This was published under the 2010 to 2015 Conservative and Liberal Democrat coalition government
Prime Minister David Cameron has delivered a speech to the Global Alliance for Vaccines and Immunisation conference on 13 June 2011.
The transcript includes the Q&A following the speech:
Thank you, Andrew, and can I add my very warm welcome to everyone today at this vital conference? Vital because of the subject that we’re addressing, vital because of the urgency of the issue, and also vital because I believe we’re going to succeed in raising the necessary money to make sure that we save the millions of lives that Andrew has spoken about.
Tabitha Muikali is 32 years old. She lives in Kibera, a slum in Nairobi. Last year, her eldest son John contracted pneumonia. For a month, he lay in agony battling the disease, but it was a fight that ultimately he didn’t win. He died aged just one. Someone like John dies every twenty seconds. Three times a minute a mother like Tabitha will see her entire world fall apart.
Today we have the chance, right here, right now, to change that. That is why the UK is hosting this conference together with Bill Gates, whose foundation has done so much to lead the fight for vaccines and immunisation across our world, and also Ellen Johnson-Sirleaf, whose leadership in turning her country around in just eight short years is inspirational. Doubling your economy, bringing such success after so many difficult years, we are full of admiration for what you have done. And it’s also why we have invited you: countries pledging money for the very first time, like Brazil and Japan; companies like GSK and the Serum Institute who have such a vital role in producing vaccines at low cost.
GAVI is quite simply a great organisation. It was set up by people who wanted to do aid in a different way and to my mind that is exactly what it’s achieved. GAVI was one of the very top performers in our root-and-branch review of the agencies that deliver British aid. Why? Well, because it delivers tangible results - saving lives with excellent value for money. How does it do this? First, it brings together national governments, private companies and donors, with the mechanisms they need to deliver vaccines to children. Second, GAVI uses innovative finance to generate additional sources of revenue for vaccines. And third it pools demand - creating strong buying power to drive down the cost of vaccines. Only last week the Serum Institute and Panacea Biotec agreed to lower prices for the life-saving pentavalent vaccine, which protects against five deadly diseases. GlaxoSmithKline offered the rotavirus vaccine to GAVI at $2.50 a dose - cutting the lowest available price by more than two-thirds. As a result of all this, over a decade, GAVI has helped prevent 5.4 million deaths and has helped immunise more than 288 million children in 72 of the world’s poorest countries. That, in my view, is a record worth investing in.
So today we come together, because we have the chance to save another four million lives by funding vaccines against diseases like pneumonia and diarrhoea. Frankly the idea of children dying from pneumonia and diarrhoea should be absolutely unthinkable in 2011.
And for most of us, thankfully, it is. But for many parents in the developing world - parents like Tabitha - it is a devastating reality. Nelson Mandela once said, ‘Life or death for a young child too often depends on whether it’s born in a country where vaccines are available.’
Today we can help end that cruel lottery and I am delighted to say that Britain will play its full part. In addition to our existing support for GAVI we will contribute £814 million of new funding up to 2015. This will help vaccinate over 80 million children and save 1.4 million lives. That is one child vaccinated every two seconds for five years. That is one child’s life saved every two minutes. That is what the money that the British taxpayer is putting in will get. And £50 million of our contribution is matched funding to incentivise further private-sector donations.
Now I want to put today’s announcement in the context of this government’s approach to tackling poverty. In the long term I know we are not going to help countries develop by just giving them money. At home we don’t tackle poverty by state hand-outs; we help people get into work, to stand on their own two feet and to take control of their own destiny. The same should be true of development. No country has ever pulled itself out of poverty through aid alone, so this government will take a new approach. The same conditions create prosperity the world over. They include access to markets, property rights, private-sector investment and they make up what I see as the golden thread of successful development. Ultimately it’s the private sector that will be the engine for growth and that’s why this government’s efforts will increasingly focus on helping developing countries achieve that growth with the jobs and opportunities it will bring.
