Chief Medical Officer annual reports and lectures
Chief Medical Officer for England, Professor Chris Whitty's annual reports and lectures on medicine and public health.
Lectures
These talks are aimed at the general public who are interested in medicine and public health, or have a medical condition (or have friends or relatives with one) and want to know more background to the disease, its diagnosis and treatment.
Some cover wider issues in public health including air pollution, vaccination, screening and obesity. They also address individual diseases or conditions like major cancers, cardiovascular disease, dementia and infections. They are not a substitute for individuals discussing with their doctors, as all situations are unique, but they explain some of the key facts, backgrounds and trends.
Written and presented by Professor Chris Whitty, they represent a personal view on each subject. These were given at Gresham College where a wider selection, including on international health, are available. Medical science moves fast so please note the date the talk was given.
Public health
The role of the state in public health, and its limits, October 2020
The respective roles of the state, the medical profession and the individual in improving health is an important question in public health. This lecture explores the areas government is perceived to be responsible for in health, ones where the public believe government should have no role, and the areas where medical professionals provide a third dimension to a triangle of responsibility with the public and the state.
The changing geography of ill health, November 2020
In the UK and globally, the geography of ill health has shifted widely over time and it continues to do so. Deprivation, ageing, physical setting, geography and behaviours all have a role. Specific geographical areas have particular health challenges including coastal, rural and inner-city areas. This lecture considers the shifting geography of ill health and its implications.
Trends in health over time in the UK: the implications for the NHS, May 2021
What the NHS has provided and had to treat over its existence has changed significantly over time. The next 2 decades of changes in health will be as striking as any seen previously. This lecture addresses some of the past trends in health and predictable changes in health the NHS will need to address.
This lecture explains how vaccines came to play such a central role in healthcare, and the role they serve today in tackling an increasing range of diseases, including new threats like COVID-19.
Air pollution: its impact on health and possible solutions, April 2018
Lung disease, heart disease, stroke, dementia and learning difficulties have all been associated with different forms of air pollution, including gases and particulate matter. This lecture considers the evidence for different forms of air pollution causing diseases and outlines some of the potential solutions.
Screening: when is it useful, when is it not? January 2021
Screening is considered one of the most powerful tools in public health. It can detect disease early, but can sometimes be useless or even harmful. This lecture considers the situations where screening can help and those where it does not.
The rising prevalence of obesity is a major threat to the current and future health of individuals, the public and the NHS. This lecture considers the health effects of the rise in obesity if we do not address it, and a framework for solutions.
The shape of things to come: future demography around the world, February 2015
Much attention is given to the total number of people living on the planet but less is given to the shape of the demographic profile of countries. This lecture considers what drives the shape of the population structure, ranging from the control of infectious diseases through contraception to internal migration, and the likely social and economic implications of this over the next 30 years, especially for health.
The future of health globally, May 2022
Global health is improving at a remarkable pace due to a combination of medical science and development. Childhood deaths and the diseases of young adults are falling rapidly, and scientific advances are transforming the major chronic diseases and cancer. This lecture pulls together threads from many previous lectures to consider what is likely to happen to health globally over the coming decades.
Infectious diseases and infections
Epidemics
The eradication of infectious diseases, April 2017
Eradicating an infectious disease for all time is one of the greatest gifts a generation can give to all subsequent ones. To date only one human disease, smallpox, has been eradicated. Eradicating diseases is very difficult for scientific, operational and political reasons. This lecture examines the opportunities and difficulties of eradication.
Infections as we go through life and age
The changing impact of infections as we go through life and age, May 2019
The immediate and long-term effects of an infection change throughout our life course. This lecture explores the changing patterns of what makes disease severe as we progress through life, and the implications for treatment and prevention of disease.
Infections and the brain, November 2018
The brain is well protected against most infections, but once they get into or around the brain they can cause fatal or serious long-term consequences. This lecture covers infections that get into the brain, what their effect is and what we can do to prevent and treat them. It includes bacterial and viral meningitis, encephalitis and parasitic diseases.
Infections of the lung and heart, February 2019
We are making substantial progress against diseases of the lung and heart, such as rapid reductions in bacterial pneumonia in the young and a gradual reduction in tuberculosis globally. This lecture covers common and uncommon infections of the lung and heart.
Infections of the abdominal organs, March 2019
Our gut is permanently full of large numbers of bacteria and other organisms, but serious infection from them is relatively rare due to its extraordinary immune system. This lecture will consider infections that normally live inside our gut, how the body keeps them there and what happens when this fails and causes serious illness.
