Annual Report 2013

London School of Hygiene & Tropical Medicine Keppel Street London WC1E 7HT United Kingdom [email protected] www.lshtm.ac.uk

Made from 100% recycled paper ISBN 978-0-9576833-0-3 © December 2013 Improving health worldwide Improving health worldwide London School of Hygiene & Tropical Medicine Active web addresses, links Click on the contents to Annual Report 2013 1 and emails are underlined. jump to the page you want

Foreword The urgent challenges Our continent is Although more of the world’s seven billion people are living longer and healthier lives than ever, we face many urgent challenges. The inexorable tide of non-communicable we now face in developing rapidly. We diseases, the emergence of antibiotic-resistance, the threat of new pandemics, and the health can only be are making significant health impacts of conflict and climate change, are all ‘wicked problems’ that impose severe burdens on health services, systems and societies, locally and globally. met by intelligent, progress in controlling The School’s mission is to help address these challenges, through our research, co‑ordinated infectious diseases, education and innovation. To achieve this, we work collaboratively with hundreds of responses, informed and meeting old and partners all over the world, ranging from governments and international agencies to local clinics and community groups. by applied research Professor Dame Sally Davies new challenges by Dr Tedros Ghebreyesus This report provides a brief overview of the School’s recent work, and a glimpse of Chief Medical Officer, the Foreign Minister and former that builds the investing in our health, the future. It has been a year of healthy growth across all areas of activity, and many UK Government’s principal Minister of Health, Ethiopia; achievements by individuals and the School as a whole. For example, our postgraduate medical adviser and Chief Alumnus and Honorary evidence base research and science programmes – both London-based and distance learning – were commended by the Scientific Adviser for the Fellow of the School UK’s Quality Assurance Agency for Higher Education, and in October the School was for effective health Department of Health infrastructure, with the Sir Tim Lankester named by the compilers of a global league table as the world’s leading research- practice focused support of funders and focused graduate school – which reflects the growing recognition our work is receiving. on public need.” partners globally.” I hope you will take a few minutes to read this review, and that you find it enjoyable and inspiring.

With the National Institute for Health Research, Policy Research Units, The London School of Hygiene & Tropical Medicine is a key partner and other partnerships, we are developing a research infrastructure that in this work, and is helping national and local governments, universities Our vision is to be a taps into world-class academic resources, and the London School of and hospitals strengthen their research and capacity, and exchange world‑leading school of public Hygiene & Tropical Medicine is a key partner in these initiatives. knowledge and expertise. and global health, working Through its collaborative work with the National Health Service, Public I am honoured to be associated with this world-leading institution, Sir Tim Lankester, Chair of Council Health England, National Institute for Health and Care Excellence, local and I know from personal experience how dedicated the School’s staff, closely with partners in the government and NGOs, the School is making many vital contributions students and alumni are – conducting research and taking practical UK and worldwide to address to public health, from laboratory research in infectious diseases to action that saves lives and improves health worldwide. contemporary and future advising on implementation of interventions, and health service and policy evaluations. critical health challenges.

Our mission is to improve health and health equity in Contents the UK and worldwide; working Making an impact: now and for the long term 2 in partnership to achieve 1 2 3 4 5 6 excellence in public and global Improving health worldwide: sub-Saharan Africa 4 health research, education Excellence and impact 6 and translation of knowledge into policy and practice. Improving health worldwide: United Kingdom 8

Knowledge translation and innovation 10 7 8 9 10 11 12 World no. 1 research- 2013: the year in review 12 focused graduate school In 2013, the School was named Faculty review: Epidemiology and Population Health 14 the world’s top research-focused graduate school in the Times Faculty review: Infectious and Tropical Diseases 16 Higher Education world rankings. Faculty review: Public Health and Policy 18 1 Maintaining the Momentum: Professor Piot 3 Research at the School has generated over 6 The bicentenary of John Snow, founder 9 ‘SASA!’ is a five-year project to stop violence and panellists at a seminar held at the 2,200 items of media coverage in 2013, of modern epidemiology, celebrated at against women and reduce HIV risk in Uganda School in June to launch the World Health double that in the previous year the School 10 In March, despite snow, we hosted our largest Education: teaching and learning 20 Organization report on AIDS in Europe, 4 The Olympics and regeneration in East London 7 Manga-style comic created by Ian Roberts Graduation Day ever co‑authored by Tim Rhodes and colleagues project is investigating the health legacy of to demonstrate the benefits of tranexamic 11 The Keppel Street Building and gardens In 2009, the School became the 2 The GOAL Trial is examining the effectiveness the 2012 Games among local people acid in emergency medicine in Spring of the Generation Skillz programme for first academic institution in the People and resources 22 5 PEEK in practice, working with Maasai 8 Malaria intervention trials in Tororo, Uganda, 12 Peter Piot and HRH The Duke of Edinburgh, reducing risk behaviour among 15–18 year old communities in Kenya courtesy Helen Allwood, Malaria Capacity world to be awarded the Gates boys and girls in Cape Town and Port Elizabeth the School’s Patron, at the launch of the Development Consortium Director’s Circle at Buckingham Palace Award for Global Health by the Global Health Council Management and governance 24 © Copyright London School of Hygiene & Tropical Medicine 2013 Photography: LSHTM/Anne Koerber, iStockphoto, Shutterstock unless otherwise credited. ISBN 978-0-9576833-0-3 2 Making an impact: now and for the long term London School of Hygiene & Tropical Medicine Making an impact: now and for the long term Annual Report 2013 3

Making an impact: now and for the long term Honours and awards 2013 Our students · Anne Mills elected Fellow of the Royal Society. Peter Piot, Director have continued · Polly Roy and Brendan Wren receive to excel academically Wellcome Trust senior investigator s a postgraduate and research This year, the School and on graduating, to awards, and Alex Mold wins junior investigator award. institution we are not included was named the secure excellent jobs in most university league tables. · Neil Pearce, Andrew Prentice and However, this year the School was world’s leading research- and placements in Anthony Scott elected Fellows of named the world’s ‘leading research- focused graduate school their chosen fields” the Academy of Medical Sciences. Afocused graduate school’ by Thomson Reuters and Times Higher Education. by Thomson Reuters and · Andy Hall received a knighthood in the As well as achieving the best overall score, Queen’s birthday honours’ list. coming top of a table ahead of elite global Times Higher Education” · Clare Gilbert wins Pisart Vision Award institutions, we were ranked particularly in recognition of her work on prevention highly for indicators including international outlook, research and citations. of childhood blindness. · Nick Black awarded a Career Achievement Impact is long-term and notoriously hard Prize in recognition of his contribution to measure. This year, the new Research to advancing the use of patient reported Professor Baron Peter Piot, Director Excellence Framework has required us to outcome measures and along with Ben evaluate and document the wider societal Goldacre, named in the inaugural Clinical benefits of our work. Although the process Leaders list by Health Service Journal. has been time-consuming, it is a good discipline for academics to assess and · Peter Piot communicate the many benefits of our work, Income from research grants increased awarded the as it is only by so doing that we can win over 10% this year to £79 million, as set Hideyo Noguchi wider public understanding and support, out in on page 23. Of this total, UK, EU Africa Prize as well as sustained funding. and US government departments and for Medical agencies contributed nearly half of this total, Research In October this year, I attended a centennial with another 45% coming from charitable by Japan’s anniversary celebration for the UK Medical sources, including the Wellcome Trust and Prime Minister Research Council at the Royal Society, at the Bill & Melinda Gates Foundation. Shinzo Abe which School researchers Austin Bradford Hill, (right). Jerry Morris and Brian Greenwood were among This year, we received an excellent report distinguished MRC-supported scientists of on the quality of our education programmes the past 100 years. This highlighted how from the UK Quality Assurance Agency, and Our students have continued to excel In London, we joined UCLPartners, contributing globalisation, the threat of antibiotics and we have contributed to the excellence of in the autumn achieved a significant increase academically and on graduating, to secure to the successful bid for a new Academic emerging epidemics, over-consumption and British science, and thanks to the quality in student enrolments, with numbers of excellent jobs and placements in their chosen Health Sciences Centre, and continued to the tsunami of chronic diseases. All health and enterprise of our staff, research at the London-based students 14% up on last fields. We strengthened our many partnerships work with University College London on the systems are now struggling: they are facing School continues to flourish and grow. year, reversing a dip in 2012. worldwide and established new links, joint development of the Bloomsbury Research new demographic, disease and technological appointments and courses, notably in China, Institute as a world-leading centre for challenges which leave them overburdened South East Asia, India and throughout Africa. infectious diseases. Our knowledge transfer and riddled with structural inefficiencies While our ability to attract funding and and innovation activity resulted in the and perverse incentives. We have to reform, the best staff and students is vital, these development of new diagnostic tools and innovate and work far more ‘upstream’, outcomes cannot be ends in themselves. the launch of our commercialisation vehicle, scaling up prevention and public health Our success is rightly measured by the Chariot Innovations Limited. policy solutions. outcomes of our research, teaching, knowledge transfer and capacity-building In October, the Oxford Martin Commission for Above all, we must resist the fatalistic activities, and the positive impacts Future Generations, of which I am a member, attitude that ‘nothing can be done’ about the of these on society and people’s lives. launched its report entitled Now for the big challenges. We need evidence-informed Long Term. This calls for governments and optimism to persistently ask better questions Evidence of such outcomes is manifold: institutions to abandon short-termism, address and find better answers. This effort requires around two thousand papers written or deep persisting inequalities, and shift priorities political science and economics as well as co-authored by staff and research students towards longer-term challenges that will shape basic science, patient care and epidemiology, over the year, with significant findings ranging our futures – hopefully a commitment which will speaking truth to power, encouraging and from new discoveries in pathogen molecular also be a main theme of the post-2015 agenda enabling our leaders to think and act for biology, to vaccine development, water for sustainable development. Translating such the long term. quality and child health, cancer survival, long-term vision into daily practice is very HIV and tuberculosis interactions, transport challenging, but vital if we are to avert the and health, health services reform, medical deep and complex crises we now face. tourism and sexual attitudes. As well as being widely cited in high-impact journals, Professor Piot taking part in BBC world service As a society we underestimate the scale of Maintaining the Momentum: Professor Piot and panellists at a seminar held at the School in June to launch the many of these findings have achieved panel as part of the inaugural Africa Science challenges such as the impacts of climate World Health Organization report on AIDS in Europe, co-authored by Tim Rhodes and colleagues Festival in Kampala global media coverage. and demographic change, migration and Professor Peter Piot 4 Improving health worldwide: sub-Saharan Africa London School of Hygiene & Tropical Medicine Improving health worldwide: sub-Saharan Africa Annual Report 2013 5

