Dr Marko Kerac
BSc MBBS DTM&H MPH PhD RNutr
Public Health Nutrition & Programme Director, Nutrition for Global Health MSc
I joined LSHTM in September 2014 as a clinical lecturer in public health nutrition. I am a medical doctor by background and have long been interested in global health. Early experiences included:
- Uundergraduate work in Yugoslavia, Guyana, and India (in and around Delhi, during a year out of med school: this also led to my first RCT in a Calcutta street clinic);
I initially trained in paediatrics in Plymouth and London. After gaining MRCPCH in 2001 I left the NHS in 2003 to volunteer for a year as a paediatric registrar/hon clinical lecturer at the College of Medicine, Malawi. Most of that life-changing year I spent on “MOYO” ward of Queen's Hospital, Blantyre, one of Africa’s biggest and busiest nutritional rehabilitation units. Following a 2004-5 LSHTM MSc (PHDC) I returned again to Malawi from 2005-8 to work on a PhD - again combining clinical work and teaching alongside research into "Improving the Treatment of Severe Acute Malnutrition in Childhood"
From 2009-2014 I was a specialty registrar in public health in London, completing MFPH (Member of the Faculty of Public Health) exams in 2011 and becoming a fellow of the Faculty of Public Health in 2014 upon gaining my CCT (Certificate of Completion of Specialty Training). Academic posts, initially at the UCL Institute for Global Health and later as a NIHR Academic Clinical Lecturer at the UCL Leonard Cheshire Disability & Inclusive Development Centre allowed me to maintain and develop my international work. With my current focus on global work I no longer practice in the UK but remain on the GMC register (registered but without licence to practice)
At LSHTM I split my time betweeen research and teaching. I am also co-lead of the MARCH Centre C-Theme (Child Theme)
Supervising MSc summer projects (and PhDs year-long!) is a particular highlight of my academic year: I especially enjoy policy/practice-relevant work which gives students experience in global nutrition 'hot topics' and can lead to conference presentations, peer review papers and other outputs which add valuable new data to the far-too-sparse evidence-base in our field of work.
My overall research focus is on severe malnutrition.
I was especially fortunate to enter this field when it was undergoing major changes from a clinically/inpatient-focused approach to a public-health/outpatient-orientated model of care, now known as ‘Community Management of Acute Malnutrition’ (CMAM). I was then, and am still inspired by the many individuals and organizations behind those changes: developing the evidence using good quality operational research as well as more 'formal' studies; encouraging effective research-policy-practice dialogue; pursing what’s realistic as well as idealistic; being aware that pushing for ‘the best’ can too easily become be the enemy of 'the good’.
Recent and current research subthemes are:
- Management of At-risk Mothers & Infants aged <6 months (MAMI):-
This began in 2008 when I was main researcher on a ENN (Emergency Nutrition Network) led project exploring MAMI in humanitarian crises. The collaboration with ENN continues to this day. Key outputs include: a paper documenting global 'burden of disease' of MAMI; a CHNRI research prioritization exercise highlighting key evidence gaps (and consequent opportunities!); field projects in Malawi and Bangladesh (the latter led by Save the Children and ICCDR,B); formation of an international network of researchers and practitioners who regularly meet to discuss and coordinate activities in this area (MAMI SIG - Special Interest Group). Particular highlights are:
- MAMI being flagged as a priority area by the 'No Wasted Lives' coalition;
- contributing to a WHO "Nutrition and Growth Advisory Group" consultation that led to infants <6m, for the first time, being included in WHO Guidelines for the Management of Severe Acute Malnutrition.
- Life-course consequences of early-life malnutrition (ensuring children THRIVE as well as survive)
I am increasingly concerned about the long-term as well as the short term (mortality) impacts of severe malnutrition, notably its role in the growing epidemic of NCDs. In the ‘Chronic disease outcomes following Severe Acute Malnutrition’ (ChroSAM) study we followed up children seven years after an episode of childhood malnutrition. In ChroSAM, as well as impairments there were also reasons to be hopeful about the potential for later-life recovery and ‘catch-up’ growth/development. Most notably, I am optimistic about the potential for adolescent-focused work to help vulnerable individuals and communities not only survive but thrive as per UN strategy for Women’s, Children’s and Adolescent’s Health