In December 2017, a group of public health experts met at the second MeSH Scientific Symposium, held in Muldersdrift in South Africa, to consider ways to improve the quality of routine HIV data collected and the capacity to use it for evidence based decision making. In a report of the meeting, released today, we present recommendations for building confidence in the collection and use of HIV data.
Group Operations & Senior Projects Manager (Maternity Cover)
Department of Clinical Research
£44,978 to £51,490 per annum, inclusive.
Thursday 14 June 2018
We are seeking to appoint a Group Operations & Senior Projects Manager for the Disability & Eye Health Group for maternity cover.
The role holder provides leadership in the project, financial, administrative, and operational activities of the Disability & Eye Health Group (DEHG) consisting of approximately 50 staff and 25 PhD students (as of April 2018). The role holder line manages the Professional Services Team providing leadership and direction and advising on development opportunities; as well as presenting a forward facing role to existing and potential funders, collaborators, partners, and external institutions.
The post-holder will be a member of the Disability & Eye Health Group Leadership Team and works closely with the Group’s Directors in developing strategic planning and implementation, governance and accountability; management support across all the Group’s processes, including grant applications and research projects; management of local human resources, fundraising and financial requirements; and ensuring alignment with School, auditor and funder regulations.
Four key areas of the role are:
Project and finance management – lead the Professional Services team to project manage approx. 80 education and research projects/grants including the £14m Queen Elizabeth Diamond Jubilee Trust Commonwealth Eye Health Consortium. Manageand monitor income and expenditure and develop project management tools and systems to successfully deliver on Funder and Group objectives;
Funder liaison – represent the Group and establish professional and positive relationships with multiple donors and stakeholders, liaising on funding opportunities and managing existing relationships effectively;
Leadership & management – lead and manage the Professional Services Team in a matrix style, currently comprising of 8 staff, providing leadership and guidance and identifying areas of development;
Strategy management – review Group strategic and operational plans, and ensure their implementation in order to support the Group’s growth and success.
The post-holder will have a degree or equivalent, experience of the oversight, management and reporting of large budgets of over £3 million, significant senior level experience of financial management and reporting of large complex budgets, strong leadership and management skills, experience of operational and project management support within an academic institution. Further particulars are included in the job description.
Ideally, we would like the role holder to be available for at least one week between end of July – early August to conduct a handover.
This full-time post, based in London, is funded by various funders, including CBM, Sightsavers, Seeing is Believing and the Queen Elizabeth Diamond Jubilee Trust until 16th August 2019 and is available from 16th July 2018. Salary is on the Professional Support Grade 7 scale in the range £44,978 – £51,490 per annum (inclusive of London Weighting). The post will be subject to the LSHTM terms and conditions of service. Annual leave entitlement is 30 working days per year, pro rata for part time staff. In addition to this there are discretionary “Director’s Days”. Membership of the Pension Scheme is available.
Applications should be made online via our website at jobs.lshtm.ac.uk. The reference for this post is ITD-CRD-2018-12. Online applications will be accepted by the automated system until 10pm on the closing date.Any queries regarding the application process may be addressed to .
The supporting statement section should set out how your qualifications, experience and training meet each of the selection criteria. Please provide one or more paragraphs addressing each criterion. The supporting statement is an essential part of the selection process and thus a failure to provide this information will mean that the application will not be considered. An answer to any of the criteria such as “Please see attached CV” will not be considered acceptable.
Please note that if you are shortlisted and are unable to attend on the interview date it may not be possible to offer you an alternative date.
A Birthday Card Competition for the National Survey of Health and Development
The Medical Research Council’s National Survey of Health and Development (NSHD) is Britain’s longest running birth cohort study. It has been collecting information about the health and life circumstances of its study members since 1946. One of the ways the research team keep study members interested and participating each year, and make sure their contact details are up to date, is to send them an annual birthday card. They have done this since 1962, when the study members turned 16 and some of them left school and home, making them harder to keep track of. A large number of the cards are available in an online gallery.
