Gavi and the Global Fund

I beg to move,

That this House has considered funding for GAVI, the Vaccine Alliance, and the Global Fund.

It is a pleasure to serve under your chairpersonship, Ms Jardine. I want to start with a quote from Gavi’s inaugural board chair, Nelson Mandela, over 20 years ago:

“Life or death for a young child too often depends on whether he”—

or she—

“is born in a country where vaccines are available”.

It is the injustice that he spoke of that the organisations we will talk about today—Gavi, the Global Fund and others—have fought against since Gavi was established in 2000. The fight has led to more than 1 billion children being vaccinated, and more than 18 million avoidable deaths prevented in low-income countries.

This is also a Labour and UK story. We had a consensus, but it was Tony Blair’s championing of Gavi at its launch in 2000, and Gordon Brown’s leading role in the creation of the international finance facility for immunisation, that helped to fund Gavi’s work at the start, and the organisation continues to turn to our Government —a Labour Government—for global leadership.

Through these organisations, we have cut the combined death rate from AIDS-related illnesses, tuberculosis and malaria by an incredible 61%, saving 65 million lives. Childhood mortality in under-fives has been reduced by over 50%, and vaccine-preventable deaths by over 70%, in the places where Gavi operates, and the coverage of key treatment and prevention interventions for HIV, TB and malaria has increased significantly in countries where the Global Fund invests. We saw TB treatment coverage increase from 45% in 2010 to 70% in 2022. In 2010 the percentage of the population with access to long-lasting insecticide-treated nets to prevent malaria was only 30%; in 2023 it reached 57%. In 2010 only 22% of people living with HIV were on antiretroviral therapy; in 2023 it reached 78%. That is the UK’s legacy.

We hosted the first replenishment for Gavi in 2011, we hosted the last one in 2020, and we will co-host the Global Fund replenishment this year alongside South Africa. This is not just about helping other countries; it is about the UK’s own soft power and security and the resilience of the NHS.

Let us talk a bit more about the UK’s contribution, because it is not just the Government’s contribution, but the contribution of amazing life sciences companies here in the UK. The UK Vaccine Network helped to develop life-saving vaccines such as the RTS,S malaria vaccine and the Oxford-AstraZeneca covid-19 vaccine, which have both been procured and rolled out by Gavi worldwide. Between 2016 and 2022 we invested £134 million to develop new vaccines for epidemic-prone diseases. An additional £103.5 million was committed in 2023 to support affordable vaccine development. Three billion doses of the covid vaccine have been supplied globally, which is estimated to have saved over 6 million lives in the first year of roll-out.

I am grateful to my hon. Friend for securing this important debate. Does she agree that it was work on malaria vaccines and others that enabled us to move quickly when covid and other infections occurred, and that investigations into neglected diseases have been the springboard to create vaccines for many other diseases that threaten the entire world?

My hon. Friend is absolutely right. It is through such programmes that we developed the expertise and the ability to rapidly create mRNA-based vaccines, which led to the creation of our own vaccines here in the UK and allowed us not only to protect our own population but to contribute to protecting biosecurity globally, by ensuring the fast spread of those vaccines.

Similarly, 18 million doses of the RTS,S malaria vaccine created here in the UK have been allocated to 12 African countries. We have administered the vaccine to over 1.7 million children in pilot countries and consequently we have been able to reduce malaria cases. We know that malaria is moving north as climate change hits, so this is not just about protecting children in those countries; it is also about protecting children here at home.

I want to share some of the quotes that were sent to me when scientists at AstraZeneca and elsewhere heard that I had secured this debate. They wanted to send a clear message. Sandy Douglas at the University of Oxford, one of the six scientists who created the covid-19 vaccine developed by AstraZeneca, said:

“Gavi brings Britain’s scientific leadership to the world, and this brings investment back into the UK’s world-leading research, generating a virtuous cycle of innovation.”

GSK also reached out because it wanted its voice to be heard in the debate. It said:

“UK life sciences are a critical economic driver to improve health outcomes and transform lives in the UK and around the world, including in the Global South. Scientific innovation underpins national and global health security and economic prosperity at a time of growing uncertainty. GSK and its HIV business…are proud of the contribution we make to deliver these priorities.”

Most importantly, it said:

“The UK’s 2025 investment in Gavi and the Global Fund will be critical in building long-term sustainable access to health technologies at scale.”

My hon. Friend is making an excellent speech and I congratulate her on securing the debate. Gavi has been one of the most successful development initiatives ever; more than 1 billion children are being routinely immunised against some of the world’s deadliest diseases. Despite its success, however, each year more than 1.5 million children continue to die from vaccine-preventable diseases. Does she agree that the UK needs to show leadership in ensuring that immunisation remains a funding priority for the UK, and that the Government, as a board member and a strong donor, should continue to fund Gavi and prioritise life-saving vaccinations?

