Pandemic Prevention, Preparedness and Response: International Agreement

Preet Kaur Gill Excerpts

Monday 17th April 2023 Westminster Hall

[Preet Kaur Gill (Birmingham, Edgbaston) (Lab/Co-op)]

It is a pleasure to serve under your chairmanship, Ms McDonagh. I thank hon. Members on both sides of the House for their contributions. I am glad that the debate has been conducted in a mostly measured and thoughtful way.

The covid pandemic has been one of the most surreal and seismic global events of our lifetimes, with 212,000 people having died as a result of it in the United Kingdom and our economy having been directly hit to the tune of £250 billion of gross value added. The social impacts on everything from our children’s lost learning to NHS waiting lists will be felt for years to come. The extent of the damage that the pandemic caused was not inevitable. The UK was badly unprepared. NHS waiting lists were at record levels even before the pandemic hit. We had staff shortages of 100,000 in our health service and 112,000 vacancies in social care.

In 2016, the outcome of Exercise Cygnus informed the Government that the NHS would not be able to cope with a flu pandemic; yet they still reduced the stock of PPE and the number of beds. Too many people have paid for that decision with their lives, particularly in care homes across our country as untested patients were ferried from hospitals to homes. Then of course there are the billions of public money wasted on unusable PPE, the chaotic shuffling in and out of lockdowns from a Government that could not get a grip, and at the end of it, the UK’s abject position as the worst hit economy in the G7.

After 12 years of Tory complacency, the next Labour Government will never leave our country with such a soft underbelly. The next Labour Government will deliver a new 10-year plan for the NHS, including one of the biggest expansions of the NHS workforce in history, doubling the number of medical school places to 15,000 a year, training more GPs, nurses and health visitors each year, and harnessing life sciences and technology to reduce preventable illness.

While it might feel like the pandemic is over now, the threat is not. That is what today’s debate is about. Far from a once-in-100-years event, many natural biological threats have emerged in recent years, including severe acute respiratory syndrome, avian flu, middle east respiratory syndrome, Ebola and monkeypox. Climate change and globalisation mean that natural biological threats are becoming more common, and it is not only biological threats that we must prepare for. Advances in gene editing mean that virologists can more easily modify viruses to be deadlier and spread more quickly, increasing the security risk posed by bioweapons and bioterrorism. Will the Minister comment on our concern that the biological weapons convention currently remains very weak, with little funding and only four staff, compared with the 500 staff for the chemical weapons convention?

Pandemic preparedness must therefore be taken seriously as a matter of national security. Future threats could be far deadlier than covid-19. During the first wave of coronavirus, 1% of infected individuals died, compared with 80% during the west African Ebola epidemic. The lesson of the pandemic was that no one is safe until everyone is safe, and that global health is local health, so global co-operation on pandemic preparedness and biological threats clearly needs to be strengthened. That is why the Opposition absolutely support the principle of a legally binding WHO treaty that sets the standard for all countries to contribute to global health security. Our country was set back not just once but three times by new, dangerous covid variants that originated overseas. We are stronger together than trying to firefight such crises alone.

The WHO is the primary UN agency for international public health. In its history of over 70 years, it has contributed to the eradication of smallpox, helped to immunise millions of children against preventable diseases such as tuberculosis and measles, and is supporting the near eradication of wild polio. Currently the WHO is responding to 55 graded emergencies around the world. Last year, it supported member states in response to 75 different health emergencies. More than 339 million people are now in need of direct humanitarian assistance, and in those countries affected by fragility and conflict we are seeing 80% of the world’s major epidemics.

The principles laid out in the zero draft text on pandemic preparedness are a strong foundation from which to begin to respond to some of those crises. The text on strengthening global health systems and universal health coverage, on international transparency and on the sharing of technology, diagnostics, vaccines and knowhow echoes what Opposition Members said consistently during the pandemic. It is through multilateral efforts, strengthened through international law, that we can ensure that the response to the next pandemic is faster and more effective, and does not leave other countries behind.

I know that the hon. Member for North West Leicestershire (Andrew Bridgen) has been calling for this debate for some time and that he has reservations. It is important that we have this debate and show that there is no shadowy conspiracy. I am afraid that the reality is much more mundane than that. I note his claims that a treaty will

“hand over…powers to an unelected…supranational body”,

even despite the fact that it would still have to be ratified by the United Kingdom and there is over a year of negotiations to go. I point out to him that the very first statement in the zero draft text reaffirms

“the principle of sovereignty of States Parties”.

Moreover, it states that the implementation of the regulations

“shall be with full respect for the dignity, human rights and fundamental freedoms of persons”.

Of course, the draft text makes no reference to vaccine mandates, lockdowns or any such draconian policies. If the hon. Gentleman reads it, he will see that the draft treaty is primarily about transparency, fostering international co-operation and strengthening global health systems, in recognition of the catastrophic impact of the pandemic on developing countries. It is on the face of the text.

[Sir Christopher Chope]

Has the hon. Lady taken the point that there is a difference between article 21 and article 19? Why is she supporting article 19 as the means of introducing this measure, rather than the more flexible article 21?

[Preet Kaur Gill]

I have set out the reasons why I support this, and I will continue to make that case so that the hon. Gentleman understands why Opposition Members support the treaty as it stands. There will, of course, be negotiations and, as I keep saying, we will have to ratify it in the United Kingdom. There is another year to go, so it is possible to contribute to and feed into the process. The hon. Gentleman should direct his comments to the Minister.

As I have said, the negotiations operate on the principle that nothing is agreed until everything is agreed. That is a really important principle to hold on to. In over a year’s time, there will be a two-thirds vote of WHO members and then, ultimately, it will be for us to ratify and enact those policies as we interpret them. It is really important that we recognise that.

