International Covid-19 Response: Innovation and Access to Treatment

Patrick Grady Excerpts

Thursday 5th November 2020 Commons Chamber

[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.

[Patrick Grady (Glasgow North) (SNP)]

I congratulate the hon. Lady on securing the debate and apologise for the fact that we have not been able to field a Front-Bench spokesperson from the Scottish National party today. I endorse everything she is saying and the points she is making about the importance of global access to a vaccine, when it is developed. As she says, it should be treated as a common good. We have to seek assurances from the Minister that the UK Government will live up to that, given all the changes they have made to their foreign policy, with the merger of the Department for International Development and the Foreign and Commonwealth Office, the risk to scrutiny from that, and the potential abolition of the Select Committee chaired by the hon. Member for Rotherham (Sarah Champion). We have to keep up that pressure on the Government, and I hope we will get a positive response from the Minister today.

[Wendy Chamberlain]

It is always good to find common ground with a fellow Scottish MP, and I absolutely endorse his comments. One reason my party was so opposed to that merger was exactly that: the UK is seen as a global leader in this regard and we do not want anything to risk the continuation of that.

I congratulate the Government on making commitments to deliver on covid medical products being treated as a public good, for example, by contributing to the covid-19 vaccine global access facility, which will help procure and equitably distribute vaccines for covid. I look forward to hearing from the Minister today, but I urge her that we must do more. We must ensure that what the Government are doing on behalf of their own citizens does not unintentionally undermine global efforts. There is simply not enough global co-ordination on equality of access, and the UK has a moral duty to engage further. It is the highest per capita buyer of future vaccine doses in the world; we have bought up 10% of potential doses, despite making up less than 1% of the global population. I wish to mention two steps—which I hope the Minister will consider and commit to—that will be vital in ensuring that equality of access for these treatments and technologies is delivered as they come to fruition.

First, the Government need to recognise that currently there are just a handful of vaccine candidates, which means that production capacity is limited. One important step the UK Government could take is to work through international institutions to help encourage reform of the patent system, given the exceptional circumstances of this pandemic. Currently, there are legal safeguards for members of the World Trade Organisation, which means that members can override patent monopolies if public health is at threat. Germany, Australia and Canada have already taken those steps. South Africa and India have also proposed at a recent WTO meeting that all intellectual property monopolies relating to covid-19 tools, medicines and vaccines should be waived. In these exceptional circumstances, the Government need to be engaging with those ideas.

It is also worth noting that many of the vaccine candidates are being produced or developed using public funds. According to the charity STOPAIDS, the cost of development of the Oxford-AstraZeneca vaccine, whose successful outcome we are all awaiting, is being covered by public money, from the UK Government and others. It is a public-funded exercise. Concerningly, STOPAIDS reports that from July next year AstraZeneca will have the ability to determine the future price of the vaccine. Given the timescales that I have outlined, as well as the ongoing uncertainty as we enter winter, with cases climbing again in many parts of the world—we are all too aware of that in this Chamber—clarity on this is essential. We cannot have nations crowded out during vaccine development and then priced out once the vaccine is available.

So much public money is being spent on covid-19 research and development, in all our interests, and it is therefore right that the Government ensure that the products created as a result of that spend are accessible to all. These reports give more weight to the idea of relaxing patents, and that leads me to my second point, which is transparency.

The Government should attach stringent conditions to future funding of covid research and development, to ensure that public money is not being invested into products that will go on to generate exorbitant profits for their owners who, as a result of public funding, have developed a vaccine at low or no cost or limited risk. Those steps will also help to speed up research and development, and will arguably make products more affordable, enabling generic competition, driving prices down and ensuring that people from all over the globe, from the wealthiest nations to the most disadvantaged, can access covid treatments in a swift and timely manner. I hope that the Minister will take those issues into consideration.

The developing situation of what is almost a vaccine nationalism must end. Let us start to engage even more fully with multilateral institutions and our allies. Let us work together to ensure that, this time next year, we are celebrating a pandemic in abeyance worldwide, rather than still being in the shadow of this deadly virus.

[Sarah Champion (Rotherham) (Lab)]

I thank the hon. Member for North East Fife (Wendy Chamberlain) for calling for the debate, and I hope that my speech will amplify the points that she is making.

The International Development Committee, which I chair, has been examining the impact of the coronavirus on developing countries, and the contribution of the UK Government to initiatives to help the global south tackle the pandemic. A key part of the UK’s strategy for the global south is funding an array of partnerships and collaborations aiming to develop, at speed, vaccines, therapies and tests for preventing, treating and diagnosing the disease. The Government have allocated the lion’s share of their global coronavirus funding to the race for those products—£388 million initially for vaccines, therapies and tests and, more recently, another £571 million for the production, purchase and distribution of vaccines. That is very welcome, but a key concern that emerged throughout the evidence that we received was about the importance of legal and practical measures to guarantee equitable access to corona vaccines, medicines and tests around the world, based on need, not economic power. The former chief scientific adviser to the Department for International Development, Professor Charlotte Watts, told the IDC:

“It is not only about finding a vaccine that is going to work, but how to ensure that there are the resources and future investment in production capability, so that that can be distributed to low and middle-income countries.”

