World Immunisation Week

Debate between Philippa Whitford and Thangam Debbonaire

Thursday 2nd May 2019 Commons Chamber

[Thangam Debbonaire (Bristol West) (Lab)]

It is truly a pleasure to follow not only my hon. Friend the Member for Enfield, Southgate (Bambos Charalambous), but the right hon. Member for North East Bedfordshire (Alistair Burt) and all the Front-Bench speakers, and I am sure that the summing up speeches will also be a pleasure to hear. It is truly a pleasure—a constructive pleasure—to be able to say during a debate in this place that there have been excellent contributions from everyone in the House. We have already come to various points of consensus and agreement. We can all point to things that need to be done, as well as to places that we can learn from and successes that we can celebrate. I will try to confine my remarks to areas that have not been covered by others—I always try really hard not to repeat things that other people have already said. I will focus mostly on antimicrobial resistance and the relationship with immunisation.

In the 1970s, when I was nine, I went to India for the very first time. Just like the right hon. Member for North East Bedfordshire, who described his experience with his dad, I can still remember the pain and discomfort of the vaccinations. I can also remember much more clearly the impact of seeing someone with elephantiasis when I reached India, and of meeting a relative who had been affected by one of the deadly diseases, which she had survived but which had left her permanently disabled, that I had been vaccinated against. It was a really visceral experience of the connection between the discomfort and pain of the vaccination and the consequences of not having access to that vaccination. It was also a real-life experience of inequality—the fact that I had received that vaccination because I was a UK citizen, and the people whom I met in India at that time were not getting those vaccinations. The experience transformed me and my understanding of what vaccinations did. Obviously, I was a child, so I was transformed from being a child without information to being a child with a really strong sense of the importance of vaccination. As an adult, I have been left with a real passion about the value of vaccinations, particularly in the way that they eradicate inequality as well as disease.

I am glad that this debate falls under the Department for International Development rather than the Department for Health and Social Care; it is an interesting place from which to be discussing this matter. Others have already provided examples of diseases, such as smallpox, and also polio, with its permanent debilitating effects. Polio is a good example of a disease that has been virtually eliminated in most countries through widespread vaccination, but still circulates partly because the symptoms are not easily recognised in certain parts of the world. The value of vaccination is so crucial in those diseases where early signs are not necessarily clear or where infection can be transmitted before there are early signs, such as in the case of measles, as the hon. Member for Central Ayrshire (Dr Whitford) mentioned.

While I cut out from my speech things that others have already said, I will also add something about the decision not to vaccinate a child. The hon. Lady was absolutely right: we must not patronise parents. If they have valid questions, they must be heard, and if they have worries, they must be understood. The right hon. Member for North East Bedfordshire mentioned certain specific examples of why we have to listen to people. Obviously, we can be gung-ho in our attitude, but not in our interactions. I apologise for being personal about this, but it occurred to me that if someone said to me right now that there was someone in the Lobby who could vaccinate me against ever having cancer again, I would not be seen for dust. We would all rush. We would have no question. We probably would not even stop to ask what the side effects would be. We would be out there immediately. It occurs to me that in our lived memory, we have lost the understanding of the fact that measles is also a deadly disease. Hearing the right hon. Gentleman read out that account from Roald Dahl was really moving and served, perhaps, as a reminder of the issues, or even as new information to many parents who are fortunate enough to live in a world where measles is no longer in front of us—in this country certainly—causing those deaths.

[Dr Whitford]

rose—

[Thangam Debbonaire]

The hon. Lady, who is about to intervene on me, gave us examples of how it still is an issue in some parts of the world.

[Dr Whitford]

I thank the hon. Lady for giving way. As I said at the end of my speech, there are researchers who are actually working on the ability to vaccinate against cancerous cells. This is something that we will hopefully be seeing in our lifetime. Is it not then surprising that, in England, even the uptake of the meningitis vaccine, a disease that parents are terrified of, has fallen down to just 92.5%, which means that the community protection is not there.

[Thangam Debbonaire]

The hon. Lady is absolutely right, and I do find that baffling, but that does reinforce the point that she and the right hon. Gentleman made about listening to people’s worries and concerns. We will not get very far if we barge through them saying that they are wrong—they are wrong, but we need to listen to where those concerns come from and to try to address them.

Take the influenza vaccination, for example. I declare an interest, in that one of my sisters has to have this vaccination every year because of problems with her immune system. Influenza is a disease about which many of us nowadays would think, “I’ll take a few days off work, take some pills, have a bit of a lie down and sweat it out, and I’ll be back to work, as right as rain.” But of course, not only does influenza still kill people today in other parts of the world; it can kill people today in this country, if their immune system is depleted or for other reasons. Influenza is a really good example of a microbe that is mutating, so new vaccines will have to be developed. As the hon. Member for Central Ayrshire said, some vaccinations are the same as the ones that we were being given 10, 20, 30, 40 or 50 years ago, but others will need to be developed. The job is not done on vaccinations. We still need to respect the developing science.

The diseases that we could eradicate forever include elephantiasis, which I mentioned earlier, as well as polio, measles, mumps and rubella. The MMR vaccination has attracted particular attention, partly because of the discredited research by that dreadful person who I do not feel like naming because I feel so angry with him. I just think that these diseases are horrible, and the irresponsibility he showed at that time was quite extraordinary.

