Snakebites, malaria & tropical medicine

During his career in tropical medicine Professor David Warrell has milked snakes, studied malaria and rabies and helped thousands of medical students learn about the deadliest diseases.

Now Professor Warrell has received the Osler Memorial Medal, which is given once every five years to the Oxford medical graduate who has made the most valuable contribution to the science, art or literature of medicine. He was presented with the bronze medal at a ceremony on Saturday.

David Warrell, emeritus professor of tropical medicine and an Honorary Fellow of St Cross College, Oxford, has played a key role in global health research at Oxford. This has been not only through the research he carried out, but in setting up a series of clinical research units in South-East Asia and Africa.

It is the success of this network of centres that has established Oxford’s global reputation for research on infectious diseases that are some of the world’s biggest killers. Currently recommended treatments for malaria, dengue shock syndrome, typhoid, and many others are all based on work conducted by tropical medicine researchers at Oxford.

As the first director of the Centre for Tropical Medicine at Oxford University, Professor Warrell set up the first of Oxford’s overseas research units in 1979 with funding from the Wellcome Trust. The success of that unit in Bangkok, Thailand, has served as a model for later units in Kenya, Vietnam and elsewhere.

Importantly, the work of these clinical research units isn’t solely about finding practical solutions that will save lives in combating infectious diseases, it’s about fostering partnerships with local researchers and doctors, and training the next generation of health leaders in the developing world.

‘There was no real tradition of tropical medicine at Oxford when I arrived,’ says Professor Warrell. But there was a readiness among those already in Oxford in the 1970s to make things happen, and ‘everything ignited from there’. Tropical medicine at Oxford is now world-renowned. ‘It won a Queen’s Anniversary Prize in 2000 and is now one of the best funded parts of biomedical science at Oxford,’ Professor Warrell adds.

Another important strand of Professor Warrell’s work since 1983 has been as a senior editor of the Oxford Textbook of Medicine, the accepted reference work for general medicine across the English-speaking world. Countless medical students in India, Australia and South Africa, as well as the UK, will have made use of this standard work during their education and once in practice.

David Warrell’s career has involved working as physician, teacher and researcher in many African, Asian and South American countries. His research interests have largely focussed on malaria, rabies and snakebites. These efforts have ranged from defining the symptoms of conditions such as cerebral malaria, to understanding the paths that diseases take, and improving treatments in the clinic. With his wife Mary Warrell, he developed less expensive ways of using high quality vaccines against rabies – very important in areas of the developing world where rabies is a problem and money is scarce.

Since he retired in 2006, he has devoted his energies to redress the neglect of snakebites. Snakebites often occur among poor rural farmers in the developing world and – although only 2% of bites result in death – he says the number of bites mean than there are estimated to be around 46,000 deaths per year in India and 6,000 deaths in Bangladesh. He published a significant review of snakebites, their prevention and treatment in the Lancet medical journal at the beginning of the year, raising it as a neglected area of medicine.

All of this is a good example of David Warrell’s drive not just to leave research at the result stage, but push it through to implementation. He has been active in helping draw up guidelines for the World Health Organisation on malaria, rabies, snakebites, and anti-venom production.

‘I was extremely surprised, and enormously moved, to be awarded the Osler Memorial Medal,’ says Professor Warrell. He says the example of William Osler, who the award is named after, means a lot. (Osler was the Regius Professor of Medicine at Oxford at the very beginning of the 20th century.) ‘Osler is a supreme example of a meticulous clinician, and a very special example for people who work in the developing world where resources are not enough for modern medicine.’