reason the UK cannot do the same, except for a failure of political will and legal infrastructure. Our report makes a serious of clear, practical recommendations that would begin to put that right.

First, we call for a reset in the UK’s approach to investigating and prosecuting international crimes. The current emphasis by UK law enforcement is overwhelmingly on terrorism offences. While that focus is understandable, it is currently insufficient. Genocide, war crimes and crimes against humanity are distinct crimes under international law and must be treated as such. The Government must develop a strategic framework that enforces and ensures that law enforcement, intelligence and prosecuting agencies work together to gather the necessary evidence to bring these cases to court. This is not just about justice for victims abroad; it is about our credibility at home too. British citizens should not be able to participate in genocide abroad and return to the UK without facing the full weight of the law.

Secondly, we call for a change in the law. At present, under the International Criminal Court Act 2001, the UK can only prosecute individuals for international crimes such as genocide, war crimes or crimes against humanity if they are UK nationals or residents. That is a major gap in our legal framework. Those are not crimes that should be subjected to jurisdictional loopholes. We urge the Government to amend legislation, specifically the Crime and Policing Bill currently before Parliament, to enshrine universal jurisdiction for those crimes in UK law. Doing so would mean that anyone, regardless of nationality or residency, could be prosecuted in the UK courts for the worst crimes known to humanity. That is not a radical proposal, but a long-overdue alignment of our legal system with our moral and international obligations.

Thirdly, we raise serious concerns about the deprivation of citizenship. The Government have used their powers to strip some individuals, particularly those suspected of involvement in terrorism abroad, of British nationality. We are concerned that in some cases the power has been used as a substitute for prosecution—in effect, removing people from our jurisdiction without holding them accountable for the crimes that they have committed. We call for greater oversight of the power. It should be subject to independent review and transparency mechanisms. Citizenship deprivation should never be used to avoid prosecution, nor to wash our hands of British nationals involved in the most serious international crimes.

Fourthly, we cannot ignore the humanitarian and security crisis in Syria. There are still UK nationals, including children, detained in camps that are overcrowded, dangerous and inhumane. Children face the daily risk of malnutrition, disease and violence. The camps have been described as, in effect, open-air prisons. They are not places for recovery or rehabilitation. The UK cannot simply look away; these are British citizens, many of whom are minors. Some of them were taken to Syria by parents, while others may have been born there. None of them should be condemned to a life of statelessness or radicalisation. We call on the Government to identify the number and status of those children, and to bring forward proposals for their resettlement and care.

Where British adults in these camps are suspected of involvement in Daesh crimes, the UK must take all steps to prosecute them here at home, in accordance with due process and the rule of law. The failure to prosecute those crimes sends a dangerous message to perpetrators, victims and the world. It tells perpetrators that they can get away with genocide if they are clever about which passport they hold, it tells victims that their suffering does not matter unless it happens within our own borders, and it tells the world that the UK is willing to tolerate impunity for the worst atrocities committed in modern times.

The Joint Committee on Human Rights believes that Britain must do better. Justice delayed is justice denied, and impunity is injustice enshrined. Let us be clear: the UK has the legal tools, the institutional capacity and the moral responsibility to act. What we need now is political leadership from the Government.

I thank everyone who gave evidence to the Joint Committee, whether written, in person or in any other form. I also thank those people who were brave in speaking out and sharing the situations that they and their families had been through. I acknowledge the work of the Committee support staff throughout this inquiry. I commend the report to the House and urge the Government to implement its recommendations without delay.

[Richard Foord (Honiton and Sidmouth) (LD)]

More than 900 people left the UK to engage in the conflict in Syria and Iraq. There was a lot of media attention at the time on the case of one of them, Shamima Begum, who was 15 when she left the UK to join Daesh. Did the Joint Committee consider her case in particular, and does it have any recommendations for the UK Government?

[Tom Gordon]

I thank my hon. Friend for that important question. Throughout our discussion, our deliberations and the formulation of the report, the Committee talked extensively about that. A number of issues pertain to the rights of a child, and one of the key structural points of the report is the deprivation of citizenship. We tried to avoid talking about specific individuals, but the report clearly sets out what we think the appropriate mechanisms are for the Government: namely, that the power should not be used as a tool routinely and that, where it is used, there should be review, accountability and scrutiny.

[Jim Shannon (Strangford) (DUP)]

The violence against and the murder and rape of Yazidi women has been truly horrendous. Way back in 2010 or 2012, I had a chance to meet some of them. Yazidi women who survived have a story to tell against their Daesh perpetrators. Has every effort been made to collate the evidence and pursue the perpetrators? The testimonies of the victims must be used to condemn the perpetrators to a long and very, very painful time in prison.

[Tom Gordon]

The Government could do more to look at, collate and document that information, so that we have something that we can refer back to for similar situations that may, sadly, occur in the future. The evidence sessions were carried out in the last Parliament, before my election, but I have read some of the transcripts, and they were truly harrowing. I cannot imagine what it must have been like for people who had to listen to that evidence, or for the people themselves giving it. We owe it to them, and to all victims of such crimes, to ensure that we never allow their words to be forgotten.

13:39

Sitting suspended.

Backbench Business

Thursday 15th May 2025 Westminster Hall

Gavi and the Global Fund

Thursday 15th May 2025 Westminster Hall

11:39

[Emily Darlington (Milton Keynes Central) (Lab)]

I beg to move,

That this House has considered funding for GAVI, the Vaccine Alliance, and the Global Fund.

It is a pleasure to serve under your chairpersonship, Ms Jardine. I want to start with a quote from Gavi’s inaugural board chair, Nelson Mandela, over 20 years ago:

“Life or death for a young child too often depends on whether he”—

or she—

“is born in a country where vaccines are available”.

It is the injustice that he spoke of that the organisations we will talk about today—Gavi, the Global Fund and others—have fought against since Gavi was established in 2000. The fight has led to more than 1 billion children being vaccinated, and more than 18 million avoidable deaths prevented in low-income countries.

This is also a Labour and UK story. We had a consensus, but it was Tony Blair’s championing of Gavi at its launch in 2000, and Gordon Brown’s leading role in the creation of the international finance facility for immunisation, that helped to fund Gavi’s work at the start, and the organisation continues to turn to our Government —a Labour Government—for global leadership.

Through these organisations, we have cut the combined death rate from AIDS-related illnesses, tuberculosis and malaria by an incredible 61%, saving 65 million lives. Childhood mortality in under-fives has been reduced by over 50%, and vaccine-preventable deaths by over 70%, in the places where Gavi operates, and the coverage of key treatment and prevention interventions for HIV, TB and malaria has increased significantly in countries where the Global Fund invests. We saw TB treatment coverage increase from 45% in 2010 to 70% in 2022. In 2010 the percentage of the population with access to long-lasting insecticide-treated nets to prevent malaria was only 30%; in 2023 it reached 57%. In 2010 only 22% of people living with HIV were on antiretroviral therapy; in 2023 it reached 78%. That is the UK’s legacy.

We hosted the first replenishment for Gavi in 2011, we hosted the last one in 2020, and we will co-host the Global Fund replenishment this year alongside South Africa. This is not just about helping other countries; it is about the UK’s own soft power and security and the resilience of the NHS.

Let us talk a bit more about the UK’s contribution, because it is not just the Government’s contribution, but the contribution of amazing life sciences companies here in the UK. The UK Vaccine Network helped to develop life-saving vaccines such as the RTS,S malaria vaccine and the Oxford-AstraZeneca covid-19 vaccine, which have both been procured and rolled out by Gavi worldwide. Between 2016 and 2022 we invested £134 million to develop new vaccines for epidemic-prone diseases. An additional £103.5 million was committed in 2023 to support affordable vaccine development. Three billion doses of the covid vaccine have been supplied globally, which is estimated to have saved over 6 million lives in the first year of roll-out.

[Dr Lauren Sullivan (Gravesham) (Lab)]

I am grateful to my hon. Friend for securing this important debate. Does she agree that it was work on malaria vaccines and others that enabled us to move quickly when covid and other infections occurred, and that investigations into neglected diseases have been the springboard to create vaccines for many other diseases that threaten the entire world?

[Emily Darlington]

My hon. Friend is absolutely right. It is through such programmes that we developed the expertise and the ability to rapidly create mRNA-based vaccines, which led to the creation of our own vaccines here in the UK and allowed us not only to protect our own population but to contribute to protecting biosecurity globally, by ensuring the fast spread of those vaccines.

Similarly, 18 million doses of the RTS,S malaria vaccine created here in the UK have been allocated to 12 African countries. We have administered the vaccine to over 1.7 million children in pilot countries and consequently we have been able to reduce malaria cases. We know that malaria is moving north as climate change hits, so this is not just about protecting children in those countries; it is also about protecting children here at home.

I want to share some of the quotes that were sent to me when scientists at AstraZeneca and elsewhere heard that I had secured this debate. They wanted to send a clear message. Sandy Douglas at the University of Oxford, one of the six scientists who created the covid-19 vaccine developed by AstraZeneca, said:

“Gavi brings Britain’s scientific leadership to the world, and this brings investment back into the UK’s world-leading research, generating a virtuous cycle of innovation.”

GSK also reached out because it wanted its voice to be heard in the debate. It said:

“UK life sciences are a critical economic driver to improve health outcomes and transform lives in the UK and around the world, including in the Global South. Scientific innovation underpins national and global health security and economic prosperity at a time of growing uncertainty. GSK and its HIV business…are proud of the contribution we make to deliver these priorities.”

Most importantly, it said:

“The UK’s 2025 investment in Gavi and the Global Fund will be critical in building long-term sustainable access to health technologies at scale.”

This is not just about what we are doing in the global south and in other countries that need our partnership; it is also about what we are doing to build economic growth, which is the single most important mission of this Government.

The reality is that this mission is not over. I could go through many of the numbers, but I know that my hon. Friends will pick up some of them. What I will say is that across the US, the UK, Germany, France and the Netherlands, which provide 90% of the HIV funding response, there could be cuts of between 8%—if we do our job well—and 70%. Modelling by the Burnet Institute estimates that such cuts would result in between 4.4 million and 10.8 million additional HIV cases, and between 770,000 and 2.9 million HIV-related deaths in children and adults, by 2030.

[Bambos Charalambous (Southgate and Wood Green) (Lab)]

My hon. Friend is making an excellent speech and I congratulate her on securing the debate. Gavi has been one of the most successful development initiatives ever; more than 1 billion children are being routinely immunised against some of the world’s deadliest diseases. Despite its success, however, each year more than 1.5 million children continue to die from vaccine-preventable diseases. Does she agree that the UK needs to show leadership in ensuring that immunisation remains a funding priority for the UK, and that the Government, as a board member and a strong donor, should continue to fund Gavi and prioritise life-saving vaccinations?

[Emily Darlington]

I absolutely agree. That reminds me of something my gran always said to me: “If you don’t have your health, what do you have?” I know this issue sounds quite niche, but health is something we all understand. If we do not have our health, we cannot talk about improving the economies of countries around the world and improving global security. That is why this is such a crucial initiative.

These diseases cross borders. Milton Keynes’s HIV rate is among the highest in the UK, so this is also about protecting our constituents. If we can reach the levels that we need to reach on HIV transmission, we will be protecting the UK population too.

I am really encouraged by the UK’s commitment to co-host the Global Fund’s eighth replenishment, alongside the Government of South Africa, and by the Prime Minister’s statement that, although we are cutting official development assistance, we will continue to support global health. These partnerships are the best and most efficient way of getting money to the ground. They bring an estimated £530 million of investment into research and development in the UK, and they balance investment by ensuring that the countries that can contribute to the programmes do so. This is not charity, but true partnership. It is about us working together to build capacity.

These programmes have public support. Various polls show that about three quarters of the British public support using our R&D and our expertise in life sciences to save lives here and abroad.

I will conclude, because a lot of other Members want to speak. This year is pivotal. Gavi, the Global Fund, Unitaid and others are requesting partnership money, but it is about not just cash but the partnership and leadership that the UK Government provide. I say to the Government and the Minister, who cares a lot about this issue, that, despite the short-term cuts—the Prime Minister said that it is one of the most difficult decisions he has had to make, and that we will look to increase funding in the future—we must not use the fact that the replenishment comes at a time when our budget is at its lowest not at least to match what we have pledged in the past.

[Several hon. Members rose—]

[Christine Jardine (in the Chair)]

Order. I remind Members that they should bob if they wish to be called in the debate. Unfortunately, because of its popularity, I will have to impose a time limit of three minutes from the beginning. I intend to go to the Front Benchers at 2.38 pm.

14:03

[David Mundell (Dumfriesshire, Clydesdale and Tweeddale) (Con)]

I am grateful to you for stepping into the Chair, Ms Jardine. I was due to chair this debate, but that would have meant that I was unable to contribute, which I very much wanted to do.

Given the restricted time, I do not want to rehearse the discussions that we had with Baroness Chapman in the International Development Committee earlier in the week. Like the hon. Member for Milton Keynes Central (Emily Darlington), whom I congratulate on securing the debate, I want to say that a contribution to Gavi and the Global Fund is not charity but a strategic investment by the United Kingdom. Although we have to deal with the reality that, as Baroness Chapman set out, the cuts are happening, we have to make the case about what should happen in that environment. I have always believed that aid spending should have maximum impact and maximum returns. Moreover, it should be in keeping with public expectations of food in bellies and shots in arms, and the Global Fund and Gavi deliver both.

