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An American in Keppel Street
An American in
Keppel Street
many institutions combine tropical with public health. One of them is at Tulane University, New Orleans; another is based in Keppel Street, in the heart of London. In January the dean of the Tulane school moved to Keppel Street. He is Prof Harrison C Spencer. In the BM7 and in The Lancet editorials have lately questioned the direction of tropical medicine. Inevitably, this was a focus when I interviewed Spencer last week. But first, did he miss research? Many deans would ask for a percentage of free time to pursue previous interests. Had he done that? No. "The reality of the world now is that the school needs a full-time person to be dean". He sees himself as a dean who is are
not
There that overtly medicine
external-"outward-looking, raising visibility of the school". Spencer comes to London with a reputation for fund-raising ("development"). "The environment here [in the UK] has not been one of development in the
the
I have been used way to in the US". During his years at Tulane the school there won significant research projects and increased endowment. But what could he bring to the UK that had not been tried before? Public health has no obvious sponsor, such as the pharmaceutical industry. "Or grateful patients", he added. "On the other hand, people are interested in public health because it affects them directly". Furthermore, the London school is unique as a free-standing school (the USA has 27 schools of public health). But it does take a long time; 90% of the money raised in New Orleans arrived in his last 2 same
as
years.
"Everyone knows what a medical school does and what medicine is. You ask someone what public health is and they all have different ideas." He sees the LSHTM as a school of public health and international health and tropical medicine. But what about tropical medicine as such? "In this country, to my surprise, tropical medicine has a certain connotation-and that is, it’s associated with the colonial. This is a framework I’m not used to, and it’s negative on balance". The heart of traditional tropical medicine is parasitic disease and much of what the LSHTM does here clinically might well be labelled infectious disease. ...
896
But that did
not
mean
neglect of for of
specialist tropical medicine; example, the forthcoming move the Hospital for Tropical Diseases to the University College site was a positive change for both. "That kind of expertise, small though it be, is usefully pulled together", and Spencer hoped that it will always be possible to define the tropical diseases hospital within the new structure.
How about research? LSHTM does research in more than one hundred countries, but not with longof term bases such as those the Medical Research Council in The Gambia and the Wellcome Trust in South-East Asia. "I don’t know what the British have to have maintained this quality", he admitted. In
leadership. WHO "is in danger of losing its ability effectively to carry out its mission". The regional structure is a problem. "... and the European WHO office in particular ?", I asked. The public health problems of the emergent nations of the former Soviet bloc had given WHO (Europe) a new lease of life, he felt. In the UK the Faculty of Public Health Medicine is agonising over whether to admit non-physicians-a battle long settled in the USA. Spencer thought this symptomatic of a physician-dominated view of public health in the UK. "The focus on the has physician been to the detriment of public health. Public health is ...
multidisciplinary". The
Spencer’s
experience there was usually a downturn in the quality of research after
to
at
LSHTM has clearly impressed the new dean: "People really care about it". The MSc degrees that the school offers are a
4 or 5 years. Nonetheless there were rela-
of longwith the London school (eg, in Brazil and Tanzania). Does a combined tropical and public health school have advantages in the late 1990s? "The whole
commitment
teaching
tionships standing
major
end-product
of that teaching, Before moving to New Orleans in and candidates can June, 1991, Spencer had worked for choose from no the US Centers for Disease Control; fewer than 80 he also held posts with WHO: and he does How has worked in Kenya and EI Salvador. options. His major research interests were this compare with diseases, public health parasitic is The the MPH? thing public health", epidemiology, and community in Spencer’s view. Was medicine. He was chairman of the MPH tended to vary, this reflected in the International Health Committee of the he said, and he was Association of Schools of Public comfortable way the school was "very Health. with the MSc". It organised? The crossfertilisation (eg, in malaria) was was probably more focused than the a rehe felt. There had been MPH though perhaps not yet offergood, 17 to from organisation departments ing the same career opportunities. four before he arrived, and the strucHarrison Spencer is determined to ture is being looked at again, this lift the image of public health, in its time with the school’s "external miswidest sense, in the UK and outside. in mind. sion" He recognises the fundamental truth LSHTM is the largest school of that public health is political though I do not think you will be seeing public health in Europe and has trained many of Europe’s current much of him on our television screens. On the other hand, he will public health leaders. So, what about not be frowning on those staff who Europe? Spencer plans to be very active wish to articulate more forceful meshere, especially via the Association of Schools of Public sages. In New Orleans there was an Health in the European Region. He activist Environmental Law Clinic. sees the European involvement not Right or wrong they were attacking the from of EU the very corporations that Spencer just perspective available for research. He was approaching for funding. Yet I money wants Europe to speak with one voice detected more amused tolerance on public health. than resentment here. And WHO? Echoing other critics, he sees the main problem as one of David Sharp Harrison
Spencer, dean, LSHTM
Keppel Street
many institutions combine tropical with public health. One of them is at Tulane University, New Orleans; another is based in Keppel Street, in the heart of London. In January the dean of the Tulane school moved to Keppel Street. He is Prof Harrison C Spencer. In the BM7 and in The Lancet editorials have lately questioned the direction of tropical medicine. Inevitably, this was a focus when I interviewed Spencer last week. But first, did he miss research? Many deans would ask for a percentage of free time to pursue previous interests. Had he done that? No. "The reality of the world now is that the school needs a full-time person to be dean". He sees himself as a dean who is are
not
There that overtly medicine
external-"outward-looking, raising visibility of the school". Spencer comes to London with a reputation for fund-raising ("development"). "The environment here [in the UK] has not been one of development in the
the
I have been used way to in the US". During his years at Tulane the school there won significant research projects and increased endowment. But what could he bring to the UK that had not been tried before? Public health has no obvious sponsor, such as the pharmaceutical industry. "Or grateful patients", he added. "On the other hand, people are interested in public health because it affects them directly". Furthermore, the London school is unique as a free-standing school (the USA has 27 schools of public health). But it does take a long time; 90% of the money raised in New Orleans arrived in his last 2 same
as
years.
