Oral Answers to Questions

Stephen Crabb Excerpts

Tuesday 26th June 2018 Commons Chamber

[Mr Speaker]

If any colleague can produce a single-sentence question, it will maximise participation.

[Stephen Crabb (Preseli Pembrokeshire) (Con)]

Will my right hon. Friend join me in welcoming the landmark visit today by His Royal Highness the Duke of Cambridge, the first member of the royal family to officially visit Israel? The visit underlines the deep bond of friendship between the two countries.

[Alistair Burt]

Yes indeed. The Government are delighted at the visit of His Royal Highness the Duke of Cambridge. It is an important opportunity for His Royal Highness to promote the strong relationships between the British, Jordanian, Israeli and Palestinian peoples.

Vaccinations: Developing Countries

Stephen Crabb Excerpts

Wednesday 13th June 2018 Westminster Hall

[Stephen Crabb (Preseli Pembrokeshire) (Con)]

I beg to move,

That this House has considered the economic effect of vaccinations in developing countries.

It is an enormous privilege to serve under your chairmanship, Mr Evans. I am grateful to have secured time to lead what will probably be a short debate, but I hope a positive and useful one, on a subject on which this Government and successive British Governments of different colours have shown leadership and genuine commitment.

I am delighted to see the Minister in his place. He has had a busy time in Westminster Hall in recent weeks and I almost feel reluctant to drag him back here again, but I hope he finds the debate useful and enjoyable. I know that I and other hon. Members here today look forward to hearing his usual wisdom and intelligence on such matters during his winding-up speech.

Today, nearly half the world’s population, including 1 billion children, live on less than $2.50 a day. More than 1.3 billion people live in extreme poverty, which means they survive on less than $1.25 a day. We get so used to reading those statistics that it is sometimes easy to forget what the reality means. It means families who go to bed at night hungry, wake up hungry and then go to bed the following night still hungry. It means families where people are incredibly blessed to have access to anything more than a very basic education, if any at all. These are people for whom daily work is repetitive, painful and dangerous, and who certainly cannot afford for themselves or a family member to fall sick.

We know that behind every statistic there is a human being. According to UNICEF, 22,000 children die every single day due to poverty. I do not believe that anyone in this House, or the wider British public, finds that acceptable. With many other countries, non-governmental organisations, private individuals and institutions, Britain is committed to working to end that poverty and to tackle the conditions and causes that trap people and whole nations in cycles of poverty.

As a Conservative, I believe strongly that free trade, markets and the rule of law play a powerful role in lifting nations out of poverty, but I also know that they cannot bring an end to some of the deep-rooted factors that perpetuate cycles of poverty around the world. That is why I am hugely supportive of the fact that as a nation, privately and through taxation, we provide large sums of money to fund interventions that seek to establish sustainable long-term solutions in the poorest nations. Britain is a leader in international development not just by virtue of the size of the budgets we make available, but through the expertise we deploy.

[John Howell (Henley) (Con)]

Is my right hon. Friend aware that the number of deaths from vaccine-preventable diseases is around 2.5 million to 3 million per year, but the number of people being inoculated has reached a bit of a plateau? Does not that say something about how we should focus our activities to establish better relationships with mothers, to reach hard-to-reach groups in Africa and Asia in particular, so as to take this further forward?

--- Later in debate ---

[Stephen Crabb]

I have heard that said, and I will go on to refer to the importance of reaching the hard-to-reach groups. There is evidence that that is the way to get, to put it crudely, more bang for our buck on the vaccinations spend, because the threat of outbreaks of killer diseases is higher for some of those isolated communities and families than for those elsewhere. My hon. Friend makes a useful point early in the debate.

For the last decade and more, there has been a political consensus that we should spend 0.7% of our GDP on international aid and assistance. At times in recent years, it has felt as though that consensus is being tested; certainly, the all-out assault on our aid budget in some sections of the popular press has had a corrosive effect, at least among some members of the general public. The discussion in the popular press is overwhelmingly dominated by questions over the headline funding commitment and the suggestion, repeated over and over again, that aid money could be better spent on domestic priorities.

While those of us who support Britain’s role as a leader in effective overseas development should never tire of restating the basic case for aid, we should also do more to draw attention to specific examples where UK aid has helped to achieve profound economic and social improvements in some of the poorest countries on earth. One area of British leadership and expertise that has received too little attention is the funding, development and distribution of vaccines against killer diseases, and I will use this short debate to highlight that. Diseases are not just an unpleasant inconvenience for a country; they ravage a nation’s economy, directly affect its ability to grow and hold back economic development. Diseases keep poor countries poor.

It was a British doctor, Edward Jenner, who pioneered the first vaccine at the end of the 18th century, when he used pus drawn from a cowpox boil to inoculate a boy against the killer smallpox—a story that many of us will have learned about in our schooldays. More than 200 years on, British science and medical research still lead the world in improving the health of people living in extreme poverty. The eradication of smallpox was one of the great achievements of immunology in the 20th century. Smallpox was once one of the world’s most feared and deadliest diseases. Just 60 years ago, it was endemic in dozens of countries containing around 60% of the world’s population. By 1980, it had been eradicated, following a concerted international effort.

More recently, polio, once epidemic, has almost been eradicated too, due to concerted vaccination efforts worldwide. It has been reduced by 99% globally and the number of polio-endemic countries has decreased from 125 in 1983 to just three today. That is the culmination of a remarkable international effort that brought together Governments, NGOs and many private individuals. Rotary clubs around the world, for example, took this up as a campaign and raised enormous sums toward the effort through community-led fundraising. Full eradication of the disease is within reach, showing again what can be achieved when we harness political will, public support, large-scale resources and world-class science. I believe that that formula is the key to so many of the interventions that will make the world a better place in the years ahead.

British medical and scientific research remain world leaders in the fight against vaccine-preventable diseases. We are part of numerous initiatives and alliances, recognising that multilateral co-ordination and use of public resources to leverage in private sector funding provide a strong platform for this work at a global level. I am sure the Minister will update us on some of those initiatives in his winding-up speech.

[Dr Dan Poulter (Central Suffolk and North Ipswich) (Con)]

I congratulate my right hon. Friend on securing the debate and on the speech he is making. On the issue of private company and pharmaceutical involvement in the development of vaccines, there has been a challenge, as we saw with the Ebola outbreak, in that this is not an area of great profit for pharmaceuticals; it is difficult for them to recoup their investment from lower-middle income countries. The pharmaceutical model needs more encouragement of pharmaceuticals to invest in development of vaccines such as Ebola. What would he say to encourage that?

[Stephen Crabb]

My hon. Friend, who knows an enormous amount about this field, makes an important point. We are essentially dealing here with a case of market failure, where markets in the purest sense do not work in bringing through vaccine development and distribution in some of the poorest countries. I will talk about that later. I am about to talk about GAVI, the Vaccine Alliance; the model on which it operates is based on tackling exactly that problem, where there is not sufficient market demand in a poor country to create the financial incentive or pull for pharmaceutical companies to invest there profitably.

GAVI was created in 2000 and it brings together the public and private sectors with the shared aim of creating equal access to vaccines for children living in the world’s poorest countries. Britain was one of its original donors, and today we provide around 25% of its funding. There is also the global health fund, which was created to accelerate the end of HIV/AIDS, tuberculosis and malaria as epidemics, and for which UK funding averages around £360 million a year. Last year, the global health fund partnered with GAVI and Unitaid to provide around $50 million to pilot the world’s first malaria vaccine for young children in Ghana, Kenya and Malawi. That vaccine has been 30 years in the making in fighting a disease that still claims thousands of lives each year.

Back in 2015, the former Prime Minister, David Cameron, announced a plan to tackle the risk of global health pandemics that included the establishment of a UK vaccines research and development network. The network’s focus is to bring together experts from industry, academia, philanthropy and Government to invest in projects on vaccines and vaccine technology to combat diseases with epidemic potential, such as Ebola and Zika, in low and middle-income countries. Britain has led from the front in the global fight against killer diseases.

Vaccines are widely recognised as an important mechanism for controlling infectious disease outbreaks, although they are by no means the only mechanism. In fact, the supply of clean water, for example, is even more important in reducing the burden of infectious diseases. However, it is right that the international effort to develop and distribute vaccines against deadly diseases, of which Britain is a key part, is a strategic priority for our overseas aid policies, and it needs to remain so.

At the heart of that challenge is the market failure referred to by my hon. Friend the Member for Central Suffolk and North Ipswich (Dr Poulter). Outbreaks of some of the world’s deadliest diseases occur only intermittently, and often in the world’s poorest countries, meaning that there might not be a strong market incentive for the pharmaceutical industry to develop vaccines for such diseases.

The UK Government are taking concerted and co-ordinated action to address that market failure. For example, the UK has committed to invest £120 million between 2016 and 2021 in the development of new vaccines for diseases with epidemic potential, in line with the expert advice provided by the UK Vaccine Network. The UK is also helping to build laboratory capacity, surveillance networks and response capacity in low and middle-income countries to deal with the threat of antimicrobial resistance, which militates against the efficacy of drugs in treating diseases.