As the hon. Member for Southgate and Wood Green (Bambos Charalambous) said, Gavi has immunised more than 1 billion children, reducing vaccine-preventable child deaths by 70% in the 78 low-income countries in which it operates. That is 18.8 million lives saved and children growing up healthy, going to school and contributing to their communities, which is a huge impact. The Global Fund has saved an estimated 65 million lives since 2002. It has cut the combined death rate from AIDS, TB and malaria by 61%. These are staggering achievements and they should not be discounted.

Gavi and the Global Fund are two of the most successful and impactful health programmes in history. They clearly meet the requirement for maximum impact and return, but they are possible only because of sustained, co-ordinated international investment. Alongside Unitaid, they are part of a habitat of organisations that have sustained progress in our understanding of diseases, and our ability to deploy medicines and improve health systems.

I join the hon. Member for Milton Keynes Central in encouraging the Minister to sustain the existing contributions to both Gavi and the Global Fund. He will be aware that in the last Parliament, I lobbied my own Government very hard to get that £1 billion into the Global Fund. Let us keep it at that at least, and keep the contribution to Gavi. These programmes make a difference.

14:06

[Steve Race (Exeter) (Lab)]

It is a pleasure to serve under your chairship, Ms Jardine. I congratulate my hon. Friend the Member for Milton Keynes Central (Emily Darlington) on securing this debate. I refer Members to my entry in the Register of Members’ Financial Interests.

I am proud to co-chair the all-party parliamentary group on nutrition for development, alongside the right hon. Member for Dumfriesshire, Clydesdale and Tweeddale (David Mundell). Nutrition and immunisation are closely linked. Children with poor nutrition are often those who are most vulnerable to infectious diseases and need protection from vaccines, yet vaccines are less effective in malnourished children and often do not trigger strong immunity.

The children whom specialised immunisation programmes are trying to reach are also the least likely to have access to food and nutrition services. Immunisation has the most impact when it is delivered alongside other interventions and integrated into primary health systems. By addressing under-nutrition and under-immunisation simultaneously, we can significantly improve health outcomes and vaccine efficacy, as well as provide interventions in the most cost-effective way.

I saw this for myself on a recent visit to Isiolo in Kenya, hosted by UNICEF and organised by United Against Malnutrition and Hunger. We saw how in rural areas, nutrition interventions are delivered alongside vaccinations, healthcare education and maternal healthcare, to ensure that people have wraparound healthcare interventions that save lives. That was funded by UK development assistance and delivered by partners including Action Against Hunger. If a woman walks for 20 km or more with her children once a week for nutrition, they are less likely to walk the same distance, at a different time, to a different place, for vaccines. Integrating the services is paramount to good healthcare.

This February, ahead of the Nutrition for Growth summit, I met the chief executive officer of Gavi, Dr Sania Nishtar, to discuss the important role that Gavi is playing in delivering these integrated services. Dr Nishtar spoke about the new $30 million programme to integrate nutrition and immunisation interventions in Ethiopia through the UK-founded Children’s Investment Fund Foundation, as well as UNICEF Ethiopia and Gavi, with support from the UK through Gavi’s matching fund mechanism.

Ethiopia has one of the highest numbers—a staggering 1.1 million—of zero-dose children, who have not received a single dose of routine vaccines. That statistic is exacerbated by the covid-19 pandemic, conflict and displacement. The pilot programme aims to reach around 140,000 of those zero-dose children in areas with the highest dual burden of malnutrition and infectious disease, providing cost-effective and efficient interventions to help children to survive and thrive.

[Iqbal Mohamed (Dewsbury and Batley) (Ind)]

Does the hon. Member agree that even before the devastating cuts to UK foreign aid, there was instability in funding for global vaccination programmes? We have already heard that over 1.5 million children die from preventable diseases. Does he agree that the reduction in UK foreign aid will have a devastating impact on the ability to provide vaccines to these children, and will end up costing lives?

[Steve Race]

I will let the Minister answer that question, but I hope there will be an impact assessment to properly map our interventions in future.

Integration costs money and Gavi cannot do it without financial support. I hope that when the Minister is assessing our contribution to this year’s Gavi replenishment, he will look at including support for nutrition integration. What plans does his Department have to integrate nutrition and immunisations more widely?

I want to touch on one issue briefly. The UK’s contribution to Gavi has not only helped to save lives but contributed to the UK’s health security by reducing the risk of global health emergencies and pandemics. It has brought money into the British economy through reputational research returns, and it showcases the UK’s leadership on the global stage.

In my constituency, the Medical Research Council-funded Centre for Medical Mycology at the University of Exeter works closely with Gavi, carrying out world-leading research into deadly fungal diseases and developing vaccines for some of the most widespread causes of death and disablement in developing countries. Does the Minister agree that the UK’s continued participation in Gavi and the Global Fund not only is the right thing to do because it saves lives around the world, but is strategically sound, as it supports our growth strategy and is an important part of delivering both our industrial strategy goals and our national health goals?

14:10

[Wendy Chamberlain (North East Fife) (LD)]

It is a particular pleasure to serve under your chairpersonship for the first time, Ms Jardine. I congratulate the hon. Member for Milton Keynes Central (Emily Darlington) on securing this important debate.

It is just six months shy of five years since I had my own Backbench Business debate on global vaccine access—albeit in the context of the global covid-19 pandemic. I look back on what the then shadow Foreign Secretary, the right hon. Member for Wigan (Lisa Nandy), said with interest. I found in her remarks a consistent emphasis on working bilaterally to tackle global health crises, and through those efforts, to tackle poverty and inequality. She said that this was not just the practical but the moral thing to do.

I hope that we have not forgotten what we should have learned from the covid pandemic about how fast a disease can turn into a global threat, about how good health produces sage and secure countries, and about how terrifying it was to reckon with the realities of the pandemic in all aspects of our lives. I do hope that the Government will think about that as they approach the spending review.

Gavi and the Global Fund have been an incredible success, and we ought to celebrate that. The UK has been a leading force in these efforts on the international stage, and that is something to be proud of, because it bolsters our reputation and our standing and forms part of our global soft power.

We will not need to fund such programmes forever. Fifteen years ago, lower income countries were able to fund, on average, only 10% of the costs of their vaccine programmes. Over the next five years, it is estimated that they will cover up to 40% of the costs on average. Some countries are already there, with Indonesia now a donor to Gavi rather than a recipient.

Let us not forget that we need the world to be vaccinated. Disease knows no borders. Disease leads to poverty, which leads to global instability. We also have seen the more immediate and direct effects of global vaccine and treatment availability, through the demand and growth of our life sciences sector here at home—will the Minister tell me that that is not the sort of growth that this Government are looking for? At best, these investments benefit us up and down the UK. In my constituency, the University of St Andrews reported just last month that its infection and global health division had been awarded early career funding to identify new therapeutic strategies for infectious diseases.

I have almost reached the end of my remarks, but I must mention the elephant in the room: the shrinking ODA budget. I have read the statistics, as others have, that show that spending on Gavi and the Global Fund gives some of the best financial returns. Just a few weeks ago, I attended a meeting in Parliament with the chief executive of the World Bank. He was clear that his role and that of his organisation is to create opportunities in the global south to develop their economies and reduce emigration from there.

Given the Government’s other priorities, such as immigration, investing in multilateral ODA activities makes sense. I really urge the Minister to look again at that cut and how long it is needed for, and to engage openly with the ONE Campaign’s pre-action letter questioning the legality of the current cut to 0.3%.

14:13

[Alice Macdonald (Norwich North) (Lab/Co-op)]

It is a pleasure to serve under your chairship, Ms Jardine. I thank my hon. Friend the Member for Milton Keynes Central (Emily Darlington) for securing this debate.

Let us be honest: most of the public do not know what Gavi or the Global Fund are, but they do know the lifesaving power of vaccinations because they, like all of us, will have benefited from them when they were children, as will their children. But we know that for too many children around the world, those lifesaving vaccinations are not available. In these debates we must remember that people’s lives are at the heart of the issue. I worked for Save the Children for many years, and I saw at first hand the impact of immunisations and the progress that has been made. Some of that is at risk in the light of what is happening around the world, so this is a really important debate.

We have covered many of the areas that I want to talk about, but 1.5 million children continue to die from vaccine-preventable diseases. That is more than the population of Cyprus—an entire island of children dying every year. Vaccination and ending AIDS, tuberculosis and malaria are not only the right thing to do but, as we have heard, in our national interest and the smart thing to do.

Vaccinations stop disease reaching our shores. They help to support healthy and prosperous nations, and they help to prevent future pandemics. They are also vital in the context of climate change, as many of the world’s deadliest diseases are susceptible to climate change, which increases the risk of them spreading. Tackling those diseases is best done—with best value for the British taxpayer—through Gavi and the Global Fund. We know we have to maximise our aid budget at this difficult time and invest it in the right things that will deliver the best value for the British taxpayer. Investing in Gavi and the Global Fund is therefore simply a no-brainer.

I asked the Minister earlier this week if investing in women and girls remained a priority for this Government, and I was reassured by his answer. I then raised that with the Minister for International Development at the International Development Committee, and we heard that the approach is more about mainstreaming gender equality—women and girls were not listed as one of our three top priorities. Although I accept that we can mainstream gender, I hope that the Minister will reply on how we will ensure that women and girls remain at the heart of programmes such as Gavi and the Global Fund.

Every week, 4,000 adolescent girls and young women between 15 and 24 become infected with HIV globally, and 3,100 of those infections are in sub-Saharan Africa. As we look at our aid budget, we know it has to be focused on tackling extreme poverty, and Africa is one of the areas that we need to focus on.

[Iqbal Mohamed]

The hon. Member talks about vaccine inequality in women and girls, but would she agree that the global Gavi programme helps to address the inequalities that people face? During the covid pandemic, it was clearly reported that richer and more affluent countries had priority for vaccines when compared with low and middle-income countries. Gavi is essential to help to perpetuate equality.

[Alice Macdonald]

I totally agree with the hon. Member. In fact, what we have seen with Gavi is that countries that were primarily recipients before have now becomes donors, such as Indonesia. Gavi is a clear pathway for countries to transition into different roles in the global economy as well.

Other Members have mentioned brilliant examples of science and innovation in their constituencies. I want to mention the John Innes Centre at the Norwich Research Park, which is not technically in my constituency, but is in Norwich. It is doing pioneering work, particularly around malaria. As we have heard, that work is helping to save lives internationally, as well as creating jobs at home and generating economic growth.

We need a new architecture for international development. We have to accept the world that we are in, but we also have to challenge ourselves as to why some of the public support for aid has been lost—although, some of the polling shows there is a lot of support for lifesaving interventions such as vaccines. Both Gavi and the Global Fund show us what that new architecture could look like: working together globally through multi- lateral institutions and pooling our resources to maximise our impact.

This is not the time to take our foot off the accelerator. We have made huge progress in this area, both in tackling disease and protecting our own health security. I am sure that the Minister will reaffirm our commitment to improving the health of some of the poorest communities in the world and to delivering a safer and more prosperous future for us all.

[Several hon. Members rose—]

[Christine Jardine (in the Chair)]

We are going to struggle to get everybody in, so can Members please keep any interventions brief?

14:18

[Jim Shannon (Strangford) (DUP)]

I commend the hon. Member for Milton Keynes Central (Emily Darlington) on setting the scene so well. It is an incredible debate, which is why Members are here to make a contribution.

Gavi has so far immunised 1.1 billion children, and it is estimated to have averted more than 18.8 million deaths globally. If we want a success story and something that is worth investing in, this is the scheme. Childhood mortality in under-fives has been reduced by over 50%, and vaccine-preventable deaths are down by 70%. That is another reason for supporting Gavi and the Global Fund.

Like the hon. Member for Norwich North (Alice Macdonald), I will focus on women and girls, because it is important that we look at the impact on them. It is a fact that women and girls are disproportionately affected by infectious diseases, and targeted investments in their health can drive broader social and economic progress. Indeed, vaccination results in better health, which in turn supports gender equality by enabling women and girls to learn, work and take an active role in their community, promoting them as individuals.

Women and girls accounted for 63% of all HIV infections in sub-Saharan Africa. Malaria in pregnancy leads to over 10,000 maternal deaths and 200,000 infant deaths. These are not just figures but families, individuals, mothers and children. Tuberculosis remains a leading infectious cause of death among women of reproductive age. The Global Fund provides 76% of all international financing for TB vaccinations. However, cuts to the US Agency for International Development, and the UK Government’s decision to cut ODA, will knock back the very scheme that has done so much to advance the cause. I look to the Minister, who is always very responsive. I know he does not hold the purse strings, but I am sure his response will be helpful.

Gavi also funds maternal tetanus immunisation and has helped to eliminate maternal and neonatal tetanus in over 20 countries. All of those things are happening because of Gavi and these organisations. Its work to prevent malaria in children and pregnant women cannot be ignored either.

To conclude, I ask the Minister how the Foreign, Commonwealth and Development Office is making the case in spending review process for the work that the Global Fund, Gavi and Unitaid do in prioritising women and girls’ health and supporting gender equality. If discussions are being held about a change in investment in those funds, how can Government ensure that women and girls, so often ignored and put down in their own communities, have access to the most basic immunisation? Will the Minister to commit to ensuring that the Government play their part for the most vulnerable women and children throughout the world?