Already, Andrew Mitchell has created a new private-sector department in his department to bring private-sector DNA into government. We will also use all of our diplomatic and aid levers to help the creation of an Africa Free Trade Area, one of the most significant potential achievements that this government can help with. Our embassies will do far more to support trade in Africa. We will use some of the DFID budget to make Africa an attractive place to trade and invest in by professionalising cross-border customs services, investing in projects that will provide roads, the internet, and infrastructure, and by helping companies do business in ways that are not only good for profits but good for development too. Because I don’t want to see the people of Africa as recipients of charity; I want to see them as trading partners, as partners in economic opportunity. That’s what I believe in and that’s what this government will help achieve.
We want people in Africa to climb the ladder of prosperity but of course when the bottom rungs of that ladder are broken by disease and preventable death on a massive scale, when countries can’t even get on the bottom rung of the growth ladder because one in seven of their children die before they reach their fifth birthday, we have to take urgent action. We have to save lives and then we can help people to live. So that’s where today’s announcement fits in. Because there cannot really be any effective development - economic or political - while there are still millions of people dying unnecessarily.
Now, at a time when we are making spending cuts at home, what we’re doing today, and the way we’re protecting our aid budget, is controversial. Some people say we simply can’t afford to be spending money on overseas aid right now; that we should get our own house in order before worrying about other people’s problems. Others see the point of helping other countries to develop, but they don’t think aid works anyway, because corrupt dictators prevent it from reaching the people who really need it. I want to briefly address both these arguments this morning.
Let’s start with those who think we shouldn’t be tackling poverty in other countries right now. Many of these people are genuinely concerned about the problems in other countries, but just think we can’t afford to help. So they believe we have to focus on ourselves right now and if that means breaking promises on aid spending then they’re sorry, this just has to be done. Well I’m sorry, but it doesn’t. I think that argument is wrong. I think there is a strong moral case for keeping our promises to the world’s poorest and helping them even when we face challenges at home.
When you make a promise to the poorest people in the world you should keep it. I remember where I was during the Gleneagles Summit and the Live 8 concert of 2005 and I remember thinking at the time how right it was that those world leaders should make such pledges so publicly. For me it’s a question of values; this is about saving lives. It was the right thing to promise; it was the right thing for Britain to do and it is the right thing for this government to honour that commitment.
So to those who point to other countries that are breaking their promises and say that makes it okay for us to do the same, I say no, it’s not okay. Our job is to hold those other countries to account, not to use them as an excuse to turn our back on people who are trusting us to help them. And to those who say fine but we should put off seeing through those promises to another day because right now we can’t afford to help, I say we can’t afford to wait. How many minutes do we wait? Three children die every minute from pneumonia alone; waiting is not the right thing to do and I don’t think that 0.7% of our gross national income is too high a price to pay for saving lives.
But there’s not just a strong moral argument for keeping our aid commitment, there’s a strong practical one too. If we really care about Britain’s national interest, about jobs, about growth, about security, we shouldn’t break off our links with the countries that can hold some of the keys to that future. If we invest in Africa, if we open trade corridors, if we remove obstacles to growth, it’s not just Africa that will grow but us too. And if we invest in countries before they get broken we might not end up spending so much on dealing with the problems, whether that’s immigration or threats to our national security.
Take Afghanistan. If we’d put a fraction of our current military spending on Afghanistan into helping Afghanistan 15 or 20 years ago just think what we might have been able to avoid over the last decade. Or take Pakistan. Let another generation of Pakistanis enter adult life without any real opportunities and what are the risks in terms of mass migration, radicalisation, even terrorism? That’s why UK support over the next four years will get four million more children in Pakistan into school. This could be life changing for those children and it can be part of the antidote to the extremism that threatens us all. So it’s not just morally right to invest in aid, it’s actually in our own interests too.
And let me say one more thing to this group of critics. I actually think that most people in our country want Britain to stand for something in the world, to be something in the world. And when I think about what makes me proud of our country, yes, I think of our incredibly brave service men and women that I have the honour to meet and see so often; and yes, I think of our capabilities as an economic and diplomatic power; but I also think of our sense of duty to help others. That says something about this country and I think it’s something we can be proud of.
Now a second group of critics makes a different argument: they see the point of aid, but think that, as it stands, it’s a waste of time because corrupt governments use it to prop up their regimes, sometimes even making the poor poorer. Now I totally get this argument. It is right to be angry when aid is badly spent and let me tell you: I’m not prepared to see a single penny of hard-earned money wasted on corrupt governments or on badly spent aid.
