World Immunisation Week

Debate between Thangam Debbonaire and Alistair Burt

Thursday 2nd May 2019 Commons Chamber

[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.

[Alistair Burt]

We cannot mention AMR in this House without mentioning Dame Sally Davies, who has done such a fantastic job. If my memory serves me right, she is standing down relatively soon as chief medical officer, but she has made a fantastic contribution, particularly in relation to AMR. She absolutely deserves that we carry on this fight when she moves on to a different role.

[Thangam Debbonaire]

The right hon. Gentleman is absolutely right. I join him in that tribute. I also pay tribute to all the scientists across the world who are helping not only to understand and promote information about AMR, but to help us rethink our relationship with antibiotics. They are also helping us to understand the need to respect antibiotics, but also to respect disease prevention, rather than having a reliance on antibiotics.

Again, I urge all parents to check their children’s records and get them vaccinated if they have not already done so. I also urge all adults to remember to do so themselves when they visit other countries; and I include myself in that. I applaud DFID, the World Health Organisation, the Bill and Melinda Gates Foundation and others for the work they do, and particularly the support of Gavi, the Vaccine Alliance. I urge the Department of Health and Social Care—this is a slight, but brief, sidebar—to accelerate the expansion of the human papilloma virus vaccination to include boys. I know that that is in train, but I would just like it to hurry up, please.

I urge social media companies and internet providers across the world to work with health services and Governments across the world on not only tackling the misuse of the internet for promoting incorrect information but highlighting the value of the internet and social media in promoting good-quality information and messaging. There are social media companies and internet providers who want to be seen as a force for good, and this is a really good way that they could contribute to that. In particular, I would like DCMS to work with the Department of Health and Social Care and with DFID on tackling those harms. This should be a cross-departmental initiative.

I join others in wishing the new Secretary of State, who is no longer in his place, well in the mission that he described earlier. He is another Minister, and now a Secretary of State, who is well respected across the House. He brings an enormous amount of knowledge and experience of a range of world contacts to this post, and that can only be a good thing. I would like him to bring that experience to this issue with razor-like precision.

I would really like us to get back to respecting experts. That does not mean doffing the cap, or never arguing or asking questions. It does not mean just saying, “Doctor knows best”—if the hon. Member for Central Ayrshire will forgive me—but saying, “Doctor probably does know best.” In my experience, the hon. Lady generally does know best, and I probably do always say that she is right. I would like us to respect experts because they are experts and, when we ask them questions, to remember that they probably do know quite a lot, but, in return, as she said, for them to listen to us and to remember that our reasonable questions have to be heard if we are going to make progress together. I would like us to respect medical science. I would like us to respect researchers and respect research—and to invest in it. In this country, we do well at that. We are an internationally respected country for knowledge creation. I would like us to continue that tradition and to challenge anybody, anywhere, who says stuff about experts in a way that is not just unhelpful but, in this context, life threatening.

I thank all right hon. and hon. Members for this debate, because it is a really good example of how a small number of people in the right room at the right time can produce a consensus on something where our country can help to show the world leadership and contribute to saving millions of lives.

Syria

Debate between Thangam Debbonaire and Alistair Burt

Monday 11th March 2019 Commons Chamber

[Alistair Burt]

My hon. Friend asks a good question. Iran will say that its support for the Syrian regime was designed to stop extremist forces taking over Damascus at a crucial stage of the civil war. On the other hand, there is no doubt that support by Iran for the regime has also contributed to a civil war being waged against the Syrian people and has involved support for various atrocities carried out by the Syrian regime.

There is no doubt that Iran’s presence in Syria is a cause of great concern, not least to Israel, with the stationing of sophisticated weaponry in southern Syria that does not appear to be directed at Daesh or anyone else. Iran will have some questions to answer about how it sees its presence in the future of Syria. What we want to see is an independent Syria, free of foreign constraints upon it, but no longer a regime that wages war on its people. Those who have been its partners will need to answer for the part they have played in the past, and it remains open whether they can play any constructive role in the future.

[Thangam Debbonaire (Bristol West) (Lab)]

I thank the Minister for his very thorough and thoughtful approach, as always, to this region and its problems. He says that 50% of United Nations requests to deliver aid are rejected or ignored by the Syrian regime, so I would like to ask him how he thinks we are ever going to be able to trust this regime’s assessment of when it will be safe for refugees to return, what measures and methods of assessment we are going to apply to evaluate when and to what extent it is safe, and whether he can tell us anything about what work is planned to rebuild the capacity of civil society to ease that transition. If he is able to say anything about that, I would be grateful.

