Covid-19: Vaccinations and Global Public Health

Lord Boateng Excerpts

Thursday 9th September 2021 Lords Chamber

Moved by

[Lord Boateng]

To move that this House takes note of (1) the shortage of, and (2) the obstacles to the manufacture and distribution of, COVID-19 vaccinations in the Global South; and of the consequent implications for global public health.

[Lord Boateng (Lab)]

My Lords, I am grateful for this opportunity to move the Motion standing in my name. Covid has revealed in every aspect of our lives the impact of inequality, has it not? In no case is that inequality greater than in access to vaccines and the means to manufacture them as between the north and south of our world, as well as between countries that have and those that do not—that is, poor and impoverished countries. The facts speak for themselves; I am grateful, as I am sure all noble Lords are, to the House of Lords Library for its research work on this.

The figures revealed are a stark reminder of the problem that we as a world face in relation to Covid and inequality. On 23 August, approximately 32.5% of the world’s population had received at least one dose of a Covid-19 vaccine, while 24.5% were fully vaccinated. That is in the world as a whole. However, only 1.4% of people in low-income countries had received at least one dose. I repeat: 1.4%, as opposed to 32.5%. There are many countries in the world, many of them in Africa—such as Chad, Burkina Faso, the Central African Republic, to name just a few—where the percentage of the population that is vaccinated is less than 1%. That is the reality on the ground. Of course, it presents a threat to us all because an unvaccinated world is a world in which variants that threaten us all are more likely to emerge. So, we have to find a way of addressing this imbalance.

We are also confronted too by the stark reality that, on existing projections, we are faced with a situation in which low-income countries cannot expect to have widespread vaccine access before late 2023. In the UK, we have bought enough vaccine to vaccinate the entire population more than three times over—on some calculations, four times over—and even after boosters have been given and the lower age groups have received their vaccinations, we will still be sitting on 210 million surplus doses. That is the figure that represents the reality of the gap between north and south.

The WHO estimates that some 16.2 billion doses will be needed for 2021-22 to achieve universal vaccination. That means that we are going to have to more than quadruple the world’s pre-Covid capacity to manufacture vaccines. That is the scale of the problem, but there is every reason to believe that, with the right attitude, approach and strategy, and with a willingness now to co-ordinate global action and to put the resources behind that action, the world could in fact meet the challenge. This is not one of those situations in which we can say, “Oh well, it’s all pretty terrible but really there’s nothing much we can do about it, that’s the way of the world”. Actually, it does not have to be the way of the world, because one thing we have learned from Covid is that where there is the concerted will, we can totally transform the picture. We know what has to be done, and what has to be done involves our Government being prepared to take a lead and the world recognising that existing mechanisms simply are not working.

Let us take a look at one of them: COVAX. The COVAX Facility was established—and we should celebrate the fact that it came into being—to create a global procurement mechanism to supply Covid vaccines to all the countries of the world in an equitable and effective way. But I am afraid it simply has not worked, because it was based on the flawed assumption that you could still have business as usual as an approach to the development, manufacture and pricing of vaccines. When I look around the Chamber, the expertise present is indicative of the degree of expertise that is present in this House on a range of issues. On this issue, we all know that, if COVAX is to work, it has to be reformed. It has not just simply to be given more resources; it also has to be geared towards dealing with inequality and not accepting it as a given.

The reality is that COVAX is at risk of failing even the modest, limited targets that it set itself. It looked to allocate just 2.3 billion vaccines by the end of 2022. That would not be enough, anyway, to deal with the scale of the problem that, as your Lordships are aware, exists, but we now face a situation in which it will be able to distribute and disburse less than a quarter of the intended doses on time.

That is hardly a wonder, because in June of this year, the UK received a distribution of vaccines that was greater than that of the entire distribution to the whole of Africa. In one month, June this year, the UK ordered and received 535,000 doses of vaccine from COVAX, and that was more than double the amount given to Africa in that month. How can the Minister justify that? Will he justify that this afternoon, or will the Government at last recognise that, yes, COVAX has got to be reformed? We and other wealthy nations cannot go on taking vaccines out of that pool, and we also need to put more into it. We hope that we will hear from the Minister this afternoon just what the Government are doing about that.

The other issue—again, one on which our nation needs to take a lead—is addressing the obstacles to scaling up manufacture in low-income and middle-income countries. We must be brave and ambitious in this regard, but we must also recognise that the capacity is there in the developing world. Even before Covid, developing country manufacturers were supplying at least 65% of the vaccine needs in all the WHO regions except the Euro region—so the countries of the developing world were already doing it with their existing capacity before Covid. India, China, Brazil, Cuba, Thailand, Senegal, Indonesia and South Africa all have the capacity to produce Covid vaccines. What they need is the additional investment and, significantly, a WTO regime that permits licensing and the sharing of information and encourages the pooling of intellectual property, and a WTO set of regulations to underpin that.

It is not about a free-for-all in which there will be inadequate and insufficient money for R&D in the pharmaceutical industry. That is not what is being proposed. What is being proposed is reform of the WTO. There are initiatives out there from South Africa and India, working together, and, importantly, from the United States. If the United States, which in the past has been at the forefront of restrictive practices in relation to intellectual property, is prepared to take a lead in reform, what is the reason for Her Majesty’s Government being so mealy-mouthed in this respect?

Why have we not taken the opportunity that the much-vaunted freedoms from the EU have given us to say that we will adopt a different negotiating position from the EU on this? Instead, what we have done is to go along with an EU consensus that has in fact been blocking reform within the WTO. I hope that we will get some inkling from the Minister. I do not expect him to reveal all his cards in a debate such as this; that would not be feasible or realistic, but he can at least indicate that we are prepared to join the United States, South Africa, India, and even France, in negotiating wording with the new director-general of the WTO that would give some hope that we will be able to see advances in this area.

There are many other experts in this House who will address this issue and talk about the importance of sharing knowledge and of building on the manufacturing capacity that exists—as I have indicated —in the global south; they will bring their expertise to bear on this. I hope that the Government will utilise the expertise that exists across Whitehall departments to come forward with a policy on this, so that we see the FCDO working with the Department for International Trade and the Department of Health. The Government should be congratulated on the energy of their Vaccines Minister and the strategy that has been brought to bear to meet the demands of our own country, so why can that not now be brought to bear to meet the demands of the world? This is not only a moral imperative but a public health imperative.

There was a great teacher who lived at the time of our Lord in Palestine by the name of Hillel. He said, in relation to self-reliance and solidarity:

“If I am not for myself, who will be for me? But if I am only for myself, what am I?”


This is the importance of recognising our common humanity, our interdependence and the need for solidarity. But he also went on to say, “If not now, when?” That is the importance of action, of getting on with it. Now is the time to demonstrate that solidarity and to make sure that all have access to vaccines for the benefit of all.

--- Later in debate ---

[Lord Boateng (Lab)]

My Lords, it is late and we have had an outstanding debate. It has been a rich debate; there has been compassion, knowledge and passion, undergirded by broad experience—experience of campaigning around human rights, experience of activism around social justice, and ministerial experience—on all sides of this House.

I hope the Minister got a sense that the House spoke with one voice, and that one voice was clear. There is, as the Minister himself has said, much more to be done. This House expects more to be done, and we intend to make sure that it is. I can say only a huge thank you to all those who have contributed, but also to all those who have come and stayed—on all sides—to hear these arguments and to indicate their support for what has to be done.

Motion agreed.