London’s School of Hygiene and Tropical Medicine and the Royal Opera House are no more than a mile apart, but last Thursday the gulf seemed unbridgeable. The problem was not opera, at which London excels (as it does in the study of tropical disease). It was what was being discussed at the conference being held at the venue by London’s mayor, Boris Johnson, to assess the future of the capital’s economy.

London possesses one of the most vibrant clusters of medical research institutions in the world. For example, the London School of Hygiene and Tropical Medicine won the 2009 Gates Award for Global Health. Professor Brian Greenwood was the first winner of the Hideyo Noguchi Africa prize last year – Japan’s equivalent of the Nobel prize – for his work on malaria. It is an extraordinary institution, one of the cluster of medical foundations, royal colleges and teaching hospitals in London that make it the world’s health capital. This is part of London’s economic and moral future that the city, and the country, should treasure, advance and speak up for.

Yet there was not a word about it at the conference – nor the other London universities such as Imperial, which ranks with Harvard and Yale in the world’s top three, nor UCL, LSE and King’s. Each is a centre of global intellectual excellence. This is the knowledge economy – London and Britain’s future.

Instead, we had to hear about the importance of hedge funds. I am sick of hedge funds. Sick of their special pleading that they should not suffer the regulation proposed by Brussels and will flee the country, supposedly taking billions in tax revenue with them. Sick of politicians – Johnson on the right and Paul Myners on the left – feeling that they have to speak up for them as an allegedly key part of our financial service industry, so hitting back at the delusions of mainland Europeans that hedge funds represent all that is bad about Anglo-Saxon capitalism.

But hedge funds do represent the unlovely priorities of Anglo-Saxon capitalism. They were an important factor behind today’s financial crisis. Brutally, it would matter scarcely a jot if the hedge-fund industry shrank to the size it was a decade ago. It might even promote a less casino-oriented financial system. Instead, I want to hear politicians talk about great innovations and inventions. I want them to fight for what counts – the clusters of wealth-generating excellence in medicine, health, biotechnology, engineering, our great manufacturing companies, creative industries, and business service companies. Wouldn’t it be fantastic if instead of pleading for hedge funds on Radio 4′s Today programme as Johnson did last week, he went into bat for, say, more resources for our financially pressed but brilliant universities and research teams. But the country’s Brian Greenwoods don’t invest the time and effort in lobbying, funding political parties or turning up at agreeable lunches. They just get on with saving lives.

The idea that financial services are somehow a sector that deserves special privileges because of its unique contribution to the balance of payments, tax receipts and employment lives on – despite the astonishing events of the last nine months. At the conference I joined a panel discussing London’s economic prospects with Clara Furse, former CEO of the London Stock Exchange, and Bob Wigley, former chair of Merrill Lynch Europe. In otherwise good and level-headed presentations both urged everyone to get beyond scapegoating financial services and move on. Finance did not need more regulation, they said, and instead needed to be allowed to get on with the job of laying the golden egg, and hedge funds in particular should be protected from Brussels’s regulation. Their case was echoed in the government’s white paper on financial services. Normal Treasury rigour, which would have been sceptical about a business sector whose current size is predicated on obviously unsustainable and rigged super-profitability, was set to one side, replaced by PR guff about the importance of the financial sector and how it must be protected from risk.

We should expect better, given the scale of the recession we have faced and the scale of support we have had to lavish on the financial sector. Hedge funds in particular cannot be allowed to peddle the fiction that they had no role in the financial crisis. For the record, in July 2007 London and New York hedge funds had assets under management of some $2 trillion, of which up to $1.75 trillion (we will never know the exact figures) was financed by borrowing. It was the collapse of two Bear Stearns hedge funds and three BNP Paribas hedge funds in July and August of 2007 that triggered the paralysis of the interbank markets in New York and London. Vast hedge-fund borrowing, sub-prime mortgage debt and falsely insured collateralised debt obligations were part of a dangerous mixture with potential losses running into trillions that terrified banks and depositors alike. Hence the run in the interbank market and the liquidity crisis. Along the way, Bernie Madoff’s hedge funds were shown to be a $50bn rip-off.