Infections and the nerves, January 2019
Certain infections have a particular impact on the peripheral nerves as part of their normal disease process, which can cause loss of voluntary movement or sensation. This lecture will cover how infections can interfere with peripheral nerves and recent progress made against these diseases.
The main routes of infection transmission, and their controls
Insect and other vector-borne diseases, October 2021
Malaria, sleeping sickness, typhus, dengue, Zika and plague are examples of diseases transmitted by insect vectors, such as mosquitoes, flies, fleas and ticks. This lecture explores several of these diseases and the approaches that can be used to break the cycles of transmission.
Food and drink borne diseases, November 2021
Many major diseases are transmitted by food or drink. Cholera (water), brucellosis (milk), BSE/nvCJD, typhoid and many parasites are ingested as part of a normal diet. The more varied the diet, the greater the range of possible infections. This lecture will cover several of these diseases and discuss approaches which can substantially reduce them.
Sexually transmitted and intravenous infections, January 2022
Some diseases are specialised in using sexual behaviour for transmission. Major pandemics including HIV and syphilis have been transmitted via this route, along with the cancer-causing infections hepatitis B and HPV. Several diseases, including HIV and hepatitis, can also be transmitted through the use of needles. This lecture discusses these diseases in more detail and the methods used to control them.
Infections which use the respiratory route, February 2022
COVID-19, pandemic influenza and tuberculosis are examples of the remarkable ability of infections to use the respiratory route of transmission. Infections which use this route can often spread very quickly, especially in crowded indoor environments. Human behaviours and engineering should be seen as much a part of our defences against respiratory infections as drugs and vaccines, as this lecture will explore.
Infections that use touch to transmit, March 2022
Some diseases are spread almost exclusively by touch or through the skin or mucus membranes. These include Ebola, several parasitic diseases such as hookworm, strongyloides and scabies and some bacterial and fungal infections. Other diseases, such as COVID-19 and influenza, are mainly transmitted via other routes but use touch as a secondary method of spread. This lecture discusses methods for controlling these diseases, including the role of isolation and sanitation.
Chronic diseases
Diabetes: a rising tide, November 2017
Diabetes is an increasingly common disease and causes raised blood sugar with serious long-term consequences. This lecture considers the epidemiology, prevention and treatment of diabetes and recent advances in the science of type 1 and type 2 diabetes.
Asthma and chronic airways disease, February 2018
Asthma, an intermittent disease, is the commonest lung disease in the UK. The second is the debilitating chronic obstructive pulmonary disease (COPD). This lecture considers trends and advances in these 2 major diseases and the genetic lung disease cystic fibrosis.
Keeping the heart young in an old body, November 2015
The heart was the organ that, until recently, aged fastest in wealthier societies, with death and disability from heart disease common in otherwise healthy people. This lecture considers how keeping the heart relatively young in the elderly has been achieved in incremental steps, and the implications for other problems.
Coronary heart disease, January 2023
Coronary heart disease, mainly caused by the narrowing and blockage of the heart arteries, causes angina, heart attacks and heart failure. While public health interventions and improvements in treatment have steadily reduced deaths from coronary heart disease, it remains one of the commonest causes of mortality in the UK and globally and angina is a common debilitating condition. This lecture discusses the causes of coronary heart disease and medical advances in reducing its effects.
Rhythm disturbances of the heart, February 2023
Our bodies depend on our hearts maintaining a steady beat and increasing it appropriately in response to exercise or other need. If the heart goes too fast, or too slowly, it can have significant effects on the body, ranging from tiredness, to passing out, or to death. This lecture considers the normal heartbeat, the diagnosis and causes of the heart going too fast or slowly and how it is treated when it does.
Diseases of the heart structure, muscle and valves, May 2023
The normal heart is very robust. However, some people are born with abnormalities of the heart structure, while others acquire damage to the heart valves which become too narrow or unable to close properly. The muscle and linings of the heart can also be affected by infections, drugs or other inherited or acquired diseases. All of these can cause heart failure or death if not treated. This lecture considers the prevention and treatment of structural heart conditions and disease.
Stroke in the elderly: slowly retreating, February 2016
The risk of stroke steadily increases with old age, but in relative terms both the risk of having a stroke and disability as a result of stroke are decreasing. This talk covers the improvements in prevention and treatment of stroke, including by reduction in hypertension and the use of blood-thinning and clot-busting drugs.
Dementia: at risk of being forgotten? April 2016
This lecture covers the epidemiology of dementia, the types of dementia, how different dementias affect the brain, the major dementias of old age, living with dementia and looking to the future.
Cancers
The outlook for many cancers has substantially improved. This series of talks explain how.
