Corporate report

UKHSA Advisory Board: Chief Executive's Report

Updated 12 May 2025

1. 1. Purpose of the paper

The purpose of the paper is to provide a forward look of priorities and a brief overview of the recent operational and response status of the UK Health Security Agency (UKHSA) since the last Advisory Board.

2. 2. Recommendations

The Advisory Board is asked to note the update.

3. 3. Overview

Since the Advisory Board last met, changes to the Agency’s senior leadership have commenced. We discussed some of these in my update in the last board meeting. Dyfed Alsop formally started with us on the 1st May as UKHSA’s new Chief Operating Officer and Deputy Chief Executive Officer, joining us from the Welsh Revenue Authority. Dyfed began attending meetings right across our dispersed teams and building relationships across the agency in March, well before his formal start date. This early involvement has been a critical planned introductory phase of the handover, helping ensure continuity of leadership and operations across the agency.

The recruitment for the new Chief Executive (CEO) is progressing to time and with my own formal departure date now confirmed as 31st May, a planned handover timetable to the Deputy Chief Executive and other Executive Committee Colleagues has commenced including risk management and formal governance arrangements.

Professor Isabel Oliver has now left UKHSA but remains directly engaged with the Agency in her new role as Chief Medical Officer for Wales which commenced on 30th April. I would like to formally acknowledge the significant leadership she provided to UKHSA, both in terms of its scientific credibility, domestically and internationally, and to its people. Isabel was particularly recognised for her compassionate and proactive enablement of the faith network. The science strategy whose development Isabel led will remain a bedrock of our work for many years to come. Recruitment for an interim Chief Scientific Officer is in progress and the post will provide up to a twelve-month period of oversight and development of the Chief Scientific Officer group leaving flexibility for the new CEO to make a substantive appointment during their first year in office.

At the end of March, we held our third UKHSA national conference in Manchester. Partnering with the Faculty of Public Health once more, the conference fostered collaboration among 1,500 attendees from a vast breadth of sectors and specialisms including industry, academia, the NHS, local and national government and many technical representative organisations and featured discussions on the latest advancements in health security and protection. Attending my final conference, I reflected on the huge privilege of establishing and leading the agency through the first years of its existence in my opening speech. I also referenced several new UKHSA initiatives which launched during conference, including a UK Priority Pathogen Tool identifying 24 key pathogen families and the ‘Infectious Diseases Impacting England’ report which examines disease patterns over the last five years, and promising results from the new respiratory syncytial virus (RSV) vaccination programme.

On 26 March, the Chancellor delivered her first spring statement to the House of Commons and presented the Office for Budget Responsibility’s latest forecast. A number of plans were announced, including a £3.25 billion transformation fund to drive public service reform and efficiencies. As part of this, the government announced their intention to bring the arm’s-length body NHS England back into the Department of Health and Social Care (DHSC) in order to reduce bureaucratic inefficiencies and duplication in the NHS. We are working with the Department to understand what this means for the two organisations, and the impact on work programmes, supporting as required.

In early April, the Government announced a review of all arm’s-length bodies (ALBs). UKHSA is an executive agency of DHSC and an ALB. We worked closely with DHSC and our Chair to provide the necessary returns to the Cabinet Office through the DHSC led process. We strongly highlighted our critical and sometimes unique functionalities in line with the key assessment principles that the Government set out. Dyfed will provide an update in the next Advisory Board meeting.

4. 4. Strategic Forward Look

We have worked very closely with DHSC and HM Treasury officials over the past couple of months as part of the Spending Review Process. The Spending Review will conclude next month, setting out the plans for day-to-day spending to 2028-29, and for capital spending to 2029-30.

Throughout the Spending Review work, I have given particular focus to the future of our laboratory estate. Work continues to ensure a cross-government decision on the funding options is reached. I confirmed at the Public Accounts Committee in March that the two options – developing a science hub at Harlow or delivering a phased refurbishment on existing sites at Porton Down and Colindale – are being discussed and HMG has committed to resolving this decision by the end of the Spending Review process in June. This decision is, of course, critical to the future of the Agency as we are aware of the pressing need to replace our ageing high containment laboratory infrastructure within the appropriate forward time period. Dyfed will provide an update to the board on finalised plans in due course.

We are working with DHSC to agree our strategic remit for 2025/26. Complementing the remit letter will be our annual business plan and outcomes framework which will set out the full list of our priorities and success metrics. The Advisory Board will be kept abreast of our progress.

Work continues on modules 4 to 8 of the COVID-19 Public Inquiry, all concurrently requiring statements from UKHSA (and individuals employed by UKHSA). A detailed overview is provided in the accompanying advisory board paper.

We are currently assessing the potential impacts of US policy changes on UK and global health, including on the World Health Organization (WHO) following the US executive order to withdraw from the organisation. We are also keeping abreast of economic policy changes with a view to assess any potential impacts on health. We continue to work with the US, WHO and international partners on global health security where we have strong shared interests.

