Examination of Witnesses (Questions 760-779)|
TUESDAY 25 MARCH 2003
760. I did not think it was Wellcome's at all
actually but I give you the opportunity to say so.
(Dr Goodwin) No, it is not.
(Dr Dukes) It does sometimes happen in studies evaluating
the effectiveness, for example, of a diagnostic system or screening
that brings with it, as part of the project, quality control measures
which are then embedded or become embedded or develop within the
wider NHS rather beyond our purview perhaps but as a consequence
of being part of a systematic piece of research. I think that
probably is as near as we get to it.
761. On the last bit of the question, where
do you feel that responsibility for these areas does lie?
(Dr Dunstan) I have had one try with NIBSCthe
National Institute for Biological Standards and Controls. I am
not sure how much their area is within that. I have to say I am
woefully ignorant about how diagnostics are licensed for use in
the NHS. It is not something of which I have any knowledge.
(Dr Goodwin) I think probably the Medicines Control
Agency and the Medical Devices Agency have a role here. Like Dr
Dunstan, I am not an expert on this.
762. This question really in part follows on
but also it has two elements in it. It relates to diagnostics
and diagnostic testing on which you have already commented but
also to the development of new vaccines. You support this, but
to what extent do you then support and promote spin-out activities?
(Dr Goodwin) The Trust does have a Technology Transfer
Division, which is devoted to providing funding to bridge the
gap, if you like, between basic research and the point where it
could be taken up by industry. That could involve setting up start-up
companies. We do have a couple of relevant examples of that. Professor
Adrian Hill has been funded to develop DNA-based vaccines for
malaria, and the Trust has been involved in the spin-out company
resulting from that. Also, we have supported Professor Helen Lee
at the University of Cambridge to produce field kits to diagnose
sexually transmitted infections. The first kits are now in production
for use in developing countries. There is the possibility of a
company coming out of that called Diagnostics for the Real World.
So we do feel we have a role to play there but it is based on
research that we have previously funded.
763. Could I pursue that? How much research
do you support into the development of new vaccines?
(Dr Goodwin) I could not give you those figures off
the top of my head but we can produce them for you.
As well as committing over £3 million to support
the basic and clinical research of Professor Adrian Hill into
malaria and tuberculosis immunology and genetics, which is of
fundamental relevance to vaccine development, the Wellcome Trust
Development Fund has awarded £343,000 to the University of
Oxford specifically for malaria vaccine development.
764. Who do you have?
(Dr Goodwin) Adrian Hill certainly has several million
765. Would you be able to tell us a little about
the Wellcome policy on vaccine development?
(Dr Goodwin) We do not have a general policy. We do
not specifically focus on that but if a proposal comes in, as
it did with Adrian Hill via our response mode general funding
schemes, that is how we would fund vaccine development.
766. You neither include it nor exclude it.
You view it on its merits?
(Dr Goodwin) That is right.
(Dr Dunstan) To go back to the beginning about exploitation
generally, I think, as you know, if MRC gives grants to universities.
Then it is up to the individual university to deal with exploitation.
Within our own units and institutes, we have MRC Technology, which
does the exploitation for us. The MRC also has a link with Medical
Ventures Management Ltd., which is a company that can actually
invest and help. It has first refusal really to help spin-out
companies that come from MRC research. I think it has done quite
a lot. I am not sure that it has actually invested much in the
infections area but it generally is a very helpful link to have.
The kind of outputs of exploitation have been from way back, and
we mention that in our submission: monoclonal human antibodies
for the treatment of RSV for example, which are now available.
We have done work on TB vaccines and that kind of thing that has
been taken up in a company which I think is called Sequella Inc.
in the United States, and so all the mechanisms are there if it
is possible to do that.
767. Could you give the Committee some indication
of your policy with respect to the development of new vaccines?
(Dr Dunstan) You may know that since 1992 or 1993
MRC, together with the Department of Health, BBSRC and what was
Glaxo Wellcome but is now GSK, has an investment in the Edward
Jenner Institute for Vaccine Research. Our contribution has been
about £1.5 million a year. Recently, all the sponsors of
that institute have considered the future beyond the 10-year funding
that has been committed. It is fair to say that they are all agreed
that times have moved on, things have changed and the perspective
has to be that in future that kind of investment needs to be nearer
the people who are working clinically. Thus, I think it is likely
that in future the balance of the MRC's investment in vaccines,
which will remain at least as high as it is now and may actually
increase, will move away from the Edward Jenner at Compton, which
is not near a clinical setting, and closer to various clinical
settings that are appropriate in the UK. I felt it was important
to tell you that but I am not sure that all of that information
is yet available to the staff at the Edward Jenner Vaccine Institute.
