World Immunisation Week

Dan Carden Excerpts

Thursday 2nd May 2019 Commons Chamber

[Dan Carden (Liverpool, Walton) (Lab)]

I genuinely welcome the new Secretary of State to his role. In his first two weeks as Prisons Minister he visited both the prisons in my constituency, which I thought showed a great sense of responsiveness to what was needed at the time. I hope that something along the same lines, and a close working relationship, will feature in his new role. I am also delighted that he used his first speech as Secretary of State to advance a robust intellectual defence of our aid spending, and I congratulate him on that.

We know why immunisations matter and why today’s debate is so important. Vaccines are, quite simply, a matter of life and death. Between 2 million and 3 million lives are saved every year thanks to immunisations, and in recent decades they have drastically reduced suffering caused by infectious diseases that were once commonplace. Smallpox was completely eradicated in 1977 through a global vaccination programme, and the world is now close to eradicating a second disease, polio. My own grandad contracted polio and lived with it for 27 years, and when I was growing up I heard a great deal about the impact of a disease that paralyses the people affected by it. I pay tribute to one of my constituents, Andy Gilliland, a polio survivor who has lobbied alongside the One Last Push campaigners; I am delighted to have become one of the campaign’s polio champions since he lobbied me.

Thanks to successful vaccination schemes the world over, today’s generation and our children do not have to suffer from the diseases that were all too commonplace for our grandparents. Immunisations are not only saving lives, but are a cornerstone of global health security. They are vital to the achievement of several of the United Nations sustainable development goals and to ensuring that no one is left behind. They also provide a vital gateway to wider public health services. If you are a child or parent being given a vaccination, this may be the first time that you interact with the public health system. The simple act of being immunised can boost your chances of going on to access important services such as family planning, birth registration, testing and screening, and regular healthcare. For the hardest to reach, immunisation can be the start of proper inclusion in the public health system.

I am proud that the UK’s Department for International Development is a world leader in global health. That has been possible only because of the House’s commitment to spending 0.7% of our country’s income on overseas aid and to maintaining an independent DFID. However, I want us to do more. Twenty million children around the world are still under-vaccinated. Fewer than 10% of children in the world’s poorest countries receive all the vaccinations that they need. In Africa alone, more than 30 million children under five suffer from vaccine-preventable diseases every year, and more than half a million of those cases result in death.

Sadly, in recent years global immunisation rates have stalled, and in some places have even decreased. Key barriers to full immunisation include the high prices of vaccines, and a growing movement of vaccine hesitancy. It is clear that we still have our work cut out if we are to reach all children, across the world, with the essential vaccinations that they need and deserve.

As the Secretary of State said, next year Gavi, the global vaccine alliance, will be up for replenishment at a conference hosted by the Government here in London, and this year the Global Polio Eradication Initiative is being replenished at a conference in Abu Dhabi. The UK should make significant pledges to make sure both are fully funded, and should make the pledges promptly enough to encourage other donors to do likewise. I therefore hope the Minister will use today’s debate to update the House on the Government’s replenishment plans for both of these funds.

Let me be clear, however, that replenishing funds is only one step to ensuring all children are vaccinated; we can and must do more. Gavi is leaving millions of under-vaccinated children in middle-income countries without all the vaccinations they need. That is because the scheme uses a country’s GDP to determine whether it is eligible for support. This is a crude way to assess need: a country’s GDP does not take into account the specific needs of that country and its population’s health needs. It fails to take into account the state of its health system, and, crucially, GDP measures do not take into account in-country inequalities.

[Rory Stewart]

indicated assent.

[Dan Carden]

The Secretary of State is nodding, and I appreciate that.

This means many of the world’s poorest children are in fact living in middle-income countries with a GDP that makes them ineligible for either official development assistance or Gavi support. I hope the Secretary of State will listen to the all-party group on vaccines for all, which has called for Gavi to bring about new criteria beyond a country’s GDP.

Let me now turn to another major threat to universal immunisation coverage. It is a threat that we face both here in the UK and right across the world: vaccine hesitancy, a phenomenon that the World Health Organisation has not only warned is on the rise but has now identified as one of the top 10 major threats to global health for 2019. This year’s theme of “Protected together: vaccines work!” also points to the difficulties in this area.

Since 2014, the number of countries reporting hesitancy has steadily increased, and in 2017 only 14 countries out of 194 reported no vaccine hesitancy. In England, dangerous false stories about immunisations are routinely spread on social media. The likes of YouTube and Facebook are failing to clamp down properly on those who peddle these lies. We must take tougher action and tell the truth about immunisations because the increasing refusal of vaccines has been described by the head of NHS England as a “growing public health timebomb.”

[Chris Elmore (Ogmore) (Lab)]

Does my hon. Friend agree that the Government’s recently published online harms consultation needs to include the beefing up of this, and that Facebook and others must be held responsible if they allow such anti-immunisation scare stories to be included on their platforms, because, as we are seeing in America, this is risking and costing lives?

[Dan Carden]

I agree with my hon. Friend wholeheartedly. We must take tougher action to tell the truth about immunisations, and we need to act fast with global partners if we are to avert the destructive potential of this. According to UNICEF, half a million British children are not vaccinated against measles, and in 2018 there were 966 cases of measles across the country, more than double the number in 2017. This is a worrying and sharp rise that requires our attention.

That is why my colleagues in Labour’s health team have committed to a vaccination action plan that includes getting tough with the big social media companies that are providing a platform that is fuelling a new public health crisis. Labour wants to see the £800 million of public health cuts reversed, more health visitors recruited to provide proper health advice backed by science to parents and GPs given the investment they need to drive up vaccination rates.

