30 September 2002

The Wellcome Trust Annual Review 1 October2001 –30September2002

Annual Review 2002 The Wellcome Trust is an independent research-funding charity, established under the will of Sir Henry Wellcome in 1936. It is funded from a private endowment, which is managed with long-term stability and growth in mind. Its mission is to foster and promote research with the aim of improving human and animal health. Its work covers four areas: Knowledge – improving our understanding of human and animal biology in health and disease, and of the past and present role of medicine in society. Resources – providing exceptional researchers with the infrastructural and career support they need to fulﬁl their potential. Translation – ensuring maximum health beneﬁts are gained from biomedical research. Public engagement – raising awareness of the medical, ethical and social implications of biomedical science. The Wellcome Trust Annual Review 1 October 2001 – 30 September 2002

FROM THE DIRECTOR CONTENTS

From the Director Reflecting on 2 Highlights of the year 4 Planning for the future five years at the 6 Financial summary Wellcome Trust 8 Knowledge Advancing knowledge and understanding in the biomedical When I became Director of the With the UK Government, for sciences and their impact on Wellcome Trust in 1998, I wanted example, we have worked on society – past, present and future. to make sure that the Trust retained projects to address the decaying its reputation for leadership, state of research infrastructure 16 Resources independence and distinctiveness. in the UK. In 1998, the Trust Contributing to a long-term and Yet I also wanted to enhance contributed £300 million to the vibrant research environment. two key aspects of its activities: £750 million Joint Infrastructure Such partnerships are not confined These are just a few examples 24 Translation innovation and collaboration. Fund, and in 2000, £225 million to to the UK, and the Trust has a of the Wellcome Trust’s activities the £1.1 billion Science Research long history of working with other over the past five years, a period Advancing the translation of Trust- Having stepped down as Director Investment Fund.These funds are countries.The great strides in that has seen massive – and much funded research into health benefits. in March 2003, it is perhaps an investing in new buildings, tropical medicine being made by needed – investment into UK apt time to reflect on the last five 30 Public engagement laboratories and equipment at our overseas research programmes biomedical research, both by years.We have seen many exciting Engaging with the public through universities throughout the UK. in South-East Asia (Thailand and the Trust and by Government. and remarkable advances during informed dialogue. Vietnam), Kenya and Malawi Such investment by the Trust is this time – the highlight, for me, I must emphasize, however, that would not be possible without the intended to enhance UK research: being the sequencing of the human we see it as the Government’s role enthusiastic support of local it does not, and will not replace 38 A year at the Trust genome. As a nation, we should to support the university research governments and close working investment by the Government. take great pride in the fact that infrastructure. I was particularly relationships with local organizations. In all that it does, the Trust is a UK Funding the UK – through its scientists at pleased with the outcome of the catalyst, not a solution. Career Schemes and Clinical Initiatives the Wellcome Trust Sanger Institute 2002 Spending Review in which Our public engagement programmes International Programmes in Cambridgeshire – should have the Government committed have also been developing rapidly Finally, I would like to say how Centres and Initiatives contributed one-third of the data £500 million per annum for over the last few years. From much I have enjoyed leading the Research Partnerships and Ventures to this huge international university infrastructure from public consultations to innovative Trust through such a productive Medicine, Society and History undertaking. 2004/2005.The Government has approaches that explore science period and give my thanks, not Catalyst BioMedica Ltd put this funding into the baseline, through drama and art, our only to the staff of the Trust, While the independence and indicating that it intends this to approach is very much one of but also to the many individuals scale of the Trust enables it to be a permanent measure. discussion, debate and listening. working within government, the 52 Board of Governors support enterprises such as the One of our latest initiatives is a research and funding councils and development of the Wellcome The Trust is also working closely 53 Advisory committees national network of science other charitable foundations who Trust Genome Campus, much with the Medical Research Council learning centres, a partnership have shared the vision and made of the work we fund requires and Department of Health on between the Trust and the it possible. a collaborative approach – often the UK Biobank project. Using Department for Education and the most fruitful method of genetic information from DNA Dr Mike Dexter Skills.The Trust is allocating up to achieving one’s aims. By working samples and the medical records Director of the Wellcome Trust £25 million over five years to the together with other organizations, of a cohort of 500 000 adults March 2003 initiative that will enable science we can take greater steps towards aged between 45–69, the Biobank teachers to learn more about our common goals – an excellent project will explore the interactions contemporary scientific ideas, example being the Human between genes, environment and train in new teaching approaches, Genome Project involving several lifestyle – and how that impacts and gain experience of new nations, multiple funders and on health – knowledge that will scientific techniques. various institutions. be essential to our understanding of common conditions of later life such as cancer and heart disease. Front cover A malaria parasite oocyst on the outside of a mosquito stomach wall. 1

FROM THE DIRECTOR CONTENTS

KNOWLEDGE RESOURCES TRANSLATION PUBLIC ENGAGEMENT THE TRUST

Biobank launched New research initiative Funding for the UK Biobank for South-East Asia project – a study of genes, and the Pacific environment and health – A major new initiative focusing was announced in April 2002. on the health problems of Cancer gene identified The Wellcome Trust, the developing countries in South Clinical Research Facilities Head On New Director A major genetic change Medical Research Council and and South-East Asia and the Wellcome Trust Clinical The Wellcome Trust gallery Professor Mark Walport, involved in 70 per cent of the Department of Health are Pacific was launched in May Research Facilities – centres at the Science Museum, which Professor of Medicine and cases of malignant melanoma providing an initial £45 million 2002 in partnership with the for patient-oriented research will run a series of thematic Head of the Division of is identified by the Cancer for the project. research councils of Australia in a hospital setting – open exhibitions to explore the Medicine at Imperial College, Genome Project at the and New Zealand. in Birmingham, Cambridge culture of medicine, opens London, is appointed to Wellcome Trust Sanger Three overseas and Manchester. with ‘Head On: Art with the succeed Dr Mike Dexter as buildings open Crick papers Institute. New Technology Brain in Mind’. the new Director of the Three Trust-funded overseas Francis Crick’s scientific archive Wellcome Trust. Malaria genome completed research buildings open: the comes to the Wellcome Library. Transfer Initiative Engaging Science A six-year project to sequence Kanchanaburi Field Station in Catalyst BioMedica, the A new £3 million Public Funding the genome of the Plasmodium Thailand, the Infectious Disease Trust’s business subsidiary, Engagement with Science The Wellcome Trust awards falciparum parasite, which Centre in Vietnam, and the is integrated within the main grants programme is launched. £419 million of grants, causes the most deadly form body of the Trust, and a new Africa Centre for Health Science Centrestage including £412 million for the of malaria, is completed. Technology Transfer initiative support of biomedical science. and Population Studies in The Science Centrestage is launched to help translate The Trust’s total expenditure Functional genomics awards South Africa. initiative for secondary school biomedical research into for the year is £585 million. The Functional Genomics students culminates in the tangible health benefits. Development Initiative makes National Festival of Drama New Governor seven awards, totalling at the Royal Opera House. Alastair Ross Goobey CBE £42 million, for thematic ReDiscover is appointed a Governor of programmes.These five-year the Wellcome Trust. The Trust allocates £5 million projects are multi-disciplinary to the ReDiscover fund – collaborations in integrated, a £33 million partnership with functional genomics research the Millennium Commission and focused on a particular the Wolfson Foundation – biological or biomedical theme. to enable science centres and International biomedical museums to replace or refresh research ethics their exhibits. A five-year £4 million funding scheme for the ethics of biomedical research in developing countries is launched.

Top left A new cardiac theatre at the Wellcome Trust Clinical Research Facility in Birmingham. Top middle Portrait Above Human melanoma of Brad Bontems by cell dividing. David Hockney, one of the exhibits in ‘Head On: Right A letter to Francis Art with the brain in mind’. Crick from a young admirer, congratulating him on his Top right Professor Mark Nobel Prize. Walport. 2 3

KNOWLEDGE RESOURCES TRANSLATION PUBLIC ENGAGEMENT THE TRUST

PLANNING FOR THE FUTURE

The Wellcome Trust 2000–05 The Wellcome Trust’s first Corporate Plan was published in October 2000. Planning for the Future sets out a philosophical and practical framework of mission, Wellcome Trust organization aims and values that will underpin all of the activities of the Trust for the next five The structure of the Trust reflects the years. Here, we present a brief overview of this framework and describe on the type of support provided to researchers. following pages how the Trust’s activities in the past year are working towards the The activities of major funding divisions of the Trust over the last year are detailed key aims and objectives of the Trust. on pages 40–51 of this Annual Review. Science Funding UK Panels Career Schemes and Clinical Initiatives Knowledge Excellence Centres and Initiatives Mission Aims Supporting basic, applied and Values To achieve excellence within International Programmes The Wellcome Trust’s The four aims identify strategically important research In all that it does to achieve our own work and in the Grants Administration mission is to foster and the priorities on which in biomedical sciences. its mission, the Wellcome work of those we support. promote research with the Trust concentrates. Researching the societal Integrity Medicine, Society and History Trust is guided by a set of Biomedical Ethics Programme the aim of improving Each aim is underpinned impact of biomedical science – values, shared by the staff To act responsibly and past, present and future. Engaging Science Programme human and animal health. by a series of objectives and Governors. with integrity in our work and interactions with others. Consultation and Education which establish the Resources Exhibitions Human resources: meeting Independence Responsiveness practical measures being History of Medicine Programme training and career development To retain our independence To maintain close relationships taken to achieve the aims Wellcome Library for the History needs of researchers. of decision making. with our communities and, and, ultimately, the mission and Understanding of Medicine through this, continue to Physical resources: building Leadership Tropical Medicine Resource of the Trust. respond flexibly to their needs. suitable conditions for research. To create and seize opportunities Research Partnerships and Ventures and help shape the agenda. Openness Translation Wellcome Trust Genome Campus To be open and transparent Promoting patient-oriented Evidence SNP Consortium To base funding priorities in our work. research and health services Synchrotron and policy making on the best Partnership research. Advanced Courses Programme available evidence. To work with others where Advancing the dissemination * this achieves the greatest Catalyst BioMedica Ltd and exploitation of the results Flexibility benefits to achieve our mission. Directorate of Trust-funded research. To support innovation and manage risk so that we can move Empowerment Director’s Office Public engagement rapidly into new and emerging To empower and develop Policy and Communications Stimulating an informed dialogue areas in imaginative ways. our staff to enable them to Legal to raise awareness and fulfil their potential and the Other divisions understanding of biomedical Trust to fulfil its mission. Investments science, its achievements, Finance and Information Management applications and implications. Personnel and Services

* Superseded by Wellcome Trust Technology Transfer 4 5

PLANNING FOR THE FUTURE

* Superseded by Wellcome Trust Technology Transfer 6 7

FINANCIAL SUMMARY

1 October 2001 to 30 September 2002 Grant expenditure for history of The Trust’s Figure 1 Figure 3 Grants awarded, Grants awarded (£m) Grants paid and outstanding (£m) Grants awarded: £419 million medicine and public engagement investment portfolio paid and outstanding with science programmes was The year has seen continued Grants awarded in the year Direct activities: £70 million £13.2 million, compared to £12.9 international tension and conﬂict, (Figure 1) represent the total 2000 1999 1998 2001 2002 2000 1999 1998 2001 Applications: 3884 applications; 2172 awards million in the previous year. economic uncertainty, and 2002 funds committed to successful applications during the Trust’s

considerable stock market 480

Total charitable expenditure: £536 million Figure 1 shows this year’s grants 1185 ﬁnancial year. Most awards are volatility. Favourable economic made to researchers’ host

expenditure compared to previous 1093 Investment assets: £9.3 billion (at 30 September 2002) data and a general improvement 419 years, and Figure 2 shows the institutions, which then claim 979 in economic activity failed to result 388 monies from the Trust.The light breakdown of funding. in improved market conﬁdence, 354 purple in Figure 3 (grants paid) Review of activities The Trust received 3884 grant and US and UK markets sank to represents the amounts claimed

of 8 per cent over the previous outstanding grants commitments negative returns for the year. 212 commitments) represents the total year (£388 million). Direct activities has increased to nearly £1.2 billion, sums committed by the Trust to The value of the investment included £56 million on the as shown in Figure 3.The graph projects which had not been assets of the Trust at 30 327 claimed by the end of the ﬁnancial Wellcome Trust Genome Campus. shows that there is a signiﬁcant 274 ◗ Grants paid

September 2002 amounted to 223 year.The gap between committed 203 and increasing time lag developing 201 ◗ Total grant expenditure includes £9.3 billion. Income for the year Outstanding grant funds and cash paid is due to the between a grant award and the £412 million approved for the to 30 September 2002 was commitments long-term nature of many grants, subsequent claims for the funds support of biomedical science, £306 million. Despite a decline and to the time lag between a by institutions. grant award and the subsequent compared with £375 million in in market value, the investment Figure 2 claim for funds from an institution. Breakdown of grants awarded 2001/02* £million the previous year.The increase in Expenditure on the direct portfolio has still supported Claims from JIF grants, for activity was largely attributable to activities of the Trust in 2002 was increased payment of grants example, will be received over grants of £46 million awarded as £70 million. Expenditure at the committed this year, as shown ◗ UK Funding† 129.9 several years. part of the Functional Genomics Sanger Institute is expected to in Figure 3, and a small increase ◗ Genetics 105.8 Additional ﬁnancial information can Development Initiative.Total Joint increase over the next few years in other charitable expenditure. ◗ Careers§ 86.9 be found in the Wellcome Trust’s Infrastructure Fund (JIF) and as the Cancer Genome Project Annual Report 2002, available from In November 2001 the Trust sold ◗ Science Research Investment Fund gets underway in full and other JIF and SRIF 70.3 the Trust’s Marketing Department 100 million of its directly held (SRIF) awards were £70 million programmes gain momentum as ◗ International 58.8 (address on inside back cover). shares in GlaxoSmithKline plc for this ﬁnancial year compared to recruitment progresses. ◗ Medicine, Society and History 13.2 1780p per share, giving total £113 million in 2001; this followed ◗ The total amount of resources proceeds of £1.78 billion.This sale Buildings and equipment (other than JIF/SRIF) 5.8 a fall in the number of JIF/SRIF expended by the Trust during the formed part of a wider portfolio- ◗ Other schemes and salary supplements awards from 51 to 26, as this year was £585 million.The Trust’s rebalancing exercise by the Trust, minus grants no longer required 7.8 programme comes to an end. * Amounts include grants to subsidiaries charitable and other expenditure with the aim of increasing the † UK Panels and Centres associated is analysed in Figure 4 as a diversity of its investments. with Panels Total: £478.5 million percentage of total resources § Includes cardiovascular expended.

Figure 4 Resources expended %

◗ Grants awarded 71 ◗ Direct activities 12 ◗ Support and administration costs 9 ◗ Investment costs 8

Total: £585 million 6 7

FINANCIAL SUMMARY

considerable stock market 480

Total charitable expenditure: £536 million Figure 1 shows this year’s grants 1185 ﬁnancial year. Most awards are volatility. Favourable economic made to researchers’ host

569 by host institutions during the year The Trust awarded £419 million applications in 2001/02 and 2172 five-year lows over the summer 722 for expenses incurred, while the of grants in 2001/02, an increase awards were made.The level of of 2002, resulting in significant dark purple (outstanding grant of 8 per cent over the previous outstanding grants commitments negative returns for the year. 212 commitments) represents the total year (£388 million). Direct activities has increased to nearly £1.2 billion, sums committed by the Trust to The value of the investment included £56 million on the as shown in Figure 3.The graph projects which had not been assets of the Trust at 30 327 claimed by the end of the financial Wellcome Trust Genome Campus. shows that there is a significant 274 ◗ Grants paid

Figure 4 Resources expended %

◗ Grants awarded 71 ◗ Direct activities 12 ◗ Support and administration costs 9 ◗ Investment costs 8

