National evaluation of the Vanguard new care models programme. Interim report: understanding the national support programme. Survey of STP leads

The Vanguard new care models (NCM) programme was established following the publication of the Five Year Forward View (FYFV) (NHS England, 2014). It brought together all of the principal Arm’s Length Bodies with responsibility for aspects of the NHS in England. The FYFV set out a vision for the future development of the NHS focussing on new ways of working to improve care delivery rather than on structures, aiming to develop more integrated ways of working between different organisations and care sectors.

Commissioned by the NIHR Policy Research Programme, the aim of our overarching research is to investigate the effects of the Vanguard programme on the NHS, including its local organisations, wider partnerships and service users. There are three over-arching objectives:

  • Determine the extent to which the Vanguard programme has resulted in the implementation of new models of service delivery in England;
  • Identify factors that support or inhibit that implementation at the local (micro), meso (local health economy) and macro (national-level support and evaluation programmes, national regulatory context) levels;
  • Ascertain the impact of the programme on relevant outcomes, including economic assessment of costs and cost-effectiveness.

Each Vanguard is situated within a complex local landscape of health and social care organisations and plans. The objective of one of our work packages was to establish the position of Vanguards within their local health economies, addressing the question:

How do Vanguards interact with other policy initiatives such as Integration Pioneers and Sustainability and Transformation Partnerships / Plans?

This is important because Vanguards existed in a complex landscape of initiatives, including Integration Pioneers, primary care Federations, non-Vanguard new care models (e.g. Accountable Care Organisations, Integrated Care Systems) and Sustainability and Transformation partnerships / plans (STPs). This short report sets out the results of one part of the research, a survey of Strategic Transformation Partnership (STP) Leads, to examine how the Vanguard programme has been understood and managed at the meso level.

Download the full report [pdf]>>

Posted in Publications | Comments Off on National evaluation of the Vanguard new care models programme. Interim report: understanding the national support programme. Survey of STP leads

Health Policy and Planning’s Top 10 articles in 2018 – Catch up now!

By Natasha Salaria (London School of Hygiene & Tropical Medicine)

Health Policy and Planning publishes health policy and systems research focusing on low- and middle-income countries. The journal consists of four sections; Health Systems Research, Health Economics, Health Policy Processes and Implementation Research and Evaluation. We had another great year in 2018 with high quality supplements and journal articles published. Below you can find our top 10 most cited, downloaded and most accessed content in the past year.

Top 10 Cited Papers

  1. Disrespectful and abusive treatment during facility delivery in Tanzania: a facility and community survey [Link]
  2. How do external donors influence national health policy processes? Experiences of domestic policy actors in Cambodia and Pakistan [Link]
  3. Health system strengthening: prospects and threats for its sustainability on the global health policy agenda [Link]
  4. The impact of cash transfers on social determinants of health and health inequalities in sub-Saharan Africa: a systematic review [Link]
  5. The role of community health workers in improving HIV treatment outcomes in children: lessons learned from the ZENITH trial in Zimbabwe [Link]
  6. ‘The money can be a motivator, to me a little, but mostly PBF just helps me to do better in my job.’ An exploration of the motivational mechanisms of performance-based financing for health workers in Malawi [Link]
  7. Using community-based evidence for decentralized health planning: insights from Maharashtra, India [Link]
  8. The silencing of political context in health research in Ethiopia: why it should be a concern [Link]
  9. Pathways to high and low performance: factors differentiating primary care facilities under performance-based financing in Nigeria [Link]
  10. A conceptual framework for investigating the impacts of international trade and investment agreements on noncommunicable disease risk factors [Link]

Top 10 Downloaded Papers

  1. 10 Best Resources on Power in Health Policy and Systems in Low- and Middle-Income Countries [Link]
  2. Cuban Infant Mortality and Longevity: Health Care or Repression? [Link]
  3. Global Health Aid Allocation in the 21st Century [Link]
  4. The role of Community Health Workers in Improving HIV Treatment Outcomes in children: Lessons Learned from the ZENITH trial in Zimbabwe [Link]
  5. The impact of cash transfers on social determinants of health and health inequalities in sub-Saharan Africa: a systematic review [Link]
  6. Strengthening health system leadership for better governance: what does it take? [Link]
  7. Resource Allocation Processes At Multilateral Organisations Working In Global Health [Link]
  8. Public-Private Partnerships in Practice: Collaborating to Improve Health Finance Policy in Ghana and Kenya [Link]
  9. Civil society participation in global public private partnerships for health [Link]
  10. How do external donors influence national health policy processes? Experiences of domestic policy actors in Cambodia and Pakistan [Link]

