Pandemic Prevention, Preparedness and Response: International Agreement

Christopher Chope Excerpts

Monday 17th April 2023 Westminster Hall

[Sir Christopher Chope (Christchurch) (Con)]

It is a pleasure to follow my right hon. Friend the Member for Tatton (Esther McVey), who does such important work with her APPG. At a recent meeting, we were privileged to be able to listen to Toby Green and Thomas Fazi, the joint authors of “The Covid Consensus”. I know that some of the material she used in her remarks comes from the fantastic work that those two individuals have put forward.

I will start with a question: why are our Government supporting changes to the treaty based on article 19? Article 19 is the compulsion—mandatory—whereas article 21 gives the opportunity to opt in and out. Why would we wish to impose a commitment that we cannot get out of under article 19? When my right hon. Friend the Minister responds, I ask her to embrace the idea, which has already been discussed in the intergovernmental negotiating body—although article 19 is the most comprehensive provision of the WHO constitution under which the instrument could be adopted—that the body is open to confirming whether article 21 could also be an appropriate way of making progress on the treaty.

Article 21 relates to the World Health Assembly’s powers to adopt regulations on a range of technical, health-related matters. Regulations under article 21 would come into force for all member states, except where members reject or make reservations within a specified notice period. In other words, it would be relatively more relaxed than article 19, which would effectively mean this was a mandatory treaty with no option but to comply.

If we think that the only way to deal with pandemics is for all countries across the globe to unite, let us remind ourselves that, if we had our time again, many of us would have said that the Swedes got it right. In a sense, they were the outliers at the time. Under some international mandatory ruling, they would not have been allowed to experiment in the way that they did—to follow their instincts for liberty, freedom and science-based evidence before restricting people from going about their normal business. Why would we want to have a treaty that gave no flexibility to individual countries to decide what was best in their particular circumstances in any given situation? I hope that we can get an answer from the Government on that and about why they are going hell for leather to try to adopt a mandatory treaty.

The extent of concern about this issue has taken many people by surprise. It is symptomatic of people’s loss of trust in Governments and, in particular, in some of the health Departments of Governments. My right hon. Friend the Member for Tatton mentioned in passing that the WHO itself did a complete volte-face. They were supposedly the experts, and they brought forward a document relating to preparedness for a pandemic in November 2019. That document made no reference whatever to many of the measures that were subsequently adopted by the WHO and by Governments across the world. My right hon. Friend referred to the fact that there was no mention even of the word “lockdown”—let alone of the idea that confining people to barracks and preventing them from going about their daily lives would be good for health outcomes. We now know that that has been pretty bad news for people, particularly the younger generation, for whom covid-19 was less of a direct threat to health. As a result of the lockdown measures, younger people have suffered disproportionately and will continue to suffer as they live the rest of their lives. Why should we want to trust the WHO absolutely?

[Andrew Bridgen]

My hon. Friend is a stalwart for those who have been vaccine harmed and vaccine bereaved, and he is making a great contribution. Does he agree that the WHO has let us all down very badly with its unilateral decision not to investigate where the virus originated? If we could find the labs in which it was developed, and if we could find those who authorised it and funded it and bring them criminally to account, that would surely be the best way of dissuading anyone from again carrying out this sort of action, which has caused so much harm around the world.

[Sir Christopher Chope]

My hon. Friend makes an excellent point, which is a question that I was going to pose and seek to answer. One of the issues is that China has a lot to cover up. If it is not covering it up, why is it not allowing people to investigate exactly what happened at Wuhan? Why is it not co-operating with the World Health Organisation? The answer is that, in a sense, the World Health Organisation is now subservient to China.

