Global Health Agencies and Vaccine-Preventable Deaths

Virendra Sharma Excerpts

Thursday 9th May 2024 Westminster Hall

[Mr Virendra Sharma (Ealing, Southall) (Lab)]

I beg to move,

That this House has considered global health agencies and vaccine-preventable deaths.

It is a pleasure to serve under your chairmanship, Sir Gary. I thank the Backbench Business Committee for granting me time today to speak about the importance of vaccines and immunisation in tackling humanity’s greatest and deadliest diseases.

The discovery and development of vaccinations is one of the most significant and impactful achievements in human history. It was here in the UK that Edward Jenner first isolated cowpox to create the world’s first vaccine: the smallpox vaccine. Since that incredible scientific breakthrough, researchers across the world have worked on developing inoculating vaccines to combat all manner of infectious diseases, including polio, influenza, diphtheria, and of course tuberculosis. As the co-chair of the all-party parliamentary group on global tuberculosis, that cause is particularly close to my heart.

Vaccines are a vital part of our public health infrastructure. First and arguably most important, vaccines help to prevent the spread of diseases by supporting the body’s immune system to fight off infections. It is irrefutable that vaccines have a positive effect in reducing the incidence, spread and mortality of infectious diseases and that when a significant proportion of the population is vaccinated, herd immunity develops, which provides indirect protection for marginal and at-risk groups, including children, the elderly and those with pre-existing medical conditions. Vaccines not only help to eradicate disease, but significantly improve the quality of life of the population by protecting against further illnesses that can lead to long-term or chronic health problems.

History has shown us how effective vaccines are. Polio was one of the leading causes of death across the world in the 20th century. Since the global polio eradication initiative began in 1988, polio cases worldwide have decreased by a staggering 99%, and many countries, such as India, have been declared polio-free as a result of our efforts. That has been achieved only because of the ambitious vaccination programme. Measles used to kill approximately 2.5 million people each year, yet since the introduction of a vaccine, more than 23 million lives have been saved. More recently, the human papillomavirus vaccine, which is used to combat cervical cancer, has been shown to reduce incidence of cancer by 40%. The history of vaccination shows us all that vaccines work, they are safe, and they are the most effective way of preventing infectious diseases.

Last week, we celebrated World Immunisation Week. This annual event, led by the World Health Organisation, aims to mobilise the international community to overcome the barriers to vaccine coverage. I was pleased to join colleagues from across the House and across the global health landscape at last week’s brilliant event on World Immunisation Week, hosted by the APPG on vaccinations for all. At the reception we heard from representatives from Gavi, the Vaccine Alliance. Gavi is a multilateral health organisation founded in 2000 that vaccinates over 50% of the children on the planet against infectious and deadly diseases. Through numerous health emergencies, Gavi’s innovation has underpinned a track record of success. It is now supporting promising vaccine candidates for malaria, TB and HIV.

The UK Government have a strong record of supporting Gavi, both with research and development, and with the roll-out of new vaccines. Gavi’s work aligns closely with the Government’s priority to end the preventable deaths of mothers and children. As I am sure the Minister is aware, Gavi is currently beginning to plan for its next replenishment, where countries around the world will commit financial resources to support Gavi’s mission. I ask the Minister: how has the Foreign, Commonwealth and Development Office been engaging with Gavi in the lead-up to the replenishment, and can he give an assurance that the UK will remain one of the leading global supporters of Gavi’s mission?

Gavi is not the only development organisation that plays a leading role in vaccinating people in high-risk or conflict-affected areas. The Global Fund, established under a Labour Government in 2002, has a long and accomplished history of tackling the TB, malaria and HIV epidemics, helping to save nearly 60 million lives since its inception. The Global Fund is the world’s largest multilateral provider of grants for strengthening health systems, investing $1.5 billion a year from 2021 to 2023.

In many countries, the Global Fund works in partnership with Gavi to support the successful roll-out of immunisation across health systems. That is because we know that having strong, responsive and accountable local health systems is imperative to tackling novel and legacy infectious disease. Without a strong health system, cases of infection go unrecorded, symptoms go untreated, diseases spread and untimely deaths increase. I ask the Minister: what support the Government are giving to the Global Fund to support its mission of strengthening health systems around the world?

The success of the mRNA vaccine during the covid-19 pandemic has led to the development of a number of promising vaccine candidates that should start to be rolled out in the near future. One such vaccine is for malaria, which is one of the world’s deadliest diseases, killing a child almost every minute. In the last few years, the World Health Organisation has granted conditional approval to two malaria vaccines, with Cameroon being the first country in the world to receive them. I know that colleagues across the House will be fascinated to see the impact that the new malaria vaccine has. We all hope that the two new vaccines are a stepping stone to more innovative and effective tools and medicines that can be used to eradicate the disease for good.

We cannot, however, be complacent. Research shows that vaccines in isolation are not enough. Vaccine programmes must be accompanied by other effective public health measures, such as population screening, case finding, education programmes and robust health systems. Strong health systems are fundamental to a successful vaccine roll-out. Particular attention should be paid to healthcare worker training, supply chain management and facilities capable of delivering vaccines safely.

In addition, local manufacturing capabilities need to be strengthened so that vaccines can be produced anywhere in the world at a much quicker pace. We saw the limitations of a lack of local manufacturing during the covid-19 pandemic, when many countries in the global south were the last to receive covid vaccines, after many people in the global north had already received multiple jabs. The inequality in our vaccine manufacturing capabilities has cost lives before, and we must ensure it never happens again. Will the Minister say what the FCDO is doing to support countries around the world to develop their own vaccine manufacturing capabilities, so that they can respond more quickly to future global health emergencies?

