Health Security – The Role of Health Protection

Overview

The COVID-19 pandemic has highlighted the importance of resilient public health systems in identifying, assessing, and managing public health risks [1] As the UK recovers from the pandemic, there must be a focus on planning for potential future pandemics,[2] tackling antimicrobial resistance,[3] and preventing a resurgence in vaccine-preventable diseases.[4] Impacts of climate change, including increased transmission of vector-borne diseases [5] also bring risks to human health. These challenges must be met by a robust health protection response to minimise impacts on public health, healthcare and other public services, society, and the economy.

FPH work and policy position

It is crucial the system takes on lessons learnt from the pandemic and drives forward pandemic and emergency preparedness taking an all-hazards, one-health approach [6] to ensure local systems are efficient, robust, resilient and sustainable. Support to health and care settings to maintain robust infection prevention control (IPC) must remain a priority for the health protection system; any disinvestment following relaxation of pandemic restrictions risks resurgence of COVID-19, flu and norovirus, as well as antimicrobial resistant pathogens.[7] 

Reduced coverage of childhood immunisations, nationally and globally, risks resurgence in some vaccine-preventable diseases. Improving vaccination coverage must therefore be a priority; systems must be able to deliver effective, cost-effective immunisation programmes to reduce the risk of future epidemics. The Mpox outbreak has demonstrated the need for health protection responses to consider wider health system capacity,[8] resilience, and capability to response to incidents. Those who led the responses to public health incidents and emergencies must be integrated into wider public health and healthcare systems and take a holistic approach.

Current and proposed policies in the UK

There is a need for greater clarity on local roles, responsibilities, legal powers in health protection, associated funding allocations, and development of the public health workforce. FPH continues to encourage greater coordination of efforts between local and national partners. It is essential all parts of the public health and health systems are engaged appropriately in health protection responses where they can bring additional assets and expertise to ensure a comprehensive response to health protection incidents. In England, Integrated Care Systems (ICSs) will become core to delivery of several health protection functions including emergency planning and preparedness, IPC, and integrated immunisation plans. IPC must be in the core funding and a mandatory responsibility of ICSs for them to take a lead in this area.

All aspects of health protection work must be underpinned by public-facing communications to advise of risks,[9] actions that individuals can take to protect their health, and reinforce models of asset-based community development. Moreover, as the COVID-19 pandemic has laid bare inequalities [10] in outcomes, health equity must be a key consideration in all health protection responses.

FPH policy recommendations

The FPH considers priority areas for policy and practice as being:

1. Funding for sustainable health protection services and workforce, being locally led, regionally coordinated and nationally supported. In England, this should include strengthening and embedding health protection functions into ICSs.
2. A holistic, all-hazards, one-health approach to pandemic and emergency preparedness, including learning lessons from the current pandemic and planning for the next one.
3. Building capability to prevent and mitigate risks associated with antimicrobial resistance and healthcare associated infections through better infection prevention and control at all levels.
4. Investing in and prioritising immunisations to prevent a resurgence of vaccine-preventable disease, including reducing inequalities in vaccination uptake.