Those of us in this House who have long expressed concerns about undue Chinese influence over our lives, and over the freedom of western civilisation, need to take stock and ask ourselves who is in charge of this World Health Organisation. Some people have referred to him by what I think is one of his Christian names, Tedros Adhanom; I will refer to him by his surname, which is Ghebreyesus. He is a former Ethiopian Minister of Health. He was previously a senior figure in the Tigray People’s Liberation Front. Some people here today may remember that many senior members of the Tigray People’s Liberation Front were also members of the Marxist-Leninist League of Tigray. Mr Ghebreyesus won support from Beijing in order to become the director general of the WHO, and China has quite a large control, through him, of the WHO. Margaret Chan, a former WHO director general, said in 2012 that the WHO budget is driven by donor interests. Let us be quite open about it: the Bill Gates Foundation, big pharma and big tech are supplying a lot of the resource to the WHO. They are not covering that up; they are proud of it—indeed, they make a big thing of the fact that more than half of the WHO’s expenditure is now on vaccine programmes rather than other ways of alleviating malnutrition and health problems across the globe.

Has this man—the current director general—got connections with the Bill Gates Foundation and the big funders of the WHO? Yes, he has. He was formerly a member of two of the Gates boards, Gavi and the Global Fund, so he is himself very much in with Gates—with the donors. How can he be trusted to be independent when he owes his continuing position to those donors and also to the support of the Chinese republic?

We may say, “Well, so what? Let the WHO carry on as it has been for many years. It could be an advisory body. Nobody has to listen to it, and we can take it or leave it.” But unfortunately, the developing influence of the WHO is that it now wishes to impose its standards on the whole world. That is why people have become became alerted and signed this petition in very large numbers. They do not wish this country to give up its control over its ability to manage its own affairs when faced with an epidemic or a pandemic. They certainly do not want some body like the WHO, which is wedded to the Chinese version of authoritarian capitalism—authoritarian capitalists—telling people what they can and cannot do: saying that people cannot go about their normal business, live their lives as individuals or, as an old person, meet their relatives, and all the rest.

I am pleased to say that in so far as we were able to, I voted against all those restrictions on freedom. I continue to believe that we made big mistakes in how we addressed the pandemic through lockdowns that were not scientifically based and in respect of which there were no proper cost-benefit analyses. But leave that on one side. The WHO is controlled by people who we would not wish to be in control of our lives. That is why both the United States and our Government are trying to break out of some of the Chinese Government’s controlling influences. But what are we doing about this situation? Why in these circumstances would a rational Government—I still believe that the Government I support are rational—engage in giving an enormous amount of power over our lives to the Chinese and Chinese-influenced and dominated organisations? That seems to be sheer lunacy to me. I hope that in responding to this debate my right hon. Friend will be able to agree on that point. One does not have to do anything other than point out the connections between the director general of the Gates Foundation, the Chinese Government and so on to get people to say, “Gosh. I’m a bit concerned about that.” In our daily lives, we judge companies and organisations on the basis of the people running them. If one looks at the people running the WHO, we should quite rightly ask some serious questions about their behaviour.

A lot more could be said about this treaty, but I am going to finish my remarks by asking the Government to change their approach and listen to the people. This petition was signed by a large number of people. It is not the sort of petition that is presented to someone with a, “Will you sign that?” because in order to sign this petition, people need to apply their mind and get a pretty good understanding of the subject matter. In that respect, although the numbers are well above the minimum threshold to get a debate in this House, the quality of the petition and the arguments within it mean that it is one of the most serious petitions that we have had to debate.

[Andrew Bridgen]

Without wishing to be accused of being a conspiracy theorist, can I just spin a scenario to my hon. Friend? Imagine a nightmare situation in which the House ignored the two new instruments from the WHO, and then some time in the next 12 months before they are ratified in May 2024 there happens to be another release from a lab—another pandemic—and then both Houses of Parliament were given no time to debate the two instruments before ratification. Should we not avoid that nightmare situation by having that debate now?

[Sir Christopher Chope]

I agree with my hon. Friend, as I almost always do. Prevention is better than cure. Why would we want to give up control over all these issues by signing up to this treaty?

I have here a quote from Richard Horton, the editor-in-chief of The Lancet. He said:

“The allegation that WHO shared responsibility for the pandemic by adopting a policy of appeasement towards China has proven impossible to refute.”

