Dr Robin Niblett CMG
Ladies and gentlemen, welcome to this Chatham House event. I’m Robin Niblett, the Director of the Institute. I have a very brief role to play today, thankfully, before I hand over to my colleague, Rob Yates. But my role is principally to welcome Secretary of State Matt Hancock, Secretary of State for Health and Social Care, to this event at Chatham House. We’re thrilled to have the opportunity to host him for this very important discussion on the Future of Global Health. Obviously, in the UK in particular, but all around the world, we are so deeply focused on the tragic impacts of the COVID pandemic within our societies that being able to keep a focus as well on the global dimensions and the global dimensions of a multilateral response are critically important. And with the UK holding the G7 Presidency this year, along with its Co-Chairmanship of the COP26 process, the UK really is in the heart of a lot of the multilateral responses to the global health pandemic, and a response to which it brings some national – important national capabilities and assets, as I’m sure we’ll hear from the Secretary of State in a moment.
Noticeable, of course, the Prime Minister did remark about wanting a five-point plan for global health back at the UN General Assembly meeting that took place back in the autumn. But, obviously, this is a time as well where the rollout of vaccines is creating some new tensions to the prospects for multilateral co-operation. In that sense, I’m very pleased to hand over now to my colleague, Rob Yates, the Director of our Global Health Programme and of our Centre for Universal Health, another important calling card for the UK, but also, a core dimension of Chatham House’s work. Rob is going to take us through this session, and moderate it. But, again, Secretary of State, thank you very much for joining us and for giving us this opportunity to hear from you about the UK’s plans for the future of global health. Rob, over to you.
Robert Yates
Thank you. Thank you very much, indeed, Robin, and greetings from the Virtual Centre for Universal Health at Chatham House where we specialise in the political economy of health and health reforms. And, of course, never has health been so high up on the agenda of the world’s Finance Ministers and Heads of Government. And thinking where we are with the pandemic at the moment, one might say that tackling it further is more of a political challenge than it is a scientific challenge. I think you’re reflecting on the tremendous collaborative efforts of the world’s Scientists to get to this point where we have the tools at our disposal to really tackle the pandemic, both in terms of vaccines, but also, the vital public health measures that are needed to combat the pandemic.
It was interesting to note that a German Minister, I think, at WHO’s Executive Board said during the week that we now have the – all the tools and recommendations to tackle the pandemic, but what we’re lacking is the common political will to use them. And I think there’s a particular concern about a lack of solidarity that’s been shown that you’ve alluded to already, Robin. The UN Secretary-General, in fact, said the other day, “Science is succeeding, but solidarity is failing.” So this is where we need very strong multilateral action, and where bodies like the G7 and G20 are absolutely vital. So, now, with the UK becoming the Chair of the G7, what better time, and we’re absolutely delighted to have with us the Rt Hon Matt Hancock MP, Secretary of State for Health and Social Care, to outline the UK’s global health priorities for the G7.
Now, I should emphasise that our meeting today is going to be recorded. It’s on the record, obviously, and therefore, we’re not following the famous Chatham House Rule. In fact, it’s quite the opposite. We want you to tweet, to use social media to really share your experiences and reflections on today’s event, and use the #CHEvents, please. Now, the format for our discussion is that I’m going to now hand over to the Secretary of State, who’s going to deliver an address to us. Then we’ll have a brief conversation, but then we’re going to move very quickly to have questions and answers from the audience. We’re very, very keen for you to participate, and put your question to Mr Hancock. And we’ll be using the ‘Q&A’ function for this, not the ‘Chat’ function. Please use the ‘Q&A’ function, and if you see a particular question you like, upvote it because then we’ll see the more popular questions rise to the top.
So, we’ll crack on now and, Secretary of State, after this amazing year of scientific achievement, bringing the world together, you know, like this, how are the G7 political leaders now going to deliver on saving us from the pandemic, and building back better? Over to you, Secretary of State.
The Rt Hon Matt Hancock MP
Well, thank you very much indeed, and it’s a great honour to be able to speak at Chatham House, and an irony that your rule is not in operation for this session. But I’m delighted to be able to join you, and I’m very grateful for you putting this on in a virtual way. And it was in 1832 that the London Quarterly Review said and stated that “We witness the birth of a new pestilence, which in the short space of 14 years, has desolated the fairest portions of the globe, and swept off at least 50 million. It has mastered every variety of climate, surmounted every natural barrier, and conquered every people.” So that was in 1832, and that pestilence was cholera, which brought devastation around the world. And one of the lessons from the emergence of cholera was that, at first, nations turned inwards and responded alone. But after three consecutive cholera pandemics, over a period of 30 years, and accelerated by growing industrialisation and urbanisation and global trade, countries soon realised that infectious diseases cannot be handled as a domestic issue alone, and collaboration and co-operation with your neighbours, in the spirit of mutual benefit, is critical to tackling cholera, just as it is today.