Capacity strengthening consortia These pages show just a few of more than 50 projects and partnerships across Improving health worldwide: sub-Saharan Africa 1 Artemisinin Combination Therapy (ACT) Consortium Africa. For more details, please read our 2013 regional publications. These 2 Consortium for health policy & systems analysis in are available on our website, as well as a searchable map of our work in over Africa (CHEPSAA) 100 countries worldwide www.lshtm.ac.uk/aboutus/introducing/map 3 Malaria capacity development consortium (MCDC) 4 South African consortia research for hanks to painstaking medical research over the past few decades, millions of lives Selected projects and partnerships excellence (SACORE) have been saved and health improved across Africa, but millions more people continue 5 Southern African centre for infectious disease surveillance (SACIDS) to suffer and die from preventable and treatable conditions: not only malaria, AIDS This new test-and-treat approach encourages 6 and tuberculosis, but undernutrition, diarrhoea, the complications of childbirth and, Tackling the structural drivers of HIV (STRIVE) East Africa and supports the entire community to test increasingly, hypertension, diabetes, cancer and cardiovascular diseases. We are also 7 Training health researchers into vocational National Institute for for HIV, and offers immediate treatment with excellence in East Africa (THRiVE) Medical Research / confronted by the emerging threats of new infections and pandemics. The School is engaged in anti-HIV drugs to everyone who is HIV-positive. T 8 Mwanza Intervention collaborative research and teaching with many partners across the region. These links have been African SNOWS Consortium: Scientists Networked This enables HIV-positive individuals to be for Outcomes from Water and Sanitation Trials Unit further enhanced by our participation in a growing number of international research consortia, diagnosed at a much earlier stage, which 9 African Meningococcal Carriage Human papillomavirus which strengthen the capacity of African institutions to carry out world-class research. should protect the health of HIV-infected Consortium (ManAfriCar) vaccine trials – MAURITANIA 9 sub-Saharan Africa patients at the same time as steeply MALI Trachoma mapping and treatment NIGER Program for resistance, reducing the number of new infections. 9 ERITREA Blinding trachoma affects more 9 CHAD immunology, surveillance SENEGAL than 21 million people globally, 9 and monitoring (PRISM) Safety of malaria drugs 3 SUDAN with up to 180 million at risk in BURKINA Good School Toolkit to prevent Artemisinin-based combination therapy is the FASO 3 8 GUINEA 3 violence against children the world’s poorest countries. The BENIN 9 first line recommended treatment for malaria.

Courtesy Teun Bousema Courtesy Teun Global Trachoma Mapping Project 3 NIGERIA Treating child sickle cell disease Although it is highly effective, there are many SIERRA 8 2 is a consortium of ministries of LEONE IVORY 1 2 CENTRAL ETHIOPIA issues around access, safety, targeting and COAST GHANA Improving newborn survival in southern 9 1 1 AFRICAN health, NGOs and academic partners LIBERIA REPUBLIC Tanzania (INSIST) drug quality. The ACT Consortium, with its CAMEROON 7 worldwide, funded by UK Department TOGO 1 Treatment of HIV-positive patients with secretariat based at the School, is a global for International Development. School 3 SOMALIA visceral leishmaniasis research collaboration that addresses these EQUITORIAL UGANDA 8 researcher Anthony Solomon, chief GUINEA 1 issues through 25 studies in 10 countries. 8 KENYA Ciclosporin in leprosy reactions clinical trial scientist for the project, is training 7 GABON 7 2 3 Protecting children through teams to use smart phones to collect RWANDA DR CONGO data on water, sanitation and hygiene, CONGO Seasonal Malaria Chemoprevention 5 Work by School researchers and partners in and examining people for clinical West and Central Africa 6 7 Senegal, Mali, Burkina Faso, Gambia and Ghana evidence of trachoma in countries Medical Research Council Gambia Unit TANZANIA 6 1 over the past decade has led to the introduction including Guinea Bissau, Cameroon Centre MURAZ – Burkina Faso 5 2 3 of a new prevention strategy known as Seasonal and Nigeria. Researchers from the GENINVADE Project – parasite population ALPHA network: population-based Malaria Chemoprevention. Children without School’s International Centre for genomics and functional studies ANGOLA 4 1 HIV data symptoms of malaria receive a dose of an Eye Health are also working with Programme for improving mental MALAWI A vast amount of data is available on various 4 ZAMBIA anti-malarial drug combination once a month hospitals across Africa as part of health care (PRIME) 5 MOZAMBIQUE aspects of health in Africa, but it can often be 5 during the high malaria transmission season. the VISION 2020 Links Programme, Improving the evidence difficult to compare studies. The network for In 2012/13, this was incorporated in World a global initiative to eliminate base on disability ZIMBABWE Analysis of Longitudinal Population-based HIV MADAGASCAR Health Organization guidelines, and the avoidable blindness worldwide. IDEAS for maternal and NAMIBIA 4 data in Africa (ALPHA) is working to improve the programme extended to Chad, Niger and Nigeria. newborn health BOTSWANA usefulness of data generated in community- Radio health messages 4 based cohort studies on HIV in sub-Saharan to reduce child mortality Africa by combining data sets into a common SWAZILAND Breakthrough on meningococcal meningitis vaccine Community-based format. The network is co-ordinated by Basia Results published in September 2013 showed that vaccination of almost 2 million people in prevention of non- SOUTH AFRICA Zaba and Jim Todd at the School, advised by 8 Chad led to a dramatic reduction in the incidence of all cases of meningitis by 94% and in communicable diseases 6 5 WHO, UNAIDS and partners in Kenya, Malawi, The GOAL Trial is examining the effectiveness of 2 1 carriage prevalence of the epidemic strain, serogroup A meningitis, by 98%, while an epidemic 4 South Africa, Tanzania, Uganda and Zimbabwe. the Generation Skillz programme for reducing risk persisted in unvaccinated parts of the country. The African Meningococcal Carriage Consortium In 2013, they published results which found behaviour among 15–18 year old boys and girls in Cape Town and Port Elizabeth (MenAfriCar), led by Brian Greenwood and funded by the Wellcome Trust and Bill & Melinda Gates Southern Africa an estimated 24% of pregnancy-related deaths Foundation, is investigating the patterns of meningitis and trialling the introduction of the new Youth-friendly health services in sub-Saharan Africa are attributable to HIV, MenAfriVac vaccine in Chad, Senegal, Mali, Ghana, Niger and Nigeria. Malawi Epidemiology and – HIV prevention clinics and that HIV positive pregnant and post-partum Intervention Research Unit Zambia AIDS related women are eight times more likely to die than Improving health systems, The Karonga Prevention Study was established tuberculosis project their HIV negative counterparts. services and policy in Malawi in 1979, and has since expanded (ZAMBART) In recent years, School researchers have to include tuberculosis, HIV, demography, Sport and HIV prevention Antiretroviral Therapy to been conducting pioneering research on and most recently, cardiovascular disease Human papillomavirus in Africa research cut HIV Transmission health economics and health policy change. and diabetes, as the epidemic of non- Can timely treatment for HIV also serve to The Consortium for Health Policy and Systems

Courtesy Rodrigue Barry partnership (HARP) communicable diseases spreads across Zimbabwe study for enhancing testing reduce transmission at population level? Analysis in Africa, led by Lucy Gilson, joint Africa. Today, a uniquely detailed database and improving treatment of HIV in A major trial is now underway to test a new professor with the University of Cape Town, links work over more than three decades on children (ZENITH) approach to the prevention and control of AIDS is a partnership of seven universities in around 300,000 people. A new site recently CONCORD Programme – surveillance in Africa. The Population effect of Antiretroviral Africa and four in Europe. Kara Hanson, Lucy opened in Lilongwe, and the combined of cancer survival therapy to Reduce HIV Transmission study Gilson and colleagues are also working in programme has been brought together as Nutritional support for Africans starting led by Richard Hayes, known as PopART seven countries across Africa and Asia in the the Malawi Epidemiology and Intervention antiretroviral therapy (NUSTART) HPTN 071, involves 21 communities with Resilient and Responsive Health Systems Research Unit (MEIRU), with Professor Moffat VISION 2020 Links Programme – eye health a total population of 1.2 million in South research programme to improve governance, Nyirenda appointed director in July 2013. Africa and Zambia. human resources and financing. 6 Excellence and impact London School of Hygiene & Tropical Medicine Excellence and impact Annual Report 2013 7

