Prevention is better than cure

The ongoing struggle to reduce the cost of vaccines in developing countries like Ghana.

 

Monday saw me in Committee room 1 in Westminster amongst Parliamentarians and health and development activists at the start of World Immunisation Week. Now I am in Ghana where more than 50 years ago I was inoculated against polio. This has now been eradicated in Ghana by the sort of mass immunisation campaign that I am privileged to see launched here this week.

Today, in Ghana the target is two of the biggest child killers in the world pneumonia and diarrhoea. These two diseases account for an estimated 20 per cent of all under 5 deaths in the country, but are largely preventable through the introduction of the pneumococcal and rotavirus vaccines. In the UK we take for granted the access and availability of these vaccines and we have little experience of the fatal impact of these diseases. But pneumonia and diarrhoea each kill roughly 500,000 children under 5 every year and 85 per cent of the diarrhoea deaths caused by rotavirus are in the developing world. In Ghana the fatal impact of these diseases is very real.

I am travelling to Ghana with the GAVI Alliance. This unique partnership between governments, North and South, civil society, and private sector philanthropists and businesses has revolutionised the market in and delivery of vaccines globally and saved the lives of millions. The origins of GAVI's funding lie in the very special coming together of activists and government that led to the UK’s historic commitments to the UN 0.7 per cent of GDP target for development. This is an enduring achievement of the last Labour government. The good news is that this saw the advent of a new national consensus. The consequence of which is that David Cameron and Andrew Mitchell, who hosted the last funding conference for GAVI, have committed a further £814 million pounds to the cause. This recognises not simply the need I see so clearly demonstrated in Ghana and indeed throughout my work in Africa but also of the effectiveness of GAVI and its unique model. This builds local ownership whilst intervening in world markets to reduce the cost of vaccines to developing nations through innovative funding mechanisms. The IFFIm on which I worked with Gordon Brown during our time at the Treasury was the first of these. Designed and championed by a very special partnership between the treasury, the city, and civil society including the Vatican, it proved to be a groundbreaking approach to securing sustainable funding for development. I am now seeing first hand in Ghana the product of a next generation initiative, the Advanced Market Commitment (AMC), which is delivering life saving pneumococcal vaccines to the poorest countries at a 90 per cent price reduction compared to the cost in the US and EU. And it has accelerated the pace of delivery so that by 2015 an additional 700,000 lives ought to be saved.

The child that I saw my self struggling for breath in the arms of her father, whilst a weeping mother looked on at the Princess Marie Louise Hospital in central Accra ought not to be joined by countless others. Politics and the budget process that protects DFID’s spending are too often disparaged by so many in the sadly cynical and disillusioned country that we have become. Not least by so many young people who have been turned off completely by the whole process. We all need reminding from time to time why politics and the contest of ideas and values matter so desperately. And why we need to restore and revitalise our own politics.

One of GAVI’s strengths, as I see it, is that GAVI builds and supports local ownership and participation. A traditional leader in rural Ghana told us through his linguist, the original version of our own Number 10 spokesperson, why he had called together the village community to get vaccinated. Ghanaian health professionals had proudly outlined the “cold chain”, the logistical triumph that will ensure that children in the remotest parts of Ghana will still get access to the vaccine in good time and at maximum effectiveness. The Health Minister rightly outlined the Ghanaian taxpayers’ contribution to the funding of the whole process supported by GAVI. This is best practice in international development. Britain’s contribution ensures that somewhere in the world every 2 seconds a child is being vaccinated and a life is saved every 2 minutes from diseases that no child in the UK ever dies. On my way back from the medical field unit so similar to the one my mum took me all those years ago now, I saw a “Tro-Tro”, Ghana’s ubiquitous minivan taxi system. They are famed for the proverbs emblazoned on them with great colour and decorative flourish. This one simply said, “Prevention is better than cure". 

Paul Boateng is a former chief secretary to the Treasury, ex-High Commissioner in South Africa and a Labour peer

Paul Boateng, a former British high commissioner to South Africa, MP, cabinet minister and civil rights lawyer, is a member of the House of Lords and a trustee of the Planet Earth Institute

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Senior Labour and Liberal Democrat politicians call for a progressive alliance

As Brexit gets underway, opposition grandees urge their parties – Labour, Lib Dems, the SNP and Greens – to form a pact.

A number of senior Labour and opposition politicians are calling for a cross-party alliance. In a bid to hold the Conservative government to account as Brexit negotiations kick off, party grandees are urging their leaders to put party politics to one side and work together.