In 1851, 12 nations came together and created the International Sanitary Convention, which is the forerunner of the World Health Organization and, over time, more countries joined that effort. And as they discovered more and more areas where they could work together for the greater good, they put in place, for instance, a legal obligation for countries to notify one another about outbreaks of disease which, in effect, was the world’s first early-warning system. And thanks to this close collaboration over generations, and the scientific effort, the illuminating breakthroughs from pioneers all over the world could be accelerated, like the work of Louis Pasteur in France, and Robert Koch in Germany, and Filippo Pacini in Italy, and Sambhu Nath De in India and, for instance, John Snow here in Britain. They came together, and they made huge strides in combatting cholera, even though, of course there is still more to do, and we must learn from this history.
The reason I talk about this history right at the start is because it is telling today. The issue of how to keep humans healthy and safe in an interconnected world is even more pressing now than it was in the 19th Century, especially given the UN forecast that two-thirds of the world are projected to live in dense urban areas by 2050. And, for me, the history of 2020 was about nations working to solve pressing challenges immediately in front of them at home. We’ve all been engaged in essentially the same effort but, too often, it’s been individual nations battling alone. Now is the time to reject protectionism and narrow nationalism and the disinformation that can divide us and can hinder the response to this common threat. And after all, COVID-19 affects every nation because we are all human. So, 2021 must be the year in which humanity comes together, even despite the restrictions that keep us physically apart.
As you mentioned, this year, the UK has the honour of holding the Presidency of the G7, and we take on this mantle at a time when the health of humanity is under great strain. And although this is a time of great global turmoil, it’s also a time to learn from shared experiences, and build a stronger international health system. We must build back better, learn from what went well, and be more prepared for future pandemics and future threats to public health. So I’m proud that the UK has been a consistent voice for global solidarity throughout this crisis. I’m proud that we’ve put our money behind that commitment. We’re the biggest donor to the international effort for access to vaccines. The UK played a leading role in the international effort to raise $2.4 billion for the COVAX Advanced Market Commitment, which will distribute at least 1.3 billion doses of coronavirus vaccines to 92 developing countries this year. And I want our stewardship of the G7 to build on this work, and on the likeminded work that’s taking place all across the world.
I’m thrilled that the United States announced last week that it has abandoned plans to leave the World Health Organization, and instead, has recommitted once more to playing a central leadership role. This is good news for everyone, and we’re all stronger and safer as a result. And I’m excited by the opportunity to work with the G7, the G20, and partners right across the whole world, to reinvigorate our global system, according to the values of empathy and shared solidarity that are crucially important in a pandemic.
I was reflecting that, in normal times, healthcare in each country is often seen as largely a domestic affair, concerned with improving the health of the nation. International collaboration is, of course, important. But in normal time, the focus is on things like universal health coverage, and tackling non-communicable diseases, like obesity and mental health crises. But a pandemic makes international collaboration absolutely central, and it makes organisations like the G7 all the more important. From a personal point of view, I found the weekly G7 Health Ministers’ calls at the height of the pandemic like a therapy session at times, frankly, and given the experience that we’ve had across the West, it’s absolutely vital that G7 members come together to provide the international leadership that people look to us for. After all, the G7 represents two-thirds of the global pharmaceutical market, the majority of the world’s genomic capability, and leads the world in life sciences and clinical trials.
The pandemic has thrust the G7 health agenda to the centre of global affairs. Health policy is now the number one economic policy, security policy, and social policy of every country, so we must make G7 leadership count. The agenda I’m setting for the G7 this year is not just about discussion, important as that is. There is significant and substantial world – work that we have to do, and concrete progress that must be made, and this work needs to be based on enlightenment values of collaboration and transparency and scientific progress. The G7 has already, for the first time, made a joint statement to the WHO Executive Board in support of vital reforms to that vital body. And today, I want to set out the UK’s G7 agenda for the rest of this year, and also, some of the actions we’re putting in place immediately to deliver on it.
The first area is health security for everyone. We must renew our commitment to the founding ideals of the WHO that, and I quote, “The enjoyment of the highest attainable standard of health is one of the fundamental rights of every human being, without distinction of race, religion, political belief, economic or social condition.” And we must do this, not just ‘cause it’s morally right, but because when we have holes in our global defences, due to inadequate or unco-ordinated health provision, that is a threat, not just to health services around the world, but to economic prosperity and our collective security. The pandemic has shown that the foundations of so many of the exciting experiences that make life worth living, like the ability to travel, go to the theatre, or to start and grow your own business, are contingent not just on our health, but the health of our near neighbours, and the health of people everywhere. So, we must work to promote health security right across the world, developing transparent ways of preventing, detecting, and responding to outbreaks, strengthening the World Health Organization, so it is more nimble, delivering effective surveillance and early-warning systems for the threats of the future, looking not just at human health, but animal health and all parts of our environment.