What really struck me while I was having cancer treatment was the sheer volume of unqualified, non-medical people willing to give pseudo-medical advice online, when it would not be allowed offline. The Front Benchers here are not quite from the right Departments to address this specific issue, but I ask them to pass on my message to their colleagues in the relevant Departments. I would like to see work done in the Department for Digital, Culture, Media and Sport to ensure that there are equivalent levels of regulation for online medical, pseudo-medical and pseudo-scientific advice as there are in the offline world, because the harm done is the same. I would not expect to go to anywhere on the high street and be given pseudo, incorrect, dangerous, non-scientific advice face to face. It would not be legal; there are laws against it. But in the online world, not so much.

I return to antimicrobial resistance. As I am sure the House is aware, if left unchecked antimicrobial resistance will lead to 10 million deaths a year by 2050, as the Scottish National party spokesperson, the hon. Member for Central Ayrshire, has said. Immunisation is a vital intervention against AMR. AMR happens when microbes adapt to become resistant to antimicrobial drugs. Once resistance occurs in pathogens—the microbes capable of causing disease—treatment options become very limited and lives are then put at risk. There are already about 700,000 deaths a year caused by infections that are resistant to treatment.

I urge all Members to read or to read a precis of—certainly to absorb the messages of—the brilliant O’Neill review on AMR of 2016, which concluded that vaccines have been overlooked as a tool to reduce AMR and that there should be a much greater focus on and investment in them. Immunisation helps to reduce the increase of AMR in two critical ways. First, it prevents infections in general and drug resistant infections, thereby preventing the disease and deaths. That then negates the need for ever more complex drugs to be used, which are often much more expensive and are therefore probably not available in poorer countries, to treat those resistant infections. Secondly, by preventing infection and the need for treatment at all, the use of antimicrobial drugs overall is reduced in both humans and animals.

Vaccines offer sustained long-term and, in some cases, lifelong—although that depends on the pathogen—protection from infection. Antibiotics do not. Far too many people have in their heads the idea that when they get sick, they will get an antibiotic and that is all that needs to happen. Many vaccines still effective today were introduced many years ago, but the same cannot be said for antibiotics. If there are high rates of mutation, we will need new vaccines. We therefore need to think about the money and investment that we put into developing vaccinations, as well as into maintaining the use of proven ones. The O’Neill review also identified some really clear contexts in which immunisation can reduce AMR, including vaccinating against hospital-acquired infections, and discussed the importance of investment in research for the early stages, when commercial viability may be some years or decades off. The effects of vaccines on AMR are, preventing disease and death; reducing progression and the severity of disease; reducing transmission; and reducing antibiotic use, and therefore the pressure of resistance.

Vaccines work. They save lives, halt the spread of disease, reduce the impact of antimicrobial resistance and prevent rare infections and illnesses. So why do we need a debate at all? Well, we need a debate partly to celebrate the achievement and the impact of vaccination, but also to reiterate the case for it. Sadly, there has been a decline in the use and take-up of vaccinations, with consequent increases in illnesses and infections. The case has to be restated to prompt parents just to check. As the hon. Member for Central Ayrshire said, there are parents in countries across the world who are busy for all sorts of reasons. They may get to their third or fourth child, and getting them vaccinated is either not practically easy or it slips their mind. Just check—I am asking all parents out there, with absolutely no judgment whatever, to use this week as an opportunity just to check whether their children are up to date with their vaccinations.

As people who travel to different countries, it also behoves us all to ensure that we are not being complacent when we travel. I know how easy that is. I have relatives in India who I like to visit on a fairly regular basis, and it is important for us adults to make a little note-to-self to check that our vaccinations are up to date.

I will refer briefly to social media because although the Library research paper—I thank the Library researchers and the Parliamentary Office of Science and Technology for providing briefings for our debates—reassures us that most parents say that the information they have seen about vaccination is supportive; unfortunately, 4% said they had seen anti-vaccination information, most of which had come from the internet or social media. We need to tackle that issue.

This debate has been located in the context of international development, so it would be remiss of me not to say how much I value the work of the Department for International Development, across Governments of different political persuasions and over many years. This Department has a high reputation. Of course, that also goes for right hon. and hon. Members who have served in it over many years, so I thank the Department. By way of triangulation, I recently visited the Bill and Melinda Gates Foundation in Seattle—I declare an interest, as my brother-in-law works there—where I was really impressed not only by the thoughtful way in which the organisation contributes to vaccination across the world, but by the high regard in which it holds DFID, and for good reason.

I would, however, like there to be a greater focus on the spread of information via social media and the internet in our international work, because disease knows no boundaries, poverty knows no boundaries and the internet knows no boundaries. Perhaps there needs to be a tie-up between the work done with social media companies, the Department for Digital, Culture, Media and Sport, the Department of Health and Social Care and the Department for International Development. Forgive me—that may already be happening, and I applaud officials if it is.

I reiterate that any right hon. and hon. Members in the Chamber who have not read the O’Neill report of 2016 on antimicrobial resistance need to read it. We have talked a lot this week about the climate emergency, and it is definitely an emergency, but so too is AMR. I am going to say this again because it is so shocking: if we stay where we are, by 2050, 10 million people a year will be dead because of antimicrobial resistance.