On 30 June 2020, the UK prime minister, Boris Johnson, unveiled a “new deal” to start the post-pandemic economic revival. The covid-19 pandemic is proof that the past decade has failed to protect our most vulnerable communities. The recovery plan must focus on building resilience. PETRA – the international trade and health network established by the UK Prevention Research Partnership – highlights the factors that will ensure that the nation’s health underpins the economy rather than becoming a commodity that can be traded. In contrast to the “new deal-lite” approach announced by Boris Johnson, PETRA is calling for a much more ambitious approach, akin to the Marshall Plan implemented to rebuild Europe after WW2 and driven by health and environmental protection.
Health at the forefront of trade deals
The stalled negotiations of the Brexit debacle suggest that the UK is heading towards a no deal outcome. The loss of the EU market will be such an act of self harm that this risks making other efforts at economic revival futile. The rapidly negotiated deals with the US, Australia, and New Zealand are unlikely to compensate. Indeed, the rush for economic recovery will provide more opportunities for the unhealthy commodities’ industries to push for US:UK mini-trade arrangements to remove, marginalise, or dilute public health standards before the US presidential elections in November and Brexit in December 2020. When the House of Commons voted on the Agriculture Bill on 13 May 2020, MPs rejected further pleas to uphold UK standards of food production, creating a high risk that chlorinated chicken and hormone-fed beef will now be traded in the UK.
While UK bakers may welcome cheaper prices on yeast, baking powder, and cocoa powder, the potential for increased availability and accessibility of highly processed food commodities will rise as a result of scrapping the current tariff variation across high fat, salt and sugar goods such as biscuits, pizzas, confectionery, and spreads. The UK is a trade dependent economy, but support must be directed to industries that make a positive contribution to the nation’s public and environmental health, as well as those that pay their due taxes.
An Office of Budget Responsibility for Population Health
The allocation of £3.2bn of extra funding to local authorities to help their response to covid-19 is welcomed, but this must be the start of greater investment in the UK’s public health system. In 2018, the UK Public Health Network brought together senior economic and political figures to discuss how an Office of Budget Responsibility for Population Health could provide independent fiscal and economic analysis of the value of health capital to the country. This function needs more urgent consideration in order to establish reinvestment in public health post-covid-19. Scientific expertise has become more valued during the pandemic, with an apparent greater willingness by both government and the public to accept advice; now would be an ideal time to embed this cross-government approach to investment in health.
Funded non-communicable disease (NCD) prevention programmes to build community resilience
When recovering from covid-19 UK prime minister, Boris Johnson, indicated that the time had come to address the question of high levels of overweight and obesity in the population. While this is a welcome announcement, further concrete measures have yet to be seen. The fact that bicycle sellers such as Halfords and Brompton report a 23% increase in share price and a “fivefold” increase in online cycle sales respectively, as well as a 255% increase in the sale of bike maintenance tools since the lockdown began, demonstrates greater public interest in active transport. Cities across the UK, Australia, Canada, USA, Germany, and Hungary are changing streets during and post-lockdown to support greater walking and cycling with measurable impacts on air pollution. The momentum from these initiatives must not be lost. But, the prevention of NCDs requires upgraded, smart and sustained investment. A WHO survey found that only 17% of countries surveyed have made budget allocations for NCD services in their national covid-19 plans.
Abandonment of the reactionary approach to global health policy.
Global health communities and governments have known for some time that a pandemic such as covid-19 was very likely and yet global health policy has been “woefully unprepared nor fit-for-purpose.” The fragmentation of health governance across the WHO, World Bank, Gates Foundation, US Agency for International Development,has resulted in a “reactionary” approach to global health policy and a lack of supranational coordination.
The most critical factor that will determine whether we enter, in Winston Churchill’s words, “an era of procrastination” or “a period of consequences” is the political motivation to shape and implement new policies. It is also the one factor over which the greatest risk and uncertainty lie. The current small window of opportunity to capitalise on a renewed interest in the public’s health must be used to create a “what if” vision of what health and wellbeing should look like post-covid-19 and create the conditions for a healthier tomorrow.
Heather Lodge, interim co-ordinator, UK PRP PETRA: trade and health network, and visiting senior lecturer, University of Chester.
David Hunter, emeritus professor of health policy and management, population health sciences institute, Newcastle University; Visiting Professor, University of Chester; co-investigator: UK PRP PETRA: trade and health network
Paul Lincoln, visiting professor, University of Chester and retired chief executive of UK Health Forum; Co-investigator: UK PRP PETRA: trade and health network
Heather Lodge is unpaid interim Co-ordinator for the UK PRP PETRA: trade and health network but receives travel and accommodation expenses for face to face meetings.
David Hunter and Paul Lincoln are unpaid Co-investigators for the UK PRP PETRA: trade and health network but receive travel and accommodation expenses for face to face meetings.