International Covid-19 Response: Innovation and Access to Treatment

I beg to move,

That this House has considered the UK Government’s role in ensuring innovation and equitable access to treatment within the international covid-19 response.

I thank the Backbench Business Committee for giving us the time to have this debate. I also thank the hon. Member for Rotherham (Sarah Champion), who is in her place, for co-sponsoring the debate with me. We applied for the debate before the summer, but it arguably could not be more timely, given the encouraging news yesterday from the chief investigator of the University of Oxford covid vaccine trial. Results of the trial are due before the end of the year, and there is a small chance of a vaccine being available by then. I echo the comments of the chair of the all-party parliamentary group on coronavirus, my hon. Friend the Member for Oxford West and Abingdon (Layla Moran): that is promising news, but we should not rely on a vaccine alone.

As has become increasingly clear over the course of this pandemic, a vaccine will not be a silver bullet, and for any vaccine to work effectively, we have to suppress the virus sufficiently within the general population in the first place. None the less, the production of a successful vaccine would be a landmark moment in the fight against covid-19; I recognise and commend that.

In that regard, the reality in the UK is that we are, in relative terms, fortunate. Our scientists and researchers are leading the battle through their ongoing work. We have deals in place in relation to six of the vaccine candidates currently being developed. The Government have now bought access to 340 million potential future doses of vaccine. That equates to five doses for each person in the UK. When a vaccine candidate’s efficacy is proven, we will be at the global forefront of rolling it out—with, I am sure, a particular focus on our healthcare workers and the most vulnerable in our society, many of whom, including in my constituency of North East Fife, have been shielding or taking extra precautions for some months.

As we consider our own situation, we also have to recognise that, as things stand, if a vaccine candidate is approved soon, billions of people—two thirds of the world’s population—are likely to have no access to such a vaccine until 2022 at the earliest. While we might live in hope that a vaccine will be with us in the next six months in the UK, for others, it is a matter of years. That is because, right now, access to covid vaccines is a zero-sum game. A limited number of candidates are being manufactured by a small handful of companies only, and between them, they do not have the capacity to produce dosages in the billions required at a global level.

When the world’s wealthy countries, representing about 13% of the world’s population, bought up access to 50% of future covid vaccine doses, it became very hard for the remaining 6.8 billion people on the planet to obtain the same protections. Almost inevitably, it is less affluent nations, and in particular the most vulnerable countries, that are crowded out. It is important to remember that this is not limited to vaccines, and we are not talking hypothetically about what might happen in the future. It is happening right now, because there are already huge inequalities in access to covid treatments that already exist.

The hon. Lady is laying out clearly the inequalities in the world. I have been present in a number of debates this week in which Members have highlighted the inequalities faced by some ethnic groups and religious minorities. When it comes to receiving any covid help, they are at the end of the queue. When it comes to getting the vaccine, they will be at the very end of the end of the queue. Does she agree that those ethnic minorities and persecuted people must have an opportunity to get a vaccine?

Absolutely. I thank the hon. Gentleman for his intervention, and I entirely agree with his sentiments. We have seen that those who are on the frontline, those who are marginalised in our society and those from minority backgrounds are often the most impacted, so it is even more important that we consider the treatments and vaccines that are available for them.

The two drugs that have been proven so far to help treat covid-19 are dexamethasone and remdesivir. The entire global stock of remdesivir was bought up by the United States Government during the summer, hence Donald Trump was in a position to receive the drug when he became unwell. What is left of the stock is currently accessible only at a very high price. The manufacturer, Gilead, sells it at almost £2,000 for a five-day course of treatment, yet it is believed that the cost to produce it is £7.

Fortunately, dexamethasone is widely available and a cheaply sourced steroid. If a patient suffering from covid requires ventilation, administering this drug reduces the chance of death by up to a third. That is great news and has greatly improved outcomes for patients who need to be ventilated. But for there to be a chance for that drug to be effective, there must be enough ventilators available for patients who need them, and there must be enough oxygen to supply those ventilators. Again, in some of the most vulnerable places globally, access to those things is very limited. In South Sudan, for example, a report earlier this year stated that there were only four ventilators available in the whole country—four.

