Select Committee on Science and Technology Written Evidence


Memorandum by the Wellcome Trust

  1.  The Wellcome Trust is pleased to respond to this Call for Evidence by the House of Lords Science and Technology Committee (the ­Committee"). The threat of pandemic influenza is an important issue, and the Wellcome Trust provides substantial funding for research in this area - mainly through the south east Asia Programme, but also with a number of ad-hoc grants via our Biomedical Science and History of Medicine funding streams. The Wellcome Trust is not well placed to answer many of the specific questions within the call for evidence. However, we would like to offer the following thoughts regarding the two main areas covered by the inquiry, i.e. the risk of pandemic influenza, and contingency planning in the UK.

A.  The risk of pandemic influenza

  2.  Most experts agree that a new influenza virus with pandemic potential will emerge in south east Asia, and that a further pandemic is to be expected. However, as the Committee will be aware, research published recently in Nature and Science suggests that a pandemic could be avoided if local health authorities react quickly to an outbreak and provide suitable drugs to prevent it spreading. The two independent modelling studies were carried out by a team led by mathematical biologist Neil Ferguson of Imperial College London,[6] and by a group led by biostatistician Ira Longini of Emory University in Atlanta, Georgia.[7] Both studies agree that it would be theoretically possible to contain an emerging pandemic - if the virus was detected early, if it did not spread too fast, if sufficient antivirals were deployed rapidly around the outbreak's epicentre, and if strict quarantine and other measures were also used.

B.  Contingency planning in the UK

  3.  The Wellcome Trust considers that there is currently a dearth of influenza expertise within the UK research community, and that action is required to ensure that a new generation of researchers are able to fill the void created once the current crop of experts reach retirement age. The scale of the global threat to human health posed by pandemic influenza would appear to warrant additional funding to stimulate an increase in basic research into influenza in the UK.

VACCINE DEVELOPMENT

  4.  The Trust has not undertaken any analysis of vaccine manufacturing capability, but anecdotally we are often told that the process for developing a vaccine to deal with a new variant will need to be a lot more efficient than it currently is in order to avert a serious problem. It is widely documented that the majority of deaths from pandemic influenza are likely to occur within the first six to twelve months, so any delay in the R&D of a new vaccine will have serious consequences. Some researchers estimate that it will be possible to develop a new vaccine within three to six months. The Wellcome Trust considers that a timescale of six to twelve months is more realistic - barring any unforeseen logistical or technical issues.

  5.  The Trust is aware that the Singapore government is pushing hard to establish itself in the flu vaccine field and it is setting up manufacturing capacity on a scale enabling it to become a global supplier. It could therefore make sense for the UK Government to enter into some form of agreement with Singapore regarding future flu vaccine needs, subject to satisfactory due diligence. It will be too late once an epidemic starts as there will be a massive scrabble to get vaccine pre-ordered from anywhere that has established the infrastructure to put in motion a crash programme. The UK needs to establish what in-country capability it currently has, or is prepared to invest in now; what additional capability the UK will need based on expected demand; where to source that additional capability from; and what backup arrangements are needed in the event of a logistical failure (like the incident last year when the flu vaccine production plant in Liverpool had to be closed for safety reasons and supplies were seriously disrupted).

WELLCOME TRUST ACTIVITY RELATED TO AVIAN FLU

  6.  The Wellcome Trust is currently funding a project to further research into what made the virus that caused the influenza pandemic of 1918 so deadly. The project will analyse the flu virus found in tissue samples from 1918 flu victims, and from people killed by other strains, to look for differences that might explain its immense impact. Led by London-based virologist John Oxford, the project team will use recently discovered preserved lung material from flu victims from 1908-33 to examine the genetic codes of viruses that were circulating before and after the 1918 virus. This will allow the team to track the development of the virus, and so build up a picture of how it became so lethal. It is hoped that research such as this will help to devise or improve systems for predicting and handling future pandemics.

  7.  The Wellcome Trust has funded an international consortium led by the UK and Hong Kong since 1999 under the IPRAVE initiative (International Partnership Research Awards in Veterinary Epidemiology). This initiative sought to support research in areas of veterinary public health that were of importance in both the developed and developing world and provided investment in research and research training programmes in the field of zoonotic and food borne disease. Funding has been provided for core support and for research projects on influenza virus epidemiology, interspecies transmission and a pandemic risk assessment study of the role of Asian live poultry markets.

  8.  The Wellcome Trust has recently allocated funding totalling up to £36 million over the next five years to its major overseas programmes in Kenya, Thailand and Vietnam. In Vietnam, where Dr Jeremy Farrar is Programme Director, research is focused on malaria, dengue, typhoid, and infections of the central nervous system such as tetanus and tuberculous meningitis. However, more recently, the programme has played an important role in the treatment and study of people infected with the avian influenza virus, providing valuable information on this deadly new global threat to human health.

  9.  The Committee may wish to note that the Trust will participate in an expert scientific meeting on pandemic flu, organised by the Medical Research Council (MRC), on 7 and 8 December 2005. The outcome of this meeting, which is likely to be attended by experts such as Dr Jeremy Farrar, may be of interest to the Committee. The meeting will address the first two of the following questions, and will contribute to the MRC's discussions with the Department of Health on the third:

    -   Prevention - what reasonably swift contribution could the MRC make to south east Asian research efforts that aim to prevent a pandemic from ever happening?

    -   Preparedness - what long term, strategic research contribution could MRC make to achieve substantive improvements in flu surveillance, diagnosis, immunisation and treatments, such that a pandemic could be averted or better controlled?

    -   Response - were a pandemic to be declared, what would be the appropriate response from MRC in supporting the international and national response?


6   Ferguson, N M et al. Nature doi:10.1038/nature04017 (2005). Back

7   Longini, I M Jr et al. Science doi:10.1126/science.1115717 (2005). Back


 
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