I absolutely agree. That reminds me of something my gran always said to me: “If you don’t have your health, what do you have?” I know this issue sounds quite niche, but health is something we all understand. If we do not have our health, we cannot talk about improving the economies of countries around the world and improving global security. That is why this is such a crucial initiative.

These diseases cross borders. Milton Keynes’s HIV rate is among the highest in the UK, so this is also about protecting our constituents. If we can reach the levels that we need to reach on HIV transmission, we will be protecting the UK population too.

I am really encouraged by the UK’s commitment to co-host the Global Fund’s eighth replenishment, alongside the Government of South Africa, and by the Prime Minister’s statement that, although we are cutting official development assistance, we will continue to support global health. These partnerships are the best and most efficient way of getting money to the ground. They bring an estimated £530 million of investment into research and development in the UK, and they balance investment by ensuring that the countries that can contribute to the programmes do so. This is not charity, but true partnership. It is about us working together to build capacity.

These programmes have public support. Various polls show that about three quarters of the British public support using our R&D and our expertise in life sciences to save lives here and abroad.

I will conclude, because a lot of other Members want to speak. This year is pivotal. Gavi, the Global Fund, Unitaid and others are requesting partnership money, but it is about not just cash but the partnership and leadership that the UK Government provide. I say to the Government and the Minister, who cares a lot about this issue, that, despite the short-term cuts—the Prime Minister said that it is one of the most difficult decisions he has had to make, and that we will look to increase funding in the future—we must not use the fact that the replenishment comes at a time when our budget is at its lowest not at least to match what we have pledged in the past.

Order. I remind Members that they should bob if they wish to be called in the debate. Unfortunately, because of its popularity, I will have to impose a time limit of three minutes from the beginning. I intend to go to the Front Benchers at 2.38 pm.

I am grateful to you for stepping into the Chair, Ms Jardine. I was due to chair this debate, but that would have meant that I was unable to contribute, which I very much wanted to do.

Given the restricted time, I do not want to rehearse the discussions that we had with Baroness Chapman in the International Development Committee earlier in the week. Like the hon. Member for Milton Keynes Central (Emily Darlington), whom I congratulate on securing the debate, I want to say that a contribution to Gavi and the Global Fund is not charity but a strategic investment by the United Kingdom. Although we have to deal with the reality that, as Baroness Chapman set out, the cuts are happening, we have to make the case about what should happen in that environment. I have always believed that aid spending should have maximum impact and maximum returns. Moreover, it should be in keeping with public expectations of food in bellies and shots in arms, and the Global Fund and Gavi deliver both.

As the hon. Member for Southgate and Wood Green (Bambos Charalambous) said, Gavi has immunised more than 1 billion children, reducing vaccine-preventable child deaths by 70% in the 78 low-income countries in which it operates. That is 18.8 million lives saved and children growing up healthy, going to school and contributing to their communities, which is a huge impact. The Global Fund has saved an estimated 65 million lives since 2002. It has cut the combined death rate from AIDS, TB and malaria by 61%. These are staggering achievements and they should not be discounted.

Gavi and the Global Fund are two of the most successful and impactful health programmes in history. They clearly meet the requirement for maximum impact and return, but they are possible only because of sustained, co-ordinated international investment. Alongside Unitaid, they are part of a habitat of organisations that have sustained progress in our understanding of diseases, and our ability to deploy medicines and improve health systems.

It is a pleasure to serve under your chairship, Ms Jardine. I congratulate my hon. Friend the Member for Milton Keynes Central (Emily Darlington) on securing this debate. I refer Members to my entry in the Register of Members’ Financial Interests.

I am proud to co-chair the all-party parliamentary group on nutrition for development, alongside the right hon. Member for Dumfriesshire, Clydesdale and Tweeddale (David Mundell). Nutrition and immunisation are closely linked. Children with poor nutrition are often those who are most vulnerable to infectious diseases and need protection from vaccines, yet vaccines are less effective in malnourished children and often do not trigger strong immunity.

The children whom specialised immunisation programmes are trying to reach are also the least likely to have access to food and nutrition services. Immunisation has the most impact when it is delivered alongside other interventions and integrated into primary health systems. By addressing under-nutrition and under-immunisation simultaneously, we can significantly improve health outcomes and vaccine efficacy, as well as provide interventions in the most cost-effective way.

I saw this for myself on a recent visit to Isiolo in Kenya, hosted by UNICEF and organised by United Against Malnutrition and Hunger. We saw how in rural areas, nutrition interventions are delivered alongside vaccinations, healthcare education and maternal healthcare, to ensure that people have wraparound healthcare interventions that save lives. That was funded by UK development assistance and delivered by partners including Action Against Hunger. If a woman walks for 20 km or more with her children once a week for nutrition, they are less likely to walk the same distance, at a different time, to a different place, for vaccines. Integrating the services is paramount to good healthcare.