I am thankful for the timely opportunity to raise this vital issue with the House. The UK has always played a leading role in the research, development and financing of vaccinations; it is a legacy of which we can be proud, but we must not rest on our laurels, as the last few years have shown us that global health emergencies can arise at any time, anywhere, with untold consequences. I hope the Government will continue to strongly support organisations such as Gavi and the Global Fund in their efforts to vaccinate and eradicate disease worldwide. I fully expect that when the Global Fund and Gavi host their respective replenishment conferences next year, the UK Government will generously pledge significant financial support to both. Perhaps the Minister can confirm today that this will be the case.

[Sir Gary Streeter (in the Chair)]

Before I turn to the SNP spokesman, can I check whether the Father of the House wishes to speak in the debate?

--- Later in debate ---

[Mr Sharma]

I am grateful for the opportunity to hold this debate, which has addressed many issues. I thank the Front Benchers for their support and their contributions. In particular, I thank the Father of the House for his presence and his intervention on the Minister.

I also thank the Minister for his response. This is a matter very close to both our hearts, and is very important to all those present and to people outside the Chamber. Thank you, Sir Gary, for the opportunity to serve under your chairmanship. I thank everybody present.

Question put and agreed to.

Resolved,

That this House has considered global health agencies and vaccine-preventable deaths.

Ceasefire in Gaza

Virendra Sharma Excerpts

Wednesday 21st February 2024 Commons Chamber

[Nadia Whittome (Nottingham East) (Lab)]

For 137 days, tens of thousands of innocent Palestinians have been killed. Entire families have been wiped out by intense bombing that has spared no one. Israeli forces have opened fire on unarmed civilians in hospitals, in queues for aid lorries and in fishing boats. They have killed children, such as six-year-old Hind Rajab—her desperate call to the Palestine Red Crescent Society, trapped in a car alongside the bodies of her dead family members, should haunt us all. The UN has expressed serious concern about the detention of women and girls, with credible reports of degrading treatment and sexual violence by Israeli soldiers. People have lost everything they own, from their homes to their most cherished belongings, and we have seen videos of Israeli soldiers stealing or destroying those people’s possessions, including the food they have had to leave behind.

Meanwhile, hundreds of thousands of displaced Palestinians face forced starvation. In one heartbreaking video, a girl begs her cat, “If we die, please don’t eat us.” This horrific situation is not some unfortunate accident. It could not be clearer that what Israel is doing in Gaza is immoral. It is wrong. And the International Court of Justice has ruled that it amounts to a plausible risk of genocide, yet Israeli leaders continue to defy the Court’s orders.

[Mr Virendra Sharma (Ealing, Southall) (Lab)]

Will my hon. Friend give way?

[Nadia Whittome]

I am afraid that I need to make progress.

If there is one moral principle that all of us in this House should share, it is that genocide should never be allowed to take place. The ICJ has said that, under article 1 of the genocide convention, states must

“employ all means reasonably available”

to prevent genocide, within the limits permitted by international law, so what are the means that our Government have? They surely include doing everything they can to bring about an immediate ceasefire, increasing humanitarian aid, and ending the arms sales and military training that are enabling Netanyahu’s hard-right Government to continue their atrocities, while continuing to call on Hamas to release all hostages.

For decades, the world has been far too indifferent to the plight of the Palestinians, who are subject to oppression and discrimination simply because they are Palestinian. Israel cannot continue to deny their right to self-determination. It must end its 67-year-long illegal occupation of the west bank and its brutal siege of Gaza. The UK Government must stop their selective empathy and help create a path to safety, security and freedom for both Palestinians and Israelis.

UN Sustainable Development Goals

Virendra Sharma Excerpts

Thursday 19th October 2023 Westminster Hall

[Mr Virendra Sharma (Ealing, Southall) (Lab)]

It is a great pleasure to speak under your chairship, Ms Bardell. I congratulate the right hon. Member for Chelmsford (Vicky Ford) on calling this debate, which is very close to my heart.

I cannot start today without mentioning the humanitarian crisis in Palestine. Civilians, old and young, men and women, sick and healthy, are in the firing line. There is no politics here: the killing of civilians is wrong. The scenes of grave destruction in Gaza are appalling and deeply troubling. There are reports that basic resources and services are being denied to civilians, half of whom are children, and that hundreds have been killed at the Al-Ahli Arab Hospital in Gaza. It is a tragedy, and the images are heartbreaking. There is no room for breaking international law, and civilian lives must be protected. Without an end to the conflict, the SDGs will never be realised in Gaza and Palestine, which have some of the most vulnerable people in the world. Unless the SDGs move everyone forward, they fail.

That message is one that we can apply in many more areas. Tuberculosis is an area of particular interest to me, and I should declare an interest as the chair of the all-party parliamentary group on global TB. The SDGs make it clear that TB should be eradicated by 2030, which is seven years from now, but we will not reach that goal without real change, real investment and a real will. In 2021, 10 million people fell ill with TB—a shocking 4% rise—and 1.6 million people died. This is not progress; it is relapse. TB diagnosis has fallen by 18%, from 7.1 million to 5.8 million, which means that fewer cases are being detected by health systems. Fewer people are getting the help they need and, as we move towards 2030, the goal gets further away. That is before we consider a particularly concerning issue that I have raised before: multidrug-resistant TB. It does not respond to typical therapies, and we are not prepared for it. Treatments and diagnoses have gone down this year, too. We are not fighting TB where we need to, and we do not have the momentum we need to fight it.

I thank the Minister and the Government for their role in the UN’s second high-level meeting on TB. Thanks to that meeting, we now have a political declaration. We now have specific, measurable and time-bound targets to find, diagnose and treat people with TB using the latest WHO-recommended tools. We now have time-bound, specific targets for funding the TB response with research and development. However, because this is a disease of the poor—a disease of poverty—engagement has been low. I ask the Minister how the FCDO will work alongside international partners and national Governments to generate momentum to achieve TB eradication by 2030. Will the R&D funding announced by the Government at the HLMs be used to support the development of new TB vaccines, diagnostics and medicines, and how can the UK utilise our world-leading life sciences sector to lead the world in the global response to the TB pandemic?