Now, of course, a threat that’s been on all of our mind, over the past few weeks, has been new variants of coronavirus. New variants can threaten the exceptional progress that we’ve made with vaccines, so it’s vital that we react swiftly to identify them, and get them under control, wherever they are. Genomic sequencing is pivotal to this, and the UK was one of the first countries in the world to recognise the need for an infrastructure for viral genomic sequencing, and we’ve backed it with huge investment long before COVID-19 emerged. And since COVID-19 has emerged, the UK has sequenced over half of the COVID-19 viral genomes that have been submitted to the global database, nearly ten times more than any other country and this bolstered capacity isn’t just important for us here at home. Combined with progressive transparency, it’s for the whole world. And thanks to this work, we identified a variant that was circulating in the UK, and we were then able quickly to alert our international partners to its danger through the WHO, and so help aid the response everywhere.
We’ve seen other countries that have substantial genomic capacity identifying new variants locally too, but many countries do not have the capacity they need. So, today, we’re announcing our New Variant Assessment Platform. We’ll be working with the WHO to offer our UK genomic capacity to help other countries analyse new variants of the virus, and offer our training and resources to help them build their capacity too. The New Variant Assessment Platform will help us better understand this virus and how it spreads, wherever any mutation is found because, as we’ve all learned, a mutation in one part of the world is a threat to people everywhere. The New Variant Assessment Platform will boost global capacity to understand coronavirus, so we’re all better prepared for whatever lies ahead, and it will form an integral part of the international offer of the new National Institute for Health Protection that begins its life in April. The NIHP will be a new UK institution, focused entirely on fighting external threats to health, principally pandemics. And, crucially, it’ll reach across borders to play its part in solving problems, with colleagues from across the world.
The second area in the G7 agenda for this year, where I’m determined that we make progress, is on clinical trials. The pandemic has shown beyond measure the value of robust clinical trials in identifying the vaccines, the therapeutics and the diagnostics that work and, crucially, ruling out the ones that don’t. While there’ve been many successful trials, there are also too many that aren’t set up in a way that the whole world can benefit. I’ve been personally frustrated to find clinical trials in different countries not recognised by each other because the data and the insights can’t be properly integrated across national boundaries, because of a lack of co-ordination in how they’re set up. There is absolutely no reason for the differences in trial structure, but they delay findings and, so, cost lives. Likewise, in some cases, final data isn’t shared with the global community, but that lack of transparency has to end. We’re all human after all.
For example, at the start of the crisis, there were no international assay standards for vaccines. This made it harder to compare results from vaccine trials, and meant that work was sometimes duplicated or, worse, unusable. One of the reasons the UK was the first country in the world to authorise a vaccine is because our regulator worked so hard to overcome some of these challenges. But it doesn’t have to be this way, and we need international leadership to change it. The ingenuity of this research is too precious to let it go to waste, so we must strengthen the frameworks that underpin clinical trials, and create shared standards, so the creation and delivery of clinical trials can be as seamless as possible around the world. These clinical trials offer hope to us all, showing how human endeavour can overcome a lethal threat to humanity, based on scientific ideals of objective analysis and truth. We must do what it takes to standardise and co-ordinate clinical trials to find more insights more quickly than the fragmented system that has existed until now, and it is my personal mission to make this happen.
The third area where we must make an impact is antimicrobial resistance. This is a matter of driving forward progress that is already being made. The silent pandemic of antimicrobial resistance, especially bacterial resistance, will have consequences that are just as deadly as COVID-19, over a longer timeframe, if we don’t act now. I’m very grateful for the work that Lord Jim O’Neill, the Chair of Chatham House, has done on this issue, and for the leadership that Dame Sally Davies, who’s the UK Special Envoy on antimicrobial resistance. Lord O’Neill’s report on the risks of AMR paints a stark picture. It predicts that if we do nothing, AMR will cost ten million deaths by 2050, at a cumulative financial cost to the global economy of $100 trillion. Not only that, but diseases that we can treat now could become untreatable in the future, and modern medicine as we know it could cease to exist.
We’ve seen, over the past few months, the devastating impact that an initially untreatable infection can have, so even as we fight coronavirus, we must not take our eye off the dangers of AMR. Antibiotics are a critical global infrastructure that underpin high-quality healthcare all across the world, but no new class of antibiotics has been brought to market for decades. We must use innovative approaches to financing and procurement to change this, based on that trinity of science, industry, and government working together that is so often so important in the life sciences. So we’ll use the UK G7 Presidency to push for the better stewardship of existing antibiotics, and reinvigorate the development of new ones too, while making sure the antibiotic supply chain is safe, secure, and transparent, and has shared standards that we can all rely on.
Finally, there are vast opportunities when it comes to digital health. During our response to the pandemic, we’ve had a weapon in our armoury that previous generations simply didn’t possess, the incredible emerging technologies that have spurred so much innovation in healthcare. In the UK, for example, artificial intelligence helped us make sure that vital resources like ventilators and oxygen were in the right place at the right time. Digital technologies have allowed us to create a database with scans from COVID patients across the country, to help Clinicians better understand the virus. And across the world, telemedicine has advanced like never before over the last year. Now, we’ve proven, beyond doubt, the benefits that healthtech can offer, and we must go further and make sure these benefits are shared by people everywhere.
