The London School of Hygiene & Tropical Medicine (LSHTM) has a long and prestigious history of continuity and change in its mission to improve health worldwide. Changes are often in response to new challenges – as exemplified by our pivotal role in the ongoing COVID-19 pandemic, which suddenly emerged in late 2019.
It is estimated that over 3% of the world’s population required humanitarian aid in 2020. As temperatures rise and weather patterns shift, one can only imagine the number of people and financial resources needed to provide services if we continue unabated on this current dangerous path. We lack accurate figures but hypothesize that the destruction of formal structures and social safety nets during natural disasters will likely lead to increases in violence against children.
On June 10 2011, a team of us launched the World report on disability at the United Nations in New York. The first of its kind, the report reviewed the global picture on the lives of people with disabilities and provided the best available evidence on what works to enable people with disabilities to flourish. I remember well the months of writing, preparation and checking. I also remember the films we made with women with disabilities, and the launch film I made with Professor Stephen Hawking.
Mark Twain said that history does not repeat itself, but it rhymes. I’m not so sure.
Innovative science is often borne out of necessity, and this pandemic is no different. Scientists around the world have sequenced the SARS Cov-2 genome, rapidly identified COVID-19 strains and developed successful vaccines in record-breaking time to tackle the virus. COVID-19 diagnostics, such as PCR and lateral flow tests (LFT), are now an intrinsic part of our everyday lives, helping to detect cases and prevent small, localised outbreaks from becoming epidemics. However, these tools – while crucial – are invasive, costly and do not offer immediate results.
After more than 14 months living with COVID-19 restrictions in the UK, the importance of social support has never been clearer, particularly when it comes to raising children. As the physical links between households were cut, maternity and community health services restricted, and early years settings and schools closed, the transmission of SARS-CoV-2 rapidly slowed. However, so did the flow of essential social support to parents.
In 1978 I went to work in The Gambia as a junior doctor at the Medical Research Council (MRC) research unit hospital. With a population of less than one million at the time there was only one government ophthalmologist, Dr Shiona Sowa. I got to know Dr. Sowa well and heard about the work which had brought her to The Gambia - to try out new vaccines for trachoma.
The COVID-19 pandemic has sparked great interest in the mathematical models used to estimate disease transmission in the population. These models have figured prominently in the decisions of many governments, as they can help project the course of the disease, allocate people and resources, and evaluate the impact of policies. But models - though undoubtedly valuable - are not crystal balls; they are only as good as the available information.
Better evidence, more trust – Drug regulators can improve decision-making to reassure public on vaccines
At a record pace, the first new vaccines were developed and entered the market in less than a year since the sequencing of the new SARS-CoV-2 virus. This astonishing achievement was made partially possible due to decades of basic research targeting the underlying biology of similar coronaviruses, and earlier clinical development efforts with the utilised vaccine platform technologies.
Malaria is caused by Plasmodium parasites, the most prevalent and deadly of which is Plasmodium falciparum (accounting for 97% cases worldwide, according to WHO). While there is a vaccine candidate, called RTS,S, it is only 30-40% effective. There are many different ways of designing vaccines. ‘Sub-unit vaccines’ are based on a component of pathogen – the organism that causes the disease. For example, the RTS,S vaccine is based on a pathogen-derived protein, P. falciparum’s circumsporozoite protein (CSP).