World Immunisation Week
Debate between Rory Stewart and Philippa Whitford(5 years, 6 months ago)
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Rory Stewart
Absolutely. It is grossly irresponsible and, I am afraid, profoundly and disturbingly misleading, and even ignorant, to go around doing that. It ends up stoking public paranoia and fear, and leads to the unnecessary loss of life. From the beginning, the story of immunisation—and, indeed, the story of international development—has often been about challenging public perceptions and irrational fears, and following through. There are reasons for that. The heart of what immunisation is carries within it the seeds of that challenge. The basic idea of immunisation is, of course, to make somebody sick to make them better. From the very beginning, that has involved not only challenging public fears, but something that Governments find quite difficult: taking risks and working, genuinely and collaboratively, internationally.
Although we tend to pat ourselves on the back a great deal in this country, immunisation was, of course, not a European discovery at all. It was a Chinese discovery of the early 16th century. Chinese public health officials, or their 16th century equivalents, went into villages and sneezed into people’s mouths, which rapidly reduced the mortality rate by tenfold or twentyfold. The normal mortality rate for smallpox was 20% to 30%, but remember that that reduced mortality rate under the new technique was still between 0.5% and 2%, so the procedure was very risky. Moving on with my international point, this immunisation practice arrived in Britain in about 1700.
Dr Whitford
I, too, welcome the Secretary of State and congratulate him on his new post. It was actually a bit more dramatic than that: variolation involved cutting into veins and putting in smallpox scabs. That did indeed make people ill, and then they were immune. However, modern vaccines do not do that—they are no longer based on making someone ill. There is a fallacy that the flu vaccine will give people flu, but it does not. Modern vaccination is no longer based on giving someone an illness to protect them from worse.
Rory Stewart
Moving rapidly forward, the key to this is scientific advances whereby things become safer all the time. Immunisation moved from China to Britain, and in 1799 in Britain, there was the development of vaccination—in other words, the use of cows to do this. There were then the developments of Louis Pasteur in the 1880s in France, and then of course the amazing developments in the post-war period.
Throughout all that, we see something that really matters for the Department for International Development, a Department that co-operates with other countries and puts science at its heart. This story, which in its early history links China to Britain, Britain to France and France to the United States, continues today with Gavi, the global alliance. In all this work, the same themes occur at an accelerated rate. We have, remarkably, achieved the eradication of smallpox, and we are close to a 99% success rate on wild polio. But it is on Ebola that we see most clearly today the security risks, the scientific advances, the complexity and the international co-operation.
In 2015-16, DFID, working with other international partners, began to develop—initially in Guinea, and then, through academic partnerships, in the United States and Canada—the first attempts at inoculation against Ebola. Ebola, like all such diseases, finds no borders, and that has a direct connection with justifying the international aid budget here in the United Kingdom. Perhaps the easiest way of explaining to people why we have an international development budget is to point out that had that disease taken off in Liberia and Sierra Leone, given modern transport mechanisms it would have found its way rapidly to Europe and ultimately to the United Kingdom, and people would have been dying here.
That investment, which seems quite complex, and which often—particularly in the case of diseases such as wild polio—involves spending a surprising amount of money on tracking down the last few cases, is the kind of investment that only a Government can make and only an international aid budget can provide. Why? Because this is not a normal economic case. If an individual were asked whether they wanted to spend a lot of money on inoculating themselves, they might say no, and on the basis of a traditional cost-benefit analysis, one might ask, in relation to that individual, “Why are you spending so much money?” The point is, however, that that individual is part of a community, and that community is part of a broader nation. If the disease takes off, it will begin to infect hundreds of millions of people. At that stage, significant investment in preventing someone from getting polio, for example in rural Afghanistan or Pakistan—there can be quite surprising investments, ending up with the spending of hundreds of thousands of dollars on tracking down the last few cases—is critical if it actually prevents millions of people from getting the disease.
The same applies to Ebola. The issue raised by the hon. Member for Rhondda (Chris Bryant) about how we deal with fears is central to the tragic death of a very courageous doctor, who was killed when bringing a vaccine and treatment to people in the eastern part of the Democratic Republic of the Congo. He originally came from Cameroon. Part of the same story is the killing of public health nurses on the Afghanistan-Pakistan border when they were trying to inoculate people against polio.
