Anthony Costello

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Anthony Costello
FMedSci FRCPCH FRCP
Anthony Costello headshot.jpg
Costello in 2016
Born (1953-02-20) 20 February 1953 (age 71)
NationalityBritish
Education St Joseph's Academy, Blackheath
Alma mater St Catharine's College, Cambridge
Middlesex Hospital
Known forImproving the health of newborn infants and mothers in developing countries
Awards James Spence Medal
Scientific career
Fields Pediatrics
Institutions University College London World Health Organization
Doctoral students Joy Lawn [1]
Website anthonycostello.net

Anthony Costello (born 20 February 1953) is a British paediatrician. Until 2015 Costello was Professor of International Child Health and Director of the Institute for Global Health at the University College London. Costello is most notable for his work on improving survival among mothers and their newborn infants in poor populations of developing countries. From 2015 to 2018 he was director of maternal, child and adolescent health at the World Health Organization in Geneva.

Contents

Early life and education

Costello was born in Beckenham, and graduated from school at St Joseph's Academy, Blackheath. Costello attended St Catharine's College, Cambridge, where he was awarded a degree in Experimental Psychology and qualified as a doctor in Medical Sciences after clinical training at the Middlesex Hospital in London. [2] He then trained in Paediatrics and Neonatology at University College London. His aunt was the atheist activist Barbara Smoker.

Career and research

Community mobilisation

After living in Baglung district in western Nepal from 1984 to 1986, two days' walk from a road, he became interested in challenges to mother and child health in poor, remote populations. His areas of scientific expertise include the evaluation of cost-effective interventions to reduce maternal and newborn deaths, women's groups, strategies to tackle malnutrition, international aid and the health effects of climate change. In 1999 he published a pioneering book on how to improve newborn infant health in developing countries. [3]

With a Nepali organisation (MIRA), that he helped to establish, a large community trial of participatory learning and action using women's groups in the remote mountains of Makwanpur District, Nepal was published in The Lancet in 2004. [4] He went on to establish partnerships and further studies with local organisations in East India, Mumbai, Bangladesh and Malawi. Seven cluster randomised controlled trials of women's groups in Nepal, India, Bangladesh and Malawi, led to a meta-analysis published in the Lancet in May 2013. [5]

Results showed that in populations where more than 30% of pregnant women joined the women's group programme, maternal death and newborn deaths were cut by one third. The intervention has now been recommended by the World Health Organization (WHO) for scale-up in poor, rural populations. [6]

Costello has led teams involved in more than a dozen cluster randomized controlled trials to show the power of community mobilization to affect health outcomes such as maternal and newborn deaths, child nutrition and diabetes. In November 2018 he published the book The Social Edge. The Power of Sympathy Groups for our Health, Wealth and Sustainable Future. [7] The book explains why a new science of cooperation is needed and suggests twenty two social experiments which use sympathy groups for resolving 21st century problems.[ citation needed ]

Climate change

Costello chaired the 2009 Lancet Commission on Managing the Health Effects of Climate Change, [8] and was co-chair of a new Lancet Commission which links the UK, China, Norway and Sweden on emergency actions to tackle the climate health crisis, published in June 2015. [9] In 2015 he led the development of the Lancet Countdown: Tracking Progress on Health and Climate Change. [10] [11] These annual reports, developed by a network of 38 universities and research institutions, produces an annual Lancet report on the health impacts, adaptation progress, renewable energy, economics and public engagement related to climate change.

World Health Organization

At WHO he helped to develop the Global Strategy for Women's, Children's and Adolescents’ Health (2016‒2030) with its three objectives of surviving, thriving and transforming – to end preventable mortality, to promote health and well-being, and to expand enabling environments. Its guiding principles include equity, universality, human rights, development effectiveness and sustainability.

With the WHO team, Costello also launched the global accelerated action for the health of adolescents (AA-HA!) and established an expert review group called Maternal and Newborn Information for tracking Outcomes and Results (MONITOR) to harmonize maternal and newborn health indicators.