It is certainly available to their board, but I am not sure if
it has been passed on to the staff. I do not quite know the best
way to deal with that information.
768. Could I ask whether you know when it might
(Dr Dunstan) I can find out and let you know as soon
Lord Oxburgh: Perhaps you can inform the Clerk. That
would be helpful.
769. I want to follow this up with Dr Goodwin. Could
you tell us a bit more about the role of the Wellcome Trust in
the spin-outs. Do you see yourself as a venture capitalist or
a long-term shareholder, or just as a funder?
(Dr Goodwin) We do have equity in the companies that we
involve in the spin-outs. But we see our role as facilitating
that important translation of basic research rather than being
a venture capitalist.
770. My question refers to something that was
referred to very briefly in passing by Dr Dunstan earlier. Do
you and do you think you should have a role in funding research
into the public perception of risk in relation to vaccine and
other areas of communicable disease practice?
(Dr Dunstan) Yes, I am sure we have a role and we
should be funding research in those areas. Indeed, as I think
Peter Dukes said earlier, we have done a lot of work in relation
to MMR and autism. We have a Consumer Liaison Group, which has
helped us enormously with that particular piece of work. They
were able as consumers themselves, but ones that did not have
a particular interest in this area, to talk to people who were
very concerned and actually elicit from them the questions that
they felt were important and to which they would like answers.
They very much were good facilitators to the relationship, if
you like, between MRC and the members of the public who were very
concerned. Clearly, this kind of research has many links with
the ESRC. I think we would expect jointly to develop a strategy
in that area. Indeed, I have mentioned the strategy for the development
on infections. That is a half-day discussion at our strategy meeting
next week. Another half-day discussion is one with the ESRC people
there on perceptions of risk and behaviour. That is not specifically
related to infections but it is related widely. It is our expectation
that quite a lot of the research that may result from those discussions
would be generic and could be applied in this area as well as
771. Are any members of the media involved with
that work? Do you brief them as well?
(Dr Dunstan) They are certainly not present at the
strategy discussions because these are in-house discussions. They
have been involved in some of the work we have done with the Consumer
Group and interfacing with the public.
(Dr Dukes) Some of that has been more despite them
being members of the media rather than because they are. They
take part in this not to report the process but because they are
fairly articulate, have expressed an interest and have been selected
to come through.
772. In the admirably speedy response to public
anxiety about the link between MMR and autism, by what mechanism
was the MRC responding to this and what funding was used? Was
it actually taken from other projects?
(Dr Dunstan) We have actually looked at MMR and autism
on more than one occasion at the request of the Department of
Health. The first time it was I suppose the old-fashioned way
of looking at it, which was to have experts looking at the question
and delivering what was then a timely answer. This time round,
we were asked to look at it again and we decided that the only
way essentially to do this was to involve the public and the people
who had concerns. We worked out with the Consumer Liaison Group
how best to do that. That was done with MRC funding. It was not
particularly expensive. When the report came out, the Department
of Health and Scotland actually gave us some £2.5 million
to spend on autism research. That is being spent in addition to
money that MRC is spending.
773. Could I ask Wellcome to answer the same
(Dr Goodwin) We agree that public engagement in this
area is extremely important. We do not have a specific programme
relating to infectious diseases but we do have a general engaging
science programme. It is a response mode programme again, so scientists,
or indeed others, can apply to us for funding in any relevant
area to promote dialogue and engagement with the public.
Lord Lewis of Newnham
774. I think this question has partly been answered.
If you take something like MMR, it is in the public at large,
so that was an obvious source of inquiry. How do you decide on
what other areas you are going to be involved? Are you prompted
by one of the health organisations or is it done by a response
from an application from outside or what?
(Dr Dunstan) Sometimes we are asked questions, as
it were, by the Department of Health. Another one which comes
to fruition I think later this week is on chronic fatigue syndrome.
That has some infection connotations. Again, we involved our Consumer
Liaison Group which has a very good interface with people who
have concerns about that. Other questions either come to us because
people write in and say, "These are things you ought to be
looking at"and that is relatively infrequentor
they come through our expert research boards. Annually, people
look at what the issues and the opportunities are. That is how
they draw things to our attention.
775. On this question of public perception of
risk, do you also have a relationship with the various pressure
groups and charities that take a great interest in this and, if
so, could you tell us how you handle those relationships?
