Examination of Witnesses (Questions 731-739)|
TUESDAY 25 MARCH 2003
731. Good morning, ladies and gentlemen, and
thank you for coming today. At the start and for the record, could
you introduce yourselves and give your affiliation. Then, if you
have any opening comments to make, either collectively or individually,
now is the time to do that.
(Dr Goodwin) I would like to thank you very much for
inviting us to give evidence today and may I start by apologising
for the fact that our outgoing Director, Dr Michael Dexter, could
not be here. I should explain that the Trust is in a period of
transition at the moment. Dr Dexter is retiring next week and
our new Director is not starting until June; hence my colleague,
Val Snewin, and I were asked to represent the Trust. You are probably
aware that the Wellcome Trust is an independent, medical research
charity established under the will of Sir Henry Wellcome and funded
from a private endowment. The mission is to foster and promote
research with the aim of improving human and animal health. As
such, clearly the subject of this Committee "Fighting Infection"
falls well within our remit. My role at the Trust is to head the
Subject Panels Department. We have four subject panels, which
deal with projects and programme grants. One of those panels deals
specifically with infection and immunity. My colleague, Dr Val
Snewin, is a Policy Officer at the Trust. She has had a previous
career in research in tuberculosis and malaria.
(Dr Dunstan) Perhaps I could start by saying how much
George Radda regretted that he could not come today. I am the
Director of Research Management for MRC, which means that I am
responsible for the group that essentially is the interface between
MRC Headquarters office and the scientific community. We facilitate
the peer review proposals and the development of scientific strategy.
(Dr Dukes) I am Peter Dukes, and I work within the
Research Management Group at MRC. I have responsibility, amongst
other things, for developing our relations with the new Health
Protection Agency. Other work that I do is across our research
boards at MRC to ensure joined-up thinking across the piece. Last
year I was responsible, for example, for the review we did on
autism and its link or not with infectious disease or vaccine.
732. Do you have any opening comments?
(Dr Dunstan) May I perhaps say that clearly MRC is
a major public funder of research in infectious disease. I think
we have told you that we spend something like £46 million
a year at the moment on that work; £42 million of that reflects
infectious disease, excluding prions. That is a very narrow definition.
We spent some £60 million more each year on immunology of
the immune system, which of course is closely related. A lot of
our investment is in the developing world; some of it clearly
is in relation to the developed world. We fund in various NHS
situations as well as in research laboratories in the acute sector
and primary care and public health. Perhaps I should end by saying
that we are very clear that infectious disease is a particularly
important area now with the new and emerging infections and the
possibility of bio-terrorism. One of the things that we are looking
at very carefully is developing a bid for SR 2004 on human infectious
disease. We have a strategy group set up, which is meeting next
week, with visitors from the CDC, NIAID in the States and a lot
of experts from the UK, who will be helping us to plan that strategy.
(Dr Goodwin) May I say that, although most of our
funding is in the UK, we do have considerable investment in infectious
diseases in the tropics. We have four tropical units and we spend
about £20 million a year on research in developing countries.
733. We move to the first question, which is
straightforward, I suppose. How do you prioritise the different
areas of research activity? As a supplement to that: is there
any collaboration between your prioritorisation processes?
(Dr Goodwin) The Trust mainly funds by response mode.
The Governors think it very important to protect response mode
baseline funding. Most of our funding is done by our general schemes:
projects, programmes and fellowships. As I have already indicated,
we do have a specific panel, the Infection and Immunity Panel,
which handles the projects and programme grants. We do occasionally
get approaches for major projects, which are assessed on a case-by-case
basis by the Governors. One example of that is our funding of
the Human Genome Project, and also the UK Biobank, which is in
collaboration with the MRC and, as you are aware, we also contributed
to the JIF and SRIF initiatives. Periodically we review specific
fields by holding workshops, carrying out questionnaires and interviews.
As a result of that process, we may decide to put focus funding
into a particular area. One example of this, which arose ten years
ago, was the setting up of a scheme for medical microbiology fellowships
in order to try and build capacity in that area. Of course, that
is of great relevance to this Committee. At the moment, we are
specifically looking at and reviewing three other fields of relevance:
antimicrobial resistance; patient-oriented research and evidence-based
medicine; and diagnostics, particularly in developing countries.
The Governors have not considered the recommendations of those
(Dr Dunstan) Every year, MRC research boards look
at their portfolio to ensure that they have as good a coverage
of their topics as possible. They will draw to the attention of
our Strategy Development Group any areas where they think there
are gaps or where they think there is an opportunity and a need
for MRC investment. We also have indications from the Department
of Health about their priorities, which we take very seriously.
One of those, for example, recently has been antibiotic resistance.
We have had a highlight notice to encourage applications in that
area. On the whole, apart from areas where we get direct funding
from Government for specific topics, for example in the last spending
review we had money for work on stem cells, we do not actually
ring-fence money. The way we decide what to fund is a mixture
of the quality of the proposal and its relevance to the MRC's
work, portfolio and mission. I think there is some benefit from
not drawing tight boundaries, in a sense, around areas because
often one area contributes to another. For example, we put out
a call for proposals in primary care. Quite a few of those that
came in were relevant to the infections research. There is a lot
of cross-talk between different areas within the MRC portfolio.
