Pandemic Prevention, Preparedness and Response: International Agreement

Anne-Marie Trevelyan Excerpts

Monday 17th April 2023 Westminster Hall

[The Minister of State, Foreign, Commonwealth and Development Office (Anne-Marie Trevelyan)]

I am grateful to my hon. Friend the Member for Don Valley (Nick Fletcher) for leading this debate on behalf of the Petitions Committee and, importantly, on behalf of the petitioners. I am also grateful for the contributions of all hon. Members, and I will try to respond as best I can. I will ask officials to write to Members to answer the questions to which I am unable to provide answers. In particular, the hon. Member for Birmingham, Edgbaston (Preet Kaur Gill) has entirely unsurprisingly taken the opportunity to ask a series of questions on areas that the Minister of State, Foreign, Commonwealth and Development Office, my right hon. Friend the Member for Sutton Coldfield (Mr Mitchell), would be highly capable of responding on. However, he is unable to be here due to other ministerial duties. I will ensure that responses are provided for those questions.

As covid-19 clearly demonstrated, it is in all our interests to invest in global health. The world was ill-prepared for the pandemic, which killed millions, wiped billions off the global economy and undid years of progress on our development goals. The three years since covid struck have been a wake-up call for the whole world. They have highlighted the importance of strong, resilient and inclusive health systems and have made clear that we need a co-ordinated approach across our work on human health, animal health and the environment. Covid also shone a spotlight on the need for agreed international protocols, so that information is shared in a timely fashion. It underlined how important it is that vaccines, treatments and tests are available to all who need them.

In short, we need collective international action, co-operation and mutual accountability to protect future generations from the catastrophic impacts of pandemics. Finding the best ways to manage communities of all economic strengths and resilient shapes and sizes is, of course, one critical part of that. That is why the UK is working with G7 partners and others to catalyse international efforts to try to help countries of all shapes and sizes to be better prepared.

As part of this, the former Prime Minister, my right hon. Friend the Member for Uxbridge and South Ruislip (Boris Johnson), joined other world leaders in 2021 in calling for a new international instrument to strengthen pandemic prevention, preparedness and response. All 194 WHO member states agreed by consensus to draft and negotiate a new pandemic instrument. There was a clear view that this could transform global health security and deliver the changes necessary to withstand health threats, for example, by making sure that the world has fit-for-purpose agreements in place for data-sharing and surveillance, to be able to help slow or contain the spread of disease and to support a speedy and effective response.

In November 2021, together with the other members of the World Health Organisation, the UK agreed to establish an intergovernmental body to draft and negotiate the new pandemic instrument, with a target date of May 2024.

To answer my hon. Friend the Member for Christchurch (Sir Christopher Chope), that is being negotiated with a view to adoption under article 19 of the WHO constitution, but without prejudice to considering adoption under article 21 as negotiations progress, if that was to be the preferred decision of all member states in the consensus decision that they hope to reach.

The article 19 route would not negate the ability of each member state to accept it through their own national constitutional processes, which is a really important part of the question that I will refer to further. Whether agreed under article 19 or 21, both will be legally binding as a matter of international law.

As part of our wider efforts to improve global health security through strengthening international law, the UK is participating in parallel negotiations to update the international health regulations: the technical public health framework, which a number of colleagues referred to, that requires countries to report and respond to potential cross-border health threats.

Over the next year, UK officials will shape and negotiate a text with other WHO members to ensure that it delivers on our priorities. Those will include: working towards faster and more equitable access to affordable vaccines, treatments and tests; strengthening collaboration on scientific research and development, including clinical trials and data sharing; improving collaboration and co-ordination across the human, animal and environment health sectors to try to control threats from zoonotic diseases among those other threats that we know are out there; and building strong health systems to support populations to access the health services they need during and after a pandemic.

We are already demonstrating global leadership in those priority areas. Through our multilateral and bilateral investments, we are helping low and middle-income countries to develop resilient systems and services. For example, we trained more than 600 health workers in Côte d’Ivoire to strengthen surveillance, reached over 53,000 people in Cameroon through outreach campaigns led by civil society partners and substantially increased response times to reported public health events in Mali.

Through our “One Health” approach, we are working to monitor and control the spread of diseases between humans, animals and the environment. We supported Cameroon to carry out a simulation exercise that tested and refined plans to deal with disease outbreaks of zoonotic origin, including monkeypox. Meanwhile, our investments in research and development are increasing equitable access to vaccines, drugs and diagnostics. With UK support, the Medicines for Malaria Venture has developed and rolled out more than 13 new anti-malarials. To date, those medicines have saved an estimated 2.7 million lives.

In all of this, we are working in strong partnership with academic institutions, the private sector and other organisations. The Coalition for Epidemic Preparedness Innovations—CEPI, as it is known—is a great example of that partnership work, helping to ensure that medical innovations are affordable and accessible to those in need. The Foreign, Commonwealth and Development Office has committed £230 million to CEPI to support the development of vaccines for covid-19, which includes the covid-19 vaccine candidate developed by the University of Oxford and AstraZeneca, with support from the Department of Health and Social Care’s UK vaccine network. As we have seen, the Oxford-AstraZeneca covid-19 vaccine has saved lives worldwide.