This March, the NSHD study members turned 72 and the birthday card they received in the post was a little different. In the Autumn, Daisy Payling and Hannah Elizabeth from the Placing the Public team joined up with Maria Popham and Marcus Richards from the NSHD and Emily Tracy, an artist who specialises in participatory projects, to run card-making workshops in two London secondary schools. At the Greycoat Hospital School and Enfield County High School we spoke to students about the history and purpose of the cohort study, and used a questionnaire from 1961 to discuss gender in the 1960s and encourage students to think about what it would have been like to be part of a birth cohort study. We showed students past birthday cards and explored their role as objects of celebration and purpose. Following this, Emily taught the students about collage techniques, and the connotations that different images can have and the emotions they can evoke.
Armed with scissors, glue and an assortment of images and reprinted archive documents, the students got to work making their own birthday cards for the study members.
Students at both schools produced fantastic card designs, all of which can be viewed online. But the card sent out to study members could only feature two designs: one on the front and one on back of the card.
Researchers working on the NSHD met to discuss the designs and chose the two that would feature. The discussion was wide-ranging, focussing on colour, mood, health messaging, and everyone involved was very aware of how each card might be received. Listening to how the researchers make their choices really hammered home the care that goes into the NSHD’s communication with its study members.
In the end, two designs were chosen: one from each school. The designs were made into a birthday card and posted out to study members with an accompanying information update in the final week of February.
Here are the final designs:
For those interested in the work of the MRC and the MRC National Survey of Health and Development they will be holding a Science Fair on June 17th where there will be opportunities to learn about NSHD history and research
This project has been a pleasure to work on and we would like to thank everyone involved; Maria, Marcus, Emily, and the staff and students at Greycoat Hospital School and Enfield County High.
A number of LSHTM experts speak to the media on the outbreak of Ebola in the Democratic Republic of Congo (DRC):
Peter Piot was interviewed by BBC World Service Radio’s Newshour programme (from 5m40s) and discusses the latest on efforts to control the outbreak including: “Everything that has to be done is being done at the moment…one case of Ebola is an emergency, you don’t know wait until there are many.” Peter is also interviewed by BBC World Service Radio’s World Update programme, TV5Monde (France) and provides comment to The Guardian.
It has been announced that the UK Public Health Rapid Support Team, jointly run by LSHTM and Public Health England, will be deployed to help support DRC control the outbreak. Team Director Daniel Bausch spoke to BBC Radio 4 Today (from 1h34m) ahead of the announcement.
Martin Hibberd was interviewed by Channel 4 News on the efforts to control the DRC outbreak: “I think we’re doing more than last time, we’re doing it earlier and we’ve got at least one hopeful tool to help us with that process.” Martin is also quoted by Live Science (US) on the deployment of 4,000 doses of the experimental VSV-EBOV vaccine.
John Edmunds provides comment to The Daily Telegraph on the logistical challenge of delivering the experimental vaccine to rural DRC: “It’s a big headache to deliver the vaccine and keep it frozen. It is a major operation to get the cold chain up and running and to get it right out into the field.”
Thomson Reuters report on the visit by the Afghanistan Minister of Public Health to LSHTM. Feroz Ferozuddin met with LSHTM researchers who are providing technical support to the Ministry to develop a basic healthcare package. The article generates coverage in Voice of America.
Pontiano Kaleebu, Director of the MRC/UVRI and LSHTM Uganda Research Unit, is quoted by AllAfrica following an event official launching LSHTM’s partnership with the Unit: “Apart from HIV/AIDS, the research unit will broaden its scope to study neglected diseases, emerging infectious diseases and non-communicable diseases such as cancer, diabetes and stroke.”
Due to an administrative error made by RCUK last year, the amount of open access funding awarded to the School has been significantly reduced for the 2018-19 block grant year (running from 1 April 2018 – 31 March 2019). The School will be unable to provide RCUK-funded researchers with funds to cover the costs of publishing in fully open access journals once this year’s allocation has been spent up. Unfortunately, owing to the error, this will occur much sooner than we had originally envisioned.
This being the case, RCUK-funded researchers wishing to submit their articles to fully open access journals should check prior to submission whether funding is likely to be available for them via the funding application form on ServiceDesk.
The funds will be made available on a first-come-first-serve basis, and a further announcement made when funding is fully allocated.
It remains the case, as announced a couple of months ago, that we can no longer cover the costs of RCUK-funded research published in hybrid journals (i.e. subscription journals with the option of paid open access). If you have already applied for funding from the RCUK open access block grant for a particular article, we have ring-fenced the funds for you, and you do not need apply again.