But the answer isn’t to walk away from aid; it’s to change the way we do development, so we get really great results and real value for money. That’s why we’ll increase our use of direct channels to give money directly to the world’s poorest. It’s why we’ll focus aid on measurable results - things that people can clearly see make a difference. By 2015, UK aid will secure schooling for more people than we educate in the UK but at one fortieth of the cost. We will vaccinate more children against preventable diseases than there are people in the whole of England. Measurable, cost-effective, live-saving aid, and it’s why we put such a focus on improving the transparency and accountability of our aid programme.
Incredible as it may seem, just 12 months ago government did not publish details of how our development money was spent. We’ve changed that. Today, people all around the world can go online and see every item of DFID spending over £500 and see evaluations of the impact of that spending. Over the next 12 months, we’ll go even further. From the beginning of the next financial year, any NGO that receives funding from the UK must publish what they do, where they get their money and where it goes. This will enable people in the developed and developing world to hold them to account for the way they spend their money and, over time, we will apply this principle to recipient governments too. Sunlight is the best disinfectant, and we’re shining the spotlight on aid funding like never before.
I know in this debate figures can become meaningless, but I want to leave you with some. If, as I hope and expect, we reach or exceed GAVI’s target of $3.7 billion over the next five years, we will protect at least a quarter of a billion children against killer diseases and save 4 million lives. Think about that: a quarter of a billion children protected from disease; 4 million lives saved.
In this world, where countries are tackling deficits and, more than ever before, the emphasis is quite rightly on getting value for money, what greater value for money can there possibly be? Thank you very much for listening. Thank you very much for that reception. You’re very welcome here for what I’m sure is going to be a successful conference.
Thank you, Prime Minister, for your extraordinary leadership here this morning. I just wanted quickly to ask what question you might pose to other leaders from around Europe you’ll be meeting next week at the European Council of Ministers, and also to countries like Finland, Switzerland and Austria which, I believe, were asked to make a contribution to GAVI and yet have been silent?
We had this discussion at the G8, where we had many visiting African leaders. I’m sure we’ll have discussions at the EU as well. I find the right approach is not to lecture and hector people. Britain has made its choice. We made a promise; we’re going to keep our promise. We’re going to work extremely hard to make sure every penny of that aid is well spent. We’re making the argument, and it’s a vigorous argument as you’ve just heard, about why it’s the right thing to do, morally and practically, and we make that argument with others. I hope that the strongest way of getting this point across to other countries is to demonstrate that actually you can take these steps and it enhances your reputation in the world, your ability to get things done and, at the same time, delivers demonstrable results about things we all care passionately about. And you can take your own public with you. If we can demonstrate that, then that is the best argument to the French or the Italians or the Swiss or the Finns.
As to GAVI itself, in making the argument about why Britain’s keeping its aid pledge, one of the easiest arguments to make with the British public is to say, ‘Look, this is an organisation backed by Bill Gates. He’s someone who knows a little bit about value for money, a little bit about business efficiency.’ 80% of GAVI’s money goes on vaccines. It doesn’t go on bureaucracy. It doesn’t go on middlemen. It doesn’t go on lobbying organisations or the rest of it. Absolutely, the money’s in the teeth and not in the tail, and you can see the results about the millions of lives saved over the past few years, and you can have a guarantee, if you like, about the millions of lives that will be saved in the future years.
My argument with those leaders will be: keep your promises about aid; it’s the right thing to do morally. You can argue it politically and win that argument, as I believe we are here in Britain. At the same time, when you’re going to do that, why not put money into great multilateral organisations like GAVI, which are not bureaucratic, which are effective and deliver results? I think that’s a good argument to make and I’m very happy to make it here in the UK.
Mr Cameron, the UK’s commitment to GAVI up to 2030 actually amounts to a third of GAVI’s budget. Whilst many will praise that, is the UK really doing too much compared to other countries, if we’re standing to commit ourselves, even before what you announced today, to a third of GAVI’s spending by 2030?
