Research interests

• Non-communicable disease (NCD) in resource-poor countries: epidemiology, clinical features and management of prevalent diseases and their risk factors.
• Health service/operational research related to strengthening health systems and appropriate health care interventions for NCDs.
• The role of cultural and belief systems in determining population engagement with NCD care systems.

Current research

A mixed portfolio of research including clinical/academic, social and behavioural science, operational and implementation studies related to the NCD problem in Ethiopia.    

The clinical, immunological and serological features of type 1 diabetes in rural Ethiopia and best practice in managing the disease in a resource-poor environment.

Prevalence studies of rheumatic heart disease and the role of echocardiography. Investigation of the very high prevalence in Ethiopia.

Evaluating domestic air pollution and the cultural use of smoke in Ethiopia and ways that exposure could be reduced.

Strategies for effectively sensitising and engaging with communities while introducing new NCD services. Reducing patient default with NCD services.

Evaluating training methods to equip nurses and health officers to deliver quality NCD care in rural areas.

Development and use of digital solutions to facilitate and continuously improve the quality of NCD clinical care.

He lectures widely to both specialist and non-specialist audiences on a range of subjects which highlight the problems of NCDs in sub-Saharan Africa.  

He was educated at Cambridge University and St Thomas’ Hospital, London, gaining his medical qualification in 1977 and following medical training posts, membership of the Royal College of Physicians (elected to the fellowship in 1995). In 1981 he was awarded a Wellcome Research Training Fellowship in clinical epidemiology based initially at the London School of Hygiene & Tropical Medicine and subsequently at the University of Southampton. Following innovative studies of the epidemiology of thyroid disease he completed his PhD in 1985. Subsequently, and while maintaining his university links, he carried out a large-scale trial of iodine supplementation in Zaire (now the Democratic Republic of the Congo) as project director of a joint MRC/Oxfam project.  On return from Africa he was appointed Lecturer in Medicine within the School of Medicine at the University of Cardiff.

In 1991 he returned to Southampton to a new post at the Medical Research Council’s Environmental Epidemiology Unit with concurrent appointments as senior lecturer in medicine and consultant physician in diabetes, endocrinology and general medicine. His research programme centred on the developmental origins of type 2 diabetes, the metabolic syndrome and related conditions and led the establishment of a research group, the MRC Metabolic Programming Group. The studies were funded by major grants from the Medical Research Council, The Wellcome Trust, The US National Institutes of Health and several UK-based charities. He collaborated extensively with research groups in other universities both in the UK and abroad and held professorial appointments at the University of Toronto, Canada, and the University of Adelaide, South Australia. He was awarded a personal chair at the University of Southampton in 1999. While at Southampton he also contributed to the teaching and supervision of medical students, supervised several PhD/MD fellows, and played an active role in developing academic diabetes and endocrinology within the University. Following the closure and redesignation of the MRC Unit in 2005, he continued to work within the university initially within the Department of Medicine and subsequently Human Development and Health. In recent years he has developed an interest in the neglected non-communicable diseases (NCDs) prevalent in rural sub-Saharan Africa, particularly in Ethiopia. This led to the establishment of a medical charity, THENA (www.thena-ethiopia.org), of which he is a founder member and which involves a number of university and clinical staff in Southampton and elsewhere. Its purpose is to help address the NCD needs of underserved, particularly rural populations in Ethiopia, who have had little or no access to appropriate medical care. Much of the work has centred on collaborations with two Ethiopian universities, Gondar and Jimma, and has led to novel research into the nature and causes of the prevalent NCDs in the rural areas around these medical schools together with operational research targeted at the development of appropriate health care interventions in these difficult to reach communities. The work has created opportunities for collaborative studies with various Southampton University departments and groups, including the School of Primary Care, Population Sciences and Medical Education; the Department of Humanities; the MRC Lifecourse Epidemiology Unit; the Air Pollution Research Partnership and the Clinical Informatics Research Unit. This has spawned a number of joint projects, exchanges with academic staff and opportunities for students and post-graduates to spend short periods of time in Ethiopia.