Although the 2019-2020 award is yet to be confirmed, we anticipate that the award will be renewed at a similar level to previous years in the next block grant year (starting 1 April 2019) and open access funds can then be made available again. The COAF block grant continues to be available (for both hybrid and fully open access journals) for Wellcome Trust funded researchers.
If funding is not available for gold open access, there are two options, both acceptable to RCUK:-
(1) Green open access
Submit your article to a subscription journal and make your work open access by depositing a copy of your accepted manuscript in LSHTM Research Online (do this as soon as possible after acceptance for publication).
You should make sure that your chosen journal is compliant with your funder’s open access policy. For the MRC, the journal should have an embargo period of no longer than 6 months, and for other funders 12 months. For the MRC, the journal should also allow the article to be deposited and made available in Europe PMC within 6 months of publication (it is the PI’s responsibility to deposit to Europe PMC).
Creative ideas from students at KIIT University, Bhubaneswar, India (written by Dr Kerry Ann Brown)
Photo credit: Benjamin Katayz
When you walk into your local food shop to pick up your groceries, you are faced with countless options. How do you decide which oil to cook with, which brand of juice is your favourite, or what biscuits to buy? Food labels can provide information to help make this decision, but many current labels provide information only on branding and the ingredients list. Consumers are becoming increasingly aware of the environmental impacts and ethical implications of the food we eat. What if food labels could provide us with some information on this too?
We asked a group of food technology students at KIIT University to design a label for a food product of their choice, thinking carefully about the information both manufacturers and consumers might want or need. The session was held on the 20th March 2018 at KIIT University, Bhubaneswar, India, organized by Professor Tapan Adhya and Dr Gargi Dey and supported by researchers from two projects; Sustainable and Health Diets in India, and SHEFS: the Sustainable and Healthy Food Systems. Through designing a food label, the aim was to think about how food is intrinsically linked to both our health and the health of our environment. Students were therefore encouraged to consider the role of their chosen product in the food system, its impact on human nutrition, and if there were any significant environmental costs.
Photo credit: Benjamin Kayatz
The students divided themselves into three groups:
Group 1: (2 products) “Drink it till you make it” pro-biotic drink + millet porridge
Group 2: Greenhouse gas heavy beef
Group 3: Indian luxury Kerala dark chocolate
The session generated lively discussions, with challenges and complexities for food labels highlighted:
The legal obligations: in India, this relates to the regulations set by the Food Safety and Standards Authority of India (FSSAI). Legal obligations determine the factors you have to include in labels, such as the ingredients list, vegetarian or non-vegetarian symbol, batch or FSSAI license number.
Calculating and displaying the environmental impacts of the food item: including both the raw ingredients and the food packaging. All the students chose to use biodegradable packaging, but there are some things that you can’t change. Beef, for example, has high greenhouse gas emissions, land-use, water-use (see study by Vetter et al, 2017 for full details of greenhouse gas emissions of foods in India). What would an environmental food label mean for beef sales? How could you devise criteria or a rating system for product sustainability – one that could distinguish between sustainability ratings in different areas of the food system? Where the food is grown will also affect the environmental impact, which further complicates the calculation.
How to make and market a healthy and sustainable product? In the case of chocolate for example, this could mean has less sugar/milk and more cocoa, but will this change the taste? Can all products be made more sustainable?
The social impact of foods as they travel through the food system: can labels display information on the welfare and working conditions of those who produce raw ingredients, such as the fair-trade foundation logo used in the UK?
Finally, is labelling useful at all? We are strongly influenced by habits, convenience, taste preferences and necessity in our food choices – so will giving more information really matter?
The engagement activity was interactive and creative: thought provoking for both the students and researchers. The students were particularly interested in the welfare of the farmer and fair trade/fair prices to minimise exploitation of those involved in the production of foods. The researchers took away from the session an awareness of the potential conflict or agreement between successfully taking a product to market versus fulfilling the legal or moral obligations related to achieving both a healthy and sustainable food system. In addition, new research questions have been generated that will feed back into the SHEFS project and could inform the future direction of the research.