Total: £585 million 8 9 KNOWLEDGE

Cancer gene identiﬁed Foot and mouth disease

Professor Mike Stratton, Richard The mutation is so clear-cut that As the UK farming industry EU regulations do not permit the Wooster, Andy Futreal and their drugs are already being designed struggles to recover from the export of vaccinated animals. team of researchers working to block the action of the defective 2001 outbreak of foot and mouth Moreover, although people can on the Cancer Genome Project protein.The findings were disease (FMD), in which six million eat infected meat without getting at the Wellcome Trust Sanger published in Nature in June 2002. animals were culled, researchers FMD, consumer confidence in Institute have identified a major are using computer simulations to meat from vaccinated animals Malignant melanoma, which is genetic change that is involved in design control strategies that would would be severely affected. mainly caused by undue exposure 70 per cent of cases of malignant minimize the cost to farmers in to sunlight, accounts for just 11 per The team is therefore assessing melanoma, a potentially lethal any future outbreaks. cent of skin cancers, but almost various reactive vaccination form of skin cancer. all of the deaths.The incidence of Professor Mark Woolhouse, strategies. Moving swiftly to The Cancer Genome Project malignant melanoma has doubled Dr Bryan Grenfell, Dr Stephen vaccinate herds as soon as the is a Wellcome Trust-funded in the past decade. In the UK Brooks and Dr Matthew Keeling – first cases of FMD have been programme to identify genetic about 6000 new cases are a team of Wellcome Trust-funded reported could limit the spread changes that cause cells to diagnosed each year, and more than epidemiologists and statisticians of the disease without affecting become cancerous. Researchers 1600 people die of the disease. at the Universities of Edinburgh, the export market too adversely. at the Sanger Institute are using Cambridge and Warwick – are However, there is a six- to ten-day The results from these early the human genome sequence investigating the effectiveness of delay before vaccinated animals stages of the project validate the as a reference to examine various vaccination strategies as are protected, in which time they method adopted by the Cancer systematically all genes in about an alternative to culling. could catch and transmit FMD – Genome Project team.The search 50 human cancers. reducing the ability of the vaccine which led to the discovery of To start with, the team is modelling to get ahead of the epidemic. The BRAF gene was found to be the BRAF mutations started only the spread of FMD and assessing mutated in about 70 per cent of 12 months ago and has served its dependence on a range of This problem could be overcome malignant melanomas, 10 per cent as a proof-of-principle for the variables. Farm size, species of by a novel predictive strategy, of colon cancers and a smaller full genome-wide exploration. livestock (whether cattle, sheep or which involves predicting the Above Professor Michael History of cancer New animal health ◗ proportion of other cancer types. The project will involve millions Stratton is leading a pigs) on farms, proximity to roads most at-risk farms over the next exploiting post-genomic Remarkably, most of the mutations of experiments capitalizing on systematic search for Professor John Pickstone, University and nearby farms, regional climate, seven to 14 days of an epidemic programme technologies for the development in the BRAF gene involve the same the automated, high-throughput genes involved in cancer. of Manchester, has been awarded a and seasonal changes in numbers and protecting these farms by The WellcomeTrust has launched of new disease control measures Wellcome Trust History of Medicine a major new programme to fund for target (i.e. veterinary) species single letter of DNA. systems in place at the Wellcome and locations of livestock – all vaccination. Models indicate that programme grant for the study of research and related activities on in the developing world; Trust Sanger Institute. the medical history of cancer in these factors impact on disease this potentially powerful ‘smart’ diseases of farmed animals in the Collaborators Professor Chris ◗ stimulating renewed and focused the UK since 1945. transmission. Detailed data strategy cuts off the tail of the developing world. Such diseases Marshall and Dr Richard Marais The Wellcome Trust announced research effort in understanding collected by the Department for epidemic by many months, and range from Rift Valley fever, which who work at the Institute of a £300 million grant in October The research is structured in a the biology of transmission; grid of three themes and three the Environment, Food and Rural could be of major economic infects humans as well as sheep and Cancer Research, in the Cancer 2001 to take the Wellcome Trust topics.The themes are: the Affairs (DEFRA) during the 2001 significance. goats, to African horse sickness, ◗ producing livestock with enhanced Research UK Centre for Cell and Sanger Institute into the post- which is carried by midges and kills relations of research and therapy; outbreak is enabling the team resistance to disease for resource- Molecular Biology, showed that genomic era. As part of this funding changing patient expectations The outcomes of these computer up to 95 per cent of the horses, poor settings; to develop a realistic and flexible mules and donkeys it attacks. the mutation renders the BRAF programme, the Cancer Genome and experiences, including risk, simulations – passed to the Office ◗ background against which to raising awareness and understanding protein active all the time so it Project will receive up to £36 diagnosis, treatment and palliation; of Science and Technology and Through its Animal Health in the simulate different control strategies. of animal health issues in resource- is no longer responsive to the million over five years to search and the changing professional and DEFRA, with whom the team Developing World initiative, the poor settings, in order to maximize signals that should control it, and for the genetic changes that cause institutional configurations around One option would be is working closely – will help the Trust is setting aside £25 million the animal health gain available the management of patients. over five years to fund researchers the affected cells can multiply the most common cancers, preventative vaccination of entire Government develop guidelines from existing control and The topics are three groups of who will use the latest technologies intervention strategies. unchecked, leading to cancer. including breast, lung, colorectal, cancers, as they were understood herds. However, although this for cost-effective vaccination in to investigate animal diseases. ovary and prostate cancer. and managed over the later 20th would prevent a major epidemic the UK.They may also inform The main areas of research the century: blood and lymph cancers; of FMD in the UK, the economic the development of international programme aims to cover are: breast cancer; and ‘recalcitrant’ effect would be disastrous: current guidelines – not only for the ◗ cancers, especially of the lungs. improving understanding of the control of FMD, but for other epidemiology of disease in order To p The outbreak of major livestock diseases, such as to predict and improve controls foot and mouth disease African swine fever. for disease outbreaks, focused on in 2001 affected millions the developing world; of cattle in the UK. Above Dr Matthew Keeling and colleagues are using computer simulations to assess control strategies. Left The foot and mouth disease virus. 8 9 KNOWLEDGE

Cancer gene identiﬁed Foot and mouth disease

The malaria genome

The sequence of the genome in which parasites evade the Left and below Images Other microbe genomes Plasmodium in vitro of Plasmodium falciparum, the host's defences, and the adhesion from a booklet about completed by the Pathogen Malaria parasites have complex malaria produced by the most important cause of malaria of infected red blood cells to Sequencing Unit or life cycles consisting of distinct US War Department for published in the year: stages, split between vertebrate and in humans, has been completed. the walls of blood vessels, which distribution to troops ◗ Yersinia pestis, the bacterium which mosquito hosts.While techniques Malaria kills up to 2.7 million underlies some of the worst during World War II.The booklet formed part of causes plague (published in Nature). for replicating the vertebrate people a year, most of them symptoms of malaria. the TwoTen exhibition stages in vitro are well established, ◗ Salmonella typhi, the bacterium children under five years old in ‘Everything I could buy the mosquito stages had proven Genome data will also enable responsible for typhoid fever sub-Saharan Africa. Along with on eBay™ about malaria’. more difficult. researchers to reconstruct entire (published in Nature). HIV/AIDS and tuberculosis, Professor Hilary Hurd and metabolic pathways of the malaria it is one of the biggest infectious ◗ Schizosaccharomyces pombe (fission colleagues at the Centre for Applied parasite. Pathways specific to the disease killers in the world. yeast), a model organism used for Entomology and Parasitology, parasite, or known to be essential the study of processes such as cell University of Keele, have now The sequencing was carried to its survival, are highly prized by division (published in Nature). succeeded in culturing mosquito stages of a mouse malaria parasite out by the Pathogen Sequencing researchers searching for new ◗ Mycobacterium bovis, which causes in vitro – an important step forward Unit at the Wellcome Trust Sanger drug targets – who will now have tuberculosis in a wide range of wild for researchers investigating new Institute, the Institute for Genomic access to all the steps in a pathway and domesticated animals. ways of tackling malaria. Research in Rockville, USA, and rather than just one or two. ◗ Streptomyces coelicolor, a soil- Al-Olayan E, et al (2002) Stanford University, USA.The The directory of parasite gene dwelling organism which is used Complete development of mosquito £18.5 million project was funded to produce pharmaceutically useful sequences also enables stages of the malaria parasite in vitro. in the UK by the Wellcome Trust compounds including anti-tumour researchers to search Science 295: 677–79. (£8 million) and in America by agents, immunosuppressants and for proteins likely to stimulate Malaria online, in print and the Burroughs Wellcome Fund antibiotics (published in Nature). strong immune responses, on CD-ROM (£4.9 million), the National Further details of projects at the The publication of the genome a valuable aid to those working Institute of Allergy and Infectious Pathogen Sequencing Unit can be of Plasmodium falciparum was on malaria vaccines. Diseases (£2.2 million) and the found at: celebrated with the launch of a new Trust website on malaria and US Department of Defense Over the last five www.sanger.ac.uk/projects/microbes Above Dr Bart Barrell, with a Wellcome News supplement, Head of the Pathogen (£3.4 million). years the Trust has www.sanger.ac.uk/projects/protozoa Research directions in malaria. Sequencing Unit at the invested more than £70 million Wellcome Trust Sanger The genome sequence – which Malaria 2nd edition, a CD-ROM in in malaria research, with a Institute. is freely available on the Internet the Trust’s ‘Topics in International significant proportion going Left A red blood cell for researchers to use – has Health’ series, was awarded the through research programmes Prix IAMS for 2002. See page 50. infected with malaria already begun to generate new parasites. in Kenya,Thailand,Vietnam discoveries, including several new www.wellcome.ac.uk/malaria and Malawi. families of genes and the full repertoire of previously known gene families. Study of these genes will help researchers understand better parasite variability, one way 10 11 KNOWLEDGE

The malaria genome

International Testing vaccination success research ethics

A new study has found that a novel was offered immunization with the The Wellcome Trust has launched raised by domestic research, vaccine introduced throughout new ‘meningococcal C conjugate a series of schemes to support cross-cultural inequalities lend the UK in November 1999 against (MCC) vaccine’, which is much studies of the ethical context of them a certain urgency. group C meningococcal disease, more effective than the older biomedical research in the Researchers face tough decisions, was working well a year later. vaccines, providing long-lasting developing world, as part of its such as whether they should protection, even to small babies. Biomedical Ethics Programme. provide successful interventions to Commonly referred to as By November 2000, more than 70 those involved in the research, and meningitis, this disease is caused by Research in developing countries, per cent of the UK’s children and Cleft lip and palate how different views of research the meningococcus, a bacterium particularly when funded by more teenagers had been immunized. and of ethics can be reconciled that normally lives in the human affluent countries, raises difficult when they differ across cultures. throat without causing symptoms. To find out how well the vaccine gene identified ethical questions – for participants, Occasionally, for reasons that was working, Martin Maiden, communities, researchers and The new Biomedical Ethics are still not understood, the James Stuart and colleagues research funders. Above all, these schemes, launched in October meningococcus invades the (the UK Meningococcal Carriage Using information from the Human Having identified the gene, the questions stem from imbalances in 2002, will support studies of the bloodstream, causing a severe Group) surveyed thousands of Genome Project, researchers at researchers found the mutations power and wealth between those ethical, legal, social and public disease that is usually fatal in the teenagers while they were being the University of Manchester, led in 45 other families affected by conducting the research and those policy implications of any part absence of treatment.There are vaccinated, and then again a year by Professor Michael Dixon, have Van der Woude syndrome, and involved as research participants. of the research process in the about 2500 cases per year in the later. Across the UK, they found helped identify the crucial faulty the mutations in the same gene developing world, from decisions Although at a practical level a lot UK, with children and adolescents that the proportion of people gene that causes Van der Woude that cause a related disorder about what biomedical research of the ‘research ethics’ questions particularly at risk. carrying group C meningococci in syndrome, an inherited form of cleft called popliteal pyterygium is undertaken, through how the that arise in international their throats had fallen by 66 per lip and palate that can cause severe syndrome (which causes cleft lip research is conducted and what Only five of the many forms of guidelines on the ethical conduct cent – indicating that the vaccine facial disfigurements in babies. and palate, genital anomalies, and happens after the research is the meningococcus cause most of research are the same as those was preventing carriage of these webbing of the skin). over, to its implications for policy disease: these are called groups Cleft lip and palate are among bacteria. During the year, the rates and practice. A, B, C, Y and W. Group B and C the most common birth defects in The results could lead to improved of disease caused by group C meningococcal disease is humans, affecting up to one in 500 understanding of normal and meningococci also fell rapidly in Above Dr Martin predominant in the UK, while infants.The condition causes either abnormal facial development, how www.wellcome.ac.uk/biomedicalethics the vaccinated age groups, but Maiden and colleagues most disease in Africa has been have examined the an opening between the mouth and why cleft and palate occurs, remained unchanged in the older group A.Vaccines against groups effectiveness of the new and the nose (which can look as and in the long term how it might unvaccinated age groups. A, C, Y and W have been available meningococcus vaccine. though there is a split in the lip), be remedied. In the meantime, for some years, although they are As the meningococcus is naturally Left From November or a small gap in parts of the the findings will have an important 1999, everyone in the UK mouth. In some cases the baby is and lasting impact on individuals ineffective in infants and provide present in the throats of many under the age of 18 was only short-term protection in adults. people, and especially teenagers offered immunization born with both.Van der Woude and families affected by Van der There is no effective vaccine and young adults, it is important with the new vaccine. syndrome accounts for about two Woude, especially regarding against group B meningococci. to know the effect of this large- per cent of all cleft lip and palate genetic counselling and post-natal scale vaccine intervention on the cases; importantly, it is a condition diagnosis. Record numbers of cases of meningococcal population. that shares similarities with many meningococcal disease, an The genetic makeup of the more other types. Professor Michael Dixon’s research increase in outbreaks caused by than 9000 meningococci which at the University of Manchester group C, and the availability of A vital clue to the identity of the were obtained in this study is was funded by the national medical a new vaccine led to the launch faulty gene underlying Van der charity Action Research, and by the being determined at the Peter of a nationwide immunization Woude syndrome came from a Wellcome Trust. Medawar Building in Oxford. campaign. From November 1999, pair of Brazilian identical twins. Kondo S, et al. (2002) Mutations The results will indicate the everyone in the UK under the age One twin was born with the in IRF6 cause Van der Woude and evolutionary pressures imposed of 18 (about 14 million people) syndrome, the other without, popliteal pterygium syndromes. by the vaccination campaign on and the Manchester researchers, Nature Genetics 32:285–289. the bacterium. Knowing about in collaboration with a team led these pressures will enable long- by Professor Jeffrey Murray at the term effects of the vaccine University of Iowa, tracked down introduction to be anticipated the difference to a mutation in a and will assist in the design and gene called interferon regulatory implementation of future vaccines factor 6 (IRF6), on chromosome 1. and vaccination campaigns. 12 13 KNOWLEDGE

International Testing vaccination success research ethics

The National Under pressure DNA Database

High blood pressure affects at genome analysis, the team aims Functional genomics ◗ £5.4 million for the study of the The collection and use of DNA to establish a national database least 5 million people in the UK, to find the genes responsible for thematic projects genes that determine the identity samples in biological and medical of DNA profiles to be used to increasing the risk of heart attacks, high blood pressure and related In 2002, the Wellcome Trust's of motor neurons and olfactory research raise many social and determine whether individual Functional Genomics Development neurons, and the partners the stroke, and heart and kidney conditions. Having tracked down ethical issues – rightly the subject of suspects could be included or Initiative made seven awards for neurons connect with in the central failure. It is also responsible for these genes, they will then go on thematic projects.These five-year nervous system.The project is led wide-ranging discussion and debate. excluded from involvement in more than half of all deaths of to examine their functional role projects are multidisciplinary by Professor Andrew Lumsden, Yet forensic databases, which also particular crimes. The body people over 65 years old. and the pathways they are collaborations in integrated functional King’s College London. store DNA samples, have been The DNA profiles are obtained genomics research focused on a involved in, at molecular, cellular ◗ £5.4 million for a study of the less subject to such analysis. Many different genetic and particular biological or biomedical from crime scenes and from as a and physiological levels. malaria parasite. Underpinned environmental factors appear theme.The other six projects are: Indeed, the National DNA individuals suspected, reported, by the malaria parasite genome to contribute to high blood The third aim of the project is Database (NDNAD), used to charged or convicted of any ◗ £5.1 million for a study of the sequence (see page 10), the project pressure.Teasing apart these to apply the findings to the study provide scientific support to the recordable offence. Since the resource functional genomics of stem cells will systematically examine the myriad factors and their effects of these genes in large groups of by Professor David Beach and genes and proteins that make the police in the investigation of crime, establishment of the NDNAD, would be extremely difficult human patients.This will involve colleagues at University College parasite so dangerous to humans. is by far the largest collection of genetic data held on this database Collecting and processing material was not until World War II that without a systematic approach, both a comparison of frequencies London and the University of The project is led by Professor DNA in the UK. Set up in 1995, have become increasingly central taken from living people and demands for reliable and regular Cambridge.The project will look at and so five major UK research of putative disease-causing gene Christopher Newbold at the the NDNAD currently holds more to the practice of criminal dead bodies is central to modern supplies led to tissue banks the genes that give stem cells their University of Oxford. medicine.While the larger body becoming established. teams have pooled their expertise variants in large case-control remarkable plasticity, and those than 1.5 million DNA profiles and investigation in the UK. in a new ‘thematic’ functional association studies as well as ◗ £5.5 million to produce a ‘biological is on target to contain the DNA organs – the heart and lungs – that can trigger their differentiation Through interviews and The development of the tissue genomics project backed by detailed evaluation and identification in a particular direction. atlas of insulin resistance’, a disorder profiles of all of the known active attract the most publicity, almost documentary evidence, the project banks occurred without public £5.4 million funding from the of intermediary conditions that underlies late-onset diabetes, criminal population. every part of the body has had an ◗ £4.8 million for the study of obesity, high blood pressure and team aims to investigate a wide debate in the UK, perhaps Wellcome Trust's Functional modified by genes. impact on medicine. From valves trypanosomes, parasites that infect heart disease.The project is led by With a Wellcome Trust Biomedical range of issues raised by the because, at the time, the NHS Genomics Development Initiative. cattle and cause a wasting disease used in heart surgery, dentists Professor James Scott at Imperial Ethics project grant, Robin NDNAD, such as the inclusiveness was relatively new and did not called nagana. Led by Professor rebuilding jaws and surgeons College London. want adverse publicity. In 1961, Led by Professors Anna Stephen Kemp, University of Williams and Dr Paul Johnson of the database, the management repairing hips, all rely on using ◗ the Human Tissue Act gave Dominiczak and Nilesh Samani, Liverpool, the project will study £4.8 million for the study of the at the University of Durham and of issues of confidentiality and other people’s bodies. the project brings together the role of genes in infection and role of genes in ageing.The project Dr Paul Martin, University of privacy, and the accountability of hospitals the right to remove and researchers from the Universities disease, and look at why some will examine the pathways that Nottingham, are investigating the the custodians and users of this With a Wellcome Trust History use tissues for therapeutic use, increase longevity in fruit flies and of Glasgow, Leicester, Oxford cattle are resistant to the parasite. social, ethical and public policy form of genetic information. of Medicine Research Leave medical research and education. nematode worms, and test their role Award, Professor Naomi Pfeffer But it failed to provide a proper and Edinburgh, Imperial College in rodent models.The project is led contexts and consequences of the The study will engage with various School of Medicine, London, by Professor Linda Partridge at establishment and rapid expansion stakeholders, and will aim to offer at London Metropolitan University regulatory framework, especially the Roslin Institute in Edinburgh, University College London. of the NDNAD. policy recommendations for the is researching and writing about in seeking consent from patients. the little-known history of tissue By the time of the Alder Hey and and the University of Maastricht A report on this project appeared governance of the NDNAD. The use of DNA typing systems banking. Her current research Bristol scandals, NHS Trusts were in The Netherlands. in Wellcome News 31. in criminal investigations was focuses on three ‘unglamorous’ holding 54 000 tissue samples. Further information on the project Using experimental animal models www.wellcome.ac.uk/wellcomenews made possible by the discovery of tissues: the cornea, skin and at www.dur.ac.uk/p.j.johnson. Governments all over the world – and state-of-the-art technologies polymorphic sequences of DNA pituitary gland. such as gene expression profiling capable of uniquely identifying www.wellcome.ac.uk/biomedicalethics including the UK – are now with microarrays and comparative individual samples. First used in These are apparently recognizing the urgent need to uncontroversial tissues collected review and revise a complicated Above Professor Linda a criminal investigation in 1986, Partridge is studying the the UK was the first jurisdiction from dead bodies, but they are in system that has arisen around the role of genes in ageing. extensive use and represent three collection of material from dead Left High blood pressure different uses of human material. people. For example, in the UK, affects at least 5 million Skin is a medical stop gap – the Retained Organs Commission people in the UK. a dressing for severe burns, which was set up in 2001 to monitor is why it was stockpiled in vast the return of organs, oversee new quantities during the Cold War legislature and address issues of by the US military. Corneas are accountability and consent, and in surgical ‘spare parts’; and pituitary 2002 the Department of Health glands are ‘raw materials’, the published a consultation document, sources of growth hormones and ‘Human bodies, human choices’. gonadotrophins (which are no longer used because of their potential to transmit CJD). All of To p Storing a piece these materials began to be used of skin for later use to in the 1920s and 30s, although it treat burns or injuries. 14 15 KNOWLEDGE