Top 10 Altmetric Scoring Papers

  1. Cuban Infant Mortality and Longevity: Health Care or Repression? [Link]
  2. 10 Best Resources on Power in Health Policy and Systems in Low- and Middle-Income Countries [Link]
  3. Priority setting for health in the context of devolution in Kenya: implications for health equity and community-based primary care [Link]
  4. The impact of cash transfers on social determinants of health and health inequalities in sub-Saharan Africa: a systematic review [Link]
  5. Estimating the cost and cost-effectiveness for obstetric fistula repair in hospitals in Uganda: a low income country [Link]
  6. Civil society participation in global public private partnerships for health [Link]
  7. Allocation of development assistance for health: is the predominance of national income justified? [Link]
  8. Global Health Aid Allocation in the 21st Century [Link]
  9. Towards an understanding of resilience: responding to health systems shocks [Link]
  10. The impact of an mHealth monitoring system on health care utilization by mothers and children: an evaluation using routine health information in Rwanda [Link]

“Demography, for me, is all about looking at both UK and international perspectives – it’s a really useful subject.”

Rebecca Musgrove, LSHTM Alumna from the MSc Demography & Health programme, talks to us about her academic and professional career in Public Health.

Hi Rebecca, thanks for talking to us today. Would you be able to tell me a bit about your academic and professional background prior to joining the MSc Demography & Health at the London School of Hygiene & Tropical Medicine?

I completed a Master’s from SOAS in violence, conflict and development, after an international career working for Save the Children in child protection and sexual violence. Before coming to LSHTM I worked in the UK for a charity called Brook. There, I worked in service and operational management in sexual health for young people.

When I decided to join the MSc Demography & Health at LSHTM, I was considering a career change. Although I loved working in health, I didn’t feel that my skills were best suited to operational management and I was really keen to develop my technical and analytical skills. I felt that there was evidence missing from work that was being done in the sector in the UK, and I wanted to be part of finding that missing evidence.

Could you tell me how this MSc has influenced your career to date?

I chose to study the Master’s part-time, and during the first year of my course, I was still working at Brook. I went down to three days per week, but was then offered a part-time analyst position at NHS England, which was exactly what I was looking for. I actually got the job before I finished the Master’s! That was really positive – I got to work 2.5 days a week in NHS England analysing mental health data and on the other 2.5 days I was in school.

After graduating, I went full-time and was promoted soon after to senior analyst; I am now working at a national level. I get to use many of the skills I learned on the MSc on a day-to-day basis and the ways in which I learned to think at LSHTM have really helped me. I recently had the opportunity to apply for a PhD working on the epidemiology of suicide and self-harm after leaving psychiatric in-patient care at the University of Manchester. This is an area that we look at in the NHS, and that I’m really interested in, so I’m going to be moving to Manchester. I never thought that I would do a PhD before I came to LSHTM. Coming to here made me think “Oh, I can do that!”

Do you think the programme played a role in giving you the confidence to do a PhD?

Certainly. I think what was wonderful about this course is that it was relatively small and we had a lot of contact time. We had some big lectures but a lot of it was taught via small, practical seminar groups of 10 or 15 people. I knew my tutors, I knew the lecturers, and they treated me very much as a colleague rather than as just a student. I learned a lot from them.

Finding the right topic and area for me was wonderful. People asked me “are you going to do a PhD?” and I said “no”, but then I realised that actually I was good at this. It kind of surprised me how well I took to it! The MSc definitely gave me the skills to take on a PhD.

Why did you pick this specific Master’s; did anything stand out for you above other programmes that you may have been considering at the time?

My starting point was health. I knew I wanted to do something that related to health and I wanted technical and analytical skills. What I really liked about the MSc Demography & Health was that I learned a lot around epidemiology and in particular social epidemiology. I was interested in social inequalities, but not just talk and discussion about it; I wanted to see how I could measure it. Having worked in sexual and reproductive health, I was interested in demography – the impact of the changing ways that people had children internationally and in this country, as well as the fact that we have an aging population in the UK. I was keen to understand more about their impact on health. This course was unique in having both the health and demography sides.

So would you be able to tell me about the research project that you completed as part of the MSc Demography & Health, which recently won a prize?

