The control, treatment and prevention of infectious diseases remains one of the greatest challenges in global public health. Some 17 million deaths a year – more than half of all deaths worldwide – are caused by infectious pathogens, and almost every year resistance to existing treatments grows and new agents are discovered. Developing countries, particularly those in the tropics, bear the greatest burden yet generally lack the resources to tackle the problem.
Vaccination is one of the most cost-effective of all health care interventions, with great power to prevent death and disability. Many researchers worldwide are seeking to develop affordable vaccines, but the process is a most demanding one and, rightly, stringent testing is required before a vaccine can be widely used.
Oxford University has an outstanding record in both tropical medicine and vaccinology. Its long-established permanent tropical research units in Thailand, Viet Nam and Kenya pioneered a mechanism of partnership between Oxford faculty members and local medical doctors and researchers, working together at the bedside to carry out both clinical investigations and treatment. The outstanding success of these collaborations has already revolutionised our understanding of malaria and other tropical diseases and introduced major changes to clinical practice.
Firmly anchored in an undergraduate medical school, Oxford's tropical research programmes are at the cutting edge of current progress in the prevention of deaths and disability, especially those caused by infectious diseases. These activities in overseas units interface with the Oxford-based scientific investigations in, for example, the Wellcome Trust Centre for Human Genetics, the Weatherall Institute of Molecular Medicine and the Medawar Building for Pathogen Research so as to provide ready access to the most recent advances in genomics, the molecular analysis and population biology of pathogenic microbes, and the cellular basis of human immune responses. This synergy of research efforts is a powerful alliance with which to drive forward the research, development and clinical testing of vaccines.
Oxford researchers are now poised to make important breakthoroughs in vaccines to prevent HIV, malaria, tuberculosis, melanoma, pneumonia and meningitis. A major new nucleus, the Centre for Clinical Vaccinology and Tropical Medicine (CCVTM) has been established to provide a vital dedicated facility for the vaccine trials essential in taking research from the laboratory to the clinic.
This desperately needed centre – which is without precedent in Europe – will establish scientific partnerships with industry (especially vaccine developers), governments and academic institutions in the pursuit of the global challenge to control the major infectious diseases of the 21st century.
As the premier centre of excellence in this field, CCVTM aims to be a scientific resource for research, teaching and training that is self-funding but not profit making. It brings together internationally recognised scientific strengths in Oxford and directly encourages their symbiosis, whilst simultaneously providing a home base for the University of Oxford Wellcome Trust Centre for Tropical Medicine and the teams involved in clinical vaccinology. CCVTM aims to be translational, bringing laboratory and field research to clinical practice and vice versa.
Clinical trials of vaccines have traditionally been undertaken by vaccine companies themselves but there is increasing recognition that the impartial scientific objectiveness that an academic environment offers is a crucial component of the scientific rigour and credibility of trials. Whilst working with vaccine manufacturers to test their products in the context of a daunting array of regulatory conditions, CCVTM is also pushing back the boundaries of scientific knowledge. Financial independence to conduct these investigations is essential.
Oxford University was awarded £6 million from the UK’s government-initiated Joint Infrastructure Fund to meet the capital costs of CCVTM. The building is sited at the Churchill Hospital in Oxford, adjacent to the regional referral centre for clinical infectious diseases and tropical medicine (the Infectious Diseases Unit). It is part of a strategic academic development on the site which already includes the Wellcome Trust Centre for Human Genetics, the Therapeutic Antibody Centre and the Institute of Health Sciences.
Scheduled to open in 2002, the building has six in-patient containment rooms and facilities for clinical research as extensions to the Infectious Diseases Unit, as well as meeting and seminar rooms plus office space for Oxford-based staff in the overseas units. Facilities for laboratory work are shared with the infectious diseases ward and CCVTM also has well equipped purpose-built laboratories for immediate on-site analysis of study results.
Vaccines are most needed today where resources and support are least available. There are few public-sector vaccine manufacturers anywhere in the world, so it falls to academia to look beyond profitability and take science out of the laboratory and into the very clinics where people need it most.
Oxford already has the strongest programme of overseas-based tropical and international health research of any medical school in the world and is a powerhouse of expertise in vaccinology and related disciplines. No other institution has the clinical and laboratory resources to move from a clinically derived definition of the most severe manifestations of a disease like malaria, through detection of the genetic basis for susceptibility, to the development of a protective vaccine.
I believe that it is appropriate that, in creating CCVTM to bring together these extraordinary strengths, we should champion the cause of those who cannot help themselves and play the fullest part in the global alliance to subdue these dreadful diseases.