The sector plainly needs regulation. Nor is the European commission’s much-criticised proposal to cap levels of hedge-fund debt so outrageous. Simon Johnson, former chief economist of the IMF, writes as an ex-insider that it takes courage to challenge the financial oligarchs created over the last 20 years – richer, more powerful and more self-interested than even Russian oligarchs. The commission should be congratulated for its bravery rather than castigated for its meddling. Hedge-fund borrowing – the key to super-returns – can destabilise the system; it needs upper limits. Thank God someone says so.

William Baumol, one of the great economic theorists of growth and development, argues that there are only limited numbers of entrepreneurs. The issue is whether they go into productive or unproductive enterprise. Countries that allow particular groups to rig markets and create too much economic rent – returns above the true added value – divert entrepreneurs into rent-seeking, unproductive enterprise. Hedge-fund oligarchs who insist they should be free to borrow as much as they like, whenever they like, whatever the wider risks, are rent-seekers – rigging the market to suit themselves. Yes, they pay some tax; but we should offset the revenue we get with the revenue we lose when investors use their services to evade and avoid tax.

A few hedge funds do bring innovation to investment management; most are an economic cost. We lose net tax revenue; we incur risks of financial instability; entrepreneurial resource is diverted into unproductive activity; we create a culture that celebrates financial oligarchs and their values rather than what goes on in our great universities and great companies. British citizens know this in their marrow – as do many in the City. It is time that someone other than the European commission spoke up for a better vision of Britain.

]]> http://www.tropicalmedicines.net/our-laboratories-and-colleges-ought-to-define-britain-not-our-greed/feed 0 http://www.tropicalmedicines.net/nhs-slips-down-world-healthcare-league http://www.tropicalmedicines.net/nhs-slips-down-world-healthcare-league#comments Mon, 22 Jun 2009 02:24:49 +0000 admin http://tropicalmedicines.asomiya.in/?p=7

The UK has plummeted in rankings of the world’s healthcare systems, coming 18th out of 19 industrialised countries, after researchers looked again at what constitutes good performance.

In 2000, the World Health Organisation (WHO) published performance rankings for the world’s health systems, looking at health outcomes, responsiveness and financing.

But the World Health Report received much criticism, with many saying it was misleading to look at deaths from all causes, no matter what the causes were.

Many said it would be more appropriate to look only at those deaths that were avoidable through timely and effective healthcare, such as some cancers and diabetes.

New research from the London School of Hygiene and Tropical Medicine has reassessed healthcare performance in the industrialised countries, taking other factors – such as diet and smoking rates, accidents and suicides – out of the equation.

But while some countries saw their ranking improve, others slipped back, the research published in the British Medical Journal showed. Japan, top of the WHO rankings, dropped to number 13, while Norway shot up from 11th place to second.

The UK, which came in at 10th place in the WHO league table, dropped to 18th place out of the 19 countries included in the analysis, beating only Portugal.

Top of the new rankings was Sweden, up from 4th place in the WHO table.

Dr Ellen Nolte, who carried out the study, said: “We have looked at how the WHO’s rankings of health system performance would change if only those causes amenable to healthcare were included. They show that, for some countries, the differences would be very substantial.”

Dr Nolte said the complexity of the rankings showed how “fragile” the system was. She said WHO should take on board their findings as a better way of measuring the effectiveness of health systems.

The new rankings
Sweden
Norway
Australia
Canada
France
Germany
Spain
Finland
Italy
Denmark
Netherlands
Greece
Japan
Austria
New Zealand
United States
Ireland
United Kingdom
Portugal

]]> http://www.tropicalmedicines.net/nhs-slips-down-world-healthcare-league/feed 0 http://www.tropicalmedicines.net/matrix-the-profit-returns http://www.tropicalmedicines.net/matrix-the-profit-returns#comments Mon, 22 Jun 2009 02:24:49 +0000 admin http://tropicalmedicines.asomiya.in/?p=8

AIM-listed IT networks group Matrix Communications is expected to get a fillip today from news that it has won a contract to upgrade the network infrastructure of the London School of Hygiene and Tropical Medicine.