Excellence and impact School Centres

Bloomsbury Centre for Genetic Epidemiology & Statistics Centre for the Mathematical Modelling of Infectious Diseases Advances the understanding of the genetic mechanisms underlying Uses models to understand and predict the spread of infectious health and disease through the development and application of diseases and to test and guide interventions. ince 2012 we have held an annual The public, including patients, benefit computational tools and quantitative methods and models. School symposium to bring all both directly from our research via better Centre for Statistical Methodology staff together, including those interventions, stronger health systems, and Centre for Evaluation Enhances methodological cross-fertilisation among public based overseas. In 2013 the evidence-based information and indirectly Improves the design and conduct of public health evaluations health researchers. theme was ‘Achieving impact’; through the influence of our research. In the through the development, application and dissemination of rigorous Centre for Tuberculosis (TB Centre) Swe showcased good practice within the UK, the users of our research, and those who methods, and facilitates the use of robust evidence to inform policy Provides a focus for the School’s long-established global research School and discussed how to address benefit from it, include several government and practice decisions. expertise in tuberculosis epidemiology, immunology, diagnosis specific difficulties around achieving impact. departments, local authorities, the Food and treatment. One of the sessions, ‘From innovation to Standards Agency, Public Health England, Centre for Global Mental Health implementation: the example of vaccines’, and the National Health Service, trusts and Fosters research, capacity building and advocacy in prevention, European Centre on Health of Societies in Transition ECOHOST featured speakers engaged in the whole charities (see page 8). treatment and care, with the ultimate objective of reducing the Research into diverse aspects of health and health care arising pipeline of vaccine research, from antigen global burden of mental, neurological and substance use disorders. from social, political and economic transformation. discovery and development of a novel Interdisciplinary collaboration is key to Professor Anne Mills, Vice-Director approach, to the synthesis of glycoconjugate facilitating the translation of our research Centre for Global Non-Communicable Diseases International Centre for Evidence on Disability vaccines, through to evaluation of vaccine results into policy and practice. Our School Strengthens and promotes research, training and international Improves health and well-being among people with disabilities effectiveness, policy and advocacy. Centres cut across disciplines, departments networking in non-communicable disease research and health policy. through excellence in research, teaching and knowledge translation. Our impact is primarily and faculties. For example the Malaria Centre International Diagnostics Centre Centre for History in Public Health Our impact is primarily on improved health fosters a close working relationship between Facilitates the development, evaluation and implementation of on improved health Promotes and undertakes high quality research in order to contribute outcomes achieved through research that parasitologists, geneticists, immunologists accessible, quality assured in-vitro diagnostics for global health to the development of the historical discipline and to historical has led to the development and evaluation outcomes achieved through and population biologists, epidemiologists, through information sharing and advocacy. of new interventions, and has influenced research that has led to the entomologists, economists and social scientists, understanding in the field of public health policy. health policy at regional, national and global enabling us to maximise the impact of our Malaria Centre levels. In recent years, our research has led development and evaluation research on malaria control and prevention. MARCH Centre for Maternal, Adolescent, Provides evidence for policy and practice in the prevention, to changes in policy worldwide, for example in Reproductive & Child Health diagnosis and treatment of malaria around the world. of new interventions, and Improves health for adolescents, women, newborns and children the control of HIV, TB and other opportunistic Over the past five years, we have established Vaccine Centre infections in southern Africa, to new malaria has influenced health policy several new interdisciplinary centres based through better numbers and evidence, leadership development, and active policy engagement. Research from antigen discovery to the evaluation of vaccine control strategies in countries in West at regional, national and on this successful model. School Centres effectiveness, policy and advocacy. Africa, and to changes in syphilis control are strongly multi-disciplinary, drawing on a strategies in Brazil, China, Peru, Tanzania, global levels” diverse range of expertise across faculties Uganda and Zambia. to address global health challenges.

The School is also having a major impact in terms of contribution to the public debate on a range of issues, with a dramatic increase in media coverage in recent years, including Evidence into policy case study: many front-page articles in national and global media. We also increased our presence in Txt2stop rolled out as national smoking cessation programme online and social media with our active press Twitter feed gaining over 4,750 followers,

and Facebook more than doubling to 4,400. Many School researchers are also highly Gates Foundation Smokers are twice as likely to succeed in quitting networked on social media, with Martin McKee and Ben Goldacre named among the when they receive encouraging text messages. Courtesy Bill & Melinda most influential health commentators of 2013. The txt2stop study, a major randomised controlled trial undertaken by Dr Caroline Free at the School, examined the long-term effects of specially-designed Media coverage 2011–13 mobile text messages on 5,800 volunteer participants. Published in The Lancet, the study Top 10 media stories and highlights in 2013 was named Research Paper of

Courtesy Justin Grainge Photography NO. OF • Bed sharing and cot death risk for young babies the Year by the Royal College of ARTICLES General Practitioners and Novartis, 25000 • Estimated premature deaths attributable to UK summer heatwave Cari Free awarded Royal College of and won the Medical Research • John Snow bicentenary symposium and exhibition General Practitioners and Novartis Council and Bupa Foundation Research Paper of the Year LSHTM Research Online, 20000 • Malaria infected mosquitoes attracted to human odour Healthy Lives Prize. our open access repository • Malaria Vaccine: latest findings from the RTS,S phase III clinical trial offering free public access to our Dr Free worked with the Department of Health to roll out the programme 15000 research outputs, has grown to • Medical tourism and the National Health Service as a service to smokers across England, and since the launch of the over 24,000 records and nearly • National Survey of Sexual Attitudes and Lifestyles results service in 2012, more than 50,000 people have received smoking 10000 cessation support. 42% of participants reported quitting after 4 weeks – 5000 full-text papers deposited. • Portable eye examination kit may revolutionise prevention of We are now developing an online results which have been widely covered in professional and global blindness in low-income countries 5000 media, and led to the development of smoking cessation support data repository to facilitate the • UK Flusurvey results from 2012/13 and launch with British Science programmes by text message in Sweden, USA, India and Italy, and reuse and reanalysis of data and the validation of research findings 0 Association in 2013/14 the World Health Organization. 2011 2012 2013 both internally and externally. • World Health Organization and the School report on global prevalence of violence against women 8 Improving health worldwide: United Kingdom London School of Hygiene & Tropical Medicine Improving health worldwide: United Kingdom Annual Report 2013 9

Evidence for decision making Improving health worldwide: United Kingdom in local government With the abolition of Primary Care Trusts, local authorities are now responsible for public health, with guidance from NICE, and this change will potentially have major t a time of great change and challenge in the National Health Service and public health There is good evidence impacts across England. As partners in systems in the UK, we are engaged in a wide range of research programmes and the NIHR-funded School for Public Health projects which are making vital contributions to health outcomes, practice and policy. that patients, Research, we are working with policy-makers Partnership is key to this work, and in recent years we have developed productive particularly those with long and practitioners in local government to and valuable collaborative links with partners in government, the NHS, Public Health develop new evaluative research to support AEngland, local authorities, Royal Colleges, universities, health policy think-tanks, charities and term conditions, benefit from action on social determinants of health funders including the Wellcome Trust and Cancer Research UK. involvement in their own care” across a range of policy sectors including regeneration, housing, transport, crime and alcohol licensing. We are now home to three Department of currently evaluating a range of policy pilot Policy Research in Commissioning Health Policy Research Units, partner in a programmes including: patient choice of and Healthcare Systems Diversity of providers in the NHS fourth, and in 2012 became a partner in the general practice, cold weather alerts for The new Policy Research Unit in One of the key aspects of the Health National Institute for Health Research School patients with chronic lung disease and Commissioning and the Healthcare and Social Care Act 2013 is the policy of for Public Health Research. direct payments in social care. System, a partnership between the School broadening the types of provider of healthcare and the Universities of Manchester and to patients to include organisations which Many other relevant research programmes Kent, works with the Department of are not part of the National Health Service and projects are conducted across the School. Health to inform the development of itself; and to encourage those organisations We published brief summaries of around policy on commissioning, and how it can which remain in the National Health Service United colours of London: 30 of the most recent in March as part improve services and access, increase to increase their autonomy by becoming map developed by of our Improving health worldwide series. effectiveness and respond better to National Health Service foundation trusts. geoinformation systems specialists in the School’s patient needs. The Unit also supports the Pauline Allen, working with colleagues at Transport and Health Group Improving the effectiveness Department of Health on policy development Bristol and Leeds Universities, is undertaking to show the impact of of pilot programmes around Personal Health Budgets, and a series of studies funded by the National changing demographics and ethnicity on public health. Pilot and demonstration programmes are explores the relationship between Institute for Health Research to examine vital to inform the early stages of policy primary care expenditure and outcomes, the extent, nature and effects of increasing development. The Policy Innovation Research and competition and co-operation as the diversity of providers. Unit, led by Nicholas Mays, Mark Petticrew strategies in local health systems. and Bob Erens at the School, brings together White – British health and social care research expertise Reducing preventable hospital deaths White – Non-British to support and improve evidence-informed UK Flusurvey, now in its fifth year, has been taken There are almost 12,000 preventable deaths In recent decades, policy-making in social care and public up by the British Science Association for its 2013/14 in hospitals in England every year due to Black or Black British schools participation project research at the School health policy at national level. The Unit is problems with care, however this is less than Asian or Asian British a third of the number previously thought. In has had a major influence a study published recently, Helen Hogan and on government health policy Olympics and regeneration Nick Black found the majority of poor care in East London associated with preventable deaths was the in areas including smoking, Healthy transport Factors affecting lung cancer survival What is the long-term legacy for health of result of poor monitoring of the patient’s air pollution and health The School’s Transport and Health Group Lung cancer survival rates in the UK are lower the London 2012 Games and associated condition, wrong diagnosis or errors in has recently worked on several high-profile than in six comparator countries, according urban regeneration? A major five-year project medication or fluid replacement. inequalities” studies for the World Health Organization, to a new international study carried out by is underway to explore whether and how the UK Department for Health and Transport the Cancer Research UK Survival Group at the social factors for health and well-being Engagement and voice Lord Crisp, former Chief Executive of the for London on road safety and accident School. While Sweden had the highest rate of among local residents have improved as a in commissioning NHS and Permanent Secretary at the UK prevention and urban cycle commuting. one-year survival from the most common form result of new facilities, job opportunities, There is good evidence that patients, Department of Health Results from these and the recent On The of the disease (non-small cell lung cancer) transport infrastructure, green spaces and particularly those with long term conditions, Buses study of the links between free bus at 46%, the UK ranked lowest at just 30%. other improvements to promote healthy living. benefit from involvement in their own travel, health and wellbeing of older people Funded by the National Institute for Health care. The Engagement and Voice in and young people received widespread Dietary salt and cardiovascular disease Research, the Olympics and regeneration in Commissioning project is funded by the Air pollution and heart attacks coverage throughout 2013. The number of people in England adding East London (ORIEL) project began in 2011, National Institute of Health Research to Comparing air pollution data with the records salt to food at the table fell with researchers collecting baseline data investigate how patients and the public of over 150,000 acute coronary patients by more than a quarter in five from around 3,000 children aged 11–12 and are involved in local commissioning of in England and Wales, Cathryn Tonne and years, according to work by their parents, followed up early in 2013. The services, and how health organisations, Paul Wilkinson found that death rates after Alan Dangour and colleagues study focuses on health, well-being, physical including Clinical Commissioning Groups, leaving hospital were higher among patients published in January 2013 in activity, socioeconomic factors and residents’ engage with service users and enable who lived in areas with increased exposure the British Journal of Nutrition. perceptions of the impact of local changes, their voices to be heard. From 2010 to particulate matter emissions from road The researchers found that compared with data from nearby control areas to 2013, researchers worked with over traffic and industry. Published in the European since the salt awareness outside the Olympic zone. The participants 90 patient groups, commissioners, Heart Journal in February 2013, the results campaign began in 2003, the will be followed up again early in 2014 and health care professionals and individual show that patients living in London had the proportion of people reporting will form a cohort for a longitudinal study of patients in three sites across England, highest exposure to air pollution levels, and that they add salt at the table how socio-economic and health impacts are focusing on diabetes, neurological that patients from poorer backgrounds were dropped from 32% to 23% sustained over time. conditions, and rheumatoid arthritis. more at risk of early death. in the following five years. 10 Knowledge translation and innovation London School of Hygiene & Tropical Medicine Knowledge translation and innovation Annual Report 2013 11

