My name is Guy Thwaites, I'm director of Oxford University Clinical Research
Unit. I work here in Vietnam, in Ho Chi Minh City in Vietnam. OUCRU has been
in existence for 27 years, started out doing malaria trials but very rapidly moved into
doing trials on a lot of other serious infectious diseases. And the reason we can do that is
because of our collaborations with the Vietnamese government and also with the Hospital for Tropical
Diseases down in the south and the National Hospital for Tropical Diseases in the north.
And OUCRU ever since its beginning and it still does it now looks at those infectious diseases
and asks the question: how can we improve their diagnosis, how can we improve their treatment,
how can we improve patients outcome. And that's very simply what we do, we do that through
observational studies, but more importantly we do that through clinical trials, randomized controlled
trials, the gold standard way of changing practice if you like. And really all of our work focuses
around optimizing treatment and therefore has to focus on the challenge that those bacteria,
those parasites becoming resistant to that treatment, and that's a major priority. I think the
other priority that's developing quite rapidly and is very interesting in Vietnam is vaccine
preventable diseases. We've had recent outbreaks, we've experienced recent outbreaks of diphtheria
and measles and there is a problem with a loss of confidence in vaccine, vaccination in this country
A lot of it's being driven we think by social media and fake news if you like
but we've got to confront this because this is a country which should not be having those vaccine
preventable diseases, and yet they're creeping back in, in many ways. And tetanus is as common now in
our hospital as it was in 1993 which doesn't make sens. You know the vaccine program delivered by
the government is actually very good but there are some problems which we think OUCRU
can help with, and that's what we'd like to do. So in 1990-1991 what brought OUCRU to Vietnam was
the ability or the acceptance, from China, that they would release some of these new anti-malarial
drugs to Vietnam for the first trials. So China had these new, the artemisinin derivative drugs and
they'd had them for a thousand years but they weren't particularly interested in doing the
conventional randomized control trials. Nick White at that stage recognized the opportunity that
these drugs should be trialled in the conventional way to be able to convince the world that they
were really truly very effective, and those first trials were done in Vietnam. But very
quickly after that it became apparent that there were two main reasons why Vietnam was
such a fascinating place to work, and that was primarily they have a very large population.
They have 90, more than 90 million people, and secondly the way the medical system works
meant that this hospital, where the trials were done, was capturing, it was serving as a
tertiary referral centre for a population of half of Vietnam, so roughly 45 million.
So this meant that lots of rare things came and found their way into this hospital, and therefore
you had an ability, in collaboration obviously with the hospital, to be able
to study those diseases in a way that you really couldn't study in any other place. So we studied
a lot of dengue, we started tetanus, we studied TB meningitis and typhoid and encephalitis,
all things that are relatively rare but in this hospital were not that rare, and it enables you
to do really big studies. So Vietnam was a fascinating place to start and in many ways
it was just luck but subsequently has turned out to be a great place to work because they
have incredibly good systems, really for supporting health and they're very willing and interested and
engaging in research and asking questions and it's been a phenomenal place to be,
to develop friends and collaborations. You know the world becomes very excited about new things, about
new infections but there are a bunch of infections that just kill people day in day out, their
importance, people recognize they're important but they're often a little bit underplayed
and those infections are becoming more and more resistant. And you see that the concerns that there
are around artemisinin resistant malaria for example in this region, and there really isn't
a lot being done about it. There should be but there isn't. Drug resistant TB is an enormous
problem throughout the world but particularly in Southeast Asia. It's sort of happening so
slowly that there doesn't seem to be that much concern, it's much
easier to capture people's imagination about the sort of the new and the
rapid and the and the scary things that blow up suddenly and then disappear. But these things
are just there in the background just eating away at us, and that's what keeps me awake.