In February 2017, together with UNICEF and the United Nations Population Fund (UNFPA), Costello helped to launch the Network for Improving Quality of Care for Maternal, Newborn and Child Health to introduce evidence-based interventions to improve quality of care for maternal and newborn health supported by a learning system. The Network aims to improve care in Ethiopia, Nigeria, India, Bangladesh, Malawi, Côte d'Ivoire, Uganda, Tanzania and Ghana. He also led work on community empowerment for family health - what it means, how to measure it, and how to plan interventions at the district level. [12] With UNICEF, he helped coordinate a new Lancet Commission on redesigning child health for sustainable development goals.

Children in All Policies

While at WHO Costello set up a WHO UNICEF Lancet Commission, chaired by the Right Honorable Helen Clark, former Prime Minister of New Zealand, and Dr Awa Coll-Seck, Minister of State for Senegal, which comprised 41 experts from around the world and led to a report in the Lancet on 'A Future for our Children'. [13] In 2020, based on this commission, he led the development of Children in All Policies 2030 which has set up links in Argentina, Senegal, Ghana, South Africa, India, Nepal and the Pacific Islands. The focus of the work is on building a commitment to children in all sectors of government, to placing children at the centre of sustainable development policies, advocacy for climate change and strategies to protect children from commercial exploitation.[ citation needed ]

Independent SAGE

In May 2020 Costello helped to set up the Independent Scientific Advisory Group for Emergencies, better known as Independent SAGE is a group of scientists, unaffiliated to government (although some are also in the government SAGE), that aims to provide advice to the United Kingdom government regarding the COVID-19 pandemic. The group, chaired by Sir David Anthony King, a former Government Chief Scientific Advisor, was formed in early May 2020 to "provide a clear structure on which an effective policy should be based given the inevitability that the virus will continue to cross borders". Costello had argued early on in the pandemic that the UK had neglected public health interventions recommended by WHO, that the government advisers did not include independent public health experts, and that the UK government and SAGE view that the virus could not be suppressed was wrong. [14] When Asian states showed that suppression of the pandemic could be achieved in early March 2020, SAGE declared in their minutes of 13 March [15] that "SAGE was unanimous that measures seeking to completely suppress spread of COVID-19 will cause a second peak. SAGE advises that it is a near certainty that countries such as China, where heavy suppression is underway, will experience a second peak once measures are relaxed." By June 2021 this had not happened. China still has a death rate of just 3 per million (compared with the Uk's 1900 per million), and has now vaccinated over 800 million people without exposure to new variants.

Costello has been critical of the UK Government's response to the COVID-19 pandemic. On 16 April 2020, he told The Telegraph:

We should have introduced the lockdown two or three weeks earlier but we didn’t. It should be combined with testing, tracing and digital apps that have been used so successfully in South Korea.... It is a total mess and we have been wrong every stage of the way. We have to change our policy and at the moment I don’t hear anything to suggest we are. They keep talking about flattening the curve which implies they are seeking herd immunity but what we should have done is crushed the epidemic and then keep it down. [16]

Awards

Costello holds fellowships of the Academy of Medical Sciences and of the Royal College of Physicians. He has also received Honorary Fellowships of the Royal College of Obstetricians and Gynaecologists, and of the Faculty of Public Health. In April 2011, Costello received the James Spence Medal, the highest honour of the Royal College of Paediatrics and Child Health, where he is a fellow. He serves on the Board of the global Partnership for Maternal, Newborn & Child Health, chaired by Graça Machel. In May 2016, he received the BMJ Lifetime Achievement Award. [17] [18]

Personal life

Costello and his wife Helen have two sons and one daughter. [19] He supports Millwall F.C., a team his family have supported since the 1890s. His cousin-in-law was Talk Talk lead singer Mark Hollis.

