Catriona Waitt is a Professor of Clinical Pharmacology and Global Health at the University of Liverpool. In 2015, with a Wellcome Clinical Research Career Development Fellowship, she moved to Uganda and established the MILK: Maternal and Infant Lactation pharmacoKinetics research group at the Infectious Diseases Institute, Makerere University, Kampala. Alongside this, the ATtaining EQUity of Access TO Research (At the Equator) public engagement programme ensures meaningful relationship with communities at all stages of our research. In March, we explored her work with the MILK and At the Equator teams, and now we're back with Catriona to discuss her wider career and inspirations.
Tell us about your current research interests.
I strongly believe everybody deserves access to the evidence they need to make informed decisions about their health. When groups of people have been systematically excluded from clinical trials, that evidence simply does not exist. I focus primarily on understanding safe, effective use of medication in breastfeeding through the MILK: Maternal and Infant Lactation pharmacoKinetics study, which I have undertaken as a Wellcome Clinical Research Career Development Fellowship. I also research other complex and understudied groups, and our team has a strong public engagement focus under the name At The EQUATOR which is an acronym for ATtaining EQUity of Access TO Research.
Did you always aspire to become a Principal Investigator?
No! Even during my early research career, I never imagined leading a group until one day I realised I was doing so. The reasons for this related to how I viewed a stereotypical Principal Investigator and my own stereotypes of leadership – I did not often see people I could relate to in research leadership roles, and did not see how I belonged in that space. I have spoken about some of this before, for example at Pharmacology 2021 when I gave a lecture associated with the Equality, Diversity and Inclusion Prize. Thankfully, I now clearly understand how excellence in research requires diversity at every level, including in personality and style, and I believe understanding of leadership is changing too, with a move away from more autocratic styles towards democratic, ambassadorial and teaching styles which I find far more comfortable.
Tell us about your most significant research accomplishments.
I believe my biggest achievement has been to get people to think differently about equity of access to research, and also about equity of access to research careers. For many years, pregnant and breastfeeding women were systematically excluded from clinical trials and there were huge gaps in data (there are still unacceptably huge gaps in data!). By describing the ethical imperative to do this work, providing some clear examples of research in these groups and its impact, and supporting it all with community engagement and involvement, I believe we have shown how such work can be done safely, ethically and well. Over the past five years, there seems to have been an important shift in perspective with several international working groups addressing this issue – I cannot claim credit for all that, but it has been wonderful to be part of the story.
With regard to equity of access to research careers, I hope that by showing a different style of leadership, and talking openly about some of the barriers that I have faced, others will see that they too can bring something unique to the research environment. Furthermore, all of my projects have a strong capacity-building ethos, aiming to equip and train the next generation of researchers with agile skillsets, able to respond to priority health-related questions..
Who has influenced you the most in your scientific career?
Although I had already done an intercalated degree in Pharmacology, my research career really started with my PhD work which explored early mortality in Malawian adults treated for pulmonary tuberculosis. At the time, the Malawi-Liverpool-Wellcome programme was led by Professors Peter Winstanley (Liverpool) and Malcolm Molyneux (Malawi). I am particularly grateful to that pair for encouraging me to pursue research, and for seeing something in me that I could not see myself; I doubt I would have chosen to pursue research had it not been for that specific mentorship. From that point, I have found many inspiring role models and informal mentors – often people who have broken stereotypes and carved out a unique and diverse role in research and leadership. Too many to list here, but if you are reading this, I hope you know who you are!
What is your leadership style? How do you manage risks and tricky situations?
My leadership style is democratic and ambassadorial. I wish all team members to embrace the vision and mission of the team, and see themselves as part of something bigger than themselves. I also aim to provide structures whereby all team members can speak freely. Increasingly, I delegate specific tasks to each team member with the aim to build confidence, skill and their own leadership ability. This has proved effective, and I believe is very important when working in a cross-cultural setting. I need my team members to be able to challenge me, and make suggestions on how best to navigate certain situations. By enabling clear channels of communication, such tricky situations do not often occur. I find the hardest situations to be the end of contracts for team members who were employed on a specific project for a specific length of time; whilst I endeavour to secure further research funding and to keep team members on, there are times when that is not possible.
What would be your advice on establishing collaborations?
Find people you enjoy working with, and who share your enthusiasm for the topic!
When you begin a collaboration, especially if you are invited into a group or network, make sure that you deliver on assigned tasks and show yourself to be a valued member of the team who makes good suggestions and is able to complete the work.
Once you are more established, look for collaborations that complement the work that you are doing, and where there is synergistic strength.
What is the best thing about teaching and training the next generation of early career researchers?
They are the future! I love to see young researchers develop and move towards independence. As I mentioned earlier, there have been some unhelpful stereotypes and hierarchies in academia, and there have been experiences of negativity and poor team dynamics which have affected myself and other members of the team in the past. Therefore I hope that by creating a different structure and equipping and empowering my team members, that they will rise to positions of leadership and make a lasting impact. I attended a graduation ceremony in Uganda recently, and the exuberant joy of the young graduates setting forth on their careers was a delight to behold.
How do you maintain work:life balance? What hobbies do you enjoy outside of the lab?
I wonder if life-work balance is the right term, as for me it is more of a continuum. I am a mother of five and have worked less than full time since 2009, as has my husband who is also a clinical academic with roles in Uganda and the UK. Because our work requires us to move between countries and to travel between sites across the entirety of Uganda frequently, we home educate our children and this has proven to be a very exciting adventure. It does require very careful planning and teamwork, and at times compromise, but we have no regrets about the choices we made.
We love to explore, and as often as possible will hike, run, swim, kayak and enjoy a range of outdoor activities. We are all active in our local church, and I enjoy playing saxophone in the music team. I am involved in several NGOs, particularly the ATTA Breastmilk Community which aims to bring donor milk banking to government facilities in Uganda, and those encouraging fostering and adoption. I believe that all of this actually enhances my approach to research, and encourages me to celebrate diversity and flexibility in my team members.
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