Shaping health security: In conversation with UKHSA's chief scientist

The UK Health Security Agency recently published its first ever science strategy, which looks at how to prepare for threats over the next decade. Its chief scientist Isabel Oliver shares the highlights
UKHSA officials. Photo: GOV.UK



What are the goals of the 10-year strategy?

Our mission in the UK Health Security Agency is to protect people from infectious diseases and environmental hazards – that is radiation, chemical, extreme weather events. To do this, we need to generate and apply the best scientific evidence. We need to detect threats, we need to understand them and the risks they pose to our health. But also importantly, we need to understand how to best protect health from those. We can only do that through our scientific activities.

The other important aspect of this is that UKHSA was established from a pandemic and in the middle of a pandemic. So we've been doing a lot of reflection about what must be learned from the pandemic, and how to secure the legacy. There were a number of areas that we know had to be strengthened or developed very quickly during the pandemic – one example is genomic surveillance. We're very keen to make sure that we learn from that experience, but also that we build on the capabilities that were strengthened during the pandemic. We've got a really tough job to do because unfortunately, we live in a context where the risk from pandemics and other threats to health is increasing because of factors such as climate and environmental change, for example.

What's the thinking behind making it a 10-year strategy? Why a decade?

We've got really complex challenges to face, so we need to look into the future to think about how these threats will change. For example, one of the things that we mentioned in our strategy is the need to further strengthen our surveillance for vectors of disease – mosquitoes and ticks – because we can see from what's happening in France and other countries that climate is already impacting on the distribution of some infectious diseases as a result of changes in in the habitats for mosquitoes and other vectors. So it's really important that we look forward. We need to be anticipating the threats that we will face.

One of the themes in our strategy is to predict and anticipate threats to health. We'll do that by strengthening our genomic surveillance, and our data and analytics to help make sure that we are able to detect those threats. Thanks to scientific advancements, we could detect threats and we could control them before they have the impact that Covid-19 had on health and society – and that's what we would like to do. We need to be looking into the future to be able to do that effectively.

What are you most excited about in the strategy?

Having this strategy in the first place is really exciting because, to my knowledge, it is the first time that a public health organisation of this kind has ever had a science strategy.

One of the lessons from the pandemic is that we saw the art of the possible. We saw what can be achieved through taking advantage of scientific developments, for example, through the enormous successful story of the vaccines. The world has never seen such rapid development and deployment of vaccines. So we know that we can achieve better health outcomes and make a really good contribution to the prosperity of the country through our scientific activity.

Through the strategy, we've also announced a number of developments that I think are really important for health security. One is the establishment of our Centre for Climate and Health Security, which is aimed at making sure that we understand not just the impact of climate change on health, but also how to best protect health.

I'm also very excited about our work to continue to strengthen our genomic surveillance capabilities and our work to establish a Centre for Vaccine Development and Evaluation. That builds on the legacy from the pandemic, to make sure that we have the tools – not just the vaccines, but also the diagnostics and therapeutics – that we need to protect health.

How far has work progressed on the Centre for Vaccine Development and Evaluation?

We are hoping to launch that in the coming weeks. UKHSA is a unique organisation in many respects: we have a distinct contribution to make to vaccine development and evaluation, which is different from that of industry and academia. So our Centre for Vaccine Development and Evaluation is aimed at strengthening partnerships with industry, academia and other parts of government to make sure that we collectively develop, assess and take forward the vaccines that we need to protect health. We're planning the launch at the moment.

How will those partnerships change?

We work now and we've worked in the past with industry and academia, but my personal reflection is that we've done lots of very good projects, but we are hoping to have longer, deeper partnerships that are more intentional in terms of helping us align our efforts to achieve a set of developments and outcomes.

We've got some good examples – the government has recently entered into a partnership with Moderna to make sure that we were able to develop the research development and manufacturing capacity in the UK needed to produce mRNA vaccines, which were shown to be extremely successful during the pandemic and have the potential to make an important contribution.

What are some of the biggest challenges to achieving the goals of the science strategy?

There are a number of challenges. One is that health challenges can require a very demanding response. One of the unique contributions of UKHSA is that we bring together scientific expertise with unique data and an operational response – so clearly, the demands of the operational response can have an impact on the overall scientific development work.

