An integrated approach to tackling drug resistance in livestock trypanosomes.

Lead Research Organisation: University of Glasgow
Department Name: College of Medical, Veterinary &Life Sci

Abstract

Drug resistance is an increasing problem for many diseases worldwide. Trypanosomes are tsetse-fly transmitted single-celled organisms that cause serious disease in cattle - African Animal Trypanosomiasis (AAT), mainly in sub-Saharan Africa, where approximately 60 million cattle are at risk and AAT kills 3 million each year. The main measure farmers have to combat AAT is drug treatment, but we only have two main drugs, both of which are >50 years old and widely used. Resistance to these drugs is increasingly reported, and there are very few drugs in the development pipeline, meaning the current control methods have very doubtful sustainability. Despite being such a significant issue, we know very little about how trypanosomes resist the effect of the drug, and how AAT drug resistance emerges and spreads. Therefore we are limited in our ability to deploy informed strategies to mitigate the problem.

This project aims to generate data and resources to bridge these knowledge gaps. The applicants have been working in an area in Northern Tanzania since 2011. Recently farmers have been reporting drug treatment failure and the need to use increasing amounts of the prophylactic drug Isometamidium chloride (ISM) more frequently, suggesting emerging resistance.We already have samples from 5,000 cattle and 10,000 tsetse flies, as well as information on farmer drug use, from a cohort of farms in the area sampled between 2011 and 2017. Additionally, we have developed resources and capabilities for working on the relevant trypanosome species, Trypanosoma congolense, in the laboratory (most information derives from the human-infective Trypanosoma brucei, but it is increasingly apparent that these are very distinct organisms). This platform of preliminary data and resources will be used to answer our central hypothesis, that the management of animal trypanosomiasis in Tanzania is threatened by an emerging failure of ISM to provide adequate prophylaxis.

To test this hypothesis, we will address four main research questions: (i) what are the likely mechanisms by which resistance to ISM occurs and can we identify a marker?; (ii) what are the extent and cause of ISM failure?; (iii) what are the epidemiological consequences of ISM failure?; and (iv) how might resistance to trypanocides, including new drugs, be prevented? To achieve this we will: (1) identify ISM resistance mechanisms by generating resistant parasites in the laboratory and comparing resistant and susceptible parasites using biochemical, molecular and genomic analysis; (2) collect field data in the same area in order to assess drug use and drug quality, isolate drug resistant parasites, and assess the epidemiology of drug use and drug resistance in the field; (3) using data combined from the laboratory and the field, generate a mathematical model whose parameters are informed by both the laboratory and field data, allowing us to accurately assess how resistance emerges and spreads in AAT in the field; and (4) apply the model and predict scenarios that will inform on the selection and spread of resistance for a new trypanocidal compound in development by our industrial partners, GALVmed.

The outputs of this project would provide unprecedented and detailed insight into the epidemiology of AAT drug resistance, uncover mechanisms of drug resistance in the disease-relevant trypanosome species (including potential markers), and will develop the first application of mathematical modelling, importantly using accurate parameters, to provide insights into the dynamics of AAT drug resistance emergence and spread. As well as providing novel insights, the outputs have the potential to inform drug development and drug usage, by identifying strategies that will have the best chances of mitigating resistance, and therefore maximising the lifetime of both existing and novel drugs.

Technical Summary

African Animal Trypanosomiasis (AAT), caused by tsetse-transmitted Trypanosoma congolense and T. vivax, is a major constraint on sub-Saharan African agriculture and food security. Control relies on the use of two main drugs, Isometamidium chloride (ISM - prophylactic) and Diminazene aceturate (DZ - therapeutic), both introduced over 50 years ago. ISM treatment failure is increasing across Africa, raising serious concerns about the sustainability of future AAT control. There is one therapeutic class currently in development, the benzoxaboroles (GALVmed/Boehringer Ingelheim; Galvmed are industrial partners on this proposal). Despite the reliance on these drugs in AAT, the understanding of drug failures, resistance mechanisms and epidemiology are poor, making it difficult to develop evidence-based mitigation strategies. This multidisciplinary project will use field, laboratory and modelling studies to test the overarching hypothesis that management of animal and human trypanosomiasis is threatened by an emerging failure of ISM to provide adequate treatment and prophylaxis. ISM resistance mechanisms and markers will be investigated through comparative biochemical, molecular and genomic analyses of resistant and susceptible Trypanosoma congolense, whilst relative fitness in hosts and vectors will be assessed. Field data will be collected to quantify trypanocide usage and effectiveness, assess resistance, isolate resistant T. congolense and measure epidemiological parameters. Resistance and spread will be investigated in silico with an AAT resistance model parameterised with field and experimental data on epidemiology and transmission of resistant and susceptible T. congolense. Finally, these findings will be extended to explore resistance in the benzoxaboroles. This is an opportunity for a step change in understanding AAT resistance, and will lead to development of strategies to maximise the useful lifetime of ISM, as well as new trypanocides such as the benzoxaboroles.