There’s one thing that digital technologies have in common with pandemics, and that’s that they grow exponentially, so we must put in place the guiderails to enable this incredible innovation. At the same time, make sure these technologies develop, according to the values that reflect the best of humanity, and so we’ll work with other G7 member states and others to look at internationally recognised standards for AI, including the ethical underpinnings that are so important. But it’s not just enough to have the technologies. We need to unlock the power of the data that fuels them, so it’s critical to develop standards of interoperability of health data, especially clinical data, moving away from the wide range of standards that we currently have across the globe, towards a common approach, so data and technologies can be shared quickly and securely across boundaries, building on the work of the Global Digital Health Partnership. Like new technologies before them, such as vaccines and antibiotics, digital technology saves lives, and we must build the international infrastructure to make the most of it. And I know that we can rise to this challenge, just as we’ve risen to so many before.
Overall, this is an ambitious agenda, building on the five-point plan set out by the Prime Minister at UNGA last year, and I’ll finish by saying this. This should be the moment when we move from nations facing this battle themselves to us joining arms, even as we have to tighten borders. The virus attacks us all because we are all human, so we must draw upon what it means to be human as we respond: our shared ingenuity, our shared solidarity, and our shared determination. We’re in a war against this virus, and the whole of humanity is on the same side. Now is the time to make that count. Thank you very much.
Robert Yates
That’s super. Thank you so much, Secretary of State, and I know that the reaction from the audience has been spectacular. We run lots of webinars at Chatham House, and my colleagues have just messaged me, saying we’ve never seen so many questions as this, you know. So, I think you really have, you know, raised some great issues there, and particularly, I think, around the need for international solidarity. I think we all recognise that, you know, countries, as you say, have been, sort of, grappling with this, often feeling very much on their own. But, you know, the way that humanity’s going to overcome this is through global solidarity, and linking arms, as you say, to tackle this as humanity. And I think in the discussion that we’re going to have now, I think we’ll, sort of, focus on this quite a bit, judging by the questions that we’ve been having coming in. Very much encourage participants to keep asking your questions. We’re trying to filter them and, sort of, pick the best ones. And please upvote the ones that you particularly like, so we’ll be able to pose the most interesting and popular questions to the Secretary of State.
But I’ll perhaps, sort of, kick things off, if I may, and really, sort of, reflect on what you were talking about solidarity. I mean, interestingly, we at Chatham House are doing some work with another G7 member, the Government of Japan, specifically looking at this issue of the importance of solidarity in tackling the pandemic. So, I think, sort of, perhaps, reflecting on this last year, Secretary of State, where do you think, you know, that solidarity has perhaps been failing, over the last year, and where do you think we can be doing better, and how can the G7 really, sort of, facilitate and improve solidarity going forward?
The Rt Hon Matt Hancock MP
Well, I think the single most important thing that we need to be doing is forging a common agenda, in terms of what we need to do, and that is what I’ve tried to set out at high level today, from our point of view. But we’ve developed this agenda very much in consultation with other countries, both in the G7 and more broadly. I think the need to work together has never been more important, and the scientific establishment and the – and Scientists around the world have worked very hard to make this happen.
But I think that stronger political co-ordination is important. The Executive Board of the WHO this month is a really good case in point, and I’d point you to the WHO’s own work in this area, strengthening their own processes, but making sure that we try to co-ordinate. For instance, just pick one example on clinical trials. If you don’t set up clinical trials in a way in which they can be compared to a clinically rigorous level, then you end up with several small samples, and you don’t get the benefit of the same treatment, whether it’s a, well, a treatment or vaccine, being tested in different countries. The MHRA in the UK worked very hard to overcome that, but it is – it makes the process harder if there isn’t that set of common standards. You know, that may seem like quite a technical issue, but get it right, and you can get therapeutics, you can get vaccines safely to market faster, and even faster than we’ve managed to over the last year, and that’s the sort of area where international leadership is needed.
Robert Yates
Yes, yes, absolutely, and I’m sure that a lot of the global health community watching will feel exactly the same thing. To bring some rationale, let’s say, to the whole clinical trials world will be vitally important. Talking about vaccines and, you know, obviously, you know, that is, you know, the hot topic, one feels, this year, and, surely, it must be the priority for the G7 and G20 to ensure universal and equitable rollout of vaccines in 2021, very – as much to get the global economy going as anything else. Our Chair, you’ve mentioned him already, Jim O’Neill, has called this, you know, a no-brainer, a bargain of the century that will bring potentially, savings of trillions of dollars in the long run.
