- 12:34 pm
- The Secretary of State for International Development (Rory Stewart)I beg to move,That this House has considered World Immunisation Week.It is an enormous privilege and pleasure to stand here for the first time as Secretary of State, but it is a deeper pleasure to be in the Chamber talking about immunisation. Immunisation is an extraordinary story that illustrates why international development really matters, how complicated it can be, in public policy terms, to pull off, and how important it is to be able to communicate to the public and others how, in the end, preventing the terrible loss of a child from polio can be connected right the way back to scientific research, businesses, international co-operation, and very brave doctors and health workers on the ground.
- May I be the first person in the Chamber to warmly welcome the Secretary of State to his new post? It is a delight sometimes to see a square peg in a square hole—if that does not sound rude, somehow or other. I warmly congratulate him on his new job.Is not one of the most disturbing developments of recent years the fact that there are politicians around the world, in some of the most advanced societies, who preach an anti-immunisation message, which will lead to the unnecessary death of children?
- Rory StewartAbsolutely. It is grossly irresponsible and, I am afraid, profoundly and disturbingly misleading, and even ignorant, to go around doing that. It ends up stoking public paranoia and fear, and leads to the unnecessary loss of life. From the beginning, the story of immunisation—and, indeed, the story of international development—has often been about challenging public perceptions and irrational fears, and following through. There are reasons for that. The heart of what immunisation is carries within it the seeds of that challenge. The basic idea of immunisation is, of course, to make somebody sick to make them better. From the very beginning, that has involved not only challenging public fears, but something that Governments find quite difficult: taking risks and working, genuinely and collaboratively, internationally.Although we tend to pat ourselves on the back a great deal in this country, immunisation was, of course, not a European discovery at all. It was a Chinese discovery of the early 16th century. Chinese public health officials, or their 16th century equivalents, went into villages and sneezed into people’s mouths, which rapidly reduced the mortality rate by tenfold or twentyfold. The normal mortality rate for smallpox was 20% to 30%, but remember that that reduced mortality rate under the new technique was still between 0.5% and 2%, so the procedure was very risky. Moving on with my international point, this immunisation practice arrived in Britain in about 1700.
- rose—
- Rory StewartI give way to the honourable and learned doctor.
- I, too, welcome the Secretary of State and congratulate him on his new post. It was actually a bit more dramatic than that: variolation involved cutting into veins and putting in smallpox scabs. That did indeed make people ill, and then they were immune. However, modern vaccines do not do that—they are no longer based on making someone ill. There is a fallacy that the flu vaccine will give people flu, but it does not. Modern vaccination is no longer based on giving someone an illness to protect them from worse.
- Rory StewartMoving rapidly forward, the key to this is scientific advances whereby things become safer all the time. Immunisation moved from China to Britain, and in 1799 in Britain, there was the development of vaccination—in other words, the use of cows to do this. There were then the developments of Louis Pasteur in the 1880s in France, and then of course the amazing developments in the post-war period.Throughout all that, we see something that really matters for the Department for International Development, a Department that co-operates with other countries and puts science at its heart. This story, which in its early history links China to Britain, Britain to France and France to the United States, continues today with Gavi, the global alliance. In all this work, the same themes occur at an accelerated rate. We have, remarkably, achieved the eradication of smallpox, and we are close to a 99% success rate on wild polio. But it is on Ebola that we see most clearly today the security risks, the scientific advances, the complexity and the international co-operation.In 2015-16, DFID, working with other international partners, began to develop—initially in Guinea, and then, through academic partnerships, in the United States and Canada—the first attempts at inoculation against Ebola. Ebola, like all such diseases, finds no borders, and that has a direct connection with justifying the international aid budget here in the United Kingdom. Perhaps the easiest way of explaining to people why we have an international development budget is to point out that had that disease taken off in Liberia and Sierra Leone, given modern transport mechanisms it would have found its way rapidly to Europe and ultimately to the United Kingdom, and people would have been dying here.That investment, which seems quite complex, and which often—particularly in the case of diseases such as wild polio—involves spending a surprising amount of money on tracking down the last few cases, is the kind of investment that only a Government can make and only an international aid budget can provide. Why? Because this is not a normal economic case. If an individual were asked whether they wanted to spend a lot of money on inoculating themselves, they might say no, and on the basis of a traditional cost-benefit analysis, one might ask, in relation to that individual, “Why are you spending so much money?” The point is, however, that that individual is part of a community, and that community is part of a broader nation. If the disease takes off, it will begin to infect hundreds of millions of people. At that stage, significant investment in preventing someone from getting polio, for example in rural Afghanistan or Pakistan—there can be quite surprising investments, ending up with the spending of hundreds of thousands of dollars on tracking down the last few cases—is critical if it actually prevents millions of people from getting the disease.
