Iran’s Influence in the Middle East

Debate between Jim Shannon and Fabian Hamilton

Wednesday 22nd March 2017 Westminster Hall

[Fabian Hamilton (Leeds North East) (Lab)]

I congratulate, as everybody else has, the hon. Member for Hendon (Dr Offord) on eventually securing this debate, despite the setbacks of two weeks ago that were totally outside his control. In this week of Nowruz, the Iranian new year, it is very appropriate to hold a debate such as this.

The hon. Gentleman talked about Iran being the chief sponsor of terror in the region—something that is well known and well documented. He also made the very important point that Iran regards Syria as its 13th province. The policies of the Iranian Government have certainly shown that to be the case. He also mentioned, rather importantly, the lifting of sanctions following the Iran nuclear deal, which he claimed has released $100 billion to the Iranian Government—to be used, as he pointed out, largely for sponsoring some of the most appalling terror groups.

My right hon. Friend the Member for Enfield North (Joan Ryan), who has been very active on middle east issues, pointed out that the nuclear deal has done nothing to stop Iran’s destabilising influence in the region, as the hon. Member for Hendon said. My right hon. Friend also drew our attention to the underground rocket factories that are under the control of Hezbollah in Lebanon. It remains to be seen what other Governments in the region will do about that, if indeed they can do anything at all.

My hon. Friend the Member for Liverpool, Riverside (Mrs Ellman), who has a reputation for being very forthright and involved in debates on the region, called Iran a dangerous promoter of terrorism overseas and of repression at home. We heard some months ago, in this very room, horrifying and hair-raising stories about the abuse of human rights in Iran, some of which have been mentioned today. The right hon. Member for Chipping Barnet (Mrs Villiers) drew our attention to them once again.

One of the most fascinating contributions this morning was from the hon. Member for South Ribble (Seema Kennedy), who drew our attention to her own family members who are still in Iran. She rightly said that we cannot ignore Iran. That is clear to all of us, and that is why this debate has been so well subscribed.

As we have heard, Iran is increasingly exerting its power in the middle east, taking advantage of the economically and politically destabilised post-Arab spring middle east. With the collapse of so many national Arab identities and the growth of sectarian identification, Iran has found a new role in the middle east as a regional superpower. As was mentioned, much of that stems from the Sunni-Shi’a rift in Islam—a historical rift going back centuries that is rearing its head with a vengeance today.

Iran is playing, I believe, a long-term game by investing in the region. It penetrates weaker systems in the region so as to make itself indispensable to many parties and, of course, as a means to project its own power. As we have heard, it invests not only in hard power but in soft power, such as by establishing cultural and religious centres and financially supporting groups in other middle eastern countries.

Iran has the largest majority Shi’a population in the region—indeed, in the world—and is a self-declared defender and supporter of Shi’a minorities in other middle eastern countries; it often criticises other countries for mistreating their Shi’a minorities. We have heard today that Iran supports Hezbollah—the Lebanese Shi’ite militia that is the most powerful military force in Lebanon. Iran also supports President Assad of Syria; it is his closest ally, of course. Iran has come to dominate so many nations in the region, especially those that I have mentioned. As we heard, it is more clandestinely supporting the Shi’a Houthi rebels in Yemen, and it has criticised Bahrain for mistreating its own Shi’a population.

The hon. Member for Hendon mentioned something that baffled me slightly; I do not know about other hon. Members. That was Iran’s support for ISIL or Daesh. I have not seen any evidence that suggests that Iran supports in any way the activities of Daesh, but if the hon. Member for Hendon has such evidence, I would be interested to see it.

Despite the sanctions, Iran is the second largest economy in the middle east and north Africa after Saudi Arabia. Its GDP in 2015 was $393.7 billion, according to the World Bank. I am sure that, once the sanctions have been fully lifted, its economy will grow much faster. Judging by the last time I was there, which was nearly 10 years ago, it certainly needs a lot of investment in its major infrastructure, because that is sadly lacking.

As we have heard, Iran’s political system is religious democracy—theocracy. It is a unique model in the world. I think the hon. Member for South Ribble said that its population is more than 80 million. According to World Bank statistics, the population was 78.8 million in 2015, but of course without a proper census, it is very hard to tell. According to the British Council in March 2016, Iran is a

“sophisticated, highly educated state…with a youthful population”.