But there are signs of vaccine nationalism undermining these efforts, which will affect, you know, global health security. So, what specific measures will the UK take as the Chair of the G7 to, sort of, accelerate a fairer allocation of vaccines around the world? And, particularly, you might’ve heard again the Director-General say at the Executive Board last week he would like to see every single country in the world starting to vaccinate to their vulnerable populations by April the 9th. Is that something that the UK adheres to, and would encourage the G7 to support as well?
The Rt Hon Matt Hancock MP
Well, I think the rejection of vaccine nationalism and the rejection of protectionism around vaccines is incredibly important because, whenever it’s been tried, protectionism has damaged those countries who try to put it in place, as well as everybody else. And I think that’s a lesson that’s incredibly important that people heed right now. So, in the UK, we’ve tried to deliver on this commitment to global fair access to vaccines in two ways. The first is with financial resources, not only putting our own substantial foreign aid budget to bear, making sure that COVAX and Gavi are well-funded, and also, done everything we can to leverage in further funds from international partners, and I hope that that continues.
But, also, the approach that AstraZeneca has taken to the international distribution of the Oxford vaccine has been to do it on a not-for-profit basis everywhere. And because that vaccine is one of the most transportable and logistically simplest of vaccines, and is by far the cheapest of the widely available vaccines, that is a very, very significant contribution, and the UK Government was, you know, we were very strongly supportive of AstraZeneca taking this benevolent international approach to making sure that that vaccine is globally available. So, both the provision of the vaccine itself and of the financing to ensure that everybody gets the opportunity to buy it, we’ve been working very hard to make sure that we not only put our resources on the table but try to leverage in others. If you think about it, the UK’s a country of around 70 million people, and we are the single biggest funder of the global vaccine effort, and I very much hope that that effort grows and grows.
Robert Yates
Great, thank you very much. One key area of solidarity that, you know, is around the move towards universal health coverage, you know, the world’s leaders all gathered at the UN in September last year and signed this political commitment to achieving universal health coverage. And you have WHO very much, sort of, saying that UHC and health security are two sides of the same coin as, you know, this is one of the best strategies to tackle the pandemic. And certainly, The Elders, that group of global leaders, are, sort of, promoting UHC as a way to tackle pandemics.
The UK has been seen as a great UHC success story over the year. You know, we’re very proud of the NHS. I see you wearing your NHS badge there. This is, sort of, a great thing that’s bring – brought solidarity to our nation. Do you see the UK having a, sort of, big role in championing universal health coverage, maybe through the G7, but even bilaterally to countries to encourage them to create a universal system, maybe even encouraging the United States to take this step at this crucial time?
The Rt Hon Matt Hancock MP
Well, you’re very tempting in the question, Robert. Obviously, I’m incredibly proud of the National Health Service, and it was once called the greatest gift a nation could ever give itself, and I strongly believe that. And I would recommend the approach that we take in the UK to anybody around the world and I think that the foundation of the National Health Service, which was formed and conceptualised during the Second World War, I think is an incredible mission that I would recommend to any of my colleagues, any Health Minister around the world, and we’re very happy to support countries that want to go on that journey.
We find that it is both fair and it’s good value for money too, and it’s in fact a good business policy because you don’t have to – because all employees get their free healthcare coverage through the NHS. And in this vaccine rollout, it’s been absolutely crucial because the NHS is delivering vaccines fairly to people, according to clinical need, right across the UK. And it’s also a very strong partner of the life sciences industry, especially as data becomes more and more important in the development of new treatments and therapeutics because the – having a single-payer system obviously means that we can track and follow and organise clinical trials in a more effective manner.
Now, it can always be improved, and the NHS strives constantly to improve, of course it does, but it comes with a very strong recommendation from me. Now, in terms of the G7 agenda, the agenda that I set out today is of concrete deliverables because there are specific international things that need to change, so that we are better prepared for pandemics in the future, and we can deliver better healthcare. But on a – whilst I wouldn’t want to get into recommending a policy for any other country specifically, a domestic policy, because, you know, we’ve got plenty to do here at home, it is – it’s an approach that I recommend.
Robert Yates
Terrific, thank you very much indeed. I was going to ask you as well about the role of WHO, but I can see that one of our participants wants to ask you the same question, so I won’t steal their thunder. And I’d now like to, sort of, start to bring in the audience, please, and we’ll be starting with a respondent who I think is ideally placed to address some of these issues, and that is the Executive Director of UNAIDS, Winnie Byanyima, who used to be the Head of Oxfam International, of course, as well. So, Winnie, would you like to, sort of, pose your question to the Secretary of State, and maybe reflect initially on what you’ve heard so far, and what would you like to ask the Secretary of State?
Winnie Byanyima
Thank you, Rob, and thank you, Honourable Secretary of State. I agree with you, I, myself, a very grateful beneficiary of the National Health Service of the UK. When I was a refugee, and then a graduate at Manchester University, I was registered at the National Health Service, and was cared for. 40 years later, when I came back to England to work as the Head of Oxfam, I found my number was still in the system of the National Health Service. It’s a great institution, and, indeed, something that every country should provide. I believe in publicly funded healthcare, the right to health, provided by the state.