The National Under pressure DNA Database

Learning about pain Launch of UK Biobank

Chronic pain, such as back pain (King’s College, London) and Right Professor Keith An integrated approach Funding for the UK Biobank In April 2002, a consultation Below and left or post-operative pain, affects including colleagues from Frayn is studying the The three projects funded by the project – a study of genes, environ- workshop examined ethical aspects The UK Biobank will be physiology of bodyweight a powerful resource for the lives of many people: it is University College London and Wellcome Trust's Integrative Animal ment and health – was announced of the UK Biobank proposal among control and obesity. and Human Physiology Initiative researchers investigating estimated that about 10 per cent Imperial College, brings together on 29 April 2002.The Wellcome a range of experts.The consultation disorders that appear are exploring the relationship in later life. of the UK population suffer from eight research groups of between genomic information Trust, the Medical Research Council brought together a selection of chronic pain at some time. Such neuroscientists and clinicians. and physiological mechanisms in and the Department of Health ethicists, medical lawyers, public pain can last for months or years, humans and animals, and develop are providing an initial £45 million policy advisers, social scientists, The five-year project is bringing reducing the physical quality of life and use whole-animal models for the project, a study of the role medical professionals, biomedical a variety of complementary and often leading to secondary that are relevant to human disease. of nature and nurture in health scientists, and representatives of approaches and expertise to symptoms such as anxiety and The other two collaborative and disease. patient and other interest groups. bear on the problem of pain. groups awarded grants are: depression. Pain is not only an adult Discussion focused on issues and For example, the consortium ◗ £4.8 million to Professor Fran Up to half a million participants condition and premature infants questions which have been raised members plan to use functional Ashcroft and colleagues (University aged between 45 and 69 years will in intensive care may experience in the course of protocol genomics techniques such as of Oxford) for a study of ion be involved in the study.They will up to several hundred painful development, public consultations, DNA microarrays to search for channels and their role in diseases be asked to contribute a blood procedures within the first few of the brain, nerves and muscles. and by expert reviewers.This will genes whose expression is sample, lifestyle details and their weeks of life. help inform further development regulated in models of inflammatory ◗ £4.8 million for a collaboration medical histories to create a national of the ethical framework of UK Although we still have few ways and neuropathic pain and by between the Universities of database of unprecedented size. Biobank’s protocol. of combating pain other than with painkillers. Using animal models, Cambridge and Oxford, led by Professor Steve O'Rahilly Many disorders, including cancer, painkillers, the past two decades they will study mutations that (Cambridge) and Professor Keith heart disease, diabetes and have seen rapid progress in pain affect the transmission and www.ukbiobank.ac.uk Frayn (Oxford), examining obesity Alzheimer’s disease, are caused research. A number of genes regulation of pain. And they will and diabetes. (A report on this by complex interactions between involved in the control of pain screen human volunteers for project can be found in Wellcome genes, environment and lifestyle. have been identified, findings that variations in pain sensitivity and News 31; www.wellcome.ac.uk/ Researchers will use the UK have already stimulated the search test whether such variations are wellcomenews.) Biobank resource to uncover the for new painkillers.Yet the function related to polymorphisms in genetic and environmental factors of these genes remains poorly pain-related genes. that lead to these common understood, and we understand An equally important goal of the conditions. little of how the function of the project is the training of young nervous system relates to the This combination of information scientists – students, post-docs control of pain. from participants will create a and junior doctors – in integrative powerful resource for biomedical With £5.4 million funding from physiology.The training programme researchers. It will enable them to the Wellcome Trust's Integrative involves each young scientist improve our understanding of the Animal and Human Physiology working in several consortium biology of disease and develop Initiative, a new collaboration – laboratories so as to learn integrative improved diagnostic tools, the London Pain Consortium – physiology techniques and how prevention strategies and tailor- is investigating how pain arises, to combine them with modern made treatments for disorders is transmitted by the nerves, and molecular and genetic approaches. that appear in later life. is regulated by the spinal cord and brainstem.The consortium, led by Professor Steve McMahon 16 17 RESOURCES

Learning about pain Launch of UK Biobank

Wellcome Library gains Crick’s papers

Thanks to funding from the The Wellcome Trust and the Wellcome Trust and the Heritage Heritage Lottery Fund – which Lottery Fund, Francis Crick’s provides financial support for the scientific archive will now be protection and enhancement of the housed at the Wellcome Library UK’s heritage – each contributed for the History and Understanding £904 000 to ensure that Crick’s of Medicine, where new generations important, landmark papers would of students and scientists can gain be saved for the nation. free, unrestricted access to his The papers, including personal papers. correspondence, laboratory Francis Crick is one of the notebooks and manuscripts for outstanding scientific figures of published articles and books, the 20th century. His discovery cover the period in the early Medical Photographic Wellcome Library of the structure of DNA with 1950s, when Crick and Watson Library website website relaunched James Watson in 1953 is widely discovered the DNA double The Wellcome Trust Medical The new website of the Wellcome recognized as one of the defining helix, together with all Crick’s Photographic Library has launched Library for the History and a new website showcasing the Understanding of Medicine went and enabling moments in the subsequent work in molecular riches of its collections and enabling live in June 2002.The site provides history of human achievement. biology and neuroscience. full online picture searching access to the Wellcome Library In 1962, with James Watson and They will be a great resource for and ordering. catalogue and image database, as Maurice Wilkins, he was awarded understanding the development The site provides online access to well as information about its the Nobel Prize for Physiology of science in the second half of the Medical Photographic Library's unrivalled historical and modern or Medicine. the 20th century, preserved for collection of 160 000 images, collections of manuscripts, books, journals, films and pictorial material. many years to come in one of the which is growing daily.The material world’s most significant scientific included is remarkably diverse, http://library.wellcome.ac.uk covering human health and its and medical libraries. Above Fragile items social context from ancient times in the Crick collection, to the present day, including many such as this 27 inch x 57 inch sheet of graph breathtaking modern images from paper, are being restored biomedical scientists and fabulous in the Wellcome examples from the Wellcome Library’s Preservation Trust’s historical collections. and Conservation http://medphoto.wellcome.ac.uk Department. Right At the Wellcome Library, archivist Chris Beckett is cataloguing the thousands of items in the Crick papers. Far right Francis Crick.

Above The 1962 Explore examples of Crick’s papers telegram to Francis Crick from the Nobel at www.wellcome.ac.uk/genome Committee. 18 19 RESOURCES

Wellcome Library gains Crick’s papers

Above The 1962 Explore examples of Crick’s papers telegram to Francis Crick from the Nobel at www.wellcome.ac.uk/genome Committee. 20 21 RESOURCES

Overseas buildings

Three Wellcome Trust-funded The Hospital for Tropical Diseases Left (from left to right) overseas research buildings were and the Wellcome Trust began their Russell Marshall, New Zealand High Commissioner opened last year: collaborative research programme to the UK, Dr Mike Dexter, in 1991, with some of the first Thailand – Kanchanaburi and Michael L’Estrange, studies of the Chinese herbal drug Australian Commissioner Field Station qinghaosu (artemisinin) for the to the UK, at the launch of The Kanchanaburi Field Station, the Australasian Partnership. treatment of malaria. Artemisinin situated 80 kilometres west of is now recognized as potentially Bangkok,Thailand, is home to a A new Australasian the most important antimalarial collaborative project between treatment yet discovered. the Wellcome Trust and Mahidol University’s Institute of Population South Africa – The Africa Centre partnership and Social Research. The new building housing the Africa Centre for Health and A major new initiative focusing on Zealand.The Trust will contribute The main aim of the project Senior Fellows in Population Studies is situated the health problems of developing £6 million towards this major Central Europe is demographic surveillance of in Somkhele, KwaZulu-Natal, countries in South and South-East international government The first round of the Central the 100 or so villages in the some 150 miles north of Durban. Asia and the Pacific was launched partnership, which will be European Senior Fellowships was Kanchanaburi province – home Research at the Centre – in May 2002 in partnership with matched by the governments of awarded during the year, following to a diverse collection of Thai and interviews held in Berlin in June a collaboration between the the research councils of Australia Australia and New Zealand. Myanmarese ethnic communities. 2002. Eleven awards were made South African Medical Research and New Zealand. This will be accompanied by The initiative will fund major five- totalling £5 million: four to Hungary, Council, the Universities of Natal research into key factors affecting The Wellcome Trust Partnership year programmes to encourage four to Estonia, two to Poland and and Durban-Westville and the one to the Czech Republic. populations such as maternal and for Developing-country Health new and innovative collaborations Wellcome Trust – reflects local child health, and causes of death, initiative will promote in infectious and non-infectious The new fellows include Dr Laszlo population and reproductive Acsady (Hungarian Academy of as well as intervention-based collaborative research and training diseases as well as health service health priorities, particularly Sciences, Budapest, Hungary) and research into migration across between developing countries in research.The centre of gravity HIV/AIDS.The prevalence of HIV Dr Gabor Tamas (University of the nearby Thai–Myanmar border. the region – which include the of the research will be in the Szeged, Hungary) who are studying infection in the community is very The results will be passed on Indian subcontinent, China, South- developing country, focusing on thalamocortical circuits and high (at least 30 per cent). to decision makers to help inform East Asia, Indonesia, the Philippines the health of these countries. information processing in cortical health and social welfare The site for the Africa Centre’s and the Pacific Islands – and Two-way training will also be networks, respectively. In Brno in the Czech Republic, Dr Jiri policy-making. new building was donated by the centres of excellence in Australia encouraged: researchers in Sponer is carrying out advanced Inkosi (Zulu tribal chief) for the and New Zealand. developing countries will receive Vietnam – Infectious computational studies of DNA area.The Centre aims to integrate training in state-of-the-art research Disease Centre The £12 million initiative will be and RNA.And in Estonia, Dr Priit fully into the local community, techniques, while developed- Kogerman is studying the hedgehog A new infectious disease centre – funded in part by the Trust and which was consulted at every stage country researchers gain first-hand signalling pathway, and Dr Tonis jointly funded by the Vietnamese in part by the governments of of development.When the building experience of the health problems Timmusk the regulation of Government and the Wellcome Australia and New Zealand: the neurotrophin gene expression was in the planning stages, every of the developing country. Trust – stands in the grounds of National Health and Medical in the nervous system. member of the local community the Hospital for Tropical Diseases Research Council of Australia and By the provision of substantial was contacted and asked if they in Ho Chi Minh City,Vietnam. the Ministry of Research, Science funding for the individuals and their were decorators, plasterers or The Department of Laboratory and Technology, and Health research programmes these awards bricklayers. As a result, out of 186 Sciences building houses world- Research Council of New will enable outstanding young jobs created by the project, 117 investigators to return to, or be class facilities for integrated clinical went to local people. retained in, their country of origin. and laboratory research – including diagnostic facilities for the Hospital and laboratories for scientists investigating malaria, typhoid, tetanus, and other major health problems in Vietnam.

Top and right The new building for the African Centre for Health and Population Studies in South Africa opened with a celebration involving the local community. 20 21 RESOURCES

Overseas buildings

Top and right The new building for the African Centre for Health and Population Studies in South Africa opened with a celebration involving the local community. 22 23 RESOURCES

Medieval manuscript saved for the nation

A rare medieval manuscript saving it for the nation and taking The manuscript also includes threatened with exile abroad has it out of private hands for the an account of how to make a been bought by the Wellcome ﬁrst time in its history. pilgrimage from London to Library.The Library stepped in to Jerusalem, a unique addition The manuscript was previously buy the 15th-century physician’s which provides a fascinating owned by a wealthy medieval handbook while it was under the account of 15th-century practitioner who valued it both order of a temporary export ban Christianity and travel. as a handbook and as an artefact, by the Arts Minister, Baroness hence the striking decorative A digital version of the Blackstone. use of gold leaf. Written entirely manuscript is available online at: The previous owner, a rare in Middle English, the 200-page http://library.wellcome.ac.uk/ books dealer, was planning to illustrated manuscript depicts the resources/etexts/ms8004 send the book abroad but the importance of astrology in the export ban was issued as it is practices of a medieval physician. considered too precious to be Accompanying the text are lost overseas.The Wellcome numerous tables and calendars Trust intervened and bought which would have been used by the book for £210 000 (including the physician to calculate the a £10 000 grant from the best time to administer medical Government’s Prism fund), treatments according to a patient’s date of birth. 22 23 RESOURCES

Medieval manuscript saved for the nation

Can vitamins prevent From bench to bedside pre-eclampsia?

In 2002, new Wellcome Trust and a study of bone protection A new Wellcome Trust-funded Pre-eclampsia occurs in about The new project led by Clinical Research Facilities (CRFs) for stroke victims, who are at project is testing whether vitamin 5–7 per cent of pregnancies, Dr David McCance at the Royal opened in Birmingham, Cambridge greater risk of hip fracture and supplements can reduce the risk the risk being increased in first Victoria Hospital, Belfast, is now and Manchester.Together with death from falls. of pre-eclampsia, the most common pregnancies, by advanced maternal testing whether vitamin C or E the CRFs in Edinburgh and cause of death and disability in age and by genetic predisposition. supplementation can reduce the Facilities within the £3.2 million Southampton, which opened in mothers and newborns.The For diabetic mothers, the risks incidence of pre-eclampsia in centre at Birmingham include 2001, these five facilities have condition occurs when narrowing are much greater: about one in diabetic mothers.The study is two isolation suites for patients been established as part of an of the mother’s blood vessels six pregnancies in women with recruiting pregnant women with undergoing gene therapy £18 million initiative by the Trust – leads to an increase in blood diabetes are complicated by type 1 diabetes from Northern treatment, day-case and in-patient in collaboration with NHS pressure and protein in the urine. pre-eclampsia. Ireland, Scotland and the north of beds, two laboratories and a hospitals, university medical schools Pre-eclampsia can be life England.The results should increase number of diagnostic and Although the cause of and the Department of Health. threatening, resulting in pre-term our understanding of how this treatment areas. Studies currently pre-eclampsia remains unclear, delivery and growth retardation in complication develops, and may The CRFs will enable clinicians being undertaken include: gene increasing evidence suggests that Heart risk for the elderly the baby, and may be associated offer important new public health to undertake patient-oriented therapy for head and neck, blood vessels may be damaged by Elderly people need to boost the with fits and multiorgan failure in strategies for prevention. research in a hospital setting, and prostate and liver cancer; steroid highly reactive substances called amount of folic acid they take by the mother. Delivery is the only form part of the Trust’s aim to and glucocorticoid metabolism oxygen free radicals.The harmful almost three times the official cure, and as a consequence many recommended level to minimize translate new knowledge into and their role in osteoporosis and effects of these radicals are babies are born prematurely, the risk of stroke, thrombosis and improved patient care.The facilities obesity, vaccination trials for bowel countered by a range of leading to both short- and long- heart disease, a new Wellcome are linked to local hospitals and cancer; interferon therapy in antioxidants, including certain term health problems. Trust-funded study in Aberdeen biomedical research departments liver transplant patients; and trials vitamins, the levels of which are has shown. in universities, and have been into vasculitis, multiple sclerosis reduced in diabetes. Folate helps reduce the level of kitted out with modern, state- and Parkinson’s disease. homocysteine, an amino acid, of-the-art equipment. which in turn can precipitate Anna Ford, BBC News presenter vascular disease.The over-50s are In January 2002, Secretary of State and University of Manchester recommended to take an extra To p Gary Lineker Left Diabetic mothers 200 micrograms of folate a day, for Health, Alan Milburn, opened Chancellor, opened Manchester’s opened the Clinical are particularly prone the facility at Addenbrooke’s Wellcome Trust Clinical Research Research Facility in to pre-eclampsia. but the study found that it should Hospital, Cambridge, and in the Facility at Manchester Royal Birmingham’s Queen be almost three times that amount to ensure 95 per cent of the same month sports presenter Infirmary on 1 July 2002. Among Elizabeth Hospital in January 2002. elderly were not at risk from high Gary Lineker opened the CRF the areas being studied at the Above Measuring homocysteine, and therefore at Birmingham’s Queen Elizabeth CRF are ovarian cancer screening, body fat at the Clinical vascular disease. Hospital. Studies being undertaken osteoporosis, childhood language Research Facility in Too much folate has its own risks, at the £3.5 million Cambridge impairment, physiotherapy for Cambridge, which also however.An excess causes people development include: the role of complications of diabetes (diabetic opened in January 2002. with deficiency of vitamin B12 to genetic factors in the development neuropathy) and wound healing. develop irreversible nerve damage of severe childhood obesity; trials The Manchester facility includes rather than the more usual and treatable anaemia.This could be of prevention of type 2 diabetes a human performance laboratory, avoided by fortification with both by lifestyle alterations in family used to monitor heart, lung and vitamins – folate and B12. members at risk of the disease; muscle function, imaging facilities Rydlewicz A, et al. (2002) The effect of for brain and bone studies, and folic acid supplementation on plasma inpatient and outpatient facilities homocysteine in an elderly population. for children and adults. Quarterly Journal of Medicine 95: 27–35. www.wellcome.ac.uk/crfs 24 25 TRANSLATION

Can vitamins prevent From bench to bedside pre-eclampsia?

