Select Committee on Science and Technology Written Evidence


Memorandum by Infectious Disease Research Network (IDRN)

PRE-AMBLE

  1.  The Infectious Disease Research Network (IDRN) fully supports the priority now being given to infectious diseases with the strategy document Getting Ahead of the Curve.

  2.   Getting Ahead of the Curve emphasizes the importance of research and development in combating infectious diseases and outlines a proposal for a research and innovation programme.

  3.  While much excellent research is ongoing in universities and at the Public Health Laboratory Service, this research is fragmented and, as identified in Getting ahead of the Curve, there is no strategy for infectious diseases research currently. Co-ordinated effort is needed to develop such research strategy.

  4.  There is also a need to encourage collaborative, multidisciplinary working in order to develop research that will inform policies to tackle the complex issues involved.

  5.  Whether considering the surveillance, diagnosis, treatment or prevention of infectious disease, quality research requires three basic elements: co-ordinated research strategy, high-quality design methodology and professionally managed implementation.

  6.  The IDRN was conceived in 2001 (and funded by the London Regional Office of the Department of Health) with the aims of stimulating the development of research strategy in priority infectious diseases and to facilitate the implementation of high quality, inter-disciplinary, pan-London (or broader) collaborative research. Currently operating mainly in London, the IDRN is planning to operate on a national basis within five years.

  7.  The IDRN is directed by a Steering Group having representation from all the London Medical Schools, the London School of Hygiene and Tropical Medicine, the Medical Research Council Clinical Trials Unit, the Public Health Laboratory Service and the Association of British Pharmaceutical Industries.

  8.  This corporate response uses data collected during a consultation exercise with the London infectious disease research community, which was conducted from December 2001 to February 2002, involving the views of 126 researchers.

  9.  Data as to which infectious diseases are perceived to pose the greatest threat are first provided. A summary of the planned operations of the IDRN is then given, in relation to how such activities will support the strategy detailed in Getting Ahead of the Curve. The achievements of the IDRN thus far are then briefed.

INFECTIOUS DISEASE THREATS

  10.  The consultation exercise conducted involved assessing the threat posed by infectious diseases to the health of Londoners, threat being defined in terms of seriousness of disease or of burden of disease. Of twenty-one disease areas, the greatest threats (in order, greatest threat first) were: tuberculosis, antimicrobial resistance, HIV/AIDS, sexually transmitted infections, health-care associated infection, hepatitis, infections as causes of chronic disease, serious imported diseases (excluding TB and HIV), meningococcal disease and bioterrorism agents.

IDRN ACTIVITIES THAT WILL SUPPORT THE STRATEGY OUTLINED IN GETTING AHEAD OF THE CURVE

Core activities

Developing research strategy

  11.  The IDRN has initiated development of research strategy in the fields of tuberculosis, antimicrobial resistance and hepatitis. Work in the other priority areas is planned to be initiated over 2003-04.

Supporting collaboration

  12.  The IDRN plans to support collaborations initiated during workshops with a range of activities to promote quality research and to reduce start-up times of multicentre work.

Continuing education of professionals

Inter-disciplinary seminar series

  13.  Combating infectious disease requires inter-disciplinary collaboration. Each specialization has its own vocabulary. In order to develop research of any depth, an appreciation of the many disciplines involved—from statistics, epidemiology and mathematical modelling to microbiology, virology and genetics—is required by members developing protocols. To aid such understanding, the IDRN plans to develop a seminar series with topics addressing the training needs identified during the consultation conducted.

Training database

  14.  The IDRN plans to develop a searchable database of training opportunities eg local seminar and conference information, training courses of relevance to infectious disease research and graduate and research training fellowship information.

Engaging researchers with policy-making and funding bodies

Researchers' news service

  15.  Researchers are necessarily focused on the work in their field. To conduct research, however, a large body of further non-medical information is required. The IDRN plans to develop a news service for researchers, to keep researchers abreast of current political, ethical and legislative developments that will have an impact on the work they do.

