Corporate report

UKHSA Advisory Board: Chief Executive's update

Updated 11 March 2025

Date: March 2025

Sponsor: Dame Jenny Harries

1. Purpose of the paper

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

2. Recommendations

The Advisory Board is asked to note the update.

3. Overview

Since the Advisory Board last received a written update from me, a number of changes to the agency’s senior leadership have been announced. We discussed some of these in my verbal update to the board in the last meeting. On 23 January 2025, I made the formal announcement of my intention to step-down from my role as Chief Executive, with a departure in early summer. Having led UKHSA from the day we launched nearly four years ago, this has been a very difficult decision to make. Leading UKHSA has been a privilege and an honour, and I will continue to champion the agency’s work in any roles I undertake in the future.

Congratulations are also in order for Professor Isabel Oliver, who has been appointed as the Chief Medical Officer for Wales and therefore will be leaving UKHSA in April. She has driven the opportunities for science – both within UKHSA and in UKHSA’s work externally – to new heights, particularly through the visionary Science Strategy for the organisation. It’s first annual review of achievements to date and opportunities for the future was published last month.

Recruitment for the replacement Chief Executive and the interim Chief Scientific Officer is already underway. Once the Chief Executive is appointed, they will lead the recruitment of the permanent Chief Scientific Officer. I will keep you updated with any developments.

We are also delighted that we have been able to announce our new deputy Chief Executive and Chief Operating Officer, Dyfed Alsop. Dyfed joins us from being Chief Executive of the Welsh Revenue Authority (WRA). During this time, he led the set-up and establishment of the WRA as the tax authority for Wales. His experience driving ambitious transformation initiatives in a nascent organisation will be very valuable.

The Public Health Minister Andrew Gwynne was replaced by Ashley Dalton on 10 February 2025. Minister Dalton has been briefed on the core activities and ambitions of UKHSA. We look forward to fostering a productive and collaborative working relationship with the minister to not only enhance awareness and impact of our health protection work, but to highlight the potential for UKHSA to contribute further to the government growth mission through our science.

4. Strategic Forward Look

We look ahead to 2025 against a backdrop of increasing geopolitical instability impacting the UK and the global public health ecosystem. The impact and instability is likely to be wide reaching, affecting global surveillance and outbreak response, disease control measures, research and development and action against climate change. Given our significant, longstanding successful work internationally to strengthen International Health Resilience capability in low and lower-middle income countries, we are working closely with DHSC following recently announced changed priorities in UK overseas aid and defence funding. As we navigate these specific areas, there is potential opportunity for UKHSA to provide enhanced wider global leadership particularly in areas such as global outbreak response and disease surveillance. We will continue to work with the World Health Organization, member states and other partners towards the collective goal of a healthier and safer world.

We continue to engage with officials and ministers as part of the ongoing Spending Review process, with a particular focus on the future of our laboratory estate. In the past month I have met with DHSC officials and ministers, and those from other departments, and I look forward to updating the Advisory Board on progress as we move towards resolution. There is strong shared understanding on the need to modernise our lab estate and ensure continuity of service, with different options being considered to ensure strong value for money. There is also increasing recognition of the UKHSA’s role as a contributor to economic growth, through our partnerships with industry and our innovative science, with further scope to develop our offer across HM Government.

Preparations are now at a final stage for the UKHSA annual conference on the 25 and 26 March in Manchester, hosted in partnership with the Faculty of Public Health, with good uptake for tickets for the venue capacity of over 2,000 (increased given high demand last year). We look forward to an array of workshops and lectures, led by a world class faculty, showcasing the best of UKHSA and testing our ambitions for the future of UK Public Health.

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

5. Update on activities

Clade 1b mpox

Up to 24 February 2025 inclusive, we have detected and managed 4 additional cases of clade Ib mpox, bringing the total cases in UK to 9. Of these, 6 were primary cases related to travel and 3 were secondary cases from household transmission within UK. We have followed up 273 contacts of these cases. This is in line with our current risk assessment and do not represent a change in the overall risk to the wider public within the UK. We are continuing to closely monitor the epidemiology of mpox globally including in the Democratic Republic of the Congo and other countries affected by community transmission, alongside Africa Centre for Disease Control and World Health Organization. Data is now reported routinely in formal public epidemiological updates at the end of each month.

