Gavi and the Global Fund

13:50:00

I beg to move, That this House has considered funding for GAVI, the Vaccine Alliance, and the Global Fund. It is a pleasure to serve under your chairpersonship, Ms Jardine. I want to start with a quote from Gavi’s inaugural board chair, Nelson Mandela, over 20 years ago: “Life or death for a young child too often depends on whether he”— or she— “is born in a country where vaccines are available”. It is the injustice that he spoke of that the organisations we will talk about today—Gavi, the Global Fund and others—have fought against since Gavi was established in 2000. The fight has led to more than 1 billion children being vaccinated, and more than 18 million avoidable deaths prevented in low-income countries. This is also a Labour and UK story. We had a consensus, but it was Tony Blair’s championing of Gavi at its launch in 2000, and Gordon Brown’s leading role in the creation of the international finance facility for immunisation, that helped to fund Gavi’s work at the start, and the organisation continues to turn to our Government —a Labour Government—for global leadership. Through these organisations, we have cut the combined death rate from AIDS-related illnesses, tuberculosis and malaria by an incredible 61%, saving 65 million lives. Childhood mortality in under-fives has been reduced by over 50%, and vaccine-preventable deaths by over 70%, in the places where Gavi operates, and the coverage of key treatment and prevention interventions for HIV, TB and malaria has increased significantly in countries where the Global Fund invests. We saw TB treatment coverage increase from 45% in 2010 to 70% in 2022. In 2010 the percentage of the population with access to long-lasting insecticide-treated nets to prevent malaria was only 30%; in 2023 it reached 57%. In 2010 only 22% of people living with HIV were on antiretroviral therapy; in 2023 it reached 78%. That is the UK’s legacy. We hosted the first replenishment for Gavi in 2011, we hosted the last one in 2020, and we will co-host the Global Fund replenishment this year alongside South Africa. This is not just about helping other countries; it is about the UK’s own soft power and security and the resilience of the NHS. Let us talk a bit more about the UK’s contribution, because it is not just the Government’s contribution, but the contribution of amazing life sciences companies here in the UK. The UK Vaccine Network helped to develop life-saving vaccines such as the RTS,S malaria vaccine and the Oxford-AstraZeneca covid-19 vaccine, which have both been procured and rolled out by Gavi worldwide. Between 2016 and 2022 we invested £134 million to develop new vaccines for epidemic-prone diseases. An additional £103.5 million was committed in 2023 to support affordable vaccine development. Three billion doses of the covid vaccine have been supplied globally, which is estimated to have saved over 6 million lives in the first year of roll-out.

I am grateful to my hon. Friend for securing this important debate. Does she agree that it was work on malaria vaccines and others that enabled us to move quickly when covid and other infections occurred, and that investigations into neglected diseases have been the springboard to create vaccines for many other diseases that threaten the entire world?

My hon. Friend is absolutely right. It is through such programmes that we developed the expertise and the ability to rapidly create mRNA-based vaccines, which led to the creation of our own vaccines here in the UK and allowed us not only to protect our own population but to contribute to protecting biosecurity globally, by ensuring the fast spread of those vaccines. Similarly, 18 million doses of the RTS,S malaria vaccine created here in the UK have been allocated to 12 African countries. We have administered the vaccine to over 1.7 million children in pilot countries and consequently we have been able to reduce malaria cases. We know that malaria is moving north as climate change hits, so this is not just about protecting children in those countries; it is also about protecting children here at home. I want to share some of the quotes that were sent to me when scientists at AstraZeneca and elsewhere heard that I had secured this debate. They wanted to send a clear message. Sandy Douglas at the University of Oxford, one of the six scientists who created the covid-19 vaccine developed by AstraZeneca, said: “Gavi brings Britain’s scientific leadership to the world, and this brings investment back into the UK’s world-leading research, generating a virtuous cycle of innovation.” GSK also reached out because it wanted its voice to be heard in the debate. It said: “UK life sciences are a critical economic driver to improve health outcomes and transform lives in the UK and around the world, including in the Global South. Scientific innovation underpins national and global health security and economic prosperity at a time of growing uncertainty. GSK and its HIV business…are proud of the contribution we make to deliver these priorities.” Most importantly, it said: “The UK’s 2025 investment in Gavi and the Global Fund will be critical in building long-term sustainable access to health technologies at scale.” This is not just about what we are doing in the global south and in other countries that need our partnership; it is also about what we are doing to build economic growth, which is the single most important mission of this Government. The reality is that this mission is not over. I could go through many of the numbers, but I know that my hon. Friends will pick up some of them. What I will say is that across the US, the UK, Germany, France and the Netherlands, which provide 90% of the HIV funding response, there could be cuts of between 8%—if we do our job well—and 70%. Modelling by the Burnet Institute estimates that such cuts would result in between 4.4 million and 10.8 million additional HIV cases, and between 770,000 and 2.9 million HIV-related deaths in children and adults, by 2030.

My hon. Friend is making an excellent speech and I congratulate her on securing the debate. Gavi has been one of the most successful development initiatives ever; more than 1 billion children are being routinely immunised against some of the world’s deadliest diseases. Despite its success, however, each year more than 1.5 million children continue to die from vaccine-preventable diseases. Does she agree that the UK needs to show leadership in ensuring that immunisation remains a funding priority for the UK, and that the Government, as a board member and a strong donor, should continue to fund Gavi and prioritise life-saving vaccinations?

I absolutely agree. That reminds me of something my gran always said to me: “If you don’t have your health, what do you have?” I know this issue sounds quite niche, but health is something we all understand. If we do not have our health, we cannot talk about improving the economies of countries around the world and improving global security. That is why this is such a crucial initiative. These diseases cross borders. Milton Keynes’s HIV rate is among the highest in the UK, so this is also about protecting our constituents. If we can reach the levels that we need to reach on HIV transmission, we will be protecting the UK population too. I am really encouraged by the UK’s commitment to co-host the Global Fund’s eighth replenishment, alongside the Government of South Africa, and by the Prime Minister’s statement that, although we are cutting official development assistance, we will continue to support global health. These partnerships are the best and most efficient way of getting money to the ground. They bring an estimated £530 million of investment into research and development in the UK, and they balance investment by ensuring that the countries that can contribute to the programmes do so. This is not charity, but true partnership. It is about us working together to build capacity. These programmes have public support. Various polls show that about three quarters of the British public support using our R&D and our expertise in life sciences to save lives here and abroad. I will conclude, because a lot of other Members want to speak. This year is pivotal. Gavi, the Global Fund, Unitaid and others are requesting partnership money, but it is about not just cash but the partnership and leadership that the UK Government provide. I say to the Government and the Minister, who cares a lot about this issue, that, despite the short-term cuts—the Prime Minister said that it is one of the most difficult decisions he has had to make, and that we will look to increase funding in the future—we must not use the fact that the replenishment comes at a time when our budget is at its lowest not at least to match what we have pledged in the past.

Order. I remind Members that they should bob if they wish to be called in the debate. Unfortunately, because of its popularity, I will have to impose a time limit of three minutes from the beginning. I intend to go to the Front Benchers at 2.38 pm.