  16.  Information would also cover practical aspects of developing research projects such as the following:

    (a)  A searchable database of researcher expertise to help identify collaborators.

    (b)  Links to directories of reagents and expensive equipment that can be shared for research purposes.

    (c)  Applying to ethics committees.

    (d)  Links to other research networks.

    (e)  Access to databases of freelance research personnel, ie qualified research monitors and auditors.

    (f)  How to run clinical trials, including a template repository of the documentation required by the EU clinical trials directive.

Researchers' contribution to public education

Role for the media

  17.  The IDRN co-ordinating centre fully supports the suggested increased capacity for providing information to the public about infectious diseases and the risks associated with them.

  18.  The IDRN co-ordinating centre also supports an increased role for the media (TV, radio, newspapers) in raising awareness about infectious diseases and considers that a proactive approach from the research community should be taken.

  19.  Other channels of communication should also be used to increase awareness in the high-risk groups themselves, eg through schools, community or patient organizations or religious leaders. Information services to patients should also be developed. Such means could open two-way communication, which would support surveillance programmes.

IDRN ACHIEVEMENTS TO DATE

Consultation exercise

  20.  A consultation exercise was conducted to inform development of IDRN functions.

  21.  Respondents identified many advantages to collaborative working and also informed us of current barriers, which the IDRN, in its development, is seeking to address:

    (a)  Advantages

      (i)  Obtaining critical mass, statistical power—there is currently a lot of small-scale research. Larger and more powerful studies could be conducted rather than small rival ones. Duplication of effort could also be avoided.

      (ii)  Obtaining the required skill mix for a particular project—enabling an increase in the depth of research by bringing together those with complementary skills but a common research focus and enabling collaborative grant applications to be made to funding agencies.

      (iii)  Making the best use of limited resources—the idea of pooling academic resources, facilities, equipment, tissues, mRNA, technical resources.

      (iv)  Facilitating the identification of, and communication with, collaborators.

      (v)  Increasing recruitment or case ascertainment rates.

      (vi)  Linking research to practice—currently, research is not well linked to practice. Opportunities to increase translation of research into practice exist through enabling centers of different types (eg tertiary referral centers and District General Hospitals and primary care groups) to work together. Researchers could therefore work more closely with those who implement research recommendations.

      (vii)  Improving inter-institutional communication and breaking down obstacles (geographic, historical, logistical) to collaboration.

      (viii)  Improving the quality of research through peer participation in study design, by drawing on the strengths of collaborating departments.

      (ix)  Enabling development of longer-term R&D programmes.

      (x)  Being very attractive to industry and, thus, helping to attract major clinical trials, which are often placed instead in the US.

      (xi)  Providing an effective political voice.

    (b)  Barriers to collaborative working fell into twelve major categories:

      (i)  Competition between institutions rather than collaboration.

      (ii)  Issues of ownership.

      (iii)  Issues of personality and politics.

      (iv)  Time.

      (v)  Financial and funding.

      (vi)  Project coordination and communication.

      (vii)  Recognition of collaborative work.

      (viii)  Bureaucracy and administrative burden.

      (ix)  Issues of authorship and publication.

      (x)  Time required for traveling around in London.

      (xi)  Maintaining collaborations.

CONCLUDING REMARKS

  22.  The IDRN has initiated activities primarily in London with pump-prime funding from the London Regional Office of the Department of Health.

  23.  To maximize critical mass gains and efficiency in research, a national infrastructure to support infectious diseases research needs to be developed. This network could map onto the proposed infectious disease clinical networks, as done by Cancer Research UK with cancer clinical networks. The IDRN is currently developing a five-year business plan, including plans to move to a national operational platform.

  24.  The IDRN is currently engaged in identifying appropriate funding source(s) to continue development from April 2003.


 
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