International Covid-19 Response: Innovation and Access to Treatment

Layla Moran Excerpts

Thursday 5th November 2020 Commons Chamber

[Wendy Chamberlain]

Absolutely. I thank the hon. Gentleman for his intervention, and I entirely agree with his sentiments. We have seen that those who are on the frontline, those who are marginalised in our society and those from minority backgrounds are often the most impacted, so it is even more important that we consider the treatments and vaccines that are available for them.

The two drugs that have been proven so far to help treat covid-19 are dexamethasone and remdesivir. The entire global stock of remdesivir was bought up by the United States Government during the summer, hence Donald Trump was in a position to receive the drug when he became unwell. What is left of the stock is currently accessible only at a very high price. The manufacturer, Gilead, sells it at almost £2,000 for a five-day course of treatment, yet it is believed that the cost to produce it is £7.

Fortunately, dexamethasone is widely available and a cheaply sourced steroid. If a patient suffering from covid requires ventilation, administering this drug reduces the chance of death by up to a third. That is great news and has greatly improved outcomes for patients who need to be ventilated. But for there to be a chance for that drug to be effective, there must be enough ventilators available for patients who need them, and there must be enough oxygen to supply those ventilators. Again, in some of the most vulnerable places globally, access to those things are very limited. In South Sudan, for example, a report earlier this year stated that there were only four ventilators available in the whole country—four.

This debate is not just about the cost of drugs or vaccines. It is also about the resources, technology and equipment needed to manage a pandemic successfully. Even with easily accessible and cheaper treatments, there is no equality of access internationally. As things stand, we run a serious risk that by 2022 we will inhabit a two-tier planet in terms of the pandemic response.

[Layla Moran (Oxford West and Abingdon) (LD)]

I congratulate my hon. Friend on securing this important debate. Does she share my concern that those parts of the world where people do not have immediate access to healthcare systems also do not have furlough schemes, and people do not have the money to be able to isolate? The public health aspect is just as important as access to medicines.

[Wendy Chamberlain]

I entirely agree. Dare I say it, but even the UK’s Prime Minister this week accepted that the isolate part of the test, trace and isolate system is not working. That is largely driven by the fact that people who have an economic need to continue to work will do so if the supports are not available, and that must be true in other parts of the world as well.

As I was saying, the most affluent countries will inevitably benefit, in terms of vaccines, access to treatment, some form of recovery and a return to aspects of day-to-day life, which we so miss in this place and beyond. For the majority of people in this world, that will, arguably, be a limited prospect; it would be a hollow victory indeed if we can get the virus under control while many people around the world continue to suffer. It would be a false victory, too. Let me go back to the comments made by my hon. Friend the Member for Oxford West and Abingdon (Layla Moran) that I mentioned at the start. In order for a vaccine to be effective, we need to suppress the virus both at home and abroad, because coronavirus does not respect national borders. No one is safe until everyone is safe. That approach has been endorsed by the UK Government. I thank them for recognising that covid-19 medical products need to be treated as global public goods and for making commitments to deliver on that.

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[Layla Moran (Oxford West and Abingdon) (LD)]

I would like to start by congratulating my hon. Friend the Member for North East Fife (Wendy Chamberlain) on securing this debate. It is a great pleasure to be part of a debate that actually gives me a huge amount of hope. I was a science teacher before I was an MP, and I spent a lot of time explaining to young people why science can be exciting and why it is the one thing that connects humans, no matter where they may be across the globe. Science is universal, regardless of our sex, creed, or wherever we may have been born. What a great time to be a science teacher! During coronavirus, by studying science someone could literally save the fate of the world. I am particularly proud that scientists in Oxford are leading from the front with the vaccine right now, and we should not forget that these times of great turmoil often spark moments of enormous human ingenuity, and we should celebrate that.

Whenever we have such moments, however, we first have to go through times of strife, and we must recognise—it is important that the House is united on this point—that it is not just morally right to ensure equitable access to these vaccines and therapeutics, but it is also scientifically smart. It is in our own self-interest, and regardless of whether people feel good going to bed at night knowing that we have done that, it is also the thing that will save us.

No one is free from these diseases until everyone is free, and I am sure hon. Members will have been struck by today’s news from Denmark, where on the mink farms it has been discovered that the virus has passed from humans to mink, and then back. The virus has mutated, and 12 people in Denmark now have that new mutation. The entire mink population is to be culled, to try to keep that at bay.

My first thought was that I am very much against mink farming, but let us put that to one side. My second thought was, “Well, that’s Denmark.” Denmark has a well developed public health arm in its Government, and they are able to act within 24 hours and introduce those measures. What about other countries that do not have that kind of safeguard? We have been talking about vaccines and therapeutics in the fight against coronavirus, but what if we forget about that public health arm, and as a result end up with a new mutation that will make those vaccines pointless as we will not be able to catch up? That underlines the importance of ensuring that all such matters are taken into account.

My hon. Friend the Member for North East Fife has already spoken about how intellectual property rights need to be reformed, and I have a few questions for the Government. Why have we not supported the TRIPS waiver proposal? What was our rationale for not doing that? Why did we not endorse the WHO covid technology access protocol? That global initiative is meant to prevent monopolies from blocking global access to coronavirus vaccines, and I do not understand how we in this House can say that we believe in global access to these vaccines, yet not back that protocol. It does not make any sense.

