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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In your 30s? You missed out on £26,000 and you're not even protesting

The 1980s kids seem resigned to their fate - for now. 

Imagine you’re in your thirties, and you’re renting in a shared house, on roughly the same pay you earned five years ago. Now imagine you have a friend, also in their thirties. This friend owns their own home, gets pay rises every year and has a more generous pension to beat. In fact, they are twice as rich as you. 

When you try to talk about how worried you are about your financial situation, the friend shrugs and says: “I was in that situation too.”

Un-friend, right? But this is, in fact, reality. A study from the Institute for Fiscal Studies found that Brits in their early thirties have a median wealth of £27,000. But ten years ago, a thirty something had £53,000. In other words, that unbearable friend is just someone exactly the same as you, who is now in their forties. 

Not only do Brits born in the early 1980s have half the wealth they would have had if they were born in the 1970s, but they are the first generation to be in this position since World War II.  According to the IFS study, each cohort has got progressively richer. But then, just as the 1980s kids were reaching adulthood, a couple of things happened at once.

House prices raced ahead of wages. Employers made pensions less generous. And, at the crucial point that the 1980s kids were finding their feet in the jobs market, the recession struck. The 1980s kids didn’t manage to buy homes in time to take advantage of low mortgage rates. Instead, they are stuck paying increasing amounts of rent. 

If the wealth distribution between someone in their 30s and someone in their 40s is stark, this is only the starting point in intergenerational inequality. The IFS expects pensioners’ incomes to race ahead of workers in the coming decade. 

So why, given this unprecedented reversal in fortunes, are Brits in their early thirties not marching in the streets? Why are they not burning tyres outside the Treasury while shouting: “Give us out £26k back?” 

The obvious fact that no one is going to be protesting their granny’s good fortune aside, it seems one reason for the 1980s kids’ resignation is they are still in denial. One thirty something wrote to The Staggers that the idea of being able to buy a house had become too abstract to worry about. Instead:

“You just try and get through this month and then worry about next month, which is probably self-defeating, but I think it's quite tough to get in the mindset that you're going to put something by so maybe in 10 years you can buy a shoebox a two-hour train ride from where you actually want to be.”

Another reflected that “people keep saying ‘something will turn up’”.

The Staggers turned to our resident thirty something, Yo Zushi, for his thoughts. He agreed with the IFS analysis that the recession mattered:

"We were spoiled by an artificially inflated balloon of cheap credit and growing up was something you did… later. Then the crash came in 2007-2008, and it became something we couldn’t afford to do. 

I would have got round to becoming comfortably off, I tell myself, had I been given another ten years of amoral capitalist boom to do so. Many of those who were born in the early 1970s drifted along, took a nap and woke up in possession of a house, all mod cons and a decent-paying job. But we slightly younger Gen X-ers followed in their slipstream and somehow fell off the edge. Oh well. "

Will the inertia of the1980s kids last? Perhaps – but Zushi sees in the support for Jeremy Corbyn, a swell of feeling at last. “Our lack of access to the life we were promised in our teens has woken many of us up to why things suck. That’s a good thing. 

“And now we have Corbyn to help sort it all out. That’s not meant sarcastically – I really think he’ll do it.”