London School of Hygiene & Tropical Medicine

What have been your highlights from your time as Director?

My proudest moment was when I sent an email to all staff in early September 2014 inviting people to work on Ebola in West Africa. More than 400 people volunteered to help. Volunteers came from across LSHTM, not just people who work on epidemics but clinical staff and administrative staff. It showed the ethos of our School. We are not just about publishing papers; we act when there is a crisis. Another highlight is that over half of our staff are now based overseas. On my third day in the job, I did a town hall meeting with staff. I asked ‘are we a London institution with global activities or a global institution with a London head office?’ I felt it was important we moved towards the latter. That was the way global health was moving.

You have met alumni and hosted events all over the world. Do you have any special memories of the alumni community?

I have travelled a lot and wherever I go I always try to meet with alumni. Just before the pandemic I had enjoyable meetings with alumni in Hong Kong, Singapore and the USA. I was impressed by the enthusiasm and dedication of our alumni. A phrase I hear over and over again is that their time at LSHTM was the best year/years of their life.

Do you have any reflections on your experience leading LSHTM through the changing world?

The last 10 years have seen an increasing number of centres of excellence in health and research across the world. As an institution we must team up and partner with others to become more global.

Another huge change is the development in communications and social media. Imagine if COVID-19 had hit us 20 years ago? We could not have had Zoom meetings or video calls. I was thinking about this while I was in total isolation in the hospital when I had COVID-19 myself. I was not allowed to go out or receive visitors, but I could use video calling and stay connected. I think this is having a profound effect on our education programmes and the ways we work. It may help in reducing our carbon footprint. The challenge is that everything now goes faster and faster. Another challenge is the growing, inward looking nationalism and identity politics, which creates problems for global health.

To counter this we have expanded our collaborations around the world, particularly in Asia. In Africa, the two MRC Units have moved from being partners to being part of us. This is new and will help to globalise, and even decolonise, our School. More and more of our activities will be led from there. Partnership is always a work in progress; we have lots to learn from each other.

We have many key partnerships with international organisations. Traditionally with WHO, GAVI and others, but also with companies such as our Ebola vaccine trials with J&J, our child health partnership with Takeda and our work on health in humanitarian crisis with MSF.

What has been your experience balancing the history and legacy of LSHTM and pushing it forward as an innovator and disruptor on the global stage?

People often think about innovation in terms of technology, but we are innovating through our research and education. We were pioneers in distance learning and invented the randomised controlled trial, in innovation to develop vaccines and insecticides, innovative interventions like treating bed nets with insecticides to prevent malaria, climate change and planetary health.

After doing research you have to take the next step to make sure it reaches people. That is why you sometimes need to team up with other institutions, entrepreneurs and business. That is how we can improve health worldwide. To meet the challenge of COVID, climate change, or health equality you sometimes need to partner with business which is something that the public health community has sometimes been reluctant to do. The world of global health has to engage with the real world to save the most lives possible.

You have brought about a steep change in how our School engages with philanthropists. How has philanthropy benefitted LSHTM over the last 10 years?

Philanthropy is absolutely essential. Without philanthropic support we won’t be able to meet LSHTM’s mission to improve health worldwide.

As Director, I have always felt it was important for me to lead by example. So I give what I can to LSHTM. Philanthropy isn’t just about Bill Gates and people who give millions, ‘every penny counts’ as my mother said. Every contribution makes a difference. I am very grateful to our alumni for all your support.

We have a great future because we have a fantastic cause. We are at the forefront, researching issues of vital global importance. The COVID-19 pandemic is the best illustration of why we are needed. So I spent a lot of my time, 30-40% of my time, on fundraising work.

Our new Chair of Council Don Robert is very committed to this. We also have a dynamic new Court chaired by Annalisa Jenkins who will help achieving a step change in our income generation.

What has it been like to lead LSHTM during the pandemic?

Responding to Ebola in West Africa gave us lots of experience of dealing with an outbreak. It helped prepare us for COVID. Very early on, we saw that this would become a big problem and we needed to act. We were the first university to tweet about COVID, already in January 2020.

We have a duty to precaution and protect ourselves, but also a duty to do something and to contribute. We have to be in the front line, as many of our colleagues in the UK and around the world have been during the pandemic.

Another challenge was taking decisions in the absence of clear evidence. We always say we need evidence-based policy but forget it in this case as the evidence was very incomplete! We closed LSHTM for all non-essential activities before the government imposed it. We moved to digital teaching before many other universities. Our two MRC African units were amongst the first to offer diagnostics in Africa.

The biggest frustration for me is that in the heat of the crisis, I got sick myself. I was really sick. It was the first time in my life I didn’t think about work. When I had long COVID, I felt so frustrated I couldn’t do more.

I am proud how the LSHTM community, particularly our modellers, have led through policy advice. As the European Union Special Adviser, I directly advise the President of the European Commission. Many of our colleagues, staff and alumni, have been advising international governments, the WHO, and SAGE in the UK. I am proud but it is exhausting. This crisis has been going on for 17 months or so. Most of us are dealing with COVID work seven days a week. So we need to be careful about burnout and looking after ourselves too.

What is next for global health?

On the substantive side, I see three big challenges: pandemic preparedness and response, climate change and chronic conditions. Health inequalities will exacerbate these challenges, therefore health equity must remain high on our agenda.

Global health has to be more of an equitable partnership between centres of excellence across the world. I have worked a lot on equitable access to HIV treatment. The issue was price. With equitable access to COVID-19 vaccines, the issue is supply. COVID could increase inequality in the world. Tackling this and gaining equitable access is one of my top priorities.

What is next for you personally?

First, I am not leaving LSHTM. I will be based in Brussels, but will remain part-time as a Professor of Global Health. I’ll continue to fundraise and support LSHTM. I am interested in issues around epidemics, climate change and policy. I will continue advising the EU. I am doing some work supporting Africa CDC. I will spend some time in Singapore. I will continue to stay in touch with alumni wherever I go. I will stay part of the alumni community.

This interview is from the 2021 Alumni News.