This February, ahead of the Nutrition for Growth summit, I met the chief executive officer of Gavi, Dr Sania Nishtar, to discuss the important role that Gavi is playing in delivering these integrated services. Dr Nishtar spoke about the new $30 million programme to integrate nutrition and immunisation interventions in Ethiopia through the UK-founded Children’s Investment Fund Foundation, as well as UNICEF Ethiopia and Gavi, with support from the UK through Gavi’s matching fund mechanism.

Does the hon. Member agree that even before the devastating cuts to UK foreign aid, there was instability in funding for global vaccination programmes? We have already heard that over 1.5 million children die from preventable diseases. Does he agree that the reduction in UK foreign aid will have a devastating impact on the ability to provide vaccines to these children, and will end up costing lives?

I will let the Minister answer that question, but I hope there will be an impact assessment to properly map our interventions in future.

Integration costs money and Gavi cannot do it without financial support. I hope that when the Minister is assessing our contribution to this year’s Gavi replenishment, he will look at including support for nutrition integration. What plans does his Department have to integrate nutrition and immunisations more widely?

I want to touch on one issue briefly. The UK’s contribution to Gavi has not only helped to save lives but contributed to the UK’s health security by reducing the risk of global health emergencies and pandemics. It has brought money into the British economy through reputational research returns, and it showcases the UK’s leadership on the global stage.

In my constituency, the Medical Research Council-funded Centre for Medical Mycology at the University of Exeter works closely with Gavi, carrying out world-leading research into deadly fungal diseases and developing vaccines for some of the most widespread causes of death and disablement in developing countries. Does the Minister agree that the UK’s continued participation in Gavi and the Global Fund not only is the right thing to do because it saves lives around the world, but is strategically sound, as it supports our growth strategy and is an important part of delivering both our industrial strategy goals and our national health goals?

It is a particular pleasure to serve under your chairpersonship for the first time, Ms Jardine. I congratulate the hon. Member for Milton Keynes Central (Emily Darlington) on securing this important debate.

It is just six months shy of five years since I had my own Backbench Business debate on global vaccine access—albeit in the context of the global covid-19 pandemic. I look back on what the then shadow Foreign Secretary, the right hon. Member for Wigan (Lisa Nandy), said with interest. I found in her remarks a consistent emphasis on working bilaterally to tackle global health crises, and through those efforts, to tackle poverty and inequality. She said that this was not just the practical but the moral thing to do.

I hope that we have not forgotten what we should have learned from the covid pandemic about how fast a disease can turn into a global threat, about how good health produces sage and secure countries, and about how terrifying it was to reckon with the realities of the pandemic in all aspects of our lives. I do hope that the Government will think about that as they approach the spending review.

Gavi and the Global Fund have been an incredible success, and we ought to celebrate that. The UK has been a leading force in these efforts on the international stage, and that is something to be proud of, because it bolsters our reputation and our standing and forms part of our global soft power.

We will not need to fund such programmes forever. Fifteen years ago, lower income countries were able to fund, on average, only 10% of the costs of their vaccine programmes. Over the next five years, it is estimated that they will cover up to 40% of the costs on average. Some countries are already there, with Indonesia now a donor to Gavi rather than a recipient.

Let us not forget that we need the world to be vaccinated. Disease knows no borders. Disease leads to poverty, which leads to global instability. We also have seen the more immediate and direct effects of global vaccine and treatment availability, through the demand and growth of our life sciences sector here at home—will the Minister tell me that that is not the sort of growth that this Government are looking for? At best, these investments benefit us up and down the UK. In my constituency, the University of St Andrews reported just last month that its infection and global health division had been awarded early career funding to identify new therapeutic strategies for infectious diseases.

It is a pleasure to serve under your chairship, Ms Jardine. I thank my hon. Friend the Member for Milton Keynes Central (Emily Darlington) for securing this debate.

Let us be honest: most of the public do not know what Gavi or the Global Fund are, but they do know the lifesaving power of vaccinations because they, like all of us, will have benefited from them when they were children, as will their children. But we know that for too many children around the world, those lifesaving vaccinations are not available. In these debates we must remember that people’s lives are at the heart of the issue. I worked for Save the Children for many years, and I saw at first hand the impact of immunisations and the progress that has been made. Some of that is at risk in the light of what is happening around the world, so this is a really important debate.

We have covered many of the areas that I want to talk about, but 1.5 million children continue to die from vaccine-preventable diseases. That is more than the population of Cyprus—an entire island of children dying every year. Vaccination and ending AIDS, tuberculosis and malaria are not only the right thing to do but, as we have heard, in our national interest and the smart thing to do.

Vaccinations stop disease reaching our shores. They help to support healthy and prosperous nations, and they help to prevent future pandemics. They are also vital in the context of climate change, as many of the world’s deadliest diseases are susceptible to climate change, which increases the risk of them spreading. Tackling those diseases is best done—with best value for the British taxpayer—through Gavi and the Global Fund. We know we have to maximise our aid budget at this difficult time and invest it in the right things that will deliver the best value for the British taxpayer. Investing in Gavi and the Global Fund is therefore simply a no-brainer.