My project used the National Survey of Sexual Attitudes and Lifestyles (NATSAL) studies, which are large scale probability surveys looking at conceptions and abortions in young women up to age 25 since 1990 to test whether factors affecting the likelihood of abortion have changed over time.  I was able to really get into the literature on the topic as well as developing a detailed methodology and doing statistical analysis across three datasets.  I found interesting links with sexual competence and wider changes in education.

I had incredible support, and challenge, from my supervisor who pushed me to develop a dissertation that I was really proud of.

 

Do you have any tips or advice for anyone who might be considering studying demography and health or pursuing a similar career path to you?

First and foremost, I would say definitely come to LSHTM – I think it is a great school. Secondly, it’s really hard work. You can’t come here just to ‘get a master’s’; you have to be really committed. I completed the programme over two years – If you are able to, I would really recommend doing that. It’s hard work, but actually the part-time option gave me the opportunity to reflect as I was learning and use my new skills in my work. I think if you are considering a career change I would really encourage this approach.

Secondly, talk to the tutors, talk to people with your ideas; you’re not here just to receive learning. You’ll meet some great people – it’s very international. What I loved about this is that demography, for me, is all about looking at both UK and International perspectives. You have fertility explosions and high birth rates in some places, but rapidly decreasing birth rates and ageing populations in others. You also have things like HIV, which have a massive impact on population growth and change – it all links together. Whichever background you’re coming from, and whether your focus is international or in a particular country, I think it’s a really useful subject.

 

Rebecca won the BSPS Early Career Award in 2018 for her dissertation: “Young women who have abortions: an investigation of associated factors in Great Britain from 1990 to 2012” which she completed as part of her MSc in Demography & Health at the London School of Hygiene & Tropical Medicine.

Posted in Demography and Health | Comments Off on “Demography, for me, is all about looking at both UK and international perspectives – it’s a really useful subject.”

10 – 16 January 2019

New LSHTM-led research, looking at readiness for first sex among young people, finds that many were not ready for first sexual activity and lose their virginity under circumstances that are incompatible with positive sexual health. Melissa Palmer said: “Examining the circumstances around first heterosexual intercourse is important for planning and targeting public health interventions to improve the conditions of first sex for young people.”

The research is widely covered in over 70 outlets including BBC News, The Independent, The Guardian, i News and the Metro. Kaye Wellings, senior author was interviewed for BBC Radio 5 Live (1hr 46 mins in), BBC London Drivetime (22min 40 seconds in) and BBC Woman’s Hour (20 mins in).

Martin Goodier provides expert comment to CNN on the safety of the yellow fever vaccination after an eminent oncologist died after having the vaccine. Martin said: “The yellow fever vaccine is extremely effective in protection against this infection and has been used worldwide for many years. Because of the widespread use of the vaccine we can say with certainty that such adverse events are rare. The benefits to health of vaccination far outweigh any potential risk.”

Ron Behrens also spoke to New Scientist about yellow fever vaccination and safety. Ron said: “About one person in 55,000 experiences a severe allergic reaction to a vaccine component and one person in 125,000 experiences severe nervous system reaction. So overall the risk of serious side effects is very low, but still higher than other vaccines, where the risk is typically one in several million.”

Martin Mckee is quoted by the New York Times about the findings of a new study showing that Coca Cola has worked to shape and influence obesity policies in China. Martin said: “These groups support and publicise scientific studies whose results sometimes muddy the waters on contentious issues like smoking or alcohol and soda consumption. They often cherry pick data in ways that mislead while portraying these issues as so terribly complex that nothing can be done.”

Martin provided comment after he wrote an accompanying editorial for the BMJ paper.

Steve Cummins is interviewed by The Guardian about his experience of taking A-levels and going to university, after proposals are leaked about students being prevented from going to university if they get fewer than three D’s at A-level. Steve said: “There are always people who, for whatever reason, don’t achieve their potential at the age of 18. I think that writing them off at that age and not giving them the opportunity to experience the transformative power of higher education is a huge mistake.”

Heidi Larson’s work on vaccine hesitancy and Rachel Lowe’s work on dengue are both featured in a Telegraph summary of the WHO’s global health threats.

Rachel said: “Several factors, including climate change and human movement, have allowed dengue to spread outside of the tropics to more temperature zones, including countries with limited capacity to respond.”