Knowledge translation and innovation Bloomsbury Research Institute

he overarching aims of our knowledge advocacy. It supports maternal health Diagnostics research translation and innovation activities projects in six countries spanning Africa, conducted by School staff in the are to stimulate take-up of research Asia and the USA with the aim of identifying past five years has already led to important findings and tools, maximise the sustainable solutions based on evidence changes in public health policy and practice impact and benefit of the School’s from the evaluation. in many countries. With collaborators in more Tresearch through actively expanding areas than 100 countries in Africa, Asia and South of application, exploiting our expertise and This year, we also launched Chariot America, we have access to a unique range innovation, and setting up responsible Innovations Limited, a wholly-owned subsidiary of clinical material for the evaluation of new partnerships with industry. of the School, to focus on commercially- diagnostics, and are particularly well placed to viable knowledge translation activities. The study the impact and cost-effectiveness of new We have major strengths in the genome School’s Arthropod Control Product Test Centre diagnostic tests in a wide variety of settings. sciences, drug resistance, disease (Arctec) is now a world-leading independent

transmission and pathogenic mechanisms, Ann Fazakerley, Director of External Relations test centre for consultancy and the evaluation which enable us to exploit biomedical and Knowledge Transfer and development of arthropod pest control and technology advances and translate technologies. It provides laboratory and Infectious and parasitic diseases account to discover and develop new tools for the that knowledge into new drugs, vaccines, field evaluation of repellent sprays, pumps, for nearly 20% of all deaths worldwide. control and treatment of infection, through diagnostic reagents and disease control lotions, impregnated textiles and insecticide- Although great strides have been made improved understanding of pathogens strategies. These innovations are widely treated products. to control the ‘big three’ – HIV, malaria and the dynamics of infectious disease disseminated through our global networks, Our International and tuberculosis – they still claim more in global populations. and partner institutions in disease than four million lives every year, mainly in endemic countries are key collaborators Diagnostics Centre low-income countries. The emergence and Over the next few years, we aim to bring in this research. works with companies spread of new and drug-resistant diseases the Institute together under one roof in Professors Polly Roy (above) and Brendan Wren is a major and growing global challenge. state-of-the-art facilities. This will create We are continuing to work with private and regulatory authorities were both awarded Wellcome Trust senior In the UK, thousands die from hospital- a centre of excellence for research and investigator awards in 2013 companies. For example, the Merck for worldwide to reduce barriers acquired infections, and treatment and enhance engagement with industry Mothers Evaluation team, based at the prevention of antibiotic-resistant strains and international networks. It offers School, is assessing the impact of the $500 to market entry for new of pathogens costs the National Health an innovative model for research and million 10‑year Merck for Mothers Initiative, diagnostic tests” Developing a safe Bluetongue Service over £1 billion annually. training that integrates advances in basic which focuses on product innovation and virus vaccine science with those in population sciences Bluetongue is a viral disease of livestock The Bloomsbury Research Institute is a and computational biology, to bring new spread by midges. Since 1998, outbreaks in joint venture between the London School understanding to disease treatment, Europe have killed more than 2 million animals. of Hygiene & Tropical Medicine and prevention and control. Dr Samuel Assefa recently joined the Department of Polly Roy’s research has led to bluetongue University College London. Its mission is Pathogen Molecular Biology as Research Fellow in becoming one of the best understood viruses Population Genomics at the structural and molecular levels. This has paved the way for improved diagnostics and vaccines, and generic applications for Led by Professor Brendan Wren, researchers viral vaccine design. Boehringer Ingelheim are using genome sequencing technologies now produces a bluetongue vaccine based to identify pathways and exploit bacterial on Professor Roy’s research, which will enable glycosylation systems for glycoengineering the creation of several other promising new and novel vaccine design. The research vaccines exploiting virus-like particles as a group exploits a range of post genome method to produce safe vaccines against research strategies to gain a comprehensive human and animal viral pathogens. understanding of how bacterial pathogens function, how they evolve and how they Using smartphone technology interact with their respective hosts. for eye health More details of this work are on page 17. School researcher Andrew Bastawrous is conducting the Nakuru Eye Disease Cohort Diagnostics are under-valued in global health, Study – a follow-up of 5,000 participants in the yet important advances have been made, Rift Valley of Kenya to assess the incidence of especially in point-of-care diagnostic tests the major eye diseases for the first time in an for malaria, HIV, syphilis and other infectious African setting. Alongside this study, Andrew diseases. These can greatly improve the is developing a Portable Eye Examination quality of clinical care, and have a major role Kit, known as Peek, which uses adapted to play in improving surveillance and targeting smartphone technology to identify, diagnose for elimination. Our International Diagnostics and map blindness and visual impairment. This Centre works with companies and regulatory has attracted widespread media coverage and authorities worldwide to reduce barriers to is now being developed as a key technological Long-life insecticide treated bed nets are one of the most important insect vector control products Peek in practice, working with Maasai communities in Kenya market entry for new diagnostic tests. innovation in eye health diagnosis. 12 2013: the year in review London School of Hygiene & Tropical Medicine 2013: the year in review Annual Report 2012 13

2013: the year in review Selected highlights and events

January February March April May June London Centre for Memorandum of The School received a The bicentenary of John Jim McCambridge and Research led by Bob Neglected Tropical Diseases Understanding signed with highly positive review from Snow, founder of modern colleagues found that the Carpenter found that the launched, a partnership with Sichuan University, China. the UK’s Quality Assurance epidemiology, celebrated alcohol industry distorted risk of cot death among Imperial College London Agency for Higher Education, at the School with a evidence on alcohol control breastfed babies increased and the Natural History which highlighted examples symposium series and measures in order to with bed sharing, even Museum to tackle diseases of good practice including public exhibition of historical influence Scottish public when the parents did not including blinding trachoma, the School’s approach treasures and new artwork health policy in their favour. smoke and the mother had schistosomiasis, soil- to staff development, inspired by his pioneering not consumed alcohol or transmitted helminths and and how research work and legacy. drugs, prompting the UK leishmaniasis, which affect excellence and our diverse government to urgently more than one billion of the student body support examine its guidelines world’s poorest people. educational programmes. on co‑sleeping. A study led by Charlotte Andy Hall knighted for Mobile phone technology, Research by David Conway A gift from Janssen Agreement signed with the Anne Mills elected a Fellow Watts with the World Health Services to Public Health including text messaging, and colleagues shows that Pharmaceutica NV to the Kenya Medical Research of the Royal Society. Organization and South in the Queen’s Birthday shown to help people malaria vector Anopheles Centre for Global Mental Institute to collaborate African Medical Research Honours list. Sir Andy adhere to antiretroviral gambiae mosquitoes Health established a on training, research Council found that as many studied MSc Epidemiology therapies and quit smoking, in Africa, are more fund for new scholarships and capacity building. as one in three women are at the School in 1982 in a systematic review led genetically complex than to support Master’s A new MSc module victims of gender violence. and went on to work by Caroline Free. previously thought due to students. A further on Pathogen Genomics The report has influenced here for 22 years. School researchers interbreeding. nine scholarships were launched, organised policy and received over discovered mosquitoes announced in November. and taught jointly with 1,500 pieces of media infected with malaria the Wellcome Trust coverage worldwide. parasites are significantly Sanger Institute. more attracted to human The Lancet Series on odour than uninfected The government Programming for Nutrition Major international study Europe launched at the mosquitoes, with important of Ethiopia signed Outcomes, a free, open- by the Cancer Research School: researchers implications for vector a Memorandum of access distance learning UK Survival Group at the led by Martin McKee control; the team who made Understanding with module, developed with the School finds lung cancer identified many disparities the discovery also featured the School, making Department for International survival rates in the UK in access to services in the Wellcome Collection’s a commitment to Development to meet are lower than in six and health outcomes. Who’s the Pest? public work closely together training needs in countries comparator countries. engagement project. to strengthen public facing a high burden of Peter Piot gave the health research and undernutrition; over 15,000 keynote address at the training capacity. people from 161 countries World Health Summit have already accessed in Singapore. the module.