The last statistic I saw was that two thirds of its population are under 35 years old. That is remarkable.

The United Kingdom, the United States and their allies in the Gulf Co-operation Council have stated that Iran engages in

“destabilising activities in the region”.

That is in the House of Common Library briefing paper of 2017. The Prime Minister stated on BBC radio in December that she was

“clear-eyed about the threat that Iran poses to the Gulf and the wider Middle East”.

The Gulf Co-operation Council views Iranian influence in the region as threatening and as a sign of Iran’s desire for regional hegemony.

Let me discuss Iran after the nuclear deal. The joint comprehensive plan of action, which was signed in July 2015 and came into force in 2016, has been called by President Trump

“the worst deal ever negotiated”.

Iran is using the nuclear agreement to ease its international isolation and reassert itself as a regional power and a regional energy and trade hub. It has placed in storage two thirds of its centrifuges for the creation of nuclear fissile material and dispensed with 98% of its stockpile of low-enriched uranium. Those facts were upheld when I visited the International Atomic Energy Agency in Vienna last November. A huge percentage of its inspectors are still in Iran. It is consuming most of the agency’s budget, Director General Amano told us at the time.

[Jim Shannon]

So far, the hon. Gentleman has not commented on this issue, but I am sure that he will do so shortly. Does he agree that every opportunity should be used to express solidarity with Christians and other religious groups being persecuted regularly and systematically in Iran, and does he feel that the Minister should take every opportunity to bring the matter to the attention of the Iranian authorities?

[Fabian Hamilton]

The hon. Gentleman has a brilliant reputation in the House of Commons for standing up for the rights of persecuted Christians anywhere in the world. Of course I agree that we should always point out abuses of the human rights not only of Christians, but of the Baha’is, who have been mentioned. There is also still a small Jewish population in Iran, frightened that they might inadvertently mention the terrible word that is forbidden—Israel.

I will conclude, because we all want to hear from the Minister. Zvi Magen, of the Israeli Institute for National Security Studies, said just last year:

“The Israeli security establishment believes that the main threat Israel is facing in Syria is in fact Iran and its local proxies like Hezbollah”,

which are being funded by the Iranian state. Israel feels threatened by a Shi’a axis within its neighbours. In 2004, King Abdullah of Jordan warned of a rising Shi’a crescent in the region. I was in Jordan just in January, when I heard in detail the Jordanian Government’s concerns about the rise of Iran.

Iran’s revolutionary Government since 1979 is in so many ways a real tragedy for the people of Iran. It is a country of such wonderful people. I have been there myself. I have met its only, and absolutely splendid, Nobel laureate, Shirin Ebadi, an extraordinary woman who is struggling to make her voice heard against the regime’s repression. Iran has made a huge contribution historically to human civilisation, human knowledge and culture, and Labour Members would love to see Iran do so again and see the Iranian people set free to once again take their rightful place in the world.

Anti-TNF Drugs

Debate between Jim Shannon and Fabian Hamilton

Wednesday 9th December 2015 Westminster Hall

[Fabian Hamilton (Leeds North East) (Lab)]

I beg to move,

That this House has considered prescription of anti-TNF drugs.

It is a pleasure to serve under your chairmanship, Mrs Main. I am grateful for the opportunity to speak about NHS prescription of anti-tumour necrosis factor drugs, a subject on which I have become somewhat familiar since I was contacted more than two months ago by my constituent, Samara Ullmann.

Before I move on to why I requested the debate and to define what anti-TNF drugs are and their uses, it may be helpful to give you, Mrs Main, the Minister and other Members present the background as to why this specialist medication will make such a difference to my constituent and so many others.

Samara Ullmann, who is now 29 years old, was born in my constituency in 1986. At the early age of just two, her parents noticed that she was walking with a limp. Worried about her clear inability to walk without pain, her parents took her to her local GP, who referred her to Leeds general infirmary where she was diagnosed with a condition known as juvenile idiopathic arthritis. The terrible condition affected both of little Samara’s legs, her wrists, her ankles and her knees. Her parents were told by the hospital that it was likely that she would have to be in a wheelchair by the time she reached the age of 10. From the age of two and until she was six, she had to wear splints on both her legs.

Professor Anne Chamberlain supervised Samara’s treatment over the next few years. During Samara’s visits to Leeds general infirmary every three to four weeks she was given hydrotherapy, physiotherapy and a cocktail of drugs. Her parents were told that little else could be done for her, which was confirmed by some of the country’s top rheumatologists.