Thinking small

The Wellcome Trust has donated into the red soil, and analyse rocks £2.6 million for the development for signs that water, and life, may of a vital piece of equipment once have existed there. on board Beagle 2, which will be The equipment includes a mass looking for traces of life on Mars. spectrometer and a 12-oven, The funding is for a small mass 31-valve gas analysis package. spectrometer, to be built by This highly sophisticated ‘cooking Professor Colin Pillinger of the Stopping the kit’ identifies atoms and isotopes Open University and his team and will determine the chemical in Milton Keynes. composition of samples. silent killer Beagle 2 will set off with the The benefits for medicine and European Space Agency’s Mars the biomedical sciences are that Express spacecraft from the the spectrometer must be Sudden cardiac death – also known The best hope for saving his or possibility of using an engineering- Russian spaceport in Kazakhstan in miniaturized and automated, as the silent killer – is terrifying. her life is to restore the heart’s based method of signal analysis – May 2003. As the main spacecraft allowing a bench-top version to It kills within minutes, often strikes normal rhythm using an emergency wave transform – to analyse orbits above Mars, the Beagle 2 be developed which it is hoped apparently healthy people with device called a defibrillator, which electrocardiogram signals from will parachute onto the planet’s may allow the technology to no known heart disease and has a delivers a brief, high-energy electric patients with cardiac arrest. surface, burrow a robotic probe move from the laboratory into survival rate of only five per cent: shock to the heart through The wave transform algorithm a range of clinical settings. most patients die before reaching electrode patches applied to the allows the signal to be ‘denoised’, hospital. It is the number one chest. Because sudden cardiac death so that users can detect underlying cause of death in the USA. is so common – and resuscitation heart rhythms.This enables them needs to be delivered instantly, to give exactly the right amount This cardiac arrest occurs when before the patient gets to hospital – of defibrillation shock at precisely the electrical signals regulating defibrillators are increasingly the right time – without halting the pumping action of the Top right and above available on airplanes and in resuscitation. It also means a lower chambers of the heart The new defibrillator, public buildings. trained first-aider could use which is being developed (the ventricles) become rapid the defibrillator, cutting out the by Cardiodigital Ltd. and chaotic.This causes the However, at present defibrillators need to wait for the arrival of ventricles to contract in a rapid, provide a noisy, chaotic signal a qualified medic. unsynchronized way – they ‘flutter’ which gives little information on rather than beat – known as the state of the heart, resuscitation The team and Napier University ventricular defibrillation. As a has to be halted for 20 seconds have set up a company, Cardiodigital result the heart pumps little or or more to determine whether Ltd.With development funding no blood to the rest of the body the pulse rate has been restored, from Catalyst BioMedica Ltd and and the brain is starved of oxygen. and treatment can only be Scottish Enterprise, they aim to The individual loses consciousness delivered by medically qualified refine the technology to a point in seconds and will die within professionals. All these factors where industry could incorporate To p Professor Colin minutes unless medical help is impact on the patient's chances it into the next generation of Pillinger with the miniaturized mass provided immediately. of survival. defibrillators – and give victims spectrometer, standing a better chance of evading the At Napier University in Edinburgh, in front of a traditional silent killer. large mass spectrometer. Professor Paul Addison, Dr Brendan Above and left Beagle 2. McGuckin and Dr Jamie Watson are therefore investigating the 26 27 TRANSLATION

Thinking small

A quick test

In 1997, the Wellcome Trust Dr Lee’s goal was to produce awarded £2.1 million to a ‘dipstick’ costing around 35p Dr Helen Lee and colleagues at each, that could test non-invasive the University of Cambridge for samples (such as urine) and the development of a simple and produce a result very quickly. inexpensive DNA ‘dipstick’ that Developing the kit involved many could detect Chlamydia. Five years different challenges, including on, the kit has been developed designing a urine collection device, and is ready for production boxes for the kits, mini test-tubes, worldwide. the actual dipstick and easy-to- New potential for an old drug Chlamydia is one of the most follow instruction cards using only common sexually transmitted pictures so there would be no diseases, with about 90 million language translation problems. Above Cortisol is an At some point in our lives, most on the 11-beta-hydroxysteroid The next step – with a important regulator of of us have walked into a room dehydrogenase type 1 (11HSD1) Development Fund Award from new cases being reported every The final designs include the fat, carbohydrate and year.Women contracting it can ‘Firstburst’ sample bottle, which protein metabolism. and forgotten why we did so. enzyme, which converts inactive Catalyst BioMedica – was to become infertile or suffer ectopic ingeniously captures the initial For some people this rather cortisone into active cortisol in carry out a pilot study to find pregnancies and abortion. It is few vital millilitres of urine that unsettling experience occurs the liver, fat tissue and the brain. out whether blocking the enzyme more frequently as they grow had the same effect in humans. estimated that 10 per cent of contain most of the Chlamydia Experiments on rats and mice older: around 15–20 per cent Surprisingly, the team found that women attending inner-city sexually organism, and a swab which looks showed that obese animals, like of the population suffer from an effective 11HSD1 inhibitor was transmitted infection clinics in the like a big cotton-bud. obese humans, have too much developed world will be infected memory loss associated with age. an old off-the-shelf drug called At present, many patients 11HSD1 enzyme – and hence by Chlamydia. Annual costs for the carbenoxolone, originally used to attending inner city clinics do This mild but persistent form excess cortisol – in fat tissue. treatment of these complications treat stomach ulcers. not return for their test results. of cognitive impairment is known This leads to the classic features amount to billions worldwide Using the dipstick, which produces to be associated with rising levels of metabolic syndrome. Conversely, Tests showed that carbenoxolone Above Dr Helen and far outweigh the costs of results in less than 25 minutes, of the hormone cortisol – the team found that a knockout enhanced insulin sensitivity in Lee, who has led the an effective diagnostic and development of a clinics will be able to test, treat a natural steroid that is produced mouse which had no 11HSD1 healthy volunteers, an effect that intervention programme. rapid test kit (right) and counsel patients during the in the adrenal gland and normally at all was protected from obesity, would alleviate the effects of for Chlamydia. Once detected, Chlamydia is same visit. underpins stress responses. diabetes and high cholesterol diabetes, and improved memory easily treated with antibiotics, but Cortisol has also been found to levels when fed a high-fat diet. in elderly men. Having ascertained Dr Lee is now investigating play an important role in a number that 11HSD1 is an important detection is not straightforward: In the brain, the 11HSD1 enzyme ways to produce and market the of other disorders, in particular therapeutic target – with a potent the disease has few obvious also increases cortisol levels, various parts of the dipstick kit in metabolic syndrome, which influence on obesity, diabetes, the symptoms, and existing tests are potentially increasing the hormone's and is already planning to develop affects around 25 per cent of metabolic syndrome and loss of both slow – taking up to three tendency to damage the the technology further – into new Western populations. Metabolic cognitive function associated with days for results – and expensive. hippocampus, a region crucial for tests for HIV, tuberculosis, hepatitis syndrome, a cluster of risk factors ageing – the team is now looking learning and memory. Just like old B and C and dengue fever. for heart disease (high blood at the impact of other compounds humans, old mice also tend to pressure, high cholesterol levels, on the enzyme. By subtly controlling become forgetful, but the 11HSD1 diabetes and abdominal obesity) cortisol levels in the body's key knockout mouse was protected is associated with abnormally tissues, research could lead to from the usual loss of memory high levels of cortisol in particular the development of effective new that accompanies old age. body tissues. medicines to manage these In both the fat tissue and the distressing conditions. At the University of Edinburgh, brain, reducing cortisol levels by Wellcome Trust-funded scientists removing or blocking the enzyme Professors Jonathan Seckl and seems to take stress out of the Brian Walker have been working system: it reduces wear and tear and prevents disease. 28 29 TRANSLATION

A quick test

National Festival of Drama Engaging Science

On 9 May 2002, the audience raised by biomedicine. One play Engaging Science, the Wellcome in the Linbury Studio Theatre at considered the irony of selecting Trust’s £3 million Public Engagement the Royal Opera House, London, a fertilized embryo with the right with Science grants programme, was treated to a series of dazzling bone-marrow match to save an was launched at the British explorations of the value of life, existing child from leukaemia – Association’s National Festival of the mystery of love, the then destroying the remaining Science at Leicester in September uncertainties of science and the embryos. Another weighed the 2002.The programme consists of tight spaces in which life-and-death devastating effects of attention two new schemes: People Awards decisions are made – all through deficit hyperactivity disorder on and Society Awards. the eyes of 11–16 year-olds. families against the fear of The People Awards, of up to changing personality through drug The occasion was the Wellcome £30 000, support small-scale therapy. A third examined the Trust’s National Festival of Drama – activities, such as workshops in ethics and safety of transplanting the culmination of the Science schools and science centres, talks a pig’s organ into a human being, Centrestage initiative, launched in and discussions in public spaces, while a fourth questioned the October 2001 as part of Science or drama and art projects, acceptability of aborting embryos Year. Some 100 schools took part covering any area of biomedicine. with a genetic condition, such as in the initiative, which encouraged The aim is to encourage people cystic fibrosis.The remaining two secondary school students to who are not experienced science pieces took a humorous look at explore the wider implications communicators – and might be DNA profiling for potential future of science through drama. deterred from applying for larger spouses and poked gentle fun at awards – to communicate science The resulting works – first the perception of scientists’ and its related issues. Funding performed at ten regional festivals attempts to communicate with decisions will be made throughout in March 2002 – showed the the public. the year, allowing the Wellcome challenge had been taken up with In all of them, superb Trust to respond quickly in order gusto: students experimented with Pulse performances did justice to the to support activities communicating a multitude of dramatic forms and Pulse, the Wellcome Trust’s Young excellence of the writing – and topical issues.The scheme People’s Performing Arts scheme, tackled a host of critical issues. dexterous use of music (much of it particularly encourages novel aims to inspire young people (aged The depth of thought that had composed by students themselves) and imaginative projects which ten to 20) to think about biomedical gone into the plays – the sensitive and choreography provided the experiment with new ways of science and its wider impact and balanced handling of complex through a diverse range of media – final polish.The amount of fun engaging the public. issues, the skilful use of comedy to including theatre, dance, musical students had is testified by the lighten scenes dealing with The Society Awards, in excess of theatre,TV, video, digital video, film fact that many schools staged sickness and death, and the high £50 000, fund much larger public or animation. repeat performances, after the standards of artistic excellence and engagement activities or research Pulse enables youth theatres, dance regional festivals, in school halls scientific accuracy – won praise programmes which aim to have companies and other organizations and local theatres. Certainly to create innovative and exciting from audiences across the country. a significant impact, ideally of judging from the almost palpable projects – by, for or with their nationwide importance.These Six plays – selected to represent adrenaline buzz – among audience young audiences – that capture awards, assessed by an external young people’s interest.A particular a wide variety of subject matter, and performers alike – at the panel of experts, focus on specific aim of the scheme is to support type of school and geographical Royal Opera House, Science themes and run for a fixed period proposals that are both experimental spread – were showcased at the Centrestage had achieved its chief of time.The first calls for proposals but also accessible, so that they are Science Centrestage National aim of firing young people with likely to spark off a lively – and are for young people’s education, Festival. Each cut to the essence a heated interest in science and hopefully ongoing – debate among broadening access to the of some of the difficult questions the intriguingly complex ethical audiences and participants. biosciences, Sciart and performing conundrums it spawns. www.wellcome.ac.uk/pulse arts for young people (Pulse). To p It could be you, by the Hurst Community www.wellcome.ac.uk/sciencecentre School,Tadley, portrayed www.wellcome.ac.uk/engagingscience stage the struggles of attention deficit hyperactivity disorder. Above Love Science, by Villiers High School, Southall, examined ‘designer babies’. 30 31 PUBLIC ENGAGEMENT

National Festival of Drama Engaging Science

Excellence in education

The Wellcome Trust is committed The Wellcome Trust has therefore Citizenship in Science to ensuring the public as a whole, committed up to £25 million in a Following the Government’s and school students in particular, £50 million partnership with the announcement that from September acquire the level of scientific Department for Education and 2002, the National Curriculum literacy needed to tackle the Skills to create a national network would be extended to include increasingly complex decisions they of science learning centres. citizenship education, the Association will face as biomedical science for Science Education and the The national network will Wellcome Trust collaborated to ‘Medicate’ in the advances.To this end, the Trust enable science teachers to build encourage teachers to include aims to support teachers in their on existing good practices and examples from science in citizenship continued efforts to deliver a high- lessons. In February 2002, a joint enhance their professional Royal Pump Rooms quality science education, both in conference held at Westminster development by learning more explaining cutting-edge scientific Central Hall, and opened by Lord about contemporary scientific ideas and – vitally – in capturing Dearing, promoted fruitful discussion ideas and techniques.They will between science and humanities The Wellcome Trust awarded hydrotherapy treatments were and holding pupils’ interest in also be able to train in new teachers about how science and £50 000 to ‘Medicate’, a major available at the Pump Rooms until science and related issues. teaching approaches and gain its social impact could be used to new collection of over 30 the 1990s when the Pump Rooms Keeping up with the deluge of experience in debating the social illustrate aspects of citizenship. contemporary works of art were finally closed.They reopened new information, and all its tangled and ethical implications of new Key points from the conference exploring our relationship with in 1999 to house Leamington's ethical and social ramifications knowledge.This should have a were circulated to schools – medicine.The collection – which Art Gallery, Museum, Library and along with two exemplar schemes includes outstanding works by Tourist Centre. thrown up by biomedical science, knock-on effect in schools, where of work, developed by the some of the country’s leading is a tall order for anyone. Continuing pupils will hopefully enjoy their Trust and the Association for ‘Medicate’ was displayed in the artists such as Damien Hirst and professional development for science classes more, and find Science Education to help main gallery, appropriately enough Christine Borland – was displayed science teachers is crucial. them stimulating and relevant. teachers incorporate science the site of the original swimming into citizenship education. in the Art Gallery at the Royal pool, which was subsequently Pump Rooms in Leamington Spa www.wellcome.ac.uk/education converted into the hydrotherapy and now forms part of their pool for physiotherapy patients. Left The Last Supper, Above I No. 1, by Alexa permanent collection. by Damien Hirst, a Wright, one of a series Indeed, some of the visitors to series of 13 screenprints. of digitally manipulated The gallery is eminently suited to the exhibition recall being treated Each screenprint consists self portraits that aim the theme: built during the 18th for rheumatism or polio by the of a boldly designed to challenge perceptions pharmaceutical package, and attitudes to physical century so that visitors could physiotherapy department in the on which the name of disability. bathe in water from Leamington Pump Rooms. In this respect, the medicine is replaced Spa’s famous saline springs, the the exhibition linked the past to with the name of Royal Pump Rooms have a long the present, reflecting the joint ordinary food (such as BeansTM or ChipsTM), history of medical treatment. impact of medicine and art on and the pharmaceutical At the time, it was fashionable to people’s lives. company logo has ‘take the waters’ for a variety of been replaced with the artist’s name. ailments, including stiffness of the tendons or joints, the effects of gout and rheumatism, and even constipation (spa water is a mild laxative). Later, physiotherapy and 32 33 PUBLIC ENGAGEMENT

Excellence in education

ReDiscover – science centre and museum renewal fund

Science centres and museums The £33 million ReDiscover around the country offer people initiative – with a £5 million stimulating ways in which to allocation from the Wellcome experience the latest ideas in Trust – supports UK organizations science and think about their presenting exhibitions with impact on everyday life. However, themes from the full spectrum keeping up with the rapid pace of of science, including biology, scientific discovery, and reflecting engineering and technology. new developments in fresh and The fund should not only help exciting exhibitions, is a the viability of science centres challenging – and costly – task. and museums across the UK, but will also help to stimulate Such organizations need new public interest and debate in injections of funds if they are scientific advances and the impact to continue presenting cutting- they have on everyday lives. edge scientific and technological ideas – and their wider social and ethical implications – www.wellcome.ac.uk/rediscover to the public.The Millennium Commission, the Wellcome Trust and the Wolfson Foundation are therefore jointly providing a capital renewal fund to enable science centres and museums to replace or refresh their Exhibits at ThinkTank exhibition spaces and reflect Science Centre, changes in the scientific world. Birmingham. 34 35 PUBLIC ENGAGEMENT