The session was led by Dr Kerry Ann Brown (LSHTM), and supported by Professor Alan Dangour (LSHTM), Benjamin Kayatz (University of Aberdeen), and Fran Harris (LSHTM). We would like to give our warm thanks to Professor Adhya, Associate Professor Gargi Dey, and all the students at KIIT University, for their participation and for welcoming the researchers from the SHEFS & SAHDI projects. SAHDI and SHEFS are both supported by the Wellcome Trust ‘Our Planet, Our Health’ programme.
‘It’s more complicated than that…’ is a common academic refrain. How many times have you watched a TV programme or read a newspaper article that touches on an area you know about and shouted (probably to no-one in particular): ‘but it’s more complicated than that’? Indeed, Ben Goldacre even called his latest book I Think you’ll Find it’s More Complicated Than That.
In this occasional series of blog posts we respond to items that appear on TV, the radio and in the press that deal with public health history topics. We want to explore some of the complexities often skated over or left out of such popular narratives. We aim to set current debates in historical context, and add some depth and complexity.
Whilst we want to show that ‘It’s more complicated than that’, we recognise that programme makers and journalists have different aims, and often limited space in which to communicate their ideas. There is an elegance to simplicity: academics invest a lot of energy making seemingly simple things complex, when we should also be spending time making complicated things, well, not necessarily simple, but at least easier to understand.
So, what we hope to do here is to add to popular narratives, not necessarily to correct or criticise (although there might be some of that as well!).
In 1986 the Department of Health and Social Security (DHSS) launched the AIDS-education campaign, ‘Don’t aid AIDS’, often recollected as the ‘Don’t Die of Ignorance’ campaign or ‘Tombstone’ campaign. The misrecollection of its official name is indicative of the two elements of this campaign which seem to stick in our minds and command the most column inches: the ‘Don’t Die of Ignorance’ leaflets; and the ominous TV advert which featured a large tombstone . These are the elements of the campaign I want to discuss.
The question, ‘Was the Tombstone campaign successful?’ is one which has reoccurred throughout my academic career. I tell people I’m a historian of HIV and AIDS, and people mention it in response. They remember the ‘Don’t Die of Ignorance’ campaign, were frightened by it, and some people may have even changed their behaviour in response to it, but how can we know if it was a success?
There has been a lot of press coverage looking back at the Tombstone campaign. The narrative offered up, in memories of the fear it conjured and through interviews with the advertisers and politicians who created it, generally paint it as a brave controversial intervention, something new, and as generally successful.
See for example the recent Guardian article which offers Norman Fowler’s perspective on the campaign:
The campaign, and the histories which echo its narrative, present the social factors which lead to AIDS stigma and transmission as boiling down to one essential problem: ignorance, the antithesis of ignorance being education. Such simple messages are useful in advertising, but aren’t nuanced enough for understanding what happened and why.
Indeed, by writing the history of AIDS as one of ignorance being replaced by education we forget the charities and activists who had began the fight against AIDS before the 1986 launch of the campaign. We can fail to ask the complicated questions of who the campaign was for exactly, and what it really contained and said about AIDS and those affected by it. We also sometimes forget to question when and why it was launched in the first place. Without these questions the narrative of success becomes too simple and leaves little space for those who were left unaffected, or adversely affected, by the efforts of the government to halt the spread of HIV through this campaign.
Okay so let’s think briefly about these big questions:
Who – It is tempting to suggest that the campaign was for everyone, but really the main targets were sexually active consenting adults and intravenous drug users. This leaves out huge swathes of the population, including some who might be HIV-affected. Public health campaigns are a blunt (and relatively cheap) tool, but those left out by the campaign still deserve to be remembered. In my PhD, which investigated the representation of HIV to children and adolescents, I came across families affected by HIV who were struggling to get the help they needed to tackle the emotional and educational demands HIV placed upon them. Parents scared by the media’s representation of AIDS and unsure how to tell their children about the disease, or where to find the resources to facilitate such a disclosure. They were not dying of ignorance, but living with a real illness and the dearth of resources with which to explain it to their children.
What – What did the TV ad really say about AIDS and those affected by it? Watch the video.
The focus on death, which conjures the fear remembered by many, created a narrative of doom, effective if the aim was to prevent new infections by scaring people into not having sex (or practising safer-sex), but not great at calming the fears of those living with the illness already. Many people affected by HIV were (and are) fighting to rewrite this pessimistic narrative to one of living with, rather than dying from, this disease.