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References

  1. ↑ Lawn, Joy Elizabeth (2009). 4 million neonatal deaths : an analysis of available cause-of-death data and systematic country estimates with a focus on 'birth asphyxia'. ucl.ac.uk (PhD thesis). University College London. OCLC   829958629. EThOS   uk.bl.ethos.564767. Lock-green.svg
  2. ↑ "International MNCA expert named as Director, WHO Department of Maternal, Newborn, Child and Adolescent Health". World Health Organization. GENEVA, SWITZERLAND. June 2015. Archived from the original on 28 June 2015. Retrieved 8 July 2018.
  3. ↑ Costello, Anthony; Manandhar, Dharma, eds. (2000). Improving Newborn Infant Health In Developing Countries. World Scientific. ISBN   978-1-78326-239-7.[ page needed ]
  4. ↑ Manandhar, Dharma S; Osrin, David; Shrestha, Bhim Prasad; Mesko, Natasha; Morrison, Joanna; Tumbahangphe, Kirti Man; Tamang, Suresh; Thapa, Sushma; Shrestha, Dej; Thapa, Bidur; Shrestha, Jyoti Raj; Wade, Angie; Borghi, Josephine; Standing, Hilary; Manandhar, Madan; de L Costello, Anthony M; Members of the MIRA Makwanpur trial, team. (September 2004). "Effect of a participatory intervention with women's groups on birth outcomes in Nepal: cluster-randomised controlled trial". The Lancet. 364 (9438): 970–979. doi:10.1016/S0140-6736(04)17021-9. PMID   15364188. S2CID   4796493.
  5. ↑ Prost, Audrey; Colbourn, Tim; Seward, Nadine; Azad, Kishwar; Coomarasamy, Arri; Copas, Andrew; Houweling, Tanja A J; Fottrell, Edward; Kuddus, Abdul; Lewycka, Sonia; MacArthur, Christine; Manandhar, Dharma; Morrison, Joanna; Mwansambo, Charles; Nair, Nirmala; Nambiar, Bejoy; Osrin, David; Pagel, Christina; Phiri, Tambosi; Pulkki-Brännström, Anni-Maria; Rosato, Mikey; Skordis-Worrall, Jolene; Saville, Naomi; More, Neena Shah; Shrestha, Bhim; Tripathy, Prasanta; Wilson, Amie; Costello, Anthony (May 2013). "Women's groups practising participatory learning and action to improve maternal and newborn health in low-resource settings: a systematic review and meta-analysis". The Lancet. 381 (9879): 1736–1746. doi:10.1016/S0140-6736(13)60685-6. PMC   3797417 . PMID   23683640.
  6. ↑ WHO Recommendation on Community Mobilization through Facilitated Participatory Learning and Action Cycles with Women's Groups for Maternal and Newborn Health. WHO Guidelines Approved by the Guidelines Review Committee. World Health Organization. 2014. hdl: 10665/127939 . ISBN   978-92-4-150727-1. PMID   25165805.[ page needed ]
  7. ↑ Costello, Anthony (2018). The Social Edge: The Power of Sympathy Groups for Our Health, Wealth and Sustainable Future. Thornwick Limited. ISBN   978-1-912664-00-9.[ non-primary source needed ][ page needed ]
  8. ↑ Costello, Anthony; Abbas, Mustafa; Allen, Adriana; Ball, Sarah; Bell, Sarah; Bellamy, Richard; Friel, Sharon; Groce, Nora; Johnson, Anne; Kett, Maria; Lee, Maria; Levy, Caren; Maslin, Mark; McCoy, David; McGuire, Bill; Montgomery, Hugh; Napier, David; Pagel, Christina; Patel, Jinesh; de Oliveira, Jose Antonio Puppim; Redclift, Nanneke; Rees, Hannah; Rogger, Daniel; Scott, Joanne; Stephenson, Judith; Twigg, John; Wolff, Jonathan; Patterson, Craig (May 2009). "Managing the health effects of climate change". The Lancet. 373 (9676): 1693–1733. doi:10.1016/S0140-6736(09)60935-1. PMID   19447250. S2CID   205954939.