Far from there being a conspiracy, this process is built on the very basis of international co-operation, which is essential for tackling transnational threats. As a country, we have a proud history of supporting the international system, using our influence and expertise to set common standards and bring parties together to achieve more than they can achieve alone. If we can use the WHO to support basic universal healthcare around the world, infectious diseases are less likely to spread and fuel global pandemics. Of course, that is in our national interest, too.

As I have said, pandemic preparedness is a matter of national security. Last year, in a debate on global vaccine access, I warned that striving for vaccine equity is not only a moral imperative but a matter of national interest. Yet those lessons have not yet been translated into action. Today, just 27% of people in low-income countries have received a first dose of a covid vaccine, demonstrating the terrible divide in coverage between richer countries and the global south. This Government have paid homage to the need to address that in words and announcements, but in truth their record has been dire. It includes a damaging departmental merger of the Department for International Development and the Foreign and Commonwealth Office at the height of the global crisis; repeated aid cuts to the very programmes designed to keep us and others safe; and consistently not keeping promises made to poorer countries.

Nobody expected the UK to retreat from the world stage at a time like that, or for it to vandalise its own relationships, expertise and capacity. The message it sent out to our partners and allies has been received loud and clear: they know who they can trust to show up in an international crisis and who they cannot. The irony is that those decisions harmed us as much as anyone. Vital research programmes to track new covid variants were slashed by 70%, pulling the plug on many programmes mid-project and causing years of research to go to waste. Programmes to treat tropical diseases were cut by a shocking 95%, leaving millions of people vulnerable and risking the wastage of over 270 million doses of life-saving drugs. The UK’s contribution to the Global Polio Eradication Initiative was cut by 95% for at least five years—last summer, polio resurfaced in the UK for the first time in 40 years.

Now, as our Government divert the development budget to prop up their failing asylum system, eight of South Sudan’s 10 state-run hospitals have lost their funding this month, putting them on the brink of collapse. Can the Minister explain what assessment she has made of the impact of that decision? Can she say when the refreshed global health framework will be published, and how it will draw lessons from the last three years?

The divide exposed by the pandemic was stark. At a time when millions in the global south were in greatest need, the international system failed them. The Government’s charity model of aid did not share vaccines equitably or effectively, leaving millions unprotected and the poorest countries paying the highest price. The UK’s own promises illustrate that point. At the G7 in 2021, the former Prime Minister, the right hon. Member for Uxbridge and South Ruislip (Boris Johnson), promised to donate 100 million surplus vaccine doses within a year. A year later, barely a third were delivered, the aid budget was raided to do it, and the UK effectively profiteered at poor countries’ expense.

Earlier this month, provisional spending figures for 2022 were revealed, and a further £225 million was charged against the aid budget for vaccines we had spare— effectively making a £330 million cut to the budget. Can the Minister provide a breakdown of the number of doses that were shared directly with developing countries, and through COVAX, by make and pricing, last year? How many doses were shared in total? What steps did she take to minimise the cost to the aid budget, bearing in mind that those surplus doses would have been incinerated if they were not used? How many vaccines were priced at the maximum possible of $6.66?

There is a different way—a way that does not merely give people crumbs from our table. Labour’s new model for development will be based not on charity, but on solidarity and long-term development planning. Our comprehensive plan to ramp up global vaccine manufacturing—set out in 2021—is the blueprint for the change we need to see. The pandemic revealed a fundamental problem: namely, that the world has more capability to invent and develop vaccines than it has to manufacture and distribute them on a global scale. While donating our surplus vaccine doses to poor countries was the right thing to do, in practice it has been slow, inefficient, and, in this Government’s case, used as a cover to make further stealth cuts to our aid budget at poor countries’ expense.

Developing countries should not have to wait for handouts at the back of the queue. The next Labour Government will strengthen global health systems, using the NHS as a model. We will help to establish an international mechanism to rapidly produce and distribute vaccines, to share technology, knowledge and skills, and to build the infrastructure the world needs to deliver it. We need a global effort to develop viable, orally active vaccines in solid dose form, building on the innovative work carried out by a number of pharmaceutical companies. That historic breakthrough would include the prospect of a vaccine delivery system that does not rely on needles and could lead to less need for trained vaccinators, increasing take up and negating cold chain storage, meaning fewer doses would expire before they could be used.

Finally, we need a binding, enforceable investment and trade agreement among all participating countries to govern the co-ordination of supplies and the financing of production, to prevent hoarding of materials and equipment, and to centrally manage the production and distribution process for maximum efficiency and output in the wake of a pandemic being declared. I am pleased to see that this draft treaty offers a strong starting point. Technology transfer and the open sharing of vaccines, science, technology and knowledge through the trade-related intellectual property rights waiver would help ensure everyone can access vaccines, diagnostics and therapeutics, and that no one is left behind.

I would be grateful if the Minister could set out the Government's approach to negotiations, particularly on the matters of intellectual property waivers, increased local production capacity and conditions on public funding for research. Future international initiatives need to be followed in letter and in spirit. Does the Minister recognise the importance of an accountability framework to ensure the accord’s success, and will she and her officials be pushing for that in talks? Separately, does she acknowledge the continued importance of action to address the debt crisis in low-income countries, which is clearly diverting resources away from public services and health systems? What does she see as the UK’s role in helping to unlock relief for countries in debt distress and bring creditors to the table?

Negotiating an effective international treaty on pandemic preparedness is an historic task, but, if we can achieve it, it will save hundreds of thousands of lives in the years to come, provide the foundation of a sustained global economic recovery and give us and our partners the freedom and confidence to plan for the future. Labour has a comprehensive plan to strengthen Britain’s health security, to end the 13 years of sticking-plaster politics under this Government and to return Britain to the international stage as a trusted development partner.