UK political parties pledge to strengthen security—yet ignore health security (2024)

Although all the political parties vying for votes in the forthcoming elections refer to the covid-19 pandemic, they have surprising little to say about preventing future ones, say Kent Buse and Martin McKee

Use of repetition as a debating device has characterised the 2024 general election campaign in the UK. The same questions are asked, and the same answers are given. At some point in most recent debates, a Conservative candidate will be asked why the British economy has performed so badly and they will inevitably blame the covid-19 pandemic and the Russian invasion of Ukraine. Similarly, a question about NHS performance, perhaps asking why waiting lists are increasing, will also be attributed to the pandemic. Questions about trust in politicians will, almost certainly make reference to “partygate,” which led to current and former prime ministers Rishi Sunak and Boris Johnson being fined for breaches of public health rules.1 In these and other ways, the pandemic has cast a long shadow over this election.

In these circ*mstances we might expect that the parties would have something to say in their manifestos about how to reduce the risks associated with another pandemic, either because of a novel pathogen or an existing one that develops antimicrobial resistance—sometimes referred to as the silent pandemic. But have they?

The Conservative Party has traditionally sought to portray itself as strong on national security. In previous campaigns it differentiated itself from the other parties by its support for the UK’s nuclear deterrent. Therefore, it is not surprising that the word “security” appears 49 times in its manifesto.2 These references to security cover financial, economic, national, border, international, European, collective, maritime, food, and the security services. Even if the word pandemic is not mentioned in the manifesto, it seems reasonable to assume that threats from micro-organisms will feature in the party’s proposed “National Defence and Resilience Plan” covering the UK’s security, preparedness, and resilience as a nation to risks on the national risk register.

Security also features frequently in Labour’s manifesto, appearing 55 times.3 Mostly it is in relation to security of energy, national borders, or food. No specific mention is made of health security, pandemic preparedness, or response plans. Labour does pledge to appoint a fixed term covid corruption commissioner, with wide ranging powers to recoup the vast sums lost from fraud and contracts that failed to deliver during the pandemic, although it will not be easy to track down the individuals or sums of money involved.4

Pandemic preparedness is largely absent from the manifesto of the Liberal Democrats, except to pledge increased support for people with long covid.5 Nothing is in the manifestos of the Green Party or Reform UK about health security.67 Elsewhere, Reform UK leader Nigel Farage has described a global pandemic threat as being “just as bad as being in the European Union” and called for the UK to adopt a “Trump-like approach”.8 Their manifesto pledges to cancel the UK’s membership of the World Health Organization—the very organisation with a mandate to support international cooperation on urgent matters around pandemics.

Antimicrobial resistance—an area where the UK is widely recognised as a global leader thanks to the tireless work of former chief medical officer Sally Davies9—is a little more prominent in the manifestos. The Conservative Party commits to “scale up high impact, cost effective global health interventions, including maternal nutrition and antimicrobial resistance, for benefit at home and overseas”. The Liberal Democrats, which unlike Conservative and Labour have committed to rejoining the EU’s single market (a view supported by a clear majority of the British public10), has pledged to match the EU’s stricter rules on preventive use of antibiotics and to introduce a plan to tackle antimicrobial resistance in farm animals. The Green Party will push for an end to factory farming, enforce maximum stocking densities of farm animals, and prohibit the routine use of antibiotics in livestock. The Labour manifesto does not mention antimicrobial resistance, and its only mention of infection and agriculture is about eradicating bovine tuberculosis. Reform UK has nothing to say on this topic. These omissions are concerning given the existential threat that antimicrobial resistance poses.

The first duty of a government is to protect the lives of its citizens. The evidence already heard by the UK’s covid-19 inquiry leaves no doubt that, in many respects, the British government failed to do this. More than 220 000 people lost their lives.11 Dithering and delay in responding meant that death rates in the first wave of the pandemic were higher than in other European countries.12 Vast sums of money were wasted in dubious purchases of personal protective equipment and other supplies.13 And even before the UK has recovered from the covid-19 pandemic, the threat from avian influenza is already looming.14 In these circ*mstances, the virtual absence of any ideas from the various manifestos seems surprising, especially given other issues that the parties have chosen to emphasise, such as the number of potholes they hope to fill.

Both pandemic preparedness and antimicrobial resistance are classic examples of topics demanding a “health for all policies” approach involving collaboration across sectors.15 Effective responses will require co-ordinated actions across and between governments. Voters may want to know how the parties plan to do better next time a pandemic occurs. Given the enormous damage the last one had on the country, it seems an important question.