There we have it. The editor-in-chief of no less than The Lancet says that we need to be extremely suspicious of what is going on and what may happen. That is a good credential for the Government to adopt in saying, “We are not going to adopt this WHO treaty under article 19; we are going to examine it more carefully, be much more circumspect, and retain the ability of our own country and our own people to decide these important issues for ourselves.”

[Siobhain McDonagh (in the Chair)]

As all the Back Benchers who wanted to speak have done so, we move on to the Front-Bench spokespeople. I call Anne McLaughlin for the SNP.

[Anne McLaughlin (Glasgow North East) (SNP)]

There is a need for reflection and scrutiny of the covid-19 pandemic, and we need to understand the plans for any future pandemics, but we need an international approach, and the SNP fully supports this WHO agreement.

The SNP has supported global co-operation and co-ordination throughout the coronavirus pandemic. It is only when the world is safe from covid-19 that any of us are truly safe. Only by working together and embracing global co-operation, not competition, can we tackle global crises such as climate change and pandemics. The covid-19 pandemic has laid bare the importance of strong, global public health infrastructure and how quickly healthcare provision can break down if the basics of medicines, tracking, treatment and other resources are not available. As others have said, international collaboration is the best way to avert and handle future pandemics. The world is not safe until all populations are safeguarded, wherever they are in the world.

I understand the principle behind the petition. I appreciate that people want to be able to hold their Government to account, and we must be able to scrutinise Governments. But there appears to be some misunder-standing around the WHO’s work and how it interacts with Governments. I have done a bit of reading and have listened to the reasons given by those who oppose this potential treaty, and they often have concerns that the WHO would be running health policy for all countries who sign up to it. But those working on drafting the treaty have already included sovereignty as one of its guiding principles and rights. The latest draft of the treaty from 1 February 2023 starts by:

“Reaffirming the principle of sovereignty of States Parties in addressing public health matters, notably pandemic prevention, preparedness, response and health systems recovery”.

There are no proposals to change that, and the healthcare policy, even in a pandemic, would remain entirely a matter for sovereign nations to decide. The World Health Organisation would be able to make recommendations once a global emergency is declared, but they would just be recommendations. Contrary to what others have said, they would be non-binding. The treaty would not require Governments to act on WHO instructions, nor would it require anyone to sacrifice sovereignty. Rather, it would enable Governments to plan together, detect pathogens more quickly, share data more broadly and respond more effectively to the next pandemic.

Those concerned about the impact of the WHO’s involvement are perhaps unaware, or have forgotten, that the UK already implements the WHO’s international health regulations, or IHR. Those regulations provide a framework that defines countries’ rights and obligations in handling public health events and emergencies that have the potential to cross borders. The regulations have been in place in some form since 1969, and the latest regulations have been in operation since 2007, but this has not meant a loss of individual nations’ control over health policy.

On the international stage, the SNP will always support measures to improve global public health. Those include reversing the damaging aid cuts by the UK Government—specifically, in this context, those inflicted on health and wellbeing projects.

[Sir Christopher Chope]

Will the hon. Lady give way?

[Anne McLaughlin]

No, I will not.

Official development assistance has been cut from 0.7% to 0.5% of gross national income, creating a £4.6 billion funding black hole compared with 2019 levels, and health and wellbeing programme funding has been absolutely slashed. As part of their wider international development pattern, the UK Government are cutting funding for conflict resolution projects at a time of renewed war, cutting health and medical funding in the aftermath of a global pandemic, and cutting food programmes during a time of global food insecurity. All of this is morally reprehensible.

It is positive, of course, that the UK Government are supporting the treaty, but it is important to remember that despite the pressing need for a global, collective response to health crises, the UK Government are repeatedly falling short of the mark and reneging on their pledges. It is morally and pragmatically indefensible that the UK Government should continue to actively jeopardise the lives and wellbeing of the world’s poorest and most vulnerable. With the Government maintaining the ODA budget at below 0.7% of GNI, there is no other way to describe what they are doing.