734. On the whole, would you tend to consider,
and fund indeed, research that is more basic rather than clinical?
There have been a number of occasions when the clinical side has
been obvious but it is very difficult for workers in that area
to get funding from, say, MRC or Wellcome Trust.
(Dr Dunstan) We try to strike a balance between the
basic content of our portfolio, the clinical and translational.
Sometimes that is difficult, particularly in terms of the quality
of the proposals that come in. I think, if I may say so, sometimes
the clinical people on the boards are pretty hard on clinical
applications. It is very much more difficult, I think, to put
forward a really good clinical application than it is for one
that is done in a basic laboratory. There is a lot of iteration
now. We do try, if we have comments, to pass them back to the
applicants and say, "Can you come back to us", if we
think the application is going to be fundable in the end, "taking
this into account?"
735. Apart from industry there are three main
funders of medical research in the country, two of which are represented
here today and the third is the NHS. There have been some notable
occasions when you three have actually got together to push a
big project, and Biobank is one at the moment that comes immediately
to mind. Do those three bodies get together formally or informally
on a regular but perhaps infrequent basis for a general look at
the biomedical research scene and to take away ideas?
(Dr Dunstan) As you know, MRC has a concordat with
the Health Departments and so, if you like, messages pass pretty
clearly between MRC and the Departments of Health in both directions.
We take close account of their needs and priorities. We meet with
them regularly both at chief executive level and our Chief Executive
meets with Sir John Pattison who leads the NHS R&D, and we
meet with the policy people, too, in the Department of Health.
We have regular meetings with the Wellcome Trust. Senior officials,
including the Chief Executive, meet, I would say, three or four
times a year at planned meetings. Generally, we take topics that
are timely and of interest to us both. Perhaps finally, I could
say that there are times, for example with Biobank but also in
other areasand I think we are planning at the moment to
do something together looking at malariawhen we jointly
look at an area and see what is needed, and then we both take
away the messages and deal with them, together or separately.
(Dr Goodwin) I do not have much to add to that except
that obviously we do not have quite such strong links with the
Department of Health as the MRC does but, nevertheless, we are
in contact with them and there are meetings between our Director
and John Pattison.
Baroness Finlay of Llandaff
736. You have already mentioned that there may
be some variation in the quality of proposals coming to you. We
are wondering whether there are sufficient high quality research
grant applications coming in the subject area of infectious diseases
and what proportion of infectious disease applications are successful
compared to those in other areas? It would be helpful to know
whether you have that divided perhaps between the basic and the
translational type of research as well. You may not have that
(Dr Dunstan) I am sorry but I do not have the figures
yet, but we will send them to you. They are quite difficult for
us to extract from our system. The MRC is very happy with the
quality of proposals that come to us in some parts of the infectious
disease area. For example, both in the clinical and in basic work
on HIV and AIDS there are very high quality applications. We tend
to get very good proposals for future work from some of our units:
the Virology Unit in Glasgow, the flu work that goes on at the
National Institute of Medical research at Mill Hill, and others.
There are areas of our portfolio where we are very happy with
the quality. There are other areas, for example in public health,
in primary care and in areas, that are to do with risk and behaviour,
where we would like to see an increase in quality, I think. We
are working with people who are in the field to try to achieve
(Dr Goodwin) I can give you information about the
Infection and Immunity Panel. The award rate there is about 30
per cent and that is very similar to all the other funding panels
in neuroscience, molecular cell biology, physiology and pharmacology.
There is really no difference in the award rates, but these are
mainly basic research proposals. We get relatively few applications
at the translational or clinical end and those that do come, tend
not to fare very well. Perhaps I can tell you about the Medical
Microbiology Fellowship Initiative that I mentioned earlier, which
was designed to try and build capacity, particularly in academic
medical microbiology. That scheme has run for ten years. We are
currently reviewing it. I think it is quite significant that in
some years we have not actually had enough high quality applications
to be able to use all the funds that we put aside for that scheme.
I think there is clearly a problem in that area. Our Medical Microbiology
Fellowship Scheme was specifically for academic medical microbiology
and trying to build capacity in that area. You may be aware that
the Academy of Medical Sciences did a review on this and published
a report on careers in academic clinical bacteriology and identified
a lot of problems in that area.
737. Has that also been the experience within
(Dr Dunstan) Yes, they did. In fact, we have 36 awards
for clinical training fellowsthose are the clinical people
who are working towards a PhDout of 274 awards in total
across the MRC's portfolio, and so that is about right. If you
look at our spend of about £40 million to £45 million
out of about £420 million, it is about consonant with how
much we spend on the area. In senior clinical awards, there are
seven clinician scientist fellowships and senior clinical fellowships
together, and that is out of 83 overall. Again, it is about 10
per cent. We are getting a reasonable number of good applications.
However, it does not mean that we would not like more and that
the area could not be built up further. I think that is something
we would agree. We have some joint fellowships with the Royal
College of Pathologists that we share in the area of infection.
Lord Lewis of Newnham
738. We are told by Wellcome that they have
a success rate of applications of, I think you said, 30 per cent.
(Dr Goodwin) That was for the project and programme
739. What is the equivalent for the MRC?
(Dr Dunstan) I am sorry, that is the figure I do not
have but we will send it to you.