It is no cliché to say that the world changed when we eradicated smallpox. A disease that killed millions, scarred many more and blighted lives was ended. That same spirit can live on. Malaria claims 600,000 lives a year, and a child under five dies from malaria almost every minute. As with TB, eradication does not just save lives; it drives growth and equality, and allows the reprioritisation of vast sums of money. For households experiencing poverty, malaria costs can account for up to one third of their income. Think what they could do with that money.

Parents struck down by any of the neglected tropical diseases that we have committed to eradicate cannot work. In turn, that takes education and childhoods from the children forced into work, which can be tiring, exhausting and backbreaking, or even dangerous, degrading and illegal. Childhoods are ruined and more generations are inured to the cruellest of behaviours.

Although we as a world are on course to achieve 15% of the SDGs, a staggering 30% have stalled or are even going backwards. I hope that the Government do not lose focus on the SDGs, but I am sad to say that it seems an all too real possibility. This Government got rid of the Department for International Development. They cut international development spending when the world needed it most. In the face of the British people, this Tory Government decrees there is no need to worry about climate change, and that dealing with it can wait a few more years. That is just wrong.

Will the UK Government commit to a second voluntary national review to monitor progress on their implementation of the SDGs, and deliver on the commitments made in the 2019 VNR? Will they meaningfully engage civil society to deliver the 2030 agenda? I want to see the British Government and this country act because it is the right thing to do. It saves lives. This country will not forgive the Government that failed to prepare us for the next fight.

Ahmadi Muslims: Pakistan

Virendra Sharma Excerpts

Wednesday 6th September 2023 Westminster Hall

[Several hon. Members rose—]

[Mr Virendra Sharma (in the Chair)]

Order. I remind Members that they should bob if they wish to be called. If there are no Divisions, I intend to call the Front Benchers at 5.10 pm. I can see six Members. [Interruption.] Seven—sorry, Fiona. We have about 22 minutes, so I will fix a time limit of three minutes each.

--- Later in debate ---

[Alison Thewliss (Glasgow Central) (SNP)]

First, I pay tribute to the Ahmadiyya community in my Glasgow Central constituency. They have always been incredibly welcoming to me, my colleagues and their neighbours and friends in Yorkhill, where their mosque is located. I particularly thank Ahmed Owusu-Konadu for the work he does in the local community. They have regular fundraising events for many charities, including Glasgow Children’s Hospital Charity, which I know is greatly appreciated.

The more I have got to know the Ahmadi community over the years, the more I have heard about the pressure, danger and threats that they have been under. Members have already spoken of the persecution of Ahmadi Muslims and the fact that this has been going on for decades. Those practising their faith, particularly but sadly not exclusively in Pakistan, have been persecuted and discriminated against—in life and in death, in mosques, in their graves, in businesses and at observances of Eid. They have faced attacks simply for wanting to keep their faith.

What makes this all the worse is that it is endorsed by the Pakistani constitution. It has disturbing consequences for us here in the UK. In 2016, Asad Shah was murdered in the neighbouring constituency to mine—[Interruption.]

[Mr Virendra Sharma (in the Chair)]

Order. The sitting is suspended for 15 minutes.

--- Later in debate ---

[Mr Virendra Sharma (in the Chair)]

I call Elliot Colburn—30 seconds.

UN High-level Meetings in 2023

Virendra Sharma Excerpts

Tuesday 11th July 2023 Westminster Hall

[Mr Virendra Sharma (Ealing, Southall) (Lab)]

I beg to move,

That this House has considered UN high-level meetings in 2023.

It is an honour to serve under your chairmanship, Mr Twigg. Most of, if not all, the pressing global challenges we face today are not confined to a single continent or country. We have all seen that—including recently with covid-19—when global challenges arise, and the consequences of those challenges are felt more widely than ever before. To face the challenges effectively, we need to use key international forums to incite support among world leaders for solutions that can save millions of lives and improve the lives of billions more.

The UN is a testament to the power of collective global resolve and the only place where 192 countries come together daily to deliberate on pressing global issues. The General Assembly is the main policy making and representative body of the UN, and it regularly calls for high-level meetings on topics of global importance. In that context, we are here for today’s debate.

In September, the UN will host three HLMs on global health topics. The first, on Wednesday 20 September, is focused on pandemic preparedness and response, or PPR. This will be a topical discussion given the recent covid-19 pandemic. On Thursday 21 September, a meeting is being convened on universal health coverage, or UHC—the principle that all people should have access to the full range of quality health services they need, when and where they need them, without financial hardship. Finally, on Friday 22 September, the UN will discuss tuberculosis. As co-chair of the all-party parliamentary group on global tuberculosis, I am particularly interested in the outcome of the final meeting, but all three HLMs are incredibly important for advocates of global health.

The topics being discussed at the UN later this year are all multifactored, and an all-society approach involving more than just the health sector is needed to resolve the issues. The HLM is the mechanism through which to convene all sectors, under the leadership of Heads of Government, to agree a plan of action that all states can implement. Precisely because the meetings call on Heads of Government to engage, they are a powerful mechanism for change. The HLMs fall in the same week as the UN General Assembly, which means many Heads of State will be around the UN, and many will be attending those important meetings. I sincerely hope that the Prime Minister and the Foreign Secretary show that the UK is resolved to tackling PPR, UHC and TB by personally attending all three HLMS later this year. Can the Minister confirm whether they will attend?

Briefly, I will touch on the PPR and UHC meetings before turning to TB. The PPR meeting is a new HLM that aims to improve the governmental and multilateral capacities required successfully to identify and contain a new pandemic. Moving beyond the health sector, the HLM will look at financing, social protections, educational support, and research and development requirements to address future pandemics. The meeting is an important opportunity for member states to commit to the necessary fiscal and policy changes required to prevent a future pandemic.