Heidi said: “In terms of antibiotic resistance we need confidence in vaccines more than ever, especially as our over-relied on antibiotics are not always working.”

Val Curtis speaks to NPR about why consumers are generally disgusted by eating edible insects for a piece on how moving towards eating insects would be more environmentally friendly than eating meat. Val said: “We have an innate response to things that might make us sick by feeling disgusted and, therefore, don’t want to consume them.”

Sally Bloomfield is quoted in a New Scientist article (£) which details bacteria commonly found in public places, such as the tube and offices. Sally said: “We’re constantly shedding stuff into our environment, but these organisms are mostly harmless.”

On social media

This week’s social media highlight comes from the LSHTM Instagram account sharing a picture of what Alexander Flemming called ‘mold juice’ – the symmetrical beads produced by penicillin. Stephanie Nofal captured the image in an LSHTM lab after a bottle of the jelly-like substance, agar, became contaminated.

Posted in Uncategorized | Comments Off on 10 – 16 January 2019

New ALiGN blogpost by DEPTH team members: Qualitative data shows how sexuality education can address social norms

PhD researcher Shelly Makleff and Professor Cicely Marston, members of the DEPTH research hub at London School of Hygiene & Tropical Medicine, have collaborated to write a new blogpost about the value of qualitative data in assessing sexuality education.

Their piece, titled ‘Qualitative data shows how sexuality education can address social norms’, explores how comprehensive sexuality education (CSE) might influence young people’s beliefs and behaviours, via a study examining a one-term comprehensive sexuality education programme implemented by Mexfam. The researchers employed an in-depth, longitudinal qualitative approach to the research field to learn about changes as they were happening, rather than after they had taken place. As Makleff and Marston argue:

A combination of retrospective interviews with a wider range of participants and longitudinal interviews with a small number of “case study” participants can be useful: it illuminates a range of participant experiences while enabling researchers to zoom in on some of the small and gradual changes that they experience.

You can read the full blog on the ALiGN website, here.

“The MSc Demography & Health… I wouldn’t be here without it!” – Ellen tells us about her career so far

This month, we interviewed Ellen Flint, Head of Scientific Strategy at the Department for Work and Pensions (DWP) about her academic and professional career. She showed us that academia isn’t the only path you can follow with an MSc from LSHTM.

Hi Ellen, thanks for talking to us today. Could you start by telling me about your background prior to joining the MSc Demography & Health at LSHTM?

I was fresh out of my undergraduate degree when I joined the programme. I did A levels in History, Geography and Biology so I was always interested in the crosscutting subjects. I went on to study Geography at Cambridge University and throughout, I picked a wide range of modules because I was interested in what connects things rather than specialising.

I was then accepted onto the Transport for London Graduate Scheme but I was still interested in applying to do either Demography or Epidemiology. That had been inspired by a course I took in my final year about human geography of the HIV pandemic, looking at it through a cultural and social geography lens. As part of that, I learned about the research that was done in the 1980s about sexual attitudes, behaviours and lifestyles at the London School of Hygiene & Tropical Medicine: the NATSAL study. I decided that I wanted to go to LSHTM on the basis of this ground-breaking research!

I was really lucky that I was offered the opportunity to do the MSc Demography & Health at LSHTM with some funding from the Population Investigation Committee. I had to phone TFL and tell them that I wasn’t coming – which I was really torn about because I love trains!

So it was a bit of a change of direction for you. When you were looking at the Demography and Health programme, would you say that there was anything about the programme itself that really grabbed you and convinced you to apply?

Yes, I think it was the health and medical focus of demography. You see lots of demography MSc programmes that are more general, but I was really interested in demography as it applies to health. Thinking about why people are born, why they die and when seemed to intersect quite unavoidably with health.

I was interested in doing demography within a public health school and wanted to keep things quite broad and interdisciplinary. I was attracted by the fact that this MSc offered the opportunity to share modules with the other MSc programmes in Reproductive & Sexual Health Research, Epidemiology and Public Health, giving students that rounded view but also getting into the specific detail of demography. I saw it as being a T-shaped course: a broad horizontal stretch, but also a deep vertical specialism as well – that’s what I was looking for.

It’s quite rare to find that balance of staying broad and allowing you that choice to then identify which area you want to specialise in. So how would you say the programme has had an influence on your career to date?

