Policy paper

Introduction and principles (UK wide)

Published 25 March 2026

This part of the strategy applies to the whole of the UK.

Introduction

Context

Since the start of the 20th century, the UK has faced 6 major pandemics, with COVID-19 being the UK’s most severe since the 1918 to 1920 H1N1 influenza outbreak. In the UK, COVID-19 killed over 200,000 people and left significant proportions of the population with long-term health consequences. Communities experienced significant loss, grief and isolation, and many of those already facing inequalities experienced higher levels of death, illness and financial loss.^{[footnote 1]}

As we saw during the COVID-19 pandemic, measures to control pandemics can also disrupt supply chains, labour markets, education and other services. This can then:

• exacerbate and widen inequalities
• harm mental health and wellbeing
• cause significant social and economic upheaval in the short and long term

While pandemics of this scale are rare, major epidemics are far more common and milder pandemics still cause significant damage. A future pandemic is a certainty - we just don’t know when it will happen or what will cause it. It would most likely be caused by a virus, though it could also be caused by bacteria or fungi. It could be spread by one or more of the routes of infection transmission, with the 5 main transmission routes being:

• respiratory
• oral
• blood or sexual
• touch
• vector borne (when infection is transmitted through a living organism such as a mosquito)

As outlined in the UK government’s Chief Medical Officer’s annual report 2025: infections, recognising transmission routes is central to building capabilities for pandemic preparedness.

Any strategy to prepare for a future pandemic must acknowledge that:

• no 2 pandemics, even if caused by the same pathogen, are identical
• a future pandemic could spread through one or more routes of transmission
• the most affected or vulnerable groups differ each time

The ‘reasonable worst-case scenario’ in the National Risk Register 2025 projects 50% of the UK population falling ill, with 1.34 million hospitalisations and 840,000 deaths, in an unmitigated respiratory pandemic.

Pandemics are the highest-impact natural hazard in the National Risk Register, with evidence suggesting likelihood has increased over the past century.^{[footnote 2]} Climate change, shifts in land use (such as deforestation), intense farming methods and urban expansion, and increasing global mobility are creating new opportunities for diseases to emerge and spread. Advances in technology and geopolitical challenges increase the risk of pandemics with unnatural origin.

Global preparedness for pandemics is also shifting. There is greater global investment in life sciences than ever before and the historic World Health Organization (WHO) Pandemic Agreement adopted by the World Health Assembly demonstrates appetite for continuing international collaboration.

On the other hand, the global context is shifting - protectionism is rising, the full impacts of reduced international donor funding are still emerging and the roles of prominent actors in global health security have changed. As the UK government’s National Security Strategy 2025 acknowledges, international co-operation may become more challenging.

Our approach to pandemic preparedness needs to be agile and reflect this changing world order. This includes considering how to better collaborate and share information internationally so that there is an effective ’global radar, and how to protect supply chains and use multilateral relationships to their best effect. It also includes co-ordinated ways to develop methods and building blocks for the rapid development of countermeasures.

A new Pandemic Preparedness Strategy

The new Pandemic Preparedness Strategy outlines the commitment of all 4 nations of the UK to rebuild our readiness and prepare our underlying capabilities for future pandemics, taking a whole-of-government and whole-of-society approach prioritising the needs of the most vulnerable.

The strategy prioritises cross-government and cross-UK co-ordination through joint planning, integrated response frameworks and clear governance structures. This will ensure that, in future, we are positioned to take rapid, co-ordinated action to protect all communities equitably, and minimise the disruption and damage to people’s lives.

Pandemic planning should reflect a joined-up approach to risk. It will require the private and public sector to work together.

This strategy reflects on lessons from the COVID-19 pandemic and the UK Covid-19 Inquiry and early findings from the national pandemic exercise (‘Exercise Pegasus’), which aimed to test our ability to respond to a pandemic, and involved all regions and nations of the UK and thousands of participants.

Exercise Pegasus intentionally tested a different scenario to what we faced in previous pandemics to help ensure that we are learning lessons and testing our planning for threats we have not encountered before, rather than just the previous pandemic. The strategy builds directly upon the foundations of the UK Biological Security Strategy, with a focus on the unique, systemic challenge of pandemics.

Diseases do not respect borders. The COVID-19 pandemic - and, more recently, lessons learned through Exercise Pegasus - have demonstrated the crucial importance of governments across the UK working together while also respecting and taking full account of devolved areas of responsibility. That is why this strategy reinforces our commitment to working in partnership across all 4 nations of the UK.

Well established areas of collaboration across the 4 nations already include:

• co-ordinated surveillance mechanisms between the UK Health Security Agency (UKHSA) and the public health agencies of Scotland, Wales and Northern Ireland
• co-ordinated procurement exercises for vaccines, medicines and personal protective equipment (PPE)
• shared data platforms

There are also other specific areas where we will continue to develop and maintain a collective 4 nations approach to our capabilities, including testing, research and development (R&D) and surveillance. Other potential areas for close 4 nations collaboration - including, but not confined to, ports and borders, and use of public health and social measures - should also be considered.

