An insight into new directions in the control of TB, one of the "big three" infectious killers worldwide.

Diagnosing TB in the 21^st century: from bench to bedside to public health policy - Professor Ajit Lalvani

Professor Lalvani trained in internal medicine and infectious diseases in London, Cambridge, Oxford and Basel. After his D.Phil. as MRC Clinical Training Fellow at the Weatherall Institute of Molecular Medicine he became Clinical Lecturer in the Nuffield Department of Medicine, John Radcliffe Hospital and has been a Wellcome Senior Research Fellow and Consultant Physician since 2001. His research has shaped international TB control and provided insights into immunity against intracellular pathogens and the action of TB and malaria vaccines. The FDA-approved, NICE-endorsed interferon-gamma release assay (IGRA, ELISpot, T-SPOT.TB) which he invented and validated is the first advance in diagnosis of latent TB in 100 years and forms the basis of new guidelines for TB screening and prevention. Since his recruitment to Imperial in 2007, he founded and directs the Tuberculosis Research Unit, a world-leading multi-disciplinary research group that investigates ! a broad spectrum of fundamental questions in tuberculosis from immunology and microbiology to epidemiology, public health and policy.

Global progress in TB vaccine development - Dr. Helen McShane

Over the last 12 years Helen McShane's group has developed a new TB vaccine, called MVA85A, which is designed to enhance the protective immunity conferred by BCG. This strategy improves BCG induced protection in preclinical models. Since 2002 the group has conducted a series of Phase I and Phase IIa clinical trials with MVA85A in the UK, The Gambia, South Africa and Senegal. In all of these clinical trials we find that MVA85A is safe and highly immunogenic. In April 2009, a Phase IIb proof-of-concept efficacy trial commenced in South African infants. This clinical trial will allow evaluation of the protective efficacy of this strategy in humans, and is the first of the new generation of TB vaccines to enter into efficacy testing.

Asylum-seekers, unlike other migrants, do not have the choice to return to their countries of origin. They are a vulnerable group at high risk of having experienced torture, sexual abuse and psychological distress. In the UK they are at high risk of poverty and destitution.

There is growing concern that the UK government, in fear of “health tourism”, is restricting access to healthcare to asylum seekers, particularly those who have reached the end of the appeals pathway in their application process. But who are the people who really suffer when we restrict access to healthcare based on immigration status?

And what about those held in immigration removal centres, outside the radar of the NHS, with healthcare services being subcontracted out to profit-making companies? Can they hope to receive an adequate standard of care in detention? Who will be their advocate?

Come and listen to our panel explain the challenges facing the healthcare profession in caring for this desperately vulnerable population and offering their thoughts on solutions which will help us work towards equality in healthcare.

 Professor Cornelius Katona (Department of Mental Health Sciences, UCL) undertakes clinical work for the NHS and medicolegal work, including work with asylum seekers and detainees. He also works extensively within Medical Justice, the South East Regional Ethics Committee and DeNDRoN and as editor-in-chief of the Journal of Affective Disorders.

 Dr Mina Fazel (Clinical Lecturer in Child and Adolescent Psychiatry, University of Oxford) is a child psychiatrist who deals at first hand with the effects of detention on asylum seekers as young as five. Her research has appeared in the Lancet and the British Medical Journal. Her involvement with refugee children during and after their confinement in UK detention centres has left her a vocal advocate for a complete end to the detention system.

 Gabriel Cantanhede (GlobalHealth MSci) carries out research on asylum-seekers and their entitlement to medical care in the National Health Service. He has researched the medical care available to failed asylum seekers, identifying involved stakeholders and critically highlighting shortcomings of healthcare provision to this population. He has studied the ethical implications in providing health care for asylum seekers and critically appraised the ethical alignment of involved stakeholders; through duty-based, right-based and utilitarian approaches. He is concerned with the development of health policy in caring for asylum-seekers.

Menaki Sharma (Institute of Psychiatry, KCL) has studied the aspirations, experiences and well-being of unaccompanied asylum-seeking children. The number of unaccompanied minors in the UK increased tenfold from 1996 to 2002. They are at a vulnerable age, have been separated from their families and culture and have often witnessed traumatic events. Their schooling has broken down and they are often coping alone. Their needs and aspirations are poorly understood by service providers and carers. Menskshi’s research aims to help to inform the development of policy and services to better meet these children’s needs.

Darfur remains the site of the largest humanitarian aid operation in the world, with more than 80 organizations and 15,000 aid workers providing assistance in a region where 2.5 million have been displaced by conflict (MSF). Aid agencies struggle with unstable frontlines, shifting alliances, targeted attacks on aid workers, and increasing government restrictions on the provision of humanitarian assistance. 11 aid workers were killed in Darfur this year and 189 abducted (UN). Southern Sudan, emerging from decades of civil war, also remains in desperate need of assistance, with some of the highest maternal mortality rates in the world.

An evening of 3 talks will discuss the complex politics of this country and their effect on humanitarian work, together with how people in Oxford can have an impact. The ongoing disaster in Darfur, the slow progress of peace and justice across the rest of the country, and the failure of diplomacy have precipitated the issue of economic pressure: Campaigners from across the world including a host of British universities, members of the UK parliament and even President Obama have supported targeted divestment from specific companies providing the Sudanese government significant revenue while Darfur burns and the South and East of the country splinter under renewed violence. Speakers will include:

 Hamish Falconer, Director of Sudan Divestment UK, who succeeded in persuading Rolls Royce to withdraw from Sudan citing humanitarian concerns and the Japanese government from debating whether to buy Sudan crude oil. He has also engaged with a range of pension and trust funds andcurrently works for the British Government.

 Harry Verhoeven, who is pursuing a DPhil in Sudanese Politics at St Cross College, focusing on the links between violent conflict and (under)development. Harry has researched the issues at stake in depth, as well as having seen first-hand what the effects of Sudan's wars are, both inside and outside the country.

 Joe Piper, who is currently a Graduate-Entry medical student at Worcester College, Oxford. He has ensured that St Catharine’s College, Cambridge divested from any companies linked to oil extraction in Darfur and has also confirmed Worcester College have no similar investments.

Speakers included Tim Goodacre (Consultant Plastic Surgeon at the John Radcliffe Hospital) and Philip Bejon (Clinical Lecturer in Infectious Diseases).

Please look at the entry for the most recent Careers' Fair to see some of the organisations and activities represented. You can also download the latest information and contacts leaflet there.