Some of the health impacts of vaccinations are widely known. For example, between 2010 and 2016, 109 million children were given the pneumococcal vaccine to protect against the main cause of pneumonia, saving an estimated 760,000 lives. In 2017, nearly 1 million people were vaccinated against cholera when an epidemic threatened South Sudan. Only 400 people lost their lives, thanks to an integrated approach that also incorporated surveillance, investigation of and response to cases by rapid response teams, the provision of clean water and the promotion of good hygiene practices. We could cite many other examples.

However, the wider economic benefit of vaccination programmes to the poorest nations has not been fully explored. More research and data are needed to help us to tell the full story of how and why investing in vaccinations helps to alleviate poverty and create stronger foundations for economic success. We certainly know that high out-of-pocket expenditures contribute to poverty, and healthcare can be one of the most significant such expenses for those living in poor countries. In 2010, the World Health Organisation reported that the cost of healthcare prevented many poor people from seeking treatment while simultaneously pushing 150 million care seekers into poverty each year. Put simply, poor people getting sick is likely to make them even poorer and to wreck their future earning potential. When that picture is repeated across families and communities, the consequences can be dire.

At economy level, we have evidence of the ravages that killer diseases can cause. For example, the 2014 Ebola crisis in west Africa disrupted international trade and travel, cost at least $2.8 billion in lost growth and killed more than 11,000 people in the three countries worst affected by the outbreak—Sierra Leone, Liberia and Guinea. It had a severe developmental impact in those counties, placing already weak health systems under extreme pressure, and had a negative impact on employment and school attendance rates.

In February, Health Affairs published a study, jointly authored by researchers at Harvard University and GAVI, that looked at the health and economic benefits of vaccinations, which it showed have a poverty-alleviating benefit, especially for the poorest people. Although the study raised some specific questions about the delivery of vaccination programmes, distributional impacts and the transition away from aid-funded programmes as countries move across the poverty eligibility threshold, it nevertheless helped to strengthen the case for continued investment in vaccinations and helped to give us a fuller picture of how good aid spent well does exactly what we claim it does—saves lives and reduces extreme poverty.

[Dr Poulter]

My right hon. Friend makes an important point. Aid initiatives are far too often evaluated purely on what they cost the Department or organisation giving the money, but cost-benefit analyses that look at the wider economic and long-term healthcare benefits are how we should evaluate aid spending in the future. Will he join me in urging the Department for International Development to look at using those more effectively in the future when looking at how it spends its money?

[Stephen Crabb]

My hon. Friend makes an excellent point and I absolutely agree with him. That is exactly the kind of research and evidence that the Department and other bodies need to provide as those who believe in and support our overseas aid spending seek to make and restate the case for it over and over again. It is a powerful message with which to challenge sceptics and cynics.

In 2016, Johns Hopkins Bloomberg School of Public Health examined the projected return on investment in vaccinations between 2011 and 2020 in 94 low and middle-income countries. Looking only at the direct costs associated with illness, such as treatment and lost productivity, it found that the return for every £1 spent on vaccines was £16. When it expanded its analysis to look at the broader economic impact of illness, it found that the return was around £44 for every £1 spent. Such studies point to investment in vaccinations being an important means of improving health equity and reducing poverty, and to vaccinations providing value for money.

There is another aspect to this: investment in vaccinations in the poorest countries is also an investment in our own national security and resilience. I am always wary of the self-interest argument when it comes to defending overseas aid, and I think people generally see through those arguments, but polling evidence indicates that the general public understand that killer diseases such as Ebola do not respect borders and shows greater support for aid that focuses resources on tackling those diseases.

I will wrap up in a few moments, but I will close with several recommendations and observations, which the Minister will perhaps respond to today or follow up in writing at a later date. What efforts is Britain making, through its international partnerships and on its own, to improve vaccine coverage rates among the very poorest, ensuring that aid is spent on those who need it most and for whom it has the biggest benefit?

Distributional impacts should be taken into account when decisions are made about introducing or expanding vaccination programmes, and programmes accruing greater benefits to the poor should be prioritised over vaccines with less equity impact. Hard-to-reach families and people in isolated areas should be priority targets, as investment among those people significantly reduces the likelihood of disease outbreaks, which are more costly in lives and the money needed to respond.

Despite significant progress since 2000, today, nearly one infant in 10—that is, around 30 million children—does not receive any vaccinations, and more than 1.5 million children under the age of five die from vaccine-preventable diseases every year. Pneumococcal conjugate vaccines immunise against the most common cause of pneumonia, but they remain inaccessible to millions largely due to high prices, thus leaving behind the poorest and most marginalised children.

[John Howell]

I thank my right hon. Friend for giving way again; he is being most generous with his time. Does he see a role for the Prime Minister’s trade envoys in this sphere? We are often assigned to countries that fall into the categories that he has been talking about and we have a seminar coming up on the healthcare applications of what we can do. I do not think that that should concentrate solely on encouraging healthcare companies into those countries; it should also look at how we can help to develop those programmes.

[Stephen Crabb]

My hon. Friend makes an extremely important point. There are well established networks nationally in the UK and internationally, which bring policy makers together with academics, scientists and researchers who look at these issues. Surely within that there needs to be a role for people with a trade focus to link that investment angle into it as well. There would probably be a lot of interest, particularly among some of the private sector interests that are part of those networks, in seeing people such as Government trade envoys getting on board and helping with these programmes.

GAVI’s advance market commitment pilot, supported by the UK Government, has created a temporary but pioneering funding model that is changing the picture that I described—the poorest and most marginalised not getting access to vaccines—and it is doing so by changing the market. That funding mechanism can reduce the price of vaccines, such as the ones I have described for pneumonia, by creating an incentive for new manufacturers to enter the market and increase competition. The advance market commitment has succeeded in reducing the usual delay between introduction of a new vaccine in developed and in developing countries from 10 to 15 years to just three, reducing inequalities in access between rich and poor countries.

As we look to the future of programmes such as GAVI and the global health fund, which I was describing a few moments ago, we know that decisions will need to be made in due course about Britain’s ongoing support for those programmes. Those decisions will not necessarily be made anytime soon, but I urge the Minister and his teams, as they prepare for the replenishment conferences for GAVI and the global health fund, to bring together as much high-quality research and evidence as possible to enable them to make a strong, positive decision to continue funding those vital, life-saving programmes and, crucially, to explain that and show members of the public that it is a really good investment of our aid money for the future.

Investments in vaccines remain an enormously effective use of aid and contribute directly to achieving the sustainable development goals. Britain has a powerful track record to point to and we should do more to highlight that—not in the sense of being self-congratulatory, but to help to strengthen the broader case for overseas aid. Britain’s leadership in the field of vaccinations flows directly from the political consensus of a decade ago to expand our overseas aid budget and direct it towards some of the most difficult global challenges. The remarkable international effort on vaccinations underlines the importance of reforging that consensus and protecting UK aid.

[Jim Shannon (Strangford) (DUP)]

It is a pleasure to serve under your chairmanship, Mr Evans. I congratulate the right hon. Member for Preseli Pembrokeshire (Stephen Crabb) on bringing this matter to Westminster Hall for consideration today. I am very happy to make a contribution to support his proposals and the views that he has put forward.

When I look at my own life and at my two beautiful granddaughters, I know that there is little in the world that I would not do to protect them and help them, because that is what a father and a grandfather would do. There is no medication that I would not fight for, and that is why I have been trying to help my constituents to secure medication for their ill child and why I continue that fight, with help from the relevant Ministers. This is not the day for that debate; this is a separate debate, but I wanted to illustrate how much it would mean to me if I had to have medication to try to save my child and what I would do to make that happen. I do not think that there is one person in this Chamber who would not have the same opinion; we would do everything within our power to make it happen.

I think of those children in Africa and, indeed, throughout the world whose parents and grandparents have nothing; they have little or no way to get the help that their children need. As fathers and grandfathers, our compassion for them is illustrated through our own personal beliefs and through our actions to help those who do not have the ability to help themselves. That is why I am supportive of aid going to make a difference to the health of people in those nations, and why I have always supported DFID’s commitment and the Government’s commitment to the DFID aid programme. It may not be popular with everybody, but let us think about what it achieves. I will illustrate in my contribution what it achieves. It achieves a massive amount of help for the people who need it, and I am very supportive of that.

Prevention is better than cure. We have been practising that for some time on our own shores. It is why our newborns, every three months, have new injections that make them scream and their mothers squirm with guilt for knowingly causing them pain. The short-term pain will prevent massive life-threatening illnesses in the future and is of course well worth it, as we all know through our own parenthood.

It is estimated that the aid that we give GAVI between 2016 and 2020 will fully deliver on the UK target to immunise 76 million children and save 1.4 million lives. If ever anyone needed motivation for doing this, surely that is it—76 million children immunised and 1.4 million lives saved through the programme that we do; it is done by our Government. That is a tremendous result for the amount of aid that we grant for immunisation purposes. The fact is that through prevention we save money and promote economic growth, in that a child who is prevented from having a debilitating illness will be able to attend school and eventually start work and be able to provide, rather than being a drain on their family.

The right hon. Member for Preseli Pembrokeshire explained that when sickness comes into a family, the opportunity to earn is restricted right away, and that affects the whole family. That is the truth. If there are multiple cases in a family—two or three children and perhaps a father who is unable to earn and a mother who is not well—all of a sudden the problem is compounded. It is so important to recognise that.