Working together with the Republic of Ireland is also essential because Northern Ireland and the Republic of Ireland share an island and a land border and, as part of the Common Travel Area arrangements, there is free movement of people between the UK and the Republic of Ireland.

In support of this joined-up approach, all 4 nations endorse the principles set out in this strategy.

The COVID-19 pandemic also demonstrated why the UK, Crown Dependencies and Overseas Territories must continue to work together on pandemic preparedness and response planning.

Resilience of the UK

Within this context, our readiness for future pandemics needs to be underpinned by both health system resilience and wider system and population resilience, and a flourishing private life sciences sector. The COVID-19 pandemic highlighted that we must not only be capable of responding to a pandemic - we must also be able to maintain essential services.

The UK government’s commitment to this has been outlined in the 2025 UK Government Resilience Action Plan, which looks to strengthen the public sector resilience system and enable the whole of society to take action to increase its resilience. Similar commitments are set out in the Wales Resilience Framework 2025, which highlights that the UK’s overall resilience is built on a foundation of our collective efforts.

The refreshed UK Biological Security Strategy also sets out the UK’s vision to be resilient to biological threats and a world leader in responsible innovation by 2030, improving health, economic and security outcomes through a ‘One Health’ approach.

Global health security

While domestic resilience is vital in being prepared for future pandemics, UK readiness depends on global resilience. The world order is changing, and any strategy for pandemic preparedness needs to reflect this.

The UK government remains committed to global health security through bilateral and multilateral engagement and support for multilateral organisations and global health initiatives, championing a One Health approach. The WHO Pandemic Agreement marks an unprecedented opportunity to turn difficult lessons from COVID-19 into lasting reform by strengthening global prevention, preparedness and response.

The UK also continues to advocate for global investment in pandemic prevention and preparedness, and provides support for strengthening public health systems in low and middle-income countries, including funding R&D for clinical countermeasures. When outbreaks occur in low and middle-income countries, the UK’s capabilities include emergency medical and public health support to help contain them at source and prevent potential pandemic emergencies.

Closer to home, the government is strengthening health security co-operation with the EU, as the UK’s closest neighbour. At the first UK-EU Summit in 2025, it was agreed to explore opportunities for exchange and co-operation on the detection of, preparedness for and response to emerging health threats, including within the existing health security provisions of the Trade and Co-operation Agreement.

Our principles for preparedness

The core principles of this strategy reflect lessons from COVID-19 and other past disease outbreaks to improve our ability to:

• detect, respond to and mitigate the impacts of a pandemic
• protect the vulnerable
• save lives

All 4 governments in the UK will develop and implement their approaches to improve preparedness, and will work together to develop cross-UK capabilities, following these guiding principles.

1. Protecting those most at risk

As we saw during COVID-19, pandemics can:

• amplify health inequities through disproportionate infection and illness rates, and the unequal access to health and care services
• deepen social and economic inequities through unequal impacts of response measures, leading to income loss, job insecurity, education gaps and social isolation, as well as worsened health outcomes^{[footnote 3]}

Importantly, these vulnerabilities often intersect, putting some people at even greater risk of negative impacts.^{[footnote 4]}

Governments are committed to tailoring their capabilities to protect all communities and aim to deliver an effective, equitable response to pandemics.

2. Taking a whole-of-government approach

A pandemic will touch upon all people and all sectors. Governments need to take a whole-of-government approach to successfully respond to a pandemic while maintaining critical national infrastructure and minimising the disruption to people’s lives and wellbeing.

3. Holding a broad range of flexible capabilities

Given the unpredictability of future pandemics, the governments of the UK should hold flexible plans underpinned by a broad range of ‘capabilities’ - equipment, skilled people and infrastructure - that can adapt to protecting the population from different pathogens. This corresponds with findings from modules 1 and 2 of the UK COVID-19 Inquiry.

4. There needs to be the ability to ‘scale up’ quickly and effectively

Both the speed and scale of the governments’ public health responses are central to mitigating the effects of a pandemic, including early and accurate detection. For preparedness, this means that many of our capabilities need to be backed up by sufficient resources to reach the required levels quickly and manage the situation while these become available. This also means looking at the full development journey for those capabilities, from R&D through to deployment of solutions.

A strong, early response can mitigate some of the impacts of a pandemic, but responding early can also mean delivering larger-scale responses to emerging infectious disease outbreaks that don’t end up becoming pandemics.