The company, which crawled its way back into the black earlier this year, is understood to have won the two-phase contract against stiff competition. It will serve as another important contract as Matrix continues its turnaround.

Earlier this month the company announced a return to profit for the six months to end-April, making £634,000, up from a loss of almost £275,000 in the previous year. The company also announced it has close to £2m in the bank.

Shares in Matrix closed down 0.17p at 2.725p.

]]> http://www.tropicalmedicines.net/matrix-the-profit-returns/feed 0 http://www.tropicalmedicines.net/poor-morale-undermining-nhs-it-project-study-says http://www.tropicalmedicines.net/poor-morale-undermining-nhs-it-project-study-says#comments Mon, 22 Jun 2009 02:24:49 +0000 admin http://tropicalmedicines.asomiya.in/?p=9

Poor morale among NHS staff implementing a sweeping new IT programme is putting the multimillion pound project at risk, researchers said today.

The National Programme for IT (NPfIT) is introducing new technology throughout the NHS, including centralised electronic patient records that can be accessed across England. The aim is for electronic patient records to be introduced in all acute NHS trusts by the end of 2007.

Researchers writing in the British Medical Journal (BMJ) said the programme, which promised “far-reaching benefits for patients”, was at risk because staff at a local level had been left feeling disengaged in the process.

Frontline staff felt demoralised, and managers said there was so little communication and consultation from NPfIT HQ that it posed a threat to getting the programme up and running.

A survey published earlier this year by the medical pollsters Medix found the integrated IT system was in danger of failing due to a collapse in confidence on the part of the doctors and consultants who were supposed to use it.

The BMJ researchers added that the overall timetable for implementing the IT programme was “unrealistic” and trusts continued to face uncertainty over the timetable for its implementation.

A report published in January by the National Audit Office found the programme to provide electronic booking of hospital appointments was behind schedule.

In 2002 the government allocated an extra £2.3bn to the IT programme to speed up its introduction.

The government has earmarked £6.2bn to introduce the new system but last year admitted that the cost of running the NHS IT programme over the next 10 years would be in the region of £15bn-£30b.

The BMJ study said uncertainty about when the IT systems would be implemented in hospitals, and what funding would be available locally to support it, was deterring trusts from getting on with introducing support systems.

The researchers found that some trusts said existing local IT systems for radiology and pathology services urgently needed replacing but that these had been put on hold as the IT programme was phased in across the country.

“Such delay may mean a risk of system failure but buying a temporary solution is seen as costly”, they said.

The research team, from the London School of Hygiene and Tropical Medicine, talked to 23 senior managers and staff involved in putting the project in place in four English hospital trusts.

They recommended that the managers of the national programme prioritise their strategies to improve communication with frontline staff and to gain their cooperation.

The researchers said the programme was “likely to succeed or fail according to the groundswell of opinion, as well as its technical performance”.

Dr Vivienne Nathanson, head of science and ethics at the British Medical Association, said the BMA had long thought that the NPfIT needed to be properly engaged with clinicians or it risked failure.

“The lack of engagement and consultation with the medical profession was wholly inadequate in the early stages of development, but NHS Connecting for Health, which is developing the new IT system, has more recently made significant progress in its efforts to involve NHS staff,” Dr Nathanson said.

“Large-scale public IT projects do not have a good track record in the UK, and so it is paramount that the NHS learn the lessons of history and engage wherever possible with the frontline staff who will be using the new systems to deliver better patient care.”

]]> http://www.tropicalmedicines.net/poor-morale-undermining-nhs-it-project-study-says/feed 0 http://www.tropicalmedicines.net/gap-in-cancer-survival-rates-between-deprived-and-affluent-areas-of-country http://www.tropicalmedicines.net/gap-in-cancer-survival-rates-between-deprived-and-affluent-areas-of-country#comments Mon, 22 Jun 2009 02:24:49 +0000 admin http://tropicalmedicines.asomiya.in/?p=10

People who live in the most deprived parts of England are less likely to survive cancer than those who live in more affluent areas, according to figures published yesterday by the Office for National Statistics.

