Gavi and the Global Fund

David Mundell Excerpts

Thursday 15th May 2025 Westminster Hall

[David Mundell (Dumfriesshire, Clydesdale and Tweeddale) (Con)]

I am grateful to you for stepping into the Chair, Ms Jardine. I was due to chair this debate, but that would have meant that I was unable to contribute, which I very much wanted to do.

Given the restricted time, I do not want to rehearse the discussions that we had with Baroness Chapman in the International Development Committee earlier in the week. Like the hon. Member for Milton Keynes Central (Emily Darlington), whom I congratulate on securing the debate, I want to say that a contribution to Gavi and the Global Fund is not charity but a strategic investment by the United Kingdom. Although we have to deal with the reality that, as Baroness Chapman set out, the cuts are happening, we have to make the case about what should happen in that environment. I have always believed that aid spending should have maximum impact and maximum returns. Moreover, it should be in keeping with public expectations of food in bellies and shots in arms, and the Global Fund and Gavi deliver both.

As the hon. Member for Southgate and Wood Green (Bambos Charalambous) said, Gavi has immunised more than 1 billion children, reducing vaccine-preventable child deaths by 70% in the 78 low-income countries in which it operates. That is 18.8 million lives saved and children growing up healthy, going to school and contributing to their communities, which is a huge impact. The Global Fund has saved an estimated 65 million lives since 2002. It has cut the combined death rate from AIDS, TB and malaria by 61%. These are staggering achievements and they should not be discounted.

Gavi and the Global Fund are two of the most successful and impactful health programmes in history. They clearly meet the requirement for maximum impact and return, but they are possible only because of sustained, co-ordinated international investment. Alongside Unitaid, they are part of a habitat of organisations that have sustained progress in our understanding of diseases, and our ability to deploy medicines and improve health systems.

I join the hon. Member for Milton Keynes Central in encouraging the Minister to sustain the existing contributions to both Gavi and the Global Fund. He will be aware that in the last Parliament, I lobbied my own Government very hard to get that £1 billion into the Global Fund. Let us keep it at that at least, and keep the contribution to Gavi. These programmes make a difference.

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[The Minister of State, Foreign, Commonwealth and Development Office (Stephen Doughty)]

It is a genuine pleasure to serve under your chairpersonship, Ms Jardine, and to respond to such a passionate and well-attended debate on a subject that many Members here in Westminster Hall today know is close to my heart.

I am particularly grateful to my hon. Friend the Member for Milton Keynes Central (Emily Darlington) for securing this debate. Of course, as well as being an excellent representative for Milton Keynes, she has many connections with me and with my constituency in Penarth, and I have connections with Milton Keynes that link to the subject of this debate, because it was in Milton Keynes that I first worked for World Vision, the international humanitarian and development NGO.

At that time, I worked in particular on ] issues related to HIV and AIDS. On a visit to Malawi with World Vision back in the early 2000s—they were very different times, when we had not made the progress that we have made today—I saw for myself the devastating impact that HIV and AIDS had on communities in southern Africa. I remember sitting in a village with a woman who had had to take on the care of her sister’s children after her sister had died in her 20s. She had already been struggling to make ends meet, but then took on the children of her sibling on top of that. That was really stark stuff that I will never forget.

I have worked on these issues throughout my career. Indeed, I was at one of the early launches of the IFFIm bonds with Gordon Brown and at many of the other events and efforts organised by the last Labour Government that my hon. Friend the Member for Milton Keynes Central rightly said we should be very proud of. I also served as the co-chair of the all-party parliamentary group on HIV, AIDS and sexual health, and it is fantastic to see some of my successors in that role here in Westminster Hall today. That APPG is one of Parliament’s longest-established APPGs and I can genuinely say that it has also been one of the most impactful over many decades, and is still doing important work today.

This is absolutely a timely moment to debate these issues, with the Gavi and Global Fund replenishments coming up later this year, and I am hugely grateful to all right hon. and hon. Members here today for their contributions. I can absolutely assure them that the Government hears those communications and that they will be communicated to Minister Chapman, my colleague in the other place. We will look very closely at a number of the points that have been raised today.

We should be very proud of our remarkable achievements over the last 20 years and we must maintain that positive trajectory, which includes increasing life expectancy and stopping the spread of pandemics. As has been said many times, disease respects no borders, and of course it has a devastating impact, not only on lives but on economies. Of course, the life-saving research to fight disease also has a benefit economically, as many hon. Members have already pointed out.

[Dr Rupa Huq in the Chair]

I can confirm, Dr Huq, that the UK will continue to champion global health, with the sustainable development goals as our lodestar and anchoring our work. Our partnerships with Gavi and the Global Fund are crucial to maintaining—indeed, to accelerating—progress. Of course, we are founding members and committed supporters of both organisations.

The Global Fund plays a crucial role, and I have worked with it many times on strengthening health systems and combating HIV and AIDs, tuberculosis and malaria. Of course, it also supports the UK’s goal to end all new HIV cases in England by 2030 and efforts across the United Kingdom to end new HIV infection. Malaria, which has been rightly referred to today, primarily affects women and children. It puts a significant strain on health systems and hinders economic growth. Nigeria, for example, accounts for more than a quarter of global malaria cases and loses more than $8 billion annually to the disease. There is also the devastating impact on lives and families. Our partnership with the Global Fund demonstrates the importance we place on working in partnership with others around the world and in the global south. Together we have saved a remarkable 65 million lives and reduced AIDS, TB and malaria deaths by more than 60%. We have also built more resilient and sustainable health systems and accelerated progress towards universal healthcare coverage.