This debate is not just about the cost of drugs or vaccines. It is also about the resources, technology and equipment needed to manage a pandemic successfully. Even with easily accessible and cheaper treatments, there is no equality of access internationally. As things stand, we run a serious risk that by 2022 we will inhabit a two-tier planet in terms of the pandemic response.

I congratulate my hon. Friend on securing this important debate. Does she share my concern that those parts of the world where people do not have immediate access to healthcare systems also do not have furlough schemes, and people do not have the money to be able to isolate? The public health aspect is just as important as access to medicines.

I entirely agree. Dare I say it, even the UK’s Prime Minister this week accepted that the isolate part of the test, trace and isolate system is not working. That is largely driven by the fact that people who have an economic need to continue to work will do so if the supports are not available, and that must be true in other parts of the world as well.

As I was saying, the most affluent countries will inevitably benefit, in terms of vaccines, access to treatment, some form of recovery and a return to aspects of day-to-day life, which we so miss in this place and beyond. For the majority of people in this world, that will, arguably, be a limited prospect; it would be a hollow victory indeed if we could get the virus under control while many people around the world continued to suffer. It would be a false victory, too. Let me go back to the comments made by my hon. Friend the Member for Oxford West and Abingdon that I mentioned at the start. In order for a vaccine to be effective, we need to suppress the virus both at home and abroad, because coronavirus does not respect national borders. No one is safe until everyone is safe. That approach has been endorsed by the UK Government. I thank them for recognising that covid-19 medical products need to be treated as global public goods and for making commitments to deliver on that.

I congratulate the hon. Lady on securing the debate and apologise for the fact that we have not been able to field a Front-Bench spokesperson from the Scottish National party today. I endorse everything she is saying and the points she is making about the importance of global access to a vaccine, when it is developed. As she says, it should be treated as a common good. We have to seek assurances from the Minister that the UK Government will live up to that, given all the changes they have made to their foreign policy, with the merger of the Department for International Development and the Foreign and Commonwealth Office, the risk to scrutiny from that, and the potential abolition of the Select Committee chaired by the hon. Member for Rotherham (Sarah Champion). We have to keep up that pressure on the Government, and I hope we will get a positive response from the Minister today.

It is always good to find common ground with a fellow Scottish MP, and I absolutely endorse his comments. One reason my party was so opposed to that merger was exactly that: the UK is seen as a global leader in this regard and we do not want anything to risk the continuation of that.

I congratulate the Government on making commitments to deliver on covid medical products being treated as a public good, for example by contributing to the covid-19 vaccine global access facility, which will help procure and equitably distribute vaccines for covid. I look forward to hearing from the Minister today, but I urge her that we must do more. We must ensure that what the Government are doing on behalf of their own citizens does not unintentionally undermine global efforts. There is simply not enough global co-ordination on equality of access, and the UK has a moral duty to engage further. It is the highest per capita buyer of future vaccine doses in the world; we have bought up 10% of potential doses, despite making up less than 1% of the global population. I wish to mention two steps—which I hope the Minister will consider and commit to—that will be vital in ensuring that equality of access for these treatments and technologies is delivered as they come to fruition.

First, the Government need to recognise that currently there are just a handful of vaccine candidates, which means that production capacity is limited. One important step the UK Government could take is to work through international institutions to help encourage reform of the patent system, given the exceptional circumstances of this pandemic. Currently, there are legal safeguards for members of the World Trade Organisation, which means that members can override patent monopolies if public health is at threat. Germany, Australia and Canada have already taken those steps. South Africa and India have also proposed at a recent WTO meeting that all intellectual property monopolies relating to covid-19 tools, medicines and vaccines should be waived. In these exceptional circumstances, the Government need to be engaging with those ideas.

I thank the hon. Member for North East Fife (Wendy Chamberlain) for calling for the debate, and I hope that my speech will amplify the points that she has made.

