Matt Hancock’s ‘kneejerk’ call to axe Public Health England could ‘risk a reversal’ of HIV progress, leading organisations warn

Matt Hancock HIV

Following the announcement that Public Health England is to be replaced by a new National Institute for Health Protection, leading HIV and sexual health organisations have warned that the changes “could risk a reversal of the progress that has been made to date”.

On Tuesday (August 18) health secretary Matt Hancock announced the formation of a new public body to replace Public Health England (PHE).

Hancock unveiled the National Institute for Health Protection (NIHP) while speaking at the Policy Exchange think tank, and said in a speech: “To give ourselves the best chance of beating this virus and spotting and tackling other external health threats now and in the future, we need to bring together the science and the skill into one coherent whole.”

The NIHP, Hancock said, would bring together “the expertise of PHE with the enormous response capabilities of NHS Test and Trace and the Joint Biosecurity Centre to put us in the best possible position for the next stage of the fight against COVID-19 and for the long term”.

He added that its “mission” would be “the investigation and prevention of infectious diseases and external health threats”.

But five leading HIV and sexual health organisations have warned that a “kneejerk” restructuring of England’s public health system could risk backtracking on the progress made in HIV prevention and sexual health.

Terrence Higgins Trust, National AIDS Trust, British HIV Association, British Association for Sexual Health and HIV, and the UK Community Advisory Board HIV treatment advocates network said in a joint statement: “The secretary of state’s speech today leaves us with more questions than answers.

“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.”

The five organisations called for “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”.

They continued: “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.”

Public Health England decision focused on “external” threats, rather than current problems like HIV.

The groups said that the announcement’s focus on “new” and “external” health threats did not acknowledge “the public health emergencies that already exist in the UK”.

While an emphasis on the current COVID-19 pandemic is right, they added, “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,” the organisations insisted, “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.”

They continued: “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.”

The letter called for the protection of PHE’s prevention and policy work in sexual health, including its commitments “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, and to oversee the development of a much-needed new national sexual and reproductive health strategy”.