I think the programme really set me on the track that I have continued along to this day; I would not be here without it! It made me realise what I wanted to do as a PhD; I was more interested in health so I wanted to lean more towards epidemiology but still situating an individual within a household, within a generation as well as time, cohort and period. It made me realise that I was interested in non-communicable conditions; also, it taught me statistics and quantitative methods for the first time. I was basically completely set up by the programme!

I went on to do an ERSC funded PhD at UCL. I did social and life course epidemiology, but I used household panel data sets from the UK, which I’d been trained to use on the Demography & Health Master’s, so I was able to hit the ground running on that.

From there, I became increasingly interested in the environments in which people are exposed to social conditions. My first postdoc was at Queen Mary University in urban health. Then I did my second postdoc at LSHTM. The school saw my training as a strong grounding, and I was able to point to my combination of demographic methods, epidemiology, and quantitative analysis. I was in the Public Health Policy faculty for three years, working on active commuting – how different transport choices shape cardiovascular risk.

I’d say that in terms of how the MSc Demography & Health shaped my career, it gave me absolutely fantastic skills in things that are really transferrable, within social science and beyond.

Can you tell us a bit more about what you’re currently working on?

So here the story changes a bit! I moved into the civil service from academia. I didn’t feel that my personality was matched up with the ways of working in academia and found it quite intellectually lonely. I loved teaching, lots of elements of research, but I was interested in looking at what else was out there.

A job came up at the Department for Work and Pensions, working for the chief scientific adviser. They were looking for someone to bring an academic research background with them and a good grounding in research, with knowledge about the intersection of the social and health worlds. It was one of those jobs where I thought, “that’s really interesting – I have to go for it”.

It’s the job I’m in now, and I really love it! Without Demography & Health, I wouldn’t have had the grounding to work in a department like the DWP, it’s so relevant. The sorts of things we think about at the department are the child maintenance system – making sure those who are experiencing family breakdown are supported, and the delivery of benefits – how you assess for those, what the nature and eligibility of them should be, how to support people to save throughout their working life and more. All of this impacts on the way the department delivers its services. DWP designs and delivers all the policies directly; it’s a massive operational delivery organisation. It’s a really interesting challenge – how to serve citizens best and in what ways – digitally, affordably, and fairly. It’s totally fascinating to anybody with my sort of interests and academic background.

In terms of someone who is in a similar position to where you were when you joined the MSc, would you have any tips or advice for someone who is wanting to pursue a similar career path to you?

Yes. Here are my top tips:

Keep your interests broad but don’t neglect the things you really need to do.
You really need to be proficient in both qualitative and quantitative methods, you can’t get away with not having a good working knowledge of both. Don’t think that you can’t do the stats modules – you can! You don’t want to hamstring yourself in future by getting baffled by it. Just make yourself do it!

There’s absolutely nothing wrong with being broad and multidisciplinary – it’s a good thing!
Don’t feel like you need to choose one thing that you’re synonymous with. It’s not a sign of weakness because the future is transdisciplinary. The more strings you have to your bow the better and a programme like Demography &Health is ideal for that.

Don’t buy into the myth that you can’t switch between sectors – you can and should. Unfortunately, academia has a bit of an issue whereby if you step out for a few years and are not publishing, that’s seen as bad news. I don’t think it is – the more we have people switching between the two worlds, the more it enriches both. Don’t think that by doing an MSc you are signing yourself up for a lifetime of academia – you’re not. It can really equip you for many, many careers.

If you want a career in government, look at the Government Social Research Service and the Government Statistical Service. Everything you learn on your Demography & Health Master’s makes you eligible to join it and not enough people realise that! Lots of people think that civil servants do “yes minister” type roles, but lots don’t! Many do active research, rigorous analysis. If you want to be a researcher – someone who wants to go out and talk to research subjects and crunches data – you can do that in government. It’s a whole different type of civil servant!

Finally, I’ll just say that I definitely learned to tease out what’s real at LSHTM. That’s totally crucial to being a civil servant. I learned lots and lots of skills that are perfect for a career in Government.

Thanks, Ellen, those are some really valuable insights.

If you want to find out more about studying the MSc Demography & Health at the London School of Hygiene & Tropical Medicine, please visit our website.

Posted in Demography and Health | Comments Off on “The MSc Demography & Health… I wouldn’t be here without it!” – Ellen tells us about her career so far

03 – 09 January 2019

Peter Piot writes an article for Wired on why harnessing machine learning to improve health is a major ambition in the healthcare industry, and the potential for using it to manage health on a global scale. Peter says: “Artificial intelligence can democratise patient power and people’s ability to manage their own health, including in low and middle-income countries.”

