When people were dying of covid-19, investigation was urgent; such momentum has not been sustained
Such feats are hard to reconcile with an independent, government-commissioned review by Lord O’Shaughnessy, a former junior health minister, published on May 25th. He finds that in commercial clinical trials Britain has been falling behind its peers . Between 2017-18 and 2021-22 it slipped from fourth to tenth in the world rankings for phase-3 trials—those closest to roll-out, when drugs are most extensively tested.
Some failings may be linked to success in the pandemic. “We focused all our activities on delivering new vaccines for covid,” says Matthew Hallsworth of the National Institute for Health and Care Research, a government agency that funds such studies. That was at the expense of other things. Yet in other ways covid was not a distraction, but a brief interlude from inertia. In 2019 Britain took the longest of ten comparable countries to set up and approve clinical trials. When people were dying of a mysterious virus, investigation was urgent; such momentum has not been sustained. A reluctance to share data sets within the National Health Service , in order to recruit and monitor trial participants, was only briefly overridden.
The breakneck pace set during the pandemic could not have been sustained. But some practices should have been. Britain’s drugs regulator, the Medicines and Healthcare-products Regulatory Agency , was, in the words of its boss, already trying to move from being a “policeman” to an “air-traffic controller”. A streamlined approvals process helped it move faster during covid. Since then, an exodus of staff and a reversion to duplicative bureaucratic checks have contributed to myriad delays.
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