Along with supporting the treaty, the SNP is calling on the UK Government to reinstate the aid budget to 0.7% of GNI as an urgent priority, ensure that aid spending on health programmes and projects around the world is increased to pre-covid-19 pandemic and pre-UK aid cut levels, and ringfence the overseas aid budget for spending abroad, to ensure that the aid budget is not being spent here in the UK on refugee and asylum support. The Government must also establish a much-improved, stand-alone Home Office model that better supports refugees and asylum seekers.

The SNP believes that referenda are essential to establish public consent on issues concerning constitutional make-up and sovereignty, not on every issue that someone might disagree with. The treaty would have absolutely no effect whatever on the UK’s constitutional function and sovereignty, and we are therefore of the firm belief that it does not warrant a referendum.

--- Later in debate ---

[Preet Kaur Gill (Birmingham, Edgbaston) (Lab/Co-op)]

It is a pleasure to serve under your chairmanship, Ms McDonagh. I thank hon. Members on both sides of the House for their contributions. I am glad that the debate has been conducted in a mostly measured and thoughtful way.

The covid pandemic has been one of the most surreal and seismic global events of our lifetimes, with 212,000 people having died as a result of it in the United Kingdom and our economy having been directly hit to the tune of £250 billion of gross value added. The social impacts on everything from our children’s lost learning to NHS waiting lists will be felt for years to come. The extent of the damage that the pandemic caused was not inevitable. The UK was badly unprepared. NHS waiting lists were at record levels even before the pandemic hit. We had staff shortages of 100,000 in our health service and 112,000 vacancies in social care.

In 2016, the outcome of Exercise Cygnus informed the Government that the NHS would not be able to cope with a flu pandemic; yet they still reduced the stock of PPE and the number of beds. Too many people have paid for that decision with their lives, particularly in care homes across our country as untested patients were ferried from hospitals to homes. Then of course there are the billions of public money wasted on unusable PPE, the chaotic shuffling in and out of lockdowns from a Government that could not get a grip, and at the end of it, the UK’s abject position as the worst hit economy in the G7.

After 12 years of Tory complacency, the next Labour Government will never leave our country with such a soft underbelly. The next Labour Government will deliver a new 10-year plan for the NHS, including one of the biggest expansions of the NHS workforce in history, doubling the number of medical school places to 15,000 a year, training more GPs, nurses and health visitors each year, and harnessing life sciences and technology to reduce preventable illness.

While it might feel like the pandemic is over now, the threat is not. That is what today’s debate is about. Far from a once-in-100-years event, many natural biological threats have emerged in recent years, including severe acute respiratory syndrome, avian flu, middle east respiratory syndrome, Ebola and monkeypox. Climate change and globalisation mean that natural biological threats are becoming more common, and it is not only biological threats that we must prepare for. Advances in gene editing mean that virologists can more easily modify viruses to be deadlier and spread more quickly, increasing the security risk posed by bioweapons and bioterrorism. Will the Minister comment on our concern that the biological weapons convention currently remains very weak, with little funding and only four staff, compared with the 500 staff for the chemical weapons convention?

Pandemic preparedness must therefore be taken seriously as a matter of national security. Future threats could be far deadlier than covid-19. During the first wave of coronavirus, 1% of infected individuals died, compared with 80% during the west African Ebola epidemic. The lesson of the pandemic was that no one is safe until everyone is safe, and that global health is local health, so global co-operation on pandemic preparedness and biological threats clearly needs to be strengthened. That is why the Opposition absolutely support the principle of a legally binding WHO treaty that sets the standard for all countries to contribute to global health security. Our country was set back not just once but three times by new, dangerous covid variants that originated overseas. We are stronger together than trying to firefight such crises alone.

The WHO is the primary UN agency for international public health. In its history of over 70 years, it has contributed to the eradication of smallpox, helped to immunise millions of children against preventable diseases such as tuberculosis and measles, and is supporting the near eradication of wild polio. Currently the WHO is responding to 55 graded emergencies around the world. Last year, it supported member states in response to 75 different health emergencies. More than 339 million people are now in need of direct humanitarian assistance, and in those countries affected by fragility and conflict we are seeing 80% of the world’s major epidemics.