So, nine months ago, world leaders declared that any COVID-19 vaccine would be a global public good, a people’s vaccine. Yet, we know now that nine in ten people in the poorest countries are set not to get a vaccine this year. A small group of rich countries, representing just 14% of the global population have bought up most of the supply of the leading vaccine contenders until the end of 2021. In fact, we are hearing disagreements amongst the rich countries about who gets how much, while the rest of the world looks on.
The South African Government has called this a new global apartheid. So the problem is not just that there’s not enough money or that the vaccines are being unfairly allocated. It is that there are not enough vaccines being made. Our best chance of staying safe from COVID is to have vaccines, tests, and treatments that are available for all. But, instead, we see pharmaceutical companies protecting their monopolies of technology and intellectual property, and then they restrict production. Pharma companies are not joining the WHO COVID-19 Technology Access Pool, and the proposals presented by the Governments of South Africa and India at the WTO TRIPS Council for a temporary waiver of certain TRIPS obligations are being blocked by rich countries. Not all producers are the same, and we do welcome Oxford-AstraZeneca for pledging to provide 64% of their doses to people in developing countries, and the British Government’s role in that. Yet, AstraZeneca-Oxford can only reach 18% of the world’s population next year at the most, so even that is not good enough, but we welcome it. So, even rich countries face challenges, over production quantities, in 2021.
You will be aware of the extremely worrying production delays to both Pfizer and AstraZeneca that are creating tensions, as we can see. But we do know one way to solve this problem, Secretary of State. It’s to open up production. We know this from the painful lessons from the early years of the AIDS response when millions of lives were needlessly lost in developing countries because a life-saving treatment remained out of reach for poorer countries. We cannot afford to repeat those mistakes. So, this is not just about justice for poor countries. The longer the virus is left to ravage developing countries, the longer people in G7 countries will remain at risk. The virus is mutating, as you know, which threatens the efficacy of the vaccines, and the economic cost will be huge. The International Chamber of Commerce have done their research, and they predict that delays to vaccine access in poorer countries will cost the global economy $9 trillion, nearly half of that in the wealthy countries. The loss is for both rich and poor.
These vaccines were developed with public money from the rich countries, like yours. These companies depend on your Government’s support. So, the UK’s Chairmanship of G7, and its position as a base of pharmaceutical industry, makes the UK key in overcoming the global COVID crisis. So my question to you, Secretary of State, are these. Support for COVAX is welcome, but cannot, on its own, solve the supply problem. How will the UK ensure that constraints on licensing and know-how no longer obstruct mass production of the vaccines? How will you help to make companies take part in C-TAP? It’s there. How will you help speed up agreement on a waiver at the WTO? How can you ensure that there are enough vaccines produced this year, so that no one is left behind? Thank you, Secretary of State.
The Rt Hon Matt Hancock MP
Well, thank you very much, Winnie. I agree with so much of the premise of your question. As you say, you know, of all of the vaccines currently being used, the approach that AstraZeneca has taken has been, I think, the most progressive, in terms of licensing its vaccine at cost in countries right around the world. And the more that we can do that, the better and you say it’s not just about the money, and, no, you’re absolutely right because it’s about access. Now, it’s, of course, understandable that countries will seek to ensure that their own citizens can get vaccinated. After all, that is their primary job. But, at the same time, it is the increase in the overall supply of vaccines that can solve this problem. So I hope that we can work together on this important agenda, and we can open up the supply of vaccines right across the board.
At the same time, we must ensure that we spot and respond to new variants, and, hence, the proposals, in terms of helping countries to spot new variants that can cause problems either because, like the variant first discovered in the UK, the transmission of that variant is faster, and there’s a risk that mortality is higher, or, as in some cases, but thankfully not the case of the new variant first discovered here, that the vaccine may respond – that the virus may respond differently to the vaccine, and not be suppressed or dealt with by the vaccine as much as the older variants. Making sure we continue to update vaccines in the future will be as important as making sure that the ones that we have now are widely available, and we must stay ahead of that too, which is best done through international collaboration. I think you’re muted, Robert.
Robert Yates
Thank you very much. Thanks for spotting that. Yes, so I would like to bring in Anne Gulland, please, who I think is going to ask you about WHO. So, Anne, would you like to come on air, and ask your question to the Secretary of State?
Anne Gulland
Oh, hi, thanks very much for letting me ask a question. Yes, I was wondering if the UK would be willing to strengthen WHO’s powers, in terms of allowing WHO to come in to investigate if there’s a disease outbreak? This has been something that people have talked about that WHO doesn’t have enough powers. Thanks very much.