July August September October November December PopART, a major study in Research led by Johanna UK Flusurvey 2013/14 Students secured South Africa and Zambia Hanefeld showed that launched, with a new £80,000 in pledges in the to test a new approach foreign patients coming to partnership with the British first three weeks of our to the prevention and the UK for private medical Science Association to Alumni Fund Campaign control of HIV and AIDS in treatment are an important focus on flu in children, 2013/14, putting it on Africa was launched led source of income for NHS with schools nationwide course to exceed last year’s by Richard Hayes. Hospital Trusts, and that now contributing data to successful campaign raising more UK residents currently this vital survey. funds for people, projects travel abroad for treatment and partnerships. than international patients travel to the UK.

Findings from the third To mark the 25th MARCH Centre for Ben Armstrong calculated Peek, the mobile app and Our Young Scientists The China Medical Board The School topped The School signed National Survey of Sexual anniversary of the Department The BCG vaccine Memoranda of Maternal, Adolescent, around 650 premature clip-on hardware developed Programme continued to awarded scholarships the table of the world’s Memoranda of Attitudes and Lifestyles, of Health Services Research has been found to be Understanding signed Reproductive and Child deaths could be attributed by Andrew Bastawrous that develop throughout the to Chinese students for leading research-focused Understanding with FHI led by Kaye Wellings at the and Policy at the School, more effective against with the University of Health seminar and to the heatwave in England transforms a smartphone year, with 33 students aged postgraduate studies at graduate schools published 360, Universidade de Sao School and Dame Anne a symposium was held to pulmonary tuberculosis Hong Kong, (below) and parliamentary briefing for in July 2013. Nick Black into a tool capable of carrying 14–18 from ten schools the School. We welcomed by Thomson Reuters and Paulo, Brazil and Fundação Johnson at UCL, revealed explore how our work has than previously thought, the National Institute for the Towards Happier Birth commissioned by the UK out eye tests and diagnosing across London undertaking the first students on Times Higher Education. Oswaldo Cruz – Centro how British sexual attitudes helped meet the challenges according to a new Parasitic Diseases in China. Days programme launched to Department of Health to problems with vision, was two-week independent this scheme. de Pesquisas Aggeu and behaviour have changed faced by health services systematic review led improve the health of babies, lead a study into avoidable tested in Kenya and profiled research projects supported Magalhães, Universidade in recent decades. and systems in the UK and by Punam Mangtani. girls and women worldwide. hospital deaths. in a BBC exclusive. by academics at the School. de Pernambuco. abroad, and how our research has supported and guided changes and reforms.

A study led by Kate Walker An evaluation of the found that publication of effectiveness of meningitis A new Master’s course in death rates for individual serogroup A vaccine, One Health, delivered jointly surgeons in England may fail MenAfriVac, found there had with the Royal Veterinary to identify poor performance been no cases of meningitis College launched to study Aurora leadership in specialties where low following a mass vaccination disease at the interface development initiative numbers of key operations campaign in Chad led by between humans, animals for women in academia lead to unreliable results. Brian Greenwood. and the environment. launched at the School. 14 Faculty of Epidemiology and Population Health London School of Hygiene & Tropical Medicine Faculty of Epidemiology and Population Health Annual Report 2013 15

Faculty review: Epidemiology and Population Health

Not all clinical trials give an unambiguously positive finding. The incidence of tuberculosis key information in South African gold miners is the highest Dean of Faculty: Professor John Edmunds in the world, being driven by HIV, silica dust Staff total: 370 Academic: 275 Professional support: 95 and crowded conditions. The Thibela TB study was a large-scale cluster randomised Departments trial led by Gavin Churchyard of the Aurum Department of Infectious Disease Epidemiology Institute, an honorary professor in the faculty, with Katherine Fielding, Alison Grant Head: Professor Carine Ronsmans and other colleagues from the School. The Department of Population Health study aimed to interrupt TB transmission by Head: Dr Phil Edwards mass screening and treatment with isoniazid Department of Medical Statistics preventive therapy. Entire workforces were randomly assigned to receive either this Head: Professor James Carpenter therapy, or standard TB control. The results, Group activities help young people build nurturing relationships at Sangath, a charity based in Goa, co-founded Professor John Edmunds by Vikram Patel, Professor of International Mental Health at the School Department of Non-communicable Disease Epidemiology to be published early in 2014, showed that Head: Professor Liam Smeeth those mines that adopted the intervention Research Degrees Directors: Professor Suzanne Filteau had similar incidences and prevalences to those that did not. At the individual level it policy-makers with clear information on and Professor Simon Cousens Our Cancer Survival ur faculty’s purpose is to appeared that the intervention did reduce TB, the comparative effectiveness of health Taught Course Director: Craig Higgins inform biological understanding but this effect was soon lost as individuals Group currently systems in managing cancer patients, and of diseases and to provide stopped taking it. involves over 270 cancer on what factors, such as stage at diagnosis, Number of doctoral students 2012/13 evidence for decision-making registries in 66 countries with ethnicity and access to care, may underlie Student total: 122 UK/EU: 63 Overseas: 59 in global public health through Intervention trials are not always possible, the differences in survival within and Oinnovative and rigorous research and so careful observational studies are often data for around 30 million between countries. Top 5 grants awarded 2012/13 excellence in teaching. This year, the faculty required to evaluate the impact of changes has continued to maintain and develop its to health care provision. One of the most cancer patients” New statistical and mathematical advances 1. International Initiative for Impact Evaluation (3ie) – Population Effects of Antiretroviral Therapy to Reduce HIV Transmission (PopART) Richard Hayes £8.9 million position at the forefront of both applied important such change in recent years is allow for better and more efficient use and methodological research; making the rolling out of antiretroviral therapy for of collected data. One example of this is 2. Wellcome Trust – Wellcome Trust Strategic Award for tuberculosis, HIV and non- communicable diseases in Malawi Shabbar Jaffar and Moffat Nyirenda £5.6 million key contributions to understanding the HIV positive patients in Africa. Basia Zaba provided by the work of Marc Baguelin and 3. Medical Research Council – Epidemiological and statistical research on health problems causes of disease, and evaluating new and colleagues have analysed data from do not become pregnant. Antiretroviral therapy colleagues here and at Public Health England. of developing countries: MRC Tropical Epidemiology Group Richard Hayes £3.9 million ways to improve health. longitudinal population based studies of has dramatically improved survivorship among They developed a novel statistical framework 4. Department of Health – HALT-IT (Haemorrhage Alleviation with Tranexamic acid-Intestinal HIV/AIDS in Africa to assess the impact of HIV-infected, non-pregnant women, though to fit a model of flu transmission to multiple System) Ian Roberts £3.4 million Randomised controlled trials are the antiretroviral therapy on deaths around the mortality remains significantly higher than for longitudinal data sources from the UK. The 5. Wellcome Trust – Population impact of conjugate vaccine on pneumococcal transmission gold standard method for determining time of pregnancy. In a paper published in the uninfected women. In HIV-infected pregnant model demonstrated the importance of and disease in Kenya Anthony Scott £2.0 million the effectiveness of an intervention, and Lancet, they showed that in their survey of and post-partum women, the fall in mortality children in spreading flu, and was used to our Clinical Trials Unit continues to lead over 138,000 women, HIV increased the risk with antiretroviral therapy introduction has guide national immunisation policy. Starting ground-breaking research into the treatment of death in pregnant or post-partum women been smaller. in the autumn of 2013, children will now be of trauma and injuries. Each year, over by around eight times. The difference is even offered an annual flu vaccination in schools 100,000 women die from bleeding after greater in non-pregnant women, due to the Another key international research programme and nurseries. childbirth, mostly in low and middle income healthy pregnancy effect – very sick women with clear policy implications is CONCORD-2, countries. Previous work led by the Unit run by our Cancer Research UK Cancer Missing data affect both randomised has shown that tranexamic acid (TXA) Survival Group. This enormous collaboration, controlled trials and observational studies, reduces surgical bleeding and death in designed to establish worldwide surveillance and a key tool for analysing the resulting trauma patients. of cancer survival for the first time, currently partially observed data is multiple imputation. involves over 270 cancer registries in 66 Bob Carpenter and Mike Kenward, who have The team, headed by Professor Ian Roberts, countries, with data for around 30 million been active in this area for a number of years, is running a new trial to test the hypothesis cancer patients. The aim is to achieve robust published a research monograph Multiple that tranexamic acid can also reduce global comparisons of survival trends since Imputation and Its Application with Wiley. death from post-partum haemorrhage. 1995 for 10 cancers in adults and leukaemia Here they describe advances that overcome As of November 2013, the WOMAN trial in children. Even in high-income countries, issues with multilevel data and non-linear has recruited nearly 10,000 women there are wide differences in cancer survival, relationships. Among many applications, this with severe post-partum bleeding in 20 which could be due to factors such as delay methodology was used in the analysis of a countries, including large cohorts from in diagnosis, unequal access to high-quality study which showed bed-sharing is a risk Sub-Saharan Africa, and is now the biggest treatment and the organisation of health factor for sudden unexplained infant death randomised controlled trial of a treatment services. These differences can be even larger (also known as cot death), even in parents for post-partum bleeding ever conducted. when comparing across low and middle- who do not have other risk factors. This article If tranexamic acid is shown to be effective income countries. CONCORD will be the most featured in numerous media interviews, and Manga-style comic created by Ian Roberts to demonstrate the benefits of tranexamic acid in in reducing maternal mortality, this will have Thibela tuberculosis project trialled interventions comprehensive analysis of cancer survival to has been downloaded over 17,000 times emergency medicine among HIV-affected gold miners in South Africa a major impact on clinical care worldwide. date. It will provide national and international since it appeared in May. 16 Faculty of Infectious and Tropical Diseases London School of Hygiene & Tropical Medicine Faculty of Infectious and Tropical Diseases Annual Report 2013 17