- 12:45 pm
- I genuinely welcome the new Secretary of State to his role. In his first two weeks as Prisons Minister he visited both the prisons in my constituency, which I thought showed a great sense of responsiveness to what was needed at the time. I hope that something along the same lines, and a close working relationship, will feature in his new role. I am also delighted that he used his first speech as Secretary of State to advance a robust intellectual defence of our aid spending, and I congratulate him on that.We know why immunisations matter and why today’s debate is so important. Vaccines are, quite simply, a matter of life and death. Between 2 million and 3 million lives are saved every year thanks to immunisations, and in recent decades they have drastically reduced suffering caused by infectious diseases that were once commonplace. Smallpox was completely eradicated in 1977 through a global vaccination programme, and the world is now close to eradicating a second disease, polio. My own grandad contracted polio and lived with it for 27 years, and when I was growing up I heard a great deal about the impact of a disease that paralyses the people affected by it. I pay tribute to one of my constituents, Andy Gilliland, a polio survivor who has lobbied alongside the One Last Push campaigners; I am delighted to have become one of the campaign’s polio champions since he lobbied me.Thanks to successful vaccination schemes the world over, today’s generation and our children do not have to suffer from the diseases that were all too commonplace for our grandparents. Immunisations are not only saving lives, but are a cornerstone of global health security. They are vital to the achievement of several of the United Nations sustainable development goals and to ensuring that no one is left behind. They also provide a vital gateway to wider public health services. If you are a child or parent being given a vaccination, this may be the first time that you interact with the public health system. The simple act of being immunised can boost your chances of going on to access important services such as family planning, birth registration, testing and screening, and regular healthcare. For the hardest to reach, immunisation can be the start of proper inclusion in the public health system.
- Rory Stewartindicated assent.
- The Secretary of State is nodding, and I appreciate that.This means many of the world’s poorest children are in fact living in middle-income countries with a GDP that makes them ineligible for either official development assistance or Gavi support. I hope the Secretary of State will listen to the all-party group on vaccines for all, which has called for Gavi to bring about new criteria beyond a country’s GDP.Let me now turn to another major threat to universal immunisation coverage. It is a threat that we face both here in the UK and right across the world: vaccine hesitancy, a phenomenon that the World Health Organisation has not only warned is on the rise but has now identified as one of the top 10 major threats to global health for 2019. This year’s theme of “Protected together: vaccines work!” also points to the difficulties in this area.Since 2014, the number of countries reporting hesitancy has steadily increased, and in 2017 only 14 countries out of 194 reported no vaccine hesitancy. In England, dangerous false stories about immunisations are routinely spread on social media. The likes of YouTube and Facebook are failing to clamp down properly on those who peddle these lies. We must take tougher action and tell the truth about immunisations because the increasing refusal of vaccines has been described by the head of NHS England as a “growing public health timebomb.”
- Does my hon. Friend agree that the Government’s recently published online harms consultation needs to include the beefing up of this, and that Facebook and others must be held responsible if they allow such anti-immunisation scare stories to be included on their platforms, because, as we are seeing in America, this is risking and costing lives?
- I agree with my hon. Friend wholeheartedly. We must take tougher action to tell the truth about immunisations, and we need to act fast with global partners if we are to avert the destructive potential of this. According to UNICEF, half a million British children are not vaccinated against measles, and in 2018 there were 966 cases of measles across the country, more than double the number in 2017. This is a worrying and sharp rise that requires our attention.That is why my colleagues in Labour’s health team have committed to a vaccination action plan that includes getting tough with the big social media companies that are providing a platform that is fuelling a new public health crisis. Labour wants to see the £800 million of public health cuts reversed, more health visitors recruited to provide proper health advice backed by science to parents and GPs given the investment they need to drive up vaccination rates.
- Mr Paul Sweeney (Glasgow North East) (Lab/Co-op)My hon. Friend is making an important point about the massive positive impacts of public health campaigns, and I am reminded of the great public health drive in Glasgow to eradicate tuberculosis from the city in the 1960s, a public awareness campaign that was a huge success. But is my hon. Friend aware that this creeping cynicism around the positive benefits of immunisation is a critical national emergency, and does he agree that it is worth exploring making it a criminal offence not to immunise our children? Perhaps we should explore whether that is a necessary step given the critical nature of this.
- I agree with my hon. Friend. This is absolutely critical, and our discussion shows the importance of raising awareness in such debates.
- The hon. Gentleman is making some extremely good points. Does he agree that it is also important to be positive and show the huge impact of past vaccination programmes? In the 1940s, diphtheria killed 3,500 children a year in the UK, but it now kills approximately zero. Showing what has happened in the past and how beneficial it has been for our children will, combined obviously with other measures that the hon. Gentleman has referred to, give us the confidence that vaccination is indeed the way forward to protect our children.
- I am grateful to the hon. Gentleman, and the figures in graphs and elsewhere in documentation show the remarkable impact that vaccinations have had. We must carry that story forward.We know from this experience how vital universal public services are for ensuring that everyone in society, regardless of their income, can realise their right to a healthy life. The Labour party founded our national health service. We are today, like then, committed to a health service that is that publicly owned and publicly run and with universal access. Universal health systems are the building block for everything else: without them we cannot reach full immunisation coverage; without them we cannot protect all the population against the national security threat of disease; without them we cannot reach the poorest and most marginalised in society with the care they need; and without them we cannot invest properly in the health of everyone equally, or deliver the fullest benefit for our society or our economy. And crucially, without universal public health systems, countries cannot fight the soaring inequality that now exists the world over.There is no greater public asset here in the UK than the NHS, and so too around the world people value and look to the founding principle of the UK’s NHS: health care available to all, regardless of wealth. And so I want to briefly mention two important commitments that the Opposition have made to how we would deliver aid and development differently.Aid is, or at least should be, delivered on the basis of poverty reduction. The Labour party has committed to a second, dual goal—to use aid to tackle inequality, too—and we know there is no better way of bringing about greater equality than universal public services in health, education and other key services. It is a tragedy that while we have our national health service—our own best-loved institution—created by the post-war Labour Government, this Government sometimes use UK aid to export to developing countries the kind of botched privatisation models that have done so much damage in the UK in recent years, instead of helping those countries to secure their own universal public health services.