No-deal Brexit would stall the NHS medical revolution

To support the best science, the UK and EU must come to a mutually beneficial compromise, says Wellcome's Director Jeremy Farrar.

Every year, about 100 babies in the UK are diagnosed with rare, soft-tissue cancers. Treating young babies with chemotherapy and surgery is difficult and dangerous, but a new way of understanding these tumours using genomics offers hope. Researcher Sam Behjati devotes his work to decoding the DNA of rare childhood cancers. Recently, Behjati and his co-researchers revealed the genetic changes that cause a group of tumours to grow on babies’ kidneys. Now better targeted treatment using existing medicines is a possibility.

This week, the NHS becomes the first in the world to offer patients routine access to cutting-edge genomic medicine. This huge advance is in no small part because science in the UK has been at the forefront of the genomic revolution.

But the world-leading research at the heart of these advances does not happen in isolation. Knowledge and discovery do not stop at borders. Progress is made because the UK, for a generation, has been an attractive place to collaborate and invest in science, nearly always across borders.

The work on infant soft-tissue cancers was a collaboration between Germany’s University of Würzburg, Great Ormond Street hospital and the Wellcome Sanger Institute, where Behjati is based. Because these tumours are rare, the research depends on working relationships sustained over decades, on access to a patient pool bigger than the UK alone can provide and on strong, shared regulations for transporting and sharing access to precious tissue samples. Openness, sustained collaboration and a common regulatory environment have enabled scientific excellence and leadership. And it has flourished during a time when the values of the UK, as part of Europe, have matched those of science.

A no-deal Brexit outcome would be hugely damaging to patients and research collaborations across Europe. Behjati, for example, does not know whether European funding will continue to be available. If he can’t access the same resources as his longstanding European partners, how quickly will he find himself outside these circles? Will he need to look to new territories, with huge regulatory changes, for new collaborations? How will a German national, who moved to the UK as an undergraduate, have his ability to travel and work freely in and outside the UK limited?

Researchers, like science, thrive on crossing borders. In a recent survey of researchers, more than 75% had lived abroad for training or work and almost half for more than a year at a time. Europe, the same survey showed, is particularly interconnected – 82% of European researchers had trained or worked in more than one country and most within Europe rather than outside it.

The environment that attracts the next generation of brilliant minds, where the ingenious thrive and where advances are made to save and improve lives for many generations to come, depends on urgent answers. No deal leaves a void on access to funding, regulation and, critically, migration. To support the best science, the UK and EU can come to a mutually beneficial compromise. There are three priorities in any deal for science: protecting funding; ensuring skilled scientists, technicians and their families can continue to live and work freely in the UK and the EU; and regulations that nurture – and adapt to – the needs of cross-border research. Science grows, and will only continue to grow, ever more global, more collaborative. China, India, Singapore – these new scientific powers are in the wings and they are not waiting.

Industry, investors, academia and philanthropy, such as Wellcome, which have committed to the UK are getting nervous. The UK must consider all the elements that encourage growth and success. It must think long term, of the consequences of cutting itself off from its closest partners, of becoming more inward looking.

Wellcome, both politically and financially independent, wants to support scientists and researchers, wherever they are from, to tackle the greatest global health challenges. We have invested in the UK for more than 80 years. It has provided an environment in which science and innovation can thrive, but if the conditions and the culture here are damaged, that will affect our support. It is not unconditional.

This opinion piece first appeared in The Observer, 30 September 2018.

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