The UHC meeting follows on from a meeting held in 2019. The 2023 meeting provides countries and stakeholders with the opportunity to reinvigorate progress towards delivering health for all. According to the latest global monitoring information, UHC progress is not on track, and the covid-19 pandemic has taken the world further from the 2019 targets. They include progressively covering 1 billion additional people under UHC with a view to covering all people by 2030. The HLM also sought to stop the rise of catastrophic out-of-pocket health expenditure, and eliminate impoverishment due to health-related expenses by 2030. Catastrophic costs are felt particularly acutely in the TB sector. Nearly 50% of people who receive a TB diagnosis will face catastrophic personal or household costs as a consequence. Concrete action is needed to strengthen equitable health systems, including public health functions that are critical for PPR and TB.

Finally, the UN is holding a follow-on HLM for TB, with the first being held in 2018. That was the first time that TB issues were discussed on such a significant international stage. The 2018 political declaration included a number of targets, which member states agreed to pursue: a commitment to provide treatment and diagnostics to 40 million people, including 350,000 children; a commitment to increase overall global investment in TB to $2 billion per year; and a commitment to end all stigma and forms of discrimination associated with TB.

[Sir George Howarth (Knowsley) (Lab)]

I congratulate my hon. Friend on securing this important debate. Does he agree with the director of Liverpool School of Tropical Medicine, Professor David Lalloo, who has said:

“As academics, public and global health experts and healthcare professionals, we see the close interrelationship between tuberculosis, pandemic preparedness and response, and universal health coverage”?

Does my hon. Friend also agree that this high-level talk is a good opportunity to take that agenda forward?

[Mr Sharma]

I thank my right hon. Friend for his important intervention. I agree and will cover those points later in my talk, but I want to put that aside for now. Yes, it is internationally known and accepted that this is an opportunity that every state should take on board.

Those ambitious targets were widely welcomed by civil society groups and TB stakeholders, but the impact of the covid pandemic significantly limited progress. Few of the TB targets were met, and the 2023 HLM is seen as a key opportunity to regain momentum towards eradicating TB by 2030, in line with sustainable development goal 3.3.2.

TB is one of humanity’s oldest diseases. It is caused by bacteria that most commonly impact lungs, but it can spread to other parts of the body. TB is spread from person to person through air droplets, with most TB infections showing no symptoms at all. In fact, 25% of the world’s population is estimated to have latent, or inactive, TB. TB becomes transmissible only when it is activated, which can be triggered by a range of health or social factors,

TB is a disease of poverty. It is more prevalent in poorer communities and can be linked to socioeconomic factors such as lower-quality housing, overcrowding and limited access to health services. TB is closely linked to other health issues, including malnutrition and HIV status. Even in high-income countries, TB is often found in migrant communities; people with alcohol, drug or mental health issues; homeless communities; or people with a history of prison.

What is most frustrating for people like me, who have been involved with TB for a long time, is that TB is both preventable and curable. Yet each year, more than 1.6 million people die from TB, including nearly 400,000 children. A lack of political will and inadequate funding continue to limit our ability to eradicate TB. All countries need to do more. There is only one existing TB vaccine. Although the BCG is effective against some serious forms of childhood TB, it provides little protection against the most infectious and deadly forms of adult TB.

There are several promising vaccine candidates in the pipeline. Six vaccine candidates are in phase 3 of the clinical development process—the final phase before the vaccine can be regulated for public use. In fact, just last month, Wellcome and the Bill and Melinda Gates Foundation announced funding to advance TB vaccine candidate M72 through a phase 3 clinical trial. M72 could become the first new vaccine to help prevent pulmonary TB, a form of active TB, in more than 100 years.

Promising vaccine candidates have emerged before and have fallen short, so we need to continue to finance and increase investment in TB research and development to find new vaccines. The Foreign, Commonwealth and Development Office has previously supported the development of new TB vaccines through product development partnerships. However, new PDP funding has been paused in recent years. Can the Minister provide the House with an update on when we might expect new or renewed PDP funding?

We also need more new treatments for TB. According to the Treatment Action Group, the UK met 96% of its fair share contribution towards TB research and development in 2021—about £30 million—with fair share measured as spending at least 0.1% of overall research and development expenditures on TB. That funding was used to support innovation at some of the UK’s most prestigious research institutions, including the London School of Hygiene and Tropical Medicine and the Liverpool School of Tropical Medicine. Although the UK might be stepping up to the challenge, it is clear that not all countries are paying their fair share. Will the Minister outline what more the FCDO can do to support UK research and development, especially in the context of TB, and encourage all countries to pay their fair share towards TB R&D?

One of the biggest concerns for TB stakeholders is antimicrobial resistance. TB is a complex bacteria and strains have become resistant to modern antibiotics. One third of all deaths due to complications from antimicrobial resistance in 2021 involved drug-resistant TB. We have some tools to tackle drug-resistant TB, but they are incredibly expensive and are not readily available to all who need them. Medicines such as bedaquiline have cut treatment times for drug-resistant TB in half, but even the UK is struggling to access them. What are the Government doing to increase access to bedaquiline in the UK and abroad?

People with TB also suffer high levels of stigma and discrimination. TB is often associated with factors that can themselves create stigma: HIV status, poverty, drug and alcohol misuse, homelessness, a history of prison, and refugee status. Fear of discrimination can mean that people with TB symptoms delay seeking help, making it more likely that they will become seriously ill. Stigma around TB can also make people reluctant to stick with their course of treatment for fear of being “found out”. By taking treatment irregularly, people risk developing drug resistance.

The TB community has not sufficiently contested the views that reinforce TB stigma. Such an approach has previously delivered positive outcomes in the context of HIV. Countries and donors need to implement locally managed, gender-responsive and well-financed TB programmes to help overcome the stigma and discrimination associated with TB infection, so can the Minister tell the House what the FCDO is doing to help eliminate the stigma and discrimination experienced by many TB-affected actors?