Faculty review: Infectious and Tropical Diseases

Whole genome sequencing technologies continue to drive research on pathogenesis, key information epidemiology, virulence, and drug and Dean of Faculty: Professor Simon Croft vaccine development. Now supported by Staff total: 360 Academic: 255 Professional support: 105 a high-throughput DNA Sequencing Facility equipped with an Illumina MiSeq machine, Departments this research has offered many new insights Department of Clinical Research into drug-resistance in tuberculosis, malaria transmission and bacterial pathogenesis. Head: Professor Philippe Mayaud New in-vivo imaging technologies, research Department of Disease Control on glycan coupling technology for bacterial Head: Professor Mark Rowland pathogens and virus-like particles from Department of Immunology and Infection bluetongue virus are enabling productive collaborations to be established with the Head: Dr Colin Sutherland private sector, both with pharmaceutical Professor Simon Croft Department of Pathogen Molecular Biology companies and the biotech sector, on vaccine, Head: Professor John Kelly diagnostics and drug development. Research Degrees Director: Dr David Baker Taught Course Director: Dr Graham Clark esearch on pathogens, infectious diseases and interventions Malaria intervention trials in Tororo, Uganda, courtesy Helen Allwood, Malaria Capacity Development Consortium Number of doctoral students 2012/13 for disease control involves Student total: 149 UK/EU: 68 Overseas: 81 challenges and opportunities to integrate new “omic” biology Top 5 grants awarded 2012/13 Rand informatics into drug, vaccine and Whole genome Clinical interventions and patient care 1. Commission of the European Community – TANDEM Hazel Dockrell £5.0 million diagnostic research and development. are being supported through our research It is also focused on evaluation and sequencing innovations. Researchers in our International 2. Medical Research Council – Seasonal malaria chemoprevention in African children Brian Greenwood £4.0 million implementation into elimination and technologies continue Centre for Eye Health have shown that eradication programmes. To meet these the Portable Eye Examination Kit (Peek), 3. UNITAID via World Health Organization – Global Network to Improve Access to drive research on and Quality of HIV Monitoring Technologies Rosanna Peeling £3.0 million challenges and opportunities, we have a smartphone-based tool, can enable made new joint appointments with the comprehensive eye examinations to aid 4. Medical Research Council – Clostridium difficile, intestinal microbiota and host response pathogenesis, epidemiology, in hospitalised patients Brendan Wren £2.4 million Sanger Institute and the Crick Institute and the delivery and co-ordination of eye care Courtesy JBrendan Wren virulence, and drug and 5. Commission of the European Community – GENINVADE David Conway £2.4 million also the development of the Bloomsbury in remote locations. Our continued input, Research Institute (see page 11). vaccine development” through the Artemisinin Combination Therapy (ACT) Consortium into malaria The faculty has led the development of Our interactions with industry are also growing control, has shown the crucial role of rapid a number of School Centres (page 7), in vector control research, with continued diagnostic tests in targeting drugs to those for example the International Centre expansion of Africa-based projects on new studies, funded through a Biotechnology who need them, both through public health for Evidence in Disability, TB Centre, product development and evaluation, working and Biological Sciences Research Council services and in the private sector, in Ghana International Diagnostics Centre, and is a with the Innovative Vector Control Consortium Responsive Mode grant, has shown for the and Uganda.

Courtesy Val CurtisCourtesy Val key partner in the Centre for Evaluation. and the Pan African Malaria Vector Research first time that malaria infected mosquitoes Our teaching partnerships have also grown Consortium. A spin-out company, Arthropod respond more to human odour than We are also conducting pioneering work with the East African Diploma of Tropical Control Product Test Centre (Arctec) is working uninfected mosquitoes. on neglected tropical diseases, mainly Medicine and Hygiene, based in Moshi with more than 60 industrial clients on the parasitic in origin. Our work continues on the Tanzania and Kampala Uganda, now well development and evaluation of insect control Research on hygiene and sanitation, also Global Atlas of Helminth Infection, disease established (with 20 students from Africa technologies. Another initiative in vector in collaboration with industry partners, has mapping for helminth control, and efforts and 40 international in 2013), and this year demonstrated the success of a new approach to eliminate trachoma, the most common we have launched a new MSc in One Health to changing behaviour. The ‘SuperAma’ infectious cause of blindness with 21 million with the Royal Veterinary College, and a animated video campaign and evaluation cases worldwide, have been boosted by new MSc module on Pathogen Genomics, uses emotional cues such as disgust and the launch of the Global Trachoma Mapping organised and taught jointly with members nurture to encourage mothers to wash their Project. School researchers are working of the Wellcome Trust Sanger Institute. hands with soap. With St John’s Research in a consortium with SightSavers and the

Courtesy James Logan Institute Bangalore, this approach significantly International Trachoma Initiative, Ministries The Wellcome Trust Bloomsbury Centre increased rates of handwashing with soap in of Health, and other NGOs and academic for Global Health Research 2013 meeting trials. Hygiene researchers also played a lead partners to complete baseline mapping included 32 Clinical Fellows, who presented role in another School study, across faculties, worldwide by 2015. the results of their research in 14 countries which showed, through the first systematic in Africa and Asia and celebrated the review and meta-analysis, the importance of renewal of the Centre, with Wellcome water, sanitation and hygiene on childhood Sanitation in Bangalore with SuperAma intervention Anopheles infected with malaria Trust funding, for a further five years. nutrition and growth. 18 Faculty of Public Health and Policy London School of Hygiene & Tropical Medicine Faculty of Public Health and Policy Annual Report 2013 19