The UK has been a global leader, working with CEPI, Gavi and the WHO to ensure that our scientific leaders can help tackle health crises. As Secretary of State for International Development back in early 2020, I was proud to lead the fundraising for Gavi and COVAX to ensure that vaccines—once, we hoped, they were found—could be delivered as quickly as possible through the incredible networks that organisations such as Gavi have to reach across the globe. When covid hit, it was clear, however, that stronger collective international action, co-operation and mutual accountability will be needed if we are to tackle to tackle more effectively the global health threats of the future. Sadly, as colleagues as have said, we know that we need to be prepared for them.

[Sir Christopher Chope]

Does my right hon. Friend believe that China is complying with the requirements to be open and transparent, sharing all its data and letting everybody know exactly how the covid-19 virus began, or does she believe that China is covering it up?

[Anne-Marie Trevelyan]

My hon. Friend speaks with a passion that we all know and respect. I am not the expert on this, but there is much commentary on whether there is the full clarity and transparency that we have seen from some countries. Indeed, when I talk about wanting to be able to build stronger, collective co-operation and mutual accountability, that is one of the reasons why we want to support the development of this new pandemic instrument.

I will try to tackle some of the concerns about the proposed instrument that are raised and highlighted in the petition. First, I would like to be clear that no text has yet been agreed. The process of drafting and negotiating it is ongoing, and we certainly do not expect the text to be agreed before May next year. It is a member state-led process, with member states negotiating the treaty, not the WHO. The WHO secretariat is supporting the process; it is a technical and bureaucratic system.

Colleagues have mentioned changes to the international health regulations, which are an important legal framework intended to prevent, protect against, control and provide a public health response to the international spread of disease commensurate with the public health risk involved. Indeed, it also helps to avoid unnecessary interference with international trade flows, so economies continue to be as strong as they can be under such pressures.

The UK and other WHO member states adopted the current version of the IHRs in 2005. They came into force in UK law in 2007. Negotiations on targeted amendments are looking to improve the framework in the light of the covid-19 lessons learnt. To be clear, the UK is right at the heart of those negotiations. We will work for good outcomes for the UK and for all member states, which we wish to work with and support.

[Andrew Bridgen]

My right hon. Friend says that amendments are being brought forward on the basis of lessons learnt, but does she not agree that WHO has refused to have an investigation into how it handled itself or into its recommendations during the pandemic? How can we have knowledge where it went right or wrong if it will not have a review of its own performance?

--- Later in debate ---

[Anne-Marie Trevelyan]

I think we have all looked closely at that. My hon. Friend highlights a question, but the whole point of the negotiations and discussions is that all member states bring their expertise and experiences to the party. As I said, the UK is at the heart of those negotiations and will look to ensure that, if a text is found that can be agreed by all member states, it is one that will meet some of those challenges and the lessons learnt that we have all identified as individual states and working together in many ways as an international community, as we have done. Importantly, once those amendments are identified, accepting them would require changes to our domestic law through legislation in the usual way. As has been discussed at some length, we are of course a sovereign state in control of whether we enter into international agreements.

Having personally spent many hours in various international negotiating fora in recent years, I know absolutely that the UK, with its voice, expertise and wisdom, and our trusted partner status with so many other member states in the UN family, is respected and listened to. Discussions continue with our officials and health experts and various other teams from across Government and, together with the leadership that we bring, that should ensure confidence in those discussions.

[Esther McVey]

Can the Minister reassure my constituents who are concerned that the Government will concede sovereignty and hand power to WHO? Can she give reassurances that that will not happen?

[Anne-Marie Trevelyan]

Yes, absolutely I can. The speculation that somehow the instrument will undermine UK sovereignty and give WHO powers over national public health measures is simply not the case. I absolutely reassure both my right hon. Friend and my hon. Friend the Member for Hastings and Rye (Sally-Ann Hart), who raised a similar issue earlier, on behalf of all their constituents: that is not the case. The UK remains in control of any future domestic decisions about public health matters—such as domestic vaccination—that might be needed in any future pandemic that we may have to manage. Protecting those national sovereign rights is a distinct principle in the existing draft text. Other Members have also identified that as an important priority, so it is good to have the opportunity of this debate, brought about by those who have concerns, to restate that that is absolutely not under threat.

To conclude, we must ensure that future pandemics—which I fear that we or our children may have to tackle—will not come with the same devastating cost as covid-19. We have the opportunity now to make real and lasting improvements to the way in which the international community prepares for, prevents and indeed responds to global health threats. The UK’s voice, our scientific leadership and the strength of our democratic processes will ensure that our vision for global health planning and pandemic preparedness is at the heart of any new treaty to protect the most vulnerable.