Heidi Larson co-authors an article for Open Access Gov about the role of anthropology and technology in the Ebola vaccine response. Heidi writes: “Anthropologists have been actively helping to build bridges between social science and public health approaches to disease outbreak response and preparedness, most recently in the case of Ebola.”

Nick Thomson speaks to BBC News about new research using genomic sequencing to trace the source of the cholera epidemic in Yemen. The research, led by Wellcome Sanger, found that the strain came from Eastern Africa, entering Yemen with the migration of people in and out of the region. Nick said: “Knowing how cholera moves globally gives us the opportunity to better prepare for future outbreaks. This information can help inform strategies for more targeted interventions with the ultimate aim of reducing the impact of future epidemics.” The research was also covered by The Telegraph and Reuters.

Dan Bausch provides expert comment to The Telegraph about hantaviruses, a group of viruses spread by rodents such as rats and mice, after WHO reported an increase in cases over the past year. Dan said: “Rodent numbers can change tenfold over a season if the conditions are right for them – if there’s a lot of rain that would lead to more food being available and they can procreate more. Hantaviruses are an under-recognised problem and we need more information about this particular virus.”

Charlotte Warren-Gash speaks to I News about upcoming LSHTM research that will investigate the impact of extending the free flu vaccine to people at high risk of heart attack and stroke, but with no recorded heart problems, such as those with high blood pressure. Charlotte also provides expert comment on why people in at-risk groups should have the flu vaccine. Charlotte said: “If you’re over 65 or have an existing heart condition then it’s pretty clear that being vaccinated against respiratory infections is a good idea because it can potentially prevent not just the infection but also heart attacks and strokes linked to the infection.”

Sally Bloomfield provides expert comment to New Scientist (£) about common bacteria found in our daily environment, such as office spaces and public transport. Sally said: “We’re constantly shedding stuff into our environment, but these organisms are mostly harmless.”

Michael Marks is quoted in a Reuters article about new LSHTM research which finds that 90% of patients with scabies can be diagnosed with a simple examination of their hands, feet and lower legs. Currently diagnosis of scabies relies on time-consuming full-body examinations. Michael says: “Our study adds valuable data to the development of a simplified diagnostic process for scabies that may be applied to guide decisions about future public health interventions.”

On social media

This week’s social media highlight comes from the LSHTM Twitter page sharing an opinion piece by Dr Rachel Lowe on how climate forecasts could help predict disease outbreaks, as well as climate extremes such as hurricanes. The piece follows on from research led by Rachel, looking at the impacts of climate change on risk of dengue fever.

Posted in Uncategorized | Comments Off on 03 – 09 January 2019

Obituary: Emeritus Professor Wallace Peters

Professor Wallace Peters (1924 – 2018)

It is with great sadness that we report the death of Wallace Peters who was head of the Department of Medical Protozoology at the London School of Hygiene Tropical Medicine (LSHTM) from 1979 – 1989.

Professor Peters lived and was educated in London and took his medical degree at St. Bartholomew’s Hospital after pre-clinical training in Cambridge. He served in the Royal Army Medical Corps from 1947 – 49, practiced tropical medicine in West and East Africa for two years, was on the World Health Organization (WHO) staff as an entomologist and malariologist in Liberia and Nepal, and then became Assistant Director (malariology) in Papua New Guinea from 1956 – 61.

After five years as Research Associate at CIBA in Basel, where he carried out laboratory research on anti-parasitic drugs, he was appointed to the Walter Myers Chair of Parasitology at the Liverpool School of Tropical Medicine in 1966, including three years as Dean. From here he moved to LSHTM as Professor of Medical Protozoology. After retirement in 1979, he became Director of the Centre for Tropical Antiprotozoal Chemotherapy at the Northwick Park Institute for Medical Research.

Professor Peters’ truly outstanding research was on the chemotherapy of malaria, spanning the greater part of his long career.

Of particular note were his studies on chemotherapy of rodent malarias, a tour de force where he tested both established and novel anti-malarials against a wide range of drug sensitive and drug resistant strains of the malaria species of rodents. From this research it was Peters who first proposed that combination therapy was the best way to avoid the development of drug resistance in the treatment of malaria. This was slow to be accepted but is now considered as the standard, indeed the only way, to use established and novel drugs. Amongst the combination drug studies he pioneered was the proguanil- atovaquone combination (Malarone®) very widely used prophylactically.