14:03:00

I am grateful to you for stepping into the Chair, Ms Jardine. I was due to chair this debate, but that would have meant that I was unable to contribute, which I very much wanted to do. Given the restricted time, I do not want to rehearse the discussions that we had with Baroness Chapman in the International Development Committee earlier in the week. Like the hon. Member for Milton Keynes Central (Emily Darlington), whom I congratulate on securing the debate, I want to say that a contribution to Gavi and the Global Fund is not charity but a strategic investment by the United Kingdom. Although we have to deal with the reality that, as Baroness Chapman set out, the cuts are happening, we have to make the case about what should happen in that environment. I have always believed that aid spending should have maximum impact and maximum returns. Moreover, it should be in keeping with public expectations of food in bellies and shots in arms, and the Global Fund and Gavi deliver both. As the hon. Member for Southgate and Wood Green (Bambos Charalambous) said, Gavi has immunised more than 1 billion children, reducing vaccine-preventable child deaths by 70% in the 78 low-income countries in which it operates. That is 18.8 million lives saved and children growing up healthy, going to school and contributing to their communities, which is a huge impact. The Global Fund has saved an estimated 65 million lives since 2002. It has cut the combined death rate from AIDS, TB and malaria by 61%. These are staggering achievements and they should not be discounted. Gavi and the Global Fund are two of the most successful and impactful health programmes in history. They clearly meet the requirement for maximum impact and return, but they are possible only because of sustained, co-ordinated international investment. Alongside Unitaid, they are part of a habitat of organisations that have sustained progress in our understanding of diseases, and our ability to deploy medicines and improve health systems. I join the hon. Member for Milton Keynes Central in encouraging the Minister to sustain the existing contributions to both Gavi and the Global Fund. He will be aware that in the last Parliament, I lobbied my own Government very hard to get that £1 billion into the Global Fund. Let us keep it at that at least, and keep the contribution to Gavi. These programmes make a difference.

14:06:00

It is a pleasure to serve under your chairship, Ms Jardine. I congratulate my hon. Friend the Member for Milton Keynes Central (Emily Darlington) on securing this debate. I refer Members to my entry in the Register of Members’ Financial Interests. I am proud to co-chair the all-party parliamentary group on nutrition for development, alongside the right hon. Member for Dumfriesshire, Clydesdale and Tweeddale (David Mundell). Nutrition and immunisation are closely linked. Children with poor nutrition are often those who are most vulnerable to infectious diseases and need protection from vaccines, yet vaccines are less effective in malnourished children and often do not trigger strong immunity. The children whom specialised immunisation programmes are trying to reach are also the least likely to have access to food and nutrition services. Immunisation has the most impact when it is delivered alongside other interventions and integrated into primary health systems. By addressing under-nutrition and under-immunisation simultaneously, we can significantly improve health outcomes and vaccine efficacy, as well as provide interventions in the most cost-effective way. I saw this for myself on a recent visit to Isiolo in Kenya, hosted by UNICEF and organised by United Against Malnutrition and Hunger. We saw how in rural areas, nutrition interventions are delivered alongside vaccinations, healthcare education and maternal healthcare, to ensure that people have wraparound healthcare interventions that save lives. That was funded by UK development assistance and delivered by partners including Action Against Hunger. If a woman walks for 20 km or more with her children once a week for nutrition, they are less likely to walk the same distance, at a different time, to a different place, for vaccines. Integrating the services is paramount to good healthcare. This February, ahead of the Nutrition for Growth summit, I met the chief executive officer of Gavi, Dr Sania Nishtar, to discuss the important role that Gavi is playing in delivering these integrated services. Dr Nishtar spoke about the new $30 million programme to integrate nutrition and immunisation interventions in Ethiopia through the UK-founded Children’s Investment Fund Foundation, as well as UNICEF Ethiopia and Gavi, with support from the UK through Gavi’s matching fund mechanism. Ethiopia has one of the highest numbers—a staggering 1.1 million—of zero-dose children, who have not received a single dose of routine vaccines. That statistic is exacerbated by the covid-19 pandemic, conflict and displacement. The pilot programme aims to reach around 140,000 of those zero-dose children in areas with the highest dual burden of malnutrition and infectious disease, providing cost-effective and efficient interventions to help children to survive and thrive.

Does the hon. Member agree that even before the devastating cuts to UK foreign aid, there was instability in funding for global vaccination programmes? We have already heard that over 1.5 million children die from preventable diseases. Does he agree that the reduction in UK foreign aid will have a devastating impact on the ability to provide vaccines to these children, and will end up costing lives?

I will let the Minister answer that question, but I hope there will be an impact assessment to properly map our interventions in future. Integration costs money and Gavi cannot do it without financial support. I hope that when the Minister is assessing our contribution to this year’s Gavi replenishment, he will look at including support for nutrition integration. What plans does his Department have to integrate nutrition and immunisations more widely? I want to touch on one issue briefly. The UK’s contribution to Gavi has not only helped to save lives but contributed to the UK’s health security by reducing the risk of global health emergencies and pandemics. It has brought money into the British economy through reputational research returns, and it showcases the UK’s leadership on the global stage. In my constituency, the Medical Research Council-funded Centre for Medical Mycology at the University of Exeter works closely with Gavi, carrying out world-leading research into deadly fungal diseases and developing vaccines for some of the most widespread causes of death and disablement in developing countries. Does the Minister agree that the UK’s continued participation in Gavi and the Global Fund not only is the right thing to do because it saves lives around the world, but is strategically sound, as it supports our growth strategy and is an important part of delivering both our industrial strategy goals and our national health goals?

14:10:00

It is a particular pleasure to serve under your chairpersonship for the first time, Ms Jardine. I congratulate the hon. Member for Milton Keynes Central (Emily Darlington) on securing this important debate. It is just six months shy of five years since I had my own Backbench Business debate on global vaccine access—albeit in the context of the global covid-19 pandemic. I look back on what the then shadow Foreign Secretary, the right hon. Member for Wigan (Lisa Nandy), said with interest. I found in her remarks a consistent emphasis on working bilaterally to tackle global health crises, and through those efforts, to tackle poverty and inequality. She said that this was not just the practical but the moral thing to do. I hope that we have not forgotten what we should have learned from the covid pandemic about how fast a disease can turn into a global threat, about how good health produces sage and secure countries, and about how terrifying it was to reckon with the realities of the pandemic in all aspects of our lives. I do hope that the Government will think about that as they approach the spending review. Gavi and the Global Fund have been an incredible success, and we ought to celebrate that. The UK has been a leading force in these efforts on the international stage, and that is something to be proud of, because it bolsters our reputation and our standing and forms part of our global soft power. We will not need to fund such programmes forever. Fifteen years ago, lower income countries were able to fund, on average, only 10% of the costs of their vaccine programmes. Over the next five years, it is estimated that they will cover up to 40% of the costs on average. Some countries are already there, with Indonesia now a donor to Gavi rather than a recipient. Let us not forget that we need the world to be vaccinated. Disease knows no borders. Disease leads to poverty, which leads to global instability. We also have seen the more immediate and direct effects of global vaccine and treatment availability, through the demand and growth of our life sciences sector here at home—will the Minister tell me that that is not the sort of growth that this Government are looking for? At best, these investments benefit us up and down the UK. In my constituency, the University of St Andrews reported just last month that its infection and global health division had been awarded early career funding to identify new therapeutic strategies for infectious diseases. I have almost reached the end of my remarks, but I must mention the elephant in the room: the shrinking ODA budget. I have read the statistics, as others have, that show that spending on Gavi and the Global Fund gives some of the best financial returns. Just a few weeks ago, I attended a meeting in Parliament with the chief executive of the World Bank. He was clear that his role and that of his organisation is to create opportunities in the global south to develop their economies and reduce emigration from there. Given the Government’s other priorities, such as immigration, investing in multilateral ODA activities makes sense. I really urge the Minister to look again at that cut and how long it is needed for, and to engage openly with the ONE Campaign’s pre-action letter questioning the legality of the current cut to 0.3%.

