Covid-19 Vaccines: Nepal

– in the House of Commons at 6:57 pm on 6th July 2021.

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Photo of Nigel Evans Nigel Evans Deputy Speaker (Second Deputy Chairman of Ways and Means) 6:57 pm, 6th July 2021

It being 6.59 pm as we go into the Adjournment debate and the Minister moves slowly to his place, the Dispatch Box has been sanitised, so we do not need to suspend the House. The fact that I am rabbiting on a little will mean that David T. C. Davies need move the Adjournment only once.

I do apologise, but as this is a very limited debate, Members other than Mr Sharma and the Minister will not be able to make speeches. However, they will at least be able to ask to intervene on the Minister; of course, it will be up to the Minister whether he accepts their intervention.

Motion made, and Question proposed, That this House do now adjourn.—(David T. C. Davies.)

Photo of Virendra Sharma Virendra Sharma Labour, Ealing, Southall 7:00 pm, 6th July 2021

Thank you, Mr Deputy Speaker, for chairing this debate to close our proceedings today. I thank all hon. Members who are unable to intervene on me today because of constraints of time and virtual participation; I especially thank my hon. Friends the Members for Feltham and Heston (Seema Malhotra) and for Stockport (Navendu Mishra), and Mrs Miller for their support and for their interest in the debate.

As chair of the Nepal all-party parliamentary group, I have spoken about the country many times in this House. I say much the same every time: Nepal is a great ally and friend of the UK, and has been for more than two centuries. The Nepali diaspora and the Gurkhas have contributed to the safety of this country, to our economy and to our cultural life throughout all that time. I talk about the wonderful country that I have visited many times, the friendly and welcoming people, Nepal’s place in the world—pressed between India and China, at the top of the world on the Himalayan plateau —and its development into a democracy with Government scrutiny and elections since 2008.

I was honoured to host Prime Minister Oli here only a few years ago, when he met the then Prime Minister and Leader of the Opposition, Mrs May and my right hon. Friend Jeremy Corbyn. No one knew of covid-19 then; discussions were about strengthening Parliament, development, trade and climate change. Everyone promised to help in 2019—they committed support and proclaimed friendship—but now, when Nepal is in dire need of vaccines, we hide behind international efforts and behind global schemes and platitudes.

The situation in Nepal is severe—indeed, it is a crisis. Amnesty International has said:

“The country’s health care system is teetering, with hospitals reaching capacity, and overstretched, hopelessly under-resourced staff are unable to keep up with overwhelming demand”.

UNICEF’s staff on the ground have reported:

“Within a short time, cases were just climbing up and up…We were stretched to the very limit, trying to do the best with the resources we had.”

More than 600,000 people have officially been infected with covid-19 and more than 9,000 people have died following a major surge in infections—similar to that in India, but less reported on. More than 50% of deaths have been among over-60s. In May, the country had the highest positivity rate in the world, at 47%. The situation is even worse, because the lack of tests and the serious under-reporting hide the real figures, but we know that the country’s weak and fragile health system has been totally overwhelmed, that patients are unable to access care and that desperate shortages of oxygen across the country claim lives.

Health experts have warned of an imminent third wave that will cause further havoc for an acutely under-vaccinated population: less than 3% of Nepalis have been fully vaccinated, and a further 6.3% have received only one dose. The lack of a second dose puts 1.4 million vulnerable Nepalis at high risk of getting covid once again and risks invalidating their first dose. Partial immunisation also increases the risk of mutations emerging, which is a problem not just for Nepal, but for everyone in the world: we have seen the damage that the delta variant has done and continues to do. New mutations are a risk to everyone, vaccinated or not.

Most older people and those in vulnerable categories received their first dose of the Oxford-AstraZeneca vaccine in March, but there are no supplies available to provide their second dose. They were due their second dose between 28 June and 5 July. The clock on the time to administer the second dose has not just started ticking; it has almost run out. The supply shortage happened because of severe problems in global supply due in part to the crisis in India, problems with COVAX and an over-dependency on a small number of vaccine producers whose supplies had been purchased by richer countries.

In response to the covid crisis in India, the export of vaccines from India largely ceased, affecting both a deal that Nepal had agreed to purchase vaccines directly and also severely impacting on the supply available to COVAX. While COVAX had forecast to deliver nearly 2 million vaccines between March and May, it was able to deliver only 348,000. But the crisis has happened, and the causes, while sad, are now a fact. It is what we can do that matters.

