Like many of us, I have followed recent coverage of disease outbreaks in the UK and globally with real concern. Stories of lives disrupted or lost are a reminder that many of these are diseases for which effective preventive tools already exist.
That gap between what we can prevent and what we actually prevent has been a consistent theme throughout my career. It underpins my belief that prevention, and vaccination in particular, should sit at the heart of our health system. Because this is not just about policy; it is about people.
I have spent my working life improving public health outcomes, and I am incredibly proud of the role our industry has played – and continues to play – in transforming what is possible through prevention. Vaccines have changed the course of human history. Diseases that once defined generations are now rare or controlled. Many lives are saved every year. And yet, despite this extraordinary progress, we are at risk of losing momentum.
Prevention, equality, and quality of life
The UK’s prevention agenda is at a critical point. An ageing population, rising levels of co‑morbidity and sustained pressure on NHS capacity all reinforce the need to shift from treatment to prevention. While this ambition is widely shared across government, the NHS and industry, delivery has proven more challenging. Vaccination illustrates this gap clearly: despite the availability of life‑saving and life‑enhancing vaccines, uptake remains below optimal levels, with persistent inequalities in access and coverage. Too often, those who would benefit most from prevention are the least likely to receive it early enough.
For many people, particularly those living with comorbidities or who are immunocompromised, vaccine‑preventable disease can have significant and lasting consequences. Infections can accelerate health deterioration, increase the likelihood of hospitalisation, and lead to a loss of independence that is often difficult to reverse. This is where prevention moves beyond clinical benefit alone and becomes life‑shaping, influencing long‑term wellbeing, care needs and quality of life.
Growing scrutiny highlights a delivery gap
In February 2026 the Health and Social Care Committee highlighted stagnating (and in some cases declining) vaccine uptake, alongside an absence of defined targets, timelines and accountability mechanisms. The committee’s conclusion was that without greater ambition and a credible delivery plan, vaccination cannot fulfil its role as the cornerstone of prevention.
In parallel, the recent National Immunisation Programme Health Equity Audit provides robust evidence that coverage is consistently lower in the most deprived communities, with gaps of up to 7 per cent for key vaccines. These inequalities have increased over time. Lower uptake is consistently associated with socio-economic deprivation, certain ethnic minority groups and specific geographies.
All of this reflects a gap between good intent and actual delivery at scale – one that is all too obvious for representatives of these seldom‑reached groups and for people who work in healthcare. That is why the Health and Social Care Committee is calling on the government to implement a more coordinated, accountable and equity‑focused approach.
The wider cost of inaction
When vaccination uptake falls short, the effects extend beyond individual health outcomes. Independent analysis by the Office of Health Economics estimates that key preventable respiratory diseases alone cost the NHS around £3.9bn each year, with a further £3.6bn impact on the wider economy, largely driven by lost productivity. These costs are reflected in sustained pressure across the system, including high volumes of GP appointments, hospital admissions and antibiotic prescribing, contributing to constraints on NHS capacity and the growing challenge of antimicrobial resistance. This analysis, which was sponsored by GSK, highlights that underinvestment in prevention carries substantial and avoidable health and economic consequences.
At the same time, the UK only spends 1.07 per cent of health expenditure and 0.1 per cent of GDP on immunisation. That imbalance should give us pause. Because even modest improvements matter. Prevention must not be seen solely as a cost. It is an investment in our future, and it is a compelling growth strategy.
From challenge to opportunity
The challenges are clear, but so too is the opportunity. This includes exploring whether there is scope to be more ambitious and more timely in how vaccination eligibility is defined and reviewed. Where evidence suggests that vulnerable groups may remain unprotected for extended periods, there is an opportunity to consider whether cohort definitions sufficiently reflect evolving risk.
Equally important is the pace at which expert advice is translated into practice. Delays between independent advice and recommendations and implementation can mean that people already at heightened risk can wait years for protection, undermining both health equity and wider prevention ambition. Following positive recommendations, implementation should take months and not years.
From ambition to action
Closing that gap requires pace and prioritisation. It means moving faster from evidence to action, ensuring eligibility reflects evolving risk, embedding vaccination across care pathways and strengthening collaboration across government, the NHS and industry. Because prevention only works when it is delivered – consistently, equitably and at scale.
As someone who has worked for many years to improve public health, I remain optimistic. We have strong scientific evidence, robust data, and proven capability. The challenge now is ensuring that this translates into timely action. Behind the data are individuals – patients, families and communities – whose lives could be healthier, longer and more secure with the right protection at the right time.
This is not just good public health policy. It makes economic sense. It makes societal sense. It supports growth, strengthens resilience and reduces pressure on our health system. Put simply, it costs us more to do nothing than it would to close these gaps. We owe it to the most vulnerable in our society to provide the protection they need – and to do so without delay
This is a non-promotional article developed in partnership with GSK.
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