Gavi is a hugely important organisation whose work I have had the pleasure of seeing in this country and elsewhere. It is of course a public-private partnership with national Governments, the World Health Organisation, UNICEF and civil society, which is critical. Many Members mentioned those connections in procuring and providing affordable vaccines. Through Gavi, more than half the world’s children are now vaccinated against some of the world’s deadliest diseases, such as measles, malaria and meningitis, saving more than 18 million lives. It has been pointed out that a child born in a Gavi-supported country today is 70% less likely to die from a vaccine-preventable disease before their fifth birthday than a child born before that crucial alliance came into existence.

Every investment brings economic benefits, too. For every £1 of investment in immunisation, we see £54 in wider economic benefits. We are working with Gavi and other donors, including the Gates Foundation, to reach more children with lifesaving vaccines than ever before. Investments in Gavi and the Global Fund also drive real innovation. British expertise has transformed the fight against HIV/AIDS, TB and malaria through licensing and technology transfer, and by developing innovative technologies such as new dual active ingredient bed nets, which were piloted with support from Unitaid and the Global Fund and are now being rolled out at scale by the Global Fund.

Investment has also supported the development of vaccines such as MenFive to protect against the five main types of meningitis. Gavi delivered 5.1 million doses of MenFive in Niger and Nigeria.

[David Mundell]

The Minister made a passing reference, as other Members did, to Unitaid. Will he more formally acknowledge the huge importance of Unitaid in ensuring the delivery of medicines in some of the most difficult environments around the world?

[Stephen Doughty]

I absolutely will. It is referenced throughout my briefings because of the important partnership and contacts that we have with Unitaid. I have seen its work as well.

We are delighted to be co-hosting the Global Fund’s eighth replenishment with South Africa. We aim to attract and deepen investor engagement, sustain collective investments, and collaborate with the private sector on financing, innovation and supply chain support. We will do everything possible to ensure the success of that replenishment. Last month, the Children’s Investment Fund Foundation made an impressive first pledge of $150 million, a fivefold increase of its previous investment. That extraordinary commitment underscores the significant role of private philanthropy in advancing global health equity and highlights the power of partnership. As countries work to increase domestic financing, we must stand together and strive for success in those replenishments. We know this is an incredibly important moment for all these issues.

Many Members have rightly asked me about financial commitments—I have heard the voices around this room. Members will understand that we cannot make any financial commitments for the next replenishment until after the spending review is complete, but I assure them that we will continue to champion the Global Fund and Gavi and the people they serve, as well as the issues that have been raised today. Members’ voices and those of their constituents have been heard. None of us want to make decisions about cuts to the ODA budget, not least because of our record of success on these issues, but when I look at some of the things I do every day, I can say that they are the right choices, although difficult. We remain committed, however, to international development and particularly to global health. The number of interventions on these issues have made that very clear across the House.

I will reply briefly to some specific points made. My hon. Friend the Member for Milton Keynes Central spoke about the wider benefits not only to the economy, but in terms of our research and the links to the covid vaccine research. I saw some of the pioneering RNA vaccine research in visits with the all-party group years ago. To then see that expertise used to combat a deadly pandemic was extraordinary.

The right hon. Member for Dumfriesshire, Clydesdale and Tweeddale (David Mundell)—my successor on the all-party parliamentary group on HIV, AIDS and sexual health—rightly talked about this being investment, not charity. I think there is a consensus across the House on the proven track record of the Global Fund, Gavi and Unitaid.

My hon. Friend the Member for Exeter (Steve Race) mentioned his visit to Kenya and the links with nutrition as well. He knows the Government’s commitment to the global compact on nutrition and the work that was done around the summit and indeed the research in his own constituency. I thank the hon. Member for North East Fife (Wendy Chamberlain) for her contribution. Her constituency is a place I know well, having done my masters at the University of St Andrews. Important work is being done at that university and at many institutions across the UK.

My hon. Friend the Member for Norwich North (Alice Macdonald) asked important questions about women and girls. I can assure her that women and girls remain at the heart of our global health work. Gavi supports countries with vaccines that directly benefit girls and women, for example those against HPV, which we know is one of the leading causes of cervical cancer. Shockingly, over 85% of cervical cancer deaths are in low-income countries, and it is the main cause of death among many young women in Africa. Women and girls therefore remain at the heart of these partnerships going forward.

The hon. Member for Strangford (Jim Shannon), who is no longer here, as ever spoke passionately on the issues. My hon. Friend the Member for Ashford (Sojan Joseph) spoke about the importance of work on TB. We are absolutely committed to this, whether through the Global Fund, Stop TB Partnership or our work with the TB Alliance. We are doing many pieces of research and operations work.

My hon. Friend the Member for Macclesfield (Tim Roca) spoke about malaria, as did others. On that, there is really remarkable process being made on vaccines. Some of the early findings from the malaria vaccine implementation programme show that an additional one in eight children can be prevented from dying if they receive vaccines in combination with other malaria interventions. We are carrying on the important work on anti-malarial bed nets and other interventions.

My hon. Friend the Member for Gedling (Michael Payne), another of my successors in the APPG on HIV/AIDS, again spoke of the importance of the Global Fund, and I completely agree with him.

My hon. Friend the Member for Gravesham (Dr Sullivan) spoke about her experience working at the Francis Crick Institute, another leading institution doing incredible work. We should be very proud of our academics and researchers in this country for what they do.

My hon. Friend the Member for Bishop Auckland (Sam Rushworth), a powerful voice for his constituents, also spoke of his own personal experiences in sub-Saharan Africa.