The UK has done good work. We must continue that in the most cost-effective way possible. I believe the Minister is seeking that balance, and I wish him and the Government every success in that endeavour.

14:21

[Sojan Joseph (Ashford) (Lab)]

While noting the excellent work that Gavi, the Vaccine Alliance and the Global Fund do in the fight against AIDS and malaria, as the chair of the all-party parliamentary group for global tuberculosis I want to focus my remarks on the need to secure continued funding for programmes to tackle tuberculosis.

TB remains one of the most significant infectious diseases worldwide. It was responsible for the deaths of 1.25 million people in 2023. The World Health Organisation says it is highly likely that the disease has

“returned to being the world’s leading cause of death from a single infectious agent, following three years in which it was replaced by…COVID”.

TB is a preventable and curable disease, but if it is not treated, someone who has active TB can spread the disease to as many as 20 people each year. Given how quickly covid spread across the globe, ending TB is critical for all of us in today’s globalised world. Indeed, TB cases in this country are currently on the rise.

As we heard at the APPG’s meeting earlier this week, the latest figures indicate that there was a 13% increase in reported cases in England last year. That takes TB numbers above pre-covid 19 levels and reverses the previous downward trend. The latest figures also show that the city of Leicester has the highest rates of TB, overtaking the borough of Newham in London. Although the focus of this afternoon’s debate is global health, it is worth reflecting on the fact that the Government have inherited a steady increase in the number of TB cases domestically since 2022. It is therefore in our own interests to continue to work to eradicate TB.

As the leading international funder for TB programmes, the Global Fund is a critical partner in helping to achieve the goal of finding and treating 45 million people between 2023 and 2027. “Missing” people with TB—people who are not diagnosed, treated or reported—are a major challenge in the fight against the disease and help to contribute to drug-resistant TB.

Drug-resistant TB does not respond to standard first-line antibiotics, so treating it is costlier, more complex and more prolonged, and it can take three to four times as long to treat it. If cases of drug-resistant TB continue to increase, it could eventually pose a risk to global health security, including in high-income countries.

The Global Fund is the largest external source of financing for drug-resistant TB responses in low and middle-income countries, and its work in this area is important. Work is being done to safeguard the decades of progress that have been made in the fight against the disease. Thanks to the work of the Global Fund, 7.1 million people with TB were diagnosed and treated in 2023. I therefore ask the Minister to reassure the House that the Government will continue to fund the Global Fund to eradicate TB from the globe.

14:24

[Brian Mathew (Melksham and Devizes) (LD)]

It is a pleasure to serve under your chairship, Ms Jardine. I thank the hon. Member for Milton Keynes Central (Emily Darlington) for introducing this vital debate.

The Global Fund to Fight AIDS, Tuberculosis and Malaria has saved over 65 million lives since its inception. It remains one of the most effective mechanisms we have to combat infectious diseases worldwide—diseases whose death tolls continue to rise every year, especially in some of the world’s poorest regions. Gavi supports the immunisation and vaccination of almost half the world’s children, and has prevented over 18.8 million deaths across the world.

The United Kingdom has historically stood at the forefront of global health. From pioneering the invention of the vaccine and life-saving medications to supporting the NHS, our commitment to science and health has shaped the world. Continuing our support for Gavi and the Global Fund is not only morally correct but strategically wise. Why? Because disease knows no boundaries. We all learned that lesson with covid. Infectious diseases not only cause individual tragedy but threaten global development and stability, and rock economies to their core.

When we invest in global health systems and these organisations, we do not just save lives abroad but protect our citizens—our constituents—by preventing future outbreaks, strengthening early-warning systems and developing research that will benefit everyone. Every penny that the UK invests in Gavi and the Global Fund yields incredible returns. It provides antiretroviral therapy for people living with TB and HIV. It creates global stockpiles of vaccines for Ebola, cholera and yellow fever, so that any emerging pandemic can be stamped out quickly. It provides mosquito nets to protect children while they sleep.

Gavi and the Global Fund help to build and strengthen health systems, empower communities and promote gender equality. They give people a chance to live and work without risk of needless infection. Failing to fund these two vital organisations would risk reversing decades of progress and letting preventable diseases kill thousands of people each year. If we step up and maintain our support, the UK will send a clear message that we will not turn our backs, and that we believe in a society where no one has to die from a disease that we can treat.

Jonas Salk, the inventor of the polio vaccine, said:

“The reward for work well done is the opportunity to do more.”

Let us help Gavi and the Global Fund to do more.

14:27

[Tim Roca (Macclesfield) (Lab)]

It is a pleasure to serve under your chairship, Ms Jardine. I thank my hon. Friend the Member for Milton Keynes Central (Emily Darlington) for securing the debate. I want to speak in strong support of continued investment in these organisations, but particularly the Global Fund to Fight AIDS, Tuberculosis and Malaria. As my hon. Friend said, it is one of the most impactful partnerships in global health history.

Since its founding in 2002, the Global Fund has saved more than 50 million lives. That is 50 million mothers, fathers and children who are alive today because of international collaboration, targeted investment and shared resolve. The death rate from AIDS, TB and malaria has been halved in the countries where the fund operates. That is a success that we should all be proud of. In an era when, as colleagues have mentioned, global co-operation seems to be going out of fashion, that is a living, breathing example of it working.

The UK has played a major role in that success but, as hon. Members have said, with the next replenishment fast approaching, we must reaffirm our commitment. The needs remain urgent and the case for investment remains overwhelmingly strong. I am proud that the fund has been a cross-party endeavour, but I want to acknowledge, as my hon. Friend the Member for Milton Keynes Central did, the crucial role that Labour has played in establishing and supporting it. Under Tony Blair, the UK helped to found the fund in 2002, recognising that tackling the world’s deadliest diseases required global leadership. Under Gordon Brown’s leadership, both as Chancellor and, later, as Prime Minister, the UK strengthened its support, with a focus on long-term funding and international co-operation. That legacy of action, compassion and multilateralism is one we will all want to uphold.

Like colleagues, I want to speak about my constituency’s role in this issue. I am proud to represent Macclesfield, which people will know is a thriving town, with a brilliant grassroots arts and culture scene, nestled on the edge of the Peak district. But it is also a key centre for UK life sciences, with AstraZeneca, the major employer in the town, playing a vital role in the production and distribution of life-saving medicines. However, AstraZeneca’s contribution goes beyond local jobs, and it has supported the wider global health agenda, particularly through working on the covid vaccine and other initiatives to improve treatments in low and middle-income countries. We know that our life sciences sector across the country, anchored by companies such as AstraZeneca, benefits from the innovation, data sharing and global networks that initiatives such as the Global Fund foster. This is what is called win-win.

Let us not forget that the diseases we are talking about have not gone away. As has been pointed out, TB is one of the world’s deadliest infectious diseases. Malaria continues to kill a child nearly every minute. Although AIDS is more manageable, it still devastates millions of families. Our support is therefore as important as ever. I urge all Members, and especially the Government, to continue to recognise the fund’s enormous value. From the laboratories of Macclesfield to the clinics of Malawi, let’s continue to make a difference.

[Christine Jardine (in the Chair)]

Apologies, but I will have to reduce the time limit to two minutes.

14:30

[Laura Kyrke-Smith (Aylesbury) (Lab)]

It is a pleasure to serve under your chairship, Ms Jardine, and I thank my hon. Friend the Member for Milton Keynes Central (Emily Darlington) for introducing the debate. I declare an interest as the former UK executive director of the International Rescue Committee. I will focus on why Gavi and the Global Fund are so critical in humanitarian crises. I also want to be clear about why this issue matters and why the role those organisations play in the world matters.

I am extremely proud of the principled role that UK aid allows us to play, and that British NGOs play, in parts of the world that are riven by conflict, poverty and climate change, where we save lives and prevent future suffering. But this is not just about charity; it is about global stability and security and, in turn, about our own stability and security. When diseases are left unchecked in fragile states, they do not stay contained; they cross borders, they become pandemics, they threaten and harm us all as human beings, and they demand costly emergency responses here in the UK and abroad that could have been prevented through earlier interventions.

I saw at first hand, particularly through the IRC’s partnership with Gavi, how Gavi and the Global Fund work in humanitarian crises. In east Africa, despite insecurity and limitations on humanitarian access making vaccine delivery difficult, the IRC was able to expand vaccine coverage. In 19 months, an IRC-led consortium funded by Gavi and powered by local partners administered 9 million vaccine doses and put nearly 1 million children on the path to full immunisation, including 376,000 zero-dose children. As of January 2025, 96% of the 156 target communities had access to vaccines—before the intervention, only 16% had—and the cost of delivering that was just $4 per person. That shows how, by institutionalising this model of providing doses and funding directly to frontline actors, we can reach people outside of Government control and deliver real impact, even in some of the toughest and most fragile humanitarian settings.

14:32

[Michael Payne (Gedling) (Lab)]

It is a pleasure to serve under your chairmanship, Ms Jardine. I thank my hon. Friend the Member for Milton Keynes Central (Emily Darlington) for securing this crucial debate. I am proud to be the co-chair of the APPG on HIV, AIDS and sexual health, a role the Minister held and carried out with distinction for more than six years. Through the APPG, we are fighting to keep the Global Fund at the top of the agenda in the Foreign Office and the Government.

At a reception in this place a few weeks ago, I was inspired by the fact that we were joined by so many people who have spent so much of their time fighting for the Global Fund and the critical work it does. I was particularly delighted that we were joined by the Under-Secretary of State for Foreign, Commonwealth and Development Affairs, my hon. Friend the Member for Hornsey and Friern Barnet (Catherine West). That was a demonstration of the UK’s commitment to this cause. We were also joined by deputy high commissioner Dineo Mathlako from the South African high commission, which likewise demonstrated South Africa’s resolve.

As was said earlier, since its inception in 2002, the Global Fund has helped to save 65 million lives around the world, and if we are to continue to save lives from treatable diseases, the Global Fund must be replenished with critically needed funds this year. The Global Fund represents a coalition of the willing, and that coalition needs us all to play our part. Constant action is required, or we can and will fall back in our battle against HIV and AIDS.

I agreed to become the co-chair of the APPG, alongside a brilliant team of cross-party parliamentarians, some of whom are present, because this fight matters and we must win it. AIDS is no longer an unrelenting reality that we have to endure, but a consequence of our collective failure to share the necessary knowledge, protection and medication with everyone who needs it.

I am delighted with the leadership shown by the Prime Minister and the Foreign Secretary in co-hosting the replenishment this year. As Nelson Mandela said,

“AIDS is no longer just a disease; it is a human rights issue.”

Let us heed Mandela’s words and do all we can to secure a successful replenishment of the Global Fund this year.

14:34

[Dr Lauren Sullivan (Gravesham) (Lab)]

It is a pleasure to serve under your chairmanship, Ms Jardine. I thank my hon. Friend the Member for Milton Keynes Central (Emily Darlington) for securing such an important debate, and I am proud to sit with her on the Science, Innovation and Technology Committee. I also pay tribute to the right hon. Member for Dumfriesshire, Clydesdale and Tweeddale (David Mundell) for his tireless work in this space.

Before I became a Member of Parliament, I was a scientist. I worked on neglected diseases—in particular, human African trypanosomiasis, which is also known as sleeping sickness. I made a diagnostic test field-ready, and it is out there diagnosing people as we speak. More recently, I moved on to work on understanding the immune responses to malaria at the Francis Crick Institute with Dr Jean Langhorne. On a recent visit to the Liverpool School of Tropical Medicine, we saw amazing science and innovation in relation to lymphatic filariasis, and to potentially using a device like this watch to detect it. That is now being looked at for diabetes.

That builds on the amazing scientific work we have in this country. A recent report from Impact Global Health in collaboration with the Liverpool School of Tropical Medicine showed that a global societal return of £1.4 trillion could be generated, and that there could be an extra £7.7 billion for the UK economy. So this is not just about protection and saving lives across the globe; it is about our industry here in the UK.

Malaria has been eliminated in nine countries since 2015. That is incredible. We must go further and we can get the job done, so please let us replenish that fund.

14:36

[Sam Rushworth (Bishop Auckland) (Lab)]

I thank my hon. Friend the Member for Milton Keynes Central (Emily Darlington) for securing this debate. I am here to speak on behalf of my constituents who have asked me to call on the Government to continue Britain’s global leadership in fighting and eradicating killer diseases. That requires a commitment not only to ongoing investment in the Global Fund, Gavi and Unitaid, but to leading other nations to do likewise.

There is often far too much doom and gloom about international aid and what it has achieved. Let us remember that in 1991, one in five children born in sub-Saharan Africa died before they reached their fifth birthday. Today that is one in 16, which is still too many. As many know, I spent a portion of my life living in sub-Saharan Africa, including as a schoolteacher. My own eyes have wet my pillow at night because one of my students died from a preventable illness, because they were not able to access the treatment that they needed. When I multiply that by the millions of children who have had that fate, I think what a tragic loss that is for the world.

Let us be clear: a child born in a Gavi-supported country is 70% less likely to die from a vaccine-preventable disease before their fifth birthday. The Global Fund has saved 65 million lives. As impressive as that is, there is also the investment that this brings to Britain by supporting British science. I say to the Minister: let us not roll back the progress of a quarter of a century.