14:13:00

It is a pleasure to serve under your chairship, Ms Jardine. I thank my hon. Friend the Member for Milton Keynes Central (Emily Darlington) for securing this debate. Let us be honest: most of the public do not know what Gavi or the Global Fund are, but they do know the lifesaving power of vaccinations because they, like all of us, will have benefited from them when they were children, as will their children. But we know that for too many children around the world, those lifesaving vaccinations are not available. In these debates we must remember that people’s lives are at the heart of the issue. I worked for Save the Children for many years, and I saw at first hand the impact of immunisations and the progress that has been made. Some of that is at risk in the light of what is happening around the world, so this is a really important debate. We have covered many of the areas that I want to talk about, but 1.5 million children continue to die from vaccine-preventable diseases. That is more than the population of Cyprus—an entire island of children dying every year. Vaccination and ending AIDS, tuberculosis and malaria are not only the right thing to do but, as we have heard, in our national interest and the smart thing to do. Vaccinations stop disease reaching our shores. They help to support healthy and prosperous nations, and they help to prevent future pandemics. They are also vital in the context of climate change, as many of the world’s deadliest diseases are susceptible to climate change, which increases the risk of them spreading. Tackling those diseases is best done—with best value for the British taxpayer—through Gavi and the Global Fund. We know we have to maximise our aid budget at this difficult time and invest it in the right things that will deliver the best value for the British taxpayer. Investing in Gavi and the Global Fund is therefore simply a no-brainer. I asked the Minister earlier this week if investing in women and girls remained a priority for this Government, and I was reassured by his answer. I then raised that with the Minister for International Development at the International Development Committee, and we heard that the approach is more about mainstreaming gender equality—women and girls were not listed as one of our three top priorities. Although I accept that we can mainstream gender, I hope that the Minister will reply on how we will ensure that women and girls remain at the heart of programmes such as Gavi and the Global Fund. Every week, 4,000 adolescent girls and young women between 15 and 24 become infected with HIV globally, and 3,100 of those infections are in sub-Saharan Africa. As we look at our aid budget, we know it has to be focused on tackling extreme poverty, and Africa is one of the areas that we need to focus on.

The hon. Member talks about vaccine inequality in women and girls, but would she agree that the global Gavi programme helps to address the inequalities that people face? During the covid pandemic, it was clearly reported that richer and more affluent countries had priority for vaccines when compared with low and middle-income countries. Gavi is essential to help to perpetuate equality.

I totally agree with the hon. Member. In fact, what we have seen with Gavi is that countries that were primarily recipients before have now becomes donors, such as Indonesia. Gavi is a clear pathway for countries to transition into different roles in the global economy as well. Other Members have mentioned brilliant examples of science and innovation in their constituencies. I want to mention the John Innes Centre at the Norwich Research Park, which is not technically in my constituency, but is in Norwich. It is doing pioneering work, particularly around malaria. As we have heard, that work is helping to save lives internationally, as well as creating jobs at home and generating economic growth. We need a new architecture for international development. We have to accept the world that we are in, but we also have to challenge ourselves as to why some of the public support for aid has been lost—although, some of the polling shows there is a lot of support for lifesaving interventions such as vaccines. Both Gavi and the Global Fund show us what that new architecture could look like: working together globally through multi- lateral institutions and pooling our resources to maximise our impact. This is not the time to take our foot off the accelerator. We have made huge progress in this area, both in tackling disease and protecting our own health security. I am sure that the Minister will reaffirm our commitment to improving the health of some of the poorest communities in the world and to delivering a safer and more prosperous future for us all.

We are going to struggle to get everybody in, so can Members please keep any interventions brief?

14:18:00

I commend the hon. Member for Milton Keynes Central (Emily Darlington) on setting the scene so well. It is an incredible debate, which is why Members are here to make a contribution. Gavi has so far immunised 1.1 billion children, and it is estimated to have averted more than 18.8 million deaths globally. If we want a success story and something that is worth investing in, this is the scheme. Childhood mortality in under-fives has been reduced by over 50%, and vaccine-preventable deaths are down by 70%. That is another reason for supporting Gavi and the Global Fund. Like the hon. Member for Norwich North (Alice Macdonald), I will focus on women and girls, because it is important that we look at the impact on them. It is a fact that women and girls are disproportionately affected by infectious diseases, and targeted investments in their health can drive broader social and economic progress. Indeed, vaccination results in better health, which in turn supports gender equality by enabling women and girls to learn, work and take an active role in their community, promoting them as individuals. Women and girls accounted for 63% of all HIV infections in sub-Saharan Africa. Malaria in pregnancy leads to over 10,000 maternal deaths and 200,000 infant deaths. These are not just figures but families, individuals, mothers and children. Tuberculosis remains a leading infectious cause of death among women of reproductive age. The Global Fund provides 76% of all international financing for TB vaccinations. However, cuts to the US Agency for International Development, and the UK Government’s decision to cut ODA, will knock back the very scheme that has done so much to advance the cause. I look to the Minister, who is always very responsive. I know he does not hold the purse strings, but I am sure his response will be helpful. Gavi also funds maternal tetanus immunisation and has helped to eliminate maternal and neonatal tetanus in over 20 countries. All of those things are happening because of Gavi and these organisations. Its work to prevent malaria in children and pregnant women cannot be ignored either. To conclude, I ask the Minister how the Foreign, Commonwealth and Development Office is making the case in spending review process for the work that the Global Fund, Gavi and Unitaid do in prioritising women and girls’ health and supporting gender equality. If discussions are being held about a change in investment in those funds, how can Government ensure that women and girls, so often ignored and put down in their own communities, have access to the most basic immunisation? Will the Minister to commit to ensuring that the Government play their part for the most vulnerable women and children throughout the world? The UK has done good work. We must continue that in the most cost-effective way possible. I believe the Minister is seeking that balance, and I wish him and the Government every success in that endeavour.

