Counter-Daesh Update

Thangam Debbonaire Excerpts

Wednesday 3rd July 2019 Commons Chamber

[Thangam Debbonaire (Bristol West) (Lab)]

I am grateful to the Secretary of State for his thoughtful responses, but I would like to pick up on two brief things. He mentions unexploded munitions and mines in Syria, and I wonder if he could expand on that and tell us how much of that country is still dangerous to live in for the many people who have been forced to flee their homes. Also, possibly a longer piece of work is about rebuilding the peace and about how this House and Governments relate to countries post conflict. What does he think the role of parliamentarians across this House—across both Houses, in fact—should be in supporting parliamentarians and potential parliamentarians in not-quite-yet democracies in the middle east? What role does he think there might be for us in that peace building?

[Rory Stewart]

First, the mines remain an unbelievably serious issue. They are ensuring that not just a lot of agricultural land but much of the urban centres of Fallujah, Ramadi, Mosul, Deir ez-Zor and Raqqa are almost uninhabitable. This is not just a question of the ordnance buried in those buildings. The old city of Mosul is so profoundly damaged that it is almost impossible to understand what we can do to rebuild these places without ceilings falling in on people’s heads. We are talking about many billions of pounds-worth of damage. This brings us to the question of the role that parliamentarians can play, and actually there is one. There is a gloomy analysis of countries such as Iraq, which would have suggested 10 or 12 years ago that there was nothing much we could do, but it is striking that a new generation of leadership is now emerging. The recent visit of the President of Iraq, Barham Salih, shows the emergence of a new, more progressive type of politics in Iraq that wishes to engage with Members of Parliament. That does not mean that we in this House hold the panacea for what is happening in Iraq, in Myanmar or indeed anywhere else, but respectful relationships, partnerships, modelling ways of behaviour and exchanging thoughts with humility about the problems we have, even in this place, dealing with sectarian conflict in Britain or with some of the polarising and divisive effects of our recent referendum here may be useful in dealing with questions on the aftermath of the referendum in Kurdistan.

World Immunisation Week

Thangam Debbonaire Excerpts

Thursday 2nd May 2019 Commons Chamber

[Thangam Debbonaire (Bristol West) (Lab)]

It is truly a pleasure to follow not only my hon. Friend the Member for Enfield, Southgate (Bambos Charalambous), but the right hon. Member for North East Bedfordshire (Alistair Burt) and all the Front-Bench speakers, and I am sure that the summing up speeches will also be a pleasure to hear. It is truly a pleasure—a constructive pleasure—to be able to say during a debate in this place that there have been excellent contributions from everyone in the House. We have already come to various points of consensus and agreement. We can all point to things that need to be done, as well as to places that we can learn from and successes that we can celebrate. I will try to confine my remarks to areas that have not been covered by others—I always try really hard not to repeat things that other people have already said. I will focus mostly on antimicrobial resistance and the relationship with immunisation.

In the 1970s, when I was nine, I went to India for the very first time. Just like the right hon. Member for North East Bedfordshire, who described his experience with his dad, I can still remember the pain and discomfort of the vaccinations. I can also remember much more clearly the impact of seeing someone with elephantiasis when I reached India, and of meeting a relative who had been affected by one of the deadly diseases, which she had survived but which had left her permanently disabled, that I had been vaccinated against. It was a really visceral experience of the connection between the discomfort and pain of the vaccination and the consequences of not having access to that vaccination. It was also a real-life experience of inequality—the fact that I had received that vaccination because I was a UK citizen, and the people whom I met in India at that time were not getting those vaccinations. The experience transformed me and my understanding of what vaccinations did. Obviously, I was a child, so I was transformed from being a child without information to being a child with a really strong sense of the importance of vaccination. As an adult, I have been left with a real passion about the value of vaccinations, particularly in the way that they eradicate inequality as well as disease.

I am glad that this debate falls under the Department for International Development rather than the Department for Health and Social Care; it is an interesting place from which to be discussing this matter. Others have already provided examples of diseases, such as smallpox, and also polio, with its permanent debilitating effects. Polio is a good example of a disease that has been virtually eliminated in most countries through widespread vaccination, but still circulates partly because the symptoms are not easily recognised in certain parts of the world. The value of vaccination is so crucial in those diseases where early signs are not necessarily clear or where infection can be transmitted before there are early signs, such as in the case of measles, as the hon. Member for Central Ayrshire (Dr Whitford) mentioned.

