T~~sacrro~s OF THE ROYAL. SOCIETY OF TROPISM MEDICINE AND HYGIENE (1988) 82, 1-2

Royal Society of Tropical Medicine and Hygiene, Joint Meeting with the Wellcome Trust, Manson House, London, 7 May 1987

WELLCOME TRUST UNIT DIRECTORS’ MEETING

A personal history of the Wellcome Trust in tropical medicine

P. 0. Wiiams The Wellcome Trust, I Park Square West, London, NW1 4L3

The history of the Wellcome Trust’s interest in tropical medicine and the setting up of its overseas units is so closely interwoven with my life that this brief overview is inevitably something of a personal picture. Many individuals have played-their parts and most of them are still alive and thriving. It is my belief that research in tropical medicine l&ds, if nothing else, to great longevity.

Between 1955 and 1960 I was a medical officer on the staff of the Medical Research Council (MRC) head office. I was resmnsible for the Council’s tropical medicine activity; to Sir Harold Himsworth whd was chairman of the Colonial Medical Research Commit- tee (CMRC). In that position I had a direct interest in the Tropical Metabolism Research Unit (TMRU) in Tamaica where John Waterlow was the Director, the infantile Maln&tion Research Unit in Kampala under Rex Dean, the Gambian Laboratories under Ian MacGregor (where Herbert Gilles was then working), and an indirect interest in the Colonial Office establishments in Mwanza, Entebbe, Amani, Tororo, Alupe, Vom and Kaduna, the Trinidad Virus Laboratory and the Institute for Medical Research in Kuala Lumpur. These establishments were the re- sponsibility of Raymond Lewthwaite, Secretary of the CMRC. Those were the days when Britain had an enormous activity in research in tropical medicine supported mostly from Colonial Office funds. It had been largely built up after India became independent. I travelled widelv and got to know the individuals who directed and worked-in these units.

I need not describe the gradual deterioration of these facilities as they were passed over to the new independent governments dtiring the 1960s.

It was during my time with the MRC that Himsworth was busy creating the Tropical Medicine Research Board (TMRB) as the successor body to the CMRC, but I had left fdr the Wellcome Trust before it held its first meeting.

I came to work at the Trust in 1960; I believe my appointment was due in no small measure to my experience of tropical medical research; Sir John Boyd, a Wellcome Trustee, knew me because he was a member of the CMRC. The Trust was very small in those days, but it had a mandate to support tropical medicine. Its trooical activities were confined to the support of Drs Fby and Kondi in Nairobi and one or two small grants, including one to Selwyn Baker in Vellore to work on sprue. I brought with me from the MRC two schemes which the Council found it

d&cult to fund, the capital cost of the laboratories and housing for the Epidemiology Unit in Jamaica, and a scheme of electives for medical students from Glasgow to go to work in Entebbe.

The Jamaica laboratories formed the base for Dr W. E. Miall’s work on the epidemiology of hyperten- sion and later for Graham Serjeant’s Sickle Cell Unit. Serieant had started his work as a Wellcome Fellow. Th6 Trustees more recently (1986) helped Graham Serieant with space and equipment for work on the eye in sickle cell anaemia. We also helped the TMRU with a mass spectrometer and various training and visiting fellowships.

These were the first new things; the Entebbe scheme, and a later one for The Gambia, were the start of an enormous flow of elective students to the tropics. After a few years we left this funding to others, including the Rogers’ Fund of the MRC.

The Trust th& began-to grow and the colonial emDire began to dwindle. The MRC continued with its inits @though two of the four have now closed or been transferred to other organizations), but the Colonial Office institutes and units were no longer Britain’s responsibility. There was clearly an impor- tant role for the Trust to day in ensuring a continuing presence of Britain in the -tropics. -

So what had we got to start from? We could helo the MRC units o&seas, and so we did. In Thk Gambia we provided a floating laboratory, the Lady Dale, and laboratories for trachoma research where Mr and Mrs Sowa isolated the trachoma organism.

But there was really no need at that stage for us to subsidize the MRC, and so we began to build up our own activities which, as with most research, was built around individuals, particularly people who wished to work long-term in the tropics, around whom the Trust has supported a number of small units.

I should like now to give a thumb-nail sketch of our units and their foundation, in the order in which they came into being.