14:21:00

While noting the excellent work that Gavi, the Vaccine Alliance and the Global Fund do in the fight against AIDS and malaria, as the chair of the all-party parliamentary group for global tuberculosis I want to focus my remarks on the need to secure continued funding for programmes to tackle tuberculosis. TB remains one of the most significant infectious diseases worldwide. It was responsible for the deaths of 1.25 million people in 2023. The World Health Organisation says it is highly likely that the disease has “returned to being the world’s leading cause of death from a single infectious agent, following three years in which it was replaced by…COVID”. TB is a preventable and curable disease, but if it is not treated, someone who has active TB can spread the disease to as many as 20 people each year. Given how quickly covid spread across the globe, ending TB is critical for all of us in today’s globalised world. Indeed, TB cases in this country are currently on the rise. As we heard at the APPG’s meeting earlier this week, the latest figures indicate that there was a 13% increase in reported cases in England last year. That takes TB numbers above pre-covid 19 levels and reverses the previous downward trend. The latest figures also show that the city of Leicester has the highest rates of TB, overtaking the borough of Newham in London. Although the focus of this afternoon’s debate is global health, it is worth reflecting on the fact that the Government have inherited a steady increase in the number of TB cases domestically since 2022. It is therefore in our own interests to continue to work to eradicate TB. As the leading international funder for TB programmes, the Global Fund is a critical partner in helping to achieve the goal of finding and treating 45 million people between 2023 and 2027. “Missing” people with TB—people who are not diagnosed, treated or reported—are a major challenge in the fight against the disease and help to contribute to drug-resistant TB. Drug-resistant TB does not respond to standard first-line antibiotics, so treating it is costlier, more complex and more prolonged, and it can take three to four times as long to treat it. If cases of drug-resistant TB continue to increase, it could eventually pose a risk to global health security, including in high-income countries. The Global Fund is the largest external source of financing for drug-resistant TB responses in low and middle-income countries, and its work in this area is important. Work is being done to safeguard the decades of progress that have been made in the fight against the disease. Thanks to the work of the Global Fund, 7.1 million people with TB were diagnosed and treated in 2023. I therefore ask the Minister to reassure the House that the Government will continue to fund the Global Fund to eradicate TB from the globe.

14:24:00

It is a pleasure to serve under your chairship, Ms Jardine. I thank the hon. Member for Milton Keynes Central (Emily Darlington) for introducing this vital debate. The Global Fund to Fight AIDS, Tuberculosis and Malaria has saved over 65 million lives since its inception. It remains one of the most effective mechanisms we have to combat infectious diseases worldwide—diseases whose death tolls continue to rise every year, especially in some of the world’s poorest regions. Gavi supports the immunisation and vaccination of almost half the world’s children, and has prevented over 18.8 million deaths across the world. The United Kingdom has historically stood at the forefront of global health. From pioneering the invention of the vaccine and life-saving medications to supporting the NHS, our commitment to science and health has shaped the world. Continuing our support for Gavi and the Global Fund is not only morally correct but strategically wise. Why? Because disease knows no boundaries. We all learned that lesson with covid. Infectious diseases not only cause individual tragedy but threaten global development and stability, and rock economies to their core. When we invest in global health systems and these organisations, we do not just save lives abroad but protect our citizens—our constituents—by preventing future outbreaks, strengthening early-warning systems and developing research that will benefit everyone. Every penny that the UK invests in Gavi and the Global Fund yields incredible returns. It provides antiretroviral therapy for people living with TB and HIV. It creates global stockpiles of vaccines for Ebola, cholera and yellow fever, so that any emerging pandemic can be stamped out quickly. It provides mosquito nets to protect children while they sleep. Gavi and the Global Fund help to build and strengthen health systems, empower communities and promote gender equality. They give people a chance to live and work without risk of needless infection. Failing to fund these two vital organisations would risk reversing decades of progress and letting preventable diseases kill thousands of people each year. If we step up and maintain our support, the UK will send a clear message that we will not turn our backs, and that we believe in a society where no one has to die from a disease that we can treat. Jonas Salk, the inventor of the polio vaccine, said: “The reward for work well done is the opportunity to do more.” Let us help Gavi and the Global Fund to do more.

14:27:00

It is a pleasure to serve under your chairship, Ms Jardine. I thank my hon. Friend the Member for Milton Keynes Central (Emily Darlington) for securing the debate. I want to speak in strong support of continued investment in these organisations, but particularly the Global Fund to Fight AIDS, Tuberculosis and Malaria. As my hon. Friend said, it is one of the most impactful partnerships in global health history. Since its founding in 2002, the Global Fund has saved more than 50 million lives. That is 50 million mothers, fathers and children who are alive today because of international collaboration, targeted investment and shared resolve. The death rate from AIDS, TB and malaria has been halved in the countries where the fund operates. That is a success that we should all be proud of. In an era when, as colleagues have mentioned, global co-operation seems to be going out of fashion, that is a living, breathing example of it working. The UK has played a major role in that success but, as hon. Members have said, with the next replenishment fast approaching, we must reaffirm our commitment. The needs remain urgent and the case for investment remains overwhelmingly strong. I am proud that the fund has been a cross-party endeavour, but I want to acknowledge, as my hon. Friend the Member for Milton Keynes Central did, the crucial role that Labour has played in establishing and supporting it. Under Tony Blair, the UK helped to found the fund in 2002, recognising that tackling the world’s deadliest diseases required global leadership. Under Gordon Brown’s leadership, both as Chancellor and, later, as Prime Minister, the UK strengthened its support, with a focus on long-term funding and international co-operation. That legacy of action, compassion and multilateralism is one we will all want to uphold. Like colleagues, I want to speak about my constituency’s role in this issue. I am proud to represent Macclesfield, which people will know is a thriving town, with a brilliant grassroots arts and culture scene, nestled on the edge of the Peak district. But it is also a key centre for UK life sciences, with AstraZeneca, the major employer in the town, playing a vital role in the production and distribution of life-saving medicines. However, AstraZeneca’s contribution goes beyond local jobs, and it has supported the wider global health agenda, particularly through working on the covid vaccine and other initiatives to improve treatments in low and middle-income countries. We know that our life sciences sector across the country, anchored by companies such as AstraZeneca, benefits from the innovation, data sharing and global networks that initiatives such as the Global Fund foster. This is what is called win-win. Let us not forget that the diseases we are talking about have not gone away. As has been pointed out, TB is one of the world’s deadliest infectious diseases. Malaria continues to kill a child nearly every minute. Although AIDS is more manageable, it still devastates millions of families. Our support is therefore as important as ever. I urge all Members, and especially the Government, to continue to recognise the fund’s enormous value. From the laboratories of Macclesfield to the clinics of Malawi, let’s continue to make a difference.

Apologies, but I will have to reduce the time limit to two minutes.

14:30:00

It is a pleasure to serve under your chairship, Ms Jardine, and I thank my hon. Friend the Member for Milton Keynes Central (Emily Darlington) for introducing the debate. I declare an interest as the former UK executive director of the International Rescue Committee. I will focus on why Gavi and the Global Fund are so critical in humanitarian crises. I also want to be clear about why this issue matters and why the role those organisations play in the world matters. I am extremely proud of the principled role that UK aid allows us to play, and that British NGOs play, in parts of the world that are riven by conflict, poverty and climate change, where we save lives and prevent future suffering. But this is not just about charity; it is about global stability and security and, in turn, about our own stability and security. When diseases are left unchecked in fragile states, they do not stay contained; they cross borders, they become pandemics, they threaten and harm us all as human beings, and they demand costly emergency responses here in the UK and abroad that could have been prevented through earlier interventions. I saw at first hand, particularly through the IRC’s partnership with Gavi, how Gavi and the Global Fund work in humanitarian crises. In east Africa, despite insecurity and limitations on humanitarian access making vaccine delivery difficult, the IRC was able to expand vaccine coverage. In 19 months, an IRC-led consortium funded by Gavi and powered by local partners administered 9 million vaccine doses and put nearly 1 million children on the path to full immunisation, including 376,000 zero-dose children. As of January 2025, 96% of the 156 target communities had access to vaccines—before the intervention, only 16% had—and the cost of delivering that was just $4 per person. That shows how, by institutionalising this model of providing doses and funding directly to frontline actors, we can reach people outside of Government control and deliver real impact, even in some of the toughest and most fragile humanitarian settings.

