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Prof Brian Greenwood

Professor of Clinical Tropical Medicine

London School of Hygiene & Tropical Medicine
Keppel St
London
WC1E 7HT
United Kingdom

Tel.
+44 207 299 4707

Brian Greenwood has spent over 50 years carrying out research in Africa combining innovative science with support for the advancement of the careers of African scientists.

After graduating in medicine and completing his internships in the UK, Brian took up an appointment as a medical registrar at University College Hospital, Ibadan, Nigeria in 1965 where he worked for the next three years. During this period, he undertook a research project for his MD thesis which showed a low incidence of autoimmune diseases in Nigerians and he postulated that this might in part be the consequences of repeated exposure to malaria and other parasitic infections. On his return to the UK for training in clinical immunology, he showed that malaria infection early in life was able to prevent mice developing autoimmune diseases and it has subsequently been established that repeated exposure to malaria alters many components of the immune system. In 1980, he returned to Nigerian to help to start a new medical school at Ahmadu Bello University, Zaria. Here he developed his interests in malaria and epidemic meningitis, both infections whose epidemiology is strongly influenced by the climate of the African Sahel and sub-Sahel. During his time in Zaria, he conducted some of the first trials of meningococcal polysaccharide vaccines and demonstrated the ability of a single injection of a long-acting chloramphenicol preparation to treat cases of meningococcal meningitis successfully during epidemics when clinical facilities could be overwhelmed.

Brian spent the next 15 years in The Gambia as director of the UK MRC Laboratories where he established a multidisciplinary research programme focused on some of the most important infectious diseases prevalent in the region at that time, including malaria, pneumonia, measles, meningitis, hepatitis B and HIV2. During his time in The Gambia, Brian and his colleagues demonstrated the effectiveness of insecticide-treated nets (ITNs) in reducing child mortality and morbidity and showed how ITN distribution could be incorporated successfully into a national malaria control program. He and his colleagues showed that because of the seasonal nature on malaria transmission in The Gambia and other countries of the African Sahel and sub-Sahel, administering antimalarial drugs to young children prophylactically during just a few months of the year could reduce mortality and morbidity in young children. Members of the malaria team also demonstrated the efficacy of intravenous artesunate in children with severe malaria and undertook one of the first trials of artemisinin combination therapy including the first trial of artemether-lumefantrine, now the most widely used treatment for malaria in Africa. .

Following on from his experience with meningococcal polysaccharide vaccines in Nigeria, Brian established a strong vaccine programme at the MRC unit, one which continues today, and he and his colleagues in The Gambia initiated a series of trials of vaccines against Haemophilus influenzae type b (Hib) and the pneumococcus based on the results of prior epidemiological studies which had demonstrated the importance of these two organisms in causing pneumonia and meningitis in young children in The Gambia and in neighbouring countries. The success of these early trials led to large phase 3 trials of both H. influenzae and pneumococcal conjugate vaccines whose success in preventing pneumonia and meningitis played an important role in the decisions by WHO and other international organizations to recommend routine deployment of these vaccines to young children in lower and middle income countries including The Gambia, which was one of the first countries in the developing world to introduce national Hib and pneumococcal conjugate vaccination programmes.

In 1996, Brian returned to the UK to take up an appointment at the London School of Hygiene and Tropical Medicine where he has continued to contribute to research on meningitis, malaria and pneumonia in West Africa. In 2008, he established a consortium with partners is several countries in the African meningitis belt to study the epidemiology of pharyngeal carriage of Neisseria meningitidis across the belt and the potential of the group A meningococcal conjugate vaccine developed by the Serum Institute of India (MenAfriVac) to prevent acquisition of carriage. This program showed that in Chad, the vaccine, now given to over 300 million people across Africa, was able to stop an epidemic by preventing carriage and thus stopping transmission of the infection. Brian's malaria research has continued to focus on the prevention of malaria in countries of the Sahel and sub-Sahel, which contribute about a half of all deaths from malaria in Africa. Following on from the early study in The Gambia, further trials of seasonal malaria chemoprevention (SMC) in Burkina Faso, Mali and Senegal confirmed the results of the earlier study and led to a recommendation from WHO for deployment of SMC in countries of the Sahel and sub-Sahel, with over 30 million children now receiving SMC each year. Brian contributed to the design and conduct of the first trials of the GSK malaria vaccine RTS,S and then to the large phase 3 trial which demonstrated the moderate efficacy of the vaccine over a period of three or four years. This led to the decision to progress to a pilot implementation program which has confirmed the efficacy and safety of the vaccine which is now recommended by WHO for deployment in countries of sub-Saharan Africa with a high malaria burden. Brian and colleagues at LSHTM and in Burkina Faso and Mali have demonstrated that a very effective way of make optimum use of the short-term efficacy of the RTS,S vaccine is to use the vaccine as a seasonal vaccine in countries of the Sahel and sub-Sahel and this is now recommended by WHO. When seasonal vaccination was combined with SMC it provided a very high level of protection to children over the first five years of their life. The results from this study are relevant to the deployment of the R21 vaccine which has many similar properties to that of RTS,S.