The International Development Committee, which I chair, has been examining the impact of the coronavirus on developing countries, and the contribution of the UK Government to initiatives to help the global south tackle the pandemic. A key part of the UK’s strategy for the global south is funding an array of partnerships and collaborations aiming to develop, at speed, vaccines, therapies and tests for preventing, treating and diagnosing the disease. The Government have allocated the lion’s share of their global coronavirus funding to the race for those products—£388 million initially for vaccines, therapies and tests and, more recently, another £571 million for the production, purchase and distribution of vaccines. That is very welcome, but a key concern that emerged throughout the evidence that we received was about the importance of legal and practical measures to guarantee equitable access to corona vaccines, medicines and tests around the world, based on need, not economic power. The former chief scientific adviser to the Department for International Development, Professor Charlotte Watts, told the IDC:

“It is not only about finding a vaccine that is going to work, but how to ensure that there are the resources and future investment in production capability, so that that can be distributed to low and middle-income countries.”

It is worth recalling why equitable access to medicines is such a concern. First, let me take the example of the antiretrovirals for HIV and AIDS. In Durban in 2000, at the XIII International AIDS Conference, Justice Edwin Cameron of the South African Constitutional Court famously declared that he had been living with AIDS for 33 months, but that

“there are 24 or 25 million people in Africa who at this moment are dying, and they are dying because they don’t have the privilege that I have of purchasing my life and health.”

I will be brief, because there is pressure on time, but I just want to say that the hon. Lady is making an incredibly powerful speech that is demonstrating the importance of the scrutiny that her Select Committee has been able to provide. I want to re-emphasise the point I made to the hon. Member for North East Fife (Wendy Chamberlain) that the Scottish National party fully supports the continuation of that Committee, either as a non-departmental Select Committee or as a wider official development assistance-scrutinising Committee. I hope that those on the Government Benches will bear that in mind.

I am extremely grateful for the hon. Member’s support for the International Development Committee. Development is a specific and key area of the work that we do, and it demands parliamentary scrutiny.

I ask the Minister to give us some certainty today on the Government’s commitment and resolve to fight to ensure that covid drugs and treatments are accessible to everybody, not just those with the deepest pockets. Will the Government support the proposed waiver of all intellectual property monopolies related to covid-19 tools, as put forward by India and South Africa to the WTO? Can the Minister confirm that, for all R&D projects that the UK has funded, transparency on finances and an obligation for resulting products to be free from monopolies were embedded in those contracts at the start and will be enforced? Finally, will the Government follow Germany, Australia, Canada and Israel in championing the use of legal safeguards that all World Trade Organisation members can implement to override patent monopolies if public health is at risk?

Let me start by congratulating my hon. Friend the Member for North East Fife (Wendy Chamberlain) on securing this debate. It is a great pleasure to be part of a debate that actually gives me a huge amount of hope. I was a science teacher before I was an MP, and I spent a lot of time explaining to young people why science can be exciting and why it is the one thing that connects humans, no matter where they may be across the globe. Science is universal, regardless of our sex, creed, or wherever we may have been born. What a great time to be a science teacher! During coronavirus, by studying science someone could literally save the fate of the world. I am particularly proud that scientists in Oxford are leading from the front with the vaccine right now, and we should not forget that these times of great turmoil often spark moments of enormous human ingenuity, and we should celebrate that.

Whenever we have such moments, however, we first have to go through times of strife, and we must recognise—it is important that the House is united on this point—that it is not just morally right to ensure equitable access to these vaccines and therapeutics, but it is also scientifically smart. It is in our own self-interest, and regardless of whether people feel good going to bed at night knowing that we have done that, it is also the thing that will save us.

No one is free from these diseases until everyone is free, and I am sure hon. Members will have been struck by today’s news from Denmark, where on the mink farms it has been discovered that the virus has passed from humans to mink, and then back. The virus has mutated, and 12 people in Denmark now have that new mutation. The entire mink population is to be culled, to try to keep that at bay.