When – The campaign is often pointed to as being an early and timely intervention. This is perhaps because it is often compared favourably with interventions in the US, and other Western European countries. But how quick was it? The Terrance Higgins Trust began its work in 1983, which included raising funds for research and to raise awareness. British newspapers began discussing AIDS in earnest in 1983. Teenage magazines had been discussing AIDS, and in a much calmer and more informative tone than the tabloid adult media, since 1985. So in 1986 the government campaign was one among many sources attempting to inform the public about AIDS. As histories and contemporary media coverage explains, the health educators behind ‘Don’t Die of Ignorance’ faced difficulty within government as they tried to launch this campaign, which accounts for the delay.
Where – The key remembered elements of the campaign were on television and delivered through leaflets. While leaflets and TV had been used as part of public health campaigns before, this was an impressive undertaking. But why use both TV and leaflets? The leaflets said what the short television advert couldn’t, one reinforcing the other. But the leaflet was perhaps also easier to ignore, somewhat less accessible and could be placed out of sight of children.
Why – With no cure, very little prospect of a cure on the horizon, prevention through education was seen as the only defence against the spread of AIDS. Moreover, people were frightened and public health campaigns are very visible signs of the government acting to combat a threat to public health. Cynically, they can be viewed as a relatively cheap and uncontroversial performance of governance in a health crisis when limited options are available. Then again, we might ask what else the government could have done?
What other mainstream media interventions, besides ‘Don’t Die of Ignorance’ should we remember?
Well besides teenage magazines, which continuously ran sympathetic and informative stories on AIDS and published safer-sex guides from 1985 until the mid-1990s, we should perhaps remember the EastEnders 1990 storyline about Mark Fowler’s experience of HIV and Grange Hill’s 1995 storyline about Lucy Mitchell’s mother who dies from AIDS-related complications. Both storylines followed heterosexual characters affected by HIV and worked hard to represent the way this disease affected families rather than individuals. Indeed research shows that the EastEnders AIDS storyline resulted in a spike in requests for HIV antibody testing, demonstrating the powerful influence public health messages have when embedded within an entertaining long-running soap.
In saying all this, I do not wish to deny the importance of the ’Don’t Die of Ignorance Campaign’. Clearly it was a significant and memorable intervention. However, in remembering it we must examine it critically and we must not allow it to overshadow the many other significant messages which were communicated about HIV and AIDS in the 1980s and 1990s.
 J D Ross and G R Scott, ‘The Association between HIV media campaigns and number of patients coming forward for HIV antibody testing’, Genitourin Med, 63 1993, pp. 193-195, p. 195.
John Oliver tackled vaccination on his HBO series Last Week Tonight
British satirist John Oliver tackled vaccination on the 25 June episode of his HBO series Last Week Tonight. There has been a series of measles outbreaks in Western Europe and North America among the populations who ought to have the best access to the vaccine against it. So why do parents not present their children for vaccination? What are their arguments? Who is persuading them to forego the recommendations of public health authorities?
I won’t go into all the issues raised by Oliver in this piece. For the most part it was standard fare from the British comedian. Oliver has a tendency to “preach to the converted” in his long-form pieces, but he usually does two crucial things. First, he lets his audience know “yes, you’re right, but here is the solid evidence for your opinions”. And second, “now you have this evidence, do you accept it’s also a little more complicated than you first thought?”
Throughout, Oliver attacked the ringleaders of anti-vaccination while acknowledging why parents might have doubts about the claims of both sides of the debate. The anger and vitriol was saved for people like Andrew Wakefield, Robert F. Kennedy and Dan Burton rather than parents just trying to work out how to keep their kids safe. As Heidi Larson et al’s work here at the School demonstrates, very few parents are totally pro- or totally anti-vaccination. Hectoring does little good to sway those on the fence.
Image from Wellcome Images
I don’t think the piece will convince the hard-core, but it was never meant to. It was supposed to use humour and evidence to reassure parents of the importance of vaccination and the dangers to all of us from having an under-vaccinated population.
But I think there were two points that stood out to me as central to the debate.
First, Oliver offers a beautiful metaphor. A growing number of parents choose to spread out vaccine doses, believing that children get too many in one go. They don’t. The CDC and NHS carefully plan vaccine schedules based on the aetiology of the disease, the way the vaccine works and the risks to certain children of particular ages. Spreading out vaccines reduces their effectiveness and there is no scientific evidence that it is safer than the existing recommendations.