There has been massive success with immunisation in Africa, and that must continue. For it to do so, we must have adequate funding and perhaps work more with partners across the world to ensure that they also have—I say this very gently—the conscience and the compassion that they should have for those who are less well off. The Vaccines for Africa Initiative website outlines success stories. There are some; let us not pass this by and say that we have not done well, because we have, but we can do more.

In 1977, smallpox was eradicated after a successful 10-year campaign carried out by the World Health Organisation. It was through our efforts with our partners that we made that happen. Before the vaccination programme began, smallpox threatened 60% of the world’s population and killed every fourth person infected. That was the magnitude of smallpox. Vaccinologists are applying the lessons learned during the eradication of smallpox to control and eliminate many other vaccine-preventable diseases, so lessons learned have become good practice. That indicates how we have learned and how we intend to do better in the future.

The development of an effective vaccine against polio was heralded as one of the major medical breakthroughs of the 20th century. Currently, several different formulations of polio vaccine are in use to stop polio transmission. Poliovirus infections have fallen by more than 99%, from an estimated 350,000 cases in 1988 to 416 reported cases in 2013. Let us dwell on that for a second: a 99% reduction resulting from an immunisation programme. If that is not good news, there is something wrong with what we are listening to. That is what can be done if we have the commitment, the effort, the finance and the drive to make it happen. Our Government have been involved in that programme; our Minister and his Department have been involved in making it happen.

More than 5 million people have escaped paralysis since the launch of the Global Polio Eradication Initiative in 1988 by the World Health Organisation and its partners, of which we are one. Polio has been eradicated in the western hemisphere, and many other countries have been declared polio free. Again, that is tremendous news. As at the end of 2012, polio was endemic in only three countries in the world. The website to which I referred states:

“According to the GPEI, if enough people in all communities are immunized, the polio virus will be limited to spread and it will die out.”

That has to be our goal: the complete eradication of polio. High levels of vaccination coverage against polio must be maintained to stop transmission and prevent outbreaks. The GPEI is constantly assessing the optimal use of the different vaccines to prevent paralytic polio and stop poliovirus transmission in different areas of the world. We have come so far, but we need to be vigilant to ensure that there is no comeback and that polio is totally eradicated.

Measles vaccination has not had the same success, but it is still a fantastic success story. It resulted in a 75% drop in measles deaths between 2000 and 2013 worldwide. During the same period, measles cases dropped by 58% from 853,500 down to 355,000—again, a massive drop and good news. The World Health Organisation recommends that every child receives two doses of the measles vaccine. I remember receiving it as a child in the 1960s quite well. I remember the swelling on my arm and the pain, but my dad stood next to me and made sure I had it done. He was always there to comfort me as well.

According to a report by the Measles & Rubella Initiative, African countries have made the most progress—fantastic progress. They reduced measles deaths by 86% between 2000 and 2014. That is another fantastic, well recorded success story of what we have done. Such stories ensure that we continue aiming for the eradication of these diseases.

Meningitis is a serious public health problem among 25 countries in the African meningitis belt. Every one of us, as elected representatives, has had constituents who have had meningitis in their family. We know of the blotches, the faintness, the dizziness and the tiredness. We know that if our child or grandchild has those symptoms, our knees knock with worry about meningitis, but in African countries meningitis is very real. It extends from Senegal, on the shores of the Atlantic ocean, to Eritrea along the Red sea. Meningitis is prevalent right across that stretch of Africa.

Half a million people living in that region are at risk from epidemic meningitis each year. In 1996, there was a particularly devastating meningitis outbreak, which caused more than 250,000 cases and 25,000 deaths. That was mainly due to the Neisseria meningitidis group A, or Men A, as it is referred to. Within 10 years, the Meningitis Vaccine Project developed an affordable Men A conjugate vaccine. The vaccine reduced the incidence of meningitis of any kind by 94%—is that not fantastic?—following a mass immunisation programme in Chad, in west Africa. If we can immunise, we can stop the disease, deaths, pain, suffering, sickness and illness, and that has to be good.

[Stephen Crabb]

I am enjoying listening to the hon. Gentleman’s speech. He captures well the sense of awe and wonder around some of the achievements that have been notched up in recent decades. Does he agree that we should be telling some of those stories in the school curriculum? As we think about Britain’s future global role, we should think about how to inspire a new generation of young British scientists to dedicate their education to going the last mile to finally eradicate some of the diseases he has been talking about.

[Jim Shannon]

The right hon. Gentleman is absolutely right. Too often, we focus on the negativity of life. Here is a positive thing we are doing. Others will speak afterwards with great knowledge of the subject matter and I look forward to their contributions. I am greatly encouraged by the young people of today, who have an eagerness and willingness to help others. That encourages me, as a grandfather and as the Member of Parliament for Strangford. I see talent, interest and compassion among young people today, who want to help. We should have this as part of our curriculum and education programme, so that we tell others and put a bit of pride back into what we do. That is why I am being positive in my speech. Sometimes we do not tell our story, but we should.

[Stephen Crabb]

On the subject of inspiring young people, is he aware of programmes such as the ONE campaign’s youth ambassadors programme, which links in young people with an interest and uses them to tell a story back to their own peer group about some of these exciting developments?

[Jim Shannon]

I am aware of that programme and the right hon. Gentleman is right; it is a smashing programme and can do great things. It can help young people to develop their personalities and their characters in a way that is good for everyone. That is the ultimate, perfect society that we all wish to live in. There are many young people who inspire us and give us great courage for the future.

I am blessed to have a great many church organisations, mission groups and individuals in my constituency of Strangford, both in Newtownards and across the whole constituency, which carry out individual projects, mostly in Africa and some in eastern Europe. They do smashing rebuild programmes for schools and medical centres. They do water aid projects as well. That is a subject for a different debate, but when it comes to ensuring that people do not have health issues, it is important that they have access to clean water. I pay credit to the churches and missions in my constituency, which do tremendous work, unselfishly giving their time, money and effort, and—I will say as a Christian—their prayer time as well. Those things are very important in trying to reflect the opinion of a constituency and how people think—how generous people are when it comes to giving, both financially and physically.

The work I have referred to must continue. We must play our part in helping other nations to fund this work for the good of humanity. It works, because we work together. How many things in this world can we do when we do it together, with a passion, belief and drive that we are all committed to? I say gently that we have to put our own people first, but that we also have to help ourselves outside our boundaries. I believe this is a great way for us to play our part. The inspiring programme that the right hon. Member for Preseli Pembrokeshire referred to is something for our young people to do—so many people want to do something. Our Minister and our Government are committed to doing the same. We should be encouraged by what we are doing, but we know that we have more to do. We have a plan of action in place—a plan of action that is working and that can do more.

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[The Minister of State, Department for International Development (Alistair Burt)]

It is a pleasure to serve under your chairmanship, Mr Evans, and I thank all colleagues for taking part in today’s debate and for the way it has been handled.

I thank my right hon. Friend the Member for Preseli Pembrokeshire (Stephen Crabb) for the way he introduced this debate—indeed, others have mentioned the passion with which he spoke. Such passion is appropriate for the leader of Project Umubano, and for a number of years he has played an integral part in the Conservative party’s social action programme in Rwanda and Sierra Leone. He spoke about the non-partisan nature of this debate, and that was emphasised by contributions from the hon. Members for Dundee West (Chris Law) and for Birmingham, Edgbaston (Preet Kaur Gill). There is no issue between colleagues in the House on this subject, and we are rightly proud of successive Administrations of all shapes and colours, and the work that has been done in making the United Kingdom a global leader in vaccination.

My right hon. Friend drew attention to the history of vaccination and the United Kingdom’s involvement in it. He mentioned our position in contemporary medicine, research and development, and spoke about looking forward to the next stage. As the long title of the debate suggests, he then moved from that historical perspective to the wider economic benefits of vaccination, and emphasised a link that is not made often enough.

The hon. Member for Strangford (Jim Shannon) spoke, as he always does, with passion, commitment and great wonder about the success of these programmes. Sometimes there is immense concentration in the press and media of everything that is wrong, but in the world of medicine, lives have been saved by finding opportunities to invest in things that have led to a reduction in diseases that were once all too common, including in our own childhoods, let alone 50 or 100 years ago. Medicine has made a remarkable contribution, and the hon. Gentleman was right to mention that. He encouraged us all to keep going on the eradication of polio, and he can be sure that we will.

My hon. Friend the Member for Ayr, Carrick and Cumnock (Bill Grant) linked access to our success and the importance of research, and he spoke with pride about his involvement with Rotary. I, too, am a Rotarian—I am an honorary member of the Rotary club of Sandy in Bedfordshire. I recently met Judith Diment, who is chair of the polio advocacy taskforce. Rotary has done remarkable work on that issue, and we pay tribute to everything it has done over the years.

My hon. Friend the Member for Stafford (Jeremy Lefroy) contributes a remarkable amount to this House through his work on malaria and in east Africa, and he related the importance of vaccine research in those areas. The hon. Members for Dundee West and for Birmingham, Edgbaston had some questions, and if I may, I will return to those at the end of my contribution—on this occasion I actually have some time, so I will be able to answer one or two of the questions, although not all of them.