People in deprived “spearhead” primary care trust areas, earmarked for special help by the Department of Health, had significantly lower survival rates than the rest of the country.

The spearhead group comprises 70 local authorities, linked to 62 primary care trusts (PCTs), deemed to have the most deprivation and worst health in the country.

The survival figures produced by the London School of Hygiene and Tropical Medicine cover patients diagnosed between 1998 and 2003.

The researchers found that survival for men was lower in the spearhead PCTs in all seven of the cancers they examined. Women had lower survival in seven out of nine cancers examined. Survival figures for cervix and ovary cancer were similar to the rest of the country.

The biggest differences were in cancer of the rectum and of the bladder.

Cancer Research UK said the survival differences needed to be explained. “It is vitally important that we understand these reasons so that we can ensure that everyone has an equally high chance of beating cancer, regardless of where they live.”

The Department of Health said more needed to be done to tackle health inequalities. The shadow health secretary, Andrew Lansley, said: “Labour’s failure to improve cancer survival rates is shameful, given the money they’ve provided.”

]]> http://www.tropicalmedicines.net/gap-in-cancer-survival-rates-between-deprived-and-affluent-areas-of-country/feed 0 http://www.tropicalmedicines.net/men-in-the-north-of-england-have-dirtier-hands http://www.tropicalmedicines.net/men-in-the-north-of-england-have-dirtier-hands#comments Mon, 22 Jun 2009 02:24:49 +0000 admin http://tropicalmedicines.asomiya.in/?p=11

It’s true. The further north men live, the grubbier their hands. Not women; only men

Men of the north, hang your heads in shame. Spot checks on commuters have revealed that the further north men live, the dirtier their hands.

In Newcastle, swabs of men’s hands revealed more than half were contaminated with bacteria normally found in faeces.

The percentage of the unclean fell with latitude, with 34% of Liverpudlian men testing positive for faecal bacteria, 21% in Birmingham, 15% in Cardiff and 6% in London.

The findings are part of a study by scientists at the London School of Hygiene and Tropical Medicine into the nation’s hand-washing habits, which was designed to highlight how infections can easily be spread by people failing to observe basic rules of hygiene.

Researchers approached 409 commuters waiting at bus stops outside major train stations in the five cities. Swabs of their hands were sent back to a laboratory, where any bacteria on them were grown and identified.

“When we first saw this north-south divide we scratched our heads. We thought it might be something to do with the way we did the tests, the weather, or the time it took to get the samples back to the lab, but the issue is with the men, not the women, so it must be a difference in behaviour. The best I can think of is that men in the north are too tough to wash their hands. We need to investigate it more, it’s puzzling,” said Val Curtis, director of the school’s hygiene centre.

Overall, 28% of people who agreed to a swab tested positive for faecal bacteria, such as Enterococcus, E coli, Klebsiella and Panteoa. The types of bacteria rarely cause serious infections, but their presence has alarmed scientists none the less.

“I was expecting to find around five to 10% of people with faecal bacteria on their hands, so I was flabbergasted at the number. It means people aren’t washing their hands after using the toilet, that they are contaminated and leave their bugs on surfaces where other people pick them up,” Curtis said.

The study, which is preliminary and has yet to be published, found that female hygiene was more consistent than that of males. On average, 27% of women had faceal bacteria on their hands, with Londoners again the cleanest at 21% and Liverpudlians the dirtiest at 31%.

The study has been released to coincide with Global Handwashing Day, a public-private partnership set up to promote hand washing with soap to reduce diarrhoea and other infections in developing countries.

“These bugs just shouldn’t be on peoples’ hands. If someone has a pathogen in them, such as rotavirus or Salmonella, this is a superhighway for passing it around to the community,” Curtis said. “Just rinsing your hands under the tap doesn’t remove bacteria, because they tend to get stuck in any dirt and grease you’ve got on your hands.”

The study found that people who used the bus were nearly twice as likely to test positive for faecal bacteria than train commuters. Bacteria can live for two to three hours on surfaces after being touched by a contaminated hand.

Worldwide, around 1.9 million people die from diarrhoea every year. In Britain, an estimated one in five has an episode of diarrhoea each year.