Planned Impact

This project will fill important knowledge gaps that are currently limiting the development of sustainable control strategies for animal African trypanosomiasis (AAT). Elucidating the mechanisms of T. congolense resistance to isometamidium chloride (ISM), identifying a marker for diagnosis, and crucially better understanding the emergence and spread of resistance, as proposed in this study, are essential steps towards effective and sustainable control, including optimal use of novel drugs. We anticipate this project will enable and contribute to wider discussions on sustainable use of drugs in AAT control and help to drive this as a priority. Hence, the economic and societal impacts from this work include:

(1) Impact on disease control policies for sustainable use of trypanocides, leading to impacts on livestock farming in developing countries through reducing detrimental effects of resistance emergence.
Ultimate beneficiaries of the project are subsistence farmers in sub-Saharan Africa, who are finding that current AAT treatments are no longer working, threatening their livelihoods and food security. Approximately 50 million cattle, plus millions of other livestock, are at risk of AAT in tsetse-infected across an area of ~10M km2. AAT impacts include reduced milk yields, meat production, fertility, and draught power as well as mortality, and are estimated to cost billions (US$) to the region annually - estimated at $2.5 billion to Eastern Africa alone. The disease severely impacts sub-Saharan regions where livestock rearing is the main livelihood of small communities, including many countries on the DAC list of least developed countries. Tanzania has the third largest livestock population in Africa, and a high proportion of poor livestock keepers, with >4 million cattle threatened by trypanosomiasis.
Livestock keepers currently use 35-70 million doses of trypanocides annually. Two primary options exist for treatment of AAT: Isometamidium chloride and Diminazene aceturate . Both drugs are >50 years old and reported resistance to them is widespread. Outputs from this project will provide local (veterinary services), national (Ministry of Agriculture, Livestock and Fisheries), global (AU-PATTEC, FAO) and donor (GALVmed, DFID, BMGF) organisations with evidence to back up decision-making on sustainable use of drugs in AAT control. This project was co-constructed with local veterinary services and livestock keepers in Serengeti District, and national decision-makers in Tanzania, who have identified effective and sustainable trypanocide use as a particular concern. The same trypanocide drugs used for AAT are also used to reduce T. brucei circulation in cattle, which can be reservoirs for human African trypanosomiasis. Sustainable use of these drugs therefore has added benefits in prevention of human disease.

(2) Impact upon academic and industry AAT drug discovery and development programmes.
We know very little about how resistance emerges and spreads in livestock trypanosomes. This project will significantly advance this knowledge, both in terms of characterising mechanisms and rate of resistance emergence to ISM, and furthering our very scanty knowledge of the epidemiology of resistance in the field. The development of a mathematical model, that is developed and based on reliable data, will both inform on the dynamics of resistance and spread of ISM, and importantly be applicable to predicting resistance emergence and spread for novel trypanocides (such as the candidate compound currently under development by project partners GALVmed) - this output is a critical gap in knowledge and capability at present, which would be able to inform strategies to minimise resistance emergence and spread, and maximise the lifetime of both ISM and novel trypanocides. The applicants have links with relevant academic, industrial and policy stakeholders to enable dissemination and uptake of results in order to translate impact to farmers.