14:37

[Monica Harding (Esher and Walton) (LD)]

It is an honour to serve under your chairship, Ms Jardine, and I congratulate the hon. Member for Milton Keynes Central (Emily Darlington) on securing this debate. This year, as both Gavi, the Vaccine Alliance, and the Global Fund conduct their funding replenishments, it is more important than ever that we consider the indispensable value of their work, both for Britain and the world. Since its inception at the beginning of the millennium, Gavi has immunised more than 1 million children and saved in the region of 20 million lives.

The UK was one of the alliance’s founders and has since constituted its largest single sovereign donor. In its short existence, the Global Fund has succeeded in driving down the death rates across AIDS, TB and malaria by 61%, saving 65 million lives. That is close to the entire population of this country and would not have been achieved without British support. That manifested most recently in a £1 billion pledge to the Global Fund’s seventh replenishment. That money is likely to avert around 1 million deaths. We have made so much progress, eliminating many diseases in some countries and reaching the edge of success in others.

However, the work of Gavi and the Global Fund is being placed at risk by short-sighted cuts to international development spending. President Trump has gutted USAID, shattered the fund that fights HIV and AIDS and is poised to eliminate much American funding for global immunisation efforts. Following that playbook, this Government have decided to slash British development spending to 0.3% of our GNI, its lowest level this century.

I, like many others, still remember the optimism of the last Labour Government, who pledged to make poverty history and funded Gavi and the Global Fund when they were created. This Government have rejected so much of the proud 1997 legacy, and they must not do so when it comes to global health. I hope that they put money behind their pledge to prioritise global health and vaccinations. There are so many strong and resonant moral arguments for Britain, but at the same time, the fight against disease serves concrete British interests.

The war against infection is currently facing an alignment of factors that make victory more challenging than ever. Climate change is amplifying disease risk. Higher temperatures are opening up regions to mosquitoes, and the incidence of dangerous weather conditions is on the rise. Pakistan’s catastrophic 2022 floods, for example, have since led to almost 7 million additional malaria cases. At the same time, the disturbing spread and intensification of conflict across the globe is impeding efforts to treat and prevent disease. Increasingly, civilian populations are being deliberately cut off from aid, while healthcare facilities are being not only disrupted, but targeted. Consequently, we are seeing the return of once-controlled diseases like polio and upticks in those like cholera, which emerge from degraded sanitary infrastructure.

Why does this matter for Britain? It is because, as we have heard, disease does not respect borders. Since covid, we are all only too aware that disease can reach our shores, putting both our NHS and our health security at risk. Resistance, particularly in strains of TB and malaria, is also an increasing threat. Both Gavi and the Global Fund are working on the development and deployment of new generations of TB vaccines, even in the face of these new headwinds. Existing interventions for fighting malaria are also seeing their efficacy decline in the face of insecticide and drug resistance. Better, sharper tools have been developed. The challenge now is getting them to where they are needed, and for that we need the Global Fund.

[Iqbal Mohamed]

Before I came to this place, I worked in the pharmaceutical industry in safety, efficacy and regulatory compliance. Does the hon. Member agree that the leadership role that the UK has played to date is not just limited to financial contributions and support, but has ensured that the vaccines that are rolled out in third world and low and middle-income countries are as safe as they can be?

[Monica Harding]

I absolutely agree, and I was about to come on to the economic benefits of Gavi and the Global Fund. There are economic benefits: a study of Gavi-supported countries showed that, through healthcare savings alone, each dollar spent returns $21. When wider social benefits are considered, that rises to $54. Accounting for trade opportunities, healthcare savings and other economic boosts for Britain, both Gavi and the Global Alliance have generated value equivalent to hundreds of billions of dollars. So we are talking about neither a charity nor a giant cash dispenser in the sky, but instead, a deposit account for the security, health and soft power of our nation.

[Richard Foord (Honiton and Sidmouth) (LD)]

My hon. Friend is making an excellent speech. On the point about soft power, China tends to deploy its vaccines in accordance with its regional influence and global standing, rather than on the basis of where there is the greatest need. Does she share my concern that the withdrawal of western funding from vaccine alliances could clear the way for China to engage in further vaccine diplomacy?

[Monica Harding]

I thank my hon. Friend for a well-made point. I have consistently said that cuts to our international aid and development spend create the space for rogue actors to move in, including China and Russia. I know that the Government like polling, so I am happy to share that the British people understand the value of spending on vaccination. Recent Adelphi polling found that 70% of our people believe that supporting global vaccine access benefits Britain.

This is about not only British funding, but British leadership. Our expertise and convening power have been continuous assets for Gavi and the Global Fund. I fear that the Government’s aid cuts have put that leadership at risk, so they must work to reverse that trend. This year, Britain will, along with South Africa, host the Global Fund’s replenishment efforts. As host nation, other countries and non-governmental organisations will look to us for leadership in making a significant pledge. I hope we will step up.

In closing, I want to say a little more about what Britain’s support means to others. I recently met Botswana’s Health Minister and the special ambassador of the African Leaders Malaria Alliance. They shared with me their pride on the progress made on AIDS—with related maternal mortality falling by 80%—and on how malaria is now on the threshold of elimination. They told me that Britain’s work in this success is “always felt very warmly,” that it “ties” the two peoples, and that it is ultimately an expression of “humanity.” They told me that the collaboration fuels trade and partnership. The Minister and the ambassador worry that so much progress and so much investment risks going into reverse in the wake of the global aid retrenchment, including by Britain. They do not expect global support to last forever, but wrenching it away before countries have fully built up their own capacity is a destructive mistake that they, and we, will pay for.

From the Liberal Democrat Benches, I encourage the Government to reaffirm our commitment and pledge generously to Gavi and the Global Fund. I encourage the Government to reaffirm our commitment and leadership in aid, and to reverse the savage cuts to our aid budget. This still-new Government must decide the Britain they want to deliver. Our wish is to bestride the world stage as a development superpower, consolidating our massive progress and gains, affirming our friendship, acting with compassion while delivering for our own people, providing security from conflict and disease, and controlling upstream migration to these shores. The space for leadership is now vacant, and I urge the Government to fill it.

14:46

[Wendy Morton (Aldridge-Brownhills) (Con)]

It is a pleasure to serve under your chairmanship, Ms Jardine. Let me start by congratulating the hon. Member for Milton Keynes Central (Emily Darlington) on securing this debate. I also pay tribute to my right hon. Friend the Member for Dumfriesshire, Clydesdale and Tweeddale (David Mundell), who is a powerful advocate for global health—I think we can all see why he prefers to be on this side of the dais today rather than where you are, Ms Jardine.

Global health is everybody’s health. This year we have significant replenishments for two organisations: Gavi and the Global Fund, which work on the frontline to secure our population against diseases, which do not respect borders. Gavi, the Vaccine Alliance, is a unique alliance of Governments, private sector foundations, civil society organisations and vaccine manufacturers. As we have heard, Gavi has vaccinated more than 1 billion children in 78 low-income countries and saved more than 18.8 million lives.

In 2025, Gavi is seeking its eighth replenishment for its five-year strategic period, from 2026 to 2030. It is an impressive organisation; since becoming a shadow Minister in November, I have been pleased to continue to meet Gavi regularly and participate in roundtables as it approaches this crucial milestone. The Global Fund to Fight AIDS, Tuberculosis and Malaria invests in sustainable health systems to eradicate those three diseases. It has saved an estimated 65 million lives. The Global Fund’s eighth replenishment is also happening this year, and it will cover the funding period from 2026 to 2028.

Global health is a good example of a positive impact that we can have through aid. If we look, for example, at neglected tropical diseases, we see that our science, technology and research sectors produced both of the world’s first malaria vaccines to be recommended by the World Health Organisation: Mosquirix and R21. During my time as Minister with responsibility for global health, I was fortunate enough to see the UK expertise in infectious diseases at first hand during a visit to the Liverpool School of Tropical Medicine, back in 2020. At the time, it was a Conservative Government who announced £15.5 million to support the Liverpool School of Tropical Medicine in its research on preventing the spread of infectious diseases, such as tuberculosis, and in strengthening health systems in fragile countries.

The UK is often cited as a leader in global health. In answers to several of my written questions on the topic—the Minister knows this well—Ministers start by saying:

“The UK is one of the largest donors to Gavi”.

They then give the reply that many right hon. and hon. Members will be accustomed to—that we need to wait until the spending review, and that all global health investments are being looked at in the round.

[Iqbal Mohamed]

Gavi relies heavily on philanthropic foundations,  notably the Gates Foundation, but there are concerns that they may have a disproportionate influence on setting the priorities for global vaccine programmes. Does the right hon. Lady agree that any reduction or pulling back of the UK’s support of those programmes could exacerbate those concerns?

[Wendy Morton]

The hon. Gentleman is absolutely right that Gavi has the ability to pull in many different donors, but perhaps the specific questions following the ODA cut should be directed to the Minister. Gavi is a good example of how partnership can deliver for the benefit of the most vulnerable.

Conservative Governments made significant interventions that contributed to the UK’s reputation as a global health leader. In 2015, we pledged £1.44 billion to Gavi over five years, and in 2020, when we hosted the global vaccine summit, we committed a further £1.65 billion. During the last two Global Fund replenishments, we pledged £1 billion in 2022 and £1.46 billion in 2020. Those pledges to Gavi and the Global Fund were just one part of our leadership and efforts to strengthen global health, and an incredibly important one at that.

I note from responses to my written questions that Ministers are often quite keen to highlight our record on global health, but I would like to take this opportunity to ask some questions about the Government’s record to date. Following the reduction in ODA to 0.3% of GNI, I ask the Minister: what does global health now look like from the strategic level of the Foreign, Commonwealth and Development Office? It would be helpful to know where the priorities are and whether the Government plan to continue the emphasis on multilateral NGOs such as Gavi and the Global Fund, or whether other models are to be considered.

Although the approach to global health may be changing under this Labour Government, the replenishment periods for Gavi and the Global Fund are rapidly approaching—in fact, Gavi’s is literally weeks away. I would therefore welcome some clarity from the Minister on the discussions he has had with representatives of both funds and other donor nations. I want to press him a little about the absence of any UK pledges to date. I have previously had no luck getting an answer on that through my written questions, so I will have another go today. Has he considered the impact of the UK’s apparent delay in pledging on our international reputation and our standing as a leader in global health?

[Sam Rushworth]

Does the right hon. Lady agree that the UK’s track record on this has been quite impressive, given that other countries frankly punch below their economic weight, so this is not just about the UK’s contribution but about the role we play in ensuring other countries shoulder the burden?

[Wendy Morton]

The hon. Gentleman is absolutely right, and I recall that during the last replenishment, there were many conversations going on to encourage other countries and partners to step up to the plate. The UK’s leadership had a real impact at that time. In a similar vein, what is the potential impact on other countries’ pledges? Is the Minister thinking about making a reduced commitment or no pledge at all? Rather than ongoing uncertainty, it would help other donors and NGOs to know what the UK is doing, so that they can plan.

The Minister will be aware that there is a range of financial instruments available to him. One is the international finance facility for immunisation, through which £590 million of our £1.65 billion pledge in 2020 was distributed. IFFIm accelerates the delivery of vaccines by making the money from long-term Government donor pledges available immediately, allowing Gavi to vaccinate more individuals, faster. I would be grateful if the Minister updated us on any discussions he has had with Gavi and with IFFIm about its potential use to front-load any UK commitments.

[David Taylor (Hemel Hempstead) (Lab)]

I agree what a good model that is. Does the right hon. Member agree it is a model the Government could consider using for other things? An international finance facility for education has been released in the last few years. Does she agree that the Government could consider adopting this model across a range of different issues as we look to find alternative methods of development finance?

[Wendy Morton]

That is a really interesting point, because IFFIm has proved what can be achieved by working with other instruments. I hope that the Government will examine the options. The Minister may be able to share that information; it is not for me to say what the Government should do, but perhaps the Minister can do so in his response to the debate.

The global landscape of development is changing; we can see that across the rest of the world. For example, the US, which for so long has been an important anchor donor to a number of global health initiatives, has made dramatic reductions to USAID, so it would be helpful to know what discussions the Minister has had with his US counterparts and with other donor countries about co-ordinating our efforts, so we can maximise value for money in global health spend.

I will conclude as I started, by saying that global health is everybody’s health. I pay enormous tribute to the Global Fund and Gavi, which harness the power of donations from taxpayers in countries like the UK to end preventable deaths from treatable diseases in some of the most vulnerable parts of the world. Global health may sometimes seem like an abstract concept, but we only have to look back at recent history to see that infectious diseases do not respect borders and that global solutions are needed to keep us all safe.

14:56

[The Minister of State, Foreign, Commonwealth and Development Office (Stephen Doughty)]

It is a genuine pleasure to serve under your chairpersonship, Ms Jardine, and to respond to such a passionate and well-attended debate on a subject that many Members here in Westminster Hall today know is close to my heart.

I am particularly grateful to my hon. Friend the Member for Milton Keynes Central (Emily Darlington) for securing this debate. Of course, as well as being an excellent representative for Milton Keynes, she has many connections with me and with my constituency in Penarth, and I have connections with Milton Keynes that link to the subject of this debate, because it was in Milton Keynes that I first worked for World Vision, the international humanitarian and development NGO.

At that time, I worked in particular on ] issues related to HIV and AIDS. On a visit to Malawi with World Vision back in the early 2000s—they were very different times, when we had not made the progress that we have made today—I saw for myself the devastating impact that HIV and AIDS had on communities in southern Africa. I remember sitting in a village with a woman who had had to take on the care of her sister’s children after her sister had died in her 20s. She had already been struggling to make ends meet, but then took on the children of her sibling on top of that. That was really stark stuff that I will never forget.