Let me bring this back to basics and the practice of vaccination. My dad is a doctor, and I am old enough to have needed injections for polio when I was very young, as that was before the wonderful man developed his oral vaccine on a sugar cube. My dad had to give me my polio injections, and I hid under every available table in the surgery because as a small boy I was terrified of needles. He will be tickled pink to know that I am responding to a debate on vaccination today, bearing in mind the struggle he had to get near me with a needle. I am eternally grateful that he did, because those vaccinations protected me—as they did many others—from the ravages of polio. My dad is still with us, so he will be able to get a copy of this debate and realise that all those days from long ago are still remembered fondly by his son. This issue is that personal. The hon. Member for Strangford referred to the moment of pain caused by a mother when a child gets vaccinated, although she knows that it will do so much good in future, and today we are remarking on the remarkable good that is done.

The number of children dying each year almost halved between 1990 and 2012—a significant achievement. Nevertheless, around 375,000 children still die every year from diseases that could be easily prevented by vaccines. As we all agree, the challenge is most acute in the developing world, where nearly 1 million children die every year from pneumonia. In 2016, 7 million people were affected by measles, resulting in nearly 90,000 deaths. It is therefore right that the UK works through organisations such as GAVI, the Vaccine Alliance, the Global Polio Eradication Initiative and the World Health Organisation to tackle vaccine-preventable diseases.

Clearly there is a strong moral case for the UK and its international partners to support developing countries to tackle the scourge of vaccine-preventable disease—the contributions to the debate have shown that we all understand that. However, the economic case for vaccination—a subject that my right hon. Friend the Member for Preseli Pembrokeshire homed in on—is also unquestionable. Vaccinating against childhood diseases is one of the most cost-effective health interventions. As colleagues have said, for every £1 spent on immunisation, there is a direct saving of £16. Those savings include healthcare costs, lost wages and lost productivity due to illness. Vaccination is a key driver towards reducing childhood mortality globally, and vaccines administered in 41 of the world’s poorest countries between 2016 and 2030 will prevent 36 million deaths.

Vaccination provides economic benefits many times beyond the direct costs of vaccinating children, which is why it is such a high impact investment. As the hon. Member for Dundee West reminded us, if we take into account broader economic and social benefits, the return on investment rises from £16 to £44 for every £1 invested. The wider economic benefits of vaccination are vast.

By preventing illness, whole families are freed from crippling medical costs, which in turn can have a substantial effect on poverty reduction. Unexpected healthcare expenses push about 100 million people into poverty every year, making medical impoverishment one of the main factors that force families below the World Bank’s poverty line. A vaccinated child is more likely to be healthier, live longer and have fewer and less serious illnesses. Healthier and more productive populations trigger a virtuous cycle that results in enormous economic gains. Vaccinated populations therefore form a more productive labour force, resulting in higher household incomes and economic growth.

There is a clear positive relationship between immunisation and education. Vaccines support cognitive development, so children learn more and have more opportunities. In the Philippines, for example, routine immunisation was found to raise average test scores among students. When translated into earning gains for adults, the return on investment was shown to be as high as 21%. In Bangladesh, measles vaccination was found to increase school enrolment of boys by 9%.

There is also an effect on the next generation. Children of educated parents are more likely to be vaccinated and healthier. In Indonesia, for example, child vaccination rates are just 19% when mothers have no education, but increase to 68% when mothers have at least a secondary school education.

Additionally, the decrease in child mortality as a result of routine immunisation can have a significant impact on a country’s economy by reducing fertility rates. Since more children are expected to survive, families have fewer children. A lower birth rate has significant effects on child and maternal health, as well as a broader economic impact, not least in the role that it might play in the development of women’s opportunities in their societies. Up to 50% of Asia’s economic growth from 1965 to 1990 is attributed to reductions in child mortality and fertility rates. Overall, the savings that come from the need to pay for fewer medical interventions, combined with a healthier, more productive labour force and demographic dividends, create more economically stable individuals, communities and countries.

Let me turn to some of the questions asked by hon. Members. First, we are very proud to be the largest investor in GAVI, the Vaccine Alliance. The UK recognises the strong and convincing economic arguments for vaccines as being a clear development best buy. That is why we, through the Department, have supported GAVI since its inception in 2000.

Since then, our investment has supported the immunisation of 640 million children and has contributed to the prevention of 9 million deaths from vaccine-preventable diseases. Those are remarkable figures that, as my right hon. Friend the Member for Preseli Pembrokeshire said at the start of the debate, and as we have all said, we do not talk about nearly enough. If someone is looking for a demonstration to put to the people of the positive advantage not just of UK aid, but of any country’s development budget, and of why they are useful, vaccination is possibly the single most obvious example that they can give.

Between 2016 and 2020, the UK’s support to GAVI will directly enable 76 million children to be vaccinated and will save 1.4 million lives. Investment through GAVI represents a particularly high rate of return. The £16 direct return for every £1 invested, which I mentioned earlier, rises to £18 in the 73 developing countries that GAVI supports. Overall, between 2001 and 2020, in GAVI-supported countries, the long-term gains associated with a more productive workforce are expected to add up to £260 billion. Every year, as a result of vaccinations, each of those 73 countries will avoid more than £3.5 million in treatment costs.

Critically, GAVI not only delivers vaccines on an impressively large scale, but works to bring down the cost of vaccines to make them more affordable for the world’s poorest countries. Since 2011, GAVI has enabled a 43% reduction in the cost of immunising a child, from $33 to $19. That price cut means that UK taxpayers’ money goes much further and delivers a much greater impact, and brings those products within the reach of poorer countries’ Governments, which was a key point made by the hon. Members for Birmingham, Edgbaston and for Dundee West. Our support for GAVI is explicitly designed to ensure that Governments in developing countries gradually increase their contributions until they eventual transition away from aid, which the price cut also helps with.

In response to the point made by the hon. Member for Dundee West about bilateral funding, some time ago the United Kingdom made a decision to put its support for vaccination into GAVI, because it has a wider reach than our bilateral funding programmes. That is why the contribution to GAVI has been so strong: it allows us to reach more children. We continue to offer bilateral support to health systems to make them more sustainable. Of course, GAVI will work in some of the areas where the UK is also working directly through the Department.

On the need to ensure that vaccinations support equity, the financial benefits of vaccines are mostly accrued by poorer households, which are more susceptible to financial shocks from unexpected healthcare expenses. Immunisation programmes reduce the proportion of households facing catastrophic out-of-pocket health expenses. GAVI ensures that the right people are reached through the three equity measures in its monitoring framework, which track vaccination coverage by geography, poverty status and the mother’s education. We work with GAVI to ensure that the vaccinations are reaching the poorest, as my right hon. Friend the Member for Preseli Pembrokeshire said in his opening remarks. GAVI is designed to do so, and we will continue to work with it on that.

[Stephen Crabb]

Will the Minister address the question asked by several hon. Members about why the levels of inoculation seem to have plateaued internationally? Is that correct and, if so, what might be the underlying causes? I hope he will forgive me if he had planned to come on to that in the next few moments.

[Alistair Burt]

I cannot give my right hon. Friend the figures, but let me say two things. First, in some areas, there has been a reaction against vaccination. Earlier this year, two vaccinators in Pakistan, a mother and a daughter, were killed. The Pakistani Government have worked with others to try to change the nature of the programmes, but that is a reminder of how brave some health workers have to be. In some cases there is a supposed religious objection to vaccination, and in others it can be more direct.

Secondly, yesterday, in another context, I mentioned in the House the issues that are being faced in Yemen due to the de facto Houthi authorities in the north of Yemen, which have refused permission to transport vaccines into Sana’a. That has meant that 860,000 people in the north have not received vaccines, while hundreds of thousands of people in the south have benefited from the campaign. The Department is working closely with the World Health Organisation and through diplomatic channels to help unblock the use of vaccines in Yemen, particularly in Houthi-controlled areas.

In some areas, the cause is conflict; in others, it is an ideological response or a false fear that has been spread. In some areas, vaccinators are somehow seen as being connected to the west, and it is easy for false stories to spread. All those things need to be combated, and perhaps one way to do that is to ensure that there are more local programmes, because it is essential that the effort of vaccination continues, as all hon. Members have said.

In particular, we cannot afford to lose the chance to eradicate polio, and we have to be very careful. The rise in measles may be connected to some false stories about vaccines. There appears to be a market for people who want to spread those false stories, not only in developing countries but in places such as the United States. Fake news has to be combated. The outstanding research in this area makes it very clear that the benefits of vaccination far outweigh any potential medical consequences, of which there are some from time to time, but in a very tiny proportion of people. It is essential that the public grasp that.

Let me return to other remarks by hon. Members. We have talked about how we can ensure that future research is done in areas where the economic benefits of a vaccine may be questionable and about what help we can give. That is not an easy issue to tackle or to be absolutely certain about, because the specific diseases market is highly variable and pharmaceutical companies need to know that they will make a sufficient profit for a new market initiative to be possible.

However, things can be done to assist with that. GAVI’s advance market commitment, which the hon. Member for Birmingham, Edgbaston mentioned, has done significantly well, and we have provided finance to support it. It now produces 150 million doses of the pneumococcal conjugate vaccine annually at a price of $2.95, which is significantly lower than market price. GAVI also provided £390 million as an advance purchase commitment for the Ebola vaccine, which enabled Merck to make 300,000 doses available. In the Democratic Republic of the Congo, that vaccine was implemented 13 days after the Ebola outbreak was announced.