I will pose three questions to the Minister. First, we know the UK has a large supply of Oxford-AstraZeneca vaccines and could donate the 1.4 million vaccines needed. This would represent 0.3% of all the vaccines ordered by the UK, and represent just three days of the UK’s roll-out. We can act unilaterally. We know the Prime Minister is proud of global Britain. Will he put the medicine where his mouth is?

Secondly, the Prime Minister, at the beginning of last month, committed to 5 million doses being sent “in the coming weeks”—his phrase, not mine. Nepal is a prime candidate to receive some of those. Will the Minister commit to Nepal receiving some of those doses and offer us an actual date for delivery?

Thirdly, COVAX is welcome, it is a good initiative and it is the right thing to do, but today it is not delivering because it does not have enough supply. What steps and on what timetable will the Government much more rapidly donate the promised vaccines to reach vulnerable people across the world, and how will we use our power overseas to encourage other countries to do the same and meet their international obligations?

I wrote to the Foreign Secretary at the end of May about this pressing need for vaccines, about the millions of lives at risk and about the crisis in Nepal. I wrote with other Members from across this House and from the other place. The response from his Department continues to talk about COVAX facing all the problems I have already outlined, followed by the line that

“this will be sufficient to vaccinate 70% of the population of Nepal once supplies allow.”

Once supplies allow—that is the heart of the problem, because supplies do not allow. Some 1.4 million older and vulnerable people need their second dose, and supplies do not allow. We can change that, but will the Minister and the Government have the courage to live up to a global Britain brand?

Photo of Nigel Adams Nigel Adams Minister of State (Foreign, Commonwealth and Development Office) 7:09 pm, 6th July 2021

I am incredibly grateful to Mr Sharma for securing the debate. I am sure everyone in the House will pay tribute to his work as chair of the Nepal all-party parliamentary group. It is absolutely right to debate vaccine access as Nepal recovers from a devastating second wave of covid-19. It is vital that the country has a clear route to a comprehensive vaccine programme.

As the hon. Gentleman knows, the United Kingdom and Nepal share a very deep relationship that has lasted over two centuries. In fact, Nepal’s first formal diplomatic relationship was established with us in 1816 and Nepal has held a special place in our hearts ever since, not least through the distinguished service of Gurkhas in the British Army and the bravery and excellence of its Sherpas who have inspired thousands of British mountaineers over the decades, as well as through the kindness and warmth of its people and because of its spectacular natural beauty.

In May, the delta variant of covid-19 spread to Nepal and quickly took hold in a devastating second wave of infections. As the hon. Member said, that overwhelmed Nepal’s healthcare system, and the people of Nepal have suffered immensely. I speak for the United Kingdom Government in offering my deepest condolences to the people of Nepal for the hardships they have endured in recent months.

Photo of Jim Shannon Jim Shannon Shadow DUP Spokesperson (Human Rights), Shadow DUP Spokesperson (Health)

I thank Mr Sharma for introducing this debate. I really appreciated his significant contribution. It is also a pleasure to see the Minister in his place.

Recently, in my role as chair of the all-party parliamentary group for international freedom of religion or belief, I had the privilege of a productive meeting with His Excellency Mr Lokdarshan Regmi, the new Nepalese high commissioner in the UK, at which he shared the details of the extremely difficult situation that Nepal faces with regards to the covid-19 pandemic. What help can this Government in the United Kingdom give in particular to Nepal’s Christians, Muslims and other religious minorities who are not getting help or getting the vaccine?

Photo of Nigel Adams Nigel Adams Minister of State (Foreign, Commonwealth and Development Office)

I am grateful to the hon. Gentleman for his intervention. He is right to mention his interaction with his excellency. We have used existing programmes to support Nepal since the second wave. We have fielded our own experts to help Nepal’s Ministry of Health and Population with epidemiological analysis and data, we have financed two covid treatment centres in hotspots in Pokhara and Bhaktapur, and we have provided local governments in those hotspots with medical equipment such as personal protective equipment, oxygen concentrators and ventilators, and much more. I will come to that in my speech.

Photo of Nigel Adams Nigel Adams Minister of State (Foreign, Commonwealth and Development Office)

I am not sure that I had advance notice of the hon. Lady’s intervention, but I am happy to take it.