5. Preparedness for all 5 main routes of disease transmission

While respiratory pathogens remain more likely to cause future pandemics, environmental changes increase the risk from other disease transmission routes. To help ensure we are planning for future pandemics, rather than assuming a repeat of previous pandemics, all governments will need to prepare for diverse pandemic scenarios across all 5 main routes of transmission. Some of the capabilities we will need to develop can be used for all routes of transmission and others are specific to particular routes of transmission.

6. Preparedness spanning the full life cycle of a pandemic

Figure 1: phases of a pandemic

Governments will proactively build capabilities to respond at each stage of a pandemic - from pandemic prevention at the point a pathogen emerges, to containment measures, to mitigating the pandemic’s impact, to recovery and future preparedness.

The emergence and early containment stage requires, for example, robust diagnostics capabilities, if available, to rapidly detect and respond to new cases and their close contacts. This is an essential early stage, and the aim should be to contain any early cases and emerging infectious disease.

In cases where these are unavailable, early containment requires the gathering of as much data from cases and contacts as possible to develop a diagnostic test as soon as possible.

If the pathogen spreads more widely, core capabilities include PPE to safeguard frontline workers, and therapeutics to treat those infected and protect people at the highest risk of becoming unwell.

Recovery is often - but not always - achieved through vaccine development and distribution. For HIV, the last major non-respiratory pandemic to affect the UK population, there is still no vaccine or curative treatment.

This will also depend on strong routine functions - for example, infection, prevention and control, and R&D.

7. A One Health approach

A multi-hazard, whole-system approach is needed for biological security, reflecting the interconnection between human, animal, plant and environmental health.

Building on the UK Biological Security Strategy, which promotes a One Health, climate-focused approach, this strategy includes primary areas where governments are prioritising a One Health approach to pandemic preparedness.

8. Decision-making will be informed by data analysis, scientific, public health and clinical evidence, and expert advice

Governments will ensure that the use of data, digital tools and evidence is integrated into decision-making at every level of preparedness and response. This includes capitalising on their expert scientific advisory structures and industry expertise in pandemic preparedness and response.

Governments will:

• build on the experience of Exercise Pegasus to ensure:
  • access to a broader forum of scientific advisers
  • continued engagement between internal and external expertise
• prioritise building comprehensive systems for collecting, sharing and analysing data to support and demonstrate evidence-based decision-making, including:
  • seeking to improve coherence and comparability of data across the 4 nations
  • changing policy in response to live evaluation and impacts data

This will bring clarity on what data is needed, where it is collected, where it flows to, how it is analysed and how interoperability is ensured.

 9. Leveraging research and development

The COVID-19 response and recommendations from the UK Covid-19 Inquiry clearly demonstrate the vital importance of investing widely in R&D and having a strong private life sciences sector.

Governments will continue to ensure investment in R&D to, for example:

• deepen understanding of pandemic threats
• accelerate the development of vaccines and therapeutics
• support improvements in capabilities
• inform and evaluate government interventions

10. National to regional and local-level engagement and co-ordination on policy and guidance development

The local intelligence, trusted community links and operational capacity of regional and local partners are central to delivering effective pandemic policy.

Governments will continue to prioritise multi-level engagement, including with community partners such as voluntary, community and social enterprise (VCSE) and faith sector organisations and affected communities, to make policies practical, resilient and responsive to local needs.

11. Preparedness is a whole-of-society effort

Pandemic preparedness is much broader than government planning. It relies on supply chain security, the UK’s life sciences sector and our manufacturing base for accessing vital clinical countermeasures, local government, and the VCSE and civil society sectors.

It requires co-operation across the 4 nations. Public trust in governments (and public health and medical experts) is critical. Governments will work together with industry, academia and civil society to achieve their goals for preparedness.

12. Domestic response needs to be considerate of global dependencies

Governments, health systems and economies rely on global organisations, institutions and supply chains. In particular, global supply chains will be influenced by the type of pandemic and response measures that countries take to protect their populations. The national governments are working with industry and international partners to understand and plan for global dependencies.

1. Scientific Advisory Group for Emergencies and the Department of Health and Social Care’s (DHSC) DHSC and ONS: direct and indirect health impacts of COVID-19 in England - long paper, 9 September 2021; the Race Disparity Unit and Equality Hub’s Final report on progress to address COVID-19 health inequalities; and Marmot M, Allen J, Goldblatt P, Herd E and Morrison J’s Build back fairer: the COVID-19 Marmot Review. ↩

2. Global Preparedness Monitoring Board’s The changing face of pandemic risk: 2024 report; and Fanelli A, Cescatti A, Ciscar J-C and others. Assessing the risk of diseases with epidemic and pandemic potential in a changing world. Science Advances 2025: volume 11, issue 30, eadw6363. ↩

3. DHSC. Technical report on the COVID-19 pandemic in the UK. 2022. ↩

4. The Rt Hon the Baroness Hallett DBE. UK Covid-19 Inquiry. Modules 2, 2A, 2B, 2C - core decision-making and political governance - volume II. 2025. ↩