I have worked on these issues throughout my career. Indeed, I was at one of the early launches of the IFFIm bonds with Gordon Brown and at many of the other events and efforts organised by the last Labour Government that my hon. Friend the Member for Milton Keynes Central rightly said we should be very proud of. I also served as the co-chair of the all-party parliamentary group on HIV, AIDS and sexual health, and it is fantastic to see some of my successors in that role here in Westminster Hall today. That APPG is one of Parliament’s longest-established APPGs and I can genuinely say that it has also been one of the most impactful over many decades, and is still doing important work today.

This is absolutely a timely moment to debate these issues, with the Gavi and Global Fund replenishments coming up later this year, and I am hugely grateful to all right hon. and hon. Members here today for their contributions. I can absolutely assure them that the Government hears those communications and that they will be communicated to Minister Chapman, my colleague in the other place. We will look very closely at a number of the points that have been raised today.

We should be very proud of our remarkable achievements over the last 20 years and we must maintain that positive trajectory, which includes increasing life expectancy and stopping the spread of pandemics. As has been said many times, disease respects no borders, and of course it has a devastating impact, not only on lives but on economies. Of course, the life-saving research to fight disease also has a benefit economically, as many hon. Members have already pointed out.

[Dr Rupa Huq in the Chair]

I can confirm, Dr Huq, that the UK will continue to champion global health, with the sustainable development goals as our lodestar and anchoring our work. Our partnerships with Gavi and the Global Fund are crucial to maintaining—indeed, to accelerating—progress. Of course, we are founding members and committed supporters of both organisations.

The Global Fund plays a crucial role, and I have worked with it many times on strengthening health systems and combating HIV and AIDs, tuberculosis and malaria. Of course, it also supports the UK’s goal to end all new HIV cases in England by 2030 and efforts across the United Kingdom to end new HIV infection. Malaria, which has been rightly referred to today, primarily affects women and children. It puts a significant strain on health systems and hinders economic growth. Nigeria, for example, accounts for more than a quarter of global malaria cases and loses more than $8 billion annually to the disease. There is also the devastating impact on lives and families. Our partnership with the Global Fund demonstrates the importance we place on working in partnership with others around the world and in the global south. Together we have saved a remarkable 65 million lives and reduced AIDS, TB and malaria deaths by more than 60%. We have also built more resilient and sustainable health systems and accelerated progress towards universal healthcare coverage.

Gavi is a hugely important organisation whose work I have had the pleasure of seeing in this country and elsewhere. It is of course a public-private partnership with national Governments, the World Health Organisation, UNICEF and civil society, which is critical. Many Members mentioned those connections in procuring and providing affordable vaccines. Through Gavi, more than half the world’s children are now vaccinated against some of the world’s deadliest diseases, such as measles, malaria and meningitis, saving more than 18 million lives. It has been pointed out that a child born in a Gavi-supported country today is 70% less likely to die from a vaccine-preventable disease before their fifth birthday than a child born before that crucial alliance came into existence.

Every investment brings economic benefits, too. For every £1 of investment in immunisation, we see £54 in wider economic benefits. We are working with Gavi and other donors, including the Gates Foundation, to reach more children with lifesaving vaccines than ever before. Investments in Gavi and the Global Fund also drive real innovation. British expertise has transformed the fight against HIV/AIDS, TB and malaria through licensing and technology transfer, and by developing innovative technologies such as new dual active ingredient bed nets, which were piloted with support from Unitaid and the Global Fund and are now being rolled out at scale by the Global Fund.

Investment has also supported the development of vaccines such as MenFive to protect against the five main types of meningitis. Gavi delivered 5.1 million doses of MenFive in Niger and Nigeria.

[David Mundell]

The Minister made a passing reference, as other Members did, to Unitaid. Will he more formally acknowledge the huge importance of Unitaid in ensuring the delivery of medicines in some of the most difficult environments around the world?

[Stephen Doughty]

I absolutely will. It is referenced throughout my briefings because of the important partnership and contacts that we have with Unitaid. I have seen its work as well.

We are delighted to be co-hosting the Global Fund’s eighth replenishment with South Africa. We aim to attract and deepen investor engagement, sustain collective investments, and collaborate with the private sector on financing, innovation and supply chain support. We will do everything possible to ensure the success of that replenishment. Last month, the Children’s Investment Fund Foundation made an impressive first pledge of $150 million, a fivefold increase of its previous investment. That extraordinary commitment underscores the significant role of private philanthropy in advancing global health equity and highlights the power of partnership. As countries work to increase domestic financing, we must stand together and strive for success in those replenishments. We know this is an incredibly important moment for all these issues.

Many Members have rightly asked me about financial commitments—I have heard the voices around this room. Members will understand that we cannot make any financial commitments for the next replenishment until after the spending review is complete, but I assure them that we will continue to champion the Global Fund and Gavi and the people they serve, as well as the issues that have been raised today. Members’ voices and those of their constituents have been heard. None of us want to make decisions about cuts to the ODA budget, not least because of our record of success on these issues, but when I look at some of the things I do every day, I can say that they are the right choices, although difficult. We remain committed, however, to international development and particularly to global health. The number of interventions on these issues have made that very clear across the House.

I will reply briefly to some specific points made. My hon. Friend the Member for Milton Keynes Central spoke about the wider benefits not only to the economy, but in terms of our research and the links to the covid vaccine research. I saw some of the pioneering RNA vaccine research in visits with the all-party group years ago. To then see that expertise used to combat a deadly pandemic was extraordinary.

The right hon. Member for Dumfriesshire, Clydesdale and Tweeddale (David Mundell)—my successor on the all-party parliamentary group on HIV, AIDS and sexual health—rightly talked about this being investment, not charity. I think there is a consensus across the House on the proven track record of the Global Fund, Gavi and Unitaid.

My hon. Friend the Member for Exeter (Steve Race) mentioned his visit to Kenya and the links with nutrition as well. He knows the Government’s commitment to the global compact on nutrition and the work that was done around the summit and indeed the research in his own constituency. I thank the hon. Member for North East Fife (Wendy Chamberlain) for her contribution. Her constituency is a place I know well, having done my masters at the University of St Andrews. Important work is being done at that university and at many institutions across the UK.

My hon. Friend the Member for Norwich North (Alice Macdonald) asked important questions about women and girls. I can assure her that women and girls remain at the heart of our global health work. Gavi supports countries with vaccines that directly benefit girls and women, for example those against HPV, which we know is one of the leading causes of cervical cancer. Shockingly, over 85% of cervical cancer deaths are in low-income countries, and it is the main cause of death among many young women in Africa. Women and girls therefore remain at the heart of these partnerships going forward.

The hon. Member for Strangford (Jim Shannon), who is no longer here, as ever spoke passionately on the issues. My hon. Friend the Member for Ashford (Sojan Joseph) spoke about the importance of work on TB. We are absolutely committed to this, whether through the Global Fund, Stop TB Partnership or our work with the TB Alliance. We are doing many pieces of research and operations work.

My hon. Friend the Member for Macclesfield (Tim Roca) spoke about malaria, as did others. On that, there is really remarkable process being made on vaccines. Some of the early findings from the malaria vaccine implementation programme show that an additional one in eight children can be prevented from dying if they receive vaccines in combination with other malaria interventions. We are carrying on the important work on anti-malarial bed nets and other interventions.

My hon. Friend the Member for Gedling (Michael Payne), another of my successors in the APPG on HIV/AIDS, again spoke of the importance of the Global Fund, and I completely agree with him.

My hon. Friend the Member for Gravesham (Dr Sullivan) spoke about her experience working at the Francis Crick Institute, another leading institution doing incredible work. We should be very proud of our academics and researchers in this country for what they do.

My hon. Friend the Member for Bishop Auckland (Sam Rushworth), a powerful voice for his constituents, also spoke of his own personal experiences in sub-Saharan Africa.

[Iqbal Mohamed]

Will the Minister give way?

[Stephen Doughty]

I will not, because we are about to run out of time and I need to leave time for my hon. Friend the Member for Milton Keynes Central to wind up.

The shadow spokespeople raised a number of choices. I do have to gently say to the hon. Member for Esher and Walton (Monica Harding) that we are not in 1997. We are in a very different set of world circumstances. That is tough, but I believe in being honest with this House about the challenges we face. That does not mean we lose our commitment to development or global health, as is clear from what the Government are setting out, and I have listened carefully to what Members have said today.

Not only did the right hon. Member for Aldridge-Brownhills (Wendy Morton) serve as the Minister; we also served on the International Development Committee together. She rightly talks about the important role that IFFIm and others can play—I might write to her more specifically on the plans on IFFIm. She asked me lots of questions about the spending review. I would love to be tempted into answering her, but I cannot, so I refer her to my previous answers.

The UK will continue to champion global health at a critical moment. We will work hard, together with our partners. We have heard about some fantastic work we have been responsible for and about some fantastic organisations. I can assure Members that the Government hear all of those voices, and they will be contemplated as we make some challenging but important decisions over the weeks and months ahead.

15:07

[Emily Darlington]

It is a pleasure to serve under your chairpersonship, Dr Huq. I do not have much time to wind up, so I will not respond to each and every intervention, but let me say a huge thank you to Members. I am so pleased to hear that we continue to have a cross-party alliance and support for our work on the Global Fund and Gavi. The reason for that support, as we have heard, is that this is about our health, global health, and our growth in this country. We are world leaders. Given that the Prime Minister has said that, in the light of the cuts, we will work to increase the ODA budget as soon as possible, I do not want us to make decisions today that put at risk not only our global leadership, but the lives of millions of people. That is something echoed by the 150 scientists who signed a letter published this week, by UK companies that support the jobs in the UK on this, and by the various interventions that we have had, including by the Minister and the ambassador from Botswana, who I have also had the pleasure to meet.

This is an opportunity for us to decide: are we going to continue to be a UK that looks out, understands that we live in a global world and puts biosecurity, the health of our population and the health of the world at the heart of our strategy? Or are we going to step back from that global leadership? I hope that we will be at the forefront of this debate and show leadership, ensuring not only that our contribution stays the same, but that each and every other country’s does, as well as those of other donors. I thank the Minister for responding today; I know how much he agrees with many of the comments made, and I look forward to us continuing to work together.

Question put and agreed to. 

Resolved,

That this House has considered funding for GAVI, the Vaccine Alliance, and the Global Fund.

World Asthma Day

Thursday 15th May 2025 Westminster Hall

15:09

[Jim Shannon (Strangford) (DUP)]

I beg to move,

That this House has considered World Asthma Day.

It is a real pleasure to serve under your chairship, Dr Huq. We had a very productive parliamentary visit to Egypt to promote freedom of religious belief. I commend you for that publicly today in the Chamber.

I am grateful to the Backbench Business Committee for accepting this debate. I am pleased, as always, to see the Minister in her place. I will come to my request to her later. My speech has been given to her staff and, I understand, to the shadow Minister, the hon. Member for Hinckley and Bosworth (Dr Evans), and to the Lib Dem spokesperson, the hon. Member for Chichester (Jess Brown-Fuller).

I am pleased and privileged to be the chair of the all-party parliamentary group for respiratory health. I have a deep interest in respiratory health. It is probably because my second son was born with asthma. From a very early age, he was on medication. He had some psoriasis as well; there is an association between the two. He seems by and large to have grown out of it, but even now, at the age of 34, he depends upon the inhaler. Therefore, I have a personal interest in the issue, as most people do when they talk about asthma.

I am delighted to sponsor the debate for this year’s World Asthma Day, which was on 6 May. This year’s theme, set by the Global Initiative for Asthma, is “Make inhaled treatments accessible for all”. GINA emphasises the need to ensure that everyone, regardless of their global location or socioeconomic status, has access to the inhaled medications that they need to control the underlying disease and to treat asthma attacks. I will be looking at that and other aspects of asthma care and treatment today. It is a pleasure to do so, and to see other Members who have been able to turn up to participate in the debate.

This may be my first occasion where the Minister has responded specifically to my debate. I wish her well in her role, I wish her well personally—she knows that—and I wish her well in the debate.

I am indebted to Asthma + Lung UK for its outstanding help and ongoing support. It has been enormously helpful to me and to the APPG. I welcome the work it does to serve the needs of people living with respiratory ill health. I also put on record my special thanks to Jonathan Fuld, the national clinical director for respiratory disease in England, for his expert advice, counsel and wisdom. I pay tribute to our expert stakeholder groups, which comprise senior clinicians, industry, professional bodies and other experts, for their ongoing work. The APPG has regular Zoom meetings, and Jonathan Fuld is always there to guide us and help us through the process.

The APPG has welcomed the improvements in inhaler technology, specifically the move to combination inhalers, which will ultimately eliminate the use of twin inhalers. That is a significant step and one that we should welcome. As highlighted in the National Institute for Health and Care Excellence asthma guideline and by the Medicines and Healthcare products Regulatory Agency in its safety warning, SABAs—short-acting beta 2 agonists—should not be used by people with a diagnosis of asthma. Therefore, there are and will always be treatments that we need to be careful with for safety reasons. Combination inhalers combine two kinds of medicine in one device, helping to keep inflammation in the lungs at bay while giving relief from symptoms such as breathlessness and tight chest.

I will come on to some figures later on, as we need to be reminded in this debate that, with asthma, it is not just that the inhaler saves someone and they are okay. There have been a number of deaths, which I will refer to later on.