ReDiscover – science centre and museum renewal fund

Head On at the Science Museum Evidence is not enough

Interactions between science ‘Head On’ – organized in Below left The TwoTen Gallery One of the biggest challenges who had been carrying out and art can add new dimensions collaboration with the European ‘The phrenological scientists have always faced is that autopsies were also treating facilities’, 1875, after The TwoTen Gallery, at 210 Euston to our understanding of human Dana Alliance for the Brain, the O S Fowler. Road, hosted a series of innovative of getting new ideas accepted. patients at the clinic. He insisted nature, biology and the world world’s leading promoter of brain exhibitions on aspects of the Today, science still moves forward that all doctors wash their hands in Below right relationship between medical we inhabit. Synergies between the research – featured exhibits An exhibit from by consensus, and new theories chlorine before entering a ward – science and art. two disciplines offered intriguing drawn from science, art, history ‘Leopold and Rudolph are often disputed, rejected and and the death rate plummeted. new ways of looking at the brain and anthropology that reflect the Blaschka: The Glass ◗ ‘Outside looking in: Photographs re-thought before they are given Aquarium’ at the from TreeHouse’ – images of the When another outbreak occurred in an inaugural exhibition at the diversity and creative potential of credence by the establishment. TwoTen Gallery. day-to-day school life of young in a ward where one woman Science Museum:‘Head On: Art the brain.Works by well-known children with autism. That notion lies at the heart of had an open sore on her leg, with the brain in mind’. artists, such as David Hockney’s Right and below left ◗ ‘Working Drafts: Envisioning Semmelweis, the first in a series Semmelweis realized something Hungarian doctor Ignaz full-scale reconstruction of a camera The exhibition, which ran from the human genome’ – an artistic of plays for school students run else: childbirth fever was being Phillipp Semmelweis. obscura, appeared alongside March to July 2002, opened a exploration of the social and by the Big Brum Theatre in spread by particles of putrefaction specially commissioned projects new gallery at the museum. scientific implications of the Education Company with the help which travelled through the air doctors employed to gather between young contemporary research outcomes from the History of Medicine Public The new space, funded and run of a History of Medicine Public and landed on an open wound, evidence about Semmelweis’s Engagement with Science artists and world-famous Human Genome Project. by the Wellcome Trust, features Engagement with Science grant. such as that left after the delivery life to find the cause of his programme neuroscientists. Among other ◗ a series of thematic exhibitions ‘Leopold and Rudolf Blaschka: of a child. madness – and interact with the The History of Medicine Public intriguing creations, these included The Glass Aquarium’ – a presentation The programme,‘Of Birth and exploring the relationship between actors.This enables them to Engagement with Science an installation exploring anxiety of glass replica sea creatures Death’, aims to engage pupils However, the medical authorities programme supports projects medical science and its social, address questions of evidence disorders through an artist’s designed and made by Leopold with historical aspects of medical crushed Semmelweis’s theories, which apply the lessons of history cultural and historical contexts. and prejudice in an engrossing depiction of attempts to park and Rudolf Blaschka alongside research and consider their he was denounced as mad and to problems science faces today, works relating to jellyfish by four way, and relate these issues to a car, and a series of puzzles relevance today. dismissed – despite having proved or seek to bring the history of contemporary artists. their own lives.The discussion medicine to wider audiences. exploring dyslexia. that he could dramatically reduce ◗ Semmelweis is based on the life and other activities exploring ‘Everything I could buy on eBay™ the death rate. Indeed, after his Other projects funded include: about malaria’ – an installation of its eponymous hero, a young these ideas should enable ◗ death it was claimed the autopsy a series of debates at the displaying products related to malaria Hungarian doctor, who worked teachers and pupils to examine revealed evidence of brain damage, University of Newcastle looking at acquired on eBay™, the world’s at the Vienna General Hospital the issues further in a range of the relevance of history to issues explaining his wild ramblings. largest online auction house. in the clinic for pregnant women classroom work. in the present day; www.wellcome.ac.uk/twoten in the mid-19th century.Women The play forms part of a whole ◗ a cancer history website created at at the clinic are dying of childbirth day of theatre-in-education activity the University of Manchester to act fever at an alarming rate, and with young people. After the play, as both a resource for academics Semmelweis realized that doctors the young people are given roles – and information for the public; for example they may be told ◗ a meeting at Glasgow Caledonian they are a group of student University to encourage dialogue between historians of social welfare and historians of medicine to achieve a wider, more contextualized perspective on the history of health; ◗ a social history and health exhibition at the Foundling Museum; ◗ a project from a Fellow at the Wellcome Unit at the University of Manchester to produce a history of foot and mouth disease in Britain (1839–2001) for a general readership. 36 37 PUBLIC ENGAGEMENT

Head On at the Science Museum Evidence is not enough

A YEAR AT THE TRUST

New Director Good research practice New Head of Policy Monte Carlo grave Cornerstone project Time capsule buried Open House Roy Porter (1946–2002) Dr Mike Dexter announced his The Wellcome Trust has published Dr Lee Elliot-Major took up the The Trust entered into Good progress was made on the new The Trust launched a competition On 21 September 2002, the Trust People throughout the Wellcome Trust, decision to retire in March 2003, its ‘Guidelines on Good Research position of Head of Policy and correspondence with the cemetery Wellcome Trust headquarters under for local schools in Camden to took part in London Open House like people around the world, were following a five-year term as Director. Practice’.The guidelines are designed Communications in June 2002. authorities in Monte Carlo – where construction at 215 Euston Road. come up with ideas for the contents day, an annual event allowing shocked and saddened by the sudden Mark Walport – Professor of to apply to all the research that Prior to this new role, Dr Elliot-Major Henry Wellcome’s business partner, During 2001/02, Unity House was of a time capsule to be buried in members of the public access to death of Roy Porter on 3 March Medicine and Head of the Division the Wellcome Trust funds, including completed a PhD in theoretical Silas Mainville Burroughs, died of demolished and the substructure the foundations of the new building. buildings of architectural and cultural 2002. He had only recently retired. of Medicine at Imperial College, biomedical, biomedical ethics, social physics – publishing three academic pneumonia in 1895 and is buried – and steel frame of the new building As a result, the capsule contains interest which are otherwise closed. Roy Porter moved to the Academic London – was appointed to succeed sciences and history of medicine. papers on quantum mechanics – to prevent his grave being replaced. were erected on the site.The old a range of items, including the Members of staff showed over 450 Unit of the Wellcome Institute for the him, taking up his new position on before setting up Research Fortnight, In parts of Europe, if a grave is substation was demolished and a three winning submissions from the visitors from a variety of countries, Institutions are expected to have in History of Medicine at the Wellcome 1 June 2003. Professor Walport was a newspaper providing information over 100 years old and considered new substation built in the southwest schools, the Human Genome including Hungary, New Zealand place their own published standards Trust in 1979, became Professor previously a Governor of the Trust . about funding opportunities for the abandoned, it is standard practice corner of the 215 site. CD-ROM, photos of all the Wellcome and Canada, around the Wellcome of good research practice. In addition, of the Social History of Medicine in research community and news on for it to be replaced.The Trust Trust staff and commemorative items Building at 183 Euston Road. with effect from 1 October 2002, The project, known as the 1993, and was elected as a Fellow research policy and politics. He then financed the necessary repairs from the Queen’s Golden Jubilee. it will be a condition of Wellcome Cornerstone project, is on track for Visitors took in the sparkling glass of the British Academy in 1994. moved on to become editor of to the grave in order to assure its Trust grants that host institutions in completion in spring 2004. Sir Roger Gibbs, the former chairman model of the new building on the His prodigious written output of more Education Guardian before joining preservation, and to preserve the the UK and the Republic of Ireland of the Trust, buried the capsule and upper ground floor and Aya Ben than 100 books included works the Trust. memory of a remarkable man: have in place formal written laid the foundation stone on 25 June Ron’s striking banner,‘Hanging’, on madness, quacks, gout, London, although much more has been procedures for the investigation of 2002.The ceremony was attended which descends through the stairwell and the Enlightenment; his Greatest written about Henry Wellcome, allegations of research misconduct. by the Governors, including the present from the top floor ceiling to the Benefit to Mankind: A medical without his charismatic and energetic The guidelines are supplemented chairman Sir Dominic Cadbury, upper ground floor.The Wellcome history of humanity (1997) is a partner, the Wellcome Trust would by a Statement on the Handling of a representative staff group, the Library’s magnificently preserved synthesis of medical history of never have existed. Allegations of Research Misconduct. winners of the schools competition reading room and Henry Wellcome’s all periods. and Local Authority representatives. portrait gallery also drew admiring comments. Opening 183 to the public in this way prefigures plans for the Wellcome Building to become a public space once the new building at 215 Euston Road is complete. 38 39

A YEAR AT THE TRUST

UK FUNDING

The Wellcome Trust makes an important contribution to UK research through its ongoing support of innovative, investigator-led proposals in all areas of biomedical science. During 2001/2002, 385 grants, with a total cost of about £110 million, were allocated through the four main subject panels, supporting research in academic institutions across the UK and Republic of Ireland.

Infection and Immunity Molecular and Cell Neurosciences Physiology and Pharmacology Advisory committee Infection and Immunity Panel Molecular and Cell Panel Neurosciences Panel Physiology and The Infection and Immunity Panel The Molecular and Cell Panel The Neurosciences Panel awarded The Physiology and Pharmacology Pharmacology Panel awarded £31.2 million, including £30.2 million, including 13 new Panel awarded £21.7 million, including awarded £26.1 million, including Remit Funds fundamental and applied Considers applications Considers applications Supports physiology and 13 programme grants. 11 new programme grants. programme grants. 13 new programme grants. research relating to infectious that fall into the general area investigating the function of the pharmacology in its broadest diseases and immunology. of molecular and cell biology, nervous system in health and context, ranging from basic Several grants focusing on the role A number of grants focused Several programme grants were Two programme grants, awarded This ranges from epidemiology including biochemistry, disease. It considers proposals cellular and molecular studies of T cells in the immune response on kidney disease. For example, funded which will investigate the to Professor Paul Stewart, and the pathology of infections developmental biology and in both cellular and cognitive in model systems to whole- were awarded. For example, Professor John Savill, University causes of common neurological University of Birmingham, and through to genetic and molecular genetics; proposals may involve neuroscience as well as clinically organ and animal studies, including Dr Peter Lane at the University of Edinburgh, received a grant to diseases. For example, Professor Professor Jonathan Seckl, University studies relevant to infectious basic, clinical or veterinary oriented proposals investigating studies of integrative physiology. characterize molecules that Peter Brophy at the University of of Edinburgh, were to investigate disease. research. common neurological, Epidemiological and mathematical of Birmingham was awarded a ophthalmological and psychiatric studies are also covered. programme grant to investigate prevent kidney inflammation, Edinburgh received a programme the impact of 11-beta-hydroxysteroid conditions. how B cells and dendritic cells the commonest cause of kidney grant to investigate proteins dehydrogenases (enzymes Total spend £26.1 million £31.2 million £30.2 million £21.7 million regulate helper T cells during failure, brought on by defects in the implicated in motor neurone disease. which mediate levels of cortisol priming. And Dr Diana Williams clearance of apoptotic cells by Professor Gillian Bates at King’s in the bloodstream and tissue) Project, programme at the University of Liverpool was macrophages. Professor Martin College, London, was awarded a on human disease. See page 29. and equipment; awarded a project grant to study Griffin, Nottingham Trent University, programme grant to investigate number of new Several grants with an epidemiological applications (new grants) 279 applications 307 applications 283 applications 251 applications helper T-cell responses induced by and Dr Timothy Johnson, University the molecular basis of Huntington’s focus were awarded. For example, 87 awards 117 awards 93 awards 77 awards Neospora caninum infection in of Sheffield, received a joint grant disease and develop therapeutic Professor Peter Whincup, pregnant cattle. to investigate an enzyme that leads interventions. Professor John Duncan Award rate 31% 38% 33% 31% St George’s Hospital Medical School, to kidney disease in diabetic at the Institute of Neurology was The ‘Genome-based Pathogen London, received a project grant to patients. Professor Michael Tanner, awarded a programme grant to use Biology’ conference, held at examine whether ethnic differences University of Bristol, received an magnetic resonance imaging Hinxton in June 2002, celebrated in the cardiovascular risk profile award to look at defective acid to identify the parts of the brain the 25th anniversary of the of British South Asians, African- University Awards Showcase Top left Professor secretion associated with kidney involved in epilepsy. John Duncan is using sequencing of the first complete Caribbeans and whites are present Eleven University Awards were also Following a review of the scheme, damage and kidney stones. magnetic resonance DNA genome – φX174 – and the Several other programme grants in childhood, and to examine the awarded through the subject panels. the Henry Wellcome Showcase imaging to identify parts success of the pathogen genome Three grants related to were around the theme of visual factors operating in the early years These awards allow universities to scheme – established to support of the brain involved sequencing projects that have spermatogenesis and infertility were psychophysics. Professor Semir of life which may cause them. attract strategically important projects in any area of biomedical in epilepsy. followed.The conference discussed awarded. Dr Mark Jobling, University Zeki at University College London Dr David McCance, Royal Victoria researchers by providing support for research that are innovative, Top middle The malaria genome map. the impact of genome information of Leicester, received a grant to received a programme grant to Hospital, Belfast, received a project an individual for up to five years, speculative, adventurous and novel – on the study of pathogen biology, carry out molecular analysis of look at the organization of the grant to conduct a randomized after which time the applicant takes was relaunched for a further five Top right Dr Mark Jobling is examining sex- from bacteriophages to sex-chromosomal deletions and different parts of the visual brain controlled trial of vitamins C and E up a guaranteed permanent post in years from October 2001. During chromosome anomalies eukaryotic parasites. translocations in sperm that lead to and the integration of different to prevent pre-eclampsia in the university.The scheme has now 2001/02, 18 awards were made to that lead to infertility infertility and sex reversal. Dr Helen visual attributes such as shape, pregnancy for women with type 1 been extended to provide support the value of £2.25 million. and sex reversal. The Biodiversity initiative terminated White-Cooper, University of colour and motion. Professor diabetes. See page 25. for research technologists or in 2002, and researchers in the Oxford, received a grant to look at Andrew Parker at the University of analysts, who may not have PhDs field now compete for project how meiotic arrest genes regulate Oxford was awarded a programme but whose expertise – in developing grants and fellowships through the spermatogenesis in the fruit fly. And grant to look at how the visual specialized experimental techniques Subject and Careers Panels. Dr Darren Griffin, Brunel University, system processes binocular depth. or equipment, or in analytical is working with Dr Nabeel Affara, And Professor Jon Driver at methods such as statistical or University of Cambridge, and University College London was computing skills – is vital to the Professor Christopher Barratt, awarded a grant to look at visual success of many biomedical Birmingham Women’s Hospital, to impairment following a stroke, research programmes. investigate whether genetic changes particularly ‘left neglect’, when affecting chromosome segregation patients ignore visual information to underpin male infertility. their left side. 40 41

UK FUNDING

CAREER SCHEMES AND CLINICAL INITIATIVES

The Wellcome Trust’s programme of personal award schemes aim to provide flexible opportunities for support for basic and clinical researchers, from the earliest stages to the pinnacle of a research career. Specific clinical initiatives help ensure that patients continue to reap improved healthcare benefits from Trust-funded research. In 2001/2002, the Trust spent £86 million providing primarily UK-based personal support for outstanding scientists at all levels and support for specific clinical initiatives.

The Roberts Review and The schemes include: Eight new Senior Research For young scientists, 73 Prize Advisory committee Basic Science Interest Group Clinical Interest Group Veterinary Medicine Interest Group the Spending Review 2002 ◗ Flexible Funding Awards (totalling Fellowships in Basic Biomedical PhD Studentships and 74 four-year £90 million) associated with grants Science were awarded – five to PhD studentships were awarded. The Roberts Review on the supply Remit This Group is responsible for several schemes The schemes that support the clinical and This Group advises the Trust on any matters of people with scientific skills and to give researchers at the laboratory researchers previously holding Vacation Scholarships were including: the Prize (PhD) Studentships, research training needs of medical, dental relating to veterinary research in a national career opportunities for scientific bench more freedom to use this Wellcome Trust Research Career awarded to 302 undergraduates Four-year PhD Training Programmes, Research and veterinary graduates are the responsibility context and on the training needs of researchers in British universities proportion of their award flexibly. Development Fellowships (RCDFs) to give them an opportunity to gain Career Development Fellowships and Senior of this Group.A separate subcommittee the profession. It considers applications for Research Fellowships in Basic Biomedical advises on Training Fellowships in Clinical intercalated BSc awards to veterinary graduates was published in April 2002. and seven Senior Research ‘hands-on’ experience of research, ◗ Value in People grants of up to a Science.A separate subcommittee is Epidemiology and Health Services Research and for other veterinary research training Fellowships were renewed for a and encourage them to consider In July 2002 the UK Government total of £30 million to be made to responsible for Research Training Fellowships (CEHSR). grants. further five years.Twenty-two research as a potential career. announced its Spending Review, selected universities to assist them in Mathematical Biology. which proposed implementing new RCDFs were awarded. to nurture talented young scientists Subject specific personal award Total spend £48.6 million £30.2 million £0.2 million some of the recommendations set within their institutions and help The Trust’s clinical fellowships allow schemes: out in the Roberts’ proposal, and them to progress to a stage where talented clinicians, be they medically, Awards include: ◗ Bioarchaeology: Four fellowships its policy to support the university they can independently apply to dentally or veterinary qualified, to Senior-level fellowships £19.1 million £16.7 million and one studentship were awarded. research base in the document, funding bodies for their own support. carry out research of the highest Intermediate-level Investing in Innovation: a strategy for quality. In the 2001/02 the Trust ◗ Biodiversity: Six Research Training fellowships £10.0 million £5.7 million ◗ An extra £30 million is set aside science, engineering and technology. awarded six new Research Leave Fellowships and four research for large state-of-the-art equipment Training fellowships Fellowships for Clinical Academics. training studentships were awarded. and studentships £18.2 million £7.7 million £0.1 million The Wellcome to be shared by scientists working Six of the prestigious Senior Research Trust’s Response on different research projects ◗ Clinical Epidemiology: Four Fellowships in Clinical Science were Subcommittees Mathematical Biology committee: CEHSR committee: The Wellcome Trust welcomed the in universities. Research Training Fellowships were £0.74 million £2.1 million awarded – three to clinicians who announcement both of a real-terms awarded. increase in the Science Budget ◗ A national network of science had previously held Trust fellowships. Other major awards: funding for universities and research learning centres. See page 32. Additionally three current Senior ◗ Health Services Research: Six Principal Research Clinical fellows were successful in Training Fellowships were awarded. Fellowships £7.6 million councils and the commitment to ◗ A new £40 million translation renewing their award for a further increase salaries for research students programme. See page 51. ◗ Mathematical Biology: Five Research five years. A category of fellowship and young researchers so that they Training Fellowships were awarded. are broadly comparable with those Personal support of particular significance is the funded by the Trust. In response, The Trust provides support schemes Clinician Scientist Fellowship, ◗ Medical Microbiology: Four Research Integrative physiology Top left Professor Steve Top middle Professor the Trust unveiled a raft of new for the most talented laboratory a nationally recognized scheme Fellowships were awarded. Following site visits in March and O’Rahilly and colleagues Doreen Contrell is initiatives with an additional funding workers at various stages of the that has been designed to allow in a Cambridge–Oxford studying T lymphocyte Clinical initiatives April 2002, the £15 million of £280 million over five years. research career – from Vacation clinicians to combine both clinical consortium are signal transduction. Three Clinical Research Facilities Integrative Animal and Human investigating illnesses Scholarships giving undergraduates and research training.The Trust Top right Studies The schemes span the spectrum such as obesity and in Birmingham, Cambridge and Physiology scheme made three at Southampton’s of activities supported by the their first taste of research to the was able to award seven of these type 2 diabetes. Manchester opened during the year. awards.The Cambridge–Oxford Wellcome Trust Clinical Trust, and aim to give extensive prestigious ten-year Principal important fellowships in 2001/02. All five Trust-funded facilities are Consortium for Integrative Research Facility. support all the way from the Research Fellowships. Five Advanced Training Fellowships now open. See page 24. Physiology of Common Metabolic classroom through early-stage In 2001/02, two new Principal were awarded, enabling basic The Cardiovascular Research Disease is tackling illnesses such as career development, right up to Research Fellowships were awarded: researchers to obtain research Initiative, based in Edinburgh and obesity and type 2 diabetes.The Ion the translation of discoveries to Professor Doreen Cantrell at the training either in a new discipline Oxford, continues to build research Channel Initiative, which includes into real health benefits. University of Dundee for her work or in a new aspect of their own capacity in the molecular aspects of researchers in Oxford, Cambridge on T lymphoctye signal transduction; field. Prize Fellowships were cardiovascular disease by supporting and London is investigating the role and to Professor Keith Gull at awarded to six Prize Students to career development in the field. of ion channels in nerve and muscle the University of Oxford for his allow them to capitalize on late cells.The London Pain Consortium study of trypanosomes. Professor findings in their PhD. is looking at the genetic basis of Alan Fairlamb’s programme grant pain and the effects of analgesic associated with his Principal drugs. See page 16. Research Fellowship held at the University of Dundee was renewed. 42 43

