Joint response to the announcement of the National Institute for Health Protection and the future of public health


Joint response to the announcement of the National Institute for Health Protection and the future of public health, published today 18 August 2020:

Terrence Higgins Trust, National AIDS Trust (NAT), British HIV Association (BHIVA), British Association for Sexual Health and HIV (BASHH), the UK Community Advisory Board (UK-CAB) HIV treatment advocates network – Tuesday 18 August 2020

Following today’s announcement regarding the National Institute for Health Protection, and the implications for the future of public health, five of the nation’s leading HIV and sexual health organisations have issued a joint response.

The Secretary of State’s speech today leaves us with more questions than answers.

Public Health England (PHE) is responsible for far more than its scientific work – it plays a significant role in the response to HIV, sexual health and reproductive health and has driven innovative national health improvement efforts. Today’s announcement provides no clarity on the future of this important health improvement function and we are concerned that structural changes could risk a reversal of the progress that has been made to date.

We also need urgent clarity on the future home of the world-leading PHE HIV and sexual health epidemiology and surveillance work that has underpinned our national efforts in tackling HIV and sexually transmitted infections (STI’s) and delivering care to vulnerable population groups at this crucial moment in the fight against HIV and the delivery of better sexual health in England.

At this juncture a kneejerk restructure of the public health system which is non-transparent, ill-thought through and leads to more fragmentation in accountability structures risks holding us back.

We know from past reforms that any sudden structural changes by government can result in poorer outcomes and risk leaving key policy areas falling through the cracks. Experience has shown us that any new agencies must to be free of politics and be science and expert led.

Any changes to PHE must also protect the prevention and policy work that it currently leads in HIV, sexual health and reproductive health and ensure that there is no backtracking, or slowing down of existing commitments, particularly:

  • to end new HIV transmissions by 2030 in England;
  • to deliver a national PrEP programme;
  • to consider and act on the recommendations of the independent HIV Commission;
  • to improve access to contraception including LARC;
  • and to oversee the development of a much needed new national sexual and reproductive health strategy.

The announcement made today focuses on “new” and “external” health threats whilst not acknowledging the public health emergencies that already exist in the UK. While attention has rightly been given to the ongoing COVID-19 pandemic, focus must not be lost in tackling longstanding HIV and STI infection rates and reversing sexual health inequalities.

It is not acceptable that these changes are being proposed in a vacuum. All changes in regard to the new National Institute for Health Protection must be fully consulted on, which includes a meaningful conversation with charities, community organisations and healthcare professionals in the HIV and sexual health sectors, to ensure that there is no harmful impact.

We urge the Government to think carefully before major changes to PHE are enacted. Any change must strengthen the national action around public health including sexual health and HIV. National accountability must be transparent, and it is essential that PHE, or its successor, is provided with the power to drive change and improvements to continue to make progress on HIV and tackle sexual ill-health.

Roy Trevelion
Member, UK-CAB and BHIVA