Publications

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Rao SPS (2019) Drug Discovery for Kinetoplastid Diseases: Future Directions. in ACS infectious diseases

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Mitchell SN (2022) FAIR data pipeline: provenance-driven data management for traceable scientific workflows. in Philosophical transactions. Series A, Mathematical, physical, and engineering sciences

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Dickie EA (2020) New Drugs for Human African Trypanosomiasis: A Twenty First Century Success Story. in Tropical medicine and infectious disease

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Barrett MP (2019) Protozoan persister-like cells and drug treatment failure. in Nature reviews. Microbiology

 
Description So far we have demonstrated that a gene, the drug and metabolite gene, when over-expressed makes Trypanosoma congoelense hypersensitive to isometamidium indicating that loss of this gene might be responsible for resistance. We have also shown that loss of CBP1 serine carboxypeptidase genes that encode an enzyme that activates benzoxaborole pro-drugs causes reisstance to these drugs. Furthermore, other resistant lines show that the drug's targeted CPSF3 over-expression can also cause resistance.

We have also developed a method that allows for the detection of counterfeit versions of the key trypanocidal drugs dimazene and isometamidium with a simple, portable device.

Modelling progress: We have developed models of the transmission of trypanosomiasis among populations of cattle and wildlife. The models capture cattle treatment with trypanocides (both prophylactic and on diagnosis) as well insecticide treatment of a proportion of cattle. The models allow the spread of multiple strains to capture the dynamics of drug susceptible and drug resistant strain. The models capture the fitness impacts of resistance and the quantify the risks of emergence of resistance in response to a range of combinations of treatment and insecticide usage options. Currently we are exploring optimal strategies for effective treatment whilst limiting the risk of emergence.
Exploitation Route Boerhinger Ingelheim and other pharmaceutical companies that are developing benzoxaborole drugs and can take resistance development into consideration. Others involved in cattle farming in Africa can also consider diagnostic tests for resistance to trypanocidal drugs. The electrochemical device developed in conjunction with Eluceda, subject to further development, may enable animal health professionals to ascertain the quality of trypanocidal drugs on the market across regions where these drugs are used.
Sectors Agriculture, Food and Drink,Pharmaceuticals and Medical Biotechnology

 
Description Finding genes responsible for drug resistant in veterinary trypanosomiasis leads the way towards developing tests for resistance. Publication of a significant article (doi: 10.1371/journal.ppat.1008932) that demonstrates the selection of resistance to new benzoxaborole trypanocides and the genes involved offers new routes to testing for the emergence and spread of resistance. Other partners with separate related Researchfish returns (Liam Morrison and Harriet Authy) have also generated key datasets reported in their own sections. Modelling progress: We have developed models of the transmission of trypanosomiasis among populations of cattle and wildlife. The models capture cattle treatment with trypanocides (both prophylactic and on diagnosis) as well insecticide treatment of a proportion of cattle. The models allow the spread of multiple strains to capture the dynamics of drug susceptible and drug resistant strain. The models capture the fitness impacts of resistance and the quantify the risks of emergence of resistance in response to a range of combinations of treatment and insecticide usage options. Currently we are exploring optimal strategies for effective treatment whilst limiting the risk of emergence. Our development in conjuncition with Eluceda of novel devices to detect and validate the quality of trypanocidal drugs we hope, will enable widespread assessment of the problem of counterfeit and substandard drug formulations in Africa
First Year Of Impact 2021
Sector Agriculture, Food and Drink,Pharmaceuticals and Medical Biotechnology
Impact Types Economic,Policy & public services

 
Description Drugs for Neglected Diseases initiative advisory board for use of fexinidazole in Rhodesiense HAT
Geographic Reach Africa 
Policy Influence Type Membership of a guideline committee
Impact The clinical trials being conducted by DNDi for use of fexinidazole in Rhodesiense HAT are already impacting on populations in Malawi and Uganda. Increased surveillance for the disease to include patients in trials is already increasing the numbers of infected people diagnosed. The drug is proving safe and effective and thus already curing in the clinical trials and it is to be hoped that upon licensing a new safe oral drug to cure the disease (replacing the very toxin melarsoprol) will improve treatment options
URL https://dndi.org/research-development/portfolio/fexinidazole-tb-rhodesiense/
 
