World Immunisation Week

Jeremy Lefroy Excerpts

Thursday 2nd May 2019 Commons Chamber

[Dan Carden]

I agree with my hon. Friend. This is absolutely critical, and our discussion shows the importance of raising awareness in such debates.

[Jeremy Lefroy (Stafford) (Con)]

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.

[Dan Carden]

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.

I have a simple message: as DFID Secretary I would use UK aid to work alongside communities and civil society groups across the global south who are fighting for their own universal public services, and I would use DFID’s resources to work in partnership with their Governments to build and strengthen them.

World Immunisation Week is a chance to celebrate the work being done to protect people from vaccine-preventable diseases and to highlight the challenges ahead and the collective action needed. This international awareness week promotes the core message that the immunisation of every child is vital to prevent diseases and protect life. Immunisations are one of the most successful and cost-effective global health interventions of our time. Delivering immunisations gives all of us in this House, as custodians of the UK’s important position as a leader in global health, the simple, remarkable ability to save countless lives.

[Alistair Burt (North East Bedfordshire) (Con)]

It is a pleasure to welcome my very good friend the Secretary of State for International Development to his new role. We all know what a tremendous background he brings to this role, with vast international experience beyond the majority of us, and we all know the dedication he has put into his previous ministerial roles, and we are certain that we will see this reflected in what he does with international development. I am delighted to see him in his place. I am also delighted by the further progress of his predecessor, my right hon. Friend the Member for Portsmouth North (Penny Mordaunt), who is now Secretary of State for Defence. She did a terrific job at DFID, and I am really pleased to see her in a post for which I think she has always been destined, bearing in mind her background. She will do a great job there. It was a great pleasure to work with her.

Not unusually for me, I find myself largely in agreement with the speeches that have been made from both sides of the House. I should like to say little bit about a topic for which I had responsibility in the Department until relatively recently and to offer thanks to colleagues who have been so effective on this and who will give great support to my right hon. Friend the Secretary of State for International Development.

First, a personal word: as some hon. Members know, I have a very personal connection with vaccination, which I never fail to bring out. My dad, who is watching this debate courtesy of the great medium of television, is a doctor. When I was a small boy, it was his responsibility as my doctor to provide me with polio jabs. In the old days in the United Kingdom, we provided jabs for polio, not sugar lumps. Yes, I am that old. As my dad knows, we are talking serious needles; not the sort of thing that children get these days. These were really serious needles that bubbled away in the steriliser in the corner of the surgery, and they absolutely terrified this small boy. My dad had to chase me round his room. I would hide under the desk, eventually I would be brought out to see all the things that were meant to entertain me as he put the needle in. Then he did it. The lesson I learned from that was that if my dad, who loves me very much, could inflict a degree of pain on his crying little boy, there had to be a really, really good reason for it. And of course there was. Like the grandfather of the hon. Member for Liverpool, Walton (Dan Carden), I was spared polio, as were the vast majority of my generation and subsequent generations, because of that vaccination. That first early introduction to vaccination and needles, and the visits with my dad to hospitals that I thoroughly resented for many years—until I did a stint at the Department of Health—have stayed with me, so vaccination matters to me. It is an important thing.

My father subsequently got involved with Rotary International, and any discussion of vaccination and global health has to include a mention of the contribution that Rotary has made to the near-eradication of polio. The United Kingdom remains absolutely supportive of that policy, and we must not get so close to the line but then fail to drive it over. The contribution of Rotary International and its members in this country must always be recognised, and we should thank them most sincerely.

[Jeremy Lefroy]

My right hon. Friend is absolutely right, and I would like to pay tribute to Rotary as well. I remember when my family was living in Tanzania and my daughter was born there, she was vaccinated against polio through a programme sponsored and funded by Rotary International, as were millions of other children in that part of the world. Rotary deserves huge credit for what it has done, and I thank the Rotary clubs across the United Kingdom for the money they have raised for that programme.