The former Labour minister Chris Mullin believes that “the only way forward” is “an eventual pact between Labour, the Liberal Democrats and the Greens not to oppose each other in marginal seats”. 

 “Given the loss of Scotland,it will be difficult for any party that is not the Conservative party to form a government on its own in the foreseeable future," Mullin argues, but he admits, “no doubt tribalists on both sides will find this upsetting” and laments that, “it may take three or four election defeats for the penny to drop”.

But there are other Labour and Liberal grandees who are envisaging such a future for Britain’s progressive parties.

The Lib Dem peer and former party leader Ming Campbell predicts that “there could be some pressure” after the 2020 election for Labour MPs to look at “SDP Mark II”, and reveals, “a real sense among the left and the centre-left that the only way Conservative hegemony is going to be undermined is for a far higher degree of cooperation”.

The Gang of Four’s David Owen, a former Labour foreign secretary who co-founded the SDP, warns Labour that it must “face up to reality” and “proudly and completely coherently” agree to work with the SNP.

“It is perfectly legitimate for the Labour party to work with them,” he tells me. “We have to live with that reality. You have to be ready to talk to them. You won’t agree with them on separation but you can agree on many other areas, or you certainly should be trying.”

The Labour peer and former home secretary Charles Clarke agrees that Labour must “open up an alliance with the SNP” on fighting for Britain to remain in the single market, calling it “an opportunity that’s just opened”. He criticises his party for having “completely failed to deal with how we relate to the SNP” during the 2015 election campaign, saying, “Ed Miliband completely messed that up”.

“The SNP will still be a big factor after the 2020 general election,” Clarke says. “Therefore we have to find a way to deal with them if we’re interested in being in power after the election.”

Clarke also advises his party to make pacts with the Lib Dems ahead of the election in individual constituencies in the southwest up to London.

“We should help the Lib Dems to win some of those seats, a dozen of those seats back from the Tories,” he argues. “I think a seat-by-seat examination in certain seats which would weaken the Tory position is worth thinking about. There are a few seats where us not running – or being broadly supportive of the Lib Dems – might reduce the number of Tory seats.”

The peer and former Lib Dem leader Paddy Ashdown agrees that such cooperation could help reduce the Tory majority. When leader, he worked informally in the Nineties with then opposition leader Tony Blair to coordinate their challenge to the Conservative government.

“We’re quite like we were in 1992 when Tony Blair and I started working together but with bells on,” Ashdown tells me. “We have to do something quite similar to what Blair and I did, we have to create the mood of a sort of space, where people of an intelligent focus can gather – I think this is going to be done much more organically than organisationally.”

Ashdown describes methods of cooperation, including the cross-party Cook-Maclennan Agreement on constitutional reform, uniting on Scottish devolution, a coordinated approach to PMQs, and publishing 50 seats in the Daily Mirror before the 1997 election, outlining seats where Labour and Lib Dem voters should tactically vote for one another to defeat Tory candidates.

“We created the climate of an expectation of cooperation,” Ashdown recalls. Pursuing the spirit of this time, he has set up a movement called More United, which urges cross-party support of candidates and campaigns that subscribe to progressive values.

He reveals that that “Tory Central Office are pretty hostile to the idea, Mr Corbyn is pretty hostile to the idea”, but there are Conservative and Labour MPs who are “talking about participating in the process”.

Indeed, my colleague George reveals in his report for the magazine this week that a close ally of George Osborne has approached the Lib Dem leader Tim Farron about forming a new centrist party called “The Democrats”. It’s an idea that the former chancellor had reportedly already pitched to Labour MPs.

Labour peer and former cabinet minister Tessa Jowell says this is “the moment” to “build a different kind of progressive activism and progressive alliance”, as people are engaging in movements more than parties. But she says politicians should be “wary of reaching out for what is too easily defined as an elite metropolitan solution which can also be seen as simply another power grab”.

She warns against a “We’re going to have a new party, here’s the board, here’s the doorplate, and now you’re invited to join” approach. “Talk of a new party is for the birds without reach and without groundedness – and we have no evidence of that at the moment.”

A senior politician who wished not to be named echoes Jowell’s caution. “The problem is that if you’re surrounded by a group of people who think that greater cooperation is necessary and possible – people who all think the same as you – then there’s a terrible temptation to think that everyone thinks the same as you,” they say.

They warn against looking back at the “halcyon days” of Blair’s cooperation with the Lib Dems. “It’s worth remembering they fell out eventually! Most political marriages end in divorce, don’t they?”

Anoosh Chakelian is senior writer at the New Statesman.