From the age of six, Samara started having problems with both her eyes, which developed uveitis, a common effect of JIA. By the time she was seven, a cataract had developed in her left eye and was removed, but it was left considerably weakened so that, by the time she reached the age of 11, she had completely lost the sight in that eye. Fortunately, her right eye continued to function normally, although when she reached the age of 14 she needed laser treatment on that good eye and was understandably frightened that she would be left completely blind.

The JIA improved considerably by the time Samara reached 17, but sadly her left eye had to be removed because it was both blind and painful. After three months, she was fitted with a prosthetic glass eye, which fortunately is able to move to a limited extent with her functioning eye. The Minister may be able to imagine the terrible effect that all of that had on a teenage girl growing up in the early part of this century. Her self-confidence was badly damaged, too.

As the arthritis gradually abated, Samara was left with a common consequence of the condition, refractory uveitis, which often causes blindness even with the best treatments currently available. Her right eye—her only eye—is now severely affected. So far, despite a paralysed iris, a stuck-down pupil and a developing cataract in her remaining eye, her sight has been partially protected by the use of a drug called mycophenolate, which together with methotrexate is commonly used to treat uveitis.

Those drugs impair the white blood cells that promote the inflammation that causes uveitis. However, despite treatment with those drugs over the past eight years, the vision in Samara’s only eye continues to deteriorate. That is why her eye specialist at Calderdale Royal hospital in Halifax, Mr Teifi James, believes that in order to save her sight, she needs to be prescribed an anti-TNF drug such as Humira—adalimumab.

An anti-TNF drug is a monoclonal antibody that specifically targets tumour necrosis factor alpha. Because of the way in which it is manufactured, it is called a biologic. TNF is involved in causing inflammation in a number of autoimmune and immune-mediated disorders. Those diseases probably cause too much TNF to be produced, modifying the body’s immune response and causing inflammation. Anti-TNF drugs reduce the amount of TNF in the body. They are expensive and may have side effects that could be severe, but, with appropriate monitoring and care, such effects are rare. In fact, they are much less common than the many problematic side effects of corticosteroids.

[Jim Shannon (Strangford) (DUP)]

I thank the hon. Gentleman for bringing this issue to Westminster Hall. The Minister will be seeking to improve the success rate of anti-TNF drugs. Many universities across the United Kingdom are looking at how to improve medication for those with eye ailments. We have two in Northern Ireland, which are Queen’s University Belfast and, in particular, Ulster University—

[Jim Shannon]

Does the hon. Gentleman agree that that is a good idea?

[Fabian Hamilton]

I thank the hon. Gentleman for that intervention. He is right. The more studies carried out across the country at university level, the better it will be for patients suffering from refractory uveitis.

The anti-TNF drugs switch off the molecule that creates the inflammation in the first place and are therefore far more effective than corticosteroids in cases such as Samara’s. I am sure that Queen’s University Belfast and many others can confirm that.

Last year, Samara married her fiancé, Ben, and the couple now want to start a family. However, it is not at all advisable for her to become pregnant while taking mycophenolate, because it may well cause a miscarriage or birth defects. An anti-TNF drug could allow her to retain her eyesight and probably to conceive safely and be able to see her child grow up.

Let me move on to why adalimumab or infliximab should be available immediately on NHS prescription for adults with sight-threatening uveitis. I am aware that the National Institute for Health and Care Excellence is about to conduct a multiple-technology appraisal of adalimumab and infliximab and that responses to the draft must be received by 16 December—this time next week. From my conversations with Teifi James, one of the country’s leading eye surgeons, and from my research into that treatment it would seem that drugs such as Humira are highly effective in the treatment of uveitis, so much so that researchers in the Sycamore trial in Bristol, to which the Minister referred in his letter to me of 4 November, have stopped recruiting to it because the children being treated are doing so well on the drug. However, NHS England did not take that into account when it made its most recent decision on the use of adalimumab and infliximab for the treatment of adult uveitis alone.

According to Mr James, approximately 120 patients with sight-threatening uveitis are waiting for anti-TNF treatments in England, whereas patients in Scotland currently have access to adalimumab and infliximab. Treatment using Humira costs just under £10,000 a year per patient, which means that approval of the use of this drug for treating refractory uveitis alone would cost no more than £1.2 million a year.