The Wellcome Trust is the UK's largest independent funder of medical research. Its work is as diverse as the interests of its founder, the pharmacist, entrepreneur, philanthropist, and collector Henry Wellcome. The charity has a broad national and international scientific portfolio, a strong medical humanities division, and is a well-known champion of the public's engagement with science and open-access publishing. All its many activities are backed by hefty funding, which is now set to increase still further.
Thanks to the success of the Trust's investments (which avoid tobacco companies), last week the organisation announced a boost in spending for biomedical research of £4 billion over the next 5 years—an increase of 60%. The 72-year-old charity is already the world's second-largest research foundation after the Bill & Melinda Gates Foundation, a fact that has enabled the UK's scientific output to compete on a world stage. But compared with the attention and publicity the Gates Foundation receives, the Wellcome Trust, and its contribution to global medical research and human health, is under-recognised and under-valued.
This situation is surprising in view of the Trust's admirable track-record of achievements. In the 1990s, Wellcome Trust scientists in southeast Asia developed and tested the antimalarial artemisinin—a major milestone in malaria research. In basic research, the charity's contribution to the Human Genome Project has been substantial; the Wellcome Trust Sanger Institute in Cambridge sequenced around a third of the human genome. The Trust's money has also been behind practice-changing clinical work, such as the development of a rapid, cheap, and effective test for chlamydia and cognitive behaviour therapy for bulimia nervosa.
Such achievements are only set to increase with the new funding boom. Although detailed information on how the new money will be spent is not yet available, the Trust's yearly spend will now be £650 million (up from around £500 million), while a one-off spend of £500 million has been earmarked for large-scale biomedical science projects. The Trust will invest some of this money into large genetic studies, such as the Wellcome Trust Case Control Consortium study of genetic effects on common diseases published in Nature last year. Research in neuroscience and mental illness is also set to benefit. And, in global health, the Trust will plough funds into strengthening research capacity in Africa to address complex public-health problems such as malaria and mother-to-child transmission of HIV.
The Trust hopes to ramp up research capacity in Africa by strengthening African universities and institutions. Funding will be awarded to health-research partnerships between African institutions and between African research bodies and institutions in developed countries. This initiative is an important addition to the Trust's work abroad. The charity has provided long-standing support (around £50 million every year) for overseas programmes in sub-Saharan Africa and southeast Asia that focus on major infectious diseases and public-health issues in those regions. These programmes have contributed a great deal to clinical tropical medicine and deserve praise.
The Trust's biggest beneficiary, however, remains the UK, where it spends around 90% of its money. And the bread and butter of the Trust's investments here are in laboratory-based research. The Trust aims to ensure “that the single biggest element of our total funding is used to support basic, curiosity-driven, investigator-led research and career initiatives—recognising that this underpins future discovery and application”. Although this strategy has produced some impressive pieces of science, investment is also needed in a strong clinical programme of work to make more rapid improvements to human health. In the UK, the Wellcome Trust only spends around 3·4% of its research budget on diagnosis of disease and treatment evaluation combined, 0·2% on other disease management, and 0·5% on health-services research, according to a 2006 analysis
To its credit the Trust does recognise this gap. In the organisation's Strategic Plan2005—2010: Making a difference
, the need to increase support for clinical research both overseas and in the UK is listed as an objective. However, what the plan acknowledges less is the need to also increase international collaborations. Collaborative research is one important way to drive innovation. The Wellcome Trust is in a prime position to accelerate progress in science and health research through increasing its worldwide partnerships. By doing so it will be able to have a more immediate effect on the wellbeing of populations in developed and developing countries and truly make a difference to the health of this, as well as future, generations.