5. 5. Update on activities

Clade 1b Mpox – On 25 February 2025 at the third meeting of the International Health Regulations Emergency Committee, it was determined that the event continues to constitute a public health emergency of international concern and would remain so until at least the 20 August 2025. There have been 12 detections of mpox Clade Ib within the UK (all of which have been detected within England). UKHSA communications have been working closely with the NHS, local authorities and key stakeholder groups and continue to issue targeted regional communications to the public via local authorities, healthcare providers and sexual health providers to advise the public on when they should seek medical advice if they suspect they have mpox. On 17 April UKHSA also published a strategy outlining how the agency would manage and suppress a sustained domestic Mpox outbreak.

H5N1 – Globally, we continue to see that mammals can be infected with avian influenza A(H5N1). However, current evidence suggests that the avian influenza viruses we are seeing circulating around the world do not spread easily to people – and the risk of avian flu to the general public remains very low. UKHSA will continue to monitor the situation closely alongside the Department for Environment, Food and Rural Affairs, the Animal and Plant Health Agency and Food Standards Agency. UKHSA was notified on 18 March 2025 that there was a sheep in Yorkshire that was positive for H5N1. UKHSA undertook investigations to determine relevant human exposures to the sheep and arranged for appropriate monitoring of exposed individuals, accompanied by the offer of antiviral treatment and testing. No transmission to humans was identified.

UKHSA has established preparations in place for detections of human cases of avian flu and will respond rapidly with NHS and other partners if needed.

Launch of call for evidence for tuberculosis (TB) – on 2 April, we launched a call for evidence to help shape the next 5-year TB National Action Plan for England, which will run from 2026 to 2031. The latest data for England show that TB rates are rising, and TB epidemiology is changing. The new Tuberculosis National Action Plan (2026–2031) aims to improve the prevention, detection, and control of TB in England by prioritising the most effective interventions, focusing on those most affected, and addressing health inequalities. Our call for evidence seeks insights from a range of partners and stakeholders, including academics, public health experts, epidemiologists, policymakers etc. The call for evidence closed on 2 May – the evidence gathered through this exercise will inform the TB National Action Plan for 2026 to 2031. This is the first stage in a broad process; the findings from this call for evidence will inform further in-depth engagement with stakeholders.

Launch of priority pathogens tool – On 25 March, UKHSA published its view on the pathogen families that could pose the greatest risk to public health, focusing preparedness efforts against these threats. The tool we have developed, featuring a list of 24 pathogen families, will help guide research and development investment in England. The tool is the first specifically designed to consider both global public health threats as well as those most relevant to a UK population. Both UKHSA’s Vaccine Development and Evaluation Centre and Diagnostic Accelerator are working closely with academia and industry to identify and prepare for pathogenic threats to UK health, with the Priority Pathogens tool helping guide this work.

RSV Vaccination programme – On 25 March we published a new UKHSA study which shows the RSV vaccination programme is already achieving a 30% reduction in hospital admissions in 75 to 79 year olds in England as roll-out continues. This analysis by the UKHSA was published as a research letter in the Lancet. This was seen after around 40% of eligible older people took up the vaccine this winter, and the impact is expected to increase with further vaccine uptake. The findings demonstrate the effectiveness of the RSV vaccine in UK older people following the programme’s launch in September 2024. UKHSA will also be evaluating infant RSV admissions prevented by the maternal vaccine programme.

Infectious disease trends – on 25 March we published our first annual report on infectious disease trends, covering key data from 2023 to early 2025 and outlining steps the organisation is taking to tackle these threats. The report shows a rise in both endemic disease and vaccine-preventable infections. Infectious diseases were the primary reason for over 20% of hospital bed usage, at an annual cost of almost £6 billion in 2023 to 2024. The report shows the re-emergence, re-establishment and an unrelenting rise in a number of infectious diseases since 2022 to 2023, with particular increases in endemic diseases and vaccine-preventable infections. The agency acknowledges that the return of social mixing, international travel and migration following the COVID-19 pandemic have contributed to these patterns.

Dengue cases – on 27 March we published new data that show imported dengue cases in England, Wales and Northern Ireland (EWNI) have reached their highest level since surveillance began in 2009.  All cases are linked to travel abroad. In 2024, 904 dengue cases were reported in returning travellers across EWNI, up from 631 in 2023. Most cases were linked to travel to Southern and South-Eastern Asia. UKHSA is enhancing surveillance of dengue cases to better understand where people are acquiring infections and what mosquito bite precautions they were using, in order to help inform public health interventions in future.

Antibiotic resistance - On the 7 April we launched a new digital campaign to tackle antibiotic resistance, a major public health threat. Research by UKHSA shows 42% of the UK population are concerned about how the issue affects them. Yet, over half (54%) are either unsure there’s anything they can individually do to prevent antibiotics becoming less effective at treating infections (28%) or incorrectly believe there’s nothing they can personally do (26%). Aiming to bust these misconceptions among young adults aged 18-34, the digital campaign will be led by a new comedic mascot character, ‘Andi Biotic’. ‘Andi’ was developed by UKHSA to take the success of the Keep Antibiotics Working Campaign from 2018 to a new generation. This first stage is a pilot which will test the potential to capture people’s attention and imagination through digital channels. Over the course of the 6-week long campaign, ‘Andi Biotic’ will embark on a mission to answer people’s uncertainties about when and how to take antibiotics to help preserve their effectiveness today and for future generations. The campaign will launch on UKHSA’s social media channels and at participating GP surgeries and pharmacies throughout April and May.

