Book review: Brain Fever: How to Prevent Meningitis and Other Killer Diseases by Richard Moxon

July 2021

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In April 2016, I found myself sat behind Professor Richard Moxon in a rather cramped and stuffy committee room in Portcullis House, UK. I was waiting my turn to give evidence to a joint select committee hearing, following an unprecedented 800,000 signatory public petition calling for the extension of the MenB vaccine to under 11-year-olds in the UK. Addressing a packed room, he made his vociferous hatred for meningitis and its devastating impacts clear. I now understand at that time, Richard had been working to defeat meningitis for over 40 years, whereas my combined experience in the field stretched to less than six months.

Brain Fever: How to Prevent Meningitis and Other Killer Diseases by Richard MoxonThis perfectly timed book again reminded me I would forever be playing catch-up as it expertly guides readers through those decades of immense contribution to the field and a little beyond – right up to the approval of the new World Health Organization Global Roadmap to Defeat Meningitis by 2030. As Dr K.Y Amoako reminds us in his recent compelling book charting the path of Ghanaian independence and Africa’s strive towards transformation, and borrowing from a local saying, it always pays to ‘Know the Beginning Well’. Professor Moxon’s book does that and so much more besides.

Through an early career (and exhaustion) as a junior doctor in the UK, through both long and short periods in clinical and scientific practice and leadership in the US, finally returning home and establishing the Oxford Vaccines Group, Professor Moxon demonstrates time and again that persistence, determination and collaboration drive progress. His work has been at the heart of developments of new vaccines for some of the leading causes of meningitis, including HiB and MenB and always, always, setting store by the advice given to him that ‘Medicine is learned by the bedside… See, and then research… But see first’.

These achievements are remarkable in themselves and, for the clinically and scientifically minded, this book provides an excellent overview of the key issues. In addition, the book is suffused with a generosity and warmth for others’ contributions (perhaps exempt for a while when rejected for a Wellcome Trust grant, but soon to return), and a lightness of touch over personal stories that make reading it a pleasure. I loved the anecdotes of a soon-to-be eminent clinical scientist being bored on a too-long transatlantic boat crossing, and of the political challenges of making progress while balancing the need for funding and commercial interests. But perhaps above all, I was struck by the wisdom – often combined with lack of sleep due to jetlag that helped with some inspired thinking – to use the latest technologies to improve options to prevent meningitis through vaccines. For example, the insights Richard provides into the vital role of genome sequencing in the development of the MenB vaccine right through to COVID-19 charts the shift in emphasis in just one generation from a lab bench to a computer screen for the latest insights in bacterial make-up (without taking away from the vital role labs still play).

To declare a conflict of interest - Richard is kindly splitting the proceeds from this book between Meningitis Research Foundation and Meningitis Now (formerly Meningitis Trust). He kindly gives credit for our support and contribution to the field. To be clear, even if this were not the case, my views would be the same. Our work and the progress we make and still need to make against this awful disease stands on the shoulders of giants. Richard is undoubtedly one of those giants and the pages of this book are an invaluable lesson in what it takes to transform a field and make positive change happen. Please do order a copy, order many copies, and share them widely.

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About the author

Vinny Smith
Chief Executive

Besides meeting my wife and having two wonderful kids, leading MRF is the greatest privilege of my life.

Since joining in 2015 I’ve helped develop and launch a new brand identity, new website and a new strategy. We’ve held governments to account on vaccine policy and called for and achieved a new World Health Organisation global task force for meningitis to 2030.
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