While I cut out from my speech things that others have already said, I will also add something about the decision not to vaccinate a child. The hon. Lady was absolutely right: we must not patronise parents. If they have valid questions, they must be heard, and if they have worries, they must be understood. The right hon. Member for North East Bedfordshire mentioned certain specific examples of why we have to listen to people. Obviously, we can be gung-ho in our attitude, but not in our interactions. I apologise for being personal about this, but it occurred to me that if someone said to me right now that there was someone in the Lobby who could vaccinate me against ever having cancer again, I would not be seen for dust. We would all rush. We would have no question. We probably would not even stop to ask what the side effects would be. We would be out there immediately. It occurs to me that in our lived memory, we have lost the understanding of the fact that measles is also a deadly disease. Hearing the right hon. Gentleman read out that account from Roald Dahl was really moving and served, perhaps, as a reminder of the issues, or even as new information to many parents who are fortunate enough to live in a world where measles is no longer in front of us—in this country certainly—causing those deaths.

[Dr Whitford]

rose—

[Thangam Debbonaire]

The hon. Lady, who is about to intervene on me, gave us examples of how it still is an issue in some parts of the world.

[Dr Whitford]

I thank the hon. Lady for giving way. As I said at the end of my speech, there are researchers who are actually working on the ability to vaccinate against cancerous cells. This is something that we will hopefully be seeing in our lifetime. Is it not then surprising that, in England, even the uptake of the meningitis vaccine, a disease that parents are terrified of, has fallen down to just 92.5%, which means that the community protection is not there.

[Thangam Debbonaire]

The hon. Lady is absolutely right, and I do find that baffling, but that does reinforce the point that she and the right hon. Gentleman made about listening to people’s worries and concerns. We will not get very far if we barge through them saying that they are wrong—they are wrong, but we need to listen to where those concerns come from and to try to address them.

Take the influenza vaccination, for example. I declare an interest, in that one of my sisters has to have this vaccination every year because of problems with her immune system. Influenza is a disease about which many of us nowadays would think, “I’ll take a few days off work, take some pills, have a bit of a lie down and sweat it out, and I’ll be back to work, as right as rain.” But of course, not only does influenza still kill people today in other parts of the world; it can kill people today in this country, if their immune system is depleted or for other reasons. Influenza is a really good example of a microbe that is mutating, so new vaccines will have to be developed. As the hon. Member for Central Ayrshire said, some vaccinations are the same as the ones that we were being given 10, 20, 30, 40 or 50 years ago, but others will need to be developed. The job is not done on vaccinations. We still need to respect the developing science.

The diseases that we could eradicate forever include elephantiasis, which I mentioned earlier, as well as polio, measles, mumps and rubella. The MMR vaccination has attracted particular attention, partly because of the discredited research by that dreadful person who I do not feel like naming because I feel so angry with him. I just think that these diseases are horrible, and the irresponsibility he showed at that time was quite extraordinary.

What really struck me while I was having cancer treatment was the sheer volume of unqualified, non-medical people willing to give pseudo-medical advice online, when it would not be allowed offline. The Front Benchers here are not quite from the right Departments to address this specific issue, but I ask them to pass on my message to their colleagues in the relevant Departments. I would like to see work done in the Department for Digital, Culture, Media and Sport to ensure that there are equivalent levels of regulation for online medical, pseudo-medical and pseudo-scientific advice as there are in the offline world, because the harm done is the same. I would not expect to go to anywhere on the high street and be given pseudo, incorrect, dangerous, non-scientific advice face to face. It would not be legal; there are laws against it. But in the online world, not so much.

I return to antimicrobial resistance. As I am sure the House is aware, if left unchecked antimicrobial resistance will lead to 10 million deaths a year by 2050, as the Scottish National party spokesperson, the hon. Member for Central Ayrshire, has said. Immunisation is a vital intervention against AMR. AMR happens when microbes adapt to become resistant to antimicrobial drugs. Once resistance occurs in pathogens—the microbes capable of causing disease—treatment options become very limited and lives are then put at risk. There are already about 700,000 deaths a year caused by infections that are resistant to treatment.

