Official Development Assistance

Baroness Suttie Excerpts

Thursday 15th December 2022 Lords Chamber

[Baroness Suttie (LD)]

My Lords, I begin by congratulating my noble friend Lord Bruce of Bennachie on his excellent, thoughtful and comprehensive opening speech, and my noble friend Lady Northover on securing this timely and extremely important debate. I refer noble Lords to my register of interests, my development assistance work and my role in the Global TB Caucus.

As my noble friend Lord Bruce said so powerfully, it is greatly to be regretted that the cross-party consensus that existed for over a decade in achieving the UN target of 0.7% has broken down, for what I sincerely hope will be a short and temporary period only. I agree with Andrew Mitchell when he said that the UK has lost its reputation as a “development superpower”. As noble Lords have said, the cuts to the overseas aid budget have already had a deeply damaging impact in so many countries. I was extremely proud to work in 2015 with my noble friend Lord Purvis of Tweed on the Bill that enshrined the commitment to 0.7%, and to work closely with the noble Baronesses, Lady Jenkin and Lady Sugg, the noble Lords, Lord Collins and Lord McConnell, and various others, on ensuring a genuinely cross-party approach to development assistance.

In my remaining remarks today, I will concentrate on the importance of focusing on the long term—however difficult in our current economic circumstances—and learning lessons from Covid in terms of global public health. Effective international co-operation through Gavi, the Vaccine Alliance, has been one of the development assistance success stories, and the UK’s continuing positive role within Gavi is to be commended.

In the last three years, we have all learned that an airborne pathogen on the other side of the world can, very quickly, have severe consequences for all of us. The first recorded cases of Covid-19 happened to be in China, a country with very strong surveillance systems, including on public health. However, at the outset of the Covid pandemic, only two countries in had the capacity to diagnose Covid-19. Where the next pandemic develops is just as important as what the next pandemic is. The only sure way to prevent the next pandemic is to make sure that there are at least basic healthcare systems to care for and prevent respiratory diseases in every part of the world.

The UK has been for decades an active participant in conversations around global health security, including the global response to antimicrobial resistance. What we have not done, however, is focus seriously on the airborne pathogen that is already killing more people than any other disease; namely, tuberculosis. Some 1.5 million people died of this curable disease in 2020. According to the WHO, Covid-19 has set back the fight against TB by as much as a decade. To quote from the WHO’s report:

“In 2020, more people died from TB, with far fewer people being diagnosed and treated or provided with TB preventive treatment compared with 2019, and overall spending on essential TB services falling … In many countries, human, financial and other resources have been reallocated from tackling TB to the COVID-19 response, limiting the availability of essential services … people have struggled to seek care in the context of lockdowns.”


Concentrating now on a stronger global TB response makes long-term sense. Measures include training more doctors, providing more diagnostic machines, assisting community groups doing outreach and awareness raising, and providing well-equipped respiratory wards, academics, and even oxygen. Can the Minister say whether the Government would support a comprehensive review into how enhanced investments in the global fight against TB could support the response to future pandemics?

In addition to the impact of Covid, one of the many tragic consequences of the truly awful war in Ukraine has been to set back the fight against multi-drug-resistant TB in Ukraine as well as in the wider region. Can the Minister say whether there are plans to give Ukraine additional support in the area of public health, and in particular in the fight against multi-drug-resistant TB?

Ebola is another prime example where a longer-term approach taken by Governments would make sense. When there is an outbreak of a disease, there is a race to find a vaccine, as we have seen with Covid, but then when the outbreak recedes, so does the urgency. This frequently reflects a desire by Governments to save money in the short term, which all too often results in paying more later. When a vaccine has been developed, as in the case of Ebola Zaire, it is often not seen as a priority to make sure that it is deployed. We know that an outbreak of Ebola Zaire could happen at any moment. When there was an outbreak in 2014, it cost west Africa $50 billion, and yet countries still cannot access the vaccine that exists.

If Covid has taught us one thing, it is that we are not safe just because we are far away. It surely makes sense to make Ebola vaccines widely available now. Can the Minister say whether the Government will press the WHO to accelerate the development of its guidelines for deploying Ebola Zaire vaccines? Will the Government outline their support for the development of an Ebola Sudan vaccine? There is a very real risk that without a global, publicly funded strategy, the market will fail to deliver vaccines to stop pandemics before they surge. I appreciate that these are quite technical questions, and if the Minister is unable to give a comprehensive reply in his closing remarks, I would be very happy to receive a letter after the debate.

To conclude, I stress again that I hope we return as soon as possible to the commitment to 0.7%. But it is not just about more aid, it is about better, more joined-up aid, and a more effective global approach. This issue is in our national interest, in our increasingly interconnected world, but, more importantly, it is also the right thing to do.