The major threats to health pay no attention to national borders. Even the most convinced supporter of Brexit must realise that the UK could not hope to quarantine itself in the face of a flu pandemic. We need effective surveillance systems, monitoring the emergence of new disease outbreaks in real time, putting the information together, and responding rapidly. Back in 2001, some of us evaluated Europe’s ability to respond to such outbreaks. We had many to choose from. Tourists contracted Legionnaires disease in a Mediterranean holiday resort but only became ill when they returned to different countries in Northern Europe. Young people attending a festival were infected with the bacteria causing meningitis and then went back to four different countries. We found lots of problems. There was failure to communicate between countries, no-one had a clear idea who was responsible, and there was no organisation or funding to respond. Since then the situation has changed completely. The EU has established the European Centre for Disease Prevention and Control, in Stockholm. It co-ordinates networks across member states, develops consistent reporting mechanisms, and through the EPIET training programme has done much to address the gaps that once existed in some member states. British public health professionals have played a key role in this process. If we left the EU, it would be weakened but so, to a much greater extent, would our defences against infectious disease. Given recent threats from Ebola and Zika virus, this hardly seems a good time to dismantle our defences.
The risks from beyond our borders are not only from germs. Tobacco is one of the leading killers worldwide. The tobacco industry is incredibly powerful and has a track record of picking off individual countries. Some are small and, in global terms, relatively weak. Others are much larger, such as Australia, which faces a threat to its introduction of standardised packaging. Working with our EU partners we are much better able to resist pressure from it. The industry was furious when the EU passed the recent Tobacco Products Directive. It spent millions lobbying against it, to no avail. This substantially strengthens tobacco control measures across Europe and will lead to many thousand fewer deaths in the years ahead. But there are many other ways in which the EU tackles dangerous products. You simply cannot have free trade without regulations to make sure that the goods that are being moved about are safe. EU standards have driven enormous improvements in vehicle safety. The toys that we give to our children are no longer likely to kill them. In so many ways, the EU has made our homes safer places in which to live.
Those advocating Brexit say that we would be better off passing our own laws, to reflect our own circumstances. You only need to breathe deeply in London’s Oxford Street to see that this is nonsense. Even now, central London fails to meet the EU’s air quality requirements. But at least the fact that the regulations exist mean that something is being done. If we left the EU, does anyone think it would be long before the UK took the easy way out and abandoned the regulations?
To read more on the powerful public health arguments to stay in, see our recent article in the journal of Public Health – Brexit: a confused concept that threatens public health.