When future medical historians document the global war against TB, they might credit the influence of the UK’s economic “Winter of Discontent” of 1978/1979. In that season biological science graduates were not getting jobs, recalls then new matriculant, Robert Wilkinson, who was born and raised near Manchester. He abandoned his initial intention to study biochemistry and entered a medical degree programme.
It was the first of what Wilkinson now describes as “elements of serendipity” that would lead to his being awarded an OBE in January in recognition of his remarkable research into infectious diseases, with a focus on TB and its co-infection with HIV.
But while his own path has been serendipitous, he helps younger researchers — preferably from Africa — to map out their own careers, he says.
In the past 21 years, Wilkinson has supervised 23 postdoctoral scientists. All but three are still working in the science sector and three have become professors. He has supervised or co-supervised 33 PhD or MD students. Most remain active in research and 10 have become professors or senior lecturers, he says proudly.
Today he is a professor in infectious diseases at Imperial College London; principal group leader at The Francis Crick Institute London, a biomedical research centre; and an honorary professor in medicine at the University of Cape Town (UCT). He directs global charitable foundation Wellcome’s Discovery Research Platform for Infection at the Centre for Infectious Diseases Research in Africa at UCT.
The centre employs, he says, about 60 people, including administrative support staff and researchers. “It’s up to me and my colleagues to get grants to support these people to carry on working,” he says. This funding keeps him awake at night, he adds. “Nobody taught me to be a financial manager, and yet the turnover is about $5m a year.”
The rate of staff retention is high. “I’ve got people around me who have been here for almost 20 years. And people don’t stay where they’re not happy,” he says.
He was awarded an OBE in recognition of his remarkable research into infectious diseases, with a focus on TB and its co-infection with HIV
He calls his method of mentorship “bottom up”. “People come to me and say: ‘Do you have a project I can do?” he says. His answer: “Write down what you want to do, because it will arise from your experiences of what you may have seen in the clinics or what you think is scientifically important. And if we make it into a grant, it’s your money, and you become the prime determinant of your future.”
Wilkinson says this method of mentoring is picking up momentum worldwide. “I think there’s been a subtle shift towards the more holistic aspects of career development and promoting a positive research culture, [advancing ] wellbeing and [developing] women in science, for example — though medicine was always at the forefront of that.”
Wilkinson’s early medical journey took him to clinical practices and fellowships in countries as far flung as the UK, the US and Gambia. In between he visited Zimbabwe, Kenya, Zambia, Tanzania and Malawi as a tourist. He first came to South Africa in 2004 after winning a senior fellowship awarded by Wellcome.
“South Africa had, and still has, one of the worst TB problems in the world,” Wilkinson says. In 2004 the government was just beginning to roll out antiretroviral medication, after initial interventions by Médecins Sans Frontières (MSF). “So we partnered with MSF to start a research unit in Khayelitsha. We also worked at the former GF Jooste Hospital in Manenberg, [where we, in effect,] built a clinical research unit.”
Wilkinson’s team stands at the forefront of global TB research. The group is now conducting a phase 3 clinical trial of the safety and efficacy of the new M72 vaccine in Indonesia, Kenya, Malawi, South Africa and Zambia — all countries with high TB rates. The $550m trial, co-sponsored by Wellcome and the Bill & Melinda Gates Medical Research Institute, will enrol a total of 20,000 patients.
Wilkinson says the previous phase of the M72 trial “was 50% effective”, as it caused an immune response and raised no serious safety concerns. “If the initial result is replicated, that may be sufficient for regulators to consider licensing it.”
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