UN High-level Meetings in 2023

Fleur Anderson Excerpts

Tuesday 11th July 2023 Westminster Hall

[Fleur Anderson (Putney) (Lab)]

It is a pleasure to serve under your chairship, Mr Twigg. I thank the hon. Member for Ealing, Southall (Mr Sharma) for securing this important debate. It is very well timed, as Ministers are agreeing the statements that will go forward to the three high-level meetings on universal health coverage, pandemic prevention, preparedness and response, and tuberculosis, which will all be happening in New York during the same week in September. As co-chair of the all-party parliamentary group for water, sanitation and hygiene, I will focus my remarks on the issues of water sanitation and hygiene as they pertain to the three high-level meetings, and on how we can mark the huge step change ahead by using the meetings to galvanise global commitment to improve health and wellbeing for all and accelerate progress towards universal health coverage globally.

The timing of this debate is very important, because the meetings will result in a number of political declarations that are currently being negotiated by member states. I know that the UK public want to see our Government taking a leadership role in the high-level meetings in order to bring about change in people’s lives, both in the UK and across the world. I thank the Minister for Development, the right hon. Member for Sutton Coldfield (Mr Mitchell), for recently attending a joint meeting of the all-party parliamentary groups for water, sanitation and hygiene, on HIV and AIDS, on malaria and neglected tropical diseases, and on global tuberculosis to talk about a lot of issues that will be discussed at the high-level meetings.

We are so grateful in this country for the NHS, whose 75th anniversary we celebrated just last week, but as we are increasingly entwined in health globally, progress in the NHS can only be helped by progress around the world. The pandemic showed us that in the most stark way. Universal health coverage, which includes water, sanitation and hygiene, will not only save many lives in countries around the world, but save lives here and mean that we are less at risk from future global health disasters.

Two thirds of healthcare facilities in the world’s least developed countries, and half of those globally, do not have access to hygiene facilities. To put that in perspective, if my local hospital or GP surgery did not have running water it would be closed down, yet half of facilities around the world do not have that access to safe water. One result is that every minute a newborn dies from infection caused by a lack of safe water and an unclean environment. Healthcare workers and patients increasingly turn to antibiotics in the absence of clean water, resulting in the misuse of antibiotics and increased resistance.

Antimicrobial resistance directly caused 1.27 million deaths globally in 2019 and contributed to an additional 4.95 million. That makes it a bigger killer than HIV/AIDS or malaria. By 2050, the death toll is predicted to have climbed to 10 million deaths annually. The UK Government have predicted that antimicrobial resistance will be the leading cause of death in the UK by 2050. The Lancet has called it an “overlooked pandemic”. But it can be addressed right now through increased water, sanitation and hygiene in healthcare facilities around the world, which would save lives immediately: it is a good value-for-money investment and could be the huge step change that we need to see.

The common thread running through all three high-level meetings is the need to prevent and treat infections effectively. Infection prevention and control, and the vital necessity of water, sanitation and hygiene, are essential to preventing infections in the first place. Treatment is, of course, important, and if the infections are bacterial, antibiotics are vital, so we need to protect the antibiotics that we have.

Recently, the APPG for water, sanitation and hygiene and the APPG on antibiotics produced a report called “Prevention first”. We took evidence from the World Health Organisation and experts around the world about the need to curb the spread of antibiotic resistance. We found that a lack of hygiene means that doctors and nurses are unable to wash their hands before and after touching patients; new mothers are unable to clean themselves or their babies; and health workers and patients do not have a safe and hygienic toilet in their healthcare facilities. That causes repeated disease outbreaks, which need to be treated with antibiotics, contributing to that resistance around the world.

Not only would greater water, sanitation and hygiene save lives immediately, but it would buy us time to develop new drugs and protect our scientific investments. It has the power to achieve safer primary healthcare services and improve health outcomes. There are lives that could have been saved by the simple act of washing, having clean water and being cared for in a clean environment by people who have washed their hands, yet women are still giving birth in environments that do not have clean water, and healthcare workers are suffering disproportionately as a result. Ensuring that all healthcare facilities in the 46 least developed countries have access to reliable water, sanitation and hygiene will cost the equivalent of just 3% of health spending in these countries. That can be a key topic at the high-level meetings.

Investment in global WASH should be seen as an insurance policy to protect UK public health, the NHS and our scientific investment, because most resistant infections treated by the NHS originated elsewhere in the world, particularly in low and middle-income countries. Tackling that problem is critical to UK public health and protecting our NHS. Healthcare-acquired infections already cost the NHS at least £2.1 billion a year, and that cost will go up as infections become increasingly resistant to antibiotics. Better alignment on antimicrobial resistance action between the Foreign, Commonwealth and Development Office and the Department of Health and Social Care could maximise our impact on UK and global health outcomes.

In a world of so many seemingly intractable problems, it is clear that with more investment, action and political resolve in the high-level meetings we can solve the financing gap for WASH in healthcare facilities by the end of the decade. Healthcare leaders can afford to collectively mobilise the annual $355 million in domestic financing and $600 million in external financing needed to support those countries. That would save millions of lives and make universal health systems dependable. There is a clear price tag, and it is not unaffordable. We must adequately fund WASH in healthcare facilities to tackle antimicrobial resistance.

As a result of the previous high-level meetings and lots of in-country work by local campaigns, many countries have costed roadmaps for WASH in healthcare facilities in place and ready to be funded. They have worked out exactly what needs to be done, but political leadership in those countries and by the UK and other allies is urgently needed. The UK Government have led on the issue previously and are well placed to drive it globally.

The UK Government recognise the necessity of improved WASH services globally to promote global health, but the steep decline in UK bilateral aid for WASH—a cut of about 80%—raises concerns about the UK’s commitment to the sector. For most of our constituents, it is a no-brainer that the UK Government should fund aid for clean water services and hygiene, but the UK Government are not backing their commitment up with financing.

I have several questions for the Minister as we face these three important high-level meetings on universal health coverage, pandemic preparedness and tuberculosis. The first is simple: who is going? Who will be representing the UK Government—representing us—at each of the high-level meetings? I and many others here and across the country hope that there will be high-level attendance at the meetings.

Secondly, will the Government prioritise WASH in healthcare facilities in meetings with peers from low-income countries during the high-level meetings to encourage domestic investment in that area as a cost-effective, high-impact investment to advance global health security and strengthen progress towards universal health coverage?

Thirdly, will the Government identify opportunities to host bilateral meetings or small roundtable events around the high-level meetings to bring together like-minded donor Governments, global health initiatives and private finance partners to discuss investment and actions to achieve universal access to WASH in healthcare facilities? We must show leadership in the actions we take around the high-level meetings.

Finally, will the Government make antimicrobial resistance and WASH in healthcare facilities a key priority within the UK’s negotiating points and ministerial speeches at the three high-level meetings? Will they protect and strengthen WASH in healthcare facilities language in the political declaration documents?

I am grateful to be able to raise the issues that matter to constituents across the country. We have an important opportunity ahead. With several weeks to go before these meetings, now is the time to build these issues into achievements so that we can be proud of the UK’s leadership at the meetings in September.