Although TB is getting its own high-level meeting in September, it also has implications for both pandemic preparedness and universal health coverage. Strengthening health systems to better detect and respond to respiratory infections is crucial to PPR, as experts agree that it is likely that the next pandemic will be respiratory in nature. TB programmes are well placed to help identify new respiratory pandemics, as they are already actively involved in the treatment, diagnostics and surveillance of respiratory diseases. The ability to respond effectively to new respiratory pathogens relies on strong infection prevention and control infrastructure, an experienced and well-compensated health workforce with expertise in managing complex respiratory infections, and access to the latest medical tools and equipment.

Much of the infrastructure needed to respond to the TB epidemic already exists. However, as we saw during the covid-19 pandemic, such programmes are quickly repurposed to respond to emerging pandemics, with significant negative impacts for people with a TB infection. More needs to be done to strengthen TB programmes, surveillance and diagnosis as the fundamental pillar of PPR. Does the Minister believe that greater investment in TB programmes, diagnosis and surveillance will help the world prepare for the next novel pandemic?

UN high-level meetings on global health matters used to be unheard of. The HIV/AIDS HLM in 2001 was the first ever global health-focused HLM. Another was not held until 2011, but this has changed over the last decade. There are now years when multiple global health issues are discussed simultaneously, as is the case this year. It is a direct response to the number of global health issues that have impacted on the world over the last 10 years. The UN recognises that a new approach is needed to help address the barriers holding back progress in global health. The upcoming high-level meetings are a perfect opportunity to reinvigorate momentum and encourage global action to face the challenges of the 21st century together.

--- Later in debate ---

[Mr Virendra Sharma]

I am thankful to everybody who contributed to this morning’s debate, which is very important not only here but also for what is going to happen in September. I am thankful to the Minister, too, although many questions need further clarification and I will certainly follow up later.

One thing everybody wanted to know is who will be going to the meetings. The Minister is not clear about that yet, but there are only two months left, and at that level diaries cannot be changed quickly. I hope we will find out who is going sooner rather than later, because that will give people like me and many non-governmental organisations an opportunity to approach or write to those individuals and find the best ways to represent our points of view.

My second disappointment is perhaps not appropriate, but I am a bit disappointed not to have had more contributions from Government Members this morning. I am not saying they are not interested, but that could have further strengthened the argument we are making.

I thank you, Mr Twigg, for your calm and patient approach to taking the debate through. Again, I thank all who contributed.

Question put and agreed to.

Resolved,

That this House has considered UN high-level meetings in 2023.

NATO Summit: Vilnius

Virendra Sharma Excerpts

Thursday 6th July 2023 Westminster Hall

[Several hon. Members rose—]

[Mr Virendra Sharma (in the Chair)]

Order. I will call the Front Benchers at 3.58 pm. There is no time limit at the moment, but Members should keep that in mind. I call Kevan Jones.

Pandemic Prevention, Preparedness and Response: International Agreement

Virendra Sharma Excerpts

Monday 17th April 2023 Westminster Hall

[Nick Fletcher]

I thank the hon. Gentleman and I will now come on to his point. Is holding a referendum the right tool for now? We had one in Scotland; this was widely accepted on all sides to be a once-in-a-generation referendum. Those who lost have ever since pushed for another referendum. The same happened over Brexit; it consumed the nation. Referendums are divisive; they polarise positions and leave a lasting legacy of division. Whether a referendum is appropriate is for the Government to decide, and if they think it is, they must make all the facts known. I suggest that petitioners, while playing their part in the education process, must do so in a sensible manner. I have no time for conspiracy theories.

There is a push for the WHO to gain policing powers over pandemic responses, and our Government need to seriously look into that, as at least 156,000 people are concerned enough to have signed the petition. They are not alone in their concern. As I have already stated, some countries have said that they will not sign the treaty. Are they right to do so? Whatever our politics may be, we should always be careful when handing over such powers to an organisation that can be influenced by nations other than ours. Questions about whose agenda the WHO takes will be asked, and it should be prepared with answers if they are to quell the concerns of many of the voices speaking on this subject.

In summary, the WHO does some wonderful work. Covid has proved what devastation a pandemic can bring. There will no doubt be another at some point, and we need that global perspective. We are a global community, therefore what happens here can soon have a bearing on a country across the globe. The petitioners are essentially asking whether an unelected organisation should have the power to sanction countries such as the UK if they do not wish to comply. Do we have no real choice but to comply, and should the UK sign up to this treaty without a referendum? I look forward to hearing the position of other Members and the Government.

[Mr Virendra Sharma (in the Chair)]

I remind Members that they should bob if they want to speak.

--- Later in debate ---

[Several hon. Members rose—]

[Mr Virendra Sharma (in the Chair)]

Order. Before I call the next Member, I will make two points. First, interventions should be brief. Secondly, those who wish to give a speech should refrain from making interventions and let other Members come in. Otherwise, we will run out of time. I call Danny Kruger.

Anti-social Behaviour Awareness Week

Virendra Sharma Excerpts

Wednesday 20th July 2022 Westminster Hall

[Mr Virendra Sharma (in the Chair)]

Before we start the debate, while the heat remains at this exceptional level, I am content for Members not to wear jackets or ties in Westminster Hall. Mr Speaker has announced similar arrangements for the Chamber. When the House returns in the autumn, Mr Speaker will expect Members to revert to wearing jackets, and strongly encourage male Members to wear ties, when speaking in the Chamber or Westminster Hall.

[Jacob Young (Redcar) (Con)]

I beg to move,

That this House has considered Anti-social Behaviour Awareness Week.

It is a pleasure to speak under your chairmanship, Mr Sharma. It is also my pleasure to host today’s debate on an issue that affects every part of our nation, and touches every Member of this House, as can be seen from the cross-party participation today.

