Coronavirus and Brexit: UK Must Act Quickly Before Being Shut out of Europe’s Health Protection System

The threat posed by 2019-nCoV and the fragmentation of existing health protection systems caused by Brexit call for urgent assessment of cross Europe cooperation, say Mark Flear , Anniek de Ruijter , and Martin McKee.

Given the UK’s departure from the European Union, the study authors argue that the coronavirus outbreak is an urgent warning highlighting the need to reflect on what Brexit might mean for the country’s health security and consequences if it is excluded from many elements of the EU’s disease control structures.


  • Countries outside the European Economic area are unable to participate in the exchange of much of the data required for effective surveillance or in certain mechanisms to coordinate responses.
  • Under the withdrawal agreement UK will continue to participate in EU arrangements until the end of the transition period on 31 December 2020. Thus the UK will retain access to the Early Warning and Response System (EWRS) under these arrangements until then.
  • Now that UK has withdrawn from the Joint Procurement Agreement and the European Medicines Agency, it will no longer have the same level of access to medical countermeasures, including those developed through the urgent market authorisation procedure. Manufacturers of these countermeasures are likely to prioritise market authorisation in the EU over the UK’s far smaller market.
  • Switzerland offers an example of the challenges involved, although its experience should be interpreted in the light of its much closer relationship with the EU, including free movement of people, than what is proposed by the UK government.
  • Switzerland and a post-Brexit UK will participate in WHO’s regime. However, despite the commitment to close alignment of the EU and WHO regimes, in practice there can be problems when coordination is not properly regulated in advance of a crisis.

Read the essay: Coronavirus shows how UK must act quickly before being shut out of Europe’s health protection systems
BMJ 2020; 368 doi: 31 January 2020

The essay was authored by Mark Flear, Reader in Law, Queen’s University Belfast; Anniek de Ruijter, Associate Professor, Amsterdam Law School; and Martin McKee, Professor of European Public Health, London School of Hygiene and Tropical Medicine.


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