 Good afternoon everybody and thank you for joining. In fact, I'm not going to be quite as broad as Brian suggests because Oxford's global health tropical medicine interests are, as you probably worked out by now, pretty vast and I don't think there's anybody that knows everything about or even what they all are. So I'm going to focus on the Oxford Tropical Medicine Overseas Units. So these are based out of the Centre for Tropical Medicine and Global Health in the NDM and we have, this is all from their website actually, our store, we have three overseas units, all supported by the welcome cluster. We've got the Thailand unit where I'm based the Vietnam unit and the Kenya unit and I'm going to give just a brief overview of each of those. You'll also see there is an Oxford Centre for Global Health Research. Over the years, quite a lot of people have come largely come back from the tropics, some have joined straight from other other places in Europe, but mainly coming back from the tropics, senior investigators and have set up their own groups in Oxford. So there is now quite a critical mass of tropical medicine researchers within the Centre for Tropical Medicine and Global Health based in Oxford. But most of us are based overseas at one of the three overseas units. So you can see here we've got these are numbers from the website. I have no idea how accurate they are. 72 points from investigators, 220 Oxford Employees Star. I think about two-thirds to three-quarters of those are actually based overseas. A lot of local stuff, local national scientists and often of a senior positions and laboratory and field staff, two thousand of those. And this is all we, Oxford, obviously has to raise funds to, we have to raise funds to be able to do this research and so that's where the 340 million pound of research portfolio, I think that's just a snapshot. And one of the major, one of our major aims is to train, to train locally, to train internationally. And so we all have a lot of PhD students. And of course, of course, to raise the funds we have to produce publications and probably more important publications is impact, impact on health. That's certainly what the World Contrast wants. So, and just to remind you, there are of course major tropical health, tropical medicine, global health interests outside of CTMGH. In the GenF, for example, in the National Department of Population Health, Department of Pediatrics, elsewhere in the Medical Sciences Division and in fact in social sciences and other divisions in the University. So this is just our bit. And our bit in the MDM, the National Department of Medicine, started with this chap on the left. I think most tropical medicine in Oxford started with him. This is Sir David, Professor Sir David Weatherall, who was the Northfield Professor of Medicine in Oxford. When I was a clinical student there, and he then went on to become Reedus Professor and sadly died just a few years ago. He's here, he's on a rice bar to the Chow Chire River. I think this photo originally comes from David Warrell, who's on our speaker list today. And David Weatherall is with Peter Williams, who then was the Director of the World Contrast. And this is in 1979 and later that year. This unit, which where I work, which was the founding director of David Warrell, was started the Morrow, we call it. Madeleine Oxford Tropical Medicine Research Unit. So this is one of three units. But the units aren't just one unit, they're all a network. So here we have an old photo of our, I think around about 1980, with David Warrell smiling in the back there, his wife, Mary, talking about our senior tie collaborators, because wherever we work in the tropics, the most important thing is having excellent collaborators. And having a key collaborator will lead to the success of the project in, I think, most people's experience. You've also got Nick White there, who was the second Director of the unit. That was a while ago. It's grown since then. And all the tropical medicine interests of Oxford have grown organically over the years, whether they've been in Oxford or in the tropics. And so we started in Thailand, spread from Bangkok, within Thailand to the Taimianma border, to the northeast Thailand near the Cambodian Laos borders. And then also started the units where I first got involved in Vietnam, in Ho Chi Minh City. So that was a sort of daughter unit or part of the network of Moru, but has long since been its own unit. So it's now a sister unit, run by Professor Guy Thwaites. He's the Director there. There's a separate unit now. Then there's a unit in Laos, Long Ru, in Bangladesh, in Chittagong, in Cambodia, Khon Ru. We also have a unit in Kinshasa, where we study chart and severe and uncomplicated malaria in African children, and also malaria in pregnancy. And then we, for the last few years, have had a unit in Myanmar, which is still working, still doing work, mainly humanitarian work, despite the disasters that have happened in that country following the coup back in April. Most recently, we opened a little unit in Chiang Rai up in the north of Thailand, near the Golden Triangle. So that's the sort of thing which happens. And we have lots of collaborators. Everything is collaborative with local collaborators, international collaborators. And so these are the places where we work at any one time. This is a snapshot from actually from pretty much the end of last year. And some of our, all the units have got involved in COVID research, of course, and some of our COVID sites are not on there. But you see, most of our clinical study sites are collaborative. And we work closely with the salmon pink blobs, which are the main Vietnam unit sites. I won't bore you with this, just to show that we're very international. We've got 35 nationalities at the last count amongst our 800 staff. We've got about 68 postgraduate students at present in the Mora network, mainly PhD students and DFL students. And the main thing that we do is clinical investigation, clinical research, clinical trials. And you can see here that we've got lots of quite large trials going. And that's what we've been doing mainly over the past 40 years since the founding of the