(Dr Dunstan) They are not always easy because in areas
where there is a lot of uncertainty there are charities, small
groups, that take very different views. They are heterogeneous
in that way and in that sense it is quite a challenge to deal
with them. Peter Dukes may have more to say about that because
he has done a lot of work on it. I have described how we think
our Consumer Liaison Group has a real role to play in interfacing
with these people. We think that when we have looked at something
like MMR or chronic fatigue syndrome, or indeed other things that
may come up in the future, we actually have an obligation to continue
the communication with the groups that have been involved in the
review. The kind of thing we are proposing to do in MMR and autism
and related areas is to hold at least one meeting a year with
interested parties and experts to tell them what has gone on in
the past year in research terms, what the new opportunities are,
and how it is really going to develop. If we are honest, none
of these things are going to be solved in an instant. They are
all long-term pieces of research. We need to build those links
and keep them going. That is something that is new for us but
we are working very hard on it.
(Dr Goodwin) We are not quite as much in the limelight
as the MRC is over this sort of thing, but obviously the main
pressure groups that we have to deal with are the animal rights
people. We are very much involved with the AMRC in addressing
that sort of thing.
776. I wondered if either organisation has done
any research into the extent to which scientific education prepares
members of the public to make decisions about their own perception
(Dr Dunstan) I am not aware of any
(Dr Dukes) I think I can illustrate this.
Firstly, in the review of autism that we did, not only did we
involve consumers, but we actually put on a research training
day for them, so that they were, if you like, more greatly empowered
to take part in scientific discussions and fora. That is at a
fairly practical ad hoc level, just as an example. Of course,
our unitsand we have a Social and Public Health Sciences
Unit in Glasgowdo some of this kind of thing, but not necessarily
overseen by MRC at the centre.
(Dr Dunstan) I think it is the sort of
thing that ESRC might have a big interest in, too.
777. One of the problems that arises when there
is suspicion about some medical treatment, be it a vaccine or
what have you, is that the popular media tend to lead a story
with a clearly very distressed person who believes that they have
been harmed by a medical practice or procedure and there is very
often no one there to answer that assertion in a sensitive but
authoritative way. Does either of your organisations feel any
obligation to be prepared to respond on those occasions?
(Dr Dunstan) We are not geared up at the moment to
be able to do that, but it is something that we have been giving
a lot of thought to recently and I would expect that we will be
able to do it rather better perhaps in the future than we have
been able to manage in the past.
(Dr Goodwin) I think we are in a similar position,
and we are very aware of the importance of our media and our press
department in dealing with these sort of things.
Lord Oxburgh: Thank you.
778. Can we just go back to your areas of interest.
I would like to ask the MRC whether there is a specific board
or panel which looks into infection in the broadest sense?
(Dr Dunstan) There is one panel that has infections
central to its remit and that is the Physiological Medicine and
Infections Board, but there are other panels that also fund work
that is relevant to infections, we have talked about the Health
Services and the Public Health Research Board and we also have
a group called the Cross-Board Group that funds co-operative groups,
which are essentially the short term three-year type of support
with some infrastructure, so they will fund infections work also.
It is more spread out than has been described by The Wellcome
779. This leads me on to ask about zoonotic
infections of both groups. What is the attitude of the MRC and
The Wellcome Trust to funding research of zoonotic problems from
animals to man both at the basic level and at the clinical level?
(Dr Dunstan) I think we would be open to proposals
in that area. I think some of the work that is done at Mill Hill
is very interested in the transfer between flu in birds and man
and so the kind of work that John Skemel does is relevant to that.
(Dr Goodwin) We have always been very interested in
funding animal health as well as human health and obviously zoonotic
diseases are included and, in fact, we have just launched a new
initiative on animal health in developing countries and we are
committing about £25 million over five years to that.
2 The Trust has committed considerable resources to
fund the research that underpins vaccine development. For example,
the Infection and Immunity Panel often considers applications
relating to vaccine research at its meetings, which are held five
times per year. Some examples awarded in 2003 include the following
three year project grants: "Dissecting the mechanisms underlying
mucosal vaccination" (£288,901); "Identifying the
immunomodulatory effects of immune stimulating complexes (ISCOMS)
and targeting these to enhance the potential of ISCOMS as vaccine
vectors" (£305,594); and "Development of the self-controlled
case series method for evaluating vaccine safety", (£111,678). Back
As supplementary information to the evidence session, the Trust
would like to inform the Committee that studies of this nature
would be considered under the Trust's public engagement "Engaging
Science" response mode grants programme, which is described
in more detail on our web site http://www.wellcome.ac.uk/en/l/pinpubsci.html. Back