Coronavirus is not a one off. We’re hurtling into a decade of health crises

There is no incentive for research into low probability, catastrophic events such as Covid-19. It will only happen if government is willing to commit and fund it, writes Chris Thomas

Covid-19 has highlighted the fragility of health in this country (PA)

It would be comforting to think of Covid-19 as a once in a lifetime event. We’d curse our bad luck, but broadly look to go back to normal.

Unfortunately, this is a fantasy. Covid-19 is not a one off. Rather, it is part of a trend of growing global health challenges, posing an ever more persistent threat to our lives and our economy. There is no going back to normal.

Covid-19 is a symptom of a world where health security has become incredibly fragile. World Economic Forum analysis shows that the number of countries reporting a “major disease outbreak”, in any given year, has now doubled since 2010. Such acceleration is alarming – and almost mimics the exponential way in which diseases like Covid-19 spread.

It is not just pandemics that pose a threat. Antimicrobial resistance – the trend of diseases becoming able to withstand treatments like antibiotics – continues to loom large. Currently, it’s associated with 700,000 deaths each year globally. The doomsday scenario would see tuberculosis, infected cuts and pneumonia once again become leading killers.

Even if we can avoid this dystopian fate, the disease burden is shifting in ways that pose grave challenges. Mortality associated with dementia is rising sharply, while a treatment still eludes us. The impact of mental health is also rising, reducing quality of life.

No single action will guarantee UK resilience. But there are few more effective safety nets than research and development (R&D). Scientific and technological progress has done more than almost anything else to extend and improve life in recent history – penicillin, vaccinations, the doubling of cancer survival over the last 40 years.

Government rhetoric has been reassuring. The prime minister has spoken about “supercharging science”, becoming a “science superpower” and building a “science-based economy”. He has recognised the important role R&D will play after Covid-19.

But delivering such commitments won’t be easy. The UK has often been at the forefront of health invention – from Watson and Crick discovering the DNA molecule’s structure, to Frederick Sanger designing a method to sequence human genomes, to modern genomic medicine. But, today, our position is under threat. We have invested too little, and too narrowly since the 1980s – while new competitors have emerged internationally, ready to take our throne.

Business as usual won’t be enough to keep the UK at the forefront. We must optimise and scale up our approach. That means tackling three challenges that we have allowed to fester.

First, we need to rapidly increase investment. The UK simply doesn’t spend enough on science. Compared to the average for advanced economies, across all types of R&D, our underinvestment totals £222bn since 1985. Rectifying that means attracting global private investment; investing more public money, and supporting our medical research charities – many of whom have taken huge financial knocks during Covid-19.

Second, we need to level up and extend opportunity across the whole country. Current policy acts as though the UK is just three city-states – London, Oxford and Cambridge. Recent IPPR research showed the north receives just half the health research funding found in the south. Yet, the north does have huge strengths – from medical technology in Yorkshire, to health data in Manchester, to health economics in Tyneside. They need support just as much as the “golden triangle” does.

Finally, we need be better at linking R&D to the country’s health needs. This means R&D on conditions that have been historically ignored. For example, mental ill health is one of the country’s biggest challenges, but R&D investment just hasn’t kept up. We should have mechanisms to accelerate the kind of R&D people in this country want and need, including preparing for future pandemics.

There is currently a lack of incentive for research into low probability, catastrophic cost events, like Covid-19. It will only happen if government are willing to commit, fund and drive it forward.

Covid-19 has highlighted the fragility of health in this country and the need to invest in the science that will underpin our resilience. Entering the 2020s without a progressive health R&D strategy would be like building a house on a volcano and not taking out insurance – an invitation to disaster.

Chris Thomas is a health research fellow at the Institute for Public Policy Research (IPPR)