Chapter 1: What contributions has Sir John Bell made to life sciences?
Hello, this is Eric Topol from Ground Truths, and I'm really delighted to welcome today Sir John Bell, who has had an extraordinary career as a geneticist, immunologist. We'll talk about several initiatives he's been involved with during his long tenure at University of Oxford. Recently became head of the Ellison Institute of Technology in the UK. So welcome, John.
Thanks, Eric. Thanks very much for having me.
Well, I think it's just extraordinary the contributions that you have made and continue to make to advance medicine. And I thought what we could do is get into that. I mean, what's interesting, you have had some notable migrations over your career, I think starting in Canada at Stanford and over at Rhodes Scholar, Oxford.
And then you, of course, had a couple of decades in a very prestigious position in which, as I understand, was started in 1546 by Henry VII, the Regis Professor of Medicine at the University of Oxford. Do I have that right?
Yeah, it was actually Henry VIII, but you were close.
Henry VIII, that's great. Yeah, okay, good.
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Chapter 2: How is the Ellison Institute of Technology transforming healthcare?
Well, that's a pretty notable professorship. And then, of course, in recent times, you left to head up this pretty formidable new institute, which is something that's a big trend going on around the world, particularly in the U.S. we'll talk about. So maybe we can start with the new thing. Tell us more about the EIT, Ellison Institute of Technology, if you will.
Yeah. So as you know, Larry Ellison has been one of the great tech entrepreneurs, focused really on developing terrific databases over his career and through Oracle, which is the company that he founded. Larry is really keen to try and give back something substantial to the world, which is based on science and technology. He and I did quite a bit together over the COVID pandemic.
He and I talked a lot about what we're doing and so on. He came to visit afterwards. I think he decided that the right way to make his contributions would be to set up an institute that would be using
that state of the art science and technology with a lot of AI and machine learning, but also some of the other modern tools to address the major problems in health care, in food security, in green energy and climate change and in global governance. So anyway, he launched this about 18 months ago. He approached me to ask whether I would run it.
Chapter 3: What role does AI play in the future of medicine?
He wanted to set it up outside Oxford. And he wanted to do something which is a bit different than others. And that is his view was that we needed to try and create solutions to these problems which are commercially viable. And, you know, not all the solutions are going to be commercially viable, but where you can create those, you make them sustainable.
So the idea is to make sure that we create solutions that people want to buy. And then if they buy them, you can create a sustainable solution to those issues. So we are actually a company, but we are addressing many of the same problems that the big foundations are addressing. And the big issues that you and I talk about in health, for example, are all on our list.
We're kind of optimistic as to where this will go. And Larry's supporting the project. And we're going to build out an institute here, which will have about 5,000 people in it. And will be, I think, a pretty exciting new addition to the science and technology ecosystem globally.
Well, I know the reverberations and the excitement is palpable in some of the colleagues I've spoken to, not just in England, but of course all over the world. So congratulations on that. It was a big move for you to leave the hardcore academics. And the other thing I wanted to ask you, John, is
You had distinguished your career in immunology, in genetics, type 1 diabetes, and other autoimmune conditions, and now you've really diversified, as you described, with these different areas of emphasis at the new institute. Is that more fun to do, or do you have helped deputies that you can assigned to things like climate change and other areas.
Trust me, Eric, I'm not making any definitive decisions about areas I know nothing about. Part of this is about how do you set up leadership, run a team, get the right people in. I have to say, one of the really interesting things about the Institute is we've been able to recruit some outstanding people across all those domains. And as you know, success is almost all dependent on people.
So we're really pretty optimistic we're going to have a significant impact. And of course, we also want to take risks because there's not a lot of point in us doing stuff that everybody else is doing. we're going to be doing some things that are, you know, pretty way out there and, uh, and some of them will fail.
So we just, we're just going to get used to trying to make sure we get a few of them across the finish line. So, so, but, but the other thing is that, and you've experienced this too, I'm, you know, you never get too old to learn.
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Chapter 4: How did the UK become a leader in genomics?
And I'm, I mean, I'm sucking up stuff that I never thought I would, I would ever learn about, which is fun actually. And yeah.
Yeah.
It's fantastic. I mean, you've really broadened and it's great that you have the runway to get these people on board. And I think you're having a big building that's under construction.