At the start of the 2014 Ebola epidemic in West Africa, Brian was asked to help in establishing a site in Sierra Leone to set up a site to test the J & J two dose Ebola vaccine regimen and during the past seven years he has continued to support the work of this centre in Kambia, a partnership between LSHTHM and the College of Medicine and Allied Health Sciences at the University of Sierra Leone, which has successfully demonstrated the safety and immunogenicity of the J &J and Merck Ebola vaccines, even in young children, and is now a partner in the WHO supported solidarity COVID-19 testing programme.

Brian has long championed support for the career development of young African scientists, mentoring several generations of African students, doctors and clinicians, many of whom have become leaders in their respective fields, enhancing the stature of African health research among the international scientific community. In 2001, following the award of a large grant to LSHTM from the Bill & Melinda Gates Foundation, he became director of the Gates Malaria Partnership which supported the training in malaria research of 40 African PhD students and postdoctoral fellows and, in 2008, he was director of its successor program, the Malaria Capacity Development Consortium, funded by the Wellcome Trust and the Bill & Melinda Gates Foundation, which supported a postgraduate malaria training program in five universities in sub-Saharan Africa. Many of the lessons learnt during these programs have been subsequently taken up by the Wellcome Trust DELTAS and the Royal Society's FLAIR postgraduate African training programs. He continues to provide support to the many African scientists with whom he has had the privilege of working at different stages of his career.

Affiliations

Department of Disease Control
Faculty of Infectious and Tropical Diseases

Centres

Centre for Evaluation
Malaria Centre
Centre for Maternal Adolescent Reproductive & Child Health
Vaccine Centre
Antimicrobial Resistance Centre

Teaching

I lecture on the DTMH course and several short courses.

I am co-supervisor for two PhD students.

Research

Malaria: The main focus of my malaria research is evaluation of malaria vaccines and how they can be deployed most effectively in different epidemiological situations.

Pneumococcal disease: The main focus of my pneumococcal research is a trial being undertaken in the Gambia which is investigating whether the three doses of pneumococcal conjugate vaccine currently the recommended regimen for African infants can be cut to two doses without losing efficacy but leading to substantial cost savings.

Research in Sierra Leone: As a result of the Ebola epidemic an excellent research centre has been established in Kambia, Sierra Leone with a well qualified staff and good laboratory support. It is important that this resource is not lost on completion of the on-going Ebola vaccine trials which are coming to a successful conclusion with five year follow-p of the participants. Efforts are, therefore, being made to attract new projects to the centre. Based on its track record the the centre was recruited by WHO to be a partner in its multicentre COVID-19 Solidarity trial which is ongoing and applications to support studies on Lassa fever and malaria vaccines in Kambia are under review.

Research Area
Bacteria
Drug discovery and development
Immunisation
Parasites
Public health
Vaccines
Epidemiology
Medicine
Microbiology
Parasitology
Vaccinology
Disease and Health Conditions
Malaria
Meningitis
Emerging infectious diseases
Respiratory diseases
Country
Burkina Faso
Gambia
Ghana
Mali
Senegal
Sierra Leone
United Kingdom
Region
Sub-Saharan Africa (developing only)