Finally, it is important to mention the context of aid and 0.7% of gross national income. Ministers have said helpfully at the Dispatch Box that they have no intention of changing or de-escalating that figure, and keeping up the pressure to ensure that that does not happen is important. As we have seen throughout the pandemic, there are already knock-on effects on other countries. In October we saw media reports about 2.5 million girls around the world being forced into child marriages over the next five years, and enormous rises in child labour in India. Suicide rates in Malawi have skyrocketed as a result of the economic downturn due to covid-19, and the UN’s “Global Report on Food Crises” warns of famines of “biblical proportions” as a result. Such economic disparities are just going to grow as the response to the virus continues, and I hope that the Government will lead from the front, and that “Global Britain” is not just rhetoric but backed up by action and not only words.

I will end on another point of hope. I hope that coronavirus will be the start of a reformation of what has been a creaking international global response over the past few years. I also very much hope that later on today we can declare that Biden has won, because Trump out of the White House would certainly help that cause. The next big crisis—the one that makes coronavirus look like just a warm-up to the main act—is of course the climate. Climate is linked to biodiversity, and biodiversity links to more likelihood of future pandemics. It is in our self-interest to use this crisis to create the new international order that will help us with our country’s and our planet’s future.

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[Wendy Morton]

I will cover that point off later, if I may, but I make clear that we have made commitments to the ACT accelerator partners across the health technologies of up to £813 million. Our commitment is very clear. That includes up to £500 million to Gavi, the vaccine alliance, for the COVAX advance market commitment. The support will also help to ensure access to covid-19 vaccines for up to 92 low and middle-income countries, providing up to 500 million people with vaccinations. The UK is also the largest ACT accelerator donor to the Foundation for Innovative New Diagnostics, or FIND, which is leading the way in developing diagnostic tools for the world’s poorest countries.

In terms of treatments, the UK is providing up to £40 million to the covid-19 therapeutics accelerator, alongside the Bill and Melinda Gates Foundation, the Wellcome Trust, Mastercard and other funders. The covid-19 therapeutics accelerator and Unitaid lead the work of the ACT accelerator therapeutics partnership. Unitaid has a track record of helping companies to bring affordable health technologies to developing country markets quickly, and the UK is the second largest funder.

Our funding to the ACT accelerator is supporting a pipeline of promising treatments, including monoclonal antibodies and new antivirals. New clinical trial data will emerge in coming weeks. The ACT accelerator is also preparing the way for the rapid deployment of new therapeutics as soon as possible after they have proved effective. We have seen some impressive results so far, but we recognise that the scale of the crisis means more funding will be needed across all three health technologies. We will continue to work with our international partners to encourage them to join us in stepping up their support and to support new and innovative solutions to address this challenge.

The UK is proud to be at the forefront of international efforts to develop vaccines, treatments and tests and ensure equitable access for the world’s poorest countries, but we recognise that we cannot do that alone. Only through global collaboration with our international partners and working through effective multilateral systems will we bring the pandemic under control. That is why on 30 September, the Foreign Secretary co-hosted a side event at the UN General Assembly with the UN Secretary-General, the World Health Organisation director-general and the Health Minister of South Africa. The event raised up to $1 billion in bilateral contributions for the COVAX advance market commitment. The World Bank also announced a package of $12 billion of support for countries to access vaccines, treatments and tests, and a coalition of 16 industry leaders announced a shared commitment to equitable access, including not-for-profit pricing. The commitments by this range of partners are a powerful demonstration of the international support for the ACT accelerator and the need for partnership across the international system.

Vaccine nationalism was raised by Members on the Opposition Benches. In the UK, we are challenging vaccine nationalism. We are a leading supporter of the COVAX facility, which is open to all countries and aims to make vaccines widely available when they are proven. At the UN General Assembly, we used our diplomacy to convene countries in support of that and announced UK aid to fund the COVAX advance market commitment.

Intellectual property rights provide incentives to create and commercialise new inventions, such as life-changing vaccines. They keep innovators innovating, creators creating and investors investing. The UK believes that a robust and fair intellectual property system is a key part of the innovation framework that allows economies to grow while enabling society to benefit from knowledge and ideas. Multiple factors need to be considered to ensure equitable access for all to covid-19 vaccines. These include increasing manufacturing and distribution capacity, measures to support or incentivise technology transfer, ensuring that global supply chains remain open, and ensuring that effective platforms are utilised to voluntarily share IP and know-how.

The UK has long supported affordable and equitable access to essential medicines. We have not signed the solidarity call to action, but we remain committed to collaborating with public and private partners, including by exploring voluntary arrangements and approaches such as non-exclusive voluntary licensing.

[Layla Moran]

Will the Minister give way?

[Wendy Morton]

I would just like to make a bit more progress so that I can cover as many points as possible.

Several hon. Member asked about the allocation of vaccines. I assure them that this is being considered. The World Health Organisation’s allocation framework recommends the highest priority populations by age, underlying conditions and health workers—estimated at about 3%. We cannot prevent a country from administering doses as they want, but there is a framework and countries will submit national deployment plans that will be reviewed by the WHO and COVAX.

The hon. Member for Strangford (Jim Shannon) raised the issue of inequalities for minority groups. I assure all hon. Members that we are working closely with organisations such as UNICEF and Gavi in that regard. These are organisations that we have worked with for many years.

I really hope that the House is reassured by the Government’s comprehensive approach to supporting innovation and equitable access to covid-19 vaccines, through scientific co-operation, working with industry, funding and multilateral collaboration. The UK is leading efforts to respond to the pandemic by developing and delivering the medical tools that are essential to ending the pandemic for everyone everywhere, but we must all work together to develop safe, effective and affordable vaccines, treatments and tests that can be produced quickly and made available to all.