Gavi and the Global Fund

Monica Harding Excerpts

Thursday 15th May 2025 Westminster Hall

[Monica Harding (Esher and Walton) (LD)]

It is an honour to serve under your chairship, Ms Jardine, and I congratulate the hon. Member for Milton Keynes Central (Emily Darlington) on securing this debate. This year, as both Gavi, the Vaccine Alliance, and the Global Fund conduct their funding replenishments, it is more important than ever that we consider the indispensable value of their work, both for Britain and the world. Since its inception at the beginning of the millennium, Gavi has immunised more than 1 million children and saved in the region of 20 million lives.

The UK was one of the alliance’s founders and has since constituted its largest single sovereign donor. In its short existence, the Global Fund has succeeded in driving down the death rates across AIDS, TB and malaria by 61%, saving 65 million lives. That is close to the entire population of this country and would not have been achieved without British support. That manifested most recently in a £1 billion pledge to the Global Fund’s seventh replenishment. That money is likely to avert around 1 million deaths. We have made so much progress, eliminating many diseases in some countries and reaching the edge of success in others.

However, the work of Gavi and the Global Fund is being placed at risk by short-sighted cuts to international development spending. President Trump has gutted USAID, shattered the fund that fights HIV and AIDS and is poised to eliminate much American funding for global immunisation efforts. Following that playbook, this Government have decided to slash British development spending to 0.3% of our GNI, its lowest level this century.

I, like many others, still remember the optimism of the last Labour Government, who pledged to make poverty history and funded Gavi and the Global Fund when they were created. This Government have rejected so much of the proud 1997 legacy, and they must not do so when it comes to global health. I hope that they put money behind their pledge to prioritise global health and vaccinations. There are so many strong and resonant moral arguments for Britain, but at the same time, the fight against disease serves concrete British interests.

The war against infection is currently facing an alignment of factors that make victory more challenging than ever. Climate change is amplifying disease risk. Higher temperatures are opening up regions to mosquitoes, and the incidence of dangerous weather conditions is on the rise. Pakistan’s catastrophic 2022 floods, for example, have since led to almost 7 million additional malaria cases. At the same time, the disturbing spread and intensification of conflict across the globe is impeding efforts to treat and prevent disease. Increasingly, civilian populations are being deliberately cut off from aid, while healthcare facilities are being not only disrupted, but targeted. Consequently, we are seeing the return of once-controlled diseases like polio and upticks in those like cholera, which emerge from degraded sanitary infrastructure.

Why does this matter for Britain? It is because, as we have heard, disease does not respect borders. Since covid, we are all only too aware that disease can reach our shores, putting both our NHS and our health security at risk. Resistance, particularly in strains of TB and malaria, is also an increasing threat. Both Gavi and the Global Fund are working on the development and deployment of new generations of TB vaccines, even in the face of these new headwinds. Existing interventions for fighting malaria are also seeing their efficacy decline in the face of insecticide and drug resistance. Better, sharper tools have been developed. The challenge now is getting them to where they are needed, and for that we need the Global Fund.

[Iqbal Mohamed]

Before I came to this place, I worked in the pharmaceutical industry in safety, efficacy and regulatory compliance. Does the hon. Member agree that the leadership role that the UK has played to date is not just limited to financial contributions and support, but has ensured that the vaccines that are rolled out in third world and low and middle-income countries are as safe as they can be?

--- Later in debate ---

[Monica Harding]

I absolutely agree, and I was about to come on to the economic benefits of Gavi and the Global Fund. There are economic benefits: a study of Gavi-supported countries showed that, through healthcare savings alone, each dollar spent returns $21. When wider social benefits are considered, that rises to $54. Accounting for trade opportunities, healthcare savings and other economic boosts for Britain, both Gavi and the Global Alliance have generated value equivalent to hundreds of billions of dollars. So we are talking about neither a charity nor a giant cash dispenser in the sky, but instead, a deposit account for the security, health and soft power of our nation.

[Richard Foord (Honiton and Sidmouth) (LD)]

My hon. Friend is making an excellent speech. On the point about soft power, China tends to deploy its vaccines in accordance with its regional influence and global standing, rather than on the basis of where there is the greatest need. Does she share my concern that the withdrawal of western funding from vaccine alliances could clear the way for China to engage in further vaccine diplomacy?

[Monica Harding]

I thank my hon. Friend for a well-made point. I have consistently said that cuts to our international aid and development spend create the space for rogue actors to move in, including China and Russia. I know that the Government like polling, so I am happy to share that the British people understand the value of spending on vaccination. Recent Adelphi polling found that 70% of our people believe that supporting global vaccine access benefits Britain.

This is about not only British funding, but British leadership. Our expertise and convening power have been continuous assets for Gavi and the Global Fund. I fear that the Government’s aid cuts have put that leadership at risk, so they must work to reverse that trend. This year, Britain will, along with South Africa, host the Global Fund’s replenishment efforts. As host nation, other countries and non-governmental organisations will look to us for leadership in making a significant pledge. I hope we will step up.

In closing, I want to say a little more about what Britain’s support means to others. I recently met Botswana’s Health Minister and the special ambassador of the African Leaders Malaria Alliance. They shared with me their pride on the progress made on AIDS—with related maternal mortality falling by 80%—and on how malaria is now on the threshold of elimination. They told me that Britain’s work in this success is “always felt very warmly,” that it “ties” the two peoples, and that it is ultimately an expression of “humanity.” They told me that the collaboration fuels trade and partnership. The Minister and the ambassador worry that so much progress and so much investment risks going into reverse in the wake of the global aid retrenchment, including by Britain. They do not expect global support to last forever, but wrenching it away before countries have fully built up their own capacity is a destructive mistake that they, and we, will pay for.

From the Liberal Democrat Benches, I encourage the Government to reaffirm our commitment and pledge generously to Gavi and the Global Fund. I encourage the Government to reaffirm our commitment and leadership in aid, and to reverse the savage cuts to our aid budget. This still-new Government must decide the Britain they want to deliver. Our wish is to bestride the world stage as a development superpower, consolidating our massive progress and gains, affirming our friendship, acting with compassion while delivering for our own people, providing security from conflict and disease, and controlling upstream migration to these shores. The space for leadership is now vacant, and I urge the Government to fill it.