June 20, 2014 6:26 pm

Wellcome Trust director Jeremy Farrar

The flu expert discusses the global war on infectious diseases
Jeremy Farrar at his home in Oxford©Sam Frost

Jeremy Farrar at his home in Oxford (Photograph: Sam Frost)

It is a brilliant Saturday afternoon in north Oxford, with lilac spilling over the pavement beside the terraced house owned by Jeremy Farrar, director of the Wellcome Trust, the £16.4bn medical foundation based in London. The front door swings open and two large dogs bound over. “Don’t mind the horses,” says a cheerful Farrar, leading the way into a modern white and stainless-steel kitchen. Sitting around the kitchen table are Farrar’s mother, brother and sister-in-law, in town for a set of celebrations.

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“Tomorrow we’re celebrating four generations of birthdays; and three generations of wedding anniversaries, including my own,” says Farrar, 52, who married Christiane Dolecek, an Austrian-born typhoid researcher, in 1998. “It’s a festive family day.” He points at the window and towards the back garden where tulips are poking out of the grass, and notes that he is marking another milestone. “It’s my first spring in many years – Vietnam has no seasons.”

Farrar took up his post at the Wellcome Trust last October, after 18 years in Ho Chi Minh City, where he had built up one of Asia’s leading infectious disease groups, the Oxford University Clinical Research Unit, and was on the front lines battling potential human pandemics including bird flu and Sars (severe acute respiratory syndrome). In 2004, Farrar and his Vietnamese colleague, Tran Tinh Hien, identified the re-emergence of the deadly bird flu, or H5N1, in humans. “It was a little girl. She caught it from a pet duck that had died and she’d dug up and reburied. She survived,” says Farrar. The harrowing experience prompted him to found a global network, working with the World Health Organisation, to improve local responses to disease outbreaks. “One hundred countries are involved,” he says.

Exterior of Farrar’s house©Sam Frost

Exterior of Farrar’s house (Photograph: Sam Frost)

Farrar offers cappuccinos and we head into a half-furnished sitting room, where pieces of Asian art remain swaddled in bubble pack. He only recently moved into the house with Dolecek and their three children, Sam, 15, Georgie, 14, and Charlie, 12, and clearly enjoys the activity as teenagers and dogs lope in and out. He grew up as the youngest of six, and constantly moved around Asia and the Middle East. “I was born in Singapore, lived in New Zealand, Cyprus . . . ” His father taught English and his mother was a writer and artist. His last childhood move in 1972 was to Libya. “I remember the day the Vietnam war ended [in 1975]. We heard it on the radio in Tripoli.”

Farrar says he did not plan to study medicine. “I did English A-levels. Medical school was a last-minute decision.” He attended University College London (UCL), where an unconventional professor offered him an extra year in a lab. “Mentors are crucial – they build confidence. She taught me to think out of the box and do it. Dream a bit,” says Farrar, who trained as a neurologist at UCL, Edinburgh and Oxford. Another chance encounter led to Vietnam. “I’d addressed a conference of neurologists in Norwich, looked over at a sea of white men and thought, I can’t spend my life with them. Back at a coffee room at Oxford [where Farrar was a professor of medicine], someone in an adjoining lab mentioned that a disease unit in Vietnam needed a director,” he says. “I applied.”

Vietnamese chest of drawers©Sam Frost

Vietnamese chest of drawers (Photograph: Sam Frost)

In the front hall hangs a big, ornate wooden sculpture. “It’s a wedding canopy – a present from a Vietnamese colleague,” says Farrar, who attended dozens of local weddings. “It takes a long time to build trust in Asia . . . When we started, there were six to 10 people in our group. Now we have 500 and it’s the main infectious disease hospital for Vietnam, southern China and Nepal.”

Shortly before the bird-flu case, Farrar and his colleagues had been battling the Sars epidemic: “We were badly hit. Our colleague Carlo Urbani put himself and the hospital in isolation. He lost his life and literally saved a nation,” says Farrar. The next disease outbreak occurred on Tet (Vietnamese New Year): “It’s every holiday rolled into one. Nobody was at work.” The sick girl with the duck drew Farrar’s attention. “Tran Hien had the samples in a rucksack on his bicycle,” says Farrar, who decided to call his wife. “She’s better at labs than I am.” The results were positive for bird flu. “In an emergency you ask yourself a lot of hard questions. I didn’t go home for a while,” he says.

