Domino effects at Wellcome

August 14, 1998

The new head of the Wellcome Trust, Michael Dexter (right), tells Alison Goddard why playing dominoes helps his work

Humming softly, the heavy double doors swing open electronically to reveal the opulent offices of a man who controls much of the money spent on scientific research in the United Kingdom.

A few weeks ago when Michael Dexter took over as director of the Wellcome Trust, the world's largest charity, it spent some Pounds 250 million on research each year. Just two weeks later, Dr Dexter added an extra Pounds 400 million over the next three years.

He cites the project to map the human genome as the reason for the investment. "I believe that the genome project is arguably the most exciting scientific endeavour in the past 30 years," he says. "The consequences for health are tremendous, absolutely tremendous. And the more we understand about the contribution of genetics to the development of disease, the better we are able to develop appropriate behaviour or treatment."

The trust promotes "scientific research which may be conducive to the improvement of the physical conditions of mankind". It is the largest contributor to the genome project, which aims to identify all of the 100,000 or so genes in human DNA and determine the sequences of the three billion chemical bases that make up these genes. Once the human genome has been mapped, it will be used as an archive for researchers who will ultimately use it to develop new treatments for disease.

"The major interest in the future is going to be in the genetic disorders which are caused by more than one gene," says Dr Dexter. These include heart disease, dementia and cancer. "How the products of these genes work together with the environment is going to be the excitement in medicine in the next ten to 20 years. When we understand the impact of the environment then we could begin to develop a treatment programme where we could advise a person: avoid situations where there is a lot of peat about because you are likely to develop severe asthmatic disease. That is going to be an amazing benefit: prevention rather than cure."

The project will provide the basis for other research: "In ten years time, we will have sequenced the human genome and many of the pathogens. Then we will need to analyse those genes and their products, so that gets us into functional genomics, and that takes us into structural biology, and that takes us to the development of new therapeutics.

"But in order to exploit this unique opportunity, we need a university system in the UK that has the infrastructure to meet the demands being placed on it. At the moment we simply don't have this - many of the science departments in our universities have crumbling infrastructures and inadequate conditions. We really couldn't stand back and allow this to continue."

So the trust dug deeper into its pockets despite the fact that it told the Dearing inquiry that it was not a research charity's responsibility to prop up British universities.

"Policies have to evolve," says Dexter, "the financial power of the Wellcome Trust means that it has got a heavy responsibility. It has the responsibility to use the money wisely, it can set medium to longer-term objectives which perhaps other organisations cannot do."

As well as investing in British biomedical research, the trust has a series of initiatives to allay public concerns about the work, an area of particular interest to the domino-playing Dexter. "Playing dominoes (in the pub) is a wonderful opportunity to meet a wide spectrum of people. You often talk about what people do and I enjoy talking to the grave digger about how he digs graves and what pleasure he gets out of it. And there is actually a great deal of job satisfaction there - making sure that it is a nice clean hole. And of course they ask me about what I do. There is a great deal of enthusiasm about science. And so that makes me think that we are not targeting these people, something is going wrong."

Wellcome organises many debates on the issues surrounding genetics, involving academics and the public. "The implications of modern molecular genetics are sometimes worrying for people. And it is only fair that we have informed debate where the public is present, the scientists are present, where doctors are present, where ethicists are present so the issues can all be aired. It is vital to inform people of the options. You don't simply tell people what you are doing. And then you have got to let them make up their own minds and contribute towards the decision-making process."

He has come a long way from leaving school with one A level to work as a manager in a firm making copper wire. "I am pleased with what I have achieved," he says. "Like everybody, there are things that I might have done better. And I certainly don't see this being the end of the road. But what happens next? I haven't even begun to consider that."

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