Description Food and Agriculture Organisation of the United Nations (FAO) - Advisory committee on rolling out a Progressive Control Pathway for Animal African trypanosomiasis
Geographic Reach Africa 
Policy Influence Type Membership of a guideline committee
Impact Working towards a progressive control pathway for animal African trypanosomiasis (AAT) brings with it improvements to the welfare and health of livestock animals (primarily cattle) in Africa
URL http://www.fao.org/3/i7587e/i7587e.pdf
 
Description Metabolism and drug resistance probed with new genetic tools in the neglected animal pathogen Trypanosoma vivax
Amount £351,337 (GBP)
Funding ID BB/W000431/1 
Organisation Biotechnology and Biological Sciences Research Council (BBSRC) 
Sector Public
Country United Kingdom
Start 03/2022 
End 02/2025
 
Description Repurposing trypanocidal drugs to tackle amoebic gill disease in Atlantic Salmon
Amount £555,163 (GBP)
Funding ID BB/T016280/1 
Organisation Biotechnology and Biological Sciences Research Council (BBSRC) 
Sector Public
Country United Kingdom
Start 03/2021 
End 02/2024
 
Description Eluceda new devices to detect counterfeit trypanocidal drugs 
Organisation Eluceda Ltd
Country United Kingdom 
Sector Private 
PI Contribution This collaboration aims to develop new electronic devices to distinguish real and counterfeit trypanocidal drugs. Since berenil (diminazene) and isometamidium carry positive charges they can be detected electrochemically using Eluceda's detection devices. We have been providing drug to optimise conditions and also blinded samples, and field samples, to determine efficacy of the device.
Collaborator Contribution Eluceda has established conditions that are capable of the quantitative detection of trypanocidal drugs berenil (diminazene) and isometamidium. They have developed the tests and confirmed their utility using samples we have provided.
Impact Multidisciplinary, multisectorial. Eluceda is a private company. A prototypical device capable of quantitative detection of berenil (diminazene) and isometamidium has been created.
Start Year 2021
 
Description GalvMed Boerhinger Ingelheim development of benzoxaboroles for animal African trypanosomiasis 
Organisation Boehringer Ingelheim
Country Germany 
Sector Private 
PI Contribution We have continued working on mode of action and resistance mechanisms of the benzoxaboroles considered for clinical veterinary development by BI.
Collaborator Contribution We identified a serine carboxypeptidase involved in activating prodrugs in T. brucei and T. congolense. The compounds target the CPSF3 protein. Resistance emerges either when the peptidase genes are lost, or else when the target (CPSF3) gene copy number is increased.
Impact Drug under development.
Start Year 2019
 
Description Glasgow Roslin institute collaboration 
Organisation University of Edinburgh
Department The Roslin Institute
Country United Kingdom 
Sector Academic/University 
PI Contribution We have a strong collaboration with Roslin generating new culture media and selecting lines of parasite resistant to drugs in vitro. We are selecting lines in mice. We perform metabolomics analysis for the Roslin group. We are also (Professor Louise Matthews) generating mathematical models of disease. THe project also involves Dr Harriet Auty collecting filed isolates from Tanzania. We will assess these for genotype and drug resistance
Collaborator Contribution Roslin institute have created drug resistant lines and sent cellular extracts and medium for metabolome analysis
Impact Isometamidium resistant T. congolense selected in vitro and genome sequenced Isometamidium resistant T. congolense selected in vivo Benzoxaborole AN11736 resistant T. congolense selected in vitro. Drug resistance gene (TcoCBP1) discovered. Also for T. brucei Other Benzoxaborole resistant lines selected.
Start Year 2019
 
Description Hariet Authy & Shauna Richards 
Organisation University of Glasgow
Country United Kingdom 
Sector Academic/University 
PI Contribution We provide support in helping identify and diagnose trypanosomes in the field. Also in assessing quality of drugs brought back from the field and input into likely resistance risk and mechanisms to various drugs
Collaborator Contribution Hariet and Shauna work in Tanzania. They are collecting drug samples for us to test authenticity. They are collecting data on prevalence and species of trypanosome causing disease in Africa, as well as information on drug treatment which will go into building models of epidemiology of disease.
Impact Hariet and Shuana have brought numerous samples of isometamidium and diminazene back to the UK from Tanzania and these will be tested for authenticty using LCMS and also used to evaluate the Eluceda device
Start Year 2019
 