There are ways in which the international community can help to ensure that some of the costs are borne collectively, but that is not always an easy process, so there will always be issues about how to develop the vaccine and how to pay for it. The Government are well engaged in dealing with those.

I will conclude and offer my right hon. Friend the Member for Preseli Pembrokeshire a chance to respond. As well as the support for GAVI, the UK invests in vaccines in developing countries in a range of ways. We are a leading supporter of eradicating polio, as has been mentioned. That investment brings economic returns of many times the magnitude, and a stronger global economy that will benefit us all.

Hon. Members also mentioned Ebola. The handling of the recent outbreak contrasts with that of the previous one. The WHO and the Department supported the development of two Ebola candidate vaccines during the 2014 outbreak that have been brought through into the most recent one. These are some examples of how we—through DFID, GAVI and bilateral programmes to strengthen and sustain health systems—have been able to put vaccination at the very top of the agenda, as the most cost-effective way of dealing with health problems.

I conclude by acknowledging the dedication and hard work of all the health workers around the world, who often put their lives at risk to deliver vaccines to children, even in the hardest-to-reach places; by saying that I am very proud of the United Kingdom’s investment in vaccines in developing countries, and I say that on behalf of us all as this is a non-party issue; and by saying that saving the lives of children and improving the lives of families in some of the world’s poorest countries is simply the right thing to do.

Finally, I will say that the exchange between the hon. Member for Strangford and my right hon. Friend the Member for Preseli Pembrokeshire about the inspiration that can be gathered for this work and the promotion of it through schools, so that people are more aware of what we can do, is the way that we should finish today. Sometimes this place has to deal with difficult subjects that occasionally colleagues fall out over—not this one. This is something we can agree on and we can all use our own influence to ensure that a new generation of young scientists, young doctors and young health professionals are inspired to work, not only in this country but throughout the world, knowing how important vaccination will continue to be.

[Stephen Crabb]

Thank you, Mr Evans, for calling me to speak again.

By way of wrapping up, I will just thank the Front Benchers. I thank my right hon. Friend the Minister for that very useful update he has given at the end of this debate. I also thank the other Front-Bench spokespeople, the hon. Members for Dundee West (Chris Law) and for Birmingham, Edgbaston (Preet Kaur Gill).

This has been a very useful debate; I have certainly learned a tremendous amount. I am grateful to all the colleagues who have spoken or made interventions, and for the spirit in which they did so. As my right hon. Friend the Minister said, this is an issue on which there should be no differences at all between the parties. It can bring this House together as something to unite behind, not to be self-congratulatory, but to recognise the remarkable progress that successive British Governments have helped to achieve internationally, in partnership with so many other international bodies and other Governments.

I will finish by asking the Minister to urge his team at the Department to keep briefing us and updating us on these developments. Do not keep Members in the dark—not that he does at all. However, there is a powerful story that we all want to tell in our constituencies about this issue, and it would be incredibly helpful if he and the NGOs that his Department works with provided us with as much information as possible.

[Alistair Burt]

Perhaps I might make an immediate commitment. I will write to all colleagues here, on the back of this debate, to set out some of the facts that have been raised by us all and, as it were, do it in the form of a factsheet, which they will then have available to give to constituents. I am very grateful to my right hon. Friend for the suggestion.

[Stephen Crabb]

I am grateful to my right hon. Friend the Minister for that response.

Finally, Mr Evans, I thank you. As ever, you have chaired this afternoon wonderfully. Diolch yn fawr.

[Mr Nigel Evans (in the Chair)]

As someone who has witnessed the vaccination, via the Department for International Development, of many babies under a tree in Uganda with the International Development Committee, may I say what a privilege it has been to chair this debate?

Question put and agreed to.

Resolved,

That this House has considered the economic effect of vaccinations in developing countries.

Hezbollah’s Rocket Arsenal: Southern Lebanon

Stephen Crabb Excerpts

Wednesday 6th June 2018 Westminster Hall

[Mr Philip Hollobone (Kettering) (Con)]

I beg to move,

That this House has considered Hezbollah’s rocket arsenal in southern Lebanon.

It is a delight to serve under your chairmanship, Sir Christopher. I thank Mr Speaker for granting this debate, and I welcome my right hon. Friend the Minister to his place to listen and respond. I called the debate because on the northern border of one of our closest allies, Israel, there is a rocket arsenal of up to 150,000 missiles aimed at all its major towns and cities, and something should be done about that. In the debate, I will rely heavily on a superb report by the High Level Military Group, “Hizballah’s terror army: how to prevent a third Lebanon war”, which was published in October.

The High Level Military Group is a group of distinguished international senior military figures, including our own General Lord Richard Dannatt and Colonel Richard Kemp, which has looked into the issue thoroughly. The report gives us a stark warning:

“The last war between Hizballah and Israel in 2006 was a severe blow to the terrorist group. But since then, Hizballah has been able to recover militarily, amassing a huge stockpile of weapons, developing and fielding new and more precise and lethal systems, and gaining combat experience fighting for Iran and…in Syria.”

[Stephen Crabb (Preseli Pembrokeshire) (Con)]

On the subject of Hezbollah being a terrorist organisation, does my hon. Friend share my view that the distinction that we choose to make on our side—that there is a military and a civil wing to Hezbollah—is entirely artificial and that Hezbollah sees itself as a unified terrorist military organisation?

[Mr Hollobone]

Yes. Not only do my right hon. Friend and I agree that there is no distinction, but so does Hezbollah. In October 2012 its Deputy Secretary General, Sheikh Naim Qassem, said:

“We don’t have a military wing and a political one; we don’t have Hezbollah on one hand and the resistance party on the other… Every element of Hezbollah, from commanders to members as well as our various capabilities, are in the service of the resistance, and we have nothing but the resistance as a priority.”

--- Later in debate ---

[Alistair Burt]

Yes, Mr Speaker—sorry, Sir Christopher. I am giving you an elevation there—in due course.

In response to the hon. Gentleman’s intervention, yes, the premise of the debate is correct; there is no argument about that here. Hezbollah is a dangerous and destabilising force. It sits on the northern border of Israel. Israel has every right to be concerned and to seek support in relation to dealing with that. That is what I would like to explain in terms of the United Kingdom’s relationship here.

I confirmed the United Kingdom’s support for the position in UN Security Council resolutions 1559 and 1701 when I was at the International Support Group for Lebanon meeting in Paris last December and at the Rome II ministerial conference on support to the Lebanese security forces in March. The joint statements that followed those meetings, which were agreed by a large cross-section of the international community, emphasised the role of the Lebanese armed forces as the sole legitimate armed force of Lebanon. I should add that Israeli overflights of Lebanon also violate UN Security Council resolution 1701 and contribute to increased tension in the area. The activity by Hezbollah risks triggering a conflict between Hezbollah and Israel on a scale far beyond that seen during the 2006 war. That could devastate Lebanon and further destabilise an already vulnerable region.

The UK has made clear our concern at Hezbollah’s destabilising actions in Lebanon and the region. We operate a policy of no contact with the entire organisation, and we have repeatedly condemned the group’s support for President Assad’s brutal regime in Syria.

[Stephen Crabb]

I am listening to the Minister with great interest, as I always do. Just a moment ago, was he drawing an equivalence between Israeli overflights of Lebanese territory and Hezbollah’s stockpile of 150,000 rockets?

[Alistair Burt]

No, not at all, and I would not seek to do so. I was saying that when people are looking for violations of resolution 1701 in the region, as they do, that is an issue that comes up. Clearly, the risk of the missiles is far beyond that of Israeli overflights. I mentioned it simply because if people are going to take note of the resolutions, then everyone should do so, but I fully understand the context in which the overflights take place.

The UK proscribed Hezbollah’s external security organisation in 2001. In light of Hezbollah’s support for militant groups such as Jaysh al-Mahdi, which was responsible for attacks on British troops in Iraq, we extended the proscription in 2008 to include Hezbollah’s military wing, including its jihad council and all units reporting to it.

We are working with our European partners to challenge Hezbollah’s malign activities, as my hon. Friend the Member for Kettering set out. We are a key player in international efforts to strengthen the global response to money laundering, terrorism financing and crime. The UK is a founding member of the Financial Action Task Force. We spend significant resource on strengthening that global network, working with it and the Financial Action Task Force regional body for the middle east and north Africa. We fund and deliver a significant amount of technical capacity-building, including in the middle east. We also designate certain individuals linked to Hezbollah under the Terrorist Asset-Freezing etc. Act 2010.

UK Relations with Qatar

Stephen Crabb Excerpts

Wednesday 23rd May 2018 Westminster Hall

[Sir David Amess]

That is a very good point, and I will come to that a little later in my remarks on the economy. My good and hon. Friend has made an excellent point.

Human Rights Watch and other groups have raised concerns about conditions that workers face while working on building sites, such as football stadiums. I did not go to the football stadiums myself, but other members of the delegation did. One gentleman was killed under terrible circumstances while involved in the construction that was taking place. Human Rights Watch says that people have been exposed to extreme heat and humidity, have lived in poor accommodation and have earned low wages. As I said, workers are reported to have died on such projects, although I think the Qatari Government would dispute the figures. Even though the figures are disputed, the British Government would obviously have some concerns about that issue.