[Alistair Burt]

I am grateful to my hon. Friend, who speaks for all of us in the House in thanking Rotary.

I also want to thank one or two more people while I am on my feet. The first is the hon. Member for Central Ayrshire (Dr Whitford), the chair of the all-party parliamentary group on vaccinations for all, who will no doubt speak later in the debate. She makes a tremendous contribution on these matters in the House on all available occasions. I also want to thank Danny Graymore, who heads up the global funds team and is our senior DFID rep in Geneva, for all the work that he puts into this, as well as the team of colleagues in DFID who work so hard on this. I offer my deep appreciation to them for all that they have provided for me in the last couple of years.

I also want to thank Gavi’s chief executive, Seth Berkley, who does a remarkable job, and Henrietta Fore at UNICEF and her team in the UK. They do a tremendous job in vaccinating and in providing the vaccines and the basis for what both Front-Bench speakers have talked about. UNICEF vaccinates half the world’s children and saves 3 million lives a year. Since Gavi came into existence, it has vaccinated some 700 million children and 10 million lives have been saved, for the reasons that have been set out. We could not do without them.

Nor could we do without the health workers who are out there doing their job but, as those on both Front Benches have mentioned, they are under increasing threat. A specific example is Pakistan, where work is being done on polio. There has been a string of attacks in recent years, with seven policemen being killed in Karachi recently while trying to protect polio workers. In February 2015, four kidnapped polio workers were found dead near Qetta. In June 2015, 15 were killed by a suicide bomb outside a polio vaccination centre. Four were killed in 2014 in Qetta, and in 2012, five were killed in Karachi and Peshawar. This is not just about the threat of intimidation to health workers in different parts of the world; it does actually result in their injury and death. We in this country should always remember what it is like in some of those places. We should remember how important those people consider their work to be and why they consider it to be of such benefit to their communities that they would take such extraordinary risks.

I am proud of the part that the United Kingdom plays in Gavi, the global vaccine alliance. It brings together the private and public sectors in a shared goal of creating equal access to new and underused vaccines for children in the world’s poorest areas. It has strategic goals, which are all of importance to the United Kingdom and illustrate why we support it. The first is to ensure equitable uptake and coverage of vaccination. The second is to ensure effectiveness and efficiency as part of a strengthened health system. The third is to be part of the sustainability of a national vaccine programme.

At this point, I want to comment on what the hon. Member for Liverpool, Walton said about DFID’s role in health systems abroad. This cannot all be done purely through the support of public sector health systems. The combination of private and public in health is absolutely vital, but he can be reassured that the determination of the UK Government and DFID is to strengthen universal healthcare systems. Money and support for healthcare must go into that, but there is a combination of public and private, as was made clear at a meeting with UNICEF in New York in September. It is a partnership, but this does not contradict the fundamental principle on which I am sure the hon. Gentleman and I are united.

[Jeremy Lefroy]

Does my right hon. Friend agree that state co-ordination is sometimes needed, but that there are different systems? If we look at Zambia, we see that the Churches provide tremendous health coverage throughout the country, but they do so in co-ordination with the state so that everybody knows, as far as is possible, that they have coverage locally. Clearly, they have a long way to go, but they do a tremendous job in co-operation with the Government there.

[Alistair Burt]

Absolutely, and I think that that is the model to take forward for the development of healthcare systems. We need to bear in mind the nature of that relationship, because it will be absolutely key.

I am proud of the United Kingdom’s support for Gavi. We are its largest donor, and we are

“currently responsible for 25% of its budget. The UK has committed £1.44 billion to Gavi from 2016 to 2020, including funding to its innovative finance mechanisms. This investment fully delivers on the UK commitment to immunise 76 million children and save 1.4 million lives by 2020.”