Artificial Intelligence (AI) - Work is currently underway to develop a system using secure large-language models to automatically detect conflicts in public health guidance, with promising early results showing over 90% accuracy. In addition, we are collaborating with The Pandemic Institute and the University of Glasgow to AI-based genetic analysis tool to predict the zoonotic potential of avian influenza strains, achieving 90% sensitivity and 92% specificity. To further enhance its AI capabilities, we have acquired new graphics processing units to integrate with its high-performance computing cluster, enabling secure development of additional AI-driven public health applications.

6. 6. Forward opportunities

In April, I attended the World Vaccine Congress in Washington with colleagues from our Vaccine Development and Evaluation Centre and Commercial, Vaccines and Countermeasures Delivery Directorate. During the last four years UKHSA has established a strong and trusted reputation for its emergency response operational capability and data use and sharing building upon a long history of work with industry in the vaccines space. Meeting with global industry, academic colleagues and partners from other public health protection agencies in the context of experiential local systems change has reinforced the opportunity for UKHSA to be a key driver of systems leadership and delivery in the UK and global life sciences arena.

7. 7. Final reflections

My stepping down marks four years in the privileged, but hugely challenging role as CEO of a brand new, complex, dispersed, operational and highly skilled technical organisation with a critical remit to protect the health of all communities both in the UK and overseas. We have research links to all continents and active teams operating in 7 countries. It is a testament to the determination and innate sense of responsibility to the communities that we serve that my colleagues right across UKHSA supported me to ‘build an organisation to fight pandemics, in the middle of a pandemic.’ But we have achieved and evidenced so much more in this relatively short period.

What I set out to deliver in the wake of the pandemic was a step change in health protection. Utilising our science, in addition to honing our operational response, I have sought to shift the focus of preparedness and response upstream in order to prevent, or immediately counter, potentially foreseeable threats to health through scientific innovation, the development of new products and countermeasures, and through sustained industry relationships. In particular, I have tried to ensure our systems move towards competent scientific pre-emption of outbreaks and pandemics.

• in our first two years UKHSA responded at pace to the pandemic including the arrival of the Omicron variant during the first month of operation, becoming renowned globally for our technical genomics briefings and delivering millions of tests to the public at short notice through our commercial and testing teams.
• we maintained and have strengthened swift and effective emergency response to significant other health protection concerns – from being the first to alert the world to novel transmission of mpox to enabling the response to the oil tanker collision, responding during the Southport incident or monitoring the potential health impact of space debris in a British Overseas Territory.
• we have published critical strategic documents and plan to enable a leap forward in health protection – the UKHSA strategic plan, a 10-year Science strategy, Genomics Strategy, data strategy and strengthened the contribution to national security through our work supporting the UK Biological Security Strategy.
• we were the first health protection agency in the world to develop a Centre for Climate and Health Security and to develop a tangible inequalities focus for health protection work, publishing a health inequalities in health protection  report this year.
• we have shared our work transparently and raised public and political awareness of the opportunities for positive intervention including through our infectious diseases impacting England report and critical reviews such as the Health Effects of Climate Change report. Importantly we have started to transparently review and challenge our own progress on moving the scientific dial forwards.
• in a world of emerging but often preventable disease UKHSA has sought to drive a focus on both existing and novel vaccine development and utilisation. We have provided the secretariats for the Joint Committee on Vaccination and Immunisation and for the UK’s 100 Day Mission. We have been instrumental in the already successful new national programme of RSV and we have established a new scientific Vaccine Development and Evaluation Centre, a diagnostics accelerator and led the governments strategic partnership with Moderna. And we have set up a new Vaccines commercial Directorate and partnership framework to better engage with industry and with academic colleagues.
• finally we have delivered a leaner more efficient health protection ‘machine’ for future flexibility and legitimate public resource use, achieving the most significant civil service single organisation downsize since the war in the first full operational year: from 18000 to 6000 staff and from £15billion to just over £3billion in the first full year, and, most importantly, begun a deep programme of work to recognise and support our greatest asset, our staff.

This job has been a huge privilege but with an equally huge mission. The activities I have provided updates or reflected on today are the tip of the iceberg of the true scale of scientific and operational work currently ongoing in UKHSA and with our partners. I hope that in reflecting at this juncture in the change of organisational leadership, those colleagues following on after me and those supporting the organisation externally, are bold in realising the genuine untapped prevention opportunities that can be delivered with focus, belief and active cross-sectoral engagement.

Finally, I would like to formally record my thanks to my Chair who has shared this historic journey with me at every step, the Advisory Board members past and present who have been so active and generous with their time in supporting the whole organisation and its people, and most importantly for me all those colleagues, past and present, inside and outside UKHSA, who have helped me  personally over many years throughout my public health career but who  particularly have supported UKHSA since its inception four years ago.

Professor Dame Jenny Harries

Chief Executive

May 2025