Faculty review: Public Health and Policy

was commissioned by the Department of Health to evaluate the Cold Weather Plan for key information England, introduced in 2011. Early findings Dean of Faculty: Professor Richard Smith have led Public Health England to review the Staff total: 286 Academic: 255 Professional support: 31 temperature thresholds used to trigger cold weather alerts to the NHS, social services Departments and other agencies. courtesy STRIVE / Raising Voices Annie Holmes, Photo by Department of Global Health and Development The National Institute for Health and Care Head: Professor Kara Hanson Excellence contracted the Environmental Department of Health Services Research and Policy Epidemiology Group to assess evidence on Head: Professor Jan van der Meulen the effectiveness of interventions to alleviate adverse health effects from cold housing ‘SASA!’ is a five-year project to stop violence against women and reduce HIV risk in Uganda. It is led by Raising Voices Department of Social and Environmental Health Research and the Centre for Domestic Violence prevention and cold weather. The group also won a Head: Professor Kaye Wellings prestigious European Research Council Professor Richard Smith Research Degrees Director: Judy Green, Nicki Thorogood (Deputy) grant to investigate the relationship between Taught Course Director: Hannah Babad particulate air pollution and risk factors At the macro level of climate change, a new Our faculty also continued to be a leading for heart disease in India. EU Framework funded project IMPRESSIONS source of advice to the UK NHS. Staff from Number of doctoral students 2012/13 (Impacts and Risks from High-End Scenarios: the Department of Health Services Research he mission of the faculty is to Strategies for Innovative Solutions) will focus and Policy, in partnership with Royal Colleges Student total: 135 UK/EU: 72 Overseas: 63 improve health globally through Integrated services, on broader scenarios relating to climate representing surgeons, obstetricians and research, teaching and engagement provided by trusted and change, and a partnership funded by the gynaecologists, advised a number of surgical Top 5 grants awarded 2012/13 in areas of health systems and Medical Research Council and Natural specialties on how best to report clinical 1. Department for International Development Asia – Regional Anti-Trafficking Programme services, health policy, and competent providers, can be Environment Research Council with Exeter outcomes for individual clinicians and Cathy Zimmerman £1.5 million Tthe individual, social and environmental a step in the right direction University will create a platform linking contributed to the national debate on achieving 2. National Institute of Health Research – Using Patient Reported Outcome determinants of health. We undertake climate and other environmental data with greater transparency on the performance of Measures to Assess Quality of Life in Dementia Sarah Smith £995,000 cutting‑edge research and contribute to ensuring access to more health and well-being data. health care providers. Staff also advised on the 3. Family Health International USAID – Multi-drug resistant Tuberculosis in Myanmar directly to policy in areas of current and health services for all” introduction of value-based pricing within the Richard Coker $750,000 future importance to public health. Sexual and reproductive health is another National Health Service to inform how National 4. National Institute of Health Research – The impact of home energy efficiency area in which we are taking a lead. In March, Institute for Health and Care Excellence will interventions and winter fuel payments on winter-and cold- related mortality Paul This year has seen a major public focus on President Joyce Banda speaking at the researchers from the Anthropology, Politics decide which treatments are funded by the Wilkinson £0.6 million gender violence: our Gender, Violence and launch of the School’s Integra partnership and Policy Group within the Department of National Health Service and at what price. 5. Rush Foundation – Rethinking and creating fiscal space for HIV through co-investments Health Centre, within the Department of project report at the UK Houses of Global Health and Development launched Charlotte Watts £0.6 million Global Health and Development, led work for Parliament, March 2013 the findings of the Integra Initiative, In October, Nick Black, Professor of Health the Global Burden of Disease in assessing the largest ever evaluation of different Services Research, was awarded a global the global prevalence and health impacts of models of HIV and social and reproductive Career Achievement Prize by the International violence against women and of child sexual health integration. The study found that Society for Quality in Healthcare, in recognition abuse. The findings, launched with the World integration of HIV and reproductive health of his work on the use of patient reported Health Organization and Medical Research services in Kenya, Malawi and Swaziland outcome measures (PROMs). Research with Council South Africa with publications in can lead to better health outcomes and collaborators at the University of York, funded Science and The Lancet, showed that 30% of service experience, decreased stigma by the National Institute of Health Research partnered women globally have experienced and cost savings. looking at the implications for the National violence from a partner. More broadly, the Health Service of inward and outward medical Centre’s evidence on effective interventions This autumn saw the culmination of work tourism, was published. The largest empirical helped inform the growing prevention agenda, by staff within the Department of Social study of medical tourism to date, the findings with staff input into a range of high-level and Environmental Health Research on the received widespread coverage in professional consultations. This expertise also led to the third 10-year UK National Survey of Sexual and national media. successful launch of a new short course on Attitudes and Lifestyles (NATSAL). Over Researching gender based violence: methods 15,000 adults aged 16–74 years participated In November, the School held a symposium and meaning. in interviews on sexual behaviour, fertility, to celebrate 25 years of Health Services contraceptive use and sex-related diseases. Research, and assess future challenges. It is now beyond doubt that environmental Funded by the Medical Research Council Looking ahead, in an exciting new joint venture change profoundly impacts health and well- and the Wellcome Trust, with support from coordinated through UCLPartners, faculty staff being. Our Environmental Epidemiology Group, the Economic & Social Research Council will play a leading role within the National based within the Department of Social and and the Department of Health this is one of Institute of Health Research Collaboration for Environmental Health Research, works at the the largest ever studies of sexual behaviour Leadership in Applied Health Research and forefront of this area, influencing national undertaken in a single country. The results, Care, to carry out applied health research policy. Together with colleagues in the Policy Integra launch at the UK House of Lords with published in a special issue of The Lancet within a population of six million people Innovation Research Unit in our Department of Susannah Mayhew and President Joyce Banda reveal how sexual behaviour and attitudes in living in north and east London and the Our new Tavistock Place buildings are home to the Faculty of Public Health and Policy of Malawi Health Services Research and Policy, the group Britain have changed in recent decades. surrounding areas. 20 Education: teaching and learning London School of Hygiene & Tropical Medicine Education: teaching and learning Annual Report 2013 21

Education: teaching and learning Facts and figures TOTAL STUDENTS ENROLLED London-Based 2013/14 Master’s 3925 DEGREE Students 546 669 London-based Master’s and research degrees (all) 1095 2012/13 2013/14 o meet increased demand and The Student Representative Council Course UK/EU Overseas Total UK/EU Overseas Total Distance learning Master’s students changing priorities in public and participated fully in the review and, as always, 2830 Control of Infectious Diseases 23 18 41 23 21 44 global health, our programmes have worked with staff throughout the year to help Demography & Health 8 4 12 9 4 13 continued to evolve and expand this improve the student experience. In addition year. Providing joint courses with to organising activities around student social, Total London‑based students Epidemiology 29 13 42 28 23 51 Tpartner institutions in the UK and globally is a welfare, charity and sports activities, the 2013/14 1095 Global Mental Health 1 13 7 20 6 19 25 key strategic goal, and in 2013 we launched Council contributed to developing enhanced Health Policy, Planning 2 26 23 49 34 37 71 a new MSc in One Health with the Royal support in areas such as careers guidance. & Financing Veterinary College, and a new short course in Type of Study Gender Immunology of Infectious Diseases 16 2 18 15 4 19 vaccinology with the Saw Swee Hock School To mark the centenary of the Medical of Public Health at the National University Research Council, the School was awarded 370 Medical Entomology for 6 1 7 3 2 5 669 426 Male Disease Control of Singapore. In April, we developed a new funds to create a competitive award for Master’s Research 725 Medical Microbiology 17 4 21 10 5 15 student recruitment strategy, focusing on a 6-month postdoctoral fellowship. The Female Medical Parasitology 17 2 19 7 3 10 engagement with prospective students and Professor Sharon Huttly, Dean of Studies fellowship was won by Dr Sarah Nogaro, applicants, and we secured significant new building on her PhD research working Medical Statistics 32 7 39 32 12 44 funding for studentships. with Dr John Raynes to investigate the Molecular Biology of Infectious development of clinical immunity to malaria. Diseases 5 2 7 6 1 7 Following a comprehensive audit by the The report identified a Mode of Study Domicile Nutrition for Global Health 10 5 15 12 9 21 UK Quality Assurance Agency for Higher 289 One Health (Infectious Diseases) 3 number of examples Part-time – – – 8 0 8 Education, we received the report in 470 UK Public Health 83 56 139 114 77 191 January 2013. This confirmed that the 806 480 of good practice, including our Full-time Overseas School ‘meets UK expectations’ in all the approach to staff development, Public Health for Eye Care 1 7 8 1 17 18 judgement areas – academic standards, 145 Public Health in Developing EU Countries 18 23 41 10 29 39 quality and enhancement of student learning the mechanisms for world-class Reproductive & Sexual opportunities, and public information about research activity to inform and Health Research 10 9 19 16 15 31 the education offered. The report identified Tropical Medicine & 17 17 34 24 20 44 a number of examples of good practice, enhance student learning, Fee Status Qualifications International Health Veterinary Epidemiology 3 including our approach to staff development, and facilitate student peer 200 13 2 15 9 4 13 the mechanisms for world-class research 508 Medical 587 Overseas 895 TOTAL 344 202 546 367 302 669 activity to inform and enhance student UK/EU Non-Medical support networks” Research poster showcase event learning and student peer support networks. 1 with Institute of Psychiatry, King’s College London 2 with London School of Economicsn 3 with Royal Veterinary College

In December, the Higher Education Funding Distance-learning doctoral degree Students Council for England announced new funding students 2830 406 426 to support an innovative ‘pre-doctoral’ course 2012/13 2013/14 2012/13 2013/14 programme in social science for mature Clinical Trials 314 284 Courtesy Rob Irving students at the School and three other Faculty UK/EU Overseas Total UK/EU Overseas Total Epidemiology University of London partners. This will be 560 597 Epidemiology and 63 59 122 68 57 125 developed and delivered by the Economic Global Health Policy 149 215 Population Health and Social Science Research Council funded Infectious Diseases 382 367 Infectious and Tropical Diseases 68 81 149 69 80 149 Bloomsbury Doctoral Training Centre. Public Health (all streams together) 1166 1126 Public Health and Policy 72 63 135 83 69 152 With major changes to the funding Individual modules 234 241 environment in UK higher education, we Total 2805 2830 Total 203 203 406 220 206 426 are planning ahead to meet the needs of future generations of postgraduate students. This includes working with sector bodies to address funding and other challenges. In Continuous professional development programme: short courses run in 2012/13 total participants 992 2013/14, we are undertaking a major internal Adolescent Health in Low & Middle Income Countries East African Diploma in Tropical Medicine & Hygiene Pathogen Genomics & Genomic Epidemiology of Infectious Disease review of our education programme to ensure Advanced Course in Epidemiological Analysis Epidemiological Evaluation of Vaccines Practical Pharmacoepidemiology it remains globally competitive and relevant Advanced Stata: Programming and other Techniques to Make Factor Analysis & Structural Equation Modelling Public Health Planning for Hearing Impairment for students’ future careers. Your Life Easier High Throughput Sequencing in Disease Studies Cancer Survival: Principles, Methods and Applications Infectious Disease Modelling Researching Gender-based Violence: Methods and Meaning Statistical Analysis with Missing Data Using Multiple Causal Inference in Epidemiology: Recent Intensive Course in Epidemiology and Medical Statistics Imputation and Inverse Probability Weighting Methodological Developments Introduction to Genetic Epidemiology in the GWAS Era Systematic Reviews and Meta-Analyses of Health Research Certificate in Pharmacoepidemiology & Pharmacovigilance Laboratory Diagnosis of Parasites Tropical Ophthalmology Clinical Trials Methods for Addressing Selection Bias in Health Diploma in Tropical Medicine & Hygiene Economic Evaluation Understanding an Eye Health System in Order to In March, despite snow, we hosted our largest Graduation Day ever Diploma in Tropical Nursing MSc Modules Achieve VISION 2020 22 People and resources London School of Hygiene & Tropical Medicine People and resources Annual Report 2013 23

