Dr Jimmy Whitworth

Biography

Jimmy Whitworth qualified in medicine from Liverpool University in 1979. He trained in general (internal) medicine at various hospitals on Merseyside before working for Save The Children Fund in Upper River Division of The Gambia in 1983-5. After a short spell at the Liverpool School of Tropical Medicine, Jimmy ran a research project on ivermectin for onchocerciasis in Sierra Leone for the Medical Research Council. In 1990 he was appointed Clinical Lecturer, later Senior Clinical Lecturer at the London School of Hygiene and Tropical Medicine. In 1995 he was seconded to direct the Medical Research Council Programme on AIDS in Uganda based at the Uganda Virus Research Institute in Entebbe. This large research programme is multidisciplinary, focusing on public health issues relevant to Uganda. These include aspects of infection with HIV-1, subsequent disease, how to deal with the medical and social consequences of the epidemic, and the development of strategies for AIDS control. Activities range from virology and immunology to social science, covering clinical studies, epidemiology and statistics. Many of the trials faced difficult ethical challenges. Jimmy was Chairman of the Uganda Virus Research Institute Committee for Science and Ethics for seven years from 1995 to 2002.

Jimmy was appointed Professor of International Public Health in 1999 and returned to London in 2002. He continued to direct the MRC AIDS Programme in Uganda until 2003. In September 2004 he took up the post of Head of International Activities at the Wellcome Trust.

Abstract of presentation

After the trial is over

It is considered best practice for successful interventions to be made available once a trial is over, but major practical issues surround implementation of guidelines on after-trial provision of care. Whose responsibility is this? Is it the investigators, sponsor, funder or national government? Who should benefit? The trial participants or the community from which they were drawn? How wide is 'the community'? Some guidelines encourage grant applicants to consider before a trial is conducted how post-research access can be ensured.The National Institute of Allergy and Infectious Diseases (NIAID) suggests researchers should submit a plan for after trial care, but note that NIAID itself would not normally foot the bill ('Science', May 2003). The Wellcome Trust takes a similar position, but will assist applicants with the instigation of processes with different stakeholders prior to the research being carried out. Who should decide what is 'best treatment' and when a successful experimental intervention should be provided routinely? Some argue that provision of health care is ultimately the responsibility of national governments.

Collateral healthcare benefits arising as a by-product of conducting a trial need to assessed carefully to ensure that they do not adversely affect the local research environment, amount to coercive or undue influence to participants, and should be of a standard that can be sustained after the research is over.

The Wellcome Trust is today launching a position statement and guidance notes for researchers for all Trust-funded research involving people in developing countries. These will be introduced and discussed.