Vaccinations: Developing Countries

John Howell Excerpts

Wednesday 13th June 2018 Westminster Hall

[Stephen Crabb (Preseli Pembrokeshire) (Con)]

I beg to move,

That this House has considered the economic effect of vaccinations in developing countries.

It is an enormous privilege to serve under your chairmanship, Mr Evans. I am grateful to have secured time to lead what will probably be a short debate, but I hope a positive and useful one, on a subject on which this Government and successive British Governments of different colours have shown leadership and genuine commitment.

I am delighted to see the Minister in his place. He has had a busy time in Westminster Hall in recent weeks and I almost feel reluctant to drag him back here again, but I hope he finds the debate useful and enjoyable. I know that I and other hon. Members here today look forward to hearing his usual wisdom and intelligence on such matters during his winding-up speech.

Today, nearly half the world’s population, including 1 billion children, live on less than $2.50 a day. More than 1.3 billion people live in extreme poverty, which means they survive on less than $1.25 a day. We get so used to reading those statistics that it is sometimes easy to forget what the reality means. It means families who go to bed at night hungry, wake up hungry and then go to bed the following night still hungry. It means families where people are incredibly blessed to have access to anything more than a very basic education, if any at all. These are people for whom daily work is repetitive, painful and dangerous, and who certainly cannot afford for themselves or a family member to fall sick.

We know that behind every statistic there is a human being. According to UNICEF, 22,000 children die every single day due to poverty. I do not believe that anyone in this House, or the wider British public, finds that acceptable. With many other countries, non-governmental organisations, private individuals and institutions, Britain is committed to working to end that poverty and to tackle the conditions and causes that trap people and whole nations in cycles of poverty.

As a Conservative, I believe strongly that free trade, markets and the rule of law play a powerful role in lifting nations out of poverty, but I also know that they cannot bring an end to some of the deep-rooted factors that perpetuate cycles of poverty around the world. That is why I am hugely supportive of the fact that as a nation, privately and through taxation, we provide large sums of money to fund interventions that seek to establish sustainable long-term solutions in the poorest nations. Britain is a leader in international development not just by virtue of the size of the budgets we make available, but through the expertise we deploy.

[John Howell (Henley) (Con)]

Is my right hon. Friend aware that the number of deaths from vaccine-preventable diseases is around 2.5 million to 3 million per year, but the number of people being inoculated has reached a bit of a plateau? Does not that say something about how we should focus our activities to establish better relationships with mothers, to reach hard-to-reach groups in Africa and Asia in particular, so as to take this further forward?

--- Later in debate ---

[Stephen Crabb]

My hon. Friend makes an excellent point and I absolutely agree with him. That is exactly the kind of research and evidence that the Department and other bodies need to provide as those who believe in and support our overseas aid spending seek to make and restate the case for it over and over again. It is a powerful message with which to challenge sceptics and cynics.

In 2016, Johns Hopkins Bloomberg School of Public Health examined the projected return on investment in vaccinations between 2011 and 2020 in 94 low and middle-income countries. Looking only at the direct costs associated with illness, such as treatment and lost productivity, it found that the return for every £1 spent on vaccines was £16. When it expanded its analysis to look at the broader economic impact of illness, it found that the return was around £44 for every £1 spent. Such studies point to investment in vaccinations being an important means of improving health equity and reducing poverty, and to vaccinations providing value for money.

There is another aspect to this: investment in vaccinations in the poorest countries is also an investment in our own national security and resilience. I am always wary of the self-interest argument when it comes to defending overseas aid, and I think people generally see through those arguments, but polling evidence indicates that the general public understand that killer diseases such as Ebola do not respect borders and shows greater support for aid that focuses resources on tackling those diseases.

I will wrap up in a few moments, but I will close with several recommendations and observations, which the Minister will perhaps respond to today or follow up in writing at a later date. What efforts is Britain making, through its international partnerships and on its own, to improve vaccine coverage rates among the very poorest, ensuring that aid is spent on those who need it most and for whom it has the biggest benefit?

Distributional impacts should be taken into account when decisions are made about introducing or expanding vaccination programmes, and programmes accruing greater benefits to the poor should be prioritised over vaccines with less equity impact. Hard-to-reach families and people in isolated areas should be priority targets, as investment among those people significantly reduces the likelihood of disease outbreaks, which are more costly in lives and the money needed to respond.

Despite significant progress since 2000, today, nearly one infant in 10—that is, around 30 million children—does not receive any vaccinations, and more than 1.5 million children under the age of five die from vaccine-preventable diseases every year. Pneumococcal conjugate vaccines immunise against the most common cause of pneumonia, but they remain inaccessible to millions largely due to high prices, thus leaving behind the poorest and most marginalised children.

[John Howell]

I thank my right hon. Friend for giving way again; he is being most generous with his time. Does he see a role for the Prime Minister’s trade envoys in this sphere? We are often assigned to countries that fall into the categories that he has been talking about and we have a seminar coming up on the healthcare applications of what we can do. I do not think that that should concentrate solely on encouraging healthcare companies into those countries; it should also look at how we can help to develop those programmes.

[Stephen Crabb]

My hon. Friend makes an extremely important point. There are well established networks nationally in the UK and internationally, which bring policy makers together with academics, scientists and researchers who look at these issues. Surely within that there needs to be a role for people with a trade focus to link that investment angle into it as well. There would probably be a lot of interest, particularly among some of the private sector interests that are part of those networks, in seeing people such as Government trade envoys getting on board and helping with these programmes.

GAVI’s advance market commitment pilot, supported by the UK Government, has created a temporary but pioneering funding model that is changing the picture that I described—the poorest and most marginalised not getting access to vaccines—and it is doing so by changing the market. That funding mechanism can reduce the price of vaccines, such as the ones I have described for pneumonia, by creating an incentive for new manufacturers to enter the market and increase competition. The advance market commitment has succeeded in reducing the usual delay between introduction of a new vaccine in developed and in developing countries from 10 to 15 years to just three, reducing inequalities in access between rich and poor countries.

As we look to the future of programmes such as GAVI and the global health fund, which I was describing a few moments ago, we know that decisions will need to be made in due course about Britain’s ongoing support for those programmes. Those decisions will not necessarily be made anytime soon, but I urge the Minister and his teams, as they prepare for the replenishment conferences for GAVI and the global health fund, to bring together as much high-quality research and evidence as possible to enable them to make a strong, positive decision to continue funding those vital, life-saving programmes and, crucially, to explain that and show members of the public that it is a really good investment of our aid money for the future.

Investments in vaccines remain an enormously effective use of aid and contribute directly to achieving the sustainable development goals. Britain has a powerful track record to point to and we should do more to highlight that—not in the sense of being self-congratulatory, but to help to strengthen the broader case for overseas aid. Britain’s leadership in the field of vaccinations flows directly from the political consensus of a decade ago to expand our overseas aid budget and direct it towards some of the most difficult global challenges. The remarkable international effort on vaccinations underlines the importance of reforging that consensus and protecting UK aid.