Global Health, Global Britain Contents

Conclusions and recommendations

Multilateral health system

1.Another pandemic could wreak just as much havoc on the global economy and have just as devastating an effect on global health outcomes as war, famine or environmental disaster. The temptation for world leaders will be to ignore the risks of a future pandemic until it is too late. We recommend that the Government takes steps to ensure that every G7 and G20 meeting includes an agenda item on mitigating pandemic risks. (Paragraph 9)

2.The pandemic has exposed shortcomings in the multilateral health system. The WHO lacks adequate funds, power and independence. It has done hugely important work in a difficult situation, facing intense pressure from many sides. However, it performed less effectively than under the leadership of Gro Harlem Brundtland and fell short on demanding transparency from Beijing, particularly in the early months, leading to costly delays in the international response. Far from being a reason to abandon the WHO, the pandemic should be a wake-up call that prompts reform to give the WHO the powers it needs to respond more effectively to future outbreaks. No country should be able to impede it effectively performing its role of protecting global health. As the second-largest donor to the WHO, the UK is in a strong position to influence this process, build a coalition of member states, and press for the necessary reforms. These should include greater transparency and accountability across its work. We recommend that the Government endorses the recommendations of the Independent Panel (IPPPR), including for greater powers to independently investigate outbreaks, an increase in member state fees, and greater independence for the WHO’s leadership. For each, the Government should assess the chances of success, and explain the efforts the UK is making to promote it, if any. (Paragraph 13)

3.To be more effective and independent, the WHO needs more reliable sources of funding, based on predictable fees from member states, rather than earmarked voluntary donations. We welcome the UK’s commitment to increase its core funding to the organisation. This should be accompanied by greater efforts to bring together other countries in support of increasing non-earmarked core contributions. We recommend that the Government campaigns for an increase in member state fees ahead of next year’s World Health Assembly. (Paragraph 14)

4.The WHO needs support to withstand political pressure from certain member states. There should be no space for doubt about the independence of the WHO’s leadership, particularly given the organisation’s important work during the pandemic. Working in a highly political environment and facing targeted attempts at influence by Beijing and other governments, the Director-General should be insulated from the need to campaign for re-election. Making key deliberations public would help to remove any scope for undue influence. We recommend that the FCDO should support proposals to give the Director-General and other senior officials a single, non-renewable term, and to publish deliberations on declaring a public health emergency. (Paragraph 15)

5.Without a full and transparent investigation into the origins of covid-19, we are at greater risk of a disastrous new outbreak. By impeding efforts to trace the origins of the virus, Beijing is endangering its own population along with the rest of the world. Even with a full investigation, the limited access to data and to key sites in China in the early days of the pandemic makes any investigation more difficult—this must be addressed for any future outbreaks. The Government should work with other countries to increase the WHO’s powers to independently access countries where an outbreak has been reported, mirroring the work of the International Atomic Energy Agency (IAEA)—including through reform of the International Health Regulations, if necessary. The Government should build a partnership of nations to investigate the virus’ origins and should make clear what measures it will take to support countries that are facing intimidation from Beijing over their backing for an independent investigation. (Paragraph 16)

6.Taiwan’s impressive response to covid-19 illustrates that its exclusion from WHO forums risks harming global health security, making it harder to exchange information with Taiwan and learn from its experiences. In a deeply interconnected world, where the next pandemic could emerge from any region, we cannot afford to arbitrarily remove key partners from global health forums. We were disappointed that the Minister responsible for global health security was not aware of the UK’s position on this topic, which suggests that the issue may not be getting the attention it deserves within the FCDO. We recommend that the Government builds on the momentum of the joint G7 statement supporting Taiwan’s participation in the WHO with a renewed push for its attendance at the 2022 World Health Assembly. (Paragraph 17)

7.We are concerned that the UK’s reduced access to European health networks could undermine the UK and European response to future disease outbreaks. We recommend that the Government builds structured permanent cooperation with the European Centre for Disease Prevention and Control (ECDC). In its response to this report, the FCDO should set out its assessment of how its new ad hoc access to the Early Warning Response System affects global health security; whether and on what terms it sought to retain membership of the ECDC during EU exit negotiations; and when the current access in the context of the pandemic will lapse. (Paragraph 19)

Covid-19 vaccines

8.When we launched this inquiry, in October 2020, it was not known whether there would ever be effective vaccines against covid-19. Today, less than a year later, all UK adults have been offered full immunisation, and 41 percent of the global population has received at least one dose. This is a huge achievement for global scientific cooperation. The UK has made an important contribution, and the UK-backed AstraZeneca vaccine is responsible for the majority of COVAX vaccinations in lower-income countries. However, these achievements are undermined by the failure to ensure anything close to global equity in access. While democratic governments have responded to the needs of their electorates, it is now time to turn our attention overseas. Promoting rapid vaccine access globally is not just morally right, but is clearly in the UK’s interest. It is necessary in order to build prosperous and healthy societies, preserve the safe travel that underpins the global economy, fend off the threat of new variants, and counter autocracies that are using vaccines to gain influence. (Paragraph 28)