We’d obviously like other countries to do more, and that is a matter for them. The fact is we’ve made our choice. If you like, we’ve made two choices. One is to keep our promise of 0.7% of our gross national income by 2013. We’ve made that promise; we’re going to keep to that promise.
The second thing we’ve decided is, within that promise, one of the best ways to get results that people can have real faith in is to invest in organisations like GAVI. While other countries may choose to do different things with their aid budget, we’ve made a self-conscious choice that actually there’s probably no better aid programme in the world than immunising children against preventable diseases. Others will have to make their own argument about whether their aid is bilateral or how much they do through NGOs, how much through direct government support, what parts of the world they support. That is for them to make their own argument, but Andrew Mitchell, the Cabinet and I have discussed this and we really think there are two principal channels for our aid budget.
One is the measurable, the deliverable, the practical - things like vaccinating children. The second is a focus on broken states. We think there’s a very important argument to make here, an argument that we can win, that actually if you help to mend countries like Afghanistan or Somalia you save yourself vast amounts of money in the long run. I’m a complete fan of all those who point to the links between war and conflict, and broken states and deep and entrenched poverty. Those two avenues for our aid are the principal ways we should be spending money in the years to come.
As I say, I’m a politician. I believe that changing things and delivering things is not only about taking the right decisions; it’s about trying to take your people with you. I think we’re doing the right thing and I think we’re doing it in a way where we can take people with us at the same time.
I think we’re really proud that the UK is giving such leadership in this way and has made such a commitment to GAVI. I just wanted to make the point that this is to catalyse expanding immunisation, but it needs the health workers in these countries and these governments need to expand the number of health workers as well. They’re going to need that support as well. If GAVI does get its money, then we also need the UK to carry on showing a lot of leadership in helping to build health services in the poorest countries.
I completely agree with that. Having said, as I did, that 80% of GAVI’s money goes on vaccines, and that’s why people can have such faith that their donations are going right into the frontline, if you don’t have the capacity to deliver things in country, you can’t get the vaccination done. Bill and I were talking earlier about the excellent Polio Eradication Initiative, which is doing a superb job but, in the countries where we’re still struggling, the problems are problems of capacity and access. I completely understand the point that you’re making.
It strikes me that the corporate sector is not doing enough. It’s very good that we have this £50 million matched funding, but I think that we need to put far greater effort into cajoling industry to stand up and do something like Mr Gates has done. I also facetiously just thought about the banking industry. We actually own most of the banking industry as a country, so perhaps you can have somewhat more success with this programme than you can with the bonuses.
I’m frequently reminded about how many banks I own - not something I expected to be able to say. What I would say to any corporate that is thinking about this whole issue of whether to donate, how to donate, what public causes to get involved in, I would just give them one piece of advice: go to a primary school anywhere in the UK. Go and sit with the children as they’re being taught about business, they’re being taught about the economy. Watch what they do when they go online. I did this several times, and they immediately go and look at the companies they’ve heard of. They look immediately at what causes those companies support.
I think we are going to see an enormous change in our country, where people will not just look up to companies that are good corporate citizens; they will absolutely expect it from those companies, just as a baseline. I think there’s a big change that’s taking place about how people look at business. We’re big supporters in this country of free enterprise, of go-getting entrepreneurs, of open-market economies and the rest of it, but we also want to know that our companies are good corporate citizens, and that sense is growing all of the time. The businesses that don’t understand that will suddenly find that, actually, their brand and their business are not as powerful as they thought they were.
I think this is an issue where, yes, we should give it the odd shunt from government and I do. As a politician, I’ve spoken about this for all of the last five years I’ve been leader of the Conservative Party, often to the surprise of some people in business. I think they are all waking up to understanding that this isn’t now something you do that’s special; this is part of the mainstream work of being a good company in Britain today.
Can I thank you all very much indeed for coming? I wish you well for the rest of this conference. I hope we’re going to meet and surpass the money that needs to be raised to do the work that GAVI does. I think it’s an excellent organisation; it’s proved its track record, and I would urge all other political leaders and countries to get behind something that works, that saves lives and doesn’t just save lives for the here and now, but gives those countries and economies - as I argued in my speech - the ability to grow and succeed, and make our world not just more prosperous but also safer for all of us as well. Thank you very much indeed.