I think Qatar has made progress in recent months in introducing new laws that provide greater protection and freedom for migrant and domestic workers. I was pleased to hear that Impactt, a UK-based ethical trade consultancy, has been working closely with the state as its external compliance monitor for the World cup, and some of our delegation met a number of officials. Work has involved an extensive audit of working conditions at sites under construction, and Impactt’s second report, published in February, highlighted the progress on recruitment fees and enhanced worker representation. I believe that the United Kingdom will always support the upholding of workers’ rights, and I welcome Qatar’s labour reforms.

[Stephen Crabb (Preseli Pembrokeshire) (Con)]

On the point about labour market reforms, did my hon. Friend become aware on his visit to Qatar and in his discussions with officials there—as I have become aware—that they genuinely sense that the eyes of the world are on them in the run-up to the World cup? They are making genuine attempts to demonstrate that their labour market reforms are real, and they are delivering real improvements to the lives of the guest and migrant workers in the country.

--- Later in debate ---

[Stephen Crabb (Preseli Pembrokeshire) (Con)]

I congratulate my hon. Friend the Member for Southend West (Sir David Amess) on securing this timely and important debate, and on the brilliant job he did in describing where we are at in UK relations with Qatar and our diverse range of mutual interests in continuing to foster a close and growing relationship. It is also a pleasure to follow my good friend, the right hon. Member for Orkney and Shetland (Mr Carmichael), who spoke with characteristic intelligence and wisdom about a difficult, challenging neighbourhood that we have relationships with; he offered thoughts about the way forward.

My hon. Friend the Member for Southend West alluded to my constituency interest in Qatar, which was the starting point for my interest in that country and in our relationship with the state more broadly. As a Welshman, I feel a natural affinity with small, ambitious countries that want to punch above their weight on the world stage. I could extend the comparison and talk about complicated relationships with larger next-door neighbours, but that might risk upsetting some of my English colleagues.

In May 2009—almost exactly nine years ago—we had the official opening of the South Hook liquefied natural gas terminal in my constituency. At the time, it was by far and away the largest single investment in Pembrokeshire for more than a generation, and it remains one of the largest single investments in Wales in the last 10 to 15 years. For the opening, we had not just one member of a royal family visiting, but six members of two royal families. Her Majesty the Queen, His Royal Highness the Duke of Edinburgh and Prince Andrew from our royal family were there, along with the Sheikh and his wife, Sheikha Mozah, and another member of the Qatari royal family. It was rightly an enormous occasion, reflecting the scale and size of the investment, and the statement that we sought to make about the future, forward-looking relationship between Qatar and the United Kingdom.

South Hook represents a growing relationship based on energy security. As my hon. Friend the Member for Southend West mentioned, we are becoming increasingly dependent on imported natural gas as our domestic production from the North sea has declined over the past 10 years, and a large share of our imported liquefied natural gas comes from Qatar. In fact, the South Hook terminal in my constituency has capacity for about 25% of the UK’s natural gas supply at any one time. It is an enormous investment. If hon. and right hon. Members in this room are interested, I encourage them to come to my constituency and see the scale of the energy facility. Such imports will be more important in future. The Qatari investment has given the United Kingdom more diversity in our energy supplies, so that we can help build increasing resilience and energy security at a time when we have become more dependent on imports.

As well as providing excellent, high-quality jobs, the South Hook terminal has been an incredibly generous and intelligent supporter and funder of local charities in my constituency. If Members were to visit Preseli Pembrokeshire, I wager they would find that no constituency outside London has a greater proportion of constituents who can describe with some knowledge our relationship with Qatar than mine. For the past 10 years, we have been very aware of the importance of the relationship.

The relationship is not just about energy security, important though that is. At the start of this month, we had the first commercial flight between Doha and Cardiff airport—an exciting development for the latter, given that it is relatively small for a capital city airport. It is a big statement of ambition that the leadership of the airport was able to secure a deal with Qatar Airways and have a commercial service fly between Cardiff and Doha. It helps put Wales on the map, and helps open up Wales’s economic opportunities in the Gulf—and, through Doha’s network of transport links, around the world.

I pay tribute to the chairman of Cardiff airport, Roger Lewis, who has done a brilliant job in taking forward the vision of cementing a strategic relationship with Qatar Airways. The Welsh Government, who I do not always have a lot of positive things to say about, have played a positive and constructive role in driving forward the airport’s relationship with Qatar.

[Bob Stewart]

I am intrigued. Presumably, Welsh tourists go to Qatar on holiday. Do they make up a percentage of the people on board the aeroplanes?

[Stephen Crabb]

I am cautious about the number of Welsh tourists visiting Doha. In the first instance, we are trying to develop the business travel market, but all these things have potential. Students from Doha visit the United Kingdom, and increasing aviation links from the UK regions to Doha can only support that.

When I was Secretary of State for Wales in 2015, I was pleased to give early support, and tried to inject a little momentum into the vision for a Qatar-Wales link. I am absolutely delighted that that has been brought to fruition, and I wish it every success. I do not expect the Minister to comment on this, because it falls far outside his Department, but for a long time the Welsh Government have been asking the UK Government to devolve air passenger duty to them, so they can use that as an extra tool to help them develop the long-haul overseas aviation market. I put on record that I was not able to convince David Cameron or George Osborne to change the policy, but it is probably time to look at that again, given that the leadership of Cardiff airport has been so successful in striking up a relationship with the Qataris.

On the wider diplomatic front, I find Qatar’s ambitious foreign policy a thing of wonder. It is extraordinary how ambitious it has sought to be over the past 10 years. It has an interesting, wide and complicated set of relationships in the region and globally. It is able to have direct conversations with partners in the region that, perhaps for political reasons, we are not able to have. There is enormous opportunity for the United Kingdom and the international community to work with Qatar to develop deeper, more constructive diplomatic ties in what is, as I say, a very challenging and difficult neighbourhood. There is the immediate issue of the blockade and its conflict with its immediate neighbours. It has to be in our national interest to see that conflict brought to an end and resolved. Looking to the longer term beyond that, Qatar has demonstrated that it is a resourceful, agile, diplomatic player globally, and we need to work with Qatar to see positive things happen in the region.

The Minister knows that I have an interest in other countries in the region. In particular, I have an interest in the quest for security for Israelis, alongside the quest for statehood for Palestinians. I am absolutely sure that Qatar has a role to play in that, given its resources and its network of relationships across the region. It is often, as I say, able to have direct conversations with players in ways that we cannot. We want Qatar to play a constructive role in the region.

I take the point made by the right hon. Member for Orkney and Shetland about having frank conversations with the Qatari Government and their ambassadors in London. I have had those frank discussions, and have always been impressed with how open and willing they have been to discuss quite difficult issues. That is what friendship is all about. Having a good friendship with a state such as Qatar means that we can have those difficult, challenging conversations. We can talk about the questions that get raised around terrorist financing and human rights, and what role Qatar can play in supporting peace between the Palestinians and Israel in the middle east. Friendship does not prevent us having those discussions; it provides a strong platform that enables us to do so.

In conclusion, this is a good moment to recognise, appreciate and celebrate the UK’s relationship with Qatar, and a good moment to think about some of the immediate challenges. I encourage the Minister to offer us his thoughts on where he sees the UK-Qatari bilateral relationship going and what benefit the UK can get from Qatar’s wider set of relationships internationally.

--- Later in debate ---

[Peter Grant]

Not being an Arabic speaker I do not watch al-Jazeera in Arabic—I seldom watch it in English—but as reported by the BBC, some of its coverage of the terrorist murders of innocent hostages, for example, was highly insensitive. It appeared to be designed to give a propaganda victory to the terrorists, which we cannot condone.

Mention was made of the close military links between the United Kingdom and Qatar, and the current Emir and his father who preceded him are both graduates from Sandhurst. One reason—not the main one—why we must hope that the current diplomatic crisis between Saudi Arabia and Qatar does not escalate into anything else is that both countries use British planes and pilots who were trained in Britain by the RAF. It would be terribly ironic if a conflict that cost lives in the Gulf involved two parties using British-made technology against each other. That is a salutary lesson, and we must be a bit more careful about who we are prepared to sell weapons and military hardware to. We cannot always be sure that those weapons will be used against the people we might wish them to be used against.

The right hon. Member for Orkney and Shetland referred to his difficulty in imagining the need for air conditioning at a football match. He is one of four or five of us in this debate who, if we were fanatical football fans, would find it difficult to imagine a situation in which it mattered a jot where the World cup was being played—I can just about remember the last time that Scotland went, and I do not think Wales have been there since 1958. I hope they will get there at some point.

Qatar is obviously using the World cup to try to persuade the rest of the world that it is moving forward, but we must ensure that progress continues after 2022. I welcome a lot of the promises made last year about improved protection and rights for workers, but we must ensure that those promises start being delivered this year, and continue to be delivered not just until 2022, but into the late 2020s, the 2030s and beyond. The improvements and changes must be permanent.

