Universal Health Coverage

Stephen Twigg Excerpts

Wednesday 10th July 2019 Westminster Hall

[Stephen Twigg (Liverpool, West Derby) (Lab/Co-op)]

It is a pleasure to serve under your chairmanship, Mr Robertson. I draw your attention to a relevant entry in the register—I visited Liberia in 2017 with the fantastic organisation, RESULTS UK, to look at Liberia’s efforts to rebuild a public health system after the Ebola crisis. I congratulate the right hon. Member for North East Bedfordshire (Alistair Burt) on securing the debate and on his fantastic work as a Minister, and the passion and commitment that he has demonstrated once again today.

As the right hon. Gentleman said, the third of the sustainable development goals commits the world to achieving universal health coverage for all by 2030. It seeks to ensure access to a full range of essential health services based on need, not on the ability to pay. Before I became Chair of the Select Committee on International Development, in 2014 the Committee published a report, “Strengthening Health Systems in Developing Countries”, which concluded that universal health coverage cannot be achieved without properly functioning health systems. At that time—five years ago—the Committee urged the Department for International Development to grasp the opportunity and demonstrate genuine global leadership worthy of its health systems expertise.

In recent years, we have seen some serious progress, and it is worth reminding ourselves of the progress that the world has made. For example, incidences of malaria and the number of new cases of HIV have each fallen by around a third since the turn of the century and the adoption of the millennium development goals. The global child mortality rate has been cut in half since 1990. Nevertheless, half of the world’s population lacks access to essential healthcare services and, every year, around100 million people are pushed into extreme poverty because of the cost of healthcare.

Let me say a few words about Ebola. In 2014, we saw the deadliest outbreak of Ebola in history—the first to hit epidemic levels. Three years ago, the Committee published an inquiry report on that. We said that a major factor in the Ebola outbreak reaching an unprecedented scale was the weak state of health systems in the affected countries. It is extremely concerning to see what is happening in eastern DRC at the moment, where there have been more than 2,400 Ebola cases. The International Development Secretary, on a visit to the Democratic Republic of the Congo this weekend, called for the World Health Organisation to declare the outbreak an emergency. It is crucial that the international system redoubles its efforts in response to the emergency. Health-system strengthening must surely form a core part of recovery efforts in the DRC. DFID has an opportunity to play a leading role in supporting that work.

As the right hon. Gentleman said, we are at a critical moment with this September’s high-level meeting. Here in the UK, we have the finest system of universal health coverage anywhere in the world, with our national health service. That gives us the expertise, knowledge and capacity to make a lasting impact on the global debate and to be a powerful voice in it. I support what the right hon. Gentleman said about high-level UK representation at September’s meeting, and on supporting other countries to increase domestic resource mobilisation, ideally to see their health spending rising to 5% of gross national income. We can share policy expertise from our NHS to support other countries to increase their own domestic investment in health.

The coming year provides an unparalleled set of opportunities, with the various replenishments to which the right hon. Gentleman referred. I look forward to the Minister appearing before the International Development Committee this afternoon, as we will have an opportunity to address some of the issues in more detail. I hugely welcome the £1.4 billion pledged by the Government to the Global Fund. It is genuinely excellent news that that commitment has been made and that it has been made early. That has lessons for replenishments in other areas, such as education, but that is for another day.

Let me endorse what the right hon. Gentleman said about Gavi. The United Kingdom hosts the replenishment of Gavi next year. The Mayor of Liverpool, Joe Anderson, and I have written to the Prime Minister, bidding for Liverpool to host Gavi’s replenishment, not least because of the presence of the School of Tropical Medicine in our city. Let me also support what the right hon. Gentleman said about polio—I welcome his focus on that. As he said, we have seen remarkable progress since the establishment of the Global Polio Eradication Initiative, with a 99% reduction in incidents since 1988, but it is still endemic in Nigeria, Afghanistan and Pakistan. The Global Polio Eradication Initiative strategy states:

“Full implementation and financing of the GPEI Polio Endgame Strategy 2019-2023 will result in a world where no child will ever again be paralysed by any poliovirus anywhere”.

We are close to a world free of polio, but this will require one last push to end polio once and for all. I pay tribute to the groups that have come together to form the One Last Push campaign. It was a pleasure to join them at a fantastic event in Birmingham in April, which was also attended by my hon. Friend the Member for Birmingham, Yardley (Jess Phillips). We heard from campaigners from a range of non-governmental organisations, as well as British people living with polio. I learned a lot about some of the challenges facing British people living with polio in this country, and about the challenge of one last push to end polio globally.

The polio initiative is vaccinating the hardest-to-reach children. Our country can be proud that we have provided £1.3 billion to GPEI since its creation. I hope we will be able to show commitment once again to a polio-free world—we have done so with the Global Fund—with a generous financial pledge ahead of the GPEI’s upcoming replenishment in November.

Let me finish by echoing strongly what the right hon. Gentleman said about the importance of multilateralism and our standing up for values. I will perhaps be a bit more explicit than he was. The Trump Administration are clearly standing in the way of many of the things that he talked about—not least on sexual and reproductive health. Those global health multilaterals have consistently been shown to deliver high-quality, effective channels for UK aid. The Department’s multilateral development review three years ago demonstrated that once again. Those multilaterals have at their heart the Department’s strategic objectives of reducing poverty and promoting global prosperity. That makes moral sense, which we rightly focus on, and it also makes economic sense. For every dollar invested in immunisation, it is calculated that around $16 is returned directly in reductions in healthcare costs, avoiding lost wages and lost productivity due to illness and death.

Over the next two years, let us grasp these key opportunities to make progress on health outcomes and work together towards the goal of achieving universal health coverage for all. The UK has been central to this endeavour over the past two decades, and I hope very much that we can continue to lead efforts to achieve a world where everyone can get access to healthcare based on their needs, not on their ability to pay.