The availability of inhalers in the UK ensures that people with asthma get the most clinically effective treatment and also allows the NHS to take a step towards its net zero targets, given that they are low carbon. It is therefore right to acknowledge that the first inhaled respiratory medicine using next-generation propellant with near-zero global warming potential was approved this week. That is a step in the right direction. Although it is for chronic obstructive pulmonary disease, the technology offers great promise for other inhalers in the future.

It is wonderful to look back at all the advances made over the years in cancer treatments, or on diabetes or cardiovascular disease. They are trying to find a cure for dementia and for Alzheimer’s, and there are some ideas for how that could be progressed, so there have been advances.

I am sure we have all seen the latest statistics on respiratory conditions and asthma—I will touch on them briefly. Lung conditions are the third biggest killer in the UK. Hospitalisations have doubled in the last 20 years and there has been little improvement over that time. I mentioned some of the improvements with inhalers, but there is still a long way to go.

Some 7.2 million people in the UK live with asthma; 2 million children live with asthma. That represents one in nine adults and one in eight children. The UK has a higher death rate due to respiratory illnesses than the OECD average, and we have the highest death rate in Europe. Asthma kills four people in the UK every day and someone has a potentially life-threatening asthma attack every 10 seconds. These are the stats, but they are not just stats—they are families and individuals, and people who deal with this every day. The children and the parents worry, the adults worry and the families worry.

Over the past 10 years, more than 12,000 people have died from asthma. Almost all of those deaths were preventable. The National Review of Asthma Deaths report, “Why asthma still kills”, published by the Royal College of Physicians in 2014, found that two thirds of asthma deaths were preventable. If they are preventable, why can we not do more and make that happen? That is one of my requests to the Minister.

Some 66% of people are not getting an appointment with a GP or an asthma nurse within the recommended 48 hours after an emergency admission. Between 2012 and 2020, deaths from asthma have increased by 26%. The number of people who have died due to asthma attacks is very cruel.

The costs to the country associated with asthma are substantial. Asthma and COPD cost the NHS some £9.6 billion in direct costs each year, representing 3.4% of total NHS expenditure, and they cause wider reductions in productivity due to illness and premature deaths, totalling £4.2 billion a year, with an overall impact of £13.8 billion on the economy. In my country, my region of Northern Ireland, asthma costs £178 million a year alone. These costs cannot be ignored.

I will put forward some ideas that the Government and the Minister can hopefully take on board to reduce the expenditure and the death toll. Adding up the cost to the NHS and direct costs from the loss of productivity and the monetary value of people suffering lung conditions, the cost to the UK economy is some £188 billion a year. The annual estimated cost of asthma and COPD to the NHS is £4.9 billion, with an estimated 12.7 million lost workdays per year. There is a financial cost, a loss of workdays and a cost to the productivity of our nation.

The impact of asthma on the NHS is considerable. Respiratory conditions are a major cause of avoidable hospital admissions. If we can avoid hospital admissions, that is a strategy and a way forward. There were some 56,853 admissions due to asthma in 2022-23. Waiting lists for respiratory care have risen by 263% over the past 10 years. Those are worrying figures. There is a need to have this debate, and today is the opportunity to do that and to look forward.

Lung conditions, including COPD, asthma and respiratory infections, place a huge burden on the NHS, especially in the winter months, when it is always worse: respiratory admissions increase by some 80%. Breathing issues are the leading cause of all emergency admissions in England, and in common with other respiratory illnesses, asthma is hit hard by inequalities and deprivation.

There is a link between poverty and asthma, so I hope that the Minister can give some encouragement in relation to that. The burden of respiratory disease disproportionately affects the most deprived. Those from the poorest communities are three times more likely to die from asthma, compared with those in the richest—that is another worrying trend. Children living in the most deprived 10% of areas are four times more likely to require emergency admission to hospital due to asthma than those living in the least deprived areas. Again, there is a clear statistical difference between those who live in deprived areas and those who do not.

The findings of the national child mortality database report on child deaths expose the inextricable link between poor lung health and deprivation, with more than half—56%—of the children who died in the period that the report covers coming from the poorest communities. I know that when the NHS was set up, this would not have been the policy of the Government, but if there are more deaths among children who just happen to live in deprived areas, we really need to address that.

I welcome and support the Government’s commitment to reducing inequalities and deprivation—in particular, inequitable asthma outcomes. We hope to run local meetings in the most deprived areas of the country to try to determine some of the causes of the variation in asthma outcomes. I would like to offer the Minister our support in any way that we can help. We are pleased to have here today representatives who carry out the admin for the APPG on respiratory health. We thank both of them, and others, for their contributions.

There have been some welcome developments in respiratory health recently, including the introduction of a new integrated guideline for asthma, which was a joint collaboration by NICE, the Scottish Intercollegiate Guidelines Network and the British Thoracic Society. It is being rolled out across the country. They are good steps in the right direction to try to do even better, but I urge the Minister to make sure that there is no implementation hesitancy across the integrated care boards, with uneven take-up. I also ask what steps she will take to ensure that it is rolled out equally across the country. That is one of our requests.

The APPG also welcomes and supports the three shifts announced by the Secretary of State: analogue to digital, hospital to community, and treatment to prevention. I suggest that respiratory health outcomes could benefit significantly from all three of those commitments from him. I also welcome the upcoming neighbourhood health services, in principle. Although we do not know all the details yet, there is an agreement in principle for that work to happen. I ask the Minister what future she sees for the community diagnostic centres, following the transition to the abolition of NHS England?

The APPG has already sent a submission for the 10-year plan, which we hope will deliver what we all wish to see. I welcome the Government’s commitment to investing £26 billion of extra money for health. I welcome the positive stance that the Secretary of State and the Minister have taken in relation to that. However, we feel that respiratory health should be key and in the centre of the 10-year plan. I understand that that plan is likely to have cancer and cardiovascular disease plans associated with it, and I hope that respiratory health conditions will be prioritised in the same way. Could the Minister ensure that respiratory health will be prioritised in national strategies and NHS guidance, including in the 10-year plan and the life sciences sector plan, which are in development, and in future winter resilience guidance?

One major issue that we see every year in the NHS is winter pressure. We cannot deny it, and it is not anybody’s fault; it is a fact of life. Vaccines for flu and other respiratory infections are enormously helpful, of course, but ensuring that patients are on the right treatment can also contribute to reducing these pressures. The transitions from hospital to community and sickness to prevention are essential to making this happen. The question is, how best can it happen? Again, I hope that the Minister can give us some thoughts on that.

The APPG will hold a roundtable in the next few weeks to discuss how good respiratory health measures can help to ease winter pressures. It might be helpful to consider those at this time of the year, long before we get to that stage in the latter part of the year. The APPG will report its findings to the Minister directly. A previous Minister agreed to a meeting with us, and I am quite sure that the Minister today will do the same, so I ask whether we could have that in the diary.

Severe asthma affects up to 5% of people with asthma, and is associated with frequent exacerbations, hospital attendances and steroid use. Biologics have been described by leading clinicians as lifesaving for severe asthma patients, yet an Asthma + Lung UK report suggested that in June 2020 only 23% of eligible patients were receiving a biologic for their severe asthma. Those figures worry me. I understand that that was five years ago, but again I seek some positivity in relation to it.

A recent poster at the European Respiratory Society congress showed that the uptake of biologics for severe asthma is low and variable in the UK. That has to be addressed, and I seek the Minister’s thoughts on it. The national median uptake of biologics by patients with severe asthma in England between 2016 and 2023 was 16%. ICBs are not maximising the uptake, which varies widely between 2% and 29%, against a target of 50% to 60%. That does not cut the cake. Based on current regional use of biologics in England, modelling forecasts that it will take 37 years for only 50% of eligible patients to be on biologic therapy. That cannot be satisfactory. We must do better.

At present, with the existing severe asthma service specification, patients can wait years for access to these treatments. There is limited awareness of severe asthma and insufficient capacity in the system, and unnecessarily complicated multidisciplinary teams hinder timely access. This must not be ignored. We must not have a postcode lottery, with some parts of the United Kingdom providing the correct standard of asthma care and other parts falling behind.

We await the publication of the new service specification, which I hope will minimise delays for patients who really need the biologics. In other areas, such as dermatology or rheumatology, secondary care clinicians can prescribe biologic medicines to patients who fit the relevant criteria without the patient requiring assessment at tertiary level, so can secondary care prescribing be introduced for severe asthma? I have had a lot of asks of the Minister, but they are positive, constructive asks that seek to move us forward, save lives and help those with asthma.

Time is going far too fast, but the facts are clear: too many people living with lung conditions are missing out on the treatments that they desperately need to live and stay well at home. Current access is limited, patchy and being held back by workforce shortages. Severe asthma accounts for only around 4% of the total asthma population, but this is still almost 5,000 people, and they are probably the ones who will contribute the most to asthma deaths in a year. Such is the severity of their symptoms that this group is estimated to account for at least half of all expenditure on asthma—some £38 million a year.

I want to give an example of what we are doing in Northern Ireland and show what it would mean here on the mainland. I know that this is not the Minister’s responsibility, but thousands of people across Northern Ireland are missing out on key diagnostic tests because of disagreements between primary and secondary care about who should deliver the services. If, for example, fractional exhaled nitric oxide were made available to all GPs across Northern Ireland, its use could save £4 million by optimising asthma treatment. An uptake in spirometry testing in primary care to just 40% of eligible patients would result in £1.7 million in direct health service cost savings in reduced COPD exacerbations —a reduction of 1,778 hospital bed days, of which 605 would be winter bed days.

I used an example from Northern Ireland because I have access to those figures, but were we to replicate that for each healthcare trust or board in the United Kingdom of Great Britain and Northern Ireland, the improvement to health and freedom from financial weight would be massive. It is not just about the money saved, or the lives saved; it is about the care of those with asthma. If we can make it better in any way through today’s debate, it will have been worth while. I look forward to everyone’s contributions. I believe that changes can and must be made. I look to the Minister to begin that process today.

15:31

[Ayoub Khan (Birmingham Perry Barr) (Ind)]

It is a privilege to speak under your chairship, Dr Huq. I am deeply grateful to the hon. Member for Strangford (Jim Shannon) for securing this debate, which is crucial—not only for my constituents of Birmingham Perry Barr and the city of Birmingham, but nationally and internationally.

Last week, we marked World Asthma Day—a moment of reflection that should fill us with not only resolve but deep discomfort. Asthma is one of the most common health conditions in the UK, as the hon. Member for Strangford mentioned, affecting over 7 million people, yet all too often it is also one of the most fatally overlooked. Every eight hours, someone in this country dies from an asthma attack. In 90% of those cases, their death means a life cut short, a family devastated and a future lost due to what should have been a manageable condition. Such people are dying not because we lack treatments but because our holistic healthcare system is failing them.

This crisis is particularly felt by my constituents in Birmingham Perry Barr. Ours is a proud industrial city, but that legacy comes at a cost. Poor air quality continues to fuel respiratory illnesses, and too many of my constituents are left battling the consequences. I received a deeply moving letter from a constituent who has lived with asthma for years. Despite managing her condition to the best of her ability, she suffers asthma attacks constantly, leaving her in constant agony. Unfortunately, her words echo the experiences of many up and down the country. Let us be clear: asthma may be common, but it is no less deadly for that, and no less deserving of urgent, focused attention.

I commend the tireless work of people such as Kim Douglas, who is a constituent of mine, after the tragic loss of her three-year-old son George to undiagnosed and untreated asthma. She founded the George Coller Memorial Fund in his memory. That foundation is now calling for two vital reforms that could save lives and ease the burden on our health system. First, it is calling for inhalers to be made free of charge for all patients; 57% of those who end up in emergency care for asthma have skipped their medication because they could not afford the prescription, and almost half missed appointments out of fear that they would not be able to pay for the medication afterwards. In one of the richest countries in the world, that is simply indefensible. A child’s ability to breathe should never depend on their parents’ ability to pay.

Secondly, the foundation is calling for all emergency inhalers to be fitted with a dose counter. Inhalers are often relied on in moments of life or death—in emergencies—yet nearly three quarters of patients cannot tell when their inhaler is empty. They go on using them, trusting them, only to find when it matters most that they offer no relief. For too many families, that avoidable failure has had devastating consequences.

Those two simple changes could prevent thousands of hospital admissions every year and, importantly, they could save lives. I ask the Minister whether she will meet with me and the George Coller Memorial Fund organisers to discuss these vital recommendations? Will she commit to a 10-year respiratory health plan that finally treats this crisis with the urgency it demands?

15:35

[Jessica Toale (Bournemouth West) (Lab)]

It is a pleasure to serve under your chairship, Dr Huq. I congratulate the hon. Member for Strangford (Jim Shannon) for bringing forward this debate to mark World Asthma Day.

There are two reasons why I wanted to speak in this debate. The first is personal: I developed asthma as a child, almost certainly as a result of the pollution of the Milan of the early 1990s, and living down the road from the Alfa Romeo factory. While the condition improved for me, unfortunately my younger sister suffered severely with it and continues to suffer today.