Description Lecture on the Scottish Encounter with Tropical Disease to the University of the Third age in Helensburgh 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach Local
Primary Audience Public/other audiences
Results and Impact I gave a lecture outlining the role of Scottish investigators in discovering the agents of tropical diseases and was able to link to the current status of tropical infectious diseases in the world today related to important Scottish research in a global context.
Year(s) Of Engagement Activity 2020
 
Description Lecture to the Helensburgh University of the Third age on the Coronavirus pandemic 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach Local
Primary Audience Public/other audiences
Results and Impact I gave an overview of the coronavirus pandemic to the University of the third age in Helensburgh
Year(s) Of Engagement Activity 2020
 
Description Magazine article - About vaccination 
Form Of Engagement Activity A magazine, newsletter or online publication
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Public/other audiences
Results and Impact THis article discussed the problems of vaccine scepticism
Year(s) Of Engagement Activity 2018
URL https://www.newstatesman.com/politics/health/2018/05/how-fake-science-costing-lives-malign-rise-anti...
 
Description Magazine article about new variants of the SARS-Cov-2 coronavirus 
Form Of Engagement Activity A magazine, newsletter or online publication
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Public/other audiences
Results and Impact The New Statesman is a UK based weekly political and current affiars magazine with 36,000 subscribers and over 200,000 online subscribers. It is read by most UK politicians.
Year(s) Of Engagement Activity 2021
URL https://www.newstatesman.com/politics/health/2021/01/truth-about-new-covid-19-variants
 
Description Magazine article about the spread of coronavirus 
Form Of Engagement Activity A magazine, newsletter or online publication
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Public/other audiences
Results and Impact This article discussed the role of superpreaders in disease transmission. It is published in a major national magazine with international outreach
Year(s) Of Engagement Activity 2020
URL https://www.newstatesman.com/politics/health/2020/02/coronavirus-and-role-super-spreader
 
Description Magazine article about the success of new interventions against neglected tropical diseases 
Form Of Engagement Activity A magazine, newsletter or online publication
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Public/other audiences
Results and Impact THis magaaine article summarised the successes the 21st Century has had in developing new interventions against neglected tropical diseases
Year(s) Of Engagement Activity 2019
URL https://www.newstatesman.com/world/africa/2019/08/how-world-winning-fight-against-neglected-tropical...
 
Description Magazine article discussing the discovery of antibiotics and ethics of drug testing 
Form Of Engagement Activity A magazine, newsletter or online publication
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Public/other audiences
Results and Impact Article in high standing UK current affairs weekly magazine, sparked further media interest afterwards and great interest from among the magazines 36,000 subscribers (>200,000 online subscribers)
Year(s) Of Engagement Activity 2020
URL https://www.newstatesman.com/international/science-tech/2020/09/lesson-antibiotics-race-science-must...
 
Description Magazine article on coronavirus and human evolution 
Form Of Engagement Activity A magazine, newsletter or online publication
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Public/other audiences
Results and Impact This article in the New statesamn discused viral and human genetic evolution in light of the competition between host and pathogen in the context of the covid-19 causing coronavirus
Year(s) Of Engagement Activity 2020
URL https://www.newstatesman.com/science-tech/coronavirus/2020/03/what-makes-us-vulnerable-covid-19
 
Description Magazine article on coronavirus immunity 
Form Of Engagement Activity A magazine, newsletter or online publication
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Public/other audiences
Results and Impact Article in high standing UK current affairs weekly magazine, sparked further media interest afterwards and great interest from among the magazines 36,000 subscribers (>200,000 online subscribers)
Year(s) Of Engagement Activity 2020
URL https://www.newstatesman.com/science-tech/coronavirus/2020/04/can-you-catch-covid-19-twice
 
Description Magazine article on the 200th anniversary of the death of poet John Keats from tuberculosis and its link to Covid19 today 
Form Of Engagement Activity A magazine, newsletter or online publication
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Public/other audiences
Results and Impact The New Statesman is a UK based weekly current affairs and political magazine. It has 36,000 subscribers and over 200,000 on line readers. It is read by most UK politicians.
Year(s) Of Engagement Activity 2021
URL https://www.newstatesman.com/culture/books/2021/02/why-keats-s-haunting-reflections-tuberculosis-res...
 
