Life expectancy has been rising thanks to better sanitation, healthcare, and nutrition but the gains have not been felt evenly worldwide and hundreds of millions of people still face great hardship, according to Bill Gates, Microsoft Founder and philanthropist.
UK research has long played a key role in improving the health of people around the planet, as can be seen in the Science Museum Group Collection, the Science Museum’s Medicine: The Wellcome Galleries and in our online content about COVID-19.
Now the importance of the UK’s medical science for future wellbeing has been underlined by the Decade of Health campaign launched by a group of organisations including the Bill & Melinda Gates Foundation and Wellcome (which recently unveiled a new strategy to focus on global challenges of mental health, global heating, and infectious diseases).
Working together is the best way to tackle health challenges in the UK and around the world.
For more than a century, the UK’s Medical Research Council has been striving to improve human health and it is committed ‘to advance people’s health worldwide,’ according to its Executive Chair, Prof Fiona Watt.
Here are a few of the many ways that the MRC has made a difference:
Preventing Pneumonia
Pneumococcal disease claims the lives of more than half a million children under five years old. Worryingly, antibiotic resistance to these infections is increasing, highlighting the importance of finding a safe and effective vaccine, a field in which the UK has a long history (dating back to Edward Jenner in 1796).
A new vaccine called PCV13 developed by Pfizer in collaboration with Gavi, the Vaccine Alliance, offers hope and tests on almost 19,000 patients by the MRC Unit The Gambia showed that it cut severe pneumonia by 61%.
The project was carried out in collaboration with the World Health Organization, The Gambian government, Pfizer and Gavi. ‘We are delighted to see this product come to market so speedily’, said Prof Beate Kampmann, Trial Director and Theme Leader for Vaccines & Immunity, MRC Unit The Gambia.
Predicting Pandemics
Diseases do not respect borders and, as we have seen this year, a health crisis somewhere can become a health crisis everywhere.
At Imperial College London, Profs Neil Ferguson, Christl Donnelly, Azra Ghani and colleagues at the MRC Centre for Global Infectious Disease Analysis have built on their work in modelling seasonal influenza and new infections to develop an epidemic simulator.
This modelling provided new insight into the feasibility of containing a pandemic at its source and the effect of antiviral measures and non-pharmaceutical public health policies, such as lockdowns.
Both the European Union and the United States took Imperial’s research into consideration when planning for pandemics.
Sharing Health Data
The UK Biobank has provided researchers worldwide with anonymised data from half a million people in the UK – from DNA to diet – to help understand the causes and variation of disease.
Initially funded by MRC and Wellcome, with contributions from the Department of Health and devolved administrations, this flagship initiative has, since its launch in 2006, set the standard for large-scale population studies.
Data from the UK Biobank have been used in over 1000 publications so far.
Two studies conducted in 2018 underline UK Biobank’s importance: one found relationships of genetic risk for major depression with educational attainment, body mass, and schizophrenia; the second identified around 500 genes linked to high blood pressure, with almost 200 of these being targets for developing new blood pressure medication.
Prof Watt remarked: ‘This unique resource will improve prevention, diagnosis and treatment of chronic and life-threatening illnesses by monitoring half a million volunteers and providing anonymised health information to approved researchers from academia and industry around the world.’
Monitoring Outbreaks
Finally, an example of how a modern advance can rest on decades of discovery science can be seen in the surveillance of the genetic makeup of Zika virus, which is linked to brain damage in babies, and Ebola virus using the remarkable MinION genome sequencing device –a ‘next generation’ DNA sequencing method which, at its heart, relies on a doughnut shaped protein whose hole is just a billionth of a meter wide – a nanopore.
Nanopore sequencing enables the genetic code (the order of the four chemical letters, or bases, A, T, C and G within their DNA code) of viruses such as Ebola and Zika to be read, providing insights into how they spread and mutate.
This tiny nanopore sequencing device rests on a multitude of discoveries and advancements in the UK funded through the research councils, notably the MRC and BBSRC and academic research funders around the world, together with significant private sector R&D investment.
They date back to the discovery of the double helix structure of DNA in the 1950s, using ‘X ray crystallography’, which paved the way for understanding the genetic code that underpins inheritance.
The original model can be seen in the Science Museum, and the Cambridge laboratory where much of the subsequent work took place, the MRC Laboratory of Molecular Biology, has garnered many Nobel prizes.
In the 1970s Dr Steve Hladky and Prof Denis Haydon at the University of Cambridge recorded the current flow through a single ion channel – a protein that contains a pore – in an artificial membrane. The ability to measure this current flow and quantify it gave a glimpse of the possibility of nanopore sequencing over three decades later.
Some membrane proteins – like doughnut shaped α-hemolysin used in nanopore sequencing – are open all the time, allowing a continuous flow of ions which can be read as a current flow, akin to a current through a wire.
Because DNA is a charged molecule, it can also be drawn through this open channel and, as it passes through, gives rise to fluctuations in the current that correspond to the genetic sequence.
The development of a commercial nanopore sequencing can be traced to basic research in the 1980s, notably Prof Hagan Bayley’s work at the University of Oxford, when the movement of nucleic acids such DNA through pore proteins was first observed.
Another key advance was slowing the movement of DNA from 1-10 microseconds per DNA base to around 2 milliseconds so the genetic sequence could be reliably read as the DNA whizzed through the nanopore.
The spin-out company Oxford Nanopore Technologies was set up in 2005 and, nine years later thanks to in-house R&D, it unveiled its first product, the MinION sequencer, which is the size and weight of a chocolate bar, powered by a laptop USB cable, and costs $1,000.
The low cost and small size allow it to be used in many settings, ranging from small clinics to the field, notably for tracking outbreaks of infectious disease.
Studying virus genetic code allows researchers to quantify the genetic diversity of a virus, reconstruct its origins, estimate rates of transmission while providing background information for vaccine development and drug design.
Working Together
With the formation in 2018 of UK Research and Innovation (UKRI), of which the MRC is a part, the MRC now plays a more central role in forging partnerships to contribute to what some call the ‘fourth industrial revolution’, a data-rich fusion of technologies in an wide range of fields, from molecular and structural biology to population health.
Working with the National Institute of Health Research, Health Data Research UK, NHS Digital and others, global health is a well-established focus of MRC research, notably in treating HIV, malaria, and other infections.
Increased government support for research to improve the health of people in low and middle-income countries has enabled the MRC to double global health expenditure to more than one-sixth of its annual total spend, setting up a new Applied Global Health Research Board and working with multinational initiatives, such as the Global Alliance for Chronic Diseases and the European Developing Countries Clinical Trials Partnership,
As the newly-launched Decade of Health campaign declares, by sharing our knowledge, skills, and expertise on COVID-19 and on other health issues, we can build a healthier, stronger, and safer future for all.