The principles laid out in the zero draft text on pandemic preparedness are a strong foundation from which to begin to respond to some of those crises. The text on strengthening global health systems and universal health coverage, on international transparency and on the sharing of technology, diagnostics, vaccines and knowhow echoes what Opposition Members said consistently during the pandemic. It is through multilateral efforts, strengthened through international law, that we can ensure that the response to the next pandemic is faster and more effective, and does not leave other countries behind.

I know that the hon. Member for North West Leicestershire (Andrew Bridgen) has been calling for this debate for some time and that he has reservations. It is important that we have this debate and show that there is no shadowy conspiracy. I am afraid that the reality is much more mundane than that. I note his claims that a treaty will

“hand over…powers to an unelected…supranational body”,

even despite the fact that it would still have to be ratified by the United Kingdom and there is over a year of negotiations to go. I point out to him that the very first statement in the zero draft text reaffirms

“the principle of sovereignty of States Parties”.

Moreover, it states that the implementation of the regulations

“shall be with full respect for the dignity, human rights and fundamental freedoms of persons”.

Of course, the draft text makes no reference to vaccine mandates, lockdowns or any such draconian policies. If the hon. Gentleman reads it, he will see that the draft treaty is primarily about transparency, fostering international co-operation and strengthening global health systems, in recognition of the catastrophic impact of the pandemic on developing countries. It is on the face of the text.

[Sir Christopher Chope]

Has the hon. Lady taken the point that there is a difference between article 21 and article 19? Why is she supporting article 19 as the means of introducing this measure, rather than the more flexible article 21?

[Preet Kaur Gill]

I have set out the reasons why I support this, and I will continue to make that case so that the hon. Gentleman understands why Opposition Members support the treaty as it stands. There will, of course, be negotiations and, as I keep saying, we will have to ratify it in the United Kingdom. There is another year to go, so it is possible to contribute to and feed into the process. The hon. Gentleman should direct his comments to the Minister.

As I have said, the negotiations operate on the principle that nothing is agreed until everything is agreed. That is a really important principle to hold on to. In over a year’s time, there will be a two-thirds vote of WHO members and then, ultimately, it will be for us to ratify and enact those policies as we interpret them. It is really important that we recognise that.

Far from there being a conspiracy, this process is built on the very basis of international co-operation, which is essential for tackling transnational threats. As a country, we have a proud history of supporting the international system, using our influence and expertise to set common standards and bring parties together to achieve more than they can achieve alone. If we can use the WHO to support basic universal healthcare around the world, infectious diseases are less likely to spread and fuel global pandemics. Of course, that is in our national interest, too.

As I have said, pandemic preparedness is a matter of national security. Last year, in a debate on global vaccine access, I warned that striving for vaccine equity is not only a moral imperative but a matter of national interest. Yet those lessons have not yet been translated into action. Today, just 27% of people in low-income countries have received a first dose of a covid vaccine, demonstrating the terrible divide in coverage between richer countries and the global south. This Government have paid homage to the need to address that in words and announcements, but in truth their record has been dire. It includes a damaging departmental merger of the Department for International Development and the Foreign and Commonwealth Office at the height of the global crisis; repeated aid cuts to the very programmes designed to keep us and others safe; and consistently not keeping promises made to poorer countries.

Nobody expected the UK to retreat from the world stage at a time like that, or for it to vandalise its own relationships, expertise and capacity. The message it sent out to our partners and allies has been received loud and clear: they know who they can trust to show up in an international crisis and who they cannot. The irony is that those decisions harmed us as much as anyone. Vital research programmes to track new covid variants were slashed by 70%, pulling the plug on many programmes mid-project and causing years of research to go to waste. Programmes to treat tropical diseases were cut by a shocking 95%, leaving millions of people vulnerable and risking the wastage of over 270 million doses of life-saving drugs. The UK’s contribution to the Global Polio Eradication Initiative was cut by 95% for at least five years—last summer, polio resurfaced in the UK for the first time in 40 years.