Description Magazine article on the UK "Kent" coronavirus variant 
Form Of Engagement Activity A magazine, newsletter or online publication
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Public/other audiences
Results and Impact The New Statesman is a leading UK based, but internationally read weekly current affairs magazine read by most UK politicians. It has a subscriber based of 36,000 plus online subscription based of >200,000 readers
Year(s) Of Engagement Activity 2020
URL https://www.newstatesman.com/science-tech/coronavirus/2020/12/how-dangerous-new-covid-19-variant
 
Description Magazine article on the flawed concept of herd immunity for Covid19 
Form Of Engagement Activity A magazine, newsletter or online publication
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Public/other audiences
Results and Impact Article in high standing UK current affairs weekly magazine, sparked further media interest afterwards and great interest from among the magazines 36,000 subscribers (>200,000 online subscribers)
Year(s) Of Engagement Activity 2020
URL https://www.newstatesman.com/politics/health/2020/10/why-herd-immunity-not-option-uk-it-faces-covid-...
 
Description Public understanding of science lecture. The impact of Covid 19 on Neglected tropical diseases. St. Andrews Clinics for children (by Zoom) 25th Jan 2022 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach Regional
Primary Audience Supporters
Results and Impact In this talk I discussed the impact of the coronavirus pandemic in Africa and how it influences efforts aginst other diseases there, e.g. neglected tropical diseases. Fruitful discussion was had with members of the public that support a charity that funds chilldrens hospitals in Africa
Year(s) Of Engagement Activity 2022
 
Description School visit 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach Local
Primary Audience Schools
Results and Impact 55 pupils attended lecture on "One World - one health" a global perspective on the interface betwen disease of man, animals and the impact of the environment
Year(s) Of Engagement Activity 2019
 
Description Talk to Edinburgh University Veterinary students (UG and PG) 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach Local
Primary Audience Undergraduate students
Results and Impact The Edinburgh University "One Health" socieity invivted me to speak on "One world, one health" giving the global context to the interface between human, animal and environmental health
Year(s) Of Engagement Activity 2019
 
Description Talk to student socieity of "One Health" 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Undergraduate students
Results and Impact I spoke at the national student "One Health" symposium comprising around 100 veterinary students (and staff). The topic covered the interface between veterinary and human health in the context of environmental conditions. Lots of discussion and follow up from students developing interest in the area ensued.
Year(s) Of Engagement Activity 2019
URL https://www.facebook.com/events/university-of-glasgow-school-of-veterinary-medicine/3rd-annual-stude...
 
Description Times Radio interview on the meeting between Dr Livingstone and Henry Stanley in 10 Nov 1871 
Form Of Engagement Activity A press release, press conference or response to a media enquiry/interview
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Public/other audiences
Results and Impact I was interviewed by Times radio about the legacy of Dr Livingstone in medicine and exploration
Year(s) Of Engagement Activity 2020
URL https://www.thetimes.co.uk/radio
 
Description Times radio interview on the 200th anniversary of the death of John Keats and his descriptions of tuberculosis (23 Feb 2021) 
Form Of Engagement Activity A press release, press conference or response to a media enquiry/interview
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Public/other audiences
Results and Impact I was interviewed about the impact of John Keats (poet) and how the tuberculosis from which he died influenced his work, and also explained how TB continues to affect the world today
Year(s) Of Engagement Activity 2021
URL https://www.thetimes.co.uk/radio
 
Description Webinar - to New Statesman magazine readers 
Form Of Engagement Activity A broadcast e.g. TV/radio/film/podcast (other than news/press)
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Public/other audiences
Results and Impact A webinar hosted by the New Statesman alongside Dr Phil Whitaker and Laura Spinney discussing the Covid19 pandemic
Year(s) Of Engagement Activity 2020
URL https://www.newstatesman.com/2020/05/watch-new-statesman-webinar-pandemics-past-present-and-future
 
Description Webinar for business 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Industry/Business
Results and Impact I gave a series of five webinars in 2020 to Investec plc discussing the science behind the coronavirus pandemic
Year(s) Of Engagement Activity 2020
URL https://www.investec.com/en_gb/focus/economy/economic-webinar-replay-professor-michael-barrett.html