Photo of Seema Malhotra Seema Malhotra Shadow Minister (Business, Energy and Industrial Strategy)

I thank the Minister for giving way. I am sure he will appreciate our concern over the stories of what is going on in Nepal. The Foreign, Commonwealth and Development Office has said that the UK stands “shoulder-to-shoulder” with Nepal, but many of my constituents—including our first Gurkha Nepalese Mayor of Hounslow, Councillor Bishnu Gurung—are deeply concerned that what is being provided to Nepal is not nearly enough, and not nearly fast enough for the situation. An estimated 63 retired Gurkha soldiers who served in the British Army have died of covid-19 in Nepalese villages. Following the powerful speech by my hon. Friend Mr Sharma, what more can the Minister say to give confidence to our constituents that enough is being done practically on the ground and in relation to vaccines to support the situation in Nepal?

Photo of Nigel Adams Nigel Adams Minister of State (Foreign, Commonwealth and Development Office)

I thank the hon. Lady. She is absolutely right to speak up for the Nepalese diaspora in her constituency and elsewhere. What I can add to my response to Jim Shannon is that the United Kingdom is stepping up. We were first out of the blocks delivering equipment, for example, to India when the second wave hit in India. Of course, whatever we do will never be enough. It is a really, really challenging situation—the hon. Lady will appreciate that—but 269 ventilator machines have been donated, and thousands of pieces of personal protective equipment. We are constructing an oxygen plant in Kathmandu, with an additional plant in Pokhara; that will be completed by August. We are stepping up. We are also working with the Gurkha Welfare Trust to help those Gurkhas who have served this country so brilliantly. Through the UK-funded welfare trust, we are ensuring that lifesaving support and supplies to Gurkha veterans and communities are getting through. That includes three medical clinics and subsidised hospital treatment.

I understand that, as of last week, just 8.8% of Nepal’s population have received a first vaccine dose and 2.6% have received both doses. I understand that some will accuse us of failing Nepal in its time of need. I can tell hon. Members that nothing could be farther from the truth. Since the beginning of the pandemic, the UK Government have reprioritised over £40 million of foreign aid through the British embassy in Kathmandu to help Nepal respond to the challenges of covid-19, and at each phase of the pandemic, as it changes and as waves come along, we have tailored our support to Nepal’s needs

Photo of Navendu Mishra Navendu Mishra Labour, Stockport

I thank the Minister for giving way; in my experience I have always found him open to dialogue. I congratulate my good friend, my hon. Friend Mr Sharma. The Minister was right to point out, early in his speech, that the UK and Nepal have a long relationship, going back over 200 years, and the Nepali community in Britain makes a significant positive contribution to this country. I appreciate that the Minister is aware of the problems of COVAX, particularly when it comes to the delivery of vaccines. India and South Africa made a proposal at the World Trade Organisation regarding a trade-related aspects of intellectual property rights—TRIPS—waiver, that would have facilitated the provision of covid vaccines, medicines and equipment to low and middle-income countries, which unfortunately the British Government blocked. I notice that the Biden Administration have changed their position and are now supporting that TRIPS waiver. Does the Minister agree that the UK Government should also amend their position on such a waiver, to help countries such as India, Nepal and so many others?

Photo of Nigel Adams Nigel Adams Minister of State (Foreign, Commonwealth and Development Office)

I can tell the hon. Gentleman that we are of course acutely aware of the challenge, whether that is getting first or, in the 1.4 million cases scenario, second doses. We have supported the Government of Nepal in liaising with and approaching the secretariat about the issue. As he knows, because it was announced recently, the majority of our over 100 million shared doses will go through the COVAX facility. That will help lower and middle-income countries enormously; that roll-out has now begun. Of course we are working constantly with Governments who are in need of those vaccines.

If I may get back to Nepal, we have targeted our support at the immediate health response and at the economic consequences of lockdowns, which we are acutely aware of in our own country. We have funded water sanitation and hygiene facilities for 400,000 people, safe spaces for women in isolation centres, cash and voucher assistance for the most vulnerable, and nutritional support for women who are pregnant or breastfeeding.

