William Pett discusses the impact of the UK's decision to withdraw from the European Union on the country's burgeoning life sciences sector.

It's difficult to remember a single event dominating the political agenda in Britain as much as the ongoing Brexit saga has over the past six months. It has had, and will continue to have, wide-ranging ramifications across the policy spectrum: on investor confidence, the value of the pound, immigration and the future of the arts, to name but a few. However, there seems to have been little focus in the broadsheets on Brexit's potential effects on health policy and the UK's thriving, but delicate, life science industries.

In recent years, the UK has punched well above its weight when it comes to life science and research. We are very much a David against Goliaths such as the USA, Japan and Germany (we spend half as much, or less, on research and development per capita as all three). It is a testament to successive governments' support for innovation that while the UK represents just 0.9 per cent of global population, 3.2 per cent of R&D expenditure, and 4.1 per cent of researchers, it accounts for 9.5 per cent of downloads, 11.6 per cent of citations and 15.9 per cent of the world's most highly-cited articles.

However, and as the science community has repeatedly highlighted, key to this success has been our membership of the European Union. In relation to life science, the EU allows member states to collaborate and share resources in a way that would not be otherwise possible (at least not without the introduction of a separate, and undoubtedly complex, international framework). There has been widespread frustration amongst researchers, therefore, that science was largely absent from pre-referendum debates on Brexit, and also that the EU was uniformly presented as a hierarchical, top-down demagogue whose orders and diktats the UK blindly follows. In some areas of the EU's remit one could argue that this might be a fair reflection, but in the life sciences the UK's relationship with member states is one of co-operation, mutual interest and shared success.

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In a recent Westminster Hall debate on the issue of the European Medicines Agency (EMA), a number of MPs set out the benefits that the UK has reaped by working so closely with our European partners. The SNP MP Dr Philippa Whitford, one of only 10 qualified doctors in the House of Commons, outlined that the UK had experienced "nothing but health gains" by being a part of the EU. She stated that the harmonisation of regulation facilitated by the EMA has ensured that drugs get from the research phase to patients far more quickly and that it has given greater clout to the state in their engagement with the pharmaceutical industries. In the past, drugs companies have, for example, been reluctant to trial drugs in children due to the extra resources involved, yet the EMA has been able to insist on paediatric trials. This has been to the benefit of all member states and the thousands of children using newly approved drugs.

The Prime Minister has uttered the phrase 'Brexit means Brexit' so many times that she must now be saying it in her sleep, and it is right that she is critically questioned on issues such as how the UK's departure will affect access to the single market, the free movement of people, and legislation on issues ranging from human rights to climate change. However, we should clearly also be questioning what Brexit will mean for the regulation of drugs, and for research and development.

From a practical perspective, the fact that the EMA currently bases its headquarters in the UK is significant. Not only do 900 highly skilled staff work there, staff from across Europe, but it is a key lure for pharmaceutical companies to base their activities in the UK. The chief executive of the Association of the British Pharmaceutical Industry has said that he foresees a major loss of inward investment in this country because of the loss of the EMA headquarters in London and because of our possible exit from the EMA.

History has shown that Big Pharma like to be based close to their regulators and should the UK leave the EMA as a result of Brexit then this will be to the advantage of a future host country. Italy and Sweden are already said to be manoeuvring themselves into position to become the next base for the organisation, both undoubtedly gleeful that this valuable asset might be prized away from the UK. It would represent a huge loss of investment, both of financial and intellectual capital, if we were to lose it, and even if we are able to stay in the EMA post-Brexit then our influence will certainly be diminished.

The fact is that, with technology, innovation and research moving so quickly, life science is an extremely competitive international environment. Comparative advantage is key and in the case of the EMA this has been a vital asset, allowing us to compete with countries with far bigger populations and far bigger wallets. There is a very real risk, therefore, of the UK being left behind. Nicola Blackwood, Minister for Health and Innovation, wrote recently that the government will ensure that Britain remains a 'science powerhouse' in spite of Brexit. I fear, however, that her words are reflective of Theresa May's optimism-through-gritted-teeth approach in government, and I doubt that they will be much consolation to the academics, researchers and doctors who are fearing for the future of British medical science. Let us hope that such fears are proved wrong.

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