CAREER SCHEMES AND CLINICAL INITIATIVES

INTERNATIONAL PROGRAMMES

Far left HIV infection is Left The South East Asia Although the greater part of its annual spend goes to foster and promote UK research, prevalent in KwaZulu- Unit is building on its the Trust also funds research outside the UK, spending £60 million in 2000/01. The Trust’s three Natal, and hence is a successful research into research priority at the combination therapy International Programmes aim to support research and associated activities aimed at improving Africa Centre for Health for malaria. human and animal health in developing countries, fostering a research environment in which and Population Studies. Left centre such countries are able to address their own health needs through research, and facilitating the The Wellcome-KEMRI application of research results into policy, practice and product development. Research Programme is investigating severe childhood illness in Kenya.

◗ INTERNATIONAL PARTNERSHIPS A joint meeting with the WHO was included those to Dr V Kushnirov In July 2002, the Major Awards to Advisory committee International Interest Group Health Consequences of Population Tropical Medicine Interest Group ◗ In May 2002, the Trust and the successful in identifying a number (Moscow) for work on yeast prion Centres of Excellence in Latin Change Panel Governments of Australia and of cost-effective interventions for structure with Professor M Tuite, America initiative was launched. Remit Develops international research strengths Supports research into the health impact of Promotes research in tropical medicine New Zealand launched a major secondary prevention of cardiovascular University of Kent; and to Professor With a budget of £5 million over five through fellowship exchange and shifts in population structure and behaviour in developing countries through major new initiative focusing on the disease, and defining potential B Margulis (St Petersburg) for years, the initiative aims to develop collaboration. Senior fellowship schemes patterns in the developing world. programmes, training and career opportunities. health problems of developing demonstration projects to assess the research on heat-sensitive proteins innovative research into the health are run in several overseas countries. countries in South and South-East effectiveness of these interventions as routes to diagnosis and therapy consequences of population change Total spend £26 million £13.7 million (including NCD awards) £18.2 million (including WT–BWF grants) in developing country settings. in neurodegenerative disease, in Latin American countries. Asia and the Pacific. See page 21. On longer-term support† £9 million £8.4 million (major awards) £13.6 million (including WT–BWF grants) with Dr M Cheeham, University ◗ The Trust contributed £500 000 INTERNATIONAL BIOMEDICAL Master’s training College London. Applications towards a new animal facility at International Senior In April 2002, a revised Master’s Number considered 549 applications 71 applications 73 applications (not including WT–BWF grants) the University of Capetown, South Research Fellowships Returning home to Moscow from Health Consequences of Population 260 awards 36 awards 33 awards (not including WT–BWF grants) The first round of Central European an EMBO fellowship in Scotland, Change research training scheme was Africa for the production of specific Success rate pathogen-free and transgenic animals. Senior Fellowships was awarded Dr E Prokhortchouk obtained CRIG launched.The scheme is open to All new grants 47% 51% 45% during the year. See page 21. support for work on Kaiso, a novel residents of the developing countries ◗ In September 2001, the Trust protein involved in repression of gene in Africa, Asia or Latin America, Major awards 20 International Senior Fellowships 3 major awards and one additional funding 1 Programme grant joined the Medicines for Malaria Following interviews in Cape Town transcription, with Professor A Bird or the restructuring countries of (New awards total: £9 million) award to existing centres of excellence. 1 Senior Fellowship Venture, a non-profit, public–private in March 2002, 11 awards were of the University of Edinburgh. Central and Eastern Europe, 20 major equipment awards total £3.6 million 3 WT–BWF awards were finalized this year foundation that aims to drive the made in the Australian/New including the former Soviet Union. development of new antimalarials. Zealand, South African and Indian HEALTH CONSEQUENCES The Trust contributed £1.8 million Senior Fellowships Scheme.This OF POPULATION CHANGE Noncommunicable diseases to the venture. was the final year for these awards The Wellcome Trust’s Health The noncommunicable diseases www.mmv.org to Australia and New Zealand; Consequences of Population initiative from the Tropical Medicine the scheme has been replaced by Change Programme (HCPC) was Programme was incorporated investigating antimalarial efficacy in infections in Thailand, respectively. An Advanced Training Fellowship Trust-funded research is now ◗ The Wellcome Trust has been a new initiative. See page 21. formally launched in October 2001. into the new HCPC programme rural Lao PDR, Dr S Karunaratne, Dr M Boele van Hensbroek, was awarded to Dr P J Cooper, examining the economic and health working with the WHO’s Special and six awards were made.These whose project on insecticide University of Liverpool, will be St George’s Hospital Medical School, policy implications of these The first ever International Senior www.wellcome.ac.uk/hcpc Programme for Research and included awards to Dr M Bobak at resistance in Sri Lanka includes studying severe anemia in Malawian to study the effects of albendazole changes. Collaborations with Lao Research Fellows meeting was held Training in Tropical Diseases (TDR) Centres of Excellence the Department of Epidemiology a period of training in Liverpool, children; and Dr V Patel, London on atopy in children in Ecuador. PDR were strengthened with the on 29 April – 1 May 2002. The on setting up a planning group to In May 2002, new research facilities and Public Health, University College and Dr S Kariuki who aims School of Hygiene and Tropical award of further funding for clinical meeting brought together current Major Overseas explore developing STD diagnostics for the Africa Centre for Health London, examining alcohol intake in to identify risk factors in invasive Medicine, will be investigating research at Mahosot Hospital, and former Fellows from Australia, Research Awards for the developing world. and Population Studies opened in Russia, Poland and the Czech Republic, salmonellosis in Kenya. gynaecological morbidity and Vientiane. India, New Zealand, and South Somkhele, KwaZulu-Natal (see page Directed by Professor Nicholas ◗ The Wellcome Trust has been and to Professor M Prince, Institute common mental disorders in India. Africa, and representatives from 20). An award was also made to the Dr Jeremy Farrar, Director of the White, the Trust’s South-East Asia The Wellcome–Kenyan Medical collaborating with the Rockefeller of Psychiatry, London, for the study national and international funding Africa Centre for a population- Wellcome Trust-funded programme Training Fellowships in Clinical unit continues to strengthen its Research Institute (KEMRI) Research Foundation and other agencies of dementia in Brazil and Cuba. bodies and research institutions. based study of HIV seroprevalence in Vietnam, was awarded a Career Tropical Medicine recommendations local partnerships with the official Programme was awarded funding to support the development of www.wellcome.ac.uk/isrf in the Hlablisa community. TROPICAL MEDICINE Post in Clinical Tropical Medicine included: from the University of opening of a new building, the to re-establish epidemiological and the INDEPTH Network, a global Overseas Fellowships for his research into the immuno- Liverpool, Dr D Bell, who will be Department of Laboratory Sciences, demographic surveillance in Kilifi, alliance of health and demographic Collaborative Research Three years further funding was Personal awards to scientists from pathogenesis of dengue. Dr P Kelly, studying antimalarial drug resistance a joint effort between the Vietnamese which will track deaths, births and surveillance sites in the Initiative Grants awarded to the the Asian MetaCentre developing countries are part of Bart’s and The London School in Kenya; Dr M Mallewa, central Government and the Wellcome migration in a population of about developing world. Twenty-nine Collaborative Research for Population and Sustainable the Tropical Medicine Programme’s of Medicine, was recommended nervous system infections in Malawi; Trust.This new laboratory will 200 000 people. www.indepth-network.net Initiative Grants (CRIGs) were Development Analysis.This virtual commitment to strengthen research for a Career Post for his tropical and Dr G Davies, pharmacology of house the Oxford University A large programme to study of the made to investigators in 14 countries centre electronically links six Asian capacity within the countries affected gastroenterology studies in Zambia. anti-TB drugs in Thailand. From the Clinical Research Unit in Ho Chi ◗ A joint meeting with the US demographic impact of HIV and linked to UK-based collaborators. centres of excellence in population by major ‘tropical’ diseases.Training University of Oxford, Dr C L Minh City (see page 20).The South- Agency for International From the University of Oxford, the immunology of tuberculosis Nine CRIGs were for research in studies.The headquarters or 'hub' Fellowships were awarded to Dr M Thwaites will be based in Vietnam East Asia unit is also building on its Development discussed the Drs M Eddleston and S Peacock, and BCG vaccination was funded in Russia, the largest number to a of the centre is located at the Imwong from Thailand, who will be to trial a treatment for tetanus, and research into combination therapy evidence base underpinning the were awarded intermediate level Karonga, Malawi, led by Professor single country, with several awards Institute for Asian Research at the studying the genetics of antimalaria Dr I Medana will receive training in for malaria.The success of the use of micronutrient supplements Career Development Fellowships Paul Fine, London School of following earlier grants.These National University of Singapore. resistance, Dr M Mayxay, a clinician Thailand for her studies into axonal therapy in Thailand has led to a during pregnancy, particularly in Clinical Tropical Medicine for Hygiene and Tropical Medicine. from Vientiane, who will be injury in malaria patients. change in guidelines for treatment in developing regions. research into pesticide poisoning in Myanmar and Cambodia and in Sri Lanka and Burkholderia 44 45

INTERNATIONAL PROGRAMMES

CENTRES AND INITIATIVES RESEARCH PARTNERSHIPS AND VENTURES

The Wellcome Trust supports a number of important The Wellcome Trust is involved in a number of collaborations enterprises in academic institutions through major awards, with academic centres, other funding agencies, governments including infrastructure awards, core funding for centres of and industry to speed up biomedical discovery, avoid excellence, and large-scale initiatives in strategic areas such duplication of effort, and disseminate knowledge so that as genome sequencing and functional genomics. healthcare advances can be achieved more rapidly.

Wellcome Trust Functional genomics Centres JIF and SRIF Synchrotron SNP Consortium Advanced Courses Other large-scale conferences Sanger Institute The Functional Genomics Wellcome Trust Research Centres The £750 million Joint Infrastructure Diamond will be the UK’s first The SNP Consortium is a £30 The 32nd, 33rd, 34th and 35th held at the Conference Centre The Wellcome Trust Sanger Institute’s Development Initiative made seven are indirectly funded, UK-based Fund (JIF), to which the Wellcome third-generation synchrotron light million collaboration between the Wellcome Trust Advanced Courses and attended by more than 100 new, five-year £300 million research awards, totalling £36.4 million, for centres of excellence which have Trust contributed £300 million, source to be built at the Rutherford Wellcome Trust, 13 pharmaceutical were held at the Genome Campus delegates included: the Second programme was announced on 15 thematic programmes. See page 14. outstanding groups of senior Trust- completed its final rounds of funding Appleton Laboratory site in and technological companies and in Hinxton, Cambridgeshire. Bioinformatics Industrialization October 2001. Under the leadership funded researchers whose work is in 2001.To date, nearly 90 per cent Oxfordshire. Once operational leading academic centres, in which These residential, laboratory-based Workshop in April 2002,‘Genome The initiative also made seven awards of its Director, Dr Allan Bradley, the of major international significance of the grants have been formally in 2006, Diamond will be the largest the Trust invested £9 million. courses aim to provide scientists Based Pathogen Biology’ in July for Bioinformatics and Technology Sanger Institute has continued its within a designated field of study. awarded to the benefit of scientific facility to be built in the with ‘hands-on’ training in advanced, 2002 and the Seventh International Development.These included In August 2001, the SNP genome sequencing projects, which Following review of the Centres 48 projects at 23 universities. UK for nearly 30 years. state-of-the-art research techniques Symposium on Pertussis in awards to Professor Jas Badyal, Consortium, Celera Genomics include the finishing of the human programme, a fixed-term initiative, directly applicable to their current September 2002. University of Durham, for the JIF’s successor, the £1.1 billion On 1 April 2002, a joint venture and Applied Biosystems announced genome, pathogen genomes, and no new applications for centre research interests. development of high-throughput Science Research Investment Fund company, Diamond Light Source Ltd, an agreement to create a high- Hinxton Hall is also home to the genomes of the mouse and status will be considered. protein microarrays, and to Dr Jason (SRIF), was established to provide was established.The shareholders resolution linkage map of the ‘DNA Microarrays’ took place in ‘retreat’ meetings: closed, invitation- zebrafish.The Institute has also Swedlow, University of Dundee, for The centres are: further funding for infrastructure. of the company are the Council for human genome.The map uses the March 2002, followed by ‘Functional only meetings that allow up to launched a number of new informatics software and a database ◗ Wellcome Centre for Molecular The Wellcome Trust has contributed the Central Laboratory of the SNPs generated previously by the Genomics’ in June 2002.‘Human 40 delegates to address areas of projects to explore the roles of for image microscopy. Parasitology at the University £225 million to SRIF; £150 million Research Councils, who hold 86 per SNP Consortium, and is available Genome Analysis: Genetic Analysis current scientific interest in an genes in health and disease. of Glasgow; of this contribution was allocated cent of the shares on behalf of the on the Consortium’s website. of Multifactorial Diseases’ was held informal but intensive way. Retreat Eleven bioinformatics PhDs www.sanger.ac.uk to support highly ranked but UK Government, and the Wellcome in July 2002, and ‘From Genotype meetings during the year included were awarded. In this pilot scheme, ◗ Wellcome Trust Centre for Cell In November 2001, the SNP unfunded applications to JIF, Trust who hold the remaining 14 to Protein’ in October 2002. ‘Bacterial Genomes’ in October Wellcome Trust holders of long-term Trust funding Biology at the University of Edinburgh; Consortium launched an Allele particularly those that aimed to per cent.The project is led by Chief 2001,‘Tissue Engineering: Missing Genome Campus can apply for an extra PhD for a Frequency Project, which aims to www.wellcome.ac.uk/advancedcourses ◗ Wellcome Trust Centre for Cell- improve working conditions. Executive Professor Gerhard Materlik. Links’ and ‘Entamoeba’ in May 2002 In April 2002, the Trust applied for non-biologist, such as a chemist, determine the frequencies of the Matrix Research at the University Hinxton conferences and ‘Cortical Mechanisms’ in planning permission to extend the physicist or computer scientist. During the year, 14 SRIF awards, Diamond Light Source Ltd will major and minor alleles of at least In September 2002, the second September 2002. Wellcome Trust Genome Campus of Manchester; with a total value of £59 million, design, build, own and operate the 60 000 SNPs in three major world ‘Genome Informatics’ conference on the south field of the Hinxton The initiative made seven awards www.wellcome.ac.uk/hinxton ◗ Wellcome Trust–Cancer Research were made by the Wellcome Trust. new synchrotron. During the year, populations (African-American, was held at the Hinxton Hall estate.The development would for biological collections.These UK Institute of Cancer and The awards included: the specifications of the first seven Asian and Caucasian).The SNP Conference Centre.These A report on the ‘Genome Based 2 included an award to Professor comprise 27 000 m of space for Developmental Biology at the beamlines (of the 21 proposed) Consortium has also been involved David Strachan, St George’s Hospital ◗ a Biogerontology Research Building conferences are jointly funded by Pathogen Biology’ conference can academic and ancillary facilities, an University of Cambridge; were outlined. in developing the proposed Medical School, for the creation of at the University of Newcastle.This the Wellcome Trust and Cold be found in Wellcome News 33. Innovation Centre, and space for Haplotype Map project. ◗ www.diamond.ac.uk Spring Harbor Laboratory. Some www.wellcome.ac.uk/wellcomenews spin-out companies. cell lines from the 1958 cohort to Wellcome Trust Centre for Human new building will support research constitute a national case control Genetics at the University of Oxford; into how intrinsic ageing contributes snp.cshl.org 250 delegates attended to www.wellcome.ac.uk/genomecampus/ disseminate new genomics-related extension series.The cell lines are being to frailty and disease in old age Structural Genomics ◗ Wellcome Trust Centre for the knowledge and to network with created by the European Collection (Professor Tom Kirkwood); Consortium Integrative physiology History of Medicine at University other scientists. of Cell Cultures (ECACC) and Avon The Trust is committed to funding The Integrative Animal and Human College London. ◗ a new facility at the University of Longitudinal Study of Parents and a structural genomics effort in Physiology Initiative promotes www.wellcome.ac.uk/centres Liverpool that will support research Children (ALSPAC) in Bristol. partnership with other funders. research exploring the relationship into the role of host and parasite www.wellcome.ac.uk/functionalgenomics Special initiatives This will include a significant effort between genomic data and behaviour in the transmission of The Dundee Biocentre at the in the UK and the aim is to Above Plans for physiological mechanisms in UK Biobank infectious diseases (Professor Jane the new synchrotron. University of Dundee has been commence operations early in humans and animals.The initiative In April 2002, funding for the UK Hurst). awarded a Strategic Award in 2003.The objective of this effort Opposite page made three awards during the year. Biobank project was announced. Left Dr Allan Bradley, Integrated Bioscience, in recognition Ten JIF construction projects were will be to increase substantially the See page 16. See page 17. Director of the of the outstanding quality of completed during the year, and a number of protein structures of Wellcome Trust Sanger www.ukbiobank.ac.uk multidisciplinary research being further 20 are in progress.Three relevance to human health available Institute. carried out there.The funds will SRIF projects were completed and in the public domain. Right Professor enable researchers at the Biocentre a further 22 are currently on site. Richard Moxon at the construction site to purchase microscopy, X-ray for the new Centre crystallography and computing for Vaccinology and infrastructure, as well as supporting Tropical-based Medicine in Oxford. some additional technical posts. 46 47

CENTRES AND INITIATIVES RESEARCH PARTNERSHIPS AND VENTURES

MEDICINE, SOCIETY AND HISTORY

Through its Medicine, Society and History division, the Wellcome Trust aims to deepen understanding of the impact of science on society in the past, present and future, to foster public trust and conﬁdence in science, and ultimately to create an environment conducive to scientiﬁc exploration informed and guided by sound ethical principles.