I urge all Members to read or to read a precis of—certainly to absorb the messages of—the brilliant O’Neill review on AMR of 2016, which concluded that vaccines have been overlooked as a tool to reduce AMR and that there should be a much greater focus on and investment in them. Immunisation helps to reduce the increase of AMR in two critical ways. First, it prevents infections in general and drug resistant infections, thereby preventing the disease and deaths. That then negates the need for ever more complex drugs to be used, which are often much more expensive and are therefore probably not available in poorer countries, to treat those resistant infections. Secondly, by preventing infection and the need for treatment at all, the use of antimicrobial drugs overall is reduced in both humans and animals.

Vaccines offer sustained long-term and, in some cases, lifelong—although that depends on the pathogen—protection from infection. Antibiotics do not. Far too many people have in their heads the idea that when they get sick, they will get an antibiotic and that is all that needs to happen. Many vaccines still effective today were introduced many years ago, but the same cannot be said for antibiotics. If there are high rates of mutation, we will need new vaccines. We therefore need to think about the money and investment that we put into developing vaccinations, as well as into maintaining the use of proven ones. The O’Neill review also identified some really clear contexts in which immunisation can reduce AMR, including vaccinating against hospital-acquired infections, and discussed the importance of investment in research for the early stages, when commercial viability may be some years or decades off. The effects of vaccines on AMR are, preventing disease and death; reducing progression and the severity of disease; reducing transmission; and reducing antibiotic use, and therefore the pressure of resistance.

Vaccines work. They save lives, halt the spread of disease, reduce the impact of antimicrobial resistance and prevent rare infections and illnesses. So why do we need a debate at all? Well, we need a debate partly to celebrate the achievement and the impact of vaccination, but also to reiterate the case for it. Sadly, there has been a decline in the use and take-up of vaccinations, with consequent increases in illnesses and infections. The case has to be restated to prompt parents just to check. As the hon. Member for Central Ayrshire said, there are parents in countries across the world who are busy for all sorts of reasons. They may get to their third or fourth child, and getting them vaccinated is either not practically easy or it slips their mind. Just check—I am asking all parents out there, with absolutely no judgment whatever, to use this week as an opportunity just to check whether their children are up to date with their vaccinations.

As people who travel to different countries, it also behoves us all to ensure that we are not being complacent when we travel. I know how easy that is. I have relatives in India who I like to visit on a fairly regular basis, and it is important for us adults to make a little note-to-self to check that our vaccinations are up to date.

I will refer briefly to social media because although the Library research paper—I thank the Library researchers and the Parliamentary Office of Science and Technology for providing briefings for our debates—reassures us that most parents say that the information they have seen about vaccination is supportive; unfortunately, 4% said they had seen anti-vaccination information, most of which had come from the internet or social media. We need to tackle that issue.

This debate has been located in the context of international development, so it would be remiss of me not to say how much I value the work of the Department for International Development, across Governments of different political persuasions and over many years. This Department has a high reputation. Of course, that also goes for right hon. and hon. Members who have served in it over many years, so I thank the Department. By way of triangulation, I recently visited the Bill and Melinda Gates Foundation in Seattle—I declare an interest, as my brother-in-law works there—where I was really impressed not only by the thoughtful way in which the organisation contributes to vaccination across the world, but by the high regard in which it holds DFID, and for good reason.

I would, however, like there to be a greater focus on the spread of information via social media and the internet in our international work, because disease knows no boundaries, poverty knows no boundaries and the internet knows no boundaries. Perhaps there needs to be a tie-up between the work done with social media companies, the Department for Digital, Culture, Media and Sport, the Department of Health and Social Care and the Department for International Development. Forgive me—that may already be happening, and I applaud officials if it is.

I reiterate that any right hon. and hon. Members in the Chamber who have not read the O’Neill report of 2016 on antimicrobial resistance need to read it. We have talked a lot this week about the climate emergency, and it is definitely an emergency, but so too is AMR. I am going to say this again because it is so shocking: if we stay where we are, by 2050, 10 million people a year will be dead because of antimicrobial resistance.

[Alistair Burt]

We cannot mention AMR in this House without mentioning Dame Sally Davies, who has done such a fantastic job. If my memory serves me right, she is standing down relatively soon as chief medical officer, but she has made a fantastic contribution, particularly in relation to AMR. She absolutely deserves that we carry on this fight when she moves on to a different role.