9.The glaring inequality in global access to vaccines has created the opportunity for autocracies such as Russia and China to seek to undermine the West and expand their influence by donating and selling vaccines. Even if these campaigns have fallen short on delivery, there is still a worrying potential to undermine UK influence overseas and harm its reputation as a force for good. We welcome the UK’s commitment to donate 100 million vaccines in the year to June 2022. However, this target falls far short of what is needed to meet the health challenge and protect British nationals from further outbreaks and variants, let alone meet our moral duty. We urge the Government to make every effort to achieve a significant increase in the speed and number of vaccines it donates through COVAX. Delays in vaccinating the world could mean irreparable damage to global health security, widening inequalities, undermining lower-income country health systems, and increasing the disease burden in the parts of the world that can least afford it. The UK should ensure that any bilateral donations are planned and timed to give real, sustainable and predictable support to other countries’ vaccination campaigns, rather than transferring small quantities that do more for the image of the donor than for the recipient. While a strategic approach may be appropriate for some foreign aid, lower-income countries in particular need predictable, needs-based vaccine supplies—this matters to us all. Ensuring there is low infection is key to ensuring there are few variants. In response to this report, the FCDO should set out a list of the countries that have and will receive bilateral donations from the UK, with dates, quantities, and the factors that went into each decision. The response should set out the FCDO’s role in selecting these countries, how this is coordinated with other Departments, and how it links to the objectives set out in the Integrated Review. We recommend that the Government sets out its strategy for delivering the vaccine to particularly vulnerable groups, including displaced people. (Paragraph 29)

10.To defeat covid-19, and tackle future pandemics, a wider range of countries need the ability to produce vaccines. The production of AstraZeneca by India’s Serum Institute offers a good model for technology transfer to build this capacity. Many national leaders have backed the call for a temporary waiver on intellectual property for covid-19 vaccines. We recommend that the Government pursues a wide range of means to bring about greater manufacturing capacity in lower-income countries, including through expanded technology transfer schemes. In its response to this report, the Government should set out the steps it is taking to transfer vaccine technology to low- and middle-income countries, and its goals in terms of increasing global vaccine production. (Paragraph 30)

11.Deliberate misinformation about the safety of vaccines is not only irresponsible—it costs lives. Tackling state-backed falsehoods on covid-19 should be an integral part of the Government’s global health security strategy. To promote global access to covid-19 vaccines and bring the pandemic under control, communities around the world need access to reliable information about immunisation, delivered in a format that is accessible and inspires trust. This requires strong local media outlets. The FCDO should lead on efforts to counter health misinformation internationally. In particular, it should target support to independent local media outlets in regions at risk of high levels of vaccine hesitancy. The Government should give the BBC World Service long-term funding to tackle fake news, with a focus on strategic locations such as Russia and China. (Paragraph 33)

Aid and global health

12.The pandemic has highlighted the global nature of health security, and the need for greater international cooperation in this area. In an interconnected world, health security is inextricable from foreign policy. A cross-Government strategy on global health security is important to UK leadership in this area, and transparency is vital to ensure proper scrutiny. It is near-certain that there will be another pandemic in the coming years, and the Government should learn the lessons of covid-19 and use them to prepare for the next pandemic. This should not mean focusing on covid-19 to the exclusion of other health issues—strengthening health systems around the world is an important part of building resilience to new outbreaks. Global health security should not be allowed to slide down the agenda once covid-19 is under control in the UK. In its response to this report, the FCDO should update the Committee on the progress of this strategy. It should complete and publish its global health strategy by the end of 2021. (Paragraph 39)

13.The Government argued that the FCO-DFID merger would be an opportunity to align aid spending with diplomatic policy, with the potential for gains in global health security. We are concerned that the Government is squandering this opportunity by making ill-considered cuts to vital global health programmes. It is short-sighted to cut spending on neglected tropical diseases, or health research for lower-income countries, in order to focus on covid-19. These steps could undermine the response to covid, and put us all at greater risk from the next pandemic. In particular, cutting spending on important medical research and development programmes is a dangerous false economy, and could endanger Global Britain’s reputation as a science superpower. We are disappointed by the lack of transparency over the cuts, and over how the decisions have been made. In response to this report, we recommend that the FCDO provides us with a full account of the changes faced by aid-funded health programmes, with details on how decisions have been made on which to cut. It should publicly commit to reinstituting previous levels of funding to health research programmes as soon as the fiscal situation allows. (Paragraph 40)

Published: 30 September 2021 Site information    Accessibility statement