Yeah, we've got the original building which Larry committed to is about 330,000 square feet of space. I mean, this is completely amazing. But we're, of course, to accommodate... Up to 5,000 people are going to need more than that. So we're looking at a much wider campus here that will involve more than just that building.
So I think we'll end up with several million square feet of space by the time we're finished. I mean, it's a really big project. But we've already made progress in some domains to try and get projects and the beginnings of companies on the road to try and solve some of the big problems. So we're quite excited about it.
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Chapter 5: What are the key initiatives like UK Biobank and Genomes England?
Now, I assume it's pretty close to Oxford, and will you have some kind of interactions that are substantial?
Yeah, so the university's been terrific about this, actually, because, of course, most universities would say, well, why don't you do it inside the university and just give us the money, and it'll all be fine. So, of course, Larry wasn't born yesterday, so I said, well, thank you very much, but I think we'll probably do this nearby.
Okay.
But the university also realized this is a really exciting opportunity for them. And we've got a really good relationship with them. We've signed an agreement with them as to who will work where. We've agreed not to steal a lot of their staff. We're going to be bringing new people into the ecosystem.
Some of the university people will spend some time with us and some time in the university, so that will help. But we're also bringing quite a few new people into the setting. So the university has been really positive. And I think one of the things that's attractive to the university, and you'll be familiar with this problem in the UK, is that we're quite good.
The discovery science here is pretty good. And we do do startups now at scale. So, you know, Oxford does lots of little startup companies in the biotech space and all the rest of it. But we never scale any of these companies because there isn't the depth of capital for scaling capital to get these things scaled. And so in a way, what we're trying to do here at Ellison
actually avoids that problem because you know larry knows how to scale companies and we've got the financial support now if we have things that are really successful we can build the full stack solution to some of these problems so i think the university is really intrigued as to how we might do that
We're going to have to bring some people in that know how to do that and build billion-dollar companies, but it's sufficiently attractive. We've already started to recruit some really outstanding people. So as a way to change the UK system broadly, it's actually quite a good disruptive influence on the way the thing works to try and fix some of the fundamental problems.
Yeah, I love that model and the ability that you can go from small startups to really transformative companies have any impact. It fits in well with the overall objectives. I can see that. The thing that also is intriguing regarding this whole effort is is that in parallel, we've learned your influence. The UK is a genomics world leader without any question.
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Chapter 6: How does the Our Future Health project aim to change public health?
So you do need large-scale cohorts to understand what you're doing. And it was really Richard that pioneered the whole thinking behind that.
When we had another element in the formula, which was the ability to detect genetic variation and put that into the formula, it seemed to me that we could move into an era where you could set up, again, large cohorts, but build into the ability to have DNA, interrogate the DNA, and also ultimately interrogate things like proteomics and metabonomics, which were just in their infancy at that stage.
So very early on, I got together, because I was at that stage the Nuffield Chair of Medicine, and I got together Rory and Richard and a couple of others, and we talked a little bit about what it would look like.
We agreed that a half a million people late to middle age, 45 and above, would probably over time, when you did the power calculations, give you a pretty good insight in most of the major diseases. And then it was really a question of collecting them and storing the samples.
So, in order to get it funded, at the time I was on the council of the MRC and George Ratta, who you may remember was quite a distinguished NMR physiologist here, he was the chief executive of the MRC.
So, I approached him and I said, look, George, this would be a great thing for us to do in the UK because we have all the clinical records of these people going back for a decade and we'll continue to do that. And so, of course, we immediately sent it out to a peer review committee in the MRC who completely trashed the idea and said, you got to be joking. So I thought, OK, you'll be good.
That's a lesson. And I did say to George, I said, that must mean this is a really good idea, because if it had gone straight through peer review, you know, you would have known you were toast. So anyway, I think we had one more swing at peer review and decided in the end that wasn't going to
So in the end, George, to his credit, took it to MRC Council and we pitched it and everybody thought, what a great idea. Let's just get on and do it. And then the welcome came in. Mark Walpert was at the welcome at the time, great guy and did a really good job at bringing the welcome on board.
And so we, and, and, you know, people forget the amount, the quantum of money we had to do this at the time was about 60 million pounds. I mean, it was, it was, it was astonishingly small. So, and, and, and then, then of course we had a couple of wise people who came in to give us advice and,
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Chapter 7: What innovations are being made in immunology and vaccine development?