Recent YouGov research commissioned by Resolve, an organisation that deals with antisocial behaviour, found that over half of people—56%—believe that

“more needs to be done”

to tackle antisocial behaviour in their community. It is a blight on our towns, cities and neighbourhoods. It causes terror, particularly for elderly and vulnerable residents, causes damage to our community facilities, undermining pride of place, and breeds a culture and perception of lawlessness, which ultimately ends in only one way.

This is my second ever Westminster Hall debate, and I picked this subject because antisocial behaviour is one of the most pressing issues in my inbox every week. I am grateful to Mr Speaker for granting the debate during Anti-social Behaviour Awareness Week. As my constituents can confirm, antisocial behaviour comes in many forms. One of the biggest problems that we face in Redcar and Cleveland is linked to off-road bikes. The motorcycles are often not roadworthy or registered, and the users are not wearing the protective gear necessary to prevent serious injury.

The problem is particularly prominent in the TS6 postcode area, around the High Farm Estate in Normanby and leading up to the Eston hills, where people on such bikes are destroying precious natural habitats on our hills. However, it is even more disturbing to learn from speaking to the children at Green Gates Primary School in Redcar that they see off-road motorbikes driving past at great speeds, often around school opening and closing times. We must also recognise the distraction that the sound of motorcycles can be for young people as they try to focus on their learning in school.

Another big issue often linked to the off-road bikes problem is the drugs trade and the ease with which criminals can avoid detection by using an off-road bike, as they know that, due to safety concerns, the police are unable to intervene and stop them. That laughable situation can see a yob on a bike mooning a police officer on the trunk road in Eston, and the police officer unable to do anything in that instant other than attempt to identify the individual.

World Tuberculosis Day

Virendra Sharma Excerpts

Thursday 24th March 2022 Westminster Hall

[Mr Virendra Sharma (Ealing, Southall) (Lab)]

I beg to move,

That this House has considered World TB Day 2022.

It is a pleasure to serve under your chairmanship—if I can use the term—again, Mrs Murray. I am delighted that we have been granted a debate for World Tuberculosis Day on World Tuberculosis Day itself. In that light, I declare my interest as chair of the all-party parliamentary group on global tuberculosis. I am gratified by the presence of Members who have chosen to join us to share their thoughts on this important day.

Before covid-19, TB held the dishonour of being the world’s deadliest infectious disease, with 10 million cases and 1.5 million deaths in 2020 alone. The situation has deteriorated further over the past two years, with the Stop TB Partnership suggesting that the fight to eradicate TB has been set back by more than 12 years. As we emerge from the covid pandemic, we should put the lessons learned over the past two years to work in order to finally eradicate TB.

TB is one of humanity’s oldest diseases. It is caused by bacteria and most often affects the lungs, but can also spread to other parts of the body. TB is spread from person to person through air droplets, and most people infected with TB show no symptoms at all. It is a disease of poverty, found in areas with low-quality housing, poor access to healthcare, overcrowded communities and high pollution. It does not just affect one part of the world or one group of people but can be found in virtually every corner of the planet. In higher-income countries, TB is more commonly found in migrant communities, among people with alcohol, drug or mental health issues, in homeless communities, or among people with a history of incarceration. Most TB cases in England are found in London and the south-east, and on the whole TB remains concentrated in urban areas. In any given year, London accounts for an average of 35% of TB cases in England.

One of the most frustrating aspects of the fight against TB is that we have medicines and vaccines that mean that TB is entirely preventable, and is for the most part curable. That said, many of the tools at our disposal are woefully out of date. For instance, the one TB vaccine that exists, the Bacillus Calmette–Guérin vaccine, celebrated its 100th anniversary last year. Decades of chronic under- funding for TB medicines and research and development mean that we do not have the most up-to-date tools and diagnostics that would enable us to deal more effectively with the threat of TB. That threat is compounded by the rise of drug-resistant and multi-drug-resistant TB—that is, strains of TB that cannot be treated using even the most potent TB drugs. Antimicrobial-resistant TB occurs when people do not take medicines correctly or break from their treatments early. Treating AMR TB is both incredibly complicated and very costly: according to the TB Alliance, someone with AMR TB will have to take as many as 14,000 pills over two years as part of their course of treatment. The O’Neill review found that by 2050 up to 10 million deaths might be associated with drug resistance each year. Around a quarter of these will come from drug-resistant strains of TB.

Domestically, the UK has a positive story to tell on TB. Between 1980 and 2012, the UK saw a near 2% increase in its TB burden year on year; since 2012, the UK has seen a 44% reduction in the number of people who test positive for TB each year, with 2020 seeing the lowest ever recorded incidence rate in England. It should be noted that 2020 was the first year of covid restrictions, which would have had a significant impact on the reduction in TB transmission that year.

TB is much more prevalent in people who are born outside the UK compared with those born in the UK. Between 2018 and 2020, 72.7% of confirmed cases were in people born outside the UK. The rate of TB is 15 times higher for people born outside the UK. These people do not come to the UK with TB, and there is considerable variation by country of birth in the median time between a person’s first entry into the UK and the time of their TB notification. The data suggests that people come to the UK free of TB, but due to poor living conditions and lack of support from the Government, they develop it over time. As I said, TB is a disease of poverty. In the UK, it is most common in more deprived communities and those with social risk factors. I ask the Minister: what more can the Government do to tackle the social determinants and key risk factors that increase the likelihood of someone contracting TB?

The APPG on global tuberculosis led calls for the Government to develop a domestic TB strategy. In 2019, we held an inquiry to examine the success of the Government’s approach. The collaborative TB strategy for England was widely praised by stakeholders for helping to reduce incidence in England by 29%. However, the APPG made a number of recommendations, including to strengthen awareness-raising activities for healthcare workers, secure more BCG vaccines and begin the development of a new strategy.

In 2021 the Government released their TB action plan for England, which outlined five priority areas for the Government, with the recovery from the covid pandemic the highest priority. As the strategy is in its early days, the APPG for global tuberculosis will continue to monitor its implementation and ambition to ensure that TB levels continue to drop in the UK.