Breast, uterine and ovarian cancers, November 2019
This lecture considers evolving treatments for breast cancer, uterine (womb) cancer and ovarian cancer, common cancers in women. It looks at the importance of genetic markers and hormonal treatments, as well as approaches to prevention and screening. The outlook for breast cancer has improved substantially, and this talk lays out how and why early diagnosis is so important.
Prostate and testicular cancer, January 2020
The most common cancer in men in the UK is prostate cancer, making up around a quarter of all male cancer diagnoses. This lecture looks at the steady improvement in treatment for prostate and also testicular cancer, which occurs in earlier life. For both, the prognosis is much better than it was.
Lung cancer and mesothelioma, February 2020
Lung cancer is the second most common cancer in both men and women, but the most important in terms of deaths causing just under 25% of all cancer deaths. This lecture covers the epidemiology of and prevention of lung cancer, and current trends in treatment.
Bowel cancer and digestive cancers, December 2020
Bowel cancer is the third most common cancer in both men and women. Other cancers of the gut are changing incidence: stomach cancer rates are falling, while oesophageal cancer is increasing in men. This lecture considers the prevention, diagnosis and treatment of these cancers.
Infection, immunity and cancer, October 2019
This lecture considers cancers caused largely by infections, including cervical cancer and some liver cancers, and how they can be prevented or treated. It also shows how understanding the importance of the immune system has led to new avenues for the treatment of cancer using the immune system (immunotherapy).
Lymphoma, leukaemia and myeloma, April 2021
Lymphoma, leukaemia and myeloma arise from different parts of the white blood cell system. Unlike solid tumours they are widely distributed in the body, and this means they need a different approach. The outlook for people with these very different cancers varies, but in all cases it is improving, and in some types over 90% will be cured.
Other emergencies
Reducing harms after nuclear, radiological and chemical incidents
Nuclear, radiological and chemical incidents have the potential to cause major harm. This lecture explores the basics of each type of incident, its health effects and how to minimise them by relatively simple measures. The lecture focuses on radiological incidents in particular and reducing harm through reducing the dose.
Health after Earthquakes, Volcanoes, Tsunamis
Major geophysical events such as earthquakes, tsunamis and volcanoes can occur with little or no warning and have catastrophic effects. This lecture will consider the health impacts of these natural disasters and how best to minimise them. Trauma often dominates the first days after the initial event but predicting the medium-term effects such as infectious diseases can head off predictable secondary health disasters over the medium and long term.
Annual reports
As CMO, Professor Chris Whitty publishes independent annual reports, presenting information about the health of England’s population to the government. These reports provide recommendations to government, and individual organisations, to make improvements to the health of the public.
Chief Medical Officer’s annual report 2023: health in an ageing society
The report focuses on how to maximise the independence, and minimise the time in ill health, between people in England reaching older age and the end of their life. The report recommends actions to improve quality of life for older adults and prioritise rural, coastal and other peripheral areas that will see the fastest growth in the proportion of older adults. Many people in older age live with multiple conditions (multimorbidity). Medical training, NHS services and research need to respond to this reality.
Chief Medical Officer’s annual report 2022: air pollution
The report highlights achievable solutions across different sectors and makes the case that we need to continue to be active in reducing outdoor air pollution. The path to better outdoor air quality is clear. However, indoor air pollution is becoming an increasing proportion of the problem as improvements in outdoor air pollution occur. We need a better understanding of how we can prevent and reduce indoor air pollution.
Chief Medical Officer’s annual report 2021: health in coastal communities
This report highlights the health disparities in coastal communities compared to their inland neighbours, exploring the drivers of poorer health outcomes, the key challenges these regions face and recommendations to address these. The report includes case studies from 10 directors of public health in coastal regions, and analysis by the Office for National Statistics, Plymouth and Exeter Universities, Health Education England and Public Health England.
Chief Medical Officer’s annual report 2020: health trends and variation in England
This report lays out key trends and data about health in England. It highlights the importance of health surveillance in monitoring trends and prioritising areas for action. After a brief section on the coronavirus (COVID-19) pandemic in England, the main report consists of charts that present a broad and high-level overview of the nation’s health. A key theme is the variation in health that exists across different dimensions: over geographies, over time, and between groups of people. Where variation and inequality exist and are recognised they can be tackled.
COVID-19 technical report
In December 2022, the UK Chief Medical Officers, Government Chief Scientific Adviser, UK Deputy Chief Medical Officers, the NHS England National Medical Director and UK Health Security Agency Chief Executive published a technical report on the scientific, public health and clinical aspects of the COVID-19 pandemic in the 4 nations of the UK.