Real-time national pathogen-surveillance network underfunded and unfinished

The 2023 Biological Security Strategy promised a National Biosurveillance Network with pathogen-agnostic, real-time detection. The Biothreats Radar launched and the Respiratory Metagenomics project scaled to ~30 NHS trusts, but CLTR questions whether the headline ~£1.5bn/year is genuinely new money, flags an absence of measurable milestones, and notes unclear operationalisation of 'unbiased metagenomic' detection. Coverage is partial (30 of ~200 trusts), wastewater and air surveillance are nascent, and durable multi-year funding is uncertain.

Real-time metagenomic surveillance is the UK's early-warning system for the next novel pathogen and the trigger for the 100 Days Mission. Partial coverage and uncertain funding mean the UK could again detect an outbreak dangerously late.

Sustained, ring-fenced funding to build pathogen-agnostic metagenomic surveillance to full NHS/national coverage, integrate wastewater and air monitoring, and publish measurable rollout milestones and capability targets.

// State-led: Instrument: ring-fenced multi-year DHSC/UKHSA funding and NHS-wide metagenomics rollout with published milestones.

Metagenomic surveillance is the pandemic early-warning trigger and scaling the existing 30-trust programme is straightforward, but government is already building it and funding decisions carry no this-year deadline.