Many of us are reasonable people. Between the extreme of anti-vaccination and doggedly abiding by official recommendations, spacing vaccines seems like a decent compromise. But, as Oliver argues, it’s the middle ground between sense and nonsense.
“It’s like saying ‘eating a bar of soap is stupid, so I’m only going to eat half’”.
Image from Wellcome Images
The parallels here are obvious in so many debates in public life. This idea that in any debate both sides have equal merit is what has allowed climate change denial to remain on the agenda long after it ought to have been abandoned. But that is another soap box for another time…
The second crucial point was his closing remarks. John Oliver recently had a son. He was born prematurely: but Oliver declared that junior would be fully vaccinated – and on schedule.
Whether we think they should or they shouldn’t – “celebrity” endorsements matter. (And those of us that remember Oliver from The Bugle podcast and the first series of Mock the Week are giggling at the idea of him being a celeb’.) Jenny McCarthy is well known in the US for convincing parents to avoid vaccines. As is Rob Schneider, who appeared in Oliver’s piece. A trusted public figure can sway opinion for or against official advice. There was a reason Elvis Presley was used in the polio vaccine campaign. I’m not saying John is Elvis… but he is a journalist and trusted public figure.
The segment appears to have resonated with people, and has received a lot of media attention. It is a very useful primer on the main anti-vaccine arguments and the clear refutations of those positions based on evidence. But when public health authorities strive for vaccination rates in excess of 95%, even a few holdouts can cause problems – especially when they are concentrated in tight geographical areas. Will arguments like Oliver’s convince all parents? Possibly not. But if they convince hesitant parents to reconsider their position, that can only be a welcome start.
The video may be hard to find outside the US as HBO region locks Oliver’s show now on YouTube. We would obviously never encourage you to search around for it or use any form of software to get around the restrictions, but it should be available to download for those of you with a Sky Atlantic subscription. It is worth a watch. For educational purposes, obviously.
QUEEN ELIZABETH DIAMOND JUBILEE TRUST MPH-CEH SCHOLARSHIP
The Queen Elizabeth Diamond Jubilee Trust MPH-CEH Scholarships have been established to provide support to Master of Public Health (community eye health track) (MPH-CEH) students from African Commonwealth countries, to strengthen the capacity of blindness prevention activities in Africa.
Call for Applications
People from African Commonwealth countries who are applying for the MPH-CEH degree and who meet the academic criteria for acceptance are invited to apply for the scholarship.
Successful applicants will be required to :
Register for full time study in the Faculty of Health Sciences
Comply with the University’s approved policies, procedures, and practices for the postgraduate sector.
Successful applicants may not hold other scholarships concurrently.
Value and Tenure
The scholarship covers academic fees for two years, living expenses in Cape Town for one year, and travel expenses to and from Cape Town.
The scholarship is initially tenable for one year. Renewal for the second year of study will be considered on evidence of satisfactory academic progress.
The requirements for admission to the degree are :
An approved degree in medicine or a health profession other than medicine with at least a four-year degree from a recognised university;
Or an approved honours or equivalent non-medical four-year degree from a recognised university;
The attainment of at least a C-grade pass in higher grade senior certificate mathematics or a recognised equivalent;
Proficiency in written and spoken English.
The scholarship application should be made on the attached form.
The application should be accompanied by –
A covering letter, in the applicant’s own hand writing.
A curriculum vitae.
Copies of academic transcripts.
Either names and contact details or letters of reference from at least two academics who have taught, supervised, or worked alongside the applicant.
Eligible and complete applications will be considered by a scholarship selection committee comprising two persons from UCT (the convenor of the MPH and the convenor of the MPH-CEH track) and one person from the London School of Hygiene and Tropical Medicine (the convenor of the MSc Public Health for Eye Care).
Closing Date for Applications
Applications should be submitted electronically.
The closing date for receipt of applications is 31 July.
Contact Details for Submission of Applications and for Enquiries
Applications and enquiries should be submitted to Chervon van der Ross ().
The University of Cape Town reserves the right to disqualify ineligible, incomplete, and / or inappropriate applications.
The University of Cape Town reserves the right to change the conditions of the scholarship or to not award the scholarship.