The second reason reflects the changes that my constituency has faced. Bournemouth was founded as a wellness resort, and back in the day visitors would come to take the air. In fact, one of our most famous residents, Sir Merton Russell-Cotes, who went on to become mayor and own the Royal Bath hotel, was sent to the south coast of England because he had chronic respiratory conditions, and ended up living in Bournemouth. It is still a place where people move to improve their quality of life and to live a healthier life—but Bournemouth was recently ranked as the 14th worst location in the UK for air quality. A staggering 83% of residents with lung conditions in my constituency say that poor air quality has made their conditions worse.

The hon. Member for Strangford has already pointed out that respiratory deaths are strongly linked to deprivation, more so than any other condition, and people living in the poorest areas of the UK are three times more likely to die from asthma than those in the wealthiest. That national injustice is reflected starkly in my constituency, where areas in the less affluent north, such as Alderney, West Howe, Kinson and Branksome, have asthma rates significantly higher than the national and regional averages.

If we are serious about improving outcomes for people with asthma, we must take a cross-departmental and holistic approach—one that addresses not just healthcare, but pollution, housing, transport and lifestyle. That is why I welcome the Environment Secretary’s commitment to improve air quality across the country, including in Bournemouth West; cleaner air saves lives and it must remain a top priority.

I welcome the Government’s broader efforts to tackle the root causes of respiratory illness: cutting emissions and improving public access to air quality information; the Tobacco and Vapes Bill and the Government’s ambition to create a smoke-free generation; and key legislation such as the Renters Rights’ Bill—specifically the inclusion of Awaab’s law, which is vital for my constituents. I am regularly contacted by residents, who are living in substandard conditions, plagued by mould and damp. These environmental hazards are not just unsightly, but dangerous. Mould is a known trigger for asthma and other respiratory conditions. With a clear link between asthma and deprivation, improving housing standards is a matter of not just fairness, but health.

Our national health service is in need of fundamental reform. We must move away from a system that reacts to ill health towards one that prevents it. I support the Government’s vision to shift more care into the community and tackle the backlog in treatment. In Bournemouth West, the challenges are particularly acute: 32% of respiratory patients are not seen within the 18-week NHS target and, worryingly, 60% of people diagnosed with asthma are not receiving even the most basic asthma care. Those outcomes place us among the worst-performing areas in the south-west. Meanwhile, over 90% of COPD patients in Dorset are not receiving the standard of care—the worst figure in the south of England.

We must end the postcode lottery in NHS services. Access to care should not depend on where someone lives. Is the Department aware of the issues facing my constituents in Bournemouth and people across Dorset? What can be done to improve access to healthcare for people with respiratory conditions in my area?

As the Health Secretary develops the NHS 10-year plan, I also urge the Minister to seriously consider the proposals set out by Asthma and Lung UK, which include: establishing national targets to reduce preventable asthma deaths, improving access to biologic medicines, supporting the use of digital monitoring tools and reviewing funding for asthma research.

In the spirit of World Asthma Day, let us recommit to ensuring that no one dies from preventable asthma attacks and ensure that every person, regardless of postcode or background, can access the care, medicine and environment they need to breathe freely.

15:39

[Jess Brown-Fuller (Chichester) (LD)]

It is a pleasure to serve under your chairmanship, Dr Huq, and always a pleasure to see the Minister in her place. I thank the hon. Member for Strangford (Jim Shannon) for securing this important and timely debate to mark World Asthma Day, which took place last week. As the chair of the all-party parliamentary group for respiratory health, he is a tireless advocate for the millions of people across the UK living with lung conditions—and, indeed, multiple other conditions. As my party’s health spokesperson, I have been in this Chamber many times for debates that he has secured. He is certainly a credit to the less-spoken-about health conditions. His commitment to raising awareness and driving change in health is deeply appreciated, and I commend him for his leadership.

To mark World Asthma Day 2025, the Global Initiative for Asthma has chosen the theme “Make Inhaled Treatments Accessible for ALL”. It is pertinent that this debate follows one on international development and global health—a powerful reminder of the need to ensure people with asthma have access to the treatments they need, not just to manage their day-to-day symptoms, but to prevent life-threatening attacks.

Asthma remains one of the most common chronic health conditions worldwide, yet, as the hon. Gentleman clearly set out, progress over the past two decades have been slow. Lung conditions are now the third biggest killer in the UK. Hospitalisations due to respiratory illness have doubled in the past 20 years, and the UK has seen little improvement in outcomes over that time. Those are not just statistics—they are people, and they reflect a systematic failure to treat respiratory health with the seriousness it demands.

There are 7.2 million people living with diagnosed asthma in the UK today, including 2 million children—one in nine adults and one in eight children. The UK’s asthma death rate is higher than the OECD average, and the highest in Europe. Every day, four people in this country die from asthma attacks. Every 10 seconds, someone experiences an asthma attack that could be life-threatening. That should be a wake-up call.

In my constituency of Chichester, 7.5% of GP patients aged six and over have been prescribed some form of asthma-related medication in the past year. That statistic is higher than the national average, and it represents hundreds of families trying to manage a condition that, with the right support, should not prevent anyone from living a full and active life. Yet time and again those are the families let down in other areas, by poor housing, air pollution—as the hon. Member for Bournemouth West (Jessica Toale) mentioned—inconsistent care and a public health system that has been hollowed out over the past decade.

The UK should be a world leader in public health. We have a long history of innovation, grassroots sports, high-quality food production and leading medical research, but, thanks to the previous Government, we now lag behind our international peers. It is profoundly troubling that our children experience some of the worst asthma outcomes across Europe and other high-income countries. The Liberal Democrats are calling on the Government to take urgent action.

First and foremost, we must reverse the Conservative cuts to public health funding, but we must not stop there. We need a comprehensive approach that tackles the root causes of poor lung health, from poverty and cold, damp housing to polluted air and hazardous working environments. We want an increase to the public health grant delivered by local authorities, with part of that funding set out for communities facing the greatest health inequalities. Those communities must be supported by co-designed solutions, including better smoking cessation services, stronger action on air quality and improvements to housing and occupational health.

Prevention must be at the heart of our approach. That means investing in primary care, supporting individuals to improve their own health and giving local areas the tools they need to build healthier environments. It is one of the most effective ways that we can reduce pressure on NHS services and deliver better value for money to taxpayers.

The Liberal Democrats would also take decisive action on air pollution by passing a clean air Act based on World Health Organisation guidelines and establishing a new air quality agency to enforce those standards. We must do more to ensure access to consistent, high-quality care for those already living with long-term respiratory conditions such as asthma. That includes guaranteeing that people with severe asthma have access to a named GP so that they do not have to constantly retell their story to new clinicians, and increasing the capacity of the Medicines and Healthcare products Regulatory Agency so that new treatments can reach patients more quickly.

I was on a Delegated Legislation Committee earlier this week, with the Minister, where the funding for the MHRA was increased. However, it was not clear whether that would speed up the process of getting new medicines to patients. As the hon. Member for Strangford rightly pointed out, the scale of this issue demands urgency. Four asthma deaths every day and a life-threatening attack every 10 seconds are tragedies could be prevented, if only we prioritised respiratory health as we ought to.

Will the Minister, therefore, commit to setting aside part of the public health grant to support those communities facing the largest health inequalities? Will the Government propose a new clean air Act based on World Health Organisation guidelines, to ensure those with severe, long-term respiratory conditions are not breathing in harmful pollutants? Finally, when can we expect the publication of the 10-year health plan, and will respiratory health be included?

Asthma is not just a clinical issue; it is a question of justice and of whether we are willing to tackle the social and environmental factors that make people ill in the first place. I hope the Minister will reflect seriously on what has been said today.

15:45

[Dr Luke Evans (Hinckley and Bosworth) (Con)]

It is a pleasure to serve under your chairmanship, Dr Huq.

I would also like to place on record my thanks again to the hon. Member for Strangford (Jim Shannon). Those unkind might say he chases the spotlight of Westminster Hall, but they would be grossly mistaken: he chases purpose, which is why we find him everywhere, with boundless energy, trying to make a difference, and nowhere more so than in health. This must be the sixth debate I have had with him, if not more, so I take my hat off to him—he really is a champion in this space—and I thank him for what he does.

Asthma teaches us never to take a single breath for granted. When simply breathing becomes a conscious effort, we realise just how much strength it takes just to stay alive. I have seen that as a clinician working in A&E and as a GP; one of the scariest moments is when a child comes in having an asthma attack, or worse still, has one in the GP surgery, and having to manage the inhalers, the puffs they take and what to do when they deteriorate.

I have a personal story too—if we are declaring interests—to share with the hon. Member for Bournemouth West (Jessica Toale). I suffered from mild asthma growing up as a child and into my teens, but I ended up in an intensive care unit after having my appendix taken out. I ended up with bilateral pneumonia. That is highly unusual in the first place, but even more so when it is a doctor involved—we seem to be the most complicated to treat. It meant that afterwards I was left with significant breathing problems and symptoms that behaved like asthma—so much so that I would need steroids to solve them. I was also under the brittle asthma clinic in Oxford when I lived there.

I know at first hand what it is like to suffer when it is impossible to breathe, when someone’s ability to run is taken away or, worse still, they up in the middle of the night in a panic. This is a very timely and important debate that the hon. Member for Strangford has brought forward, and he has my sympathies and gratitude for doing so. On that line, I also thank Asthma + Lung UK for all the work it does to highlight this issue. As we have heard, with 7 million people suffering, this is the bread and butter of the NHS: from primary care to secondary care, day in, day out, people are being diagnosed with and treated for asthma.

As we await the 10-year plan for the NHS next month, this debate provides the chance for us to ask where we have got to with the Government. The last Government had come forward with the major conditions strategy but, alas, the new Government decided to take a different direction. Of course, that is their prerogative—no Government are bound by their predecessors. However, it does raise the question: what next? The Government will need to set out what they will do as an alternative to tackle asthma and other respiratory conditions.

It would be helpful to hear from the Minister today what assurances she can give about the inclusion she may have made of these conditions in the plan. Can she also set out what engagement her Department has had with patient groups such as Asthma + Lung UK, who put a lot of time into previous submissions to ensure the last Government understood what was needed? It would be sad to see that replication being needed, but at least the work would not be lost.

Part of dealing with asthma and respiratory conditions is vaccines and prevention. Work is clearly needed to increase uptake of the respiratory syncytial virus vaccine. I welcome findings that there was nearly a 30% reduction in hospital admissions among those aged 75 to 79, thanks to this vaccine, but the UK Health Security Agency has warned that many more older adults remain unprotected from RSV. To illustrate that point, up to the end of March, only half of eligible older adults had been vaccinated and more than 1 million people were yet to receive their vaccine.

I think we all share concerns about the significant increase in the number of bed spaces occupied by people with flu in the 2024-25 winter. That was partly due to vaccination rates among eligible groups being below what we would hope for. This winter, three times as many people as in the previous year were hospitalised because of the flu, which contributed significantly to waiting times in A&E departments. Without a clear increase in vaccination, the NHS will continue to face difficulties in urgent and emergency care. What steps will the Minister take over the next few months to increase the uptake of RSV, flu and pneumonia vaccines, particularly by those who suffer with asthma and COPD?

As a clinician, I remember over the years having to deal with different sets of guidelines. The hon. Member for Strangford hit the nail on the head. It was great to see the BTS, NICE and SIGN guidelines all coming together in November 2024, but there is a challenge in having guidelines, rolling them out and making sure clinicians are educated on the changes. What steps have the Government taken to ensure that ICBs and royal colleges are aware of the guidelines and that they are percolating down to everyone who might need to see them?

Access to fractional exhaled nitric oxide—FeNO—testing is an important step in diagnosis. There is also spirometry. Given the success of community diagnostic centres, have the Government given any thought to how such apparatus could be rolled out to communities so that more people might get access to it?

One thing that is really important with respiratory diseases, especially asthma, is smoking cessation. The Tobacco and Vapes Bill is going through Parliament, but is there any targeted approach for those who suffer with asthma to help them to reduce smoking?

Much of asthma care is delegated to nurses, not doctors. How does that fit into the forthcoming workforce plan? Will special consideration be given to respiratory nurses in both primary and secondary care? After all, they have become the experts in exactly what to prescribe and when.

Finally and most importantly, what steps are being taken to reduce asthma deaths, especially preventable ones? The word “preventable” is the biggest key here. I am keen to hear from the Minister how the Government intend to tackle this problem.

Breathing: it is the first and last thing we do, but we rarely notice it until it has gone—or, in the case of asthma, until it is threatened. I know the Minister understands that, and I know the people out there watching understand it. I hope that understanding transforms into policy.

15:53

[The Parliamentary Under-Secretary of State for Health and Social Care (Ashley Dalton)]

It is a pleasure to serve under your chairship, Dr Huq. I thank the hon. Member for Strangford (Jim Shannon) for bringing this timely debate forward as we mark last week’s World Asthma Day. It shows real leadership from the chair of the APPG for respiratory health. In that spirit, I would be delighted to take him up on his offer of a meeting. We will arrange that as soon as we possibly can—I am keen to do it.

I thank hon. Members for their contributions. I am more than happy to meet the hon. Member for Birmingham Perry Barr (Ayoub Khan) to discuss the issues that he raised, including prescription charges. There are currently no plans to review the list of medical conditions that entitle someone to apply for a medical exemption certificate. However, approximately 89% of prescription items are dispensed free of charge in the community in England and a wide range of exemptions are already in place. Eligibility depends on factors such as the patient’s age and whether they are in qualifying full-time education, are pregnant, have recently given birth or are in receipt of certain benefits. People on low incomes can apply for help with their health costs through the NHS low income scheme. Children are of course entitled to free prescriptions.

