PhD project

I'm in a slight PhD limbo zone at the moment - I know I'd like to do one at some point in the next few years, but the what, when and where are all still slightly uncertain. I've currently got a tentative project proposal sketched out, but have no idea if this will evaporate with the first blast of things going wrong ...

I'll put the current idea on the table, sometimes laying it all out helps with the decision. It is all to do with the use of vaccines against a type of bacteria called streptococcus pneumoniae, which (as you might guess from the name) is commonest cause of bacterial pneumonia : see below.



There are two conjugate-type vaccines on the market at the moment : Prevenar (for under 2 years) and Pneumovax II (for over two years. The main difference between the two vaccines is the number of serotypes (strains) of the s.pneumoniae against which it protects: prevenar has 7 whilst pneumovax has 23.

So the thrust of my PhD would be to look at whether it mightbe possible to get some of the protective effects of these vaccines (either type) to transfer from a mother to a new-born baby by giving the vaccine around the time of birth. The protective antibodies and cells might then transfer across the placenta and in the breastmilk in sufficient quanitities to confer some protection.



Gambia would be a useful setting to try out this kind of work because of the very high rate of transmission and carriage of the this particular bacteria, and the low rate of HIV wohich would be a major counfounding factor in much of southern/eastern Africa.

So, in some ways it seems a good project to commit to... as one person told me, "if you're going to spend several years of you life trying to answer one question, you should be sure that it is a question that it is worth asking". Perhaps everyone doing a PhD should be asking themselves that question ?

But my concerns are 1) I'm not a paediatrician 2) I haven't fully gone through the ethical implications of the work. I was at an Amnesty International lecture last week where one (rather shrill) journalist railed against the evils of westerners trying out drugs on unsuspecting third world populations. I don't think I agreed with her, but it did make me think...