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Infectious disease and global health - what UCL is doing

10 March 2016

We face a growing global threat from infectious disease.

David Lomas This was highlighted by the devastating outbreak of Ebola virus disease in West Africa, which affected over 28,000 people and claimed the lives of over 11,000. The recent outbreak of Zika virus infection in Brazil, transmitted through the bite of an infected Aedes species mosquito, particularly affects pregnant women resulting in children born with microcephaly (very small heads and brains).

Moreover, a third of the world's population are, or have been, infected with tuberculosis (TB). The Chief Medical Officer, Professor Dame Sally Davies, has highlighted the risk to health of growing antimicrobial resistance, particularly amongst gram negative bacteria. If left unchecked it will seriously impact the medical resources available to treat infectious disease, and increase the risks of undergoing even the simplest surgical procedure.

Grand Challenge of Global Health

The threat posed by infectious disease is one of the reasons that UCL has a Grand Challenge of Global Health, which harnesses expertise from across the whole of UCL. There are existing strengths in the faculties of Medical, Population Health, Life and Brain Sciences, Arts and Humanities, Social and Historical Sciences, and the UCL Institute of Education, but also great opportunities to exploit strengths in engineering, devices, nanotechnology, and many other areas.

All this dovetails with UCL's new Global Engagement Strategy in a number of important ways: to quote directly from that strategy, it helps us 'to deepen our knowledge and understanding of different parts of the world and of the various research, education and enterprise-led collaborations that UCL has with partners overseas' and 'to co-create wise solutions to enduring and emerging global problems and Grand Challenges'. We have established a new Health Strategy Forum with representation from all faculties across UCL in order to foster collaboration into all aspects of health research and education.

New partnerships and initiatives related to infectious disease

UCL is engaging with the Grand Challenge of Global Health, and in particular infectious disease, in many ways. There is currently great excitement about: (i) the development of the Bloomsbury Research Institute; (ii) a bid to the Wellcome Trust for funding for a unified Institute between the Wellcome Trust Africa Centre and The KwaZulu-Natal Research Institute for Tuberculosis and HIV (K-RITH); (iii) plans to co-locate academic microbiology on the Royal Free site; (iv) exploiting photodynamics to overcome antimicrobial resistance at the UCL Eastman Dental Institute and the Royal National Orthopaedic Hospital, Stanmore; and (v) the use of nanoparticles that release hydrogen peroxide by UCL groups based at laboratories on the Stevenage Biosciences Campus. Antimicrobial resistance and infectious disease is also proposed as a new theme in the recently submitted bid to renew the National Institute for Health Research (NIHR) UCLH/UCL Biomedical Research Centre.

Bloomsbury Research Institute and Wellcome Trust Africa Centre/K-RITH

The first two listed above are particularly topical. We are working with our close neighbour the London School of Hygiene and Tropical Medicine (LSHTM) in a multidisciplinary and complementary partnership to develop a dedicated research institute for infectious disease, the Bloomsbury Research Institute (BRI).

The BRI is led by Professor Sharon Peacock and brings together researchers in viral research (with particular emphasis on HIV), parasitology and population cohorts from UCL and LSHTM. The institute will focus on HIV, tuberculosis and malaria, newly emerging infections and antimicrobial resistance. We have received planning permission from Camden Council for a new building in Tavistock Place and are working to secure funding for the new build from both universities, philanthropy, HEFCE (who have contributed £7.5m) and government matched-funding schemes. The building will be a physical embodiment of the collaboration, and co-location will enable and facilitate joint working between both institutions.

Africa

Our commitment to infectious disease and public health is strengthened by an application by Professor Deenan Pillay for approximately £30 million to fund an institute in South Africa that unifies the Wellcome Trust Africa Centre in Somkhele in rural Kwa-Zulu Natal and the Durban-based, Howard Hughes Medical Institute-funded KwaZulu-Natal Research Institute for Tuberculosis and HIV (K-RITH). A demographic surveillance study has been underway in this region for the past 15 years, with blood sampling three times each year from approximately 100,000 individuals from 12 thousand homes.

This has allowed the identification of geographic HIV transmission hotspots and social science studies to assess risk behaviours that facilitate transmission. There is an overall prevalence of HIV of 34% in the demographic surveillance area with peaks of 65% in women aged 30-35. There is also a very high prevalence of multi- and extensively drug resistant TB. Moreover, people are living longer with HIV following widespread treatment with antiretroviral therapy. This raises emerging issues of non-communicable diseases such as cardiovascular disease, arthritis and obesity.

Last week, the deans of Medical Sciences and Population Health Sciences (Professor Mark Emberton and Professor Graham Hart) and I visited the Wellcome Trust Africa Centre for the site visit from the Wellcome Trust's review panel. The presentations from research scientists and students, and the visit to field stations were all outstanding and we are awaiting a decision by the governors. Vice-Provost (International) Dame Nicola Brewer and UCL's Global Implementation Group are considering whether to recommend UCL forms an institutional 'anchor partnership' with the new unified institute.

Global health and infectious disease is a major issue for us all. Addressing this challenge is key to many of our aspirations outlined in our 20 year vision, UCL 2034. There are significant challenges ahead and UCL stands ready to play its part in finding long-lasting solutions to these tough but tractable problems.

Professor David Lomas, Vice-Provost (Health)

Images, from top to bottom: Professor David Lomas, Wellcome Trust Africa Centre

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