14:32:00

It is a pleasure to serve under your chairmanship, Ms Jardine. I thank my hon. Friend the Member for Milton Keynes Central (Emily Darlington) for securing this crucial debate. I am proud to be the co-chair of the APPG on HIV, AIDS and sexual health, a role the Minister held and carried out with distinction for more than six years. Through the APPG, we are fighting to keep the Global Fund at the top of the agenda in the Foreign Office and the Government. At a reception in this place a few weeks ago, I was inspired by the fact that we were joined by so many people who have spent so much of their time fighting for the Global Fund and the critical work it does. I was particularly delighted that we were joined by the Under-Secretary of State for Foreign, Commonwealth and Development Affairs, my hon. Friend the Member for Hornsey and Friern Barnet (Catherine West). That was a demonstration of the UK’s commitment to this cause. We were also joined by deputy high commissioner Dineo Mathlako from the South African high commission, which likewise demonstrated South Africa’s resolve. As was said earlier, since its inception in 2002, the Global Fund has helped to save 65 million lives around the world, and if we are to continue to save lives from treatable diseases, the Global Fund must be replenished with critically needed funds this year. The Global Fund represents a coalition of the willing, and that coalition needs us all to play our part. Constant action is required, or we can and will fall back in our battle against HIV and AIDS. I agreed to become the co-chair of the APPG, alongside a brilliant team of cross-party parliamentarians, some of whom are present, because this fight matters and we must win it. AIDS is no longer an unrelenting reality that we have to endure, but a consequence of our collective failure to share the necessary knowledge, protection and medication with everyone who needs it. I am delighted with the leadership shown by the Prime Minister and the Foreign Secretary in co-hosting the replenishment this year. As Nelson Mandela said, “AIDS is no longer just a disease; it is a human rights issue.” Let us heed Mandela’s words and do all we can to secure a successful replenishment of the Global Fund this year.

14:34:00

It is a pleasure to serve under your chairmanship, Ms Jardine. I thank my hon. Friend the Member for Milton Keynes Central (Emily Darlington) for securing such an important debate, and I am proud to sit with her on the Science, Innovation and Technology Committee. I also pay tribute to the right hon. Member for Dumfriesshire, Clydesdale and Tweeddale (David Mundell) for his tireless work in this space. Before I became a Member of Parliament, I was a scientist. I worked on neglected diseases—in particular, human African trypanosomiasis, which is also known as sleeping sickness. I made a diagnostic test field-ready, and it is out there diagnosing people as we speak. More recently, I moved on to work on understanding the immune responses to malaria at the Francis Crick Institute with Dr Jean Langhorne. On a recent visit to the Liverpool School of Tropical Medicine, we saw amazing science and innovation in relation to lymphatic filariasis, and to potentially using a device like this watch to detect it. That is now being looked at for diabetes. That builds on the amazing scientific work we have in this country. A recent report from Impact Global Health in collaboration with the Liverpool School of Tropical Medicine showed that a global societal return of £1.4 trillion could be generated, and that there could be an extra £7.7 billion for the UK economy. So this is not just about protection and saving lives across the globe; it is about our industry here in the UK. Malaria has been eliminated in nine countries since 2015. That is incredible. We must go further and we can get the job done, so please let us replenish that fund.

14:36:00

I thank my hon. Friend the Member for Milton Keynes Central (Emily Darlington) for securing this debate. I am here to speak on behalf of my constituents who have asked me to call on the Government to continue Britain’s global leadership in fighting and eradicating killer diseases. That requires a commitment not only to ongoing investment in the Global Fund, Gavi and Unitaid, but to leading other nations to do likewise. There is often far too much doom and gloom about international aid and what it has achieved. Let us remember that in 1991, one in five children born in sub-Saharan Africa died before they reached their fifth birthday. Today that is one in 16, which is still too many. As many know, I spent a portion of my life living in sub-Saharan Africa, including as a schoolteacher. My own eyes have wet my pillow at night because one of my students died from a preventable illness, because they were not able to access the treatment that they needed. When I multiply that by the millions of children who have had that fate, I think what a tragic loss that is for the world. Let us be clear: a child born in a Gavi-supported country is 70% less likely to die from a vaccine-preventable disease before their fifth birthday. The Global Fund has saved 65 million lives. As impressive as that is, there is also the investment that this brings to Britain by supporting British science. I say to the Minister: let us not roll back the progress of a quarter of a century.

14:37:00

It is an honour to serve under your chairship, Ms Jardine, and I congratulate the hon. Member for Milton Keynes Central (Emily Darlington) on securing this debate. This year, as both Gavi, the Vaccine Alliance, and the Global Fund conduct their funding replenishments, it is more important than ever that we consider the indispensable value of their work, both for Britain and the world. Since its inception at the beginning of the millennium, Gavi has immunised more than 1 million children and saved in the region of 20 million lives. The UK was one of the alliance’s founders and has since constituted its largest single sovereign donor. In its short existence, the Global Fund has succeeded in driving down the death rates across AIDS, TB and malaria by 61%, saving 65 million lives. That is close to the entire population of this country and would not have been achieved without British support. That manifested most recently in a £1 billion pledge to the Global Fund’s seventh replenishment. That money is likely to avert around 1 million deaths. We have made so much progress, eliminating many diseases in some countries and reaching the edge of success in others. However, the work of Gavi and the Global Fund is being placed at risk by short-sighted cuts to international development spending. President Trump has gutted USAID, shattered the fund that fights HIV and AIDS and is poised to eliminate much American funding for global immunisation efforts. Following that playbook, this Government have decided to slash British development spending to 0.3% of our GNI, its lowest level this century. I, like many others, still remember the optimism of the last Labour Government, who pledged to make poverty history and funded Gavi and the Global Fund when they were created. This Government have rejected so much of the proud 1997 legacy, and they must not do so when it comes to global health. I hope that they put money behind their pledge to prioritise global health and vaccinations. There are so many strong and resonant moral arguments for Britain, but at the same time, the fight against disease serves concrete British interests. The war against infection is currently facing an alignment of factors that make victory more challenging than ever. Climate change is amplifying disease risk. Higher temperatures are opening up regions to mosquitoes, and the incidence of dangerous weather conditions is on the rise. Pakistan’s catastrophic 2022 floods, for example, have since led to almost 7 million additional malaria cases. At the same time, the disturbing spread and intensification of conflict across the globe is impeding efforts to treat and prevent disease. Increasingly, civilian populations are being deliberately cut off from aid, while healthcare facilities are being not only disrupted, but targeted. Consequently, we are seeing the return of once-controlled diseases like polio and upticks in those like cholera, which emerge from degraded sanitary infrastructure. Why does this matter for Britain? It is because, as we have heard, disease does not respect borders. Since covid, we are all only too aware that disease can reach our shores, putting both our NHS and our health security at risk. Resistance, particularly in strains of TB and malaria, is also an increasing threat. Both Gavi and the Global Fund are working on the development and deployment of new generations of TB vaccines, even in the face of these new headwinds. Existing interventions for fighting malaria are also seeing their efficacy decline in the face of insecticide and drug resistance. Better, sharper tools have been developed. The challenge now is getting them to where they are needed, and for that we need the Global Fund.