I am grateful to the team for the briefing it gave me for the meeting with the all-party group, which I have kept. Credit where it is due: that was a quote from the Department’s own briefing. The replenishment conference is coming up. There was very little I could say about that when I was a Minister, but speaking from the Back Benches, I can say to the Secretary of State that I am sure we will sort it out and I hope he will be really, really generous. He can be absolutely sure that I will be on his tail if we do not make a serious commitment to Gavi, because it really delivers. Seth Berkley delivers for us, and the visit to Bognor Regis in the past few months when he saw the work being done here was really important. I hope the Secretary of State will bear that in mind.

Vaccination does more than the obvious function of preventing diseases in children. Its background, not only in the health system but in the development of countries, is fundamental. A healthy child goes to school, is able to learn, and grows into a productive adult. Unless that basis for immunisation is clear, so much development work is stymied right at the beginning. Immunisation is part of a sustainable, integrated health system. The reckoning is that the overall impact is that every £1 spent on immunisation leads to a £16 saving in terms of subsequent health care bills and people’s inability to interact effectively in the community.

Before I deal with the threats, I want to remind the House of what this is all about, and I will talk briefly about measles, because measles outbreaks have suddenly returned in recent times. The tendency in the United Kingdom is to accept measles as a rudimentary childhood suffering that is easy to go through, so the misery of measles is forgotten. A recent piece in Forbes Magazine talked about the problems of anti-vaccination and included a quote from Roald Dahl. His oldest daughter, Olivia, died of measles in 1962 at the age of seven, and the article quotes his words:

“one morning, when she was well on the road to recovery, I was sitting on her bed showing her how to fashion little animals out of coloured pipe-cleaners, and when it came to her turn to make one herself, I noticed that her fingers and her mind were not working together and she couldn’t do anything. ‘Are you feeling all right?’ I asked her. ‘I feel all sleepy,’ she said. In an hour, she was unconscious. In twelve hours she was dead. The measles had turned into a terrible thing called measles encephalitis and there was nothing the doctors could do to save her.”

That is how real it is. When we talk about vaccination and take on those who are concerned about it, that is the reason.

Measles has largely died out in the United Kingdom, but it is coming back in different places, and it will come back here unless we challenge it. The United States declared measles eliminated in 2000, but there have been 695 cases this year, mostly concentrated in three outbreaks and mostly concentrated in small tightly knit communities. The rise in measles cases in both the developing world and the developed world is really frightening, and it must be challenged.

When I was first made aware of the rising figures, I had a discussion with my ministerial team about how to deal with it. I have to say that I was pretty gung-ho and thought, “We’ve really got to take this on aggressively.” The team, to their credit, tried to scale me down from that, saying, “There are different reasons for the threat to vaccination, and you need to handle them differently.” That was good advice, and my sense is that the challenges are as follows. The first is the straightforward matter of incomplete coverage—the millions of children who do not currently get vaccinated. Gavi needs to look at where it is developing its resources, but it is committed to go to the poorest areas, and we need to keep that up. We need to deal with the areas where coverage is not great, but there are other threats, too.

We can divide anti-vaccination into several categories. First, there are religious reasons. I am unaware of any tenet in any major religion that suggests that vaccination is inherently wrong. It is quite the reverse. As a practising Christian, I believe that one of the revelations of God has been to give us the skills to discern what harms us and what helps us. That is where science and medicine come in, and vaccination is part of that. We have been given the skills to be able to help our God-given children and keep them healthy.

No major religion contradicts that, but sects in various religious denominations are against it. When we do get an outbreak, such as in an Orthodox Jewish community in New York, it runs around quickly. The United States has seen recent outbreaks in the Orthodox Jewish community, among Slavic migrants, in the Amish community in Ohio and the Somali community in Minnesota, because measles spreads quickly in a small, closed group and then it affects anyone else they come into contact with outside who has not been immunised. The United Kingdom should urgently work with religious leaders worldwide and say, “Please make a declaration to ensure that none of your leaders—none of those who promote a faith under your auspices—are in any way in any doubt about the value and importance of vaccination and say that there is no religious tenet against it.”