"Everyone knows what a medical school does and what medicine is. You ask someone what public health is and they all have different ideas." He sees the LSHTM as a school of public health and international health and tropical medicine. But what about tropical medicine as such? "In this country, to my surprise, tropical medicine has a certain connotation-and that is, it’s associated with the colonial. This is a framework I’m not used to, and it’s negative on balance". The heart of traditional tropical medicine is parasitic disease and much of what the LSHTM does here clinically might well be labelled infectious disease. ...
896
But that did
not
mean
neglect of for of
specialist tropical medicine; example, the forthcoming move the Hospital for Tropical Diseases to the University College site was a positive change for both. "That kind of expertise, small though it be, is usefully pulled together", and Spencer hoped that it will always be possible to define the tropical diseases hospital within the new structure.
How about research? LSHTM does research in more than one hundred countries, but not with longof term bases such as those the Medical Research Council in The Gambia and the Wellcome Trust in South-East Asia. "I don’t know what the British have to have maintained this quality", he admitted. In
leadership. WHO "is in danger of losing its ability effectively to carry out its mission". The regional structure is a problem. "... and the European WHO office in particular ?", I asked. The public health problems of the emergent nations of the former Soviet bloc had given WHO (Europe) a new lease of life, he felt. In the UK the Faculty of Public Health Medicine is agonising over whether to admit non-physicians-a battle long settled in the USA. Spencer thought this symptomatic of a physician-dominated view of public health in the UK. "The focus on the has physician been to the detriment of public health. Public health is ...
multidisciplinary". The
Spencer’s
experience there was usually a downturn in the quality of research after
to
at
LSHTM has clearly impressed the new dean: "People really care about it". The MSc degrees that the school offers are a
4 or 5 years. Nonetheless there were rela-
of longwith the London school (eg, in Brazil and Tanzania). Does a combined tropical and public health school have advantages in the late 1990s? "The whole
commitment
teaching
tionships standing
major
end-product
of that teaching, Before moving to New Orleans in and candidates can June, 1991, Spencer had worked for choose from no the US Centers for Disease Control; fewer than 80 he also held posts with WHO: and he does How has worked in Kenya and EI Salvador. options. His major research interests were this compare with diseases, public health parasitic is The the MPH? thing public health", epidemiology, and community in Spencer’s view. Was medicine. He was chairman of the MPH tended to vary, this reflected in the International Health Committee of the he said, and he was Association of Schools of Public comfortable way the school was "very Health. with the MSc". It organised? The crossfertilisation (eg, in malaria) was was probably more focused than the a rehe felt. There had been MPH though perhaps not yet offergood, 17 to from organisation departments ing the same career opportunities. four before he arrived, and the strucHarrison Spencer is determined to ture is being looked at again, this lift the image of public health, in its time with the school’s "external miswidest sense, in the UK and outside. in mind. sion" He recognises the fundamental truth LSHTM is the largest school of that public health is political though I do not think you will be seeing public health in Europe and has trained many of Europe’s current much of him on our television screens. On the other hand, he will public health leaders. So, what about not be frowning on those staff who Europe? Spencer plans to be very active wish to articulate more forceful meshere, especially via the Association of Schools of Public sages. In New Orleans there was an Health in the European Region. He activist Environmental Law Clinic. sees the European involvement not Right or wrong they were attacking the from of EU the very corporations that Spencer just perspective available for research. He was approaching for funding. Yet I money wants Europe to speak with one voice detected more amused tolerance on public health. than resentment here. And WHO? Echoing other critics, he sees the main problem as one of David Sharp Harrison
Spencer, dean, LSHTM