People and resources

Income from all sources 2006/07 to 2012/13

£M Other Total (£ million) Research income has increased Tuition fees over recent years and represents £M Other Total (£ million) 140 Higher Education Funding Council for England (HEFCE) grants Tuition fees 125.1 63% of our total income, Research grants and contracts amongst the highest proportion 140 Higher Education Funding Council for England (HEFCE) grants 125.17.5 120 Research grants and contracts of any UK Higher Education 7.5 120 14.2 Institution. School staff have been successful in generating 100 14.2 23.3 research grant income, with an 100 above average success rate for 80 23.3 UK research council funding. In 80 addition, the School has a broad Richard Benson, Secretary and Director of Resources and Planning (left) and Andrew Young, 60 portfolio of funders, including Chief Operating Officer (right) 60 large charitable organisations 40 79.3 such as the Wellcome Trust and the Bill and Melinda Gates 40 79.3 Foundation, the UK Research e aim to recruit, manage, 20 Council and government develop and retain excellent 20 departments, the USA’s National staff based in the UK and 0 Institute for Health, the European elsewhere to deliver the School’s Union, industry, small charities mission. We have also made 0 2006/07 2007/08 2008/09 2009/10 2010/11 2011/12 2012/13 and individual donors. Wgreat progress in improving the School’s 2006/07 2007/08 2008/09 2009/10 2010/11 2011/12 2012/13 management and administration. The School’s research encompasses a spectrum The School embraces and values the diversity Research income:UK research grants councils and contractsIndustry and commerce outside the EU EU Commission and other from fundamental laboratory of its staff and student population and government bodies UK research councils Industry and commerce outside the EU EU Commission and other research in infectious diseases seeks to promote equality as an essential UK charities Other sources outside the EU EU other government bodies and studies of disease element in contribution to the improvement UK charitiesgovernment departments OtherCharities sources based outside outside the the EU UK EU other causation, through development of health worldwide. Our Talent and Educational Education. Aurora aims to enable a wider 20 and health authorities The School’s UK government departments Charities based outside the UK and assessment of novel Development Programme provides a range of range of women in academic and professional andUK other health authorities 18.4 20 interventions and services, to training workshops, seminars, online courses and success is founded roles to become future leaders, developing UK other 18.417.7 advising on implementation in other personal and professional development their skills and advancing their institutions. 15 on its committed staff, 17.714.3 real life settings of interventions, opportunities for staff across the School. 15 service and system reforms, its collaborators and the In November, the School was one of the first 14.3 11.2 and evaluation that informs Higher Education Institutions to be accredited 10 synergies that result from 11.2 policy and practice. as Living Wage Employers by the Living Wage 10 8.6 these interactions” Foundation. To be accredited, an employer 8.6 Our Values must ensure all directly-employed staff and 5 4.7 The School seeks to foster and contractors receive the Living Wage, which 4.71.9 5 1.2 sustain a creative and supportive We are developing the programme to meet is calculated according to the basic cost of 1.01.9 working environment based upon individual training and our Postgraduate living (currently £8.80 in London). This award 0 1.2 1.0 an ethos of respect and rigorous Certificate in Learning and Teaching (PGCILT) is recognises our commitment to fair pay. 0 2006/07 2007/08 2008/09 2009/10 2010/11 2011/12 2012/13 scientific enquiry. accredited by the Higher Education Academy. 2006/07 2007/08 2008/09 2009/10 2010/11 2011/12 2012/13 We support learning and transferable skills This year, the School joined the Stonewall We are committed to: development for early career researchers. Diversity Champion programme, Britain’s • Excellence and creativity good practice employers’ forum on • Maximising synergies The School is an equal opportunities employer, sexual orientation. We will be working Our strategy 2012–17 between research, education and part of the Athena SWAN award scheme with Stonewall and other employers on and knowledge translation to promote women in Science. In 2013, the programme to ensure that we are a The purpose of the Strategy is to provide • Prioritise development of facilities and and innovation two faculties secured Bronze departmental workplace of good practice. a framework to guide decisions focused on support services to optimise efficiency • Sharing expertise to strengthen awards, in addition to the Bronze Award for School-wide priorities over the next five years. and effectiveness capacity globally the School last year. We are currently working The School is a certified user of the Two Ticks The strategy enables the School to: • Ensure the School’s reputation continues to • Partnerships based on mutual towards achieving Silver awards across the Disability Symbol Scheme, and is committed • Identify key areas of development and grow globally, helping us to fulfil our vision respect and openness School in 2014. to employing people with disabilities. investment, appointments, research and mission • Equity and diversity directions and collaborations, education • Financial and environmental In October 2013, we appointed four members programmes and capital projects sustainability of staff to the Aurora programme, the leadership development initiative for women, • Frame communication with key The Strategy document can be downloaded from run by the Leadership Foundation for Higher stakeholders and audiences www.lshtm.ac.uk/aboutus/introducing/mission 24 Management and governance London School of Hygiene & Tropical Medicine

Management and governance

Organisational structure from December 2013

Key Senior Leadership Team Academic Department Director Peter Piot Vice-Director for Academic Affairs Anne Mills Faculty Teaching & Executive Officer Professional Support Services Patron Training Roles Frances Fowler HRH Prince Philip Executive Office Duke of Edinburgh KG KT Advisor on Africa Hazel Dockrell Honorary Fellows

Faculty of Epidemiology Faculty of infectious Division of Education Professional Support Services Resources & Planning Faculty of Public Health & Policy External Relations & Population Health & Tropical Diseases Dean of Studies: Chief Operating Officer: Secretary and Director: An Honorary Fellowship is the Dean: Richard Smith Director: Ann Fazakerley Dean: John Edmunds Dean: Simon Croft Sharon Huttly Andrew Young Richard Benson School’s most prestigious honour and is conferred Department of Infectious Department of Global Department of Clinical Research Human Resources Finance Communications on those people who have Disease Epidemiology Health & Development Quality & Management Team Philippe Mayaud Johanna Brake-Oakes John Garnham Patrick Wilson Carine Ronsmans Kara Hanson rendered exceptional service to the School or have attained Department of Health Services Research Management exceptional distinction in Hospital for Teaching Support Office Information Technology Services Development Department of Medical Statistics Research & Policy Chris Andrews & Sue Gammerman Tropical Diseases Ruth Ellis Jon Faulkner William Friar any of the subjects taught James Carpenter Jan van der Meulen & Michael Robinson in the School. Department of Department of Non-Communicable Department of Social & Distance Education & Professional Registry Disease Control Alumni Disease Epidemiology Environmental Health Research Development Office James Brown & Mark Rowland Legal Alice Perry Valerie Beral Liam Smeeth Tim Rhodes Sue Horrill Christopher McMahon Jens Hinricher David Bradley Department of André Capron Department of Nutrition & Public Knowledge Transfer Immunology & Infection Taught Course Director E-Learning Estates Health Intervention Research Deborah Carter Colin Sutherland Hannah Babad Trevor Manning Nick Jones Planning & Governance Jimmy Carter Phil Edwards Hilary Hunter Baroness Chalker Of Wallasey

Department of Pathogen Faculty Research Student Advice & Manuel Dayrit Taught Course Director Molecular Biology Counselling Service Library & Archive Services Research Governance Degrees Director Caroline Lloyd Craig Higgins John Kelly Judith Green and Emma Nabavian & Quality John Robert Evans Nicki Thorogood (Deputy) Patricia Henley Sir Richard Feachem Faculty Research Taught Course Director Procurement William Foege Careers Centre Degrees Directors Graham Clark Keith Flanders Suzanne Filteau & Tedros Adhanom Ghebreyesus Simon Cousens Tore Godal Faculty Research Health & Safety John Godfrey Degrees Director Heidi Alderton David Baker Coluthur Gopalan Sir Brian Greenwood Demissie Habte Donald Henderson Council Ralph Lainson Robert Logan Chair: Sir Tim Lankester KCB MA (Camb) MA (Yale) Appointed by the University of London Academic Staff Members Adetokunbo Lucas Deputy Chair: Dr Diana Walford Professor Nicholas Barber BPharm PhD MRPharmS Ms Lynda Clarke BSc MSc CBE MA BSc MSc MD FRCP FRCPath FFPH FRS FRSM (to 31.08.13) Dr Kara Hanson BA MPhil ScD Dame Sally Macintyre Professor John Kelly BSc PhD Halfdan Mahler Ex-Officio Members Independent Appointees Professor Eleanor Riley BSc BVSc PhD Tony McMichael Mr Dino Motti, Chair, Student Mr Kash Chandarana BSc ACA Professor David Ross MA BM BCh MSc PhD DLSHTM David Nabarro Representative Council Ms Ann Grant BA, MSc Professor Paul Wilkinson BSc BM BCh MRCP (UK) MSc Sadako Ogata Dr David Jolliffe CB FRCP (Chairman of Court) Sir Tim Lankester KCB MA (Camb) MA (Yale) Sir Eldryd Parry Professor Baron Peter Piot CMG MD PhD Mr John O’Donnell Professional Support Staff Members Sir Richard Peto FRCP FMedSci (Director) Mr Jan Pethick (Honorary Treasurer and Mr Dan Arthur BSc Chairman of Planning & Finance Committee) K Srinath Reddy Appointed by the Secretary Mr Sushil Premchand BA, FCA Secretary & Director of Amartya Sen of State for Health Mr Jonathan Roper MA (Cantab) Resources & Planning John Hilary Smith Dr Simon Tanner BM MSc MRCGP FFPH Professor John Stephenson BSc PhD CBiol FSB Mr Richard Benson BA Alfred Sommer (to 31.03.13) Dr Diana Walford CBE MA BSc MSc MD FRCP Robin Weiss FRCPath FFPH Peter Williams Appointed by the Secretary of State for International Development Dr Andrée Carter PhD FISoilSci MCIWEM Design: Ball Design Consultancy