Nairobi develooed around Henrv Fov and Athena Kondi working on anaemia and malaha. They had spent periods in Salonika, Johannesburg, and Assam, and finally settled in Nairobi in 1949 in the stimulat- ing atmogphere of the Medical Research Institute. Thev continued their research there until 1970 when they retired (although Henry Foy still goes into the laboratory every day and continues to work). Subse- quently the unit worked on vitamin deficiency and cirrhosis of the liver, schistosomiasis and the eosin-

ophil (V. R. Houba, R. F. Sturrock and A. E. Butterworth) and then on the epidemiology of hyper- tension with Hopwood, once- more on-the scene, taking charge. Now there is a branch of the Wellcome Trop&l Institute (WTI) museum there and W. M. Watkins works on anti-malarial drugs.

Vellore started as a project grant to !%vyn Baker in the later 1950s to work on snrue. He had worked on vitamin B12 at the Royi Postgraduate Medical School, Hammersmith, with David Mollin and was therefore very intrigued by the malabsorption syn- drome he identified in Vellore. It gradually built up to a considerable sized unit working on the pathogenesis and epidemiology of sprue. Baker left in 1977 and the Mathans, who had trained with him, took over and have developed and expanded the programme into the broader compass of the diarrhoeal diseases.

A co-operative study on sprue linking Vellore, Nairobi, London, Singapore and Haiti resulted in the publication of a book.

The next unit started in 1965 in Belt% under Ralph Lainson and Jeffrey Shaw. I remember Lainson, who was then in Belize, coming into my office after a visit to Belem very excited by the prospect of working alongside the Rockefeller arbovirologists who were traooing all the animals he wished to examine for &&n&a parasites.

For five vears Bill Brav ran a unit in Addis Ababa and, with Ashford, discovered that the hyrax is the reservoir of the local leishmanial parasite. He then went to The Gambia as Director before he returned to Imperial College.

Next, in 1979, David Warrell set up a Unit in Bangkok. He wanted to get overseas again after a few vears in Oxford. where the work he was dome was so unlike what he undertook during his time in Z>ria as a Wellcome Fellow. The Trust also wanted to have a presence in the Far East. I chose Kuala Lumpur very much with Gordon Smith’s acquiesence because the staff spoke English and I thought Warrell would not learn Thai. We were wrong; Warrell chose Bangkok because there was more infectious disease there, and he and his wife Mary learnt Thai and worked on malaria, snake-bite and rabies. The Warrells did very interestine work in Thailand and now Nick White has succeeded them and they are back developing the home base in Oxford for other ventures overseas.

Finally we come back to 7umaicu. Mike Golden is now the-Acting Director of the TMRU in Jamaica. He went there first under the Trust’s London-Harvard Scheme and after a few years set up his own Trace

Element Group with Trust support. The TMRU is now a joint enterprise between the University of the West Indies and the Wellcome Trust.

That is where we are today, continuing to see the gradual contraction of Britain’s government involve- ment in the tropics and as a result seeing the Wellcome Trust playing a more and more significant role - but of course only a microcosm of the research that should be undertaken.

At the Trust, when Sir John Boyd retired he was reolaced as a Trustee bv Gordon Smith and araduallv, as‘ the Trust expanded, I had to pass over personal responsibility for the tropics to others and in succes- sion first Tom Hopwood, then Bridget Ogilvie and now James Howard have taken charge of the Trust’s tropical activities. Each has added his or her flavour but all have been very enthusiastic in their efforts to make our units thrive. I must also say a special word of thanks to the many panel members and referees who have helped us to make decisions on what to support during the past 10 years.

But what of the future? Our tropical units are an element of stabilitv - nlaces where there is a reaular programme linked back to bases in Oxford,- the London School of Hygiene and Tropical Medicine (LSHTM), the Clinical Research Centre, Northwick Park, the Rowett Research Institute, and the Liver- pool School of Tropical Medicine, m which neonle can carry out a conti&ng programme, neophyies can be trained. and the future leaders can start their careers. Pdlitical events, personal problems, running down of scientific ideas can lead to the failure of units to thrive. The philosophy underlying the setting up of the Units is that it is no use having a unit if we have no one to direct a programme in it, but it is also no use having an idea if there is nowhere to carry it out.

Those who worry about the prospects for a career in tropical medical research can, I think, take solace in the fact that if they do a good job their future is assured. But it is hard work and no sinecure - even if there can be some pleasant recreation on the cricket field, the golf course or the beach.

The Wellcome Trust’s policy is to continue to support tropical medical research and also to develop and modernize the WTI museum and its distance learning programme under Eldryd Parry, who had received Trust sunnort during his 25 vears in Africa.

We will, I am sure, set up new units where there is the right man and a programme that should be undertaken in the tropics.