Although the domestic situation is better, internationally we are miles behind where we need to be. In 1993, the World Health Organisation elevated TB to the level of “global emergency”, marking the first time that an infectious disease had been given that distinction. At the time, the WHO noted that TB kills more adults each year than any other infectious disease—more than AIDS, diarrhoea, malaria and other tropical diseases combined. Never in the history of medicine has one disease caused so many deaths yet remained so invisible. While the global outlook for TB has improved since 1993, many of the same underlying issues continue to affect the fight to eradicate it in 2022.

Even before the outbreak of covid-19, the international community was seriously off target to meet the goals set out at the 2018 United Nations high-level meeting or those set out in the sustainable development goals. SDG 3.3 calls for the international community to eradicate TB globally by 2030, yet at the current pace it will take more than a hundred years for that feat to be achieved. The WHO’s 2020 TB report—the last report before the covid-19 pandemic—highlighted just how far behind the international community was on its targets. For instance, the international community set the target of reducing TB incidence by 20%, between 2015 and 2020, but achieved only a 9% reduction during that period. There was a target to reduce the number of TB deaths by 35% during the same period, but we have seen only a 14% reduction. In the coming years, as the full impact of the covid pandemic is felt around the world, we expect the numbers to rise significantly.

Between 2019 and 2020, the number of people diagnosed with TB globally fell by 18%. Although that may seem like a positive development, we must approach it with caution. We know that the TB burden has not decreased, so a decrease in the number of positive tests suggests there are even more people with TB who do not know they have it. In the same period, the number of people treated for drug-resistant TB and TB-preventative treatments went down 15% and 21% respectively. The similarities between covid and TB meant that at the outset of the pandemic, many TB services were repurposed to deal with the emerging pandemic. Between June 2020 and August 2020, the Global Fund’s TB programmes experienced “very high” disruption as a consequence of covid. By May 2021, TB services delivered by the Global Fund were the most disrupted of the three diseases it works directly with.

The fight against global TB suffers from chronic underfunding. Between 2019 and 2020, global spending on TB diagnostics, treatments and prevention services fell by 5%. Even with that reduction, global spending on TB in 2019 was less than half of what was needed to make meaningful change in the fight to eradicate TB. The 2021 G-FINDER report showed that global investment in TB research and development totalled $684 million, down by $33 million—4.6%—from its record high in 2019. However, the Stop TB Partnership estimates that $2.16 billion is required annually to develop and deliver new tools, such as diagnostics, vaccines and medicines, that can end the TB epidemic.

The United Nations will host the next UN high-level meeting on TB in 2023. It is highly unlikely that between now and then, the international community will be able to meet the ambitious TB targets it has set itself. That meeting must serve as a rallying call for the world to act to eradicate TB before the end of the decade. To achieve this, we need more money for innovative TB vaccines, medicines and diagnostic tools. It is time for the international community to put its money where its mouth is in the fight to eradicate TB globally. I ask the Minister, in advance of the UN high-level meeting, what more can the UK Government do to regain momentum towards achieving the TB targets set out in the UNHLM and the SDGs?

The UK provides no bilateral official development assistance funding for TB. Instead, the Government work through multilaterals, such as the Global Fund to Fight AIDS, Tuberculosis and Malaria. Historically, the UK is the third largest sovereign donor to the Global Fund, providing over £1.4 billion to the fund since 2002. The Global Fund is the world’s largest financier of TB prevention, diagnostic and treatment programmes, accounting for 77% of all TB financing globally. The Global Fund invests more than $4 billion each year to support programmes run by local experts in more than 100 countries. By its own estimate, the work of that innovative multilateral has saved more than 44 million lives since 2002 and it has overseen a 46% reduction in the number of deaths from AIDS, TB and malaria in the countries in which it operates.

In September this year, the Global Fund will host its seventh replenishment conference in the United States. The final pledged amount at the conference will fund the Global Fund’s work over the next three years. It is vital that the Global Fund is generously replenished so that we can regain the ground and momentum lost in the previous two years. According to the Global Fund, the impact of the pandemic has led to a 33% increase in the global AIDS, TB and malaria burden.

In our report released earlier today, the APPG on global tuberculosis calls on the UK Government to increase our pledge in line with the increase in the global burden. The UK can and should play a leading role in the replenishment process by bringing together our friends and partners around the world to commit generously and showing that we remain a leader in the global health field. Will the Minister outline what more the UK Government can do to ensure that our allies and partners around the world contribute generously to the next replenishment of the Global Fund?

In November 2020, the Chancellor of the Exchequer announced that the Government would no longer spend the statutory 0.7% of gross national income on official development assistance. The decision amounted to a £4.5 billion reduction in the UK’s ODA budget, although the full impact of the cuts is yet to be recognised. I must declare my interest: I am also a member of the International Development Committee, so I am wearing the hats of two bodies.

In 2020, the APPG wrote to the then Foreign Secretary, the right hon. Member for Esher and Walton (Dominic Raab), highlighting that any cuts to the UK’s aid budget would have a significant impact on global health research, severely limiting international public-private partnerships that have been developing new and innovative medicines to tackle the world’s deadliest infectious diseases. Not only does the cut to the ODA budget threaten future research and development funding, but it jeopardises research capacity built up over a decade. The Government must commit to the restoration of the UK’s R&D funding on global health issues so that the UK can remain a leader in developing the tools that will bring an end to deadly epidemics.

The APPG on global TB’s most recent report called for the Government to commit at least 5% of ODA to research, and to ensure spending for TB research does not fall below the 0.1% of gross domestic expenditure on research and development between 2020 and 2025. Will the Government commit to restoring TB R&D funding so that the UK can remain a leader in developing the tools necessary to end the TB epidemic? In November 2021, the Chancellor of the Exchequer announced that the Government are to invest £20 billion in R&D funding by 2024-25. The Government should commit a sizeable portion of that funding to the development of new diagnostic tools and vaccines for the fight to eradicate global TB. How much of the £20 billion committed to R&D in the autumn spending review will be used to end TB epidemics?

