Working together to improve human health 2004/05 Annual Review The Medical Research Council (MRC) is the UK’s leading publicly funded biomedical research organisation. Our mission is to: ● Encourage and support high-quality research with the aim of improving human health. ● Produce skilled researchers, and to advance and disseminate knowledge and technology to improve the quality of life and economic competitiveness in the UK. ● Promote dialogue with the public about medical research. Welcome 1 Introduction 2 Working in partnership 4 Accelerating research 8 A sense of achievement 12 14 Cancer 16 Cardiovascular disease and stroke 18 Respiratory disease 20 Infectious disease 22 Neurosciences and mental health 24 The ageing population 26 Obesity, diet and diabetes 28 Health inequalities 30 Clinical investigation and trials 32 From discovery to treatments Welcome From Professor Colin Blakemore MRC Chief Executive In this Annual Review you will read about some of the many achievements of MRC-funded scientists in 2004/05 and the partnerships that have made much of this vital work possible. The research that we fund is aimed at tackling major challenges to human health. These range from potentially devastating infections such as AIDS and avian flu to the gradual increase in ageing-related diseases resulting from longer life expectancy. But it is not enough for us simply to support and carry out the highest-quality biomedical science. We must relate what we are doing in the laboratory to clinical research involving patients and the work of the NHS. By focussing on medical research ‘in the round’, as a continuum involving interaction and two-way feedback between a variety of disciplines, we can ensure that our scientists’ discoveries are translated into health benefits for people as soon as possible. As the leading public funder of medical research in this country, with a portfolio that covers the spectrum of biomedical and clinical sciences, the MRC is able to create timely, effective links between our fundamental science and clinical research. As a result, there are countless examples of MRC-funded basic research leading to major breakthroughs in patient treatment, from the discovery of monoclonal antibodies – now the basis of 30 per cent of new treatments – to magnetic resonance imaging, the most important diagnostic advance of the 20th century. The strength of the MRC’s basic research is recognised worldwide. Clinical research is now an equally high priority for us, as shown this year by our commitment to clinical trials, population studies and a new partnership initiative in experimental medicine. In the year ahead and beyond, we shall continue to forge new working relationships with professional partners and the public. Together, we can achieve the MRC’s overriding aim – better health for everyone. MRC Annual Review 2004/05 1 The MRC works across all medical research Introduction disciplines and with a wide range of stakeholders to improve human health The Medical Research Council (MRC) is the UK’s leading publicly funded biomedical research organisation. We are funded by the UK taxpayer, but are independent of the Government. This gives us the flexibility to decide which research to support, taking into account both national needs and scientific quality. We work closely with the Health Departments, other government agencies, other research funders and the biotech industry. We fund world-class medical research in our own institutes and units, and in universities and teaching hospitals throughout the UK. The MRC’s portfolio spans the whole spectrum of biomedical science – from basic studies in the laboratory to clinical investigations in hospitals, GP surgeries and the community. The changing face of medicine Over the years MRC scientists have been responsible for many groundbreaking discoveries that have dramatically changed how we think about disease and the ways in which medicine is practised. This year has been no exception. But, as the challenges facing medical science become ever more complex, it is vital that we do not stand still. The MRC is constantly evolving, in order to meet the new and often unexpected challenges inherent in medical science, to increase our overall effectiveness and to continue strengthening our relationships with stakeholders, including the general public. The power of partnership From page 12 onwards this Annual Review describes a selection of MRC-funded scientific achievements during the last year, in nine health priority areas. Leading up to those pages is information about some of our key partners and how together we are increasing the speed with which new treatments and diagnostic techniques are developed from MRC scientists’ discoveries. 2 MRC Annual Review 2004/05 Working in partnership 4 Accelerating research 8 A sense of achievement 12 MRC Annual Review 2004/05 3 To help take forward our efforts at all levels, from basic research to clinical trials, Working in we involve a wide variety of stakeholders, partnership including the public. Today, the impact of rapid social and economic change – at a national and global level – makes the challenges facing scientists increasingly complex. What’s more, we are striving to ensure that MRC discoveries lead as quickly as possible to improved diagnostic tests, treatments and methods of prevention. All of which means that our “Working in partnerships – such as the examples presented below – are more crucial then ever. partnership is essential Reshaping the clinical research environment to make sure that The MRC is a major player in the UK Clinical Research Collaboration (UKCRC), which aims to establish this country as a world leader in clinical research. The investments by member organisations include the Health Departments, the NHS, the MRC, medical different funders are charities, patients and the biotechnology industry. Clinical investigation is an essential well coordinated and step in the journey from scientific discovery to patient benefit, and we are united in our commitment to making the very most of the unique opportunities that the UK mutually beneficial.” offers for such work. Professor Colin Blakemore, The UKCRC’s first step has been to identify ways to develop the research MRC Chief Executive infrastructure within the NHS and to make sure that the country has enough trained and qualified clinical researchers. We have also been addressing the need to streamline regulation and governance and to coordinate approaches to research funding across the member organisations. The MRC is well placed to help drive the UKCRC’s objectives forwards. Along with our strategic emphasis on funding clinical research, we have widely recognised expertise in the ethical governance of research investigations involving human OUR PARTNERS AND STAKEHOLDERS OST / TREASURY / DFID / OTHER GOVERNMENT DEPARTMENTS RESEARCH PATIENTS COMMUNITY AND CARERS RESEARCH PUBLIC AND NHS UKCRC COUNCILS MEDIA MRC UNIVERSITIES MRCT AND INDUSTRY UK HEALTH DEPARTMENTS MEDICAL INTERNATIONAL CHARITIES PARLIAMENTARIANS / POLICY MAKERS MRC Annual Review 2004/05 5 Working in partnership participants. UKCRC Chief Executive, Dr Liam O’Toole, spent ten years at the MRC in a variety of research management roles, and MRC Chief Executive Professor Colin “The creation of Blakemore brings a wealth of public communication experience to his role as chair of the UKCRC offers us the UKCRC’s Public Awareness Task and Delivery Group. an incredible Promoting prevention opportunity to reshape While diagnosis and treatment are vitally important, the ideal approach is to prevent ill health in the first place. This is the aim of the National Prevention Research the environment in Initiative, which was launched in October 2004 with a budget of £12m and will run which clinical research for five years. The Initiative is a broad consortium of charities, the MRC, other is conducted in research organisations and the Government, who have come together to find ways to prevent major diseases such as cancer, heart disease and diabetes. this country.” Our joint efforts will focus on ways to discourage unhealthy habits such as smoking Dr Liam O’Toole or excessive alcohol intake and to encourage a healthy lifestyle including more Chief Executive, UKCRC physical activity and a nutritious, balanced diet. MRC Chief Executive Colin Blakemore says, “Research in this area is complicated by the fact that we are dealing with real populations with a tremendous number of interacting variables such as diet, lifestyle, levels of stress and so on. However the potential payoff could be huge.” All over the world Ever since the 1920s, the MRC has funded a range of international research collaborations. For example, at our research units in The Gambia and Uganda we work with African scientists on pioneering research into HIV/AIDS, malaria and other life-threatening infections. It is now more important than ever that our science has a global reach. Widespread international travel, movement of populations and the evolution of pathogens make it easier than ever before for infectious diseases to cross the world. GLOSSARY This year we have been focussing on developing existing links with scientists in South-east Asia. A panel of senior MRC scientists visited North Vietnam, China and Characterise To define the biological properties of particular kinds of stem Hong Kong in October 2005 to assess the potential for collaborative research into cells. avian flu and other emerging (and re-emerging) infections. This international Microbicides Substances which