The Rt Hon Matt Hancock MP
Yes, well, obviously, I think it’s incredibly important that we share transparently all that’s going on, with respect to COVID and other communicable diseases. The approach that we’ve tried to take is to be immediately transparent, and what I call progressive transparency in my comments. And the reason that I put it like that is that it is a – there’s a challenge here. There’s a paradox. The countries that have spotted and sequenced new variants of concern then, understandably, cause reactions from neighbours and other countries around the world. But it is still the right thing to do to protect life around the world. So, you know, we published the details of the new variant first discovered here and, understandably, our neighbours reacted by saying, “Well, we must be more cautious on travel.” I entirely understand why they did that, and, indeed, we had taken the same approach to a new variant discovered in Denmark, which, itself, has a high genomic sequencing capacity.
At the same time, when the South African Government, which – it has a high genomic sequencing capacity, based in the South African universities, and their excellent work, which discovered and sequenced the South African new variant of concern, understandably led to the response. The variants of concern I worry most about are the ones that are spreading, but are not yet identified, and, hence, the offer, the global offer that we will put some of our genomic sequencing capability to sequence new variants where they are – where they’re thought to exist, which you can spot through the epidemiology, but where the sequencing isn’t available to find out for sure and, of course, to support other countries to develop the sort of genomic capability that we have in the UK.
And the striking thing is that this genomic capability is not evenly shared, not evenly spread, and it’s not even – it’s not evenly spread amongst developed countries either. There are some developed countries which have almost no genomic capability, and there are some developing countries that have very significant genomic capability. This is really an area where the world needs to work together, and the WHO has an important responsibility, which it’s working very hard on as well.
Robert Yates
And if I could just follow-up on that and ask about WHO funding. I mean, you referred to the very welcome announcement of increased UK funding for the WHO. But, overall, WHO is spending still so much time having to fundraise, and is grossly under-resourced for what it really needs to do. Is this something that you’re going to be, sort of, championing in the G7 to encourage other countries to increase their contributions, and taking that into the G20 as well? ‘Cause if we are going to tackle this collaboratively, you need a well-resourced WHO.
The Rt Hon Matt Hancock MP
Well, it’s an incredibly important issue and an incredibly important question, and there’s also a question over the baseline funding, as opposed to project funding within the WHO. I mean, the first thing to say there, Robert, is you’ve got to acknowledge progress where we’ve seen it, and just in the last week, with the change of administration in the United States, the threat of the withdrawal of the single biggest funder of the WHO has gone, and I warmly welcome President Biden’s decision to fully re-engage in the WHO. I think that helps, and that is an important moment when the WHO can now stride forward again with confidence, and we can all come together behind what is obviously a critical part of the international infrastructure.
Robert Yates
Yeah, excellent, thank you. Right, now, another, sort of, funding-related question. I think Ben Simms, if we – have we got Ben Simms on there? And there’s Ben, yes.
Ben Simms
Secretary of State, thank you very much for everything you’ve said about expressing solidarity. I’m just wondering, how does the Government’s decision to reduce our commitment to 0.7 UK ODR square with that appetite you have for solidarity?
The Rt Hon Matt Hancock MP
Oh, because, Ben, we still have one of the biggest ODR budgets in the world, and it’s a matter of putting it to use as best we can. Of course, these have been very difficult times globally, in terms of finances and the public finances in most countries. So, of course, there’s a financial challenge. Many of the advances that we’re talking about, many of the things I’ve put on the table are not about money. They’re about co-ordination, and, for instance, the question that Winnie asked, quite rightly, is about availability of intellectual property, as much as anything. The funding is important but, as she said, money is only one part of this equation.
Improving clinical trials saves lives but doesn’t take a penny. It is a matter of leadership to standardise methodology for clinical trials that if they’re all set up off the same methodology, will be interoperable in a way that they’re not now. And each individual Researcher or clinical trials group has a reason why they set their data structure up the way they do, but there’s no reason why that can’t be standardised. So, of course, money’s important, but it is only one part of the picture, and the UK still is a formidable funder of international aid.
Robert Yates
Thank you very much, Secretary of State. So, next, I think we were going to ask Victoria next if she could, I think, Victoria Macdonald. Ah, but I think she might have gone.
The Rt Hon Matt Hancock MP
But she gave – it’s a great question. “The President of South Africa…
Robert Yates
It’s the – yes, that’s what she was talking about.
The Rt Hon Matt Hancock MP
…vaccine nationalism, are you satisfied we’re not guilty of this in our albeit understandable desperation to get as many people in the UK vaccinated?” And the answer to this question, which many people have said they want answered is, it’s not either/or. It’s and. Of course, we’ve got to vaccinate the UK population. As the UK Health Secretary, it is my duty to protect the UK population, of course. But we’ve got to make sure that there’s broad availability of vaccine for the rest of the world too, both by the funding and by the very open and generous approach that AstraZeneca have taken to the global distribution of the Oxford vaccine. It’s not either/or. It’s both.