Now, as our Government divert the development budget to prop up their failing asylum system, eight of South Sudan’s 10 state-run hospitals have lost their funding this month, putting them on the brink of collapse. Can the Minister explain what assessment she has made of the impact of that decision? Can she say when the refreshed global health framework will be published, and how it will draw lessons from the last three years?

The divide exposed by the pandemic was stark. At a time when millions in the global south were in greatest need, the international system failed them. The Government’s charity model of aid did not share vaccines equitably or effectively, leaving millions unprotected and the poorest countries paying the highest price. The UK’s own promises illustrate that point. At the G7 in 2021, the former Prime Minister, the right hon. Member for Uxbridge and South Ruislip (Boris Johnson), promised to donate 100 million surplus vaccine doses within a year. A year later, barely a third were delivered, the aid budget was raided to do it, and the UK effectively profiteered at poor countries’ expense.

Earlier this month, provisional spending figures for 2022 were revealed, and a further £225 million was charged against the aid budget for vaccines we had spare— effectively making a £330 million cut to the budget. Can the Minister provide a breakdown of the number of doses that were shared directly with developing countries, and through COVAX, by make and pricing, last year? How many doses were shared in total? What steps did she take to minimise the cost to the aid budget, bearing in mind that those surplus doses would have been incinerated if they were not used? How many vaccines were priced at the maximum possible of $6.66?

There is a different way—a way that does not merely give people crumbs from our table. Labour’s new model for development will be based not on charity, but on solidarity and long-term development planning. Our comprehensive plan to ramp up global vaccine manufacturing—set out in 2021—is the blueprint for the change we need to see. The pandemic revealed a fundamental problem: namely, that the world has more capability to invent and develop vaccines than it has to manufacture and distribute them on a global scale. While donating our surplus vaccine doses to poor countries was the right thing to do, in practice it has been slow, inefficient, and, in this Government’s case, used as a cover to make further stealth cuts to our aid budget at poor countries’ expense.

Developing countries should not have to wait for handouts at the back of the queue. The next Labour Government will strengthen global health systems, using the NHS as a model. We will help to establish an international mechanism to rapidly produce and distribute vaccines, to share technology, knowledge and skills, and to build the infrastructure the world needs to deliver it. We need a global effort to develop viable, orally active vaccines in solid dose form, building on the innovative work carried out by a number of pharmaceutical companies. That historic breakthrough would include the prospect of a vaccine delivery system that does not rely on needles and could lead to less need for trained vaccinators, increasing take up and negating cold chain storage, meaning fewer doses would expire before they could be used.

Finally, we need a binding, enforceable investment and trade agreement among all participating countries to govern the co-ordination of supplies and the financing of production, to prevent hoarding of materials and equipment, and to centrally manage the production and distribution process for maximum efficiency and output in the wake of a pandemic being declared. I am pleased to see that this draft treaty offers a strong starting point. Technology transfer and the open sharing of vaccines, science, technology and knowledge through the trade-related intellectual property rights waiver would help ensure everyone can access vaccines, diagnostics and therapeutics, and that no one is left behind.

I would be grateful if the Minister could set out the Government's approach to negotiations, particularly on the matters of intellectual property waivers, increased local production capacity and conditions on public funding for research. Future international initiatives need to be followed in letter and in spirit. Does the Minister recognise the importance of an accountability framework to ensure the accord’s success, and will she and her officials be pushing for that in talks? Separately, does she acknowledge the continued importance of action to address the debt crisis in low-income countries, which is clearly diverting resources away from public services and health systems? What does she see as the UK’s role in helping to unlock relief for countries in debt distress and bring creditors to the table?

Negotiating an effective international treaty on pandemic preparedness is an historic task, but, if we can achieve it, it will save hundreds of thousands of lives in the years to come, provide the foundation of a sustained global economic recovery and give us and our partners the freedom and confidence to plan for the future. Labour has a comprehensive plan to strengthen Britain’s health security, to end the 13 years of sticking-plaster politics under this Government and to return Britain to the international stage as a trusted development partner.

[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.