  9. ↑ Watts, Nick; Adger, W Neil; Agnolucci, Paolo; Blackstock, Jason; Byass, Peter; Cai, Wenjia; Chaytor, Sarah; Colbourn, Tim; Collins, Mat; Cooper, Adam; Cox, Peter M; Depledge, Joanna; Drummond, Paul; Ekins, Paul; Galaz, Victor; Grace, Delia; Graham, Hilary; Grubb, Michael; Haines, Andy; Hamilton, Ian; Hunter, Alasdair; Jiang, Xujia; Li, Moxuan; Kelman, Ilan; Liang, Lu; Lott, Melissa; Lowe, Robert; Luo, Yong; Mace, Georgina; Maslin, Mark; Nilsson, Maria; Oreszczyn, Tadj; Pye, Steve; Quinn, Tara; Svensdotter, My; Venevsky, Sergey; Warner, Koko; Xu, Bing; Yang, Jun; Yin, Yongyuan; Yu, Chaoqing; Zhang, Qiang; Gong, Peng; Montgomery, Hugh; Costello, Anthony (November 2015). "Health and climate change: policy responses to protect public health". The Lancet. 386 (10006): 1861–1914. doi: 10.1016/S0140-6736(15)60854-6 . hdl: 10871/17695 . PMID   26111439. S2CID   205979317.
  10. ↑ "Lancet Countdown: Tracking Progress on Health and Climate Change". Institute of Global Health. Project Summary: University College London. 16 January 2017. Retrieved 7 December 2018.
  11. ↑ "Lancet Countdown". Lancet Countdown. Retrieved 3 December 2019.
  12. ↑ "Launch of Network for Improving Quality of Care for Maternal, Newborn and Child Health". Geneva, Switzerland: World Health Organization. The partnership for Maternal, Newborn and Child Health. 4 May 2017. Retrieved 8 December 2018.
  13. ↑ Clark, Helen; Coll-Seck, Awa Marie; Banerjee, Anshu; Peterson, Stefan; Dalglish, Sarah L.; Ameratunga, Shanthi; Balabanova, Dina; Bhan, Maharaj Kishan; Bhutta, Zulfiqar A.; Borrazzo, John; Claeson, Mariam; Doherty, Tanya; El-Jardali, Fadi; George, Asha S.; Gichaga, Angela; Gram, Lu; Hipgrave, David B.; Kwamie, Aku; Meng, Qingyue; Mercer, Raúl; Narain, Sunita; Nsungwa-Sabiiti, Jesca; Olumide, Adesola O.; Osrin, David; Powell-Jackson, Timothy; Rasanathan, Kumanan; Rasul, Imran; Reid, Papaarangi; Requejo, Jennifer; Rohde, Sarah S.; Rollins, Nigel; Romedenne, Magali; Sachdev, Harshpal Singh; Saleh, Rana; Shawar, Yusra R.; Shiffman, Jeremy; Simon, Jonathon; Sly, Peter D.; Stenberg, Karin; Tomlinson, Mark; Ved, Rajani R.; Costello, Anthony (22 February 2020). "A future for the world's children? A WHO–UNICEF–Lancet Commission". The Lancet. 395 (10224): 605–658. doi: 10.1016/S0140-6736(19)32540-1 . PMID   32085821. S2CID   211163182.
  14. ↑ Costello, Anthony (15 March 2020). "The UK's Covid-19 strategy dangerously leaves too many questions unanswered | Anthony Costello". The Guardian.
  15. ↑ "SAGE 15 minutes: Coronavirus (COVID-19) response, 13 March 2020".
  16. ↑ 'UK faces eight to ten waves of coronavirus before population achieves herd immunity', Telegraph, 16/4/20.
  17. ↑ "Anthony Costello: Irreverent, melancholic, dogged". BMJ. 353: i3550. 29 June 2016. doi:10.1136/bmj.i3550. PMID   27358256. S2CID   35973031.
  18. ↑ "Professor Anthony Costello". EAT Forum. EAT. Retrieved 7 December 2018.
  19. ↑ Honigsbaum, Mark (May 2009). "Anthony Costello: making climate change part of global health". The Lancet. 373 (9676): 1669. doi: 10.1016/S0140-6736(09)60929-6 . PMID   19447244. S2CID   139095946.
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