[Mr Paul Sweeney (Glasgow North East) (Lab/Co-op)]

My hon. Friend is making an important point about the massive positive impacts of public health campaigns, and I am reminded of the great public health drive in Glasgow to eradicate tuberculosis from the city in the 1960s, a public awareness campaign that was a huge success. But is my hon. Friend aware that this creeping cynicism around the positive benefits of immunisation is a critical national emergency, and does he agree that it is worth exploring making it a criminal offence not to immunise our children? Perhaps we should explore whether that is a necessary step given the critical nature of this.

[Dan Carden]

I agree with my hon. Friend. This is absolutely critical, and our discussion shows the importance of raising awareness in such debates.

[Jeremy Lefroy (Stafford) (Con)]

The hon. Gentleman is making some extremely good points. Does he agree that it is also important to be positive and show the huge impact of past vaccination programmes? In the 1940s, diphtheria killed 3,500 children a year in the UK, but it now kills approximately zero. Showing what has happened in the past and how beneficial it has been for our children will, combined obviously with other measures that the hon. Gentleman has referred to, give us the confidence that vaccination is indeed the way forward to protect our children.

[Dan Carden]

I am grateful to the hon. Gentleman, and the figures in graphs and elsewhere in documentation show the remarkable impact that vaccinations have had. We must carry that story forward.

We know from this experience how vital universal public services are for ensuring that everyone in society, regardless of their income, can realise their right to a healthy life. The Labour party founded our national health service. We are today, like then, committed to a health service that is that publicly owned and publicly run and with universal access. Universal health systems are the building block for everything else: without them we cannot reach full immunisation coverage; without them we cannot protect all the population against the national security threat of disease; without them we cannot reach the poorest and most marginalised in society with the care they need; and without them we cannot invest properly in the health of everyone equally, or deliver the fullest benefit for our society or our economy. And crucially, without universal public health systems, countries cannot fight the soaring inequality that now exists the world over.

There is no greater public asset here in the UK than the NHS, and so too around the world people value and look to the founding principle of the UK’s NHS: health care available to all, regardless of wealth. And so I want to briefly mention two important commitments that the Opposition have made to how we would deliver aid and development differently.

Aid is, or at least should be, delivered on the basis of poverty reduction. The Labour party has committed to a second, dual goal—to use aid to tackle inequality, too—and we know there is no better way of bringing about greater equality than universal public services in health, education and other key services. It is a tragedy that while we have our national health service—our own best-loved institution—created by the post-war Labour Government, this Government sometimes use UK aid to export to developing countries the kind of botched privatisation models that have done so much damage in the UK in recent years, instead of helping those countries to secure their own universal public health services.

I have a simple message: as DFID Secretary I would use UK aid to work alongside communities and civil society groups across the global south who are fighting for their own universal public services, and I would use DFID’s resources to work in partnership with their Governments to build and strengthen them.

World Immunisation Week is a chance to celebrate the work being done to protect people from vaccine-preventable diseases and to highlight the challenges ahead and the collective action needed. This international awareness week promotes the core message that the immunisation of every child is vital to prevent diseases and protect life. Immunisations are one of the most successful and cost-effective global health interventions of our time. Delivering immunisations gives all of us in this House, as custodians of the UK’s important position as a leader in global health, the simple, remarkable ability to save countless lives.

--- Later in debate ---

[Dan Carden]

With the leave of the House, I would like to speak briefly in the closing of the debate. I add my congratulations to my hon. Friend the Member for Bristol West (Thangam Debbonaire).

This has been a debate of great quality. It is pleasing to know that across the House there is deep concern for the health and wellbeing of children and adults across the world. Care and compassion must never stop at our own country’s borders. I have enjoyed the contributions of all Members who have spoken today—the right hon. Member for North East Bedfordshire (Alistair Burt), the hon. Member for Central Ayrshire (Dr Whitford), and my hon. Friends the Members for Enfield, Southgate (Bambos Charalambous) and for Bristol West.

In many places around the world, parents walk for many miles simply to get to a clinic and a vaccine that they know could save their child’s life. Yet the same cannot be said in all parts of the world. Many barriers still exist in getting people the healthcare they need. No matter how much money we give or how many vaccines are developed, immunisation will not succeed, in the UK or overseas, unless people trust that clinics, hospitals, medication and vaccines are safe; and unless they know that the care they receive is available free of charge. In the Democratic Republic of the Congo, the alarming outbreak of Ebola continues to spread. It is a tragedy that many communities simply do not trust that the new Ebola vaccine is safe. Despite efforts to develop a new vaccine for this horrific virus, around one in 10 people who are offered the vaccine are not taking it up. So we need system-wide solutions that tackle the root causes of ill health as the only way to bring about sustainable improvements to people’s lives. Clearly, we need to build trust between communities and health services. Too often in developing countries, the clinic is thought of as the place we go to die rather than recover. If we want global coverage of immunisations for all, then we must do far more to support countries to invest in public, free health services.

I agree with Ministers on their goals for immunisation, but my party disagrees with the Government, in some ways, on how we should support health systems overseas. This Government send Ministers to developing countries to talk up public-private partnerships. They encourage Governments to open up their health systems to British businesses. Labour Members want the UK’s international development work to be focused on supporting publicly owned, publicly run services that everyone can access, and an end to promoting private finance initiative schemes overseas. The next Labour Government will increase the aid spend on health and education and set up a new dedicated public services unit within DFID to help countries to invest in their public services and get them working for everyone. We want a fairer international patent regime that helps people to access medicines, not pharmaceutical companies to hoard profits. Only with a system-wide approach like this will we achieve the goal of immunisations for all.