In the solution to this, then, is human courage, and in the driver of this is human suffering, but in the broader story are things that we have to communicate. Pharmaceutical companies, which we are often nervous about, can play an incredibly positive role if properly harnessed. Merck, which is developing some of this vaccination, has a structured contract with Gavi to deliver 350,000 vaccinations, on hold, at any one time. We have reduced the price of vital drugs from $4 to $2, which means that we have access to twice as many people. We have worked out how to use the fact that Britain is the global leader in Gavi. Britain puts in 25% of the funds for this extraordinary global programme of vaccination. The second biggest contributor is the Bill and Melinda Gates Foundation, and the third biggest is the Government of the United States.[Official Report, 7 May 2019, Vol. 659, c. 6MC.] All that makes our money go much further, and tied into it are the World Health Organisation and some of the best universities and researchers in the world.
In telling the story of immunisation, we are telling the story of international development, and in telling the story of international development, we are telling the story of international co-operation: the fact that researchers from China and Europe can come together; the fact that brave health workers on the ground in eastern DRC risk their lives delivering vaccines; and the fact that a single child in eastern DRC who was saved from death, with their family saved from the horror that they would have experienced, can be traced back to money spent by British taxpayers, alongside people from other countries. It has meant bringing in the private sector, the best academics in the world and, above all, brutal, bruising practicality: how do we make sure that the refrigeration is right in eastern DRC so that the vaccines survive in transport; how do we get the electricity to ensure that the vaccination works; how do we deal with communities, politics and conflict to get to the front line; and how do we understand the political and economic structures on the ground so that we can make sure that the local mullah or village chief in Afghanistan will not block the arrival of the polio vaccine in that community?
Get all those things right and we protect Britain from dying from Ebola. Get all those things right in the world of climate change and we can potentially save the planet. Get all those things right and we can show how our international aid budget can touch everyone in this country, re-energise a younger generation, and prove that if we can sometimes do less than we hope, we can do much more than we fear.
Joint HMI Prison and Probation Report
Debate between Rory Stewart and Philippa Whitford(5 years, 10 months ago)
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Rory Stewart
Resolving that problem is partly about resources. We need to make sure not just that we are putting in the 9.7% extra funding but that we are able to recruit the additional staff to reduce the caseload. It is partly about processes and management systems in order to make sure that we really record any contact with offenders. It is also absolutely about picking up on any issues where our national policy is not being followed at a local level.
Dr Philippa Whitford (Central Ayrshire) (SNP)
Over the past two years in Scotland, we have had the lowest recorded crime for almost 45 years. In particular, violent crime has been halved in the past 10 years because of the work of the violence reduction unit. However, exactly as across the rest of the UK, we have seen an increase in sexual offences. As the Minister said, this has been for different reasons. Some of it is about exposure to pornography and some of it is about new crimes—digital crimes—but, in particular, it is about victims coming forward, which everyone should welcome. We now have the challenge of reducing the re-traumatisation they often face in the criminal justice system.
The report highlights that the national probation service is managing over 100,000 offenders, one in five of whom need supervision. The treatment programme that was being used failed: it increased reoffending and has had to be changed. How will the Minister ensure that there are sufficient staff and that they have training in the new programmes and, particularly, support, because they are often dealing with very harrowing cases that can take a toll on them? How will he improve integration—in the courses, the approach, and the IT— between custody and community? How will he ensure that the MAPPA—multi-agency public protection arrangements—level that offenders are given is consistent across England? How will he provide monitored accommodation where required?
Two years ago, Scotland got the power to introduce sexual harm protection orders and sexual risk orders, but amendment is required so that they can be recognised across the UK. We cannot have it that people can offend and move. I know that the Minister recognises that and that our Cabinet Secretary has written again this week. When will this be changed so that we can take forward these protection orders in Scotland?
Rory Stewart
To take the hon. Lady’s last point first, we will look very closely at that. I am very happy to have a meeting with her as soon as possible in order to do so.
The hon. Lady raised some very serious points, and I agree with all of them. We already have in place a lot of procedures to ensure that staff dealing with traumatic cases are given proper breaks and proper support. However, there are ongoing challenges, particularly around IT, data management and information-sharing between different databases that we are trying to address by making the tools simpler and by making sure that the databases speak to each other properly.
The hon. Lady’s questions about MAPPA and accommodation are absolutely on the nail. Because of the limited time, it is difficult to go through all the policy areas in detail, but she made five very strong points, and I thank her.