It is worth recalling why equitable access to medicines is such a concern. First, let me take the example of the antiretrovirals for HIV and AIDS. In Durban in 2000, at the XIII International AIDS Conference, Justice Edwin Cameron of the South African Constitutional Court famously declared that he had been living with AIDS for 33 months, but that,

“there are 24 or 25 million people in Africa who at this moment are dying, and they are dying because they don’t have the privilege that I have of purchasing my life and health.”

In 2000, the anti-retroviral drugs capable of transforming AIDS into a manageable illness were far beyond the means of most South Africans, costing up to $10,000 a year—much more expensive than any other country when compared with generic substitutes. When South Africa passed legislation to facilitate the use of cheaper, generic and imported products on public health grounds, 39 multinational pharmaceutical companies banded together to sue the Government for violating WTO rules. Rightly, that resulted in a PR disaster for the pharmaceutical industry. The case was dropped and the WTO recognised member states’ rights to take such measures to protect public health and, in particular, to promote access to medicines for all. But even now, the use of that safeguard is largely limited to the original HIV/AIDS drugs because of the complexities required in legislation, health system weaknesses and political pressure.

Let us look at cancer. Cancer drugs are a lucrative pharmaceutical market—for example, representing 27% of the sector’s revenue in the US. Efforts to set prices to recoup research and development costs over a set period are one thing, but funding the inflated billion-dollar trade in whole companies holding just one or two attractive patents seems less defensible. Whatever the reason, low and middle-income countries invariably find the prices set to take advantage of demand in a high-income country an insurmountable barrier to access. Pricing invariably results in wide variations in survival rates. For example, the US five-year overall survival rate for breast cancer is 84%, compared with just 12% in Gambia. That is hardly equitable.

Finally, I want to talk about polio. The polio story is essentially a triumph, with a 99% reduction in cases since the start of the global effort in 1985. However, each year, the oral polio vaccine, which is widely used in the global south, is linked to outbreaks of the disease where the wild virus has been eliminated. The injectable vaccine is an inactive virus, but it costs about $3. The oral vaccine, at about 12 cents, contains live virus. Unfortunately, children can shed a mutated version of the live virus in their stools, which can then infect unvaccinated children in areas with poor sanitation. Clearly there are other considerations than just costs when comparing injected and ingested doses of medicine, but the reality is that cost kills.

Let us hold these examples in our mind as we consider equitable access to future coronavirus products. And let me be blunt: the prospect of the international community behaving morally, or at least rationally, on a global scale over the distribution of an effective vaccine, or even accurate and simple tests, at an affordable price, is not good. In his September speech to the first virtual United Nations General Assembly, the Prime Minister rightly lambasted the international community over its fractious and competitive reaction to the procurement of personal protective equipment during the first wave of the pandemic—and that was just over masks and aprons. Imagine the pressure on every Government to deliver the long-awaited panacea of covid-19 immunity to their own populations.

Any rational response to the pandemic must surely take account of the science and the almost unique status of this crisis by incorporating the sustainable development principle of leaving no one behind. No one will be safe and secure until everyone is covid-free. For once, everyone’s interests are overtly aligned. The UK finds itself in a unique moment in time when we can reposition ourselves as a global leader for good. The soft power gained by doing the right thing for the very poorest in the world, and by standing up to those looking to profit from others’ misery, will be immeasurable. I am grateful for the leading role the UK has taken to date in the development of covid vaccines and products.

[Patrick Grady]

I will be brief, because there is pressure on time, but I just want to say that the hon. Lady is making an incredibly powerful speech that is demonstrating the importance of the scrutiny that her Select Committee has been able to provide. I want to re-emphasise the point I made to the hon. Member for North East Fife (Wendy Chamberlain) that the Scottish National party fully supports the continuation of that Committee, either as a non-departmental Select Committee or as a wider official development assistance-scrutinising Committee. I hope that those on the Government Benches will bear that in mind.

[Sarah Champion]

I am extremely grateful for the hon. Member’s support of the International Development Committee. Development is a specific and key area of the work that we do, and it demands parliamentary scrutiny.

I ask the Minister to give us some certainty today on the Government’s commitment and resolve to fight to ensure that covid drugs and treatments are accessible to everybody, not just those with the deepest pockets. Will the Government support the proposed waiver of all intellectual property monopolies related to covid-19 tools, as put forward by India and South Africa to the WTO? Can the Minister confirm that, for all R&D projects that the UK has funded, transparency on finances and an obligation for resulting products to be free from monopolies were embedded in those contracts at the start and will be enforced? Finally, will the Government follow Germany, Australia, Canada and Israel in championing the use of legal safeguards that all World Trade Organisation members can implement to override patent monopolies if public health is at risk?