Before I came to this place, I worked in the pharmaceutical industry in safety, efficacy and regulatory compliance. Does the hon. Member agree that the leadership role that the UK has played to date is not just limited to financial contributions and support, but has ensured that the vaccines that are rolled out in third world and low and middle-income countries are as safe as they can be?

I absolutely agree, and I was about to come on to the economic benefits of Gavi and the Global Fund. There are economic benefits: a study of Gavi-supported countries showed that, through healthcare savings alone, each dollar spent returns $21. When wider social benefits are considered, that rises to $54. Accounting for trade opportunities, healthcare savings and other economic boosts for Britain, both Gavi and the Global Alliance have generated value equivalent to hundreds of billions of dollars. So we are talking about neither a charity nor a giant cash dispenser in the sky, but instead, a deposit account for the security, health and soft power of our nation.

My hon. Friend is making an excellent speech. On the point about soft power, China tends to deploy its vaccines in accordance with its regional influence and global standing, rather than on the basis of where there is the greatest need. Does she share my concern that the withdrawal of western funding from vaccine alliances could clear the way for China to engage in further vaccine diplomacy?

I thank my hon. Friend for a well-made point. I have consistently said that cuts to our international aid and development spend create the space for rogue actors to move in, including China and Russia. I know that the Government like polling, so I am happy to share that the British people understand the value of spending on vaccination. Recent Adelphi polling found that 70% of our people believe that supporting global vaccine access benefits Britain. This is about not only British funding, but British leadership. Our expertise and convening power have been continuous assets for Gavi and the Global Fund. I fear that the Government’s aid cuts have put that leadership at risk, so they must work to reverse that trend. This year, Britain will, along with South Africa, host the Global Fund’s replenishment efforts. As host nation, other countries and non-governmental organisations will look to us for leadership in making a significant pledge. I hope we will step up. In closing, I want to say a little more about what Britain’s support means to others. I recently met Botswana’s Health Minister and the special ambassador of the African Leaders Malaria Alliance. They shared with me their pride on the progress made on AIDS—with related maternal mortality falling by 80%—and on how malaria is now on the threshold of elimination. They told me that Britain’s work in this success is “always felt very warmly,” that it “ties” the two peoples, and that it is ultimately an expression of “humanity.” They told me that the collaboration fuels trade and partnership. The Minister and the ambassador worry that so much progress and so much investment risks going into reverse in the wake of the global aid retrenchment, including by Britain. They do not expect global support to last forever, but wrenching it away before countries have fully built up their own capacity is a destructive mistake that they, and we, will pay for. From the Liberal Democrat Benches, I encourage the Government to reaffirm our commitment and pledge generously to Gavi and the Global Fund. I encourage the Government to reaffirm our commitment and leadership in aid, and to reverse the savage cuts to our aid budget. This still-new Government must decide the Britain they want to deliver. Our wish is to bestride the world stage as a development superpower, consolidating our massive progress and gains, affirming our friendship, acting with compassion while delivering for our own people, providing security from conflict and disease, and controlling upstream migration to these shores. The space for leadership is now vacant, and I urge the Government to fill it.

14:46:00

It is a pleasure to serve under your chairmanship, Ms Jardine. Let me start by congratulating the hon. Member for Milton Keynes Central (Emily Darlington) on securing this debate. I also pay tribute to my right hon. Friend the Member for Dumfriesshire, Clydesdale and Tweeddale (David Mundell), who is a powerful advocate for global health—I think we can all see why he prefers to be on this side of the dais today rather than where you are, Ms Jardine. Global health is everybody’s health. This year we have significant replenishments for two organisations: Gavi and the Global Fund, which work on the frontline to secure our population against diseases, which do not respect borders. Gavi, the Vaccine Alliance, is a unique alliance of Governments, private sector foundations, civil society organisations and vaccine manufacturers. As we have heard, Gavi has vaccinated more than 1 billion children in 78 low-income countries and saved more than 18.8 million lives. In 2025, Gavi is seeking its eighth replenishment for its five-year strategic period, from 2026 to 2030. It is an impressive organisation; since becoming a shadow Minister in November, I have been pleased to continue to meet Gavi regularly and participate in roundtables as it approaches this crucial milestone. The Global Fund to Fight AIDS, Tuberculosis and Malaria invests in sustainable health systems to eradicate those three diseases. It has saved an estimated 65 million lives. The Global Fund’s eighth replenishment is also happening this year, and it will cover the funding period from 2026 to 2028. Global health is a good example of a positive impact that we can have through aid. If we look, for example, at neglected tropical diseases, we see that our science, technology and research sectors produced both of the world’s first malaria vaccines to be recommended by the World Health Organisation: Mosquirix and R21. During my time as Minister with responsibility for global health, I was fortunate enough to see the UK expertise in infectious diseases at first hand during a visit to the Liverpool School of Tropical Medicine, back in 2020. At the time, it was a Conservative Government who announced £15.5 million to support the Liverpool School of Tropical Medicine in its research on preventing the spread of infectious diseases, such as tuberculosis, and in strengthening health systems in fragile countries. The UK is often cited as a leader in global health. In answers to several of my written questions on the topic—the Minister knows this well—Ministers start by saying: “The UK is one of the largest donors to Gavi”. They then give the reply that many right hon. and hon. Members will be accustomed to—that we need to wait until the spending review, and that all global health investments are being looked at in the round.

Gavi relies heavily on philanthropic foundations,  notably the Gates Foundation, but there are concerns that they may have a disproportionate influence on setting the priorities for global vaccine programmes. Does the right hon. Lady agree that any reduction or pulling back of the UK’s support of those programmes could exacerbate those concerns?