Prof Peters’ published books are noteworthy for their comprehensiveness and attention to fine detail, and they quickly became standard works of reference, especially two editions of Chemotherapy and Drug Resistance of Malaria, and the beautifully illustrated atlases of tropical medicine and parasitology (each compiled with a co-author). His own view of this remarkable career is given in an autobiography, Four Passions.

Not surprisingly his expertise was called on repeatedly, in particular the WHO Expert Advisory Panel on Malaria (1967 – 2003), and the Steering Committee on Malaria Chemotherapy. He was Director of the Public Health Laboratory Service Malaria Reference Laboratory while Head of Department at LSHTM.

Prof Peters’ outstanding contributions were widely recognized by honours and awards, notably the King Faisal International Prize, the Le Prince Medal from the American Society of Tropical Medicine, and the Emil Brumpt prize from France. He was President of the Royal Society of Tropical Medicine and Hygiene and the British Society for Parasitology. His was a remarkable contribution to the improvement of drug treatment of malaria and other tropical infections.

Written by Geoff Targett, Emeritus Professor of Immunology of Parasitic Diseases

Posted in Obituary | Comments Off on Obituary: Emeritus Professor Wallace Peters

13 December 2018 – 02 January 2019

John Edmunds speaks to ITV news about Ebola as part of a wider piece on how a trial vaccine is being used in the current outbreak in the Democratic Republic of Congo. John said: “It has a wild animal reservoir, probably bats although we don’t know that for sure, and every now and then somebody is going to be exposed to the virus, contract Ebola and potentially spread it to others. Because of that Ebola is not something we can get rid of but what we have to do is manage those cases and outbreaks, if and when they occur.” (link to interview not available online)

Heidi Larson is quoted in The Guardian about the growing anti-vaccine movement in Europe as figures show that measles cases across Europe are at their highest for 20 years. Heidi said:  “We’re in a very vulnerable place right now. I don’t know a country in the world that doesn’t have some questioning going on.”

Heidi is also featured in Horizon Magazine  for an article on ‘What to look out for in 2019’. Heidi says that we should take lessons in how to combat negative messaging online from elsewhere in order to tackle anti-vaccination sentiment. “We need to bring to the whole social media landscape the kind of rigour that is currently going on around containing hate rhetoric.”

Beate Kampmann provides expert comment to CNN on acute flaccid myelitis, a polio-like condition that can cause weakness or paralysis and largely affects children. The coverage comes as Public Health England (PHE) reported an increase in cases across England in 2018. Beate said: “It is essential to determine the causes as quickly as possible. A new type of enterovirus has recently emerged, and there was a larger outbreak in the United States in 2014. Doctors working with children and infectious diseases are alert to this strain, which has been associated with the limb paralysis.”

Martin McKee is quoted in the Daily Mail about the safety of e-cigarettes, after PHE conducted an experiment exposing jars of cotton wool to tobacco smoke and to e-cigarette vapour. Cotton wool exposed to e-cigarette vapour was barely visible compared to the discoloured and sticky remnants left by tobacco. Of the findings Martin said: “There are growing concerns about the risks of vaping on heart disease. While there are lots of anecdotal accounts of people using e-cigarettes to quit smoking, we have yet to see any good evidence from clinical trials, the gold standard method, that they work.”

Martin also speaks to the Huffington Post about Brexit after a BMJ investigation revealed that many NHS trusts were struggling to predict how medicines, staffing and supply chains would be affected by Brexit. Martin said: “These findings are extremely concerning and it is clear that any form of Brexit will have profound implications for the NHS. It is inconceivable that the NHS will be prepared for anything other than a situation that, in effect, continues the current arrangements by the end of March 2019.”

On social media

Our social media highlights come from the LSHTM Twitter page.

The first shares a blog published by the UK Public Health Rapid Support Team about how social science can be used to improve outbreak response.

The second promotes new LSHTM-led research which finds that the discovery of novel Wolbachia strains in Anopheles malaria vectors could lead to a reduction in the transmission of malaria.