Robert Yates
Great, thank you very much indeed. I realise that we’re coming towards the top of the hour. We’ve got 88 questions, which is definitely a record, and I think maybe we’ll, sort of, take one or two, sort of, media-related questions as well now. Was it – I think the BBC had a question, if I’m not mistaken. Was it Nick from the BBC who had a question? Just asking my colleagues can – yes, Nick Eardley, that’s right. So, if you’d like to unmute, Nick. Nick Eardley, are you there? Are you able to put – pose your question to the Secretary of State? Right, now, I’ve got to, sort of, try and find his question because he seems to have come on the screen, but he’s not – may – actually, I’m struggling to find his question, so I don’t know if my colleague can maybe, sort of, come in on and ask the specific question that he was asking. I think it was around this issue of the vaccine – the export ban on vaccines from the European Union, Secretary of State. Can you react to these developments of, sort of, about them saying that they’re not going to allow the export of vaccines to the United Kingdom?
The Rt Hon Matt Hancock MP
Well, we oppose protectionism in all its form, and I think protectionism is unfortunate, and especially so in the midst of a pandemic, when we are working so closely together with countries right around the world. And the contribution that the UK has made that we’ve been talking about, for instance, through the Oxford-AstraZeneca vaccine and the therapeutics that are available, has been in partnership with countries right around the world, including in the EU. So, I’m sure that we can work with the EU to ensure that whilst transparency is welcome, that no blockers are put in place. And I’m glad to say that I’m confident, having spoken to the Chief Executives of both of Pfizer and AstraZeneca, I’m confident of the supply of vaccine into the UK. I’m confident that that won’t be disrupted. But I would urge all international partners, in fact, to be collaborative, and working closely together, and I think that – I think protectionism is not the right approach in the middle of a pandemic.
Robert Yates
Yeah, great, thank you. Next question, and we’re coming towards the end now, but if we could bring Richard Koch on screen, please. That’s quite an upvoted question, so with 15, and I think that Richard would like to ask really about testing. So, Richard, would you like to ask your question, please?
Richard Koch
Yes, Honourable Minister, it’s really to try and reflect, within the G7 in particular, the fact that there’s, sort of, a paradox of COVID-19, and it’s hits the highest income and the most developed countries the worst. Is this a reflection of the unhealthiness of our societies in high-income countries, rather than any issue over preparedness? There’s a lot of focus on that, and our abilities to use genomics, etc., which is all important. But, actually, what about our unhealthiness and our vulnerabilities and loss of resilience in so-called developed nations? I think it’s very worrying, thank you.
Robert Yates
Thank you, Richard.
The Rt Hon Matt Hancock MP
Well, I’ve absolutely no doubt that a healthier society and, in particular, a society with less obesity is better placed to deal with a COVID pandemic. We know that after age and sex, obesity is the third-highest determinant of your morbidity when – if you catch COVID, and that is obviously a very significant problem in countries that have a long-term challenge when it comes to obesity. So, it is something that obviously, we’ve got to do a lot of work on to make sure that everybody’s as fit and healthy as possible.
Richard Koch
Thank you.
Robert Yates
Thank you, and just one final one to maybe, sort of, as a summing-up type question, if I may, Secretary of State. The recent IPPR report, you know, the Independent Pandemic Response Committee have noted that last year that both the G7 and G20 really underperformed, you know, that they were very reactive in their responses, and it wasn’t really, sort of, planning ahead strategically. What do you hope is going to happen differently this year, sort of, thinking ahead to June and the big summit? What are your expectations and hopes that the G7 is going to get its act together to tackle the pandemic?
The Rt Hon Matt Hancock MP
Well, I think people are crying out for international leadership. I think that there are so many issues, including the four that I put at the centre of the G7 health agenda, there are so many issues that we need to deliver on. And, understandably, when a crisis hits, and people look to tackling the enormous challenges at home, but we can best do that by reaching our arms out and collaborating closely and in an open and trusting way with partners right around the world, and so I think we should be using all multilateral fora to do this. The G7, because we’re Presidents, obviously, has a particular focus for the UK, but, also, I know that the Italian Government feels the same about the Presidency, the Italian Presidency of the G20, which has an incredibly important role, and the work that the World Health Organization is doing too, to make sure that it plays its part.
So, I really hope that we can look outwards, that we can work collaboratively, and that we can raise our eyes collectively to the horizon. I welcome the new administration in the United States really opening the way for that with their clear commitment to playing their full part in international fora and multilateralism, and I think that, therefore, we have a chance to solve some of these problems, even whilst we still grapple with these incredibly difficult challenges at home.
Robert Yates
Great, thank you very much indeed. I know you have a hard stop at two, so apologies to all the people who’ve asked questions. We didn’t quite make the 100, but we got very near to it. So thank you very much indeed for joining us today, and we at Chatham House would be delighted to work with you through this process to move forward in tackling the pandemic and towards universal health coverage. So, thank you very much indeed for joining us, and thank you to the audience as well. Good day to everyone.
The Rt Hon Matt Hancock MP
Thanks for having me.