[Alistair Burt]

I am grateful to the hon. Lady for her question, and I thank her for her kind comments. Essentially, it is a UN assessment. The UNHCR and UN agencies are the bodies most likely to give their assessment of when areas of Syria have become safe for return in every sense of the word—not only an end to physical conflict there, but the circumstances being right for people to return—and we support the UN agencies in doing that.

The most likely difficulty will be differences of opinion. For example, it is clear at the moment that it is the practice for some in Lebanon to return to Syria at the weekend or from time to time. Those who fled earlier go back to certain areas, and the Lebanese Government draw attention to that and say that people would not be going back if they did not feel safe to do so. None the less, that is not a definition of safety per se.

I think the honest thing to say is that there is real pressure, rightly so, from host nations that are worried about the burden they are bearing. The first thing we can do is to make sure we continue to support them and that we do not, just because of the passage of time, neglect their needs. Secondly, we should make it clear that we do wish for and support the return of refugees. However, the international community must continue to say that that can only be when the conditions are right for safe and dignified return, and at this stage the facilitation and promotion of returns does not meet that test.

Oral Answers to Questions

Debate between Thangam Debbonaire and Alistair Burt

Wednesday 21st November 2018 Commons Chamber

[Thangam Debbonaire (Bristol West) (Lab)]

T3. In the light of yesterday’s horrifying revelations of children being beaten, tortured and starved in Libyan detention centres to which they have been returned after trying to cross the Mediterranean, will the Government increase the number of safe and legal routes to sanctuary using refugee resettlement?

[Alistair Burt]

The situation in Libya remains extremely difficult. These abuses that come to light remind us all that Libya cannot be forgotten and that the efforts to reduce conflict and create peace must continue, as happened in Palermo last week. We are spending £75 million on safer migration routes to help tackle some of these crises, and we continue to do all we can to get people out of the difficult areas, but it requires international co-operation.

Oral Answers to Questions

Debate between Thangam Debbonaire and Alistair Burt

Tuesday 30th October 2018 Commons Chamber

[Alistair Burt]

I should like to start by thanking Staffan de Matura for all the work he has put in. As the House will know, the United Nations special envoy will be standing down in November. He has devoted the past few years of his work to trying to achieve a settlement and agreement in Syria that will indeed enhance the rights of civilians. At present, he is still working on the details of the constitutional settlement. It will involve a constitutional committee, for which he has put forward various names. There is an impasse on that at the moment, but his work, and the work of the Syrian high negotiating committee, to ensure that civilians have a recognised role in the future of Syria remain a key part of the United Kingdom’s contribution to these discussions.

[Thangam Debbonaire (Bristol West) (Lab)]

I am grateful to the Minister for that response, but could he take this a little bit further and tell us what conversations he is having with his counterparts in other countries to ensure that civil society and civilians are at the heart of the post-conflict resolution and the peace and reconciliation that are so needed?

[Alistair Burt]

That is a good question. We as a Government are engaged in regular consultations with states that have an interest in supporting the UN process. Essentially, this is a UN process, supported by the UN Security Council, to ensure a settlement that involves civil society. All the evidence suggests that conflict will reoccur unless women, civil society and others are involved in the resolution of that conflict. The United Kingdom takes this issue forward very carefully.

Idlib

Debate between Thangam Debbonaire and Alistair Burt

Monday 10th September 2018 Commons Chamber

[Alistair Burt]

A joint statement issued by the United States, France and the United Kingdom made it clear that we will respond appropriately to any chemical weapons attack. Nobody wants to do that, and the warning was intended to prevent it, rather than to give an indication of response.

[Thangam Debbonaire (Bristol West) (Lab)]

I echo the comments of my hon. Friend the Member for Ilford South (Mike Gapes) on the Foreign Affairs Committee’s report. I hope that, at some point soon, we can try to find a way out of this political and intellectual cul-de-sac whereby intervention seems to be seen as, de facto, the bad response and non-intervention as, de facto, the peaceful response. Let us look at the lessons we have to learn from Syria.

I have a specific question for the Minister. Will he update us on the possibility of safe exit and assessment points on the border with Turkey and on assistance with triaging people who have to flee so that we can provide more resettlement, possibly in this country?

[Alistair Burt]

As I indicated earlier, we are working very closely with Turkey on what the responses would be if a large number of people were to move. Preparations are already in place for the provision of support in safe areas on the Syrian side of the border. Turkey is cautious about a large number of people coming across the border, and we have offered assistance in relation to that. All this is currently being worked out to try to find the best ways in which humanitarian access can be safeguarded and to find how people can be protected. That work is ongoing, and I commit to updating the House whenever anything new is available.