Medical Research Perspectives
Working with the Wellcome Trust
Bridget M Ogilvie
In June 1998, Dr Bridget Ogilvie retired as Director of the Wellcome Trust, the world's largest medical charity. The MJA invited Dr Ogilvie to tell us about her career (see "Speaking personally") and the work of the Trust.
MJA 1998; 169: 634-639
The Wellcome Trust was created in 1936 by the will of Sir Henry
Wellcome. Under the terms of the will, the entire share capital of his
pharmaceutical company, the Wellcome Foundation Ltd, was vested in
Trustees (now known as Governors) who are responsible for
distributing the income according to the wishes laid down in the will.
The guiding principle is that the Wellcome Trust should support
"scientific research which may conduce to the improvement of the
physical conditions of mankind".
The income grew slowly but surely and the pharmaceutical company remained a private company owned by the Trustees of Sir Henry Wellcome until 1986. By then, the company was doing particularly well, largely because of its invention of the antiherpes drug aciclovir. The Trustees decided the time had come to diversify their asset base and 25% of the equity was sold on the London stock market. The company, now known as Wellcome plc, continued to flourish, a further tranche of shares was sold in 1992, and in 1995 Glaxo bought the remaining shares in a cash + shares deal which resulted in the Wellcome Trust owning 4%-5% of the shares of Glaxo Wellcome plc.
By these sales of shares, the Wellcome Trust has become the largest endowed medical research charity in the world. In 1998, the Trust's asset base of about £10 billion enables it to spend about £350 million on medical research and allied subjects.
The Trust's investment base comprises more than 2000 investments in more than 30 countries. About £7 billion is managed externally by investment managers in London, Geneva, Hong Kong, New York and Baltimore. A further £3.5 billion is managed internally, mainly the continuing investment in Glaxo Wellcome plc, real estate investments in the UK and investments in private (unlisted) shares throughout the world. The Trust seeks income to support its spending programs, but also capital growth over the long term (ie, it is a "total return" investor). The only specific ethical restriction is the exclusion of investment in companies with major involvements in the tobacco industry. Investment decisions are taken entirely separately from the grant-making process.
Supporting scientists in their careers
The Wellcome Trust has functioned as a grant giving body for about 50
years -- before that it was engaged in sorting out the complications of
Sir Henry Wellcome's will. The Trust always funds scientists by
grants to support a defined research program. While the Trust devises
the various schemes through which it provides support, grants are
decided on the basis of competition guided by peer review. For the past
35 years and more, it has put great emphasis on career support schemes.
Its flagship career support scheme, the Wellcome Senior Clinical
Fellowships, was set up in the early 1960s to provide five-year
fellowships for medical graduates to devote themselves to research
free from the demands of clinical service.
As the Trust has grown in financial strength, it has put continual effort into devising schemes to support medical, basic science and veterinary graduates at all stages of their research careers. Recently it set up a number of four-year PhD training schemes for basic scientists in response to a request that PhD students should receive a broad grounding in research approaches before choosing their research project. All Wellcome Trust PhD students are expected to take part in communication courses during their studentship and the Trust also tries to monitor the quality of their supervision. The Trust helps people in all sorts of ways: for example, starting with the scientists who went to tropical countries to do research with Trust support, the Trust now provides individuals who win fellowships to work abroad with a guaranteed year back in the UK.
Funding innovative science
Once the Trust's income was stabilised by the initial sale of part of
its shareholding in Wellcome plc, it began to fund research on a larger
scale and through longer-term grants. Five-year program grants have
been awarded since 1986, and in the decade since then many longer-term
awards have been given and major centres have been established with
When funds for research become harder to obtain, there is a tendency to wish to spread the money as widely as possible by cutting the amount and the duration of grants. One admires this characteristic fair-minded habit of the academic community, but innovative science is more likely to be produced by individuals who are given time and the financial flexibility to try new approaches, many of which may fail. At the same time that funds for research have become harder to obtain, the cost of biological science has soared and the technological requirements at the cutting edge of research are continually changing. For these reasons, it is regrettably not sensible to give grants of more than about five years' duration. However, even when the Wellcome Trust was a relatively small organisation, it tried to ensure that an increasing percentage of the grants awarded were for more than three years and that all grants were fully funded (ie, were not reduced in an arbitrary way to spread funds around).
While the Trust's funds grew throughout my nearly 20 years on its staff, the most profound change followed the second sale of its shares in Wellcome plc in 1992, during my first year as Director. Overnight our budget went up from £90 million per annum to £200 million. This huge increase opened up the potential to completely change the way the Trust operated. Should the Trust establish its own fully funded research laboratories outside the University system? Should it open up its funds for competition by scientists outside the UK and Ireland? Should it work more closely with other national or even international funding bodies? It was an extraordinary and exhilarating time. In practice, the Trust has remained a grant-giving organisation, primarily funding via grants to the staff of UK universities. While it has set up major centres in the universities, these are not solely Trust funded.
Apart from its wide portfolio of career awards and project program grants, to which the Trust has devoted more than half its income, over the past decade the Trust has invested more than £200 million in new and refurbished buildings and equipment in the universities of the UK. It is widely recognised in Government as well as academic circles that without this investment by the Trust UK biomedical science would no longer be internationally competitive.