Mike Catchpole, director of the Health Protection Agency’s Centre for Infections, said: “Hand washing is one of the most important ways of controlling the spread of infections, especially those that cause diarrhoea and vomiting, colds and flu.

“Global Handwashing Day serves as a timely reminder that people should always wash their hands after using the toilet, before eating or handling food, and after handling animals. And remember to cover all cuts and scratches with a waterproof dressing.”

HPA figures suggest that cases of norovirus, the winter vomiting bug, are rising and that the annual norovirus season is likely to have begun already. Norovirus is the most common cause of gastrointestinal disease in the UK,with the number of cases peaking between October and March. Between 600,000 and a million people in the UK are affected each year.

• This article was amended on Thursday October 16 2008. In the article above we stated that: “Worldwide, around 1.9 million people die from diarrhoea every day”. We meant to say, every year. This has been changed.

]]> http://www.tropicalmedicines.net/men-in-the-north-of-england-have-dirtier-hands/feed 0 http://www.tropicalmedicines.net/rae-2008-london-school-of-hygiene-tropical-medicine-results http://www.tropicalmedicines.net/rae-2008-london-school-of-hygiene-tropical-medicine-results#comments Mon, 22 Jun 2009 02:24:49 +0000 admin http://tropicalmedicines.asomiya.in/?p=12 Results for London School of Hygiene & Tropical Medicine in the Research Assessment Exercise 2008

]]> http://www.tropicalmedicines.net/rae-2008-london-school-of-hygiene-tropical-medicine-results/feed 0 http://www.tropicalmedicines.net/bat-sorry-for-offer-to-sponsor-student http://www.tropicalmedicines.net/bat-sorry-for-offer-to-sponsor-student#comments Mon, 22 Jun 2009 02:24:48 +0000 admin http://tropicalmedicines.asomiya.in/?p=3

British American Tobacco yesterday apologised for offering to sponsor a student at the London School of Hygiene and Tropical Medicine which has a policy of not accepting money from tobacco companies.

The company admitted it should never have invited academics to suggest candidates for the £1,500 support and a graduate job afterwards at its Southampton office.

David Leon, at the school of hygiene, said the approach had been “indecent” and other universities should be on their guard.

“It was a mistake, quite honestly,” said a BAT spokesman. “Their views on smoking and health are well known. We should never have written to them.”

BAT provoked protests last year when it became the principal funder for an international centre for corporate responsibility at Nottingham University.

It also funds a chair in international relations at Cambridge University and helps support Russian and Chinese scholars through a charitable trust.

The company had been trying to recruit an epidemiologist. Cancer Research UK has commissioned researchers at Strathclyde University to investigate how many universities and medical schools accept funding from tobacco companies. A recent survey in Canada suggested nearly four in 10 institutions received some sponsorship.

Jean King, director of tobacco control at Cancer Research UK, argued that companies were trying to buy influence and that there was evidence that companies had tried to “muddy the waters” over the effect of passive smoking .

Donations were often in areas that had little to with health but “we would argue this gives them credibility in parts of the world where the arguments on health are not well known.”

]]> http://www.tropicalmedicines.net/bat-sorry-for-offer-to-sponsor-student/feed 0 http://www.tropicalmedicines.net/corrections-and-clarifications http://www.tropicalmedicines.net/corrections-and-clarifications#comments Mon, 22 Jun 2009 02:24:48 +0000 admin http://tropicalmedicines.asomiya.in/?p=4

The international conference on air pollution mentioned in 50 years after the great smog, a new killer arises (page 7, November 30) is being held on Monday and Tuesday December 8-9, and not on Saturday as we said. The conference is organised by the London School of Hygiene and Tropical Medicine and will be held at the School of Oriental and African Studies in London (see http://www.lshtm.ac.uk/smog).

Professor Devra Davis, who was named in the piece, is a woman and not a man. The secondary piece on the same page (Memories of grime hard to scrub away) attributed the song, A Foggy Day in London Town, to George Gershwin. He wrote the music but his brother Ira penned the lyric.

