Charlotte Chapman CA takes up the fight against drug-resistant infections
By CA magazine
30 September 2020
The Wellcome Trust operates at the intersection of science and policy. Charlotte Chapman CA, Programme Manager of Drug Resistant Infections, credits trust, curiosity and diverse experience with helping her team’s important work fighting off the superbugs of the future.
While the effects of the pandemic continue to dominate headlines, rapidly shaping government policy and influencing the minutiae of our lives, it would be easy to forget about other invisible threats to global health. The ones that have been there for decades and which scientists, researchers, clinicians and practitioners have never stopped battling. The ones that pose a constant threat to modern medicine, whether that’s surgery, childbirth, chemotherapy, diabetes care or even a simple tooth extraction.
“I’m talking about anti-microbial resistance (AMR) and specifically drug-resistant infections (DRI),” explains Charlotte Chapman CA, Programme Manager of Drug Resistant Infections at the Wellcome Trust. “Although we are making huge progress in addressing it in the form of antibiotics, diagnostics and other treatments, we need to manage the spread of anti-microbial resistance through making those treatments as good as they can possibly be. Not to mention safeguarding the future by developing new treatments for infections as well.”
We always talk about how bacteria and viruses know no border – something that we’re seeing in sharp relief with Covid-19 at the moment.
Common examples of drug-resistant microbes include MRSA and mycobacterium tuberculosis. Although antibiotics have long been a safe and effective weapon against common infections, their overuse has caused serious problems as bacteria have developed resistance to them. “Anti-microbial resistance is always going to be out there – it’s a biological phenomenon that we need to learn to live with,” says Chapman. “One of the most challenging things about AMR is that it’s a global issue and it needs a global system for addressing it. We always talk about how bacteria and viruses know no border – something that we’re seeing in sharp relief with Covid-19 at the moment.”
Appliance of science
As a team, Wellcome’s DRI cohort don’t just focus on the science; structural and strategic issues are also on their radar. “We don’t invest in exciting new science for the sake of science,” says Chapman. ‘When we plan new activities, we involve policy input at all stages because we want to make sure that the evidence is appropriate and robust enough for decision-makers to effect good decisions. Of course, the evidence needs to be good evidence, but we also want to know how it’s going to be used.”
This long-view approach requires a mix of skills, leadership and process coordination, and it’s Chapman’s job to ensure that the DRI programme is able to deliver on its operational and strategic objectives in an effective and efficient way. “When the priority areas were established at Wellcome – DRI was one of the first – it triggered a totally new way of working,” she says. “In the past, Wellcome was more of a response-mode funder. You’d get in tonnes of grant applications and fund the best science. The priority areas were set up to acknowledge that there are specific health challenges that need a more targeted approach.
“I was actually the first programme manager to join, and coming from EY two jobs back, where everything is set up for you, it was a challenge. At EY, processes are already in place, there’s this huge infrastructure. I came in and started trying to create processes, at times from scratch. It was challenging to arrive at the balance between wanting to establish things that worked for our programme specifically and acknowledging that we need to align with the wider Wellcome way of working. We ended up very effectively pioneering what a new way of working could look like. It was challenging, but fun.”
Like many CAs, Chapman started her career at a Big Four firm before finding her niche. Her journey to the charity sector was firmly in her sights, though she had originally anticipated staying in corporate finance a bit longer than she did. “That Big Four environment is right for a lot of people, but it just wasn’t for me,” she says. “There were times when you would get towards the end of a project, deliver what was probably a really valuable report and then go away – your bit was done. You don’t always get to see it all the way through, which I found frustrating. Once I came to that realisation I found it quite difficult not to look at opportunities in the charity sector, and health in particular, which is what I was most interested in.”
After EY, Chapman joined Macmillan Cancer Support as a Data Analysis Project Manager. Her work there involved mapping cancer registry data against, for example, patient interactions with the NHS, and interpreting when interventions and support might be beneficial. “Although the system for health data was a bit of a shock after EY, I found the transition quite straightforward,” she says. “There’s a broad skillset that your ICAS training provides around how to approach analysis. I found that those skills were entirely relevant and valuable when I applied them to health data.”
Theory of change
These complementary skills and experiences have proved an ideal mix in the complex environment within which Wellcome’s DRI team operates. But Chapman stresses that her role is not without its hurdles. “Not being an expert in the subject, I can find the sheer complexity of the ecosystem we’re working in a little bit overwhelming at times,” she says. “Even though our team has a thorough understanding of AMR, all the insights that come out of a stakeholder workshop, for example, are things I may not have considered before: different geography, different industry, all the factors that affect the environment, manufacturing and supply chains. It’s why our team has adopted a theory of change approach. It’s a buzzword, I know, but it’s helped us to define what a critical path looks like to make sure we’re prioritising in the right way. There are still so many external factors that we just don’t know yet about AMR.”
Management theories and methodologies aside, Wellcome’s DRI team would operate quite differently were it not for less tangible qualities such as trust, curiosity and diversity of thought. “Trust allows for so many things to happen, including constructive challenge – feeling comfortable in challenging ideas within the team, and also being challenged yourself,” says Chapman. “One of the great things about our team is that challenge can come from anyone. And if someone doesn’t understand an element of our strategy, then in my opinion we’ve either got it wrong or we’re not communicating it clearly. I’m not an AMR scientist – far from it – but the team have enough trust in me that I can challenge their ideas.”
Wellcome is also a founding partner of CARB-X (Combating Antibiotic-Resistant Bacteria), a biopharmaceutical accelerator. Based at Boston University, this ambitious initiative counts Biomedical Advanced Research and Development Authority, the UK and German governments, and the Bill and Melinda Gates Foundation among its funders. A global non-profit partnership whose sole purpose is to accelerate AMR research, CARB-X exists to develop new antibiotics, diagnostics and vaccines targeted at AMR-specific pathogens.
“The scale of it means that it could naturally benefit from some initial input from our team as its operations develop – and it has scaled up very quickly,” explains Chapman. “I’m calling on all the things that I did while I was at EY: looking at operations, scale-up, financial management and portfolio management. On an initiative of that scale, that background is tremendously helpful and enables me to have meaningful conversations.”
Chapman’s enthusiasm has fuelled a project of her own: a part-time PhD in global health at UCL: “It’s unlike anything I’ve done before – completely independent and structureless. But the skills I acquired from doing my CA qualification set me up well to be an independent researcher in my own right. I can’t imagine going straight into a PhD from my previous study without working in between. The ICAS graduate programme gave me the structure to work independently: I learned problem-solving, independent thinking and operational discipline. Things I wouldn’t have had without it.“