As the UK plans for a post-Brexit state, careful consideration of current health security provisions is needed to protect and enhance the public’s health across the UK and EU.
Infectious diseases do not conform to national borders. It is imperative that countries continue collaborating to develop robust systems for surveillance and preparedness. This can be ensured by retaining our close bilateral working relationship with the European Centre for Disease Prevention and Control (ECDC)—an independent EU agency whose mission is to strengthen Europe’s defences against infectious diseases.
Proximity to Europe and high levels of cross-border travel means cases of infectious diseases in the UK are regularly imported from Europe and vice versa. Outbreaks of measles in England and Wales have been repeatedly linked to ongoing outbreaks in countries in Eastern Europe, while cases of Hepatitis A among men who have sex with men across Europe have been shown to be linked, with 3813 cases identified to date. This year a case of multi-drug resistant Neisseria Gonorrhoeae was confirmed in the UK and found to be acquired from South East Asia.
Infectious diseases remain a major burden on the UK health system and economy. The ECDC works in partnership with national health protection bodies across Europe, strengthening and developing continent-wide disease surveillance and early-warning systems. It pools Europe’s health knowledge to develop authoritative scientific opinion about current and emerging risks. And it provides the NHS with evidence for effective decision-making, helps strengthen our public health system, and supports our response to public health threats. It does so through surveillance, epidemic intelligence, scientific advice, microbiology, preparedness, public health training, international relations, and health communication. Health protection experts across Europe have come to regard ECDC as a vital facilitator of professional networking, partnership and collaboration.
We welcome the secretary of State for Health and Social Care’s recent commitment that “improving health security will form an important part of our negotiating position.” He has also affirmed the government’s ambition for “an agreement that allows us to maintain the important and mutually beneficial collaboration with Europe on health issues.” The public health community has also responded warmly to the government’s recent confirmation that the duty to “Do No Harm,” enshrined in Article 168 of the Lisbon Treaty, will continue to apply after Brexit. The article says that “a high level of human health protection shall be ensured” in all policies and activities.
To support the government in delivering these commitments, the UK Faculty of Public Health (FPH) has today launched a new “blueprint” recommending how the UK could continue its relationship with the ECDC post-Brexit. The blueprint sets out three potential options which can be summarised as: 1) Retaining our current relationship 2) Creation of a bespoke relationship 3) Creation of a European neighbourhood agreement.
The UK has considerable expertise in health protection and is regarded as one of the EU’s leaders in communicable disease control. Yet, part of our leadership is conferred by our membership of the EU. Post Brexit, without a formal relationship with ECDC, important and expert social networks and professional relationships may fragment and the UK’s ability to tackle infectious diseases may decline. If the UK wishes to continue to achieve the highest standards of health protection then maintaining our relationship with the ECDC post-Brexit offers the best chance.
Mary Dallat, Faculty of Public Health.
Competing interests: None declared.