Mention has been made of some of the demands that the Saudis and their neighbours have made on Qatar, but as I said when I intervened on the right hon. Member for Orkney and Shetland, a lot of those countries need to examine their consciences about some of the groups that they have supported in other countries. It is, for example, a bit much for Saudi Arabia to object to the fact that Qatar appears to be supporting unpleasant acts in other countries, while it is bombing civilians to death in Yemen and elsewhere.

Although some of the demands and requests appear to be reasonable, Qatar is being asked to break all contact not only with terrorist groups in certain countries, but with political opposition groups. Imagine if the United States Government asked us to stop sending parliamentary groups over to meet Democrats at the time of a Republican President, or to stop going to European countries and speaking to Opposition politicians as well as those in the Government. That is effectively what the Saudis are asking for, and although some of the demands are perfectly reasonable—any allegations of state funding of terrorism anywhere must be independently investigated by an international court or tribunal—we must also say to our friends in Saudi Arabia, “Just wait a minute, you’re going a wee bit too far with this.”

Some of the rhetoric we are seeing from the Saudis and some of their allies reminds me of some of the inflammatory language that we have become far too used to in the claims and counter-claims between Israel and its Palestinian neighbours. They are not just talking about digging a ditch to physically cut off Qatar from the rest of the continent; they are talking about deliberately dumping nuclear and toxic waste on the Qatari border, where the potentially lethal impact will affect Qataris as much as—or more than—anybody else. That sounds to me like a threat of chemical and biological warfare. It might simply be rhetoric, and perhaps the claims are being made more for the consumption of the Saudi Arabian population, to convince people that their Government are standing up to Qatar, but any such threat should be dealt with by a firm response from the international community. Saudi Arabia should be asked to explain itself at the United Nations. All too often in the conflict between Israel and Palestine, once people start talking the language of atrocity the action of atrocity follows quickly afterwards.

We should call on all sides in the dispute in the Gulf to tone down their language, resort to diplomacy, and look to get some kind of agreement. We must also make it clear to Qatar that if there are credible allegations of serious crimes against international norms, whether or not the Government are directly involved, it must be open to having them investigated.

[Stephen Crabb]

The hon. Gentleman is making an interesting speech. Has he sat down with any of the diplomats at the embassy in London and had this discussion with them? If he has, what feeling did he get from them?

[Peter Grant]

I have not personally had such discussions, although I would be perfectly happy to.

As I was saying, we should be prepared to seek independent investigations into alleged funding or support for terrorism by Qatar, but we should also seek independent international investigations into the 150-plus allegations of war crimes against Saudi Arabia. It is not good enough for the UK Government to say that we should just let the Saudis investigate themselves. Although I hear some of the optimistic noises about new trade with Qatar and other countries after we leave the European Union, I hope we can get an assurance from the Minister that if we seek to increase our trade with any country, that will be done in terms that recognise the need for improvements in human rights. Trade should not simply mean a trade in weapons that can be used for the wrong purposes, or a trade in infrastructure that benefits the wealthy royal family of Qatar at the expense of the working conditions and lives of native born Qataris and permanent or temporary migrants.

In some countries, people live in difficult situations because that country is intrinsically poor, and we have a responsibility to help lift those countries out of poverty. Qatar, however, does not have that excuse. Any poverty or poor conditions endured by anyone in Qatar are a deliberate choice by the Government of Qatar, and at times we must call them out for that and say that we expect things to improve.

I am pleased to have contributed to the debate, and I would be happy to take up any offer to meet representatives from the Governments of Qatar or Saudi Arabia, should they want to explain their countries’ policies to me and my colleagues. I hope the Minister will assure us that although a large part of Qatar’s relationship with London is about money, when it comes to the crunch it will not just be money that talks, and that the lives of people in Qatar and its neighbouring countries will be seen as being at least as important as the money that flows in from the coffers of the royal family.

Gaza: UN Human Rights Council Vote

Stephen Crabb Excerpts

Monday 21st May 2018 Commons Chamber

[Alistair Burt]

I think that the circumstances of last week indicate—as the United Kingdom Government have said on many occasions—that there is no status quo in relation to Gaza. Conditions are getting worse, and circumstances are getting worse. As we rightly call on Israel in relation to issues such as settlements, in relation to Gaza we remain of the view that until these issues are settled there is no future, and no future for peace in the region.

[Stephen Crabb (Preseli Pembrokeshire) (Con)]

Does my right hon. Friend agree that what this points to again is the need for reform of the UN Human Rights Council? Does he agree that, whatever difficult questions Israel needs to answer about last week’s violence, using this absurd body on which some of the world’s worst human rights abusers play judge and jury on the rest of the world is not the way to deal with that?

[Alistair Burt]

As I have said, the United Kingdom has had concerns about the UN Human Rights Council for some time, particularly in relation to Israel. We are not alone in that. The Human Rights Council must be impartial and balanced, and it has not always demonstrated those qualities in relation to Israel.

Oral Answers to Questions

Stephen Crabb Excerpts

Tuesday 15th May 2018 Commons Chamber

[Boris Johnson]

I can direct the hon. Gentleman to no better text than the Prime Minister’s Lancaster House speech—fleshed out by her Mansion House speech—in which she made it clear that the UK’s commitment to the defence and security of our friends and partners is unconditional and indivisible.

[Stephen Crabb (Preseli Pembrokeshire) (Con)]

rose—

[Mr Speaker]

I wish the right hon. Gentleman a full and speedy recovery.

[Stephen Crabb]

Thank you, Mr Speaker; that is very kind. The Iranian Government responded to President Trump’s announcement last week by showering Israel with rockets using their own forces inside Syria. What does my right hon. Friend think those forces of the Iranian Revolutionary Guard are actually doing inside Syria? If the Iran nuclear deal was not the thing to encourage Iran to become a more responsible member of the international community, what does he think will be?

[Boris Johnson]

My right hon. Friend is completely right to raise the disgraceful behaviour of the Iranian Revolutionary Guard Corps and the missiles that are fired from Syria at Israel and elsewhere. The JCPOA was not designed to constrain that activity; it was specifically designed to stop Iran acquiring a nuclear weapon and it has succeeded in that effort so far. That is why we propose to keep the core of that deal alive, but to work with our friends and partners to constrain the malign activity that my right hon. Friend describes.

Gaza Border Violence

Stephen Crabb Excerpts

Tuesday 15th May 2018 Commons Chamber

[Alistair Burt]

It is of course crucial that the truth is both uncovered and spoken about. Any breach of international humanitarian law and any use of live fire in circumstances that would breach it would be wrong. I noticed the right hon. Gentleman’s statement yesterday. It is the United Kingdom’s job to support an examination of what happened, partly to expose it but partly to remind people of the importance of bringing these circumstances to an end.

[Stephen Crabb (Preseli Pembrokeshire) (Con)]

Even the staunchest friend of Israel would recognise that yesterday’s bloodshed was just appalling and deeply, deeply distressing, but when there is such a highly orchestrated and deliberate attempt by the Hamas regime to use legitimate protests as a cover for trying to breach the security zone and bring chaos and bloodshed on to Israeli soil, what role does my right hon. Friend see for the international community in putting pressure on the Hamas leadership to pull back from this really dangerous activity?

[Alistair Burt]

It is difficult. As we know, Hamas is a proscribed terrorist organisation, but the efforts being made in the Palestinian body to try to seek a reconciliation, which can come only with the Palestinian Authority on Quartet terms, where violence has been renounced, are part of that process. We certainly urge that that process continues and succeeds but, where there is clear evidence of extremism that has caused people’s deaths, that must be brought out and condemned.

Iran Nuclear Deal

Stephen Crabb Excerpts

Wednesday 9th May 2018 Commons Chamber

[Boris Johnson]

As the hon. Gentleman knows well, we work not only hand in glove with the United States, but with our allies, friends and partners in continental Europe. Indeed, that work has intensified over the past few months because, as the Prime Minister has said many times, we may be leaving the EU, but we are not leaving Europe. As for Federica Mogherini, I expect that I shall probably see her next week.

[Stephen Crabb (Preseli Pembrokeshire) (Con)]

While many across the House will want to continue to give the benefit of the doubt to the Foreign Secretary on the Iran deal, does he nevertheless acknowledge that there remain serious questions about what our wider policy of engagement with the Iranian regime is achieving? Has my right hon. Friend seen anything over the past two years to indicate that Iran is taking steps towards becoming a more responsible member of the international community, instead of remaining the force for chaos and terror that it continues to be?

[Boris Johnson]

As my right hon. Friend knows, the UK is in the lead in trying to disrupt malign Iranian behaviour in the region. Whether trying to stop Iranian missiles going to Yemen or to Hezbollah in Lebanon, the UK is doing that. Indeed, this country maintains sanctions on the entire Islamic Revolutionary Guard Corps. We are determined to bear down on Iranian malign activity, but we can do that while retaining the core achievement of the JCPOA.

Oral Answers to Questions

Stephen Crabb Excerpts

Tuesday 9th January 2018 Commons Chamber

[Tulip Siddiq (Hampstead and Kilburn) (Lab)]

15. What recent assessment he has made of the strength of relations between the UK and Iran.

[Stephen Crabb (Preseli Pembrokeshire) (Con)]

23. What recent assessment the Government have made of the implications for his policies of Iran’s ballistic missile programme.