The hon. Gentleman is absolutely right that Gavi has the ability to pull in many different donors, but perhaps the specific questions following the ODA cut should be directed to the Minister. Gavi is a good example of how partnership can deliver for the benefit of the most vulnerable. Conservative Governments made significant interventions that contributed to the UK’s reputation as a global health leader. In 2015, we pledged £1.44 billion to Gavi over five years, and in 2020, when we hosted the global vaccine summit, we committed a further £1.65 billion. During the last two Global Fund replenishments, we pledged £1 billion in 2022 and £1.46 billion in 2020. Those pledges to Gavi and the Global Fund were just one part of our leadership and efforts to strengthen global health, and an incredibly important one at that. I note from responses to my written questions that Ministers are often quite keen to highlight our record on global health, but I would like to take this opportunity to ask some questions about the Government’s record to date. Following the reduction in ODA to 0.3% of GNI, I ask the Minister: what does global health now look like from the strategic level of the Foreign, Commonwealth and Development Office? It would be helpful to know where the priorities are and whether the Government plan to continue the emphasis on multilateral NGOs such as Gavi and the Global Fund, or whether other models are to be considered. Although the approach to global health may be changing under this Labour Government, the replenishment periods for Gavi and the Global Fund are rapidly approaching—in fact, Gavi’s is literally weeks away. I would therefore welcome some clarity from the Minister on the discussions he has had with representatives of both funds and other donor nations. I want to press him a little about the absence of any UK pledges to date. I have previously had no luck getting an answer on that through my written questions, so I will have another go today. Has he considered the impact of the UK’s apparent delay in pledging on our international reputation and our standing as a leader in global health?

Does the right hon. Lady agree that the UK’s track record on this has been quite impressive, given that other countries frankly punch below their economic weight, so this is not just about the UK’s contribution but about the role we play in ensuring other countries shoulder the burden?

The hon. Gentleman is absolutely right, and I recall that during the last replenishment, there were many conversations going on to encourage other countries and partners to step up to the plate. The UK’s leadership had a real impact at that time. In a similar vein, what is the potential impact on other countries’ pledges? Is the Minister thinking about making a reduced commitment or no pledge at all? Rather than ongoing uncertainty, it would help other donors and NGOs to know what the UK is doing, so that they can plan. The Minister will be aware that there is a range of financial instruments available to him. One is the international finance facility for immunisation, through which £590 million of our £1.65 billion pledge in 2020 was distributed. IFFIm accelerates the delivery of vaccines by making the money from long-term Government donor pledges available immediately, allowing Gavi to vaccinate more individuals, faster. I would be grateful if the Minister updated us on any discussions he has had with Gavi and with IFFIm about its potential use to front-load any UK commitments.

I agree what a good model that is. Does the right hon. Member agree it is a model the Government could consider using for other things? An international finance facility for education has been released in the last few years. Does she agree that the Government could consider adopting this model across a range of different issues as we look to find alternative methods of development finance?

That is a really interesting point, because IFFIm has proved what can be achieved by working with other instruments. I hope that the Government will examine the options. The Minister may be able to share that information; it is not for me to say what the Government should do, but perhaps the Minister can do so in his response to the debate. The global landscape of development is changing; we can see that across the rest of the world. For example, the US, which for so long has been an important anchor donor to a number of global health initiatives, has made dramatic reductions to USAID, so it would be helpful to know what discussions the Minister has had with his US counterparts and with other donor countries about co-ordinating our efforts, so we can maximise value for money in global health spend. I will conclude as I started, by saying that global health is everybody’s health. I pay enormous tribute to the Global Fund and Gavi, which harness the power of donations from taxpayers in countries like the UK to end preventable deaths from treatable diseases in some of the most vulnerable parts of the world. Global health may sometimes seem like an abstract concept, but we only have to look back at recent history to see that infectious diseases do not respect borders and that global solutions are needed to keep us all safe.

14:56:00

It is a genuine pleasure to serve under your chairpersonship, Ms Jardine, and to respond to such a passionate and well-attended debate on a subject that many Members here in Westminster Hall today know is close to my heart. I am particularly grateful to my hon. Friend the Member for Milton Keynes Central (Emily Darlington) for securing this debate. Of course, as well as being an excellent representative for Milton Keynes, she has many connections with me and with my constituency in Penarth, and I have connections with Milton Keynes that link to the subject of this debate, because it was in Milton Keynes that I first worked for World Vision, the international humanitarian and development NGO. At that time, I worked in particular on ] issues related to HIV and AIDS. On a visit to Malawi with World Vision back in the early 2000s—they were very different times, when we had not made the progress that we have made today—I saw for myself the devastating impact that HIV and AIDS had on communities in southern Africa. I remember sitting in a village with a woman who had had to take on the care of her sister’s children after her sister had died in her 20s. She had already been struggling to make ends meet, but then took on the children of her sibling on top of that. That was really stark stuff that I will never forget. I have worked on these issues throughout my career. Indeed, I was at one of the early launches of the IFFIm bonds with Gordon Brown and at many of the other events and efforts organised by the last Labour Government that my hon. Friend the Member for Milton Keynes Central rightly said we should be very proud of. I also served as the co-chair of the all-party parliamentary group on HIV, AIDS and sexual health, and it is fantastic to see some of my successors in that role here in Westminster Hall today. That APPG is one of Parliament’s longest-established APPGs and I can genuinely say that it has also been one of the most impactful over many decades, and is still doing important work today. This is absolutely a timely moment to debate these issues, with the Gavi and Global Fund replenishments coming up later this year, and I am hugely grateful to all right hon. and hon. Members here today for their contributions. I can absolutely assure them that the Government hears those communications and that they will be communicated to Minister Chapman, my colleague in the other place. We will look very closely at a number of the points that have been raised today. We should be very proud of our remarkable achievements over the last 20 years and we must maintain that positive trajectory, which includes increasing life expectancy and stopping the spread of pandemics. As has been said many times, disease respects no borders, and of course it has a devastating impact, not only on lives but on economies. Of course, the life-saving research to fight disease also has a benefit economically, as many hon. Members have already pointed out. [Dr Rupa Huq in the Chair] I can confirm, Dr Huq, that the UK will continue to champion global health, with the sustainable development goals as our lodestar and anchoring our work. Our partnerships with Gavi and the Global Fund are crucial to maintaining—indeed, to accelerating—progress. Of course, we are founding members and committed supporters of both organisations. The Global Fund plays a crucial role, and I have worked with it many times on strengthening health systems and combating HIV and AIDs, tuberculosis and malaria. Of course, it also supports the UK’s goal to end all new HIV cases in England by 2030 and efforts across the United Kingdom to end new HIV infection. Malaria, which has been rightly referred to today, primarily affects women and children. It puts a significant strain on health systems and hinders economic growth. Nigeria, for example, accounts for more than a quarter of global malaria cases and loses more than $8 billion annually to the disease. There is also the devastating impact on lives and families. Our partnership with the Global Fund demonstrates the importance we place on working in partnership with others around the world and in the global south. Together we have saved a remarkable 65 million lives and reduced AIDS, TB and malaria deaths by more than 60%. We have also built more resilient and sustainable health systems and accelerated progress towards universal healthcare coverage. Gavi is a hugely important organisation whose work I have had the pleasure of seeing in this country and elsewhere. It is of course a public-private partnership with national Governments, the World Health Organisation, UNICEF and civil society, which is critical. Many Members mentioned those connections in procuring and providing affordable vaccines. Through Gavi, more than half the world’s children are now vaccinated against some of the world’s deadliest diseases, such as measles, malaria and meningitis, saving more than 18 million lives. It has been pointed out that a child born in a Gavi-supported country today is 70% less likely to die from a vaccine-preventable disease before their fifth birthday than a child born before that crucial alliance came into existence. Every investment brings economic benefits, too. For every £1 of investment in immunisation, we see £54 in wider economic benefits. We are working with Gavi and other donors, including the Gates Foundation, to reach more children with lifesaving vaccines than ever before. Investments in Gavi and the Global Fund also drive real innovation. British expertise has transformed the fight against HIV/AIDS, TB and malaria through licensing and technology transfer, and by developing innovative technologies such as new dual active ingredient bed nets, which were piloted with support from Unitaid and the Global Fund and are now being rolled out at scale by the Global Fund. Investment has also supported the development of vaccines such as MenFive to protect against the five main types of meningitis. Gavi delivered 5.1 million doses of MenFive in Niger and Nigeria.