We need to share information, treat people and act on critical research in 24 hours, not 18 months

Soon after their return to the UK, Farrar and Dolecek bought their home in Oxford, a fully renovated 1903-era house with finished floors and double-glazed windows. “The previous owners did all the work,” he says. “We didn’t have much time to choose.” The decision to take the Wellcome post was not an easy one. “I felt I hadn’t finished the other job,” he says of ISARIC, the disease response network which supports local hubs around the world.

Landing with a wall of framed photographs©Sam Frost

Landing with a wall of framed photographs (Photograph: Sam Frost)

On a first-floor landing is a wall of framed photographs. Wedged between images of family hikes is a photo of Farrar receiving an OBE from the Queen for his work on global health. So how worrying is the slew of diseases now on the horizon: bird flu, Ebola and Mers (Middle Eastern respiratory syndrome)? “The good bit is that post-Sars, our surveillance is much better,” says Farrar. “The bad bit is that we didn’t learn any clinical lessons from Sars. The public health and medical research worlds still don’t communicate.”

He adds that reluctance from Middle East governments to divulge information on Mers echoes Chinese silence, a decade ago, on Sars. “It’s taken 18 months from the first case of Mers to now, when people are waking up to it. Ten years ago, China blocked access. But now China is transparent and superb at disease monitoring,” says Farrar. “So is Vietnam.”

Flowers in the kitchen©Sam Frost

Flowers in the kitchen (Photograph: Sam Frost)

Displayed by the staircase is a handsome grey poster, a present when Farrar left Ho Chi Minh City. “These are the street names where I spent my life.” He points to an area called Tan So’n Nhat. “That’s the airport, where I spent the most time,” says Farrar. When swine flu broke out in Mexico in 2009, Farrar immediately jumped on a plane. “Intensive care units were filled with young people,” he says.

In the wake of the virus, was it the right decision to globally stockpile Tamiflu, a move which a recent study [a Cochrane Collaboration Review] criticised as ineffective and a waste of money? “The swine flu was milder than expected. But in those intensive care units, there were many deaths. The world’s policy makers were absolutely right to make this call . . . When a new disease emerges, it’s chaos. You need a quick response.” Farrar adds that the study was flawed and did not include observational reports that antivirals helped. He insists the real waste was the failure to collect evidence on 1.9bn people who had the flu. “Scientists who tried ran into brick walls.” In the future, he says, “we need to share information, treat people and act on critical research in 24 hours instead of 18 months”.

The kitchen with built-in appliances, including a cappuccino machine©Sam Frost

The kitchen with built-in appliances, including a cappuccino machine (Photograph: Sam Frost)

The house has fallen silent; family members have taken the dogs on a walk. Downstairs, we carry coffee cups into the kitchen and Farrar pauses to admire the built-in cappuccino machine. “I don’t care about the other rubbish, but this is brilliant. I’m married to an Austrian and they take their coffee seriously.” He does miss Asian meals, however. “Here we fill up our individual plates. In Asia you have a shared bowl. It changes the way you interact with people,” he says, showing me a glazed painting of three suspended bowls. “It’s called rice bowls. It’s by a handicapped Vietnamese artist.”

Back in the hall, a tidy row of trainers is the only hint of the swell of visitors and teenagers in the house. I note that on the Wellcome Trust website even students can submit proposals. “We’re inundated with great ideas,” says Farrar, whose trust gives out £750m a year. His job as director is a chance to break down medical silos and have a broader impact, he says. “Science does not exist in a bubble. The greatest scientists may not be the best technicians. They’re like the greatest artists. It’s just that science is the canvas.”

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Favourite things

Model of Anopheles sundaicus, the mosquito that carries malaria©Sam Frost

(Photograph: Sam Frost)

“My favourite thing is a poetry anthology my father gave me but it’s at the office,” says Farrar, who then chooses a photograph of himself as a child with his father. “This was taken at the Parthenon.”

Another favourite object is a model of a mosquito made of soft felt (right). “It was a present – Anopheles sundaicus. It transmits malaria. It’s so different from a dengue mosquito,” says Farrar, who studies dengue fever in his spare time. “Isn’t it beautiful?”

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