[Thangam Debbonaire]

The right hon. Gentleman is absolutely right. I join him in that tribute. I also pay tribute to all the scientists across the world who are helping not only to understand and promote information about AMR, but to help us rethink our relationship with antibiotics. They are also helping us to understand the need to respect antibiotics, but also to respect disease prevention, rather than having a reliance on antibiotics.

Again, I urge all parents to check their children’s records and get them vaccinated if they have not already done so. I also urge all adults to remember to do so themselves when they visit other countries; and I include myself in that. I applaud DFID, the World Health Organisation, the Bill and Melinda Gates Foundation and others for the work they do, and particularly the support of Gavi, the Vaccine Alliance. I urge the Department of Health and Social Care—this is a slight, but brief, sidebar—to accelerate the expansion of the human papilloma virus vaccination to include boys. I know that that is in train, but I would just like it to hurry up, please.

I urge social media companies and internet providers across the world to work with health services and Governments across the world on not only tackling the misuse of the internet for promoting incorrect information but highlighting the value of the internet and social media in promoting good-quality information and messaging. There are social media companies and internet providers who want to be seen as a force for good, and this is a really good way that they could contribute to that. In particular, I would like DCMS to work with the Department of Health and Social Care and with DFID on tackling those harms. This should be a cross-departmental initiative.

I join others in wishing the new Secretary of State, who is no longer in his place, well in the mission that he described earlier. He is another Minister, and now a Secretary of State, who is well respected across the House. He brings an enormous amount of knowledge and experience of a range of world contacts to this post, and that can only be a good thing. I would like him to bring that experience to this issue with razor-like precision.

I would really like us to get back to respecting experts. That does not mean doffing the cap, or never arguing or asking questions. It does not mean just saying, “Doctor knows best”—if the hon. Member for Central Ayrshire will forgive me—but saying, “Doctor probably does know best.” In my experience, the hon. Lady generally does know best, and I probably do always say that she is right. I would like us to respect experts because they are experts and, when we ask them questions, to remember that they probably do know quite a lot, but, in return, as she said, for them to listen to us and to remember that our reasonable questions have to be heard if we are going to make progress together. I would like us to respect medical science. I would like us to respect researchers and respect research—and to invest in it. In this country, we do well at that. We are an internationally respected country for knowledge creation. I would like us to continue that tradition and to challenge anybody, anywhere, who says stuff about experts in a way that is not just unhelpful but, in this context, life threatening.

I thank all right hon. and hon. Members for this debate, because it is a really good example of how a small number of people in the right room at the right time can produce a consensus on something where our country can help to show the world leadership and contribute to saving millions of lives.

[Madam Deputy Speaker (Dame Eleanor Laing)]

The House has had the opportunity during this week to congratulate many hon. Members who took part in the London marathon last week. I do not think there has yet been an opportunity for the hon. Member for Bristol West (Thangam Debbonaire) to be congratulated on her particularly courageous performance and on raising so much money for great causes, so she also has the congratulations of the House.

Oral Answers to Questions

Thangam Debbonaire Excerpts

Wednesday 22nd February 2017 Commons Chamber

[Priti Patel]

My hon. Friend is right to raise that matter. It is a really important issue given the movement of migrants and refugees. Ensuring the safety of refugees and protecting them from persecution is absolutely at the heart of the UK’s involvement, especially with regard to the aid and support that we provide in Syria and the wider region. I can assure him that all the agencies and partners with which we work pay particular attention to monitoring the welfare and safety of minorities, including those of Christians.

[Thangam Debbonaire (Bristol West) (Lab)]

I recently had a very helpful meeting with one of the DFID Ministers about the situation in the berm—an area of no man’s land between Jordan and Syria. I am aware of how much the Government are doing with aid, but will the Secretary of State please update us on the humanitarian situation in the berm and what else is being done and could be done to help those refugees?

[Priti Patel]

I thank the hon. Lady for raising the appalling situation in the berm; it is a devastating situation. She asked about what we are doing. Obviously, work has taken place through our agencies and partners, and more directly with the Jordanian Government. We are working with them in a very difficult, hostile terrain and territory in order to ensure that people and children are being protected and that they are getting access to food and water, which, frankly, is a major priority in the berm.