That's an understatement, by the way. A big understatement. Yeah. Anyway, so I wrote the... the strategies in 2017 for Teresa about what we would do as a nation to support life sciences. And it was interesting because I brought a group of pharma companies together to say, look, this is for you guys. So tell us what you want done.
We had a series of meetings and what became clear is that they were really interested in where healthcare was going to end up in the next 20 years. And they said, you guys should try and get ahead of that wave.
And so we agreed that one of the domains that really hadn't been explored properly was the whole concept of prevention, early diagnosis and prevention, which they were smart enough to realize that the kind of current paradigm of treating everybody in the last six months of life You know, you can make money doing that, there's no doubt, but it doesn't really fix the problem.
And so they said, look, we would love it if you created a cohort from the age of 18 that was big enough that we could actually track the trajectories of people with these diseases, identify them at a pre-symptomatic stage, intervene with preventative therapies, diagnose diseases earlier, and see if we could fundamentally change the whole approach to public health.
Anyway, we went back and did those numbers because, of course, it's a much wider age group. A lot of people don't get it all sick, but we thought if we collected 5 million people, we would probably have enough. That's 10% of the UK population, adult population. So anyway, amazingly, the government said, off you go.
We then had COVID, which, as you know, kept you and I busy for a few years before we could get back to it. But then we got at it and We hired a great guy by the name of Riley Valley who had done a bit of this in the UAE and he came across and we set up a population health recruitment structure which was community-based and we rapidly started to recruit people.
We've now got 2.9 million people registered, 2.3 million people consented, and we've got blood in the bank and all the necessary data, including questionnaire data, for 1.5 million people growing up. So we will get to 5 million, and it's amazing.
It really is. I'm just blown away by the progress you've made. And what was interesting, too, besides you all weren't complacent about, oh, we got this UK biobank, and you just kept forging ahead. And by the way, I really share this importance of finally what has been a fantasy of primary prevention, which I never really achieved. It's always, oh, after a heart attack, then only you know.
But that's what I wrote about in Super Ager's book, and I'll get you a copy.
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Chapter 8: What is the global perspective on the future of science and collaboration?
We need to get the regulators on board. We've got to get them to understand that we need diagnostics that define risk, not disease, because that's going to be a key bit of what we're going to try and do. And we need to... We need to understand that for a lot of these diseases, you have to intervene quite early to flatten that morbidity curve.
Yeah, absolutely. And what we've learned, you know, for example, from the UK biobank is not just, of course, the genomics that you touched on, but the proteomics. Yeah, the organ clocks and all these other layers of data. So that gets me to my next topic, which I know you're all over it, which is AI. So when I did the NHS review back in 2018, 2019,
The group of people, which were amazing, that I had to work with, no doubt why the UK punches well beyond its weight. I had about 50 people, and they just said, you know what? Yeah, we are the world leaders in genomics. We want to be the world leader in AI. Now, these days, you only hear about US and China, which is ridiculous. And you have perhaps one of the
I would say most formidable groups there with Demis and Google Deep completely. Just extraordinary. So all the things that you, the main foci of the Ellison Institute,
intersect with ai they do and we've got we've got two underpinning platforms well actually three underpinning platforms that go across all those domains larry was really keen that we became a real leader in ai so he's funded that with a massive compute capacity and remember most universities these days have a hard time competing on compute because it's exciting yeah yeah
So that is a real advantage to us. He's also funded a great team. We've recruited some people from Demis's shop who are obviously outstanding, but also others from around Europe. So we've recruited now about 15 really outstanding machine learning and AI people. And of course, we're now thinking about the other asset that the UK's got, and particularly in the healthcare space, is data.
So we do have some really unique data sets because those are the three bits of this that you need if you're going to make this work. So we're pretty excited about that. as an underpinning bit of the whole Ellison Institute strategy is to fundamentally underpin it with very strong AI.
Then the second platform is generative biology or synthetic biology, because this is a field which is sort of, as they say, limped along, but it's lacked a real focus. But we've been able to recruit Jason Chin from the LMB in Cambridge, and he is one of the real dramatic innovators in that space.
And we see there's a real opportunity now to synthesize large bits of DNA, introduce them into cells, microbes, use it for a whole variety of different purposes, try and transform plants at a level that people haven't done before. So with AI and synthetic biology, we think we can feed all the main domains above us. And That's another exciting concept of what we're trying to do.
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