My first thought was that I am very much against mink farming, but let us put that to one side. My second thought was, “Well, that’s Denmark.” Denmark has a well developed public health arm in its Government, and they are able to act within 24 hours and introduce those measures. What about other countries that do not have that kind of safeguard? We have been talking about vaccines and therapeutics in the fight against coronavirus, but what if we forget about that public health arm, and as a result end up with a new mutation that will make those vaccines pointless as we will not be able to catch up? That underlines the importance of ensuring that all such matters are taken into account.

I thank the hon. Member for North East Fife (Wendy Chamberlain) for securing this important and timely debate. I pay tribute to the many organisations that have campaigned so powerfully on this issue, including Global Justice Now, Doctors Without Borders, and Just Treatment.

We are in the middle of battling a global pandemic, and to successfully overcome it, there must be a united cross-border approach. Anything less only undermines the United Kingdom’s reputation as a development superpower. It also jeopardises the health of our citizens, given the rapid speed at which the virus travels around the world. The Government’s failure to provide equitable access to covid vaccines means that many developing countries that already have overstretched and underfunded healthcare systems will suffer further still if they are unable to access affordable covid vaccines. As a member of the International Development Committee —it is great to see the Chair of the Committee, my hon. Friend the Member for Rotherham (Sarah Champion), in the Chamber—I know how the coronavirus crisis could set development progress back by 30 years. That is completely unacceptable, and a failure to intervene to prevent it would be wanton disregard for our international obligations. Countries in the global south should not continually be low in the pecking order: they must be prioritised in order to help them, and us, to overcome this deadly virus.

Our Government must take the lead in tackling this crisis, but pharmaceutical companies must also play their part in finding a cure. Currently, the Government are handing billions to big pharma, which is taking very little risk while maintaining monopoly control of the drugs once they are developed. For example, AstraZeneca has stated that its costs in developing a covid vaccine at Oxford University will be fully covered by Governments. This approach will serve only to exacerbate gross health inequalities and cannot be tolerated during a pandemic when tens of thousands of lives are at stake. Terms and conditions must be attached to any funding the Government provide to ensure innovations for all those who need them, including those living in low-income and middle-income countries. Indeed, the Government should not relinquish their responsibility to introduce stringent public interest conditions on their funding to ensure equitable access. That means, with millions of pounds of public money going into the research and development of future covid medical technologies, that it is critical that the final products are sold at cost, and that the pharmaceutical companies do not profiteer from public funding when Governments are required to buy back the products that they initially funded the development of.

I thank my hon. Friend the Member for Rotherham (Sarah Champion) and the hon. Member for North East Fife (Wendy Chamberlain) for securing this debate, which could not have come at a more important time.

Our ability to rise to the challenge that Members have laid out so compellingly today is in many senses dependent on the outcome of the US election and the UK’s response to it. I think I probably speak for many in this House when I say that the approach the United States has taken to participation in global efforts to tackle covid-19 has been of serious concern to many of us. We know that a potential Biden Administration would mark a change in the approach of the United States, but do the Government have a strategy for a second-term Trump Administration? What is their strategy to convince the United States to change course? The UK is due to host the G7 next year. We cannot afford to see a repeat of what happened earlier this year, when despite all the talk of the special relationship, the Prime Minister was unable to persuade the United States even to participate.

The director general of the World Health Organisation said recently:

“The greatest threat we face now is not the virus itself. Rather, it is the lack of leadership and solidarity at the global and national levels.”

I think we all accept that the issues around vaccine, treatment and diagnostics have the potential to become a competition and to pit people against one another both within countries and between them, and that this poses a significant challenge for the Government.

At the beginning of this crisis, there was a chaotic and cut-throat global scramble for PPE and medical supplies. Some countries introduced export controls on vital equipment, even to neighbouring countries and allies. Prices were inflated as countries sought to outbid one another, and while scientists and doctors across the world have worked together to understand and fight the virus, they have too often done so in a vacuum of global leadership.