The Genome Centre
The major Trust initiative of the past five years has been the
establishment of the Wellcome Trust Genome Centre at Hinxton near
Cambridge, the Trust's only investment outside the university
system. This development began as a joint enterprise with the UK
Medical Research Council, building on its long-term investment in
its distinguished Laboratory for Molecular Biology.
A group at the Laboratory led by Dr John Sulston had developed expertise in genome sequencing through their project to establish the free-living nematode Caenorhabditis elegans as a model system for developmental biology and genetics of complex organisms. In 1992, it was felt that the time had come to apply their technology to the mammoth task of sequencing the human genome. This enterprise was established as a freestanding institute which has become known as the Sanger Centre, after the Nobel laureate Fred Sanger, whose technique is used in genome sequencing. The Sanger Centre now occupies a building built for its purposes at Hinxton village near Cambridge, where it has been joined by the Medical Research Council's Human Genome Mapping Project Resource Centre and the European Molecular Biology Laboratory's outstation (the European Bioinformatics Institute). These laboratories, together with a conference centre, make up the Wellcome Trust Genome Campus.
The Trust has already invested over £180 million in this complex and its research projects, which now include a major program of pathogen sequencing. One of the first fruits of this investment was the sequence of Mycobacterium tuberculosis, completed and released electronically in December 1997 and published in Nature in an annotated form in June 1998. Earlier this year, the Wellcome Trust's Governors committed the Trust to a further investment of more than £100 000 000 to speed up the sequencing of the human genome, which should be complete in about the year 2001, and additional funds have been made available to sequence the genomes of various pathogens which cause tropical diseases (eg, malaria, leishmaniasis and trypanosomiasis).
The Trust tries to strengthen research in areas of medical
importance. It takes many years to develop strength in neglected
areas. The Trust has had special research training programs in mental
health, clinical epidemiology, tropical and veterinary medicine
throughout my time there. More recently, biodiversity,
mathematical biology, bioinformatics, cardiovascular medicine
and clinical microbiology have been added to this list.
While the Trust has always had an international program (mainly in exchange fellowships and travel grants), this portfolio was extended when it agreed to award two five-year Senior Fellowships in Australia in 1984. This scheme, run in partnership with the Royal Australasian College of Physicians, was extended to New Zealand, South Africa and this year to India. The international portfolio has been enlarged in other ways, perhaps most significantly by the Trust's population initiative: a grant scheme to fund research into human demography and the global problems caused by population growth and change. This is the only Trust-funded scheme that is open to scientists with appropriate expertise from anywhere except the United States.
The Trust does not fund in the United States, as it has endowed a sister organisation, the Burroughs Wellcome Fund, to operate there under the auspices of Sir Henry Wellcome's will. The Governors of the Trust believe the Trust should operate primarily in the UK, but have decided that up to 15% of its funds should be used to support a variety of international programs, mainly in Europe and the tropics.
History of medicine and the public understanding of science
Apart from its activities funding scientific research, the Trust
spends about 4% of its funds supporting its Library of the History of
Medicine (which was part of Sir Henry Wellcome's legacy) and academic
activities associated with it. Over the past 10 years, a substantial
program of activities to promote public understanding of science and
studies in the social and ethical consequences of scientific advance
has been established. These include £16.5 million towards a new wing
at the Science Museum, which houses some of the original Wellcome
collections, grant giving activities, competitions for books on
science, the production of plays, and meetings and workshops.|
All funding bodies are keen to develop their policies in a thoughtful,
knowledgeable way and to ensure that outcomes of their grant giving
activities are known and applied to the public good. As The Wellcome
Trust now has over 3000 active grants at any one time, it is not an easy
matter to determine outcomes, especially when the main outcome,
publication, mostly occurs some years after a grant ends and new
knowledge may take years before it bears fruit in the form of better
medical care. In 1989 these considerations led the Trust to establish
its Policy Research in Science and Medicine Group (PRISM), with a
remit to devise ways to help policy development and assess outcomes.|
Relations with government
As the Trust grew to the same size in funding power as the national body,
the Medical Research Council, it became necessary to work more
closely with the UK government. This has mainly been through officer
to officer discussion with the staff of the relevant government
bodies. Apart from the initial joint grant to establish the Sanger
Centre and some small joint enterprises in public understanding of
science, the Trust has not made grants jointly with the research
councils. However, earlier this year, the Trust agreed to contribute
to a fund together with the government to support the early stages of
development of university research which has indications of
industrial value; and in July this year, the Trust agreed to become a
full partner with the government in establishing a £600 million fund
to which each will contribute £300 million. This money will be used to
upgrade UK university buildings and equipment infrastructure for
research. These decisions herald a much closer working relationship
between the Trust and the UK government in the future. |
Wellcome on the Web: www.wellcome.ac.uk
1 Park Square West, London NW1 4LJ, United Kingdom.
Bridget Ogilvie, DBE, DSc.
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Received 21 February 2019, accepted 21 February 2019
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