◗ BIOMEDICAL ETHICS ReDiscover fund A conference held by the Trust in EXHIBITIONS AND ART Advisory committee Medicine in Society Panel – Medicine in Society Panel – History of Medicine Grants Panel Following a review in 2001, the The Wellcome Trust is allocating December 2001 encouraged policy Science Museum gallery Public Engagement with Science Biomedical Ethics £5 million to the ReDiscover fund – makers, science communicators, In March 2002, a new gallery run Biomedical Ethics grants scheme Remit To make recommendations on grant To make recommendations on grant A broad definition of the history of was renewed and relaunched, a £33 million partnership with the educators and academics to by the Trust opened at the Science applications in the areas of public applications in the field of biomedical ethics. medicine embraces the study of all factors with £15 million funding over Millennium Commission and the consider how to implement the Museum.The first show was engagement with science.Awards may be affecting the health experience of people the next six years to continue Wolfson Foundation – to enable recommendations of the influential ‘Head On: Art with the brain in for research or activities (Impact Awards). and animals in all countries at all periods. science centres and museums to Valuable Lessons report, which mind’. See page 36. its support of research into the Total spend Research awards Impact Awards ethical, legal and social implications replace or refresh their exhibition explored how teachers approach TwoTen Gallery £226 845 £933 907 £1.7 million £5.2 million spaces. See page 34. controversial topics raised by of biomedical research. The TwoTen Gallery, at 210 Euston science in their lessons. A report Youth drama Road, hosted a series of innovative Applications A £4 million funding scheme for of the conference is available on Number considered 11 23 47 219 ◗ The Wellcome Trust’s Science exhibitions on aspects of the the ethics of biomedical research in the Wellcome Trust website. developing countries was launched Centrestage initiative, which relationship between medical Award rate 27% 39% 53% 35% in October 2002.The scheme aims encouraged secondary school ◗ In spring 2002, Clare Matterson, science and art. See page 36. Head of the Medicine in Society to enable researchers in developing students to explore the wider Artists-in-residence implications of science through division, was invited to give oral countries to address ethical questions Artists Alexandre Da Cunha and drama, culminated with the evidence to the Science and related to biomedical research, and Gonzalo Páramo Pino each spent National Festival of Drama at the Technology Committee at a session to develop strategies for making six months at the Wellcome Trust, HISTORY OF MEDICINE Far left The History Above middle such research useful to funders and Royal Opera House. See page 30. on scientific literacy, based on the Grants of Medicine Public A visitor at the exhibition using the Trust’s extensive library Engagement with Science ‘Everything I could policy makers. See page 13. Valuable Lessons report. ◗ A programme grant was awarded ◗ Pulse – the Trust’s Performing resources and expertise to develop programme funded buy on eBay™ about to Professor John Pickstone at the In June 2002, a workshop at the Arts for Young People scheme – ◗ The Wellcome Trust awarded art projects related to biomedicine an exhibition at the malaria’, held in the Wellcome Unit for the History of Foundling Museum. TwoTen Gallery. Trust discussed ‘Communicating was launched to encourage youth £300 000 towards a pilot GCSE, and its wider impact. Medicine, University of Manchester, Above left Alexandre Above right Research in Biomedical Ethics’. theatres, dance companies and ‘21st Century Science’, which Symposium on sciart and for his research programme Da Cunha was one of Jodie, by St Bernard’s The workshop brought together other organizations to create includes more contemporary two artists-in-residence Catholic High School, Science on Stage and Screen ‘Constructing cancers, 1945–2000’. innovative performing arts projects science topics and reflects the at the Trust during Barrow-in-Furness, one grant holders, policy makers and In September 2002, the Wellcome other users, and is part of a greater that engage young people in science ethical debates they raise, and ◗ Four University Awards were made the year. of six productions at Trust and sciart consortium – the National Festival and its social impact. See page 31. £70 000 towards a pilot AS-Level, emphasis on the dissemination in partnership with Liverpool School to researchers at the Universities of of Science Drama in ‘Perspectives on Science’, which of the results of biomedical ethics Education of Art and Design at Liverpool John Manchester, Newcastle, Durham May 2002. research projects. explores the history and philosophy ◗ The Wellcome Trust has committed Moores University – held a two-day and Warwick. of science. CONSULTATION AND up to £25 million in a £50 million symposium as part of the Liverpool International history EDUCATION partnership with the Department BBC open-house debates Biennial Events programme. of medicine In January 2002 the Wellcome for Education and Skills to create In February and March 2002, the The symposium looked at award- A new scheme, International Trust and the Medical Research a national network of science Trust and the BBC jointly hosted winning art and science projects Collaborative Research Initiative Council carried out a consultation learning centres for the continuing six open-house debates around the from the sciart and Science on Grants in History of Medicine, exercise with members of the professional development of science UK.The debates were linked to the Stage and Screen schemes, exploring was launched.The scheme enables public on the ethical and teachers. See page 32. Gene Stories season of BBC radio the impact of scientific knowledge established historians of medicine management issues relating to the and television programming.The on the lives of individuals and ◗ In February 2002, the Association based in developing countries proposed UK Biobank project. partnership with the BBC meant their wider communities – as well for Science Education and the (South-East Asia, China, Africa, that these events were followed by as interdisciplinary explorations Engaging Science Wellcome Trust held a joint Latin America), or in restructuring discussions on regional and national of space, perception and the countries of central and eastern In September 2002, the Wellcome conference at Central Hall, radio; the radio slots reached an environment. It enabled artists, Europe, and the independent states Trust launched a new £3 million Westminster to encourage teachers estimated audience of three- scientists, bio-ethicists, science of the former Soviet Union, to Public Engagement with Science to include examples from science quarters of a million people. communicators and students to undertake a research programme grants programme, Engaging in citizenship lessons. See page 32. share ideas and view new work. to be carried out in their home Science. See page 31. institution, in conjunction with a collaborating department in the UK. Continued on page 50 48 49

MEDICINE, SOCIETY AND HISTORY

MEDICINE, SOCIETY AND HISTORY CONTINUED CATALYST BIOMEDICA LTD

Catalyst BioMedica Ltd, the business subsidiary of the Wellcome Trust, was set up to take forward promising History of Medicine Units Public engagement New awards to libraries over 6000 Sexually Transmitted research that is at too early a stage or too high-risk to attract ◗ The Trust continued to support programme and archives Infections,Tuberculosis and venture capital or be taken up by industry. Ultimately, the aim HIV/AIDS CD-ROMs to distribute two History of Medicine Units The History of Medicine Grants The Research Resources in Medical is to make research available to the commercial sector, which at the Universities of Manchester Panel has set aside £250 000 to History scheme awarded more to non-governmental organizations and Oxford.The Unit at the fund public engagement projects than £275 000 to help open up and other agencies. has the knowledge and resources necessary to develop it into new therapies that will benefit patients. University of East Anglia closed that aim to help the history of access to, or help conserve, New CD-ROMs and staff transferred to University medicine to reach wider audiences important documentary resources ◗ Acute Respiratory Infections, College London. and ensure the history of medicine in medical history.The 11 successful addressing one of the most is included in general history projects include Royal Colleges, ◗ Professor Michael Worboys took important causes of disease and coverage.The key aim of the fund is archives services and university Since its first fully operational ◗ The development of new The Technology ◗ University Translation Awards up his post as the new Director crossing many different specialties, to give perspective and context to libraries.The £1 million scheme is trading year in 1999/2000, Catalyst defibrillators (see page 27) and of Transfer initiative provide ‘hands-off’ support – of the Wellcome Trust's History was launched in November 2001. current health and research issues funded by the Wellcome Trust and BioMedica, the Wellcome Trust's the use of carbenoxolone for the This new initiative will build on of up to £300 000 – for projects of Medicine Unit at the University and stimulate dialogue between run in conjunction with the British ◗ Work continued on a new edition business subsidiary, has concluded treatment of memory loss the strengths of previous work managed by university technology of Manchester on 1 August 2002. researchers, policy makers and the Library. Due to the high quality of of Sexually Transmitted Diseases, more than 60 licence agreements, (see page 29). undertaken by Catalyst BioMedica transfer offices. Early-stage projects, Professor Worboys, formerly of wider public. See page 37. applications, the scheme was to be called Sexually Transmitted and supported 30 Development Ltd and the Development Fund. as yet insufficiently developed to Sheffield Hallam University, was ◗ In a one-off grant, the Trust has extended for a further, final two Infections, and to be launched in Fund projects leading to more than However, its activity will be attract first-round professional awarded a seven-year Wellcome THE WELLCOME LIBRARY supported the development of a years, the Wellcome Trust taking early 2003. a dozen new start-up companies. refocused. financing, covering any aspect of Trust University Award, which will FOR THE HISTORY AND miniaturized mass spectrometer for over its administration. technology development in lead to a permanent academic UNDERSTANDING OF MEDICINE ◗ TMR has been working in The Development Fund of the Beagle 2 Mars lander project. ◗ Recognizing the important role biomedical science will be funded, position at Manchester. Acquisitions TROPICAL MEDICINE RESOURCE collaboration with the Liverpool £20 million has nearly completed its See page 26. played by the biotechnology provided they address The Wellcome Library’s collections International Award for School of Tropical Medicine funding cycle.The wide range of new and pharmaceutical industries in Strategic and Review an unmet need in healthcare. continued to be developed Malaria CD-ROM to develop training materials technologies supported includes: translating research innovations into Enhancement Awards During 2002, the Wellcome Trust throughout the year. Major Malaria 2nd edition, one of 12 on lymphatic filariasis for health new medicines, the new division ◗ Strategic Translation Awards In recognition of the need for ◗ Catalyst awarded £427 000 to and Catalyst worked together acquisitions included the archives CD-ROMs in the Trust's ‘Topics in professionals and politicians. aims to support promising early- provide ‘hands-on’ support – of up a more open competition in the the Trust-funded Cancer Genome with external consultants to review of Francis Crick (see page 18) International Health’ series, was The materials, to be completed in stage projects to a point where to £500 000 – to projects focused history of medicine field, a new Project for a drug discovery and reorganize Catalyst.The aim and a medieval physician’s awarded the Prix IAMS for 2002. spring 2003, are being developed as they can be taken up by investors on areas of strategic scientific scheme was launched.The Strategic programme to screen for molecules was to develop an effective strategy handbook. See page 22. Named after the International part of the Global Alliance for the and industry. importance to the Trust, such as and Enhancement Awards will that interact with BRAF – a protein for managing intellectual property Association for Media in Science, Elimination of Lymphatic Filariasis – the various fixed-term initiatives provide core support for groupings Opening up access associated with malignant melanomas. and business development arising ◗ The new initiative will provide the annual prize is awarded to the a project which has funding from the Trust supports.The themes may of historians of medicine at any New technology has continued These compounds will form the out of Trust-funded research. As a a high-quality technology transfer most innovative and informative the Gates Foundation for the first change, according to the strategic UK institution. to widen access to the Wellcome basis of a future collaboration to result of the review, it was decided service for the Wellcome Trust and multimedia product in the area of five years of a 20-year campaign. focus of the Trust. Unlike University Library’s rich collections. develop new cancer-fighting drugs. to integrate Catalyst within the will seek to enhance the level of ◗ Strategic Awards will be made to scientific, technical and medical Translation Awards, projects will be ◗ A new CD-ROM, Medicine in main body of the Trust. A new biomedical translation of Trust- established groupings of researchers ◗ The new website of the Wellcome multimedia publishing.The Malaria ◗ CellTran Limited, a spin-off from managed by Technology Transfer at Literature, began trials.The disc, TechnologyTransfer initiative will funded research. enabling them to pursue research Library went live in June 2002. CD-ROM, which includes 850 Sheffield University Enterprises the Wellcome Trust. aimed at medical students, has been handle all translation projects. around a theme or related themes. See page 19. images and 13 interactive tutorials Limited, was set up to develop and ◗ A new funding programme of developed by Professor Janet This continues the theme concept to help healthcare workers market the pioneering research Translation Awards will replace ◗ The Trust’s Medical Photographic Browne at the Wellcome Centre of the units, which formed around understand, identify and treat the of two University of Sheffield the Development Fund.The outputs Library website, providing online for the History of Medicine in a focus that was sufficiently loose disease, has been used by more academics.With a £600 000 award will be platform technologies and access to the collection of 160 000 collaboration with TMR and the to allow for the interests of than 10 000 people in 70 countries. from Catalyst, and other funding, products aimed at the biotechnology images, was launched in July 2002. Wellcome Library, and funded different scholars to be pursued the company is currently and pharmaceutical industries. See page 19. Sales by a Wellcome Trust History of within an overall framework. investigating the use of patient's Innovations developed under these ◗ To date, more than 16 000 ‘Topics Medicine grant. ◗ The public interface of the Library’s own cells on plasma-coated awards will offer opportunities for ◗ The smaller Enhancement Awards in International Health’ CD-ROMs archives (original manuscripts) polymers for burn and wound licensing deals and the establishment will be made to provide some have been sold. database, CALM, was launched in repairs in the form of biological of start-up companies.They will core funding for small groups of June 2002. ◗ The department is supplying the bandages. Ongoing patient trials span all areas of biomedical science. researchers, or individuals, enabling Open University with 3000 copies are demonstrating significant They will be of interest to venture them to develop collaborative links http://archives.wellcome.ac.uk each of the Malaria,Tuberculosis health benefits. capitalists, the life science industries and build their research strengths. ◗ MedHist, a searchable catalogue of and HIV/AIDS CD-ROMs for use in and local commerce, including If desired, the awards can help to over 500 Internet resources to help its new ‘Infectious Diseases’ course business angels and Regional make them competitive for students, teachers and researchers starting in February 2003. Development Agencies.The Strategic Awards. locate high-quality websites relating programme has two schemes. to the history of medicine, ◗ GlaxoSmithKline has ordered Above A sperm fertilizing an egg, the image that was launched in July 2002. formed the basis of www.medhist.ac.uk Technology Transfer’s new launch materials. 50 51

MEDICINE, SOCIETY AND HISTORY CONTINUED CATALYST BIOMEDICA LTD

BOARD OF GOVERNORS ADVISORY COMMITTEES

The Board of Governors of The Wellcome Trust Limited, The Wellcome Trust is committed to the principles of peer review. It is indebted to the the corporate trustee of the Wellcome Trust, carries out the many researchers who give up their time to sit on the Trust’s advisory committees, charitable objects of the Wellcome Trust as laid out in the and to the many thousands of scientiﬁc referees, in the UK and overseas, who provide Trust’s constitution. comments on grant applications.The following pages list the membership of the Trust’s advisory committees during 2001/02. March 2003

