Memorandum by the Wellcome Trust
The Wellcome Trust welcomes the opportunity
to respond to the House of Lords on this issue. The Trust has
recently responded to the Department of Health, regarding the
discussion document Getting Ahead of the Curve: Action to strengthen
the microbiology function in the prevention and control of infectious
diseases and the consultation documents, Health Protection:
A consultation document on creating a health protection agency
and PathologyThe Essential Service, Draft Guidance
on Modernising Pathology Services, where issues raised are
relevant to the work of the Trust.
The Trust is encouraged by the action of the
Science and Technology Select Committee in setting up a Sub-Committee
to consider and report on surveillance issues relating to infection.
In addition, the Trust agrees that public attitude, risk perception
and the media are also important factors related to this issue.
The six questions posed fall within the Trust's
remit, "to foster and promote research with the aim of improving
human and animal health", although we have kept our response
to a research focus, rather than one of general health policy,
with particular respect to the first three questions.
1. What are the main problems facing the
surveillance, treatment and prevention of human infectious disease
in the United Kingdom?
Isolate and strain collections, which have been
obtained through surveillance, need to be maintained, enhanced
and made more generally available to academic researchers. Research
into vaccination strategy, pathogenicity, antibiotic resistance
and improved intervention techniques require access to such resources
and collections. Development of new diagnostic techniques for
improved isolate characterisation also depend upon access to comprehensive
2. Will these problems be adequately addressed
by the Government's recent infectious disease strategy, Getting
Ahead of the Curve?
It appears from Getting Ahead of the Curve,
that the research budget of the Public Health Laboratory Service
(PHLS) will pass to the National Health Service (NHS) under the
proposed changes. The Trust considers that these funds should
remain ring-fenced for public health, both within NHS and the
Health Protection Agency (HPA). If adequate government funding
of research and development into public health is not protected,
there could be a risk to surveillance and hence treatment and
prevention of human disease. The development of new vaccinations,
diagnostics and intervention methods rely extensively on such
collections. Alternatively the formation of the HPA could be taken
as an opportunity to strengthen this area within the UK science
base and attract researchers into this area.
3. Is the United Kingdom benefiting from
advances in surveillance and diagnostic technologies; if not,
what are the obstacles to its doing so?
The Trust considers that although currently
the UK has a strong expertise in this area, the UK may not currently
be benefiting fully from advances in surveillance and diagnostics,
and this could in part be due to the current structure of the
PHLS. The reorganisation proposed in "Getting Ahead of the
Curve" could therefore be an opportunity to make dramatic
improvements in this area. However, there is also a risk that
if the changes are not either adequately funded or managed, the
situation in the UK could worsen rather than improve.
Because of the similarity of a response to this
Call for Evidence, to that recently submitted by the Trust to
the Department of Health, we enclose a copy of our response concerning
the Health Protection Agency (HPA) and modernisation of pathology
services, which we hope may be of interest to the Committee. Please
do not hesitate to contact us if you require further information
on the issues discussed.
The Trust would like to draw the attention of
the Committee to the consultation exercise regarding the formation
of the HPA and modernisation of pathology services, which was
rather restrictive in response time.
In conclusion, the Trust is concerned that aspects
such as the funding and organisation of research and development
under the proposed HPA may not have yet been fully considered
or addressed under the proposed new structure due to come into
force in March 2003. I have written to the Chief Medical Officer
for clarification on these issues. The Trust considers that such
reorganisation should be used as an ideal opportunity to strengthen
the UK research base in public health and infectious disease surveillance
and increase links to the academic community.
We hope our response is helpful to the Committee.