[The Secretary of State for Foreign and Commonwealth Affairs (Boris Johnson)]

We have consistently made clear our concern about Iran’s destabilising and disruptive activity in the region, about its ballistic missile programme —it remains sanctioned by both the EU and the UN— and of course about reported Iranian weapons supplies to the Houthis in Yemen, which would be a violation of UN Security Council resolution 2231. We have set out those concerns with great clarity at the Security Council.

--- Later in debate ---

[Boris Johnson]

I thank the hon. Lady. She and I have discussed this case on several occasions. I think that perhaps the best thing I can tell the House is that work continues assiduously at all levels on all our consular cases in Iran. It is, I am afraid, not particularly helpful in securing the result that we both want to get into detailed commentary at this stage about how we are doing.

[Stephen Crabb]

More than a year since we re-established diplomatic ties with the Iranian Government, Iran continues to develop its weapons programme, continues to fund regional terror groups and proxies, and continues to crack down on human rights campaigners. What positive fruit can we expect this year from our closer ties with the Iranian regime?

[Boris Johnson]

My right hon. Friend makes an excellent point. I would simply remind the House of the virtues of our approach, which is on the one hand to be extremely tough with the Iranians on what they are doing wrong—as I say, they remain a highly disruptive and destabilising force—but on the other hand to do what we can not just to confront them, but to engage with the forces of reform in Iran, which do exist, need encouragement and could be imperilled. That has to be the way forward, and it is one of the reasons why we believe—I know that this sentiment is shared by many in this House—that the joint comprehensive plan of action, the Iran nuclear deal, is valid, represents a considerable diplomatic achievement and should be safeguarded.

--- Later in debate ---

[The Minister for Asia and the Pacific (Mark Field)]

I hope the hon. Lady will be assured that we are keeping abreast of the issue of genocide or any sort of referral to the International Criminal Court. It is obviously difficult because Burma is not currently a member of the ICC. We are working with other countries at the UN to ensure that the very real concerns she expresses are put into place.

[Stephen Crabb (Preseli Pembrokeshire) (Con)]

Ahead of Emmanuel Macron’s first visit here as President next week, will my right hon. Friend the Foreign Secretary reaffirm the importance of a continuing, deep and close relationship between the UK and France? Does he agree that the relationship must get stronger after Brexit, not weaker?

[Boris Johnson]

My right hon. Friend is absolutely right. The relationship between Britain and France is of huge and historic importance, and it has been intensifying over recent years, particularly in the sphere of defence and security co-operation, following the Lancaster House agreement. I hope he will be pleased by some of the developments and announcements that we will be making on 18 January.

Centenary of the Balfour Declaration

Stephen Crabb Excerpts

Wednesday 25th October 2017 Westminster Hall

[Dr Offord]

I think that that intervention was not directed to me, but perhaps to some other Members in the Chamber. I thank my hon. Friend for it anyway.

The Labour party’s official position has just been confirmed, but it seems to me that the next generation of Labour activists do not believe that the Jewish people have the right to self-determination in their historic homeland. Zionism is entirely compatible with a two-state solution; it does not reject the establishment of a Palestinian state alongside Israel. Legitimate criticism of the Israeli Government’s policies and actions should be and is justified, just as we in this House rightly criticise the Governments of liberal democracies, but to deny the two-state solution is to side with the hardliners in both camps. The leader of Her Majesty’s Opposition compounded the mess last week when he declined an invitation to attend a dinner to commemorate the Balfour Declaration next month. Hamas’s official English-language Twitter account welcomed that decision.

The horrors of the second intifada abruptly ended a period in which Palestinians and Israelis were interacting more closely than ever on a day-to-day basis. A whole generation of Israelis and Palestinians has now grown up with close to no knowledge or experience of the other side. That is a major obstacle to the long-term viability of any future peace agreement.

[Stephen Crabb (Preseli Pembrokeshire) (Con)]

My hon. Friend is being generous in taking interventions, and the point he is making is extremely important. Does he agree that one of the most striking things for someone who visits Israel, and has the opportunity to speak in private both to Palestinians and Israelis, is the sense of regret and tragedy on both sides about the decline of engagement and economic interaction, and the fact that they used to do business with each other on a daily basis? That is very sad.

[Dr Offord]

Without a doubt; I have had the opportunity to meet people on both sides of the debate in Israel—and, indeed, outside it—and I do not think that the assistance of those who would term themselves Palestinian refugees, who live in places such as St John’s Wood, is always productive. Sometimes I just wish that they would keep out of the problem and let others who are actually affected by this issue on a day-to-day basis find their own resolution. We do not need assistance from outside people.

As I said, the Government should be proud of their announcement this year to invest an unprecedented £3 million in peaceful co-existence projects, bringing Israelis and Palestinians together. Alongside honourable colleagues here, I have seen some of those projects, so I know how they plant the seeds for peace and understanding. It is hugely symbolic to have made that important contribution this year through that financial remuneration. I could ask the Minister whether he will seek more funding to go further and achieve more good things in the country.

Although a unified Palestinian leadership is an essential component in the successful outcome of any peace process, I have severe doubts about recent developments between Hamas and Fatah. Hamas is, and remains, a terror group committed to the destruction of Israel. The group must be obliged to accept the Quartet principles in full and unconditionally, including full disarmament. Israel cannot realistically be expected to enter into peace negotiations without Hamas taking that crucial step. Does the Minister agree that Israel’s measured response to the unity agreement is laudable and that its continued co-operation with the Palestinian Authority is an important source of stability at this sensitive juncture? I would be grateful if he could address that in his summing-up.

--- Later in debate ---

[Stephen Crabb (Preseli Pembrokeshire) (Con)]

I add my congratulations to those that have been offered to my hon. Friend the Member for Hendon (Dr Offord) on securing this timely opportunity to debate the beginnings of one of modern history’s most remarkable stories: the rebirth of the state of Israel, the Jewish state.

The Balfour Declaration was described by Winston Churchill in 1921 as “manifestly right”, and we can wholeheartedly endorse that view today. It is manifestly right that we mark its centenary with pride—and that the Government do so too. Israel’s achievements since its establishment speak for themselves. It has one of the world’s most diverse societies, and its economic successes and commitment to the same values that we hold so dear in this country make it a close and vital ally. Israel’s commitment to liberalism and tolerance shine brightly in a region where, sadly, persecution and a denial of basic human rights are all too common. To celebrate the Balfour Declaration, therefore, is to celebrate everything that our nations have achieved together, and serves as a reminder of what two countries can accomplish if they embrace the shared principles of freedom and liberalism.

As we celebrate how far Israel has come, however, it is important to remember that today, in 2017, more than 30 members of the United Nations still refuse to recognise or maintain diplomatic relations with the state of Israel, including 19 of the 21 Arab League states. I believe that that is an absurdity and a stain upon the international community. Let us be clear: Israel’s existence is not up for debate. Indeed, few states have such legitimacy in law as Israel. Let us consider, for one moment, the fact that the content of Foreign Secretary Balfour’s letter to Lord Rothschild in 1917 became international law after being incorporated into the San Remo resolution in 1920, and was further unanimously endorsed by the League of Nations in its mandate for Palestine in 1922.

[Andy Slaughter]

All states should recognise Israel, as Britain did in 1950, but does the right hon. Gentleman think, also, that all states, including this one, should recognise the state of Palestine?

[Stephen Crabb]

All states in the international system should, I believe, work together for the realisation of the two-state solution. That should be the objective of our foreign policy.

If anything, the lack of recognition by so many UN member states and the resurgence of a vile anti-Semitic ideology around the world underscores again the need for the Jewish homeland.

[Jack Lopresti (Filton and Bradley Stoke) (Con)]

I am sorry to interrupt my right hon. Friend’s excellent speech. Does he agree that the issue is not just about supporting Israel’s right to exist; it is about supporting its right to defend itself?

[Stephen Crabb]

My hon. Friend makes an important point about recognising that the country that will take the primary responsibility for defending the state of Israel is the state of Israel itself. We should defend that principle.

At this centenary moment we can with sadness observe—and we have this afternoon observed—that we have yet to see the completion of the vision for the establishment of a viable Palestinian state alongside a safe and secure Jewish state. That has been a difficult path, marked with false starts and missed opportunities, and it will ultimately require bold leadership and difficult compromises from both sides if progress is to be made. On my most recent visit to Israel in February, I was struck again by the number of Israelis from different walks of life who told me of their deep desire to live in peace and security. Those words, “peace and security”, are heard time and again in speaking to Israelis. I remain hopeful that we can reach that point, but, if we are being realistic, recent history does not provide much encouragement. The successive failures of the Palestinian leadership to grasp opportunities have already been pointed out this afternoon. I am reminded of the famous quotation by the former Israeli diplomat Abba Eban:

“Palestinians never miss an opportunity to miss an opportunity”.

It is a great tragedy that Palestinians have been let down by successive poor leadership and poor decisions.

I urge my right hon. Friend the Minister and his colleagues to redouble their efforts in pursuit of the two-state solution, and to do whatever they can, in a challenging and difficult environment, to get the two sides to speak to each other and pursue that course. I also encourage him to enjoy celebrating the Balfour centenary, and to do so with pride. It is important that we all do so.