Today’s announcement from Cabinet Office Minister Pat McFadden is a welcome first step in improving our national outbreak preparedness. In addressing the recommendations of the COVID inquiry, the government must be ready for all virus threats, including STIs.
The experience of mpox in summer 2022 should be a wakeup call. It showed how even a relatively small number of cases of a virus can inflict a huge strain on our health system. Sexual health services reacted heroically as the service of choice for those with mpox but were not properly resourced to do so. We were lucky, but they are still suffering for responding brilliantly to demand. We cannot respond to future outbreaks solely on the goodwill of our healthcare workforce. We need a plan, proper capacity and resilience.
Learning the lessons from this means embracing expert advice and implementing it quickly. We are pleased that the government has committed to doing that today.
Our first line of defence is vaccines. In November last year, the JCVI advised the government to introduce routine mpox vaccines and the newly approved MenB gonorrhoea vaccine in sexual health services. This could prevent a further mpox outbreak, turn the tide on soaring gonorrhoea rates, and hold back antibiotic resistance. Yesterday we discussed this with the new Public Health Minister.
A sexual health outbreak is firmly on the national risk register. The lessons from the COVID inquiry are about resilience and capacity. We must ensure this applies to sexual health services too.
Richard Angell, Chief Executive of Terrence Higgins Trust said:
“The lesson of mpox is that outbreaks can be scary, impactful not just for those who are directly affected by the virus and put great strain on the system. As the government seeks to implement the recommendations of the COVID Inquiry in this area, capacity in sexual health services needs to be addressed. We saw the dire consequences of what happens when there is no resilience in the system: a 90% reduction in the provision of HIV-PrEP and long-acting reversible contraception.
"The first line of defence against outbreaks is vaccines for known threats. The JCVI have approved vaccines for mpox and gonorrhoea but for too long they have gone uncommissioned. It’s time to right this wrong.”
Professor Matt Phillips, President of the British Association for Sexual Health and HIV said:
“It was heartening to see sexual health services being the provider of choice for those experiencing mpox. My GUM colleagues across the country went above and beyond in responding to this outbreak and gave world-class, personalised care to those impacted, but time and again we were put in an unworkable situation and our services faced overwhelming pressure.
"As we learn the lessons from COVID, we must also learn the lessons from mpox and the marginalised communities that were so disproportionately impacted. I look forward to working with the Cabinet Office and Department for Health on a new way forward.”