NHS England’s children and young people’s transformation team have been working closely with the MHRA on dose counters being added to inhalers. The “British National Formulary for Children” has been updated with guidance and supportive resources for patients and clinicians, which have been widely shared. We are awaiting an update on progress on making dose counter inhalers dominant in the supply chain from the pharmaceutical industry. I will be more than happy to update the House when we have it.

I thank my hon. Friend the Member for Bournemouth West (Jessica Toale), who focused on air quality, which is a priority for the Government and part of our prevention strategy, and the technology to help to manage asthma. There are a range of technologies available to help people to manage their asthma, and NHS England and NICE are exploring the potential for the platforms for digital self-management of asthma to be evaluated, but that depends on the technology readiness level. Guidelines developed jointly by NICE, the Scottish Intercollegiate Guidelines Network and the British Thoracic Society to harmonise recommendations across the organisations were published in November 2024, and I hope they are useful.

Before I respond to the Front-Bench contributions—if there is anything I do not cover, please let us know and we will endeavour to write with the relevant details—I want to pay tribute to charities and campaigners: people who are doing the hard yards of helping to equip our hospitals and supporting people to manage their conditions in their day-to-day lives. I thank Asthma + Lung UK, Beat Asthma and the Asthma Relief Charity, to name just a few. The shadow Minister, the hon. Member for Hinckley and Bosworth (Dr Evans), asked about the contributions by charities to the major conditions strategy. I reassure him that engagement with such stakeholders has been central to the development of the 10-year plan. All submissions made to the major conditions strategy have been taken into account—nothing was wasted.

As the hon. Member for Strangford outlined, asthma is the most common lung condition, affecting nearly 5.5 million people in the UK. Just under one in 10 kids live with asthma, and more than 12,000 people have died from asthma attacks in the last 10 years. World Asthma Day is not just about treating a condition; it is about shining a spotlight on inequalities. I strongly agree with the hon. Gentleman that everyone, regardless of where they live or how much they have in their bank account, has the right to access the inhaled medications they need to control their condition and treat attacks.

Nevertheless, statistics published by Asthma + Lung UK just this month show that Asian people with asthma from the most deprived quintile in England are almost three times more likely to have an emergency admission to hospital than their white counterparts. Black people with asthma from that group are also more than twice as likely to be admitted to hospital. This is a burning injustice. As if that were not enough, the annual economic burden of asthma in the UK is around £3 billion a year. Lung conditions collectively cost the NHS £11 billion annually. That is why we must act.

I will update Members on NHS England’s activities in this space before moving on to wider Government efforts. NHS England is taking steps to support integrated care systems to improve outcomes for people with asthma through its national respiratory programme by providing targeted funding, clarifying what systems should be doing to ensure that people with asthma receive a high-quality and timely diagnosis, and working with key partners, industry representatives, patient groups and clinicians to support improved respiratory disease management. That will include shared decision making on inhaler choice and making better use of inhalers to reduce the overuse of reliever inhalers and encourage the use of preventer inhalers.

The hon. Member for Strangford raised the issue of access to and roll-out of treatments. Healthcare Quality Improvement Partnership, on behalf of NHS England, commissioned a national audit across respiratory care, which includes asthma, and all data from the audit is published for open access. NICE is working with BTS, SIGN, NHS England and others to review the resources available to support implementation of the guidelines, and plans to publish a respiratory toolkit. To support implementation of NICE guidance, NHS England has been engaging with health system partners across the country to co-ordinate resources and implementation efforts to make sure that patients are on the appropriate treatment regime.

NHS England is also protecting our children and young people through the national bundle of care. It is putting asthma care at the top of the agenda by giving asthma a higher priority within systems, providing funding for regional leadership, and strengthening governance and accountability to improve outcomes. It has also played a crucial role in making training easier and more readily available for staff by bringing together existing guidance and resources with a structured training scheme. Since its publication there has been a noticeable reduction in hospital admissions.

The hon. Member for Strangford and the shadow Minister both raised spirometry, a diagnostic test for asthma as well as other respiratory diseases. NHS England is working with a range of partners, including Asthma + Lung UK, the British Thoracic Society, the Association for Respiratory Technology and Physiology and clinical leads to make sure that systems have everything they need to increase the number of people receiving early and accurate diagnosis for respiratory disease. In the past year the Government have made extra funding available to make sure that staff have the proper training and accreditation to use spirometry effectively.

On inequalities, NHS England is taking steps to uplift the most deprived quintile through Core20PLUS5. That initiative focuses on five areas of improvement, of which chronic respiratory disease is a key part. There are targeted interventions to detect and treat asthma. The PLUS population groups include ethnic minority communities, people with a learning disability, autistic people, coastal communities, people with multimorbidity and protected characteristic groups. Core20PLUS5 also has a dedicated workstream for children and young people. The primary focus is to address over-reliance on reliever medications while decreasing the number of asthma attacks. That has made some progress, with clear reductions in the over-prescribing of reliever inhalers over the past few years. Between April 2022 and February 2025 the proportion of patients with asthma who received six or more reliever inhaler prescriptions fell from just under 20% to under 16%. The Government are supporting systems to take innovative approaches to expanding access to their diagnostic services, with a particular focus on addressing health inequalities.

Finally, the NHS rightly offers the flu vaccine free of charge to people with severe asthma as seasonal illnesses pose more of a threat to them than others. NHS England has been working with the severe asthma collaborative to develop the capacity of severe asthma centres to improve patient access to biologic treatments and to reduce variation in prescribing and patient management. That work has shown improved identification of patients with potential severe asthma in primary and secondary care, resulting in referral to severe asthma centres for consideration of their eligibility for biologic therapy. For four in 10 asthma patients with severe asthma those treatments can significantly improve their quality of life. However, it is vital that biologics are prescribed only following specialist assessment. Currently, the NHS is deploying six biological treatments approved to treat severe asthma.

The shadow Minister raised the issue of vaccines. I reassure him that a strategy and action are being delivered to increase vaccination uptake, including RSV and flu, because that is a priority for the Government. Returning to biologics, significant work was undertaken to drive uptake and access to them through the NHS England severe asthma collaborative, and patient outcomes are submitted to the UK severe asthma registry. That has improved the identification of patients with potential severe asthma, and has resulted in those people being referred to the relevant care pathways.

Every member of the Government is committed to raising the healthiest generation of children in our history. We are taking steps to protect our kids from obesity and smoking, which are major risk factors; each one is responsible for roughly a third of asthma deaths. We are taking action through the Tobacco and Vapes Bill, which I am pleased to say has just passed Second Reading in the other place.

In her autumn Budget, my right hon. Friend the Chancellor took steps to ensure that the soft drinks industry levy remains effective. We have not just uprated the levy to bring it in line with inflation; we also published a consultation just last month on two proposed changes—reducing the lowest sugar tax threshold from 5 grams to 4 grams of total sugar per 100 ml, and removing the exemption for milk-based and milk substitute drinks. Finally, my right hon. Friend the Secretary of State for Energy Security and Net Zero is cleaning up our air with Great British Energy and a raft of other measures.

My Department will shortly be publishing its 10-year plan for health to make our NHS fit for the future. We will shift the focus of our NHS from sickness to prevention, hospital to community, and analogue to digital. Until then, we are already taking steps on prevention by helping people to lose weight and quit smoking or vaping, and by helping to clean up our air. We are helping people to get diagnosed closer to home by requiring community diagnostic centres to provide spirometry tests. The Government remain committed to ensuring that existing CDCs, where they are not already, are rolled out at full operational capacity at their permanent site.

[Dr Luke Evans]

The Minister mentioned spirometry. Could she comment on FeNO, and if not, could she write to us? The guidelines are built around that, but access is going to be an issue.

[Ashley Dalton]

Yes, I confirm that I will write to the shadow Minister on FeNO at a later date. NHS England is also piloting a digital annual asthma check.

I am sorry, Dr Huq, this is highly irregular, but I am feeling extremely unwell; I need to go and make myself okay. [Interruption.] Thank you for your forbearance, Dr Huq. Crohn’s is not something that we have debated in this Chamber; if we did, no doubt I would be the responding Minister, and I can assure you that I would be able to speak from personal expertise.

[Jim Shannon]

I used to have close contact with a guy called Simon Hamilton, who was an MLA for the constituency that I represent. He had Crohn’s disease—my knowledge of it came through him—and he was caught short many a time, if that is the way to put it.

May I ask the Minister a wee question? I asked about CDCs once NHS England is abolished—[Interruption.] I can see that she is coming to that. That is grand.

[Ashley Dalton]

Yes, I will come to many of those issues.

As I was saying, NHS England is piloting a digital annual asthma check, which, if successful, will mean that fewer people miss that valuable check and will keep the monitoring of their asthma up to date.

The Lib Dem spokesperson, the hon. Member for Chichester (Jess Brown-Fuller), asked about the public health grant. The grant has been increased and local directors of public health are best placed to identify where to target resources in their communities. As I have said, the 10-year health plan will be published next month. It will cover all conditions and will consider lung health. I have talked about the stakeholder engagement that was really important in that, and I can guarantee that, with the 10-year strategic plan for the NHS, we will look right across the board at how we can make sure that all conditions get due consideration.

During our short interruption, I was able to get a little more information for the shadow Minister on FeNO. Wessex Academic Health Science Network has created a FeNO rapid uptake product delivery toolkit, which is providing downloadable tools and resources to support NHS organisations with the adoption and implementation of FeNO testing to improve outcomes. Anyone can access that toolkit, which contains case studies of best practice identified through the programme. I hope that is helpful.

On the changes to NHS England, we are abolishing NHS England in itself, but none of its functions is disappearing. We are working really closely across the Department and NHS England, as well as with our ICB colleagues, to ensure that all services are transferred in an appropriate way. The purpose of the changes is to make things as efficient and targeted as possible and to ensure that they get to the people who need them the most.

Ensuring that community diagnostic centres are supported is really important to the Government, as it is very much part of one of our three shifts: from hospital to community. Those shifts—the other two are from sickness to prevention and from analogue to digital—are at the very heart of the 10-year plan.

I thank the hon. Member for Strangford for bringing forward the debate. I am sure that he would agree that World Asthma Day is not just for raising awareness; it should also be a celebration of the great things that people with asthma have accomplished. I did not know this until I saw the research for this debate, but past asthmatics have included Dickens, Disraeli and Beethoven. If those examples seem archaic, I can also point to Harry Styles, Jessica Alba and David Beckham, as well as to many prominent Olympic medallists. People with asthma achieve great things. It is our job in this place to help them to reach their full potential, with a particular focus on addressing how respiratory conditions affect people in deprived communities.

16:14

[Jim Shannon]

I thank all hon. Members for participating in the debate. The hon. Member for Birmingham Perry Barr (Ayoub Khan) referred to the fact that someone dies every six hours—four people in a day—from asthma. He also talked about young George Coller, and the Minister kindly agreed to meet the hon. Gentleman and the family. That is very positive; I would not expect anything other than positivity of the Minister, but I thank her for that. Such meetings help us to represent our constituents in a positive fashion.

The hon. Member for Bournemouth West (Jessica Toale), who is an asthma sufferer—I know about asthma only through my son, but the hon. Lady has lived experience—talked about how asthma affects her life, and I understand that her sister also suffers from it. She also referred to the Tobacco and Vapes Bill and the Renters’ Rights Bill, which are relevant to issues that contribute to asthma. Asthma goes way outside the remit of Health Ministers alone; Ministers in other Departments have to be part of addressing it.

The hon. Member for Chichester (Jess Brown-Fuller) always brings her knowledge to the subject matter. She referred to air pollution and the Lib Dems’ commitment to addressing that issue. She mentioned poor housing and healthier homes, and said that the increase in children’s asthma needs to be addressed. Again, lung conditions are the third biggest killer in the UK, as others have mentioned.

I have lost count of the number of debates that my friend, the hon. Member for Hinckley and Bosworth (Dr Evans), and I have been in together—it is like a tag team here on a Thursday afternoon—and I thank him for his personal story about asthma. He referred to the work of charities and to primary and secondary care, which the Minister referred to positively in her contribution. He mentioned smoking cessation, the passage of the Tobacco and Vapes Bill, and preventable deaths. I thank him for bringing his knowledge as a doctor to add to the debate.

I thank the Minister; I think that we are all impressed by her replies. She did her utmost to answer all our questions in a positive fashion. I thank her for agreeing to the meeting, which we will look forward to. It will give the APPG a chance to talk more insightfully, if that is the way to put it, about the issues.

The commitment to asthma shines out across the nation. The Minister referred to the Government’s commitment to improving air quality, which we are all pleased about, and she referred to the national bundle of care—I hope I got that right—as well as regional funding. She also referred to spirometry diagnostic tests, which is an issue that the hon. Member for Hinckley and Bosworth and I were trying to pursue.

The Minister also mentioned action for those with severe asthma—biologics—and the training of staff; her positive replies to our questions were an example of how other Ministers should reply. She mentioned the moves from sickness to prevention and from analogue to digital. She discussed ensuring, first of all, that we prevent the deaths, but also that we help those who have asthma.

It has been a positive debate. It may be a few weeks after World Asthma Day, but none the less it has been World Asthma Day for this hour or so. I thank everyone for their contributions and look forward to meeting the Minister.

Question put and agreed to.

Resolved,

That this House has considered World Asthma Day.

16:19

Sitting adjourned.