Nicholas White, M.D., D.Sc.

Mahidol Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Bangkok

"for his definitive clinical studies on the effectiveness of artemesinins in the treatment of malaria and elucidating the basis for the use of ACT to prevent resistance"

2010 Canada Gairdner Global Health Award Recipient

Professor White graduated in medicine from Guy's Hospital Medical School in London, and trained  in internal medicine in several London teaching hospitals and the Radcliffe Infirmary, Oxford . In 1980 he went to Thailand to join a small research collaboration between the Faculty of Tropical Medicine, Mahidol University and the Nuffield Department of Medicine, University of Oxford, supported by the Wellcome Trust. Professor White stayed there ever since and in 1986 took over as director of this unit, and later opened sister units in Vietnam (1991) and Laos (1999). These units and their collaborations have grown considerably, and are at the forefront of clinical research on malaria, meliodosis, typhoid, tetanus, dengue, central nervous system infections, rickettsial diseases and avian influenza.

Infections cause about half of all deaths in tropical countries. Many of those who die are young children and most of these deaths could be prevented. Professor White conducts medical research on infectious diseases in tropical countries, particularly those infections which carry a high death toll. He works with a multinational team of investigators based in Thailand, Vietnam and Laos who have focused particularly on finding better ways of treating these infections, in order to save life and reduce suffering. They study patients with these infections in order to discover how the infections cause illness and death, and how these lethal processes can be interrupted. Much of hiswork has been on malaria, a mosquito borne parasitic infection, which still kills nearly 3000 people every day. It has been found that many of the available drugs were being used at the wrong dose, particularly young children and pregnant women. We have helped introduce a remarkable drug from China, a traditional herbal remedy called artesmisinin or qinghaosu, and we have shown that this is superior to all other medicines in the treatment of severe malaria. Our research then led to the development of artemisinin combination treatments (ACTs) to improve treatment and to prevent resistance, and we showed in both Asia and Africa that these ACTs were better than other antimalarials for uncomplicated malaria. They are now recommended by the World Health Organisation as the first-line drugs throughout the world. Our current challenge is the development of artemisinin resistance in Western Cambodia, where these drugs have been readily available for over 30 years as monotherapies. We desperately need to prevent artemisinin resistance  spreading across Asia to Africa, otherwise it could derail  the renewed global efforts to eliminate malaria. We have developed the methods that are currently used to assess antimalarial drugs, we have also discovered the best treatments for a several important bacterial infections (melioidosis, typhoid, leptospirosis) which are important in the Asian region, and we have led the fight against the counterfeit medicines which plague many poor countries.

Most people in tropical countries do not have access to the best medicines, and many live far from a hospital or health centre.  Even when seriously ill patients do reach medical attention, it may be difficult to distinguish killing diseases such as malaria or pneumonia. We are using the best science to develop simple approaches which can be applied at the village level to improve outcomes. Scientific research directed against making best use of available medicines can yield health improvements comparable to those of developing new drugs and vaccines, at a fraction of the cost.