The Minister made a passing reference, as other Members did, to Unitaid. Will he more formally acknowledge the huge importance of Unitaid in ensuring the delivery of medicines in some of the most difficult environments around the world?

I absolutely will. It is referenced throughout my briefings because of the important partnership and contacts that we have with Unitaid. I have seen its work as well. We are delighted to be co-hosting the Global Fund’s eighth replenishment with South Africa. We aim to attract and deepen investor engagement, sustain collective investments, and collaborate with the private sector on financing, innovation and supply chain support. We will do everything possible to ensure the success of that replenishment. Last month, the Children’s Investment Fund Foundation made an impressive first pledge of $150 million, a fivefold increase of its previous investment. That extraordinary commitment underscores the significant role of private philanthropy in advancing global health equity and highlights the power of partnership. As countries work to increase domestic financing, we must stand together and strive for success in those replenishments. We know this is an incredibly important moment for all these issues. Many Members have rightly asked me about financial commitments—I have heard the voices around this room. Members will understand that we cannot make any financial commitments for the next replenishment until after the spending review is complete, but I assure them that we will continue to champion the Global Fund and Gavi and the people they serve, as well as the issues that have been raised today. Members’ voices and those of their constituents have been heard. None of us want to make decisions about cuts to the ODA budget, not least because of our record of success on these issues, but when I look at some of the things I do every day, I can say that they are the right choices, although difficult. We remain committed, however, to international development and particularly to global health. The number of interventions on these issues have made that very clear across the House. I will reply briefly to some specific points made. My hon. Friend the Member for Milton Keynes Central spoke about the wider benefits not only to the economy, but in terms of our research and the links to the covid vaccine research. I saw some of the pioneering RNA vaccine research in visits with the all-party group years ago. To then see that expertise used to combat a deadly pandemic was extraordinary. The right hon. Member for Dumfriesshire, Clydesdale and Tweeddale (David Mundell)—my successor on the all-party parliamentary group on HIV, AIDS and sexual health—rightly talked about this being investment, not charity. I think there is a consensus across the House on the proven track record of the Global Fund, Gavi and Unitaid. My hon. Friend the Member for Exeter (Steve Race) mentioned his visit to Kenya and the links with nutrition as well. He knows the Government’s commitment to the global compact on nutrition and the work that was done around the summit and indeed the research in his own constituency. I thank the hon. Member for North East Fife (Wendy Chamberlain) for her contribution. Her constituency is a place I know well, having done my masters at the University of St Andrews. Important work is being done at that university and at many institutions across the UK. My hon. Friend the Member for Norwich North (Alice Macdonald) asked important questions about women and girls. I can assure her that women and girls remain at the heart of our global health work. Gavi supports countries with vaccines that directly benefit girls and women, for example those against HPV, which we know is one of the leading causes of cervical cancer. Shockingly, over 85% of cervical cancer deaths are in low-income countries, and it is the main cause of death among many young women in Africa. Women and girls therefore remain at the heart of these partnerships going forward. The hon. Member for Strangford (Jim Shannon), who is no longer here, as ever spoke passionately on the issues. My hon. Friend the Member for Ashford (Sojan Joseph) spoke about the importance of work on TB. We are absolutely committed to this, whether through the Global Fund, Stop TB Partnership or our work with the TB Alliance. We are doing many pieces of research and operations work. My hon. Friend the Member for Macclesfield (Tim Roca) spoke about malaria, as did others. On that, there is really remarkable process being made on vaccines. Some of the early findings from the malaria vaccine implementation programme show that an additional one in eight children can be prevented from dying if they receive vaccines in combination with other malaria interventions. We are carrying on the important work on anti-malarial bed nets and other interventions. My hon. Friend the Member for Gedling (Michael Payne), another of my successors in the APPG on HIV/AIDS, again spoke of the importance of the Global Fund, and I completely agree with him. My hon. Friend the Member for Gravesham (Dr Sullivan) spoke about her experience working at the Francis Crick Institute, another leading institution doing incredible work. We should be very proud of our academics and researchers in this country for what they do. My hon. Friend the Member for Bishop Auckland (Sam Rushworth), a powerful voice for his constituents, also spoke of his own personal experiences in sub-Saharan Africa.

Will the Minister give way?

I will not, because we are about to run out of time and I need to leave time for my hon. Friend the Member for Milton Keynes Central to wind up. The shadow spokespeople raised a number of choices. I do have to gently say to the hon. Member for Esher and Walton (Monica Harding) that we are not in 1997. We are in a very different set of world circumstances. That is tough, but I believe in being honest with this House about the challenges we face. That does not mean we lose our commitment to development or global health, as is clear from what the Government are setting out, and I have listened carefully to what Members have said today. Not only did the right hon. Member for Aldridge-Brownhills (Wendy Morton) serve as the Minister; we also served on the International Development Committee together. She rightly talks about the important role that IFFIm and others can play—I might write to her more specifically on the plans on IFFIm. She asked me lots of questions about the spending review. I would love to be tempted into answering her, but I cannot, so I refer her to my previous answers. The UK will continue to champion global health at a critical moment. We will work hard, together with our partners. We have heard about some fantastic work we have been responsible for and about some fantastic organisations. I can assure Members that the Government hear all of those voices, and they will be contemplated as we make some challenging but important decisions over the weeks and months ahead.

15:07:00

It is a pleasure to serve under your chairpersonship, Dr Huq. I do not have much time to wind up, so I will not respond to each and every intervention, but let me say a huge thank you to Members. I am so pleased to hear that we continue to have a cross-party alliance and support for our work on the Global Fund and Gavi. The reason for that support, as we have heard, is that this is about our health, global health, and our growth in this country. We are world leaders. Given that the Prime Minister has said that, in the light of the cuts, we will work to increase the ODA budget as soon as possible, I do not want us to make decisions today that put at risk not only our global leadership, but the lives of millions of people. That is something echoed by the 150 scientists who signed a letter published this week, by UK companies that support the jobs in the UK on this, and by the various interventions that we have had, including by the Minister and the ambassador from Botswana, who I have also had the pleasure to meet. This is an opportunity for us to decide: are we going to continue to be a UK that looks out, understands that we live in a global world and puts biosecurity, the health of our population and the health of the world at the heart of our strategy? Or are we going to step back from that global leadership? I hope that we will be at the forefront of this debate and show leadership, ensuring not only that our contribution stays the same, but that each and every other country’s does, as well as those of other donors. I thank the Minister for responding today; I know how much he agrees with many of the comments made, and I look forward to us continuing to work together. Question put and agreed to.  Resolved, That this House has considered funding for GAVI, the Vaccine Alliance, and the Global Fund.