In response to the second wave of covid in Nepal, we have provided additional medical support through our embassy in Kathmandu. We have funded experts to support the federal Government response. We have helped to establish temporary treatment centres in hotspots and, as I said to Seema Malhotra, we constructed an oxygen plant in Kathmandu, with another one coming in Pokhara next month. We have delivered medical equipment and PPE to local governments in the worst affected areas. That has included providing oxygen concentrators and ventilators for hospitals in Banke and Mugu. Throughout the pandemic, the Gurkha Welfare Trust—I referred to that in response to the hon. Member for Strangford—has been UK funded, and we have also ensured access to life-saving support and supplies to veterans and their communities.

In May, my colleague, Lord Ahmad of Wimbledon, who is Minister for South Asia and responsible for the Nepalese portfolio, spoke to Mr Gyawali, Minister of Foreign Affairs, to discuss what further support the UK could provide. In response to that conversation, a military flight from Brize Norton arrived in Kathmandu a week later. It carried 260 ventilators and many thousands of pieces of PPE. Make no mistake, Mr Deputy Speaker, those pieces of equipment and that assistance are saving lives in Nepal as I speak. I recognise, however, that medical supplies are only part of the solution. Vaccines are also crucial—that point has been raised in the other place on several occasions by Lord Lancaster, who takes a keen interest in Nepal.

We are playing a leading role in ensuring equitable access to vaccines for countries such as Nepal. The COVAX initiative sits at the centre of that effort, and the United Kingdom was integral to building COVAX from scratch. Our early commitment of more than £548 million, which in turn leveraged $1 billion of funding from other donors, allowed COVAX to arrange supply deals with vaccine manufacturers. Despite supply challenges, COVAX has started to make significant progress in delivering vaccines around the world, with almost 348,000 doses already delivered to Nepal, and another tranche on the way in the next few weeks.

Ninety-six per cent. of vaccines distributed by COVAX to date have been the Oxford AstraZeneca vaccine, including in Nepal. Clearly, the United Kingdom was crucial to the development of that vaccine. We provided £90 million to support the initial research and development, and the subsequent manufacturing required to produce the Oxford AstraZeneca vaccine. What is more, we made clear that, as part of that funding, the vaccine should be affordable around the world. In total, more than 0.5 billion doses of the AstraZeneca vaccine have already been delivered at a non-profit price globally, with two thirds going to lower and middle-income countries.

With United Kingdom support, a global licensing deal was also struck to transfer AstraZeneca’s technology to other manufacturers and establish 20 supply chains across the world, taking it to even more people. We have also been at the forefront of efforts around the world to boost confidence in covid-19 vaccines. Unfortunately, misinformation about vaccines—which can spread quickly, as we all know, on social media, with no respect for borders—has the potential to undermine trust and confidence in vaccines, which, ultimately and sadly, can cost lives. At the G7 global vaccine summit earlier this month, the UK Government and Google Cloud announced that they would work with some of the world’s leading tech companies on new digital solutions to tackle misinformation around vaccines.

Furthermore, the United Kingdom has supported the World Bank and the Asian Development Bank to provide special finance to Nepal to tackle the consequences of covid-19, including to purchase those vaccines. The World Bank has already released $75 million and the Asian Development Bank will shortly agree an additional $165 million financing deal with the Government of Nepal. The United Kingdom supported these contributions as a shareholder in both those banks. With that finance and COVAX allocations, the Government in Nepal will be able to vaccinate seven out of every 10 Nepalis when, clearly, supplies allow.

We have also used our presidency of the G7 to spear- head a commitment from G7 members to share 1 billion vaccine doses by June 2022. At least 100 million of those vaccines will come from the United Kingdom. As the House knows, the majority of our shared doses will go to COVAX. I am sure that the hon. Member for Ealing, Southall will understand that we are not yet able to announce the detailed allocations of those, but we will endeavour to share with him and the House that information regarding the distribution as soon as possible.

Let me emphasise that the United Kingdom remains committed to supporting Nepal’s development and recovery from covid-19, and I hope that some of the measures that I have outlined in answer to hon. Members’ interventions put some clarity on what we have actually delivered for the people of Nepal. As I said, we have reprioritised over £40 million of foreign aid to help Nepal respond to this awful pandemic. We sent scores of life-saving equipment to help Nepal respond to the country’s second wave and we have played a leading role in establishing COVAX and ensuring access to vaccines for Nepal—and not just Nepal, but all developing countries.

Question put and agreed to.

House adjourned.