A technical error caused part of a picture to obliterate text in the cover story, The crunch, on page 2 of Media Guardian yesterday. It is possible to assume the missing parts of words but if you want to check the full text go here.

The international standard symbol for micrograms is not ug, as we mistakenly said in a correction in this column yesterday, but µg (mu, the Greek letter which transliterates as m). Unofficially, prescriptions and medical packaging sometimes use mcg instead.

Our headline, vCJD screening may be years away, warns scientist (page 9, yesterday) was inaccurate. While Stanley Prusiner, the scientist referred to, has developed a test for infectious prion proteins and believes that every Briton should be tested, it was public health officials who expressed frustration at signs of delay in introducing such tests.

It is the policy of the Guardian to correct significant errors as soon as possible. Please quote the date and page number. Readers may contact the office of the readers’ editor by telephoning 0845 451 9589 between 11am and 5pm Monday to Friday (all calls are charged at local rate).
Mail: Readers’ editor, The Guardian, 119 Farringdon Road, London EC1R 3ER.
Fax: 020-7239 9997.
Email: reader@guardian.co.uk

]]> http://www.tropicalmedicines.net/corrections-and-clarifications/feed 0 http://www.tropicalmedicines.net/aid-agencies-ill-prepared-for-aftermath-of-chemical-attack http://www.tropicalmedicines.net/aid-agencies-ill-prepared-for-aftermath-of-chemical-attack#comments Mon, 22 Jun 2009 02:24:48 +0000 admin http://tropicalmedicines.asomiya.in/?p=5

International relief agencies are completely unprepared to deal with the consequences of a chemical or biological attack on a civilian population in Iraq, experts from the London School of Hygiene and Tropical Medicine warned yesterday.

Without prohibitively expensive detection devices, aid agencies are unable to rapidly detect whether chemical or biological agents have been used. Nor do they have practical means of protecting themselves, and they have no experience in decontamination, quarantine or barrier nursing to stem an epidemic.

A paper produced jointly by the school and Merlin, the British-based charity, warned that humanitarian organisations preparing for a conflict in Iraq had stark choices to face.

They either had to develop their own capacity to respond to the consequences of weapons of mass destruction, which would be free from military control, or they had to work with the military, thus compromising long-standing rules of impartiality and neutrality. The alternative was that humanitarian aid could not be delivered safely when these weapons are involved.

The paper revealed that contingency planning had been taking place in Geneva and New York “for several months”, but behind closed doors.

“Although contingency planning has been taking place in Geneva and New York for some months, it has been discreet and in camera for fear of suggesting lack of confidence in the arms inspection process,” the paper said. “A critical window for creating what may be life-saving preparedness among all parties is being lost.”

Health experts raised a number of reasons why the British or US armies might not want to share their knowledge.

Military commanders may not reveal the nature of the agents used because they fear that by revealing evidence they could be made personally liable for a war crimes investigation by the international criminal court.

Battlefield use of weapons of mass destruction created problems for the protection of aid workers themselves. Performing anything but the most simple tasks in chemical suits is almost impossible without extensive training, while all vaccines except smallpox require more than a single dose to provide adequate protection. In the case of anthrax, seven months of vaccination is required to build advance immunity, while bubonic plague takes four months.

There was also a huge need for training. Russian medical teams responding to the gas attack that ended the Moscow theatre siege had no training and no access to treatment protocols. As a result, most deaths of liberated hostages occurred either outside the theatre or en route to hospital. Similar problems occurred in the Japanese response to the 1995 sarin nerve gas attack in the Tokyo metro.

Aid agencies have no capacity to intubate and give oxygen in the battlefield. Both would save lives in the event of a chemical attack.

One of the authors of the report, Egbert Sondorp, said: “The reality is that expert knowledge in protection from and response to weapons of mass destruction currently lies almost solely with the military.”

Geoff Prescott, the chief executive officer of Merlin, said: “NGOs need to retain their neutrality and impartiality while developing the knowledge and capacity to respond to weapons of mass destruction.”

The paper called for aid agencies to be included in the planning of disaster relief in the aftermath of an attack, for agencies to set up an independent capacity to respond to chemical and biological warfare, and for effective channels of communication to be established with the army.

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