Throughout the pandemic, debate has swirled around the relationship between science and Government. This debate has been fierce, loud and challenging. But beneath the noise, there is a history of successive UK Governments of different political parties working with and backing a sector that is now at the heart of our way forward.
Back in early 2010, the Royal Society, at the request of the Government, prepared a plan for science research spending against three possible scenarios: a 0%, 10% and 30% cuts in cash terms. The Budget that followed ushered in an array of spending cuts, but UK science was one of only two areas of spending (the other being international aid) protected by the Conservative-led coalition. Shortly after the announcement, the then Universities Minister David Willetts appeared on radio and praised the ability of the sector to provide the necessary evidence to show it was a vital national asset worth safeguarding.
Fast forward a decade, and the world is benefitting from this decision. UK science has been at the forefront of finding answers to our current predicament from cutting edge research using genomics to developing new treatments for the disease. The vaccine developed by Oxford University and British based AstraZeneca will likely be rolled out most extensively, given both its lack of cold storage requirements, and the commitment by the manufacturer to make it available on a non-profit basis to low and middle income countries.
How would a 30% cut in the 2010 Budget have impacted on our ability to generate such discoveries into COVID-19? We cannot absolutely know for certain, but the UK’s ability to punch above its weight in the development of scientific solutions to the pandemic has certainly benefited from consistent and supportive science policymaking.
Much has already been written about the role of British scientists in the development of the Oxford/AstraZeneca vaccine, and also in the identification of dexamethasone, the steroid which costs just £5 per patient and is now used worldwide for the most severe COVID-19 cases which require oxygen support. But there was further good news last week with the announcement from the Prime Minister that two further medicines can be added to the armoury of NHS clinicians in the battle against COVID.
Tocilizumab and sarilumab, part of a group of drugs known as IL-6s normally used in rheumatoid arthritis, have been shown in UK-run trials to be effective in the most unwell patients. This is all the more striking given that earlier trials led by the manufacturers concluded that the drugs didn’t discernibly improve outcomes, yet an Imperial College London study found that mortality reduced from 35% to 28% in ICU patients when used in combination with dexamethasone within 24 hours of starting organ support. In layman’s terms, this means that of 100 people admitted to intensive care, seven pulled through who would have otherwise died from COVID. Extrapolated to the current situation facing the NHS, it could mean that hundreds of people are able to celebrate next Christmas with their loved ones who might otherwise not have been there.
When the new, more transmissible variant of the virus was found to be circulating in large numbers in the South East of England and London, the first response of many international countries was to understandably tighten up travel restrictions to Britain. But it was only due to a commitment by the UK Genomics Consortium to sequence one in 20 infections that the variant was picked up as quickly as it was. The UK has in total sequenced more than 170,000 virus genomes to date – staggeringly this equates to about 50% of all those sequenced worldwide. How is it possible that the UK can be performing half of all virus sequencing on the globe? The answer lies in a decision in 2012, when David Cameron personally led a national mission to commit the UK to sequence 100,000 genomes – the first time such a feat had been attempted in the world. By the time that Genomics England had finished the 100,000 genome in 2018, the UK had a genuinely world-beating genomics industry made up of university, Government and commercial entities. This meant that when COVID struck in March 2020, we had a ready-made set of partners to form a sequencing consortium, backed by £20m in funding from UK Research and Innovation (UKRI). It is this consortium which helped to map the spread of the new variant and enabled Governments internationally to make sense of the rapid increase in cases, despite the introduction of lockdowns.
This pandemic has presented fundamental challenges across Government on effective policymaking and execution. The example of the life sciences sector presents a case study with a number of important working parts. First, there is a need for Government leadership. The life science sector has benefitted from support and sponsorship from successive Prime Ministers.
Gordon Brown was a champion for research spending as both Chancellor and Prime Minister and oversaw the creation of the Technology Strategy Board in 2007 which was renamed as Innovate UK and has now been subsumed within UKRI. His successors have maintained this commitment, from the Sir Paul Nurse review commissioned by the Coalition, to Theresa May’s Industrial Strategy which put UK science at its centre, and now to our current Prime Minister with his manifesto commitment for the UK to spend 2.4% of total GDP on research and development.
Second, is the need for a long term view. The best policy development is cumulative, where successive administrations show patience to commit to sectors, ride out periods of uncertainty, and take the outcomes and dividends beyond the pitfalls of the political cycle. UK science is in many ways an example of this: a policy area that has benefitted from support across the political divide.
Third, is investment. The protection of investment in R&D has helped build up knowledge, resilience and capability that has driven the UK life science response and the benefits that are now being seen. This investment needs to be balanced judiciously between backing low-risk, medium return projects and also a number of higher risk, high return projects with a 10-15 year horizon. As argued by Policy Exchange in earlier research, the commitment to establish a British equivalent to ARPA creates the right vehicle for the latter – and it is important that this Government’s science risk appetite does not wane in the aftermath of the crisis.
Finally, partnership. The scale and impact of the pandemic has demonstrated that like all major policy challenges, no one organisation, department or group has the answer. It is only by bringing together the best from Government, academia and the private sector that complex challenges can be fully tackled.
For Government these building blocks present significant hurdles to wider policy adoption. Not everything can be a number 10 priority, a target for investment and long term plans inevitably hit short term political headwinds. With significant financial challenges ahead however, it will be more important than ever that the Government perseveres in backing a sector that can not only deliver us from the current pandemic but also deliver a stronger economic and healthier future. Following the science long term remains the right course.
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