Governors Executive Board Other senior staff UK FUNDING PROGRAMME Infection and Immunity Panel Medical Microbiology Professor L Pearl Sir Dominic Cadbury Dr Mike Dexter Dr Pat Goodwin Professor N A R Gow Interviewing Committee Institute of Cancer Research, London Bioarchaeology Panel Chairman Director of the Wellcome Trust Head of Subject Panels (Chair) University of Aberdeen Professor K A V Cartwright Professor M K Jones Professor M S Povey (Chair) Public Health Laboratory (Chair) University of Cambridge Professor J D Barry University College London Professor Sir Michael Rutter Linda Arter Dr Richard Lane Gloucestershire Royal Hospital Deputy Chairman Director of Finance and Information Head of International Programmes (Vice-Chair) University of Glasgow Dr D J Ortner Dr S Rastan Management Professor J S Kroll (Vice-Chair) Smithsonian Institute, USA Professor A P Bird Ceros Ltd, Cambridge Professor Adrian Bird Dr Barbara Skene (Vice-Chair) Imperial College of Science, Governor Dr Ted Bianco Acting Head of Ventures and Initiatives Governor,The Wellcome Trust Professor J O Thomas Technology and Medicine, London Dr M Robinson Director of Technology Transfer Governor,The Wellcome Trust Professor P C L Beverley University of Cambridge Professor Martin Bobrow Dr Sally Woodward Professor D H Crawford Governor John Cooper Head of Career Schemes The Edward Jenner Institute Professor L C Aiello University of Edinburgh Professor A Sharrocks Director of Human Resources and Clinical Initiatives for Vaccine Research, Compton Professor Christopher Edwards University College London University of Manchester and Services Dr N J Klein Governor Dr Lee Elliot-Major Professor I N Clarke Dr D G Bradley Institute of Child Health, London Professor A Smith Dr Rick Fuller Head of Policy and Communications University of Southampton Mr Alastair Ross Goobey University of Dublin, Republic of Ireland University of Edinburgh Director of Science Funding Professor T N Mitchell Governor Jill Saunders Dr J P Derrick Professor J E Buikstra University of Glasgow Dr J-P Vincent Clare Matterson Head of Grants Administration Manchester University Professor Julian Jack University of New Mexico, USA National Institute for Medical Research Director of Medicine, Society Institute of Science and Technology Professor I S Roberts Governor John Stewart and History Dr P Halstead University of Manchester Neurosciences Panel Head of Legal Services Dr D W Dunne Professor Jean Thomas University of Shefﬁeld Professor D A S Compston Gary Steinberg and Company Secretary University of Cambridge Molecular and Cell Panel Governor (Chair) Addenbrooke’s Hospital Professor M Stoneking Professor D R Critchley Chief Investment Ofﬁcer Professor A C Hayday Max Planck Institute for Evolutionary (Chair) University of Leicester Professor N J Abbott Mr Edward Walker-Arnott Guy’s, King’s and St Thomas’ Anthropology, Germany King’s College, London Governor School of Medicine and Dentistry Professor M J P Arthur Biodiversity Interviewing Committee (Vice-Chair) University of Southampton Professor M L J Ashford Dr N J Klein Dr D Rollinson University of Dundee Institute of Child Health, London Professor J J B Jack (Chair) Natural History Museum, Governor,The Wellcome Trust Professor G Bates London Dr J P Latgé King’s College, London Institut Pasteur, France Professor S Busby Professor M Akam University of Birmingham Professor M Bobrow University of Cambridge Dr A McLean Governor,The Wellcome Trust University of Oxford Professor I D Campbell Professor I N Clarke University of Oxford Professor Sir Michael Rutter University of Southampton Professor H R P Miller Governor,The Wellcome Trust University of Edinburgh Professor B Caterson Professor W Gibson University of Cardiff Professor D J Brooks University of Bristol Professor P J M Openshaw Imperial College School of Medicine, Imperial College of Science, Professor P Cullen Professor A F Read London Technology and Medicine University of Bristol University of Edinburgh Professor N J Buckley Professor J R Saunders Professor D G Hardie Professor B G Spratt University of Leeds University of Liverpool University of Dundee Imperial College School of Medicine, Professor N Craddock London Professor S Siddell Dr T Hunt University of Birmingham University of Bristol Cancer Research UK Professor H Townson (Clare Hall Laboratories) Professor S Dunnett University of Liverpool Dr B Stockinger Cardiff University National Institute of Medical Professor A F Markham Research, London St James's University Hospital, Leeds Professor I Forsythe University of Leicester Dr A P Waters Leiden University, Netherlands Dr J M Woof University of Dundee 52 53

BOARD OF GOVERNORS ADVISORY COMMITTEES

ADVISORY COMMITTEES CONTINUED

Neurosciences Panel cont. Professor J J Mullins Cardiovascular Research Clinical Research Facilities Professor M S P Sansom Professor I McConnell Dr R Brent Professor A Tait Dr G G R Green University of Edinburgh Working Party Committee University of Oxford University of Cambridge University of California, USA University of Glasgow University of Newcastle upon Tyne Professor P Poole-Wilson Professor Sir Michael Rutter Professor C P Page Professor J A Sherratt Professor W I Morrison Dr L R Cardon Dr J R Tata (Chair) Imperial College School (Chair), Governor,The Wellcome Trust Professor I Grierson King’s College London Heriot-Watt University, Edinburgh Institute for Animal Health, Berkshire University of Oxford National Institute for Medical of Medicine, London University of Liverpool Professor Sir Leszek Borysiewicz Research, London Professor D P Strachan Dr W Taylor Professor A Trees Professor B Charlesworth Professor M J Walport Imperial College School of Medicine Professor J Henley St George's Hospital Medical School, National Institute for Medical Research, University of Liverpool University of Edinburgh Professor M Yaniv Governor,The Wellcome Trust University of Bristol London Professor G R D Catto London Institut Pasteur, France FUNCTIONAL GENOMICS Professor J Darlington Professor G Fitzgerald King’s College, London Professor E Kuipers Professor P Vallance Professor M Woolhouse DEVELOPMENT INITIATIVE Imperial College of Science,Technology Health Consequences University of Pennsylvania, USA Institute of Psychiatry, London University College London Professor R Frackowiak University of Edinburgh and Medicine, London of Population Change Panel Biomedical Resources Panel Professor K M Spyer University College London Professor W Graham Professor R Lemon Professor J S Yudkin Research Career Development Professor K E Davies Dr P Grindod University College London (Chair) University of Aberdeen The National Hospital for Neurology University College London Professor R Galbraith Fellowship Interviewing Committee (Chair) University of Oxford Numbercraft Ltd, Oxford and Neurosurgery, London Professor J E Tooke University of Vermont, USA Professor J C Buckingham Professor C R W Edwards CAREER SCHEMES AND Professor J O Thomas Dr R Hill University of Exeter (Chair) Imperial College School of Governor,The Wellcome Trust Professor S Lewis CLINICAL INITIATIVES Professor J Schlechte Governor,The Wellcome Trust Merck Sharp & Dohme UK Medicine, London University of Manchester PROGRAMME Professor P Weissberg University of Iowa, USA Professor N Chaturvedi Dr R Apweiler Dr P Jeffreys University of Cambridge Professor A P Bird Imperial College of Science,Technology Professor A Monaco Basic Science Interest Group Professor Sir Leslie Turnberg European Bioinformatics Institute University of Oxford Governor,The Wellcome Trust and Medicine, London University of Oxford Professor C R M Bangham Clinical Interest Group Association of Medical Research Professor M Bailey Professor K Lindpainter (Chair) Imperial College School of Professor S O’Rahilly Charities Professor N J Abbott Professor J H Darbyshire Dr D Price University of Oxford Basel Institute of Immunology, Medicine at St Mary's, London (Chair) University of Cambridge King’s College, London MRC Clinical Trials Unit, London The University of Edinburgh Health Services Research Panel Switzerland Dr A E Bianco Professor A Bird Professor M Bobrow Professor Sir Michael G Marmot Professor M L J Ashford Professor I Diamond Dr G Richardson The Wellcome Trust Professor H P H Makela Governor,The Wellcome Trust Governor,The Wellcome Trust (Chair) University College London University of Aberdeen University of Southampton University of Sussex National Public Health Institute, Finland Medical School Professor N Craddock Professor J O Thomas Professor J J B Jack Professor N J Buckley Dr S Diaz Professor P Shaw University of Birmingham Professor J McKerrow Governor,The Wellcome Trust Governor,The Wellcome Trust Professor M J Walport University of Leeds Chilean Institute for Reproductive University of Sheffield University of California, USA Governor,The Wellcome Trust Professor P J Donnelly Medicine Professor P J Brophy Professor M J Walport Professor S Busby Professor A Stein University of Oxford Professor E Shooter (From May 2002) Governor,The Wellcome Trust Professor A Grant University of Birmingham Professor S B J Ebrahim Warneford Hospital Stanford University, USA University of Edinburgh University of Aberdeen Professor M A J Ferguson University of Bristol Professor C M Black Dr J P Derrick Professor A W Young University of Dundee INTERNATIONAL Professor D A Brown Royal Free Hospital School Professor P Jones University of Manchester Institute of Professor J Falkingham University of York PROGRAMMES University College London of Medicine, London University of Cambridge Science and Technology Professor D B Goldstein Southampton University Professor M P Young University College London International Interest Group Professor J C Buckingham Professor I Griffiths Professor A L Kinmonth Dr D W Dunne Dr M Garenne University of Newcastle upon Tyne Professor A W Segal Imperial College School of Medicine, University of Glasgow University of Cambridge University of Cambridge Professor K Gull Institut Pasteur, France (Chair) University College Medical Physiology and Pharmacology Panel London University of Manchester Professor J Hodges Professor D Mant Professor J J Mullins School, London Professor A Gilbert Professor M J Whitaker Professor W C Earnshaw University of Cambridge University of Oxford University of Edinburgh Professor M C Holley University College London (Chair) University of Newcastle upon Professor S P Shirazi-Beechey University of Edinburgh University of Sheffield Tyne Professor G Murphy Dr K Rowan Professor C P Page (Vice-Chair) University of Liverpool Dr A Glasier Professor T J Elliott University of East Anglia Intensive Care National Audit and King’s College, London Professor C G P Mathew Edinburgh Healthcare NHS Trust Professor J R E Davis Professor C R W Edwards University of Southampton Research Centre, London King’s College, London (Vice-Chair) University of Manchester Professor P J Openshaw Professor L Pearl Governor,The Wellcome Trust Professor G Lewis Dr J Langhorne Imperial College School of Medicine, Professor A Silman Institute of Cancer Research, London Professor C S Peckham University of Bristol Professor J O Thomas Professor A Ehlers National Institute of Medical Research, London University of Manchester Institute of Child Health, London Governor,The Wellcome Trust Veterinary Medicine Interest Group University of Oxford Professor R Martorell London Professor M J Owen Mathematical Biology Committee Professor H R P Miller Professor D Porteous Emory University, USA Professor F M Ashcroft Professor V Horejsi Professor G Murphy University of Wales College of Medicine, Professor L F Abbott (Chair) University of Edinburgh University of Edinburgh University of Oxford Academy of Sciences of the Czech Professor H Moore University of East Anglia, Norwich Cardiff (Chair) Brandeis University, USA Professor A Waterman-Pearson Dr L Rechaussat Republic, Prague University of Sheffield Dr J E Compston Professor J N P Rawlins Professor R E Phillips Professor V S Isham (Vice Chair) University of Bristol INSERM, France University of Cambridge Professor J G R Jeffreys Professor J Weber University of Oxford University of Oxford (Vice Chair) University College London Professor M J Walport Dr D Shepherd University of Birmingham Imperial College School of Medicine Professor G J Dockray Professor A P Read Professor L Regan Professor J O Thomas Governor,The Wellcome Trust University of Southampton at St Mary’s, London University of Liverpool Professor O A Krishtal University of Manchester Imperial College School of Medicine, Governor,The Wellcome Trust Professor R Batt Functional Genomics Bogomoletz Institute of Physiology, Ms B Zaba Professor C J Garland London Professor J C Smith Mr D Clayton Waltham Centre for Pet Nutrition, Development Panel Kiev, Ukraine London School of Hygiene and University of Bath University of Cambridge Professor P Stewart University of Cambridge Leicestershire Professor G Warren Tropical Medicine Professor M I McCarthy Professor D O Haskard University of Birmingham (Chair) Yale University, USA Professor J M Thornton Dr R J De Boer Mr E A Chandler St Mary’s Hospital, London Imperial College School of Medicine, University College London Professor R Trembath Utrecht University,The Netherlands Animal Health Trust, Suffolk Professor Sir Michael Rutter London Professor H R Saibil University of Leicester Governor,The Wellcome Trust Professor M K B Whyte Professor R E Hubbard Dr J Dobson Birkbeck College, London Professor I T Huhtaniemi University of Sheffield Professor H Watkins University of York University of Cambridge Dr L Beeley Imperial College School of Medicine, Professor H Le Breton Skaer University of Oxford Pfizer Central Research, Kent London Professor J G Williams Professor A Johnston Professor N T Gorman University of Cambridge University of Dundee Professor A Weetman University College London Pedigree Master Foods, Leicestershire Professor M J Bevan Professor G Milligan University of Sheffield University of Washington, USA University of Glasgow Professor M K B Whyte University of Sheffield 54 55

ADVISORY COMMITTEES CONTINUED

Tropical Medicine Interest Group History of Medicine Grants Panel Mr E Walker-Arnott Acknowledgements The Wellcome Trust Annual Review is All photographs are courtesy of the Dr A Holder Professor A Digby Governor,The Wellcome Trust We are grateful to everyone who agreed distributed via a mailing list held in the Wellcome Trust Medical Photographic (Chair) National Institute for (Chair) Oxford Brookes University to be reviewed in this issue, everyone who Marketing Department of the Wellcome Library, except as follows: cover, malaria Dr A Tomei Trust. If you would like to be added to this oocyst (J D Charlwood, P M Graves/TMR); Medical Research, London supplied pictures or gave us permission for Professor C Jones Nuffield Foundation their pictures to be used, and the many list, or if you have a colleague who would inside front cover, Mike Dexter (D Kampfner); Professor A A Jackson (Vice Chair) University of Warwick members of Wellcome Trust staff who like to receive The Wellcome Trust Annual page 3, portrait of Brad Bontems Professor A Lucas (Vice-Chair) University of Southampton helped produce this volume. Review, please contact: (D Hockney); page 4, Kenyan mother and Professor V Berridge King’s College, London child, page 13, Kenyan woman, page 45, Science Editor The Wellcome Trust Professor C R W Edwards London School of Hygiene and Tropical Kenyan children (C Penn); page 9, foot and Professor A McCall-Smith Dr Giles Newton PO Box 57 Governor,The Wellcome Trust Medicine mouth virus, page 10, red blood cell and University of Edinburgh Ely CB7 4WZ, UK Corporate Writer malaria parasite, page 15, skin graft storage, Tel: +44 (0)20 7611 8651 Professor J Blackwell Professor M A Crowther Penny Bailey page 18, Francis Crick, page 29, cortisol, Professor S Mendus Fax: +44 (0)20 7611 8416 University of Cambridge University of Glasgow page 44, HIV (SPL); page 12, vaccination University of York Design E-mail: [email protected] (Windrush Films); page 15, handcuffs, Professor D G Colley Dr A Hardy Sally Watts Professor M Reiss ISBN 1 841290 42 4 page 17, cyclists and women in hairdressers University of Georgia The Wellcome Trust Centre for the Picture Research (Photodisc); page 20, Africa Centre and Institute of Education, London The Wellcome Trust is a registered History of Medicine at University Anne-Marie Margetson marchers (P Schedler); page 26, Beagle 2 Professor R J Hayes charity, no. 210183 College London Professor M Richards (Beagle 2); page 33, I No.1 (A Wright); London School of Hygiene and Printed by Trustee:The Wellcome Trust Limited University of Cambridge page 33, Last Supper (D Hirst); page 47, Tropical Medicine Professor E S Houwaart Wyndeham Westway Registered in England, no. 2711000 synchrotron (JacobsGIBBS Ltd/Crispin Wride Vrije University, Amsterdam Professor M Strathern Registered office: 183 Euston Road, Design Manager Architectural Design Studio); page 48, Professor G T Keusch London NW1 2BE University of Cambridge Alan Stevens Foundling Hospital (Foundling Museum). Fogarty International Centre, USA Dr M A Jackson First published by the Wellcome Trust, 2003 University of Exeter Dr J Turney © Professor K P Klugman Publishing Manager The Trustee of the Wellcome Trust, London. University College London Ian Jones Emory University, USA Professor T Treasure All rights reserved. No part of this Guy’s Hospital, London Professor A Weale Comments on The Wellcome Trust publication may be reproduced, stored Professor M Levin University of Essex, Colchester Annual Review are welcomed and in a retrieval system, or transmitted, in any Imperial College of Science, Professor M Worboys should be sent to: shape or form by any means electronic, Technology and Medicine University of Manchester Professor S Yearley Publishing Manager mechanical, photocopying, recording or University of York Publishing Department otherwise without the prior permission Professor M Tanner Library Advisory Committee The Wellcome Trust of the Wellcome Trust. Swiss Tropical Institute, Switzerland Dr P Ayris 210 Euston Road The Wellcome Trust University College London London NW1 2BE Professor H Townson 183 Euston Road University of Liverpool Professor H Cook Fax: +44 (0)20 7611 8242 London NW1 2BE Wellcome Trust Centre for the E-mail: [email protected] Professor M E J Woolhouse Tel: +44 (0)20 7611 8888 History of Medicine at University University of Edinburgh Fax: +44 (0)20 7611 8545 College London MEDICINE, SOCIETY E-mail (General information): Dr T M Dexter [email protected] AND HISTORY Director,The Wellcome Trust Web: www.wellcome.ac.uk Medicine, Society Dr C Field and History Committee DC-2703.p/15k/05-2003/SW The British Library, London Professor A Lucas (Chair) King’s College, London Mr P Fox University of Cambridge Professor Sir Michael Rutter Governor,The Wellcome Trust Dr J Hall University of Durham Professor M Walport Governor,The Wellcome Trust Dr R Lester Natural History Museum, London Professor A Digby (retired) Oxford Brookes University Ms C Matterson Mr P K Fox The Wellcome Trust Cambridge University Library Mr D Pearson Dr J T D Hall The Wellcome Trust University of Durham Mr E Walker-Arnott Professor C Jones Governor,The Wellcome Trust University of Warwick Dr T Woods Mr A Tomei The Wellcome Trust Nuffield Foundation Medicine in Society Panel 56

ADVISORY COMMITTEES CONTINUED