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Health protection in the next millennium: from tactics to strategy?

This article reflects the successes and failures of programs directed towards the prevention and control of communicable diseases in the United Kingdom as the next millennium begins. Two notable public health failures namely: the outbreak of salmonella at Yorkshire in 1984 and the outbreak of Legionnaires disease at Stafford General Hospital in 1986 led to the strengthening of the Communicable Disease Control. Since then the Consultant in Communicable Disease Control has been successful in the prevention and control of communicable diseases. Recently suggestions to focus on effective tactics and the use of a strategic approach in the prevention and control of communicable diseases have been made. As part of the development elements of the strategy are being formulated from some initiatives which can be broaden further into a National Communicable Disease Control Strategy. Without strategy the purpose and appropriateness of communicable disease control activities may become unclear and lack focus cohesion and direction. A more strategic response to non-communicable environmental hazards is also needed to build upon the tactical framework currently in place.