Selected Publications

Engaging the public in decisions about emergency vaccine deployment strategies: Lessons from scenario-based discussions in Sierra Leone.
MANSARAY, A; Bangura, M; Watson-Jones, D; GREENWOOD, B; BURNS, R; Susan Lees, S; FAYE, F; Leigh, B; Enria, L;
2024
Global public health
Helminth exposure and immune response to the two-dose heterologous Ad26.ZEBOV, MVA-BN-Filo Ebola vaccine regimen.
Barry, H; Lhomme, E; Surénaud, M; Nouctara, M; Robinson, C; Bockstal, V; Valea, I; Somda, S; Tinto, H; Meda, N; GREENWOOD, B; Thiébaut, R; Lacabaratz, C;
2024
PLoS neglected tropical diseases
Impact of pneumococcal conjugate vaccination on pneumococcal nasopharyngeal carriage in the Gambia: Population-based cross-sectional surveys.
MACKENZIE, GA; Hossain, I; SALAUDEEN, R; Badji, H; Manjang, A; USUF, E; BOTTOMLEY, C; GREENWOOD, B; Hill, PC;
2024
Vaccine
Safety and efficacy of malaria vaccine candidate R21/Matrix-M in African children: a multicentre, double-blind, randomised, phase 3 trial.
Datoo, MS; Dicko, A; Tinto, H; Ouédraogo, J-B; Hamaluba, M; Olotu, A; Beaumont, E; Ramos Lopez, F; Natama, HM; Weston, S; Chemba, M; Compaore, YD; Issiaka, D; Salou, D; Some, AM; Omenda, S; Lawrie, A; Bejon, P; Rao, H; CHANDRAMOHAN, D; Roberts, R; Bharati, S; Stockdale, L; Gairola, S; GREENWOOD, BM; ... R21/Matrix-M Phase 3 Trial Group,
2024
Lancet (London, England)
Post-discharge malaria chemoprevention in children admitted with severe anaemia in malaria-endemic settings in Africa: a systematic review and individual patient data meta-analysis of randomised controlled trials.
Phiri, KS; Khairallah, C; Kwambai, TK; BOJANG, K; Dhabangi, A; Opoka, R; Idro, R; Stepniewska, K; Van Hensbroek, MB; John, CC; Robberstad, B; GREENWOOD, B; Kuile, FO T;
2024
The Lancet. Global health
What factors are associated with paediatric admissions and their outcomes in a rural hospital in northern Sierra Leone? Insights from a pilot observational study
AFOLABI, MO; Ayieko, P; Njie, Y; Kowuor, D; Adetola, HH; Kamara, B; Jalloh, AB; Sesay, F; Swaray, E; Odeny, L; Pearce, RM; Samai, MH; Deen, GF; Koedoyoma, S; Sesay, IG; Ishola, D; Leigh, B; Watson-Jones, D; GREENWOOD, B;
2023
BMJ Public Health
Safety and immunogenicity of an Ad26.ZEBOV booster vaccine in Human Immunodeficiency Virus positive (HIV+) adults previously vaccinated with the Ad26.ZEBOV, MVA-BN-Filo vaccine regimen against Ebola: A single-arm, open-label Phase II clinical trial in Kenya and Uganda.
Man-Lik Choi, E; Abu-Baker Mustapher, G; Omosa-Manyonyi, G; Foster, J; Anywaine, Z; Musila Mutua, M; AYIEKO, P; Vudriko, T; Ann Mwangi, I; Njie, Y; Ayoub, K; Mundia Muriuki, M; Kasonia, K; Edward Connor, N; Florence, N; MANNO, D; Katwere, M; McLean, C; Gaddah, A; Luhn, K; Lowe, B; GREENWOOD, B; Robinson, C; Anzala, O; KALEEBU, P; ... EBL2010 Study Team,
2023
Vaccine
Feasibility and safety of integrating mass drug administration for helminth control with seasonal malaria chemoprevention among Senegalese children: a randomized controlled, observer-blind trial.
AFOLABI, MO; Sow, D; Agbla, SC; Fall, EH B; Sall, FB; Seck, A; Manga, IA; Mbaye, IM; Loum, MA; Camara, B; Niang, D; Gueye, B; Sene, D; Kane, NM; Diop, B; Diouf, A; Gaye, NA; Diouf, MP; Lo, AC; GREENWOOD, B; Ndiaye, JL A;
2023
Malaria journal
Safety and immunogenicity of the two-dose heterologous Ad26.ZEBOV and MVA-BN-Filo Ebola vaccine regimen in infants: a phase 2, randomised, double-blind, active-controlled trial in Guinea and Sierra Leone.
CHOI, EM-L; Lacarra, B; AFOLABI, MO; Ale, BM; Baiden, F; Bétard, C; Foster, J; Hamzé, B; Schwimmer, C; Manno, D; D'Ortenzio, E; Ishola, D; Keita, CM; Keshinro, B; Njie, Y; Van Dijck, W; Gaddah, A; Anumendem, D; Lowe, B; Vatrinet, R; Lawal, BJ; Otieno, GT; Samai, M; Deen, GF; Swaray, IB; ... EBOVAC-3/EBL2005 Study Team,
2023
The Lancet Global health
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