In the last few days there have been concerning reports in The Daily Telegraph and Devex that the Foreign Secretary is planning to make substantial cuts to health, humanitarian aid and climate change ODA spending. I share the sentiments of the Chair of the International Development Committee, who called this potential move “illogical”. Does the Minister agree that if the UK is to remain a respected leader and a reliable partner in the global health community, the Foreign, Commonwealth and Development Office and the Foreign Secretary must not reduce their ODA health spending?

I want to briefly mention the situation in Ukraine and its implications for the fight against global TB. Ukraine has one of the highest drug-resistant TB burdens in the world, with nearly one third of all new TB infections there having some level of resistance. Some 22% of Ukrainians who contract TB also have an HIV co-infection, and TB is the leading cause of death among Ukrainians living with HIV. The Global Fund has been providing drug procurement facilities in Ukraine since the Russian invasion. It released $30 million in emergency funding, including $15 million to support the continuity of HIV and TB prevention, testing and treatment services in Ukraine. Peter Sands, executive director of the Global Fund, has said:

“We are extremely alarmed by the devastating effects on peoples’ lives in Ukraine. Ensuring patients affected by the conflict can continue to access prevention and treatment services is our immediate priority.”

The UK has played a leading international role throughout the Russian invasion of Ukraine. What additional humanitarian support can the UK offer Ukraine to ensure that the war does not lead to a significant rise in TB or HIV in the country?

TB remains a global killer, but it is almost unrecognised, except where it blights lives. In my years of political activism, I have seen Governments commit multiple times to ending TB. I have heard warm words of concern, but they fall by the wayside as Ministers change—I hope that will not happen here—and new fashions rise and fall. I hope we can finally be the Parliament that gets a grip on global TB and acts for the good of all.

--- Later in debate ---

[Mr Sharma]

I thank hon. Members, but I am a bit disappointed that not many joined us for such an important debate. As a Member, I can understand that people’s priorities are different on a Thursday afternoon and when there is a one-line Whip in place. However, I am grateful to the hon. Member for Strangford (Jim Shannon) for joining us, and I thank my hon. Friend the Member for West Ham (Ms Brown) for contributing on behalf of the Opposition. I am pleased to hear a conciliatory tone from the Minister—given the sensitivity of the issue, sometimes misunderstandings can arise.

From the APPG’s point of view and my personal point of view, we are here to work together and support the Minister and the Government to ensure that we achieve our goals, so the most important thing is understanding how we can best work together. I am glad that the Minister pointed to that partnership role in her contribution. I am also grateful for her announcement of £6 million for TB REACH, and I am sure that more will come in the future.

I will not repeat what I have already said. As no solution can be found overnight, it will be a long struggle. I have been in a TB campaigning role for more than 25 years. Before I joined Parliament, I was a local councillor and involved in TB activism, and I look forward to working with the Minister and the Government —not only so we can eradicate TB in Britain, but so we can be the best partners in eradicating TB globally.

Thank you, Mrs Murray, for the way you have chaired the debate; although you have not been under a lot of pressure, I thank you for giving me the longest time to contribute.

Question put and agreed to.

Resolved,

That this House has considered World TB Day 2022.

UK-Taiwan Friendship and Co-operation

Virendra Sharma Excerpts

Thursday 10th February 2022 Commons Chamber

[Mr Virendra Sharma (Ealing, Southall) (Lab)]

I congratulate the hon. Member for Rutland and Melton (Alicia Kearns) on leading this important debate. I must declare an interest, having been a guest of Taipei in the past. I welcome the ambassador and his team to the House this afternoon.

This month, we have been reminded more than ever of the importance of allies around the world, and of friendship with nations that are at risk from bullying neighbours. Taiwan is a liberal democracy. It has free and fair elections and a free press. Indeed, it outperforms the UK in international democracy rankings. Those are principles and a record worth defending. Just as we all look on cautiously at what is happening in Ukraine, the future of Taiwan, too, could change the world. It is in no one’s interest to see conflict, but, as we saw in Syria with President Obama’s red lines, a commitment to act that is not backed by action is a free pass for enemies of peace. President Biden and other Pacific allies understand the importance of Taiwan. The new-found focus on the Pacific will bear fruit. Stability, democracy and freedom are valuable and right. They are our own aims and values, and they should be recognised as such.

That is surely part of the reason why relations between Taiwan and the UK continue to improve. Nine out of 10 UK companies feel positive or very positive about their business outlook in Taiwan—an all-time high. Trade is booming, investment grows and British whisky is used to toast that success. Taiwan is a critical partner for the UK. As a world leader in high-tech manufacturing, Taiwan accounts for one fifth of global chip manufacturing and, it is estimated, half of all cutting-edge capacity. Any risk to that is a serious threat to the UK, and it would put the entire global supply chain at risk. The impact does not bear thinking about.

Taiwan is currently excluded from regional co-operation and trade bodies. While we may have chosen to exclude ourselves from our neighbours, Taiwan wants to make no such mistake. I hope the UK will continue to support Taiwan’s continued attempts at international participation. I urge partners around the world, including the World Health Organisation and the International Civil Aviation Organisation, to co-operate with Taiwan. Taiwan has much to offer us in knowledge and expertise, and we should not allow it to be stifled.

The United States remains unparalleled in its importance, guaranteeing Taiwanese independence, and we must stand shoulder to shoulder against intimidation. I look forward to continued ministerial engagement with Taiwan, and to us being able to learn as much as possible from Taiwan’s sizeable healthcare experience. I urge the Government to afford the Taipei representative office in the UK some form of legal status and to ease existing restrictions on high-level Taiwanese officials travelling to the UK.