A Festschrift to honour Professor Warwick Britton AO
Warwick Britton’s longstanding interest in the control of tuberculosis and leprosy began in 1971 when as a 5th year medical student he undertook an elective period in Thailand.
After finishing his medical training at the University of Sydney then Royal Prince Alfred Hospital, Warwick and his wife, fellow physician Annette Britton, travelled to Nepal in 1978.
The pair spent the next three years working at the Tansen Mission Hospital, 300 kilometres outside the Nepalese capital of Kathmandu. With a young son in tow and another born during their stay, Warwick and Annette worked as rural doctors in a 100-bed hospital serving about 2 million people.
It was here that Warwick’s interest in mycobacterial infections, the most notable of which are Mycobacterium tuberculosis complex and Mycobacterium leprae, really took off.
“We had 1200 new TB patients and 250 new leprosy patients each year at a time when leprosy was developing drug resistance,” he said.
Back in Sydney, Warwick undertook at PhD on the immunology of leprosy with Professor Tony Basten at the Clinical Immunology Research Centre, University of Sydney (CIRCUS), identifying six new antigens of Mycobacterium leprae.
“The body’s immune response is responsible for the damage to the tissue and unfortunately the infection lives within nerves and skin,” he said.
“Because of that it changes the way people look and their functional capacity and thus results in the stigma associated with leprosy.”
With three children in tow, the couple returned to Nepal in 1986 and established the Mycobacterial Research Laboratory at Anandaban Leprosy Hospital, Kathmandu. For the next four years Warwick facilitated studies improve the management of leprosy and their fourth child, a daughter, was born.
In 1990 the Britton family returned to Sydney where Warwick was appointed to the University of Sydney as a Senior Lecturer in Immunology. He also worked as a consultant clinical immunologist at RPA and appointed Head of the Mycobacterial Research Group at the Centenary Institute.
To obtain funding for his research, Warwick moved the focus to the immunology and control of TB to his research program. While the illness had largely been controlled in Australia, it remained a huge global problem.
“TB had been a neglected area of research… at the time it was really unfashionable and we were the only centre in Australia studying the immunology of these major human pathogens,” he said.
In 1991 Warwick was part of his first NHMRC program grant to study celluar and molecular aspects of immune responses to mycobacteria. Over the next decades Warwick’s studies included the cloning and characterisation of mycobacterial genes, analysis of cellular and cytokine immune responses to mycobacteria and the immunogenetics of tuberculosis.
His research demonstrated that non-living vaccines, based on parts of the tuberculosis bacteria, were as effective as live vaccines against TB.
Warwick also focused on research into how the immune system fights TB and the different genetic factors that influence an immune response to a TB infection. He developed the aerosol model of infection with virulent Mycobacterium tuberculosis in a dedicated PC3 containment facility purpose-built in the new Centenary Institute building in 1997.
In 2004 he was awarded the prestigious RPA Foundation Medal for Research Excellence. The $50,000 prize money supported continued research in mycobacterial immunology and the development of TB vaccines and drugs, and research collaborations in new directions.
“This work led to new NHMRC funding and a successful collaboration… on TB drug discovery and vaccine development that continues today,” he said.
His latest projects include collaborating to develop a fusion protein TB vaccine, investigating new TB drug leads and delivering TB drugs to the lungs and studies to identify genes that influence susceptibility to TB.
“TB was a huge global health problem when I started in the 1970s and it is still huge health problem 40 years later.
“Unless we control TB in our region, we will never control TB in Australia.”
Annette retired five years ago after more than 25 years at RPA. This year, Warwick is retiring from his numerous positions at the University of Sydney, including Bosch Professor of Medicine and Professor of Immunology. He is also stepping down from clinical work.
But he will continue as Chief Investigator on the second NHMRC Centre of Research Excellence on the Control of Tuberculosis. The Centre offers opportunities for a multi-disciplinary team to expand research collaboration, training and translation to improve TB control in Australia and the region.
In 2014 he was the inaugural Director of the District’s Clinical Research Centre, a position he will retain going forward. The Centre was created to strengthen and support the District’s vast network of hospital-based, community and primary care researchers translate research to patient care. And he will still travel to Nepal, Vietnam and China for research on TB and his long standing interest in leprosy.
“It’s a bit of a Clayton’s retirement,” he said.
His exemplary work was acknowledged when he was appointed an Officer of the Order of Australia for “distinguished service to medical research as an academic and immunologist, to humanitarian and public health improvements for the people of Nepal, and to the community”.
Warwick has received continuous funding from the NHMRC since 1991. During this time he has supervised 27 completed PhD students, 2 MSc and 30 BSc/BMediSci Honours students. His publications include 282 peer-reviewed papers and book chapters, which have been cited more than 14,000 times. He was closely involved in the implementation of the Graduate Medical Program at The University of Sydney as Sub-Dean at RPA.
“I have particularly enjoyed seeing my former PhD students flourish as independent scientists, both here and overseas, and then returning to establish their own research groups and to continue collaborating on TB and immunology research.”
A Festschrift to honour Warwick’s achievements was held on 27 September by Sydney Local Health District, The University of Sydney and Centenary Institute.