International Covid-19 Response: Innovation and Access to Treatment — House of Commons, 2020-11-05
Topic: Health
Sarah Deborah Champion (Labour, Centre-left): I thank the hon. Member for North East Fife (Wendy Chamberlain) for calling for the debate, and I hope that my speech will amplify the points that she is making. The International Development Committee, which I chair, has been examining the impact of the coronavirus on developing countries, and the contribution of the UK Government to initiatives to help the global south tackle the pandemic. A key part of the UK’s strategy for the global south is funding an array of partnerships and collaborations aiming to develop, at speed, vaccines, therapies and tests for preventing, treating and diagnosing the disease. The Government have allocated the lion’s share of their global coronavirus funding to the race for those products—£388 million initially for vaccines, therapies and tests and, more recently, another £571 million for the production, purchase and distribution of vaccines. That is very welcome, but a key concern that emerged throughout the evidence that we received was about the importance of legal and practical measures to guarantee equitable access to corona vaccines, medicines and tests around the world, based on need, not economic power. The former chief scientific adviser to the Department for International Development, Professor Charlotte Watts, told the IDC: "It is not only about finding a vaccine that is going to work, but how to ensure that there are the resources and future investment in production capability, so that that can be distributed to low and middle-income countries." It is worth recalling why equitable access to medicines is such a concern. First, let me take the example of the antiretrovirals for HIV and AIDS. In Durban in 2000, at the XIII International AIDS Conference, Justice Edwin Cameron of the South African Constitutional Court famously declared that he had been living with AIDS for 33 months, but that, "there are 24 or 25 million people in Africa who at this moment are dying, and they are dying because they don’t have the privilege that I have of purchasing my life and health." In 2000, the anti-retroviral drugs capable of transforming AIDS into a manageable illness were far beyond the means of most South Africans, costing up to $10,000 a year—much more expensive than any other country when compared with generic substitutes. When South Africa passed legislation to facilitate the use of cheaper, generic and imported products on public health grounds, 39 multinational pharmaceutical companies banded together to sue the Government for violating WTO rules. Rightly, that resulted in a PR disaster for the pharmaceutical industry. The case was dropped and the WTO recognised member states’ rights to take such measures to protect public health and, in particular, to promote access to medicines for all. But even now, the use of that safeguard is largely limited to the original HIV/AIDS drugs because of the complexities required in legislation, health system weaknesses and political pressure Let us look at cancer. Cancer drugs are a lucrative pharmaceutical market—for example, representing 27% of the sector’s revenue in the US. Efforts to set prices to recoup research and development costs over a set period are one thing, but funding the inflated billion-dollar trade in whole companies holding just one or two attractive patents seems less defensible. Whatever the reason, low and middle-income countries invariably find the prices set to take advantage of demand in a high-income country an insurmountable barrier to access. Pricing invariably results in wide variations in survival rates. For example, the US five-year overall survival rate for breast cancer is 84%, compared with just 12% in Gambia. That is hardly equitable. Finally, I want to talk about polio. The polio story is essentially a triumph, with a 99% reduction in cases since the start of the global effort in 1985. However, each year, the oral polio vaccine, which is widely used in the global south, is linked to outbreaks of the disease where the wild virus has been eliminated. The injectable vaccine is an inactive virus, but it costs about $3. The oral vaccine, at about 12 cents, contains live virus. Unfortunately, children can shed a mutated version of the live virus in their stools, which can then infect unvaccinated children in areas with poor sanitation. Clearly there are other considerations than just costs when comparing injected and ingested doses of medicine, but the reality is that cost kills Let us hold these examples in our mind as we consider equitable access to future coronavirus products. And let me be blunt: the prospect of the international community behaving morally, or at least rationally, on a global scale over the distribution of an effective vaccine, or even accurate and simple tests, at an affordable price, is not good. In his September speech to the first virtual United Nations General Assembly, the Prime Minister rightly lambasted the international community over its fractious and competitive reaction to the procurement of personal protective equipment during the first wave of the pandemic—and that was just over masks and aprons. Imagine the pressure on every Government to deliver the long-awaited panacea of covid-19 immunity to their own populations Any rational response to the pandemic must surely take account of the science and the almost unique status of this crisis by incorporating the sustainable development principle of leaving no one behind. No one will be safe and secure until everyone is covid-free. For once, everyone’s interests are overtly aligned. The UK finds itself in a unique moment in time when we can reposition ourselves as a global leader for good. The soft power gained by doing the right thing for the very poorest in the world, and by standing up to those looking to profit from others’ misery, will be immeasurable. I am grateful for the leading role the UK has taken to date in the development of covid vaccines and products.