H5N1

In January, the Animal and Plant Health Agency (APHA) identified an outbreak of avian influenza A(H5N1) at a poultry farm (one of 20 so far to 24 February 2025). APHA and UKHSA mounted a response in line with agreed plans. One symptomatic worker who had had significant exposure to sick birds tested positive for flu A(H5N1). This individual was the sixth detection since the enhanced surveillance project began in 2023 and was the first symptomatic case. The case has recovered, there have been no further detected human cases, and there is no evidence of human-to-human transmission. Following sequencing of the influenza genome from the case by UKHSA, no high-risk mutations associated with human adaptation or antiviral resistance were detected. UKHSA established an enhanced incident to respond to the case, maintain situational awareness, manage the ongoing seasonal risk of avian influenza, and to continue preparedness activities for a scenario with human-to-human transmission of H5N1.

Norovirus

Following the emergence of an unusual norovirus genotype (GII.17) in April 2024 which replaced GII.4 as the most commonly detected genotype, norovirus activity has remained higher than previous seasons throughout the 2024-to-2025 season and with a further surge in recent weeks. Norovirus laboratory reports in the 2 weeks from 3 to 16 February 2025 were 29.4% higher than the previous fortnight and more than double the 5-season average (168.0%) for the same 2-week period. The impact is particularly severe in hospitals and care homes, with cases highest among people aged 65 and over. While it is likely the GII.17 genotype has driven up norovirus cases this season due to a lack of previous immunity, the higher numbers we are seeing may also reflect UKHSA’s improved testing capabilities and changing patterns of infection since the COVID-19 pandemic. UKHSA is monitoring the circulating genotypes closely and has reported an increase in detections of GII.4 in recent weeks, however it is too soon to say whether GII.4 will return as the most commonly detected genotype this season. Norovirus also spreads more easily in lower temperatures as people spend more time indoors and typically peaks during winter months.

Acute febrile syndrome outbreak in the Democratic Republic of the Congo (DRC)

UKHSA is closely monitoring the ongoing acute febrile syndrome outbreaks in two health districts within Equateur province in the DRC. The cause of illness in both outbreaks is still undetermined, however testing has ruled out Ebola and Marburg virus disease. Potential diagnoses under investigation currently include meningitis, malaria, food or water poisoning, and typhoid fever. These two outbreaks are not epidemiologically linked.

Human Immunodeficiency Virus (HIV) Elimination Programme Monitoring and Evaluation Report

On 28 November 2024, we published the third HIV monitoring and evaluation report, which focuses on the interim ambitions of England’s HIV action plan 2022 to 2025. The report showed that while substantial progress has been made to reduce new HIV diagnoses first made in England between 2019 and 2023, particularly for gay, bisexual and other men-who-have-sex-with-men, it is unlikely that the 2025 target will be met. The 2030 target of zero new HIV transmissions remains within reach.

Bloodborne Virus (BBV) Testing Evaluation Report

An opt out programme to increase the diagnosis and onward care and treatment provision for HIV, hepatitis B and hepatitis C was introduced for people receiving a blood test in 34 emergency departments in April 2022. The 24-months interim evaluation report, looking at 21 of the 34 sites, was published on 28 November 2024. In programme reported data, there were 857,117 HIV tests, 473,723 HCV tests and 366,722 HBV tests undertaken by participating emergency departments during the first year. The number of tests done in the programme is equivalent to more than half of all BBV tests done in general practice (GP), sexual health, drug and prison services combined.

Launch of Tuberculosis (TB) Annual Report

On 5 December 2024, the annual TB report for 2023 was published. The report took a closer look at TB rates, demographics, treatment and antibiotic resistance. While England remains a low incidence country (8.5 per 100,000), TB rates rose by 11% between 2022 and 2023. 80% of TB cases are detected in people born outside the UK, predominantly India, Pakistan, Nigeria and Romania.

Launch of Diagnostic Accelerator

On 12 December 2024, we formally launched the Diagnostic Accelerator, a unit with a specialist team built to speed up the country’s ability to diagnose and test for emerging infectious disease threats, support the development of new testing products and significantly boost the UK’s pandemic preparedness and response.

Launch of the metagenomics Surveillance Collaboration and Analysis Programme (mSCAPE)

On 30 January 2025, we announced the launch of the world-first metagenomics initiative to aid in the rapid detection of infectious diseases that could threaten the UK. MSCAPE has been in development over the last year and is a collaboration between UKHSA, academia and NHS partners. MSCAPE aims to develop the capability to use relevant data as part of UKHSA’s ongoing surveillance of new and emerging infections, pathogens of pandemic potential and to monitor the evolution of pathogens that cause disease.

HIV Testing in Community Settings Report

On 11 February, we published a report which set out how impactful community testing has been between January to December 2023. There was an increase in testing in community settings in 2023, with a decrease in test reactivity by a third, compared to 2022.

I look forward to updating the Advisory Board further on the matters described above, and welcoming you to our office in Quarry House.

Professor Dame Jenny Harries

Chief Executive

March 2025