unit. And there on the left, you can see the sort of mix of publications, you know, the subjects, the publications that we produce. And in our unit, in the Mora network, we tend to focus on rural health rather than urban health. We do do some of that, but many rural health, that's particularly important in Southeast Asia where you have these large areas of upland Southeast Asia, which are quite mountainous, all trying to live access to former health care systems, which is very restricted. And they don't really often don't understand illness and their health-seeking behaviour is very, very different. And getting to the sites is very difficult too. This in the bottom left is in Myanmar, going to one site. It took 15 days trek to get to the study sites that we supply the workers there. And this upland area has been termed Zomir by one writer. It's quite a nice word, so we use it as a descriptive. So what research do we do? The main thing we do is see what the problems are. Many infectious diseases, not solely. What are the problems, afflicting the populations, mainly poor rural populations, where we end up doing epidemiology and diagnostics. Very ingenious, a major problem in the developing world. We do pathophysiology and pathobiology studies. And we try and improve patient care through community health, trying to work out better ways to look after the critically ill ICU in resource limited settings. There's a lot of work on that. And improving treatment, which can be pharmacology, pharmacokinetic studies, and clinical trials of course of new treatments. There's quite a big program on maternal and child health. And just because it's been such a big thing for us over the past 40 years, we have a theme of malaria elimination as a theme all to itself. And all of the units, Kenya, Vietnam, and Thailand, use this multi-central approach when doing clinical trials. And in fact, doing lots of observation studies as well. Because you can increase the power, you can increase the generalizability of the results, the geographical reach of your research, and if you're powerful enough, you can uncover heterogeneity and treatment effects and disease manifestations. Just a couple of examples of the power of multi-center studies, where it's two trials with one example. This is, the first one is the sequel math study, which is a trial to, which we did nearly 20, started nearly 20 years ago now, well 15 years ago now, comparing artesionate with the usual quinine per entry for the treatment of severe malaria. And this was done in four Asian countries, 11 sites, and mainly in adults. And we found that with artesionate, there was a 35% relative production in mortality. So this Chinese drug, quite a remarkable drug, was incredibly effective, reduced mortality, reduced the mortality from this devastation disease. It wasn't clear whether this would also work for African kids. African kids are the main sufferers in terms of total burden from severe malaria. That's still the heartland of malaria in Africa. So the study was repeated in the Aquamats study in Africa, in African children, and a similar result, 23% relative reduction in mortality. So that then led to a change in the treatment guidelines 10 years ago. And that in turn, these are our estimates, this is from the medicines from an area venture. That change in treatment has already saved nearly a million lives in terms of the death prevented by that change in recommendation. And actually, then of course, lots of other huge, huge programmatic effort was put into deploying artesionate rather than clinic. So that's just an example of impacts in this. Examples from Vietnam and Kenya as well. In Vietnam, they did very large, the largest ever TV meningitis studies. And in Kenya, there are multiple very large multi-center studies, including the Feast study, which you may have heard of, which showed that giving boluses to very sick kids was deneterious and causing increase in mortality. So kids with severe malaria or sepsis, unknown after physiology, we don't know why that happens. So moving, first of all, Eastwoods to the Vietnam unit, as I say now, a separate unit run by Guy Thwaites. Guy Thwaites is currently on an island off the coast of Vietnam celebrating his wife's birthday. So can't be with us today, but he's given me these some slides. So we'll create them soon for that. It's again a multi-center program. There are four main units, one in Ho Chi Minh City, one in Hanoi, one in Nepal, and one in Jakarta. Obviously, Indonesia is a huge population, very important place to do medical research. And that's a very nice mission statement from him. Our vision is to have a local regional, global impact on health by leaving a locally driven research program on infectious diseases in Southeast Asia. And apart from the Southeast Asia bit, that could probably apply to all of us. So this is just a little bit of history and also showing you what, how the science has developed. It's all organic as we talked about with the Thailand unit. So we've got Debbie Waller who's a GP in Beaumont Street and came out and ran the unit for the first year there with Nick White and Professor He-in, a remarkable man, key to have a local collaborator who wants to have the same vision. And you can see we started working on malaria, tetanus plague, and typhoid, and then dengue, and then brain infections. I was particularly interested of Jeremy Farrah who took over as director in 1996. And he started the work on TB meningitis and then worked on avian influenza and did similar work on that. So you can then AMR and also someone health work and lots of different methodologies that we have to develop and have in-house or have really good collaborators. The in-house research methods that are there in Oxford University Clinical Research Unit is what the Vietnam unit is called, at least that's what it's called in Vietnam. It's called EOCRU for Eitman Oxford Clinical Research Unit in Indonesia. So the traditional stuff we do, this is Guy's approaches is his nice graphic, is clinical research using randomized controlled trance. How do we get sick patients well? And we need laboratory support. Although most of our laboratory workers, which can