Posted in Uncategorized | Comments Off on 13 December 2018 – 02 January 2019

Thirty years and counting: LSHTM’s maternal health group turns 30

In January 1989, a new research group was launched at the London School of Hygiene & Tropical Medicine, created formally by virtue of a grant award from the Ford Foundation and the MacArthur Foundation. Loosely-called the “maternal health research group” and comprising just three individuals – now all Professors: Oona Campbell, Veronique Filippi and Wendy Graham – a journey began. The initial grant was to develop methodologies for measuring maternal health. This focus has remained a strong one since 1989, but today at LSHTM many other disciplines, perspectives and focal areas contribute towards a common aim – high quality research to improve the health and well-being of mothers and newborns. Across 2019, the 30 year anniversary will be celebrated through a series of events, marking not only the contribution made by academics at the School but also the many country collaborative partners and alumni. Watch this space for more details on these events and on how to take part. Here we kick-start the year with the voices of the three original musketeers – seen “before and after” in these photos.

Image: The Measuring Maternal Health Workshop participants meet at LSHTM in 1989. The group includes Veronique Filippi & Wendy Graham (front row, 3rd & 4th from the left). Oona Campbell (back row, 2nd from left).

Prof Wendy J Graham: “My memory of 1989 as our launch year is one of excitement and in trepidation – a sense of privilege that we were so new but entrusted with the challenge to improve understanding on the definition of “maternal health” and the options for measuring levels, determinants and consequences. This was at a time when the definition was, in practice, seen essentially as equivalent to “maternal mortality.” Although we had already developed The Sisterhood Method to give low-income countries an opportunity to gain some estimate of the magnitude of deaths, we were now charged to look also at the much broader field of maternal morbidity. We launched into this minefield with a unique set of colleagues from six countries. Thirty years on, the sense of responsibility but also the invitation to think outside the usual measurement box and be innovative has had a lasting impact on me.”

Prof Veronique Filippi: “In 1989, I was incredibly lucky to be hired by Wendy as a research assistant/fellow to work on measurement issues related to maternal health together with Oona. This is when I started learning my trade, particularly with respect to the measurement of maternal morbidity which became my specialty. The funding context was probably as competitive in 1989.  Granted, very few groups such as ours were working in maternal public health.  On the other hand, research funders were not making huge financial commitments. Although some USA-based private foundations, such as Ford Foundation and MacArthur Foundation, financed research in maternal health in low income settings, the Gates Foundation, Buffet Foundation and CIFF – who  are so important today in shaping the research agenda- did not exist. 1989 was a time when there was little reliable information coming from countries. There was an agreement that there was a need for better measurement tools, such as the sisterhood method developed by Wendy and Prof Bill Brass, and better programmatic responses beyond primary health care and community-based intervention, which were better suited to child health or family planning. Although poor quality of care was sometimes documented in maternity units back in the late 1980’s, efforts around its measurement, including outcomes such as near-miss and components such as respectful care and accountability, were minimal.  The challenge today is to demonstrate that a sustained focus on maternal wellbeing is essential for sustainable development and from a human right perspective.”

30 years on, the founders of the Maternal Health Group: Veronique Filippi, Oona Campbell, and Wendy Graham.

Prof Oona Campbell: “I knew I was coming to live in London about a year before I’d finished my PhD. On a visit, I walked past LSHTM , hoping it might be a place I would find work.  It was a dull November Sunday, and I made the mistake of thinking the Gower Street side was the main entrance.  All was steely-gray and firmly shut, with a barren sidewalk, speeding traffic and the strange pits leading to what I later learned were the underground vaults. There was no sign of life. It seemed unwelcoming and daunting.

Coming in the front entrance in January 1989 to a new job, in a new unit, with new colleagues was an immense contrast – full of excitement and anticipation. We focused on a new challenge- one which I think we never really cracked- of capturing maternal morbidity through household surveys. We set off an early trip to US institutions setting out our vision, which was received with enthusiasm, and we came back with a very early version of a laptop that had no memory and weighed a ton! Most exciting of all was a trip with Wendy to Assiut University in Egypt to meet the first ever colleagues that responded to our call for collaboration.  We arrived in Cairo, and we called Assiut from the Guest House where we were staying.  As I spoke to them in Arabic to clarify that I was Dr Campbell, I then realized they were expecting me to be a man.  They then asked rather plaintively “and Dr Wendy, HE is here?” The adventure of designing new research and data collection as a woman-only team had begun………..“

Watch this website for further details on how 2019 will be as, if not more, exciting than 1989! This year also marks the 120th anniversary of LSHTM- check out the schools anniversary timeline which features the start of the Maternal Health Group.