But the biggest challenge that we face at the moment relates to the scientific workforce, making sure that we are able to recruit and retain the staff that we need. The strategy describes four key enablers: people, which is the most important one, and the area where I think our greatest challenge is; facilities - we need to continue to invest in our facilities to allow us to do the science that we need to do; our partnerships; and the ability to do research and to get additional funding externally for research. Those are the four critical enablers, or the foundations of the success of this strategy.

The strategy talks about attracting and developing the scientific leaders of the future. How does UKHSA plan to do that?

It is a challenge. We are very pleased about the recognition of the importance of the science and engineering professions in government – the former chief scientific adviser, Sir Patrick Vallance, did a lot of work in this area – and the recent review [of research development and innovation] undertaken by Sir Paul Nurse,

The science strategy talks about making sure that people have interesting and rewarding careers, and that we remove the barriers that exist for people to have a career that spans government, academia and industry. We continue to invest in the training of scientists through our PhD programme, but also in collaboration. So for example, through our partnership with Moderna, we are in discussions about joint PhD studentships with them. We already have a lot of programmes with academia in that area, but we are also aiming to provide more opportunities and flexibilities in terms of joint appointments, secondments and staff exchanges – and we're also discussing that with other parts of government.

We've got a very active National Laboratories Alliance that brings together a range of organisations and we are discussing how we can support each other to improve recruitment and retention of scientists more generally.

Across the civil service, pay is one barrier to recruiting and retaining specialists. Will UKHSA have any flexibility to address that?

It is a major barrier at the moment, sadly. I think part of the problems faced by scientists are the fact that in civil service, terms and conditions are designed with different roles in mind. So you might find that in our laboratories, people stay for quite a prolonged period of time and progress by deepening their knowledge and skills, and they're unlikely to move jobs and secure progression through civil service grades very quickly. That means that pay for scientists can be relatively low, and it is currently not competitive compared to other sectors – and that doesn't just include academia and industry, but also the NHS, for example.

An SEO in one of my laboratories will be one of the most senior people there, with a lot of skills and expertise – with multiple qualifications, doctorates and so on. That can be a difference in terms of other roles in the civil service.

What will UKHSA be doing to address the ongoing threats from Covid-19?

We have a whole programme of work on pandemic preparedness. We have established the Centre for Pandemic Preparedness to coordinate and oversee our efforts in this area and we are doing work from strengthening our surveillance and building on our genomic surveillance to make sure that we are able to monitor not just changes to Covid-19, but identify any new and emerging threats to health rapidly.

We're also working with partners globally to strengthen global surveillance, because a threat might arise anywhere and it's important that we do everything we can to detect it and control it at source before it spreads rapidly across the world. That includes helping a number of other countries, where we are sharing our genomics skills, expertise and capacity. We are also leading efforts in the UK on the 100 days mission – the initiative very much driven by the UK in the context of its G7 presidency a year or two ago to make sure that we learn the lessons from the pandemic and we have mechanisms to develop the diagnostics, vaccines and therapeutics that we need within 100 days of a new threat being identified.

What would you say the establishment of UKHSA has done for the coordination of science in the UK?

The creation of the UK Health Security Agency has provided an opportunity to think about what we need in this country to protect health and to build on that evidence from the pandemic about the importance of science and scientific advancement.

One of the things that it's helped us do is to increase the visibility of our science. There is fantastic science taking place in UKHSA that was not always very visible externally. It’s really important that colleagues, including colleagues across government, understand the capabilities, the evidence that we're generating, so that we can build on that. All of our scientific work is to inform public health action and policy, but it's not always very visible.

We’re hoping to build on that through our science strategy. That will also help us strengthen our partnerships because we'll know what we have to offer. When I travel internationally, invariably, everybody talks about the fact that our data – our pathogen-surveillance data, genomic-surveillance data – is the best in the world. It is used across the world by industries, academia and other governments. As we saw during the pandemic, it is really important that we unlock the potential of our scientific assets to secure better health outcomes and increase our contribution to economic prosperity, and that's what this strategy is trying to do.

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