be quite sophisticated in terms of sequencing, immunology, etc., is done to support the clinical research. That can help you work out what the pathways to health could be, what pathogenesis diseases, how you can interrupt it, how you can improve health. And then in Vietnam they go to the community and involve the whole community. So this community health program, epidemiology, modeling, genomics, public engagement, health economics and social science and that feeds into the research in hospitals as well. So research at community level, hospital level and laboratory level. And then how to get impact influence is you work nationally and internationally with governments and with WHO and other organizations as we're trying to translate your research findings into impact on health. These are the diseases that the Vietnam unit is currently working on. So we've got TB, malaria and dengue, probably the three big ones at the moment and you can see the rest there as well. And of course everybody is doing COVID-19 and I'm not going to talk about that because you've probably had an enormous amount of that over the last couple of years. And we need to get funding, try to get personal funding for our young scientists and welcome fellowships. Obviously publications are important and you can see here that the Vietnam unit guy and the rest of the team there have produced some high impacts. Publications over the last five years, lots of PhD students, mainly probably almost all of these are our local PhD students. We do have a few, both in Thailand and Vietnam, a few more in Thailand of international PhD students as well. And impact, getting impact, this sitting on such advisory boards, et cetera, it's very important. So there we go. And I stole this from David Worrell. This is him in Ho Chi Minh City in 2004, I believe, milking in Malayan crates of Venom. And you can see Jeremy Farrer is not particularly impressed by that or is rather very impressed but slightly worried. And I think that's Dr. Vinh there. Anyway, so moving westwards to East Africa. And our next speaker in fact is going to be Philip Bijon, who, Professor Philip Bijon is the director of the Camry Welcome Trust program, which is like the other programs, institutionally linked to Oxford. So he's intended a bit more about their work on malaria in the next talk. Just describe where their sites are. Again, we've got this hub and spoke topology, which we have in most of the Oxford tropical units and their networks. You've got three main hubs in Califi on the coast, where there are amazing state-of-the-art laboratories and other facilities adjacent to a provincial hospital. I believe it's a provincial hospital. And I think that the Camry Welcome unit started about two years before the Vietnam unit. So the Vietnam unit started in 91. I think it was about 89 and got going in earnest around about 91. And there's also a hub in Nairobi and where a lot of international work and population health modeling, that sort of thing, health economics, pragmatic clinical research, implementation science. And in Uganda, there's a lot of swim there and kids there. And clinical research happens in Mbali, where there's high transmission and a very good team of clinical researchers to collaborate with. And of course, there's other places as well, not just in Kenya, Uganda. They have collaborating centers in Tanzania and Ethiopia too. These are the research themes for the Camry unit. Vaccinology, genomics and transmission of pathogens, population health, health systems research, research into ethics, and of course, clinical research. They have a demographic surveillance system around Kalefi for the population health side and lots of other parts of the research. Fantastic labs, as I say, with fantastic staff. It's a nice picture of somebody standing on a chair, hopefully safely taking that photo. And the clinical research, these big multi-center studies into fluids, the Fuse study, there's been also a study on blood transfusion, which has been seminal two, and on oxygen, how much oxygen, look at that, look at that way of giving oxygen to these babies. It doesn't do any good above a certain threshold. Nutrition, anti-malarial, still a lot of work on malaria and antibiotics. All three of these units, Kenya, Vietnam and Thailand, work closely together. They collaborate on lots of studies. So a lot of our studies, we do with which we have African sites, we do with Philip and his team as well. So just some highlights for the Camry Wellcome Trust research program. Number one, Philip's going to talk about in the next talk, 115 years of malaria day from Africa. And then in the, I think it's the fourth talk, three o'clock, Adrian Hill, Professor Adrian Hill will talk about the amazing vaccinology work that he's done with the Philip and the team in the Camry Wellcome unit on Ebola, Rift Valley Fever and of course malaria. There's the, I've mentioned the FEE study, critical care, Kathmandu is the main PI on those studies. And number four, the largest cohort of human malaria challenge to determine mechanisms of immunity. This is where healthy volunteers, you give them malaria and you follow them closely and then you treat them. It's a very, it's quite a major undertaking, especially to do in an endemic setting, like on the coast of Kenya, but very, very valuable in terms of the information you can gain. So that's the, at the end of the introduction to the three overseas tropical units. So I couldn't cover more. You may have noticed that the final speaker on our list today is Professor Sassi Moranu. And she has recorded her talk, but sadly she can't be with us today because her father has just passed away just on Tuesday night. And I'd like to just mention a tribute to Malcolm Moranu who worked at the Liverpool School of Tropical Medicine and spent 30 years of his life in Malawi, setting up the Welcome Trust Malawi Liverpool unit. And also helping set up the University of Malawi College of Medicine, first medical school in Malawi. An amazing clinical investigator and an amazing man as well. He also was the co-inventor of the Blantyre Coma Store, and sadly he died on Tuesday night, and we've all been missing very much.