Sharing global responsibilities

More of our planet’s inhabitants must have access to good healthcare and good health, believes the president of Karolinska Institutet. Ole Petter Ottersen’s vision for what medical research and education can contribute is both global and long-term. The path forward requires strong ethics, transparency and open dialogue with the world around us.

Name: Ole Petter Ottersen

Title: President of Karolinska Institutet.

Age: 63

Family: Partner who is a researcher at the University of Oslo, two sons.

Motto: “There is only one academia and it is global”

How I relax: Collecting art, listening to music and hill running.

Role model: Physicist and Nobel Laureate Niels Bohr. Like myself, he was inspired by art.

The hardest thing about being president: I can be impatient; everything takes time in academia. Still, that’s as it should be.

Notable characteristics according to colleagues: “Energetic, engaged and enthusiastic.” “The best communicator I have encountered.”

Ole Petter Ottersen in Biomedicum 2018.
President Ole Petter Ottersen, credit: Martin Stenmark.

Text: Cecilia Odlind, first published in Swedish in Medicinsk Vetenskap, No 2/2018.

For eight years Ole Petter Ottersen led the University of Oslo. In August 2017, he took up the post of president of Karolinska Institutet.

“This is of course far from a routine job, which suits me. As soon as I wake up, I’m looking forward to the challenges the day will bring. All of those things that happen at any university, things that one can’t foresee, make the job interesting. I see it as a great privilege,” he says.

One issue close to Ole Petter Ottersen’s heart, and one that he has carried with him into his role as president, is the experience he gained as chairman of the Commission on Global Governance for Health between 2011 and 2014. The commission investigated the underlying political causes of inequity in access to health and healthcare among people globally.

“This work was an eye-opener for me. For example, did you know that five billion people lack access to safe, affordable surgical care? An entire life might be spent suffering from a hernia that could have been easily treated,” he says.

Ole Petter Ottersen also realised that there is often a correlation between power and health, mentioning an example from the commission’s report.

“When it came to designing warnings on cigarette packets, a major corporation such as tobacco giant Philip Morris was shown to have greater power than the nation of Uruguay. This demonstrates how economic interests can have a negative impact on human health across an entire country,” he says.

Achieving good health

The conditions required for achieving good health and their close relationship with other issues, such as climate change, the environment, and economic and social sustainability, is also something that the United Nations has addressed when developing their Agenda 2030, a resolution that, among other things, addresses greater equality in health care globally. Now, Ole Petter Ottersen would like to see this goal adopted in Karolinska Institutet’s coming strategy.

“It is our joint responsibility to see that this goal is achieved. In order to succeed, we must cooperate across fields, disciplines and geographical boundaries in brand new ways,” says Ole Petter Ottersen.

In November, Karolinska Institutet will be arranging a conference on the goals contained in Agenda 2030, and students will play an important role.

“The students we educate now will, of course, be responsible for achieving these goals in the future. And this is incredibly complex work that demands lateral thinking, given the need to consider so many other determining factors, not purely medical ones. We must adapt our study programmes to meet these requirements,” he says.

In other words, Ole Petter Ottersen sees the job of president as no simple task. However, it all began with a broken radio; the object of the 10-year-old Ole Petter’s care and curiosity. An interest in how things work and can be repaired has remained with him since then. Over time, the brain became the focus of his desire to understand – and to repair.

“I have never had cause to regret my choice of subject. It is incredibly interesting to research the organ one uses when conducting research,” he says.

Over recent years, the focus of Ole Petter Ottersen’s basic research has been on the brain’s water channels, or aquaporins. These proteins sit in cell membranes and allow the passage of water molecules and nothing else, giving them an important role in maintaining the body’s fluid balance.

The development of cerebral edema

One goal of Ole Petter Ottersen’s research, mainly conducted at the University of Oslo, has been to achieve a better understanding of how water channels are involved in the development of cerebral edema, swelling of the brain, for example after a stroke. This is a potentially life-threatening condition that can occur rapidly as a result of too much water collecting in the brain.

“We have mapped the organisation of aquaporin 4 in the brain. There, they gather around small blood vessels and form portals, water channels in and out of the brain. The transportation of water into the brain after a stroke is reduced in genetically modified mice that lack aquaporin 4 around blood vessels,” explains Ole Petter Ottersen.

The research group is now attempting to transform this knowledge into a treatment. To understand the mechanisms of disease, and to improve diagnosis, treatment and prevention for those suffering strokes, as well as other brain diseases such as Alzheimer’s and Parkinson’s, has always been the driving force behind Ole Petter Ottersen as a researcher. And in his opinion, maintaining contact with research even as vice-chancellor is of the utmost importance.

“There are important synergistic effects between these activities.”

He describes his own relationship to research as verging on addiction.

“When conducting research, one’s thought processes differ from those that are at play when exerting academic leadership. After a week without research, I suffer withdrawal symptoms,” he says.

However, the issues facing a president are many and time consuming. One issue that engages Ole Petter Ottersen is the inability to replicate many of the medical research results currently being published.

“This risks reducing the level of trust in research. It is a problem that needs to be discussed in detail by the research community, and it must be resolved,” he says.

That published results are robust and trustworthy is also a fundamental ethical issue. And according to Ole Petter Ottersen, ethical issues linked to medical research present one of the greatest challenges to be faced.

“Karolinska Institutet has of course had good reason to discuss ethics over recent years, although similar concerns took up a great deal of my time even before I came here. I believe that universities must adopt a proactive approach. We must always consider in advance which ethical questions may arise as a result of new knowledge – for example, new methods such as the DNA editing tool CRISPR – and I consider it to be Karolinska Institutet’s duty to be at the forefront of this work,” he says.

Ole Petter Ottersen is therefore currently working on establishing a global commission into the ethical grey zones of medical research.

“After all, there are many. How, for example, does one differentiate between care and research? This remains unclear. There are also differences in how misconduct in research is defined from one country to the next; for example, in Sweden we have no clear definition of the term,” he says.

Share one’s results and ideas

He believes that one of the most important preventive activities against scientific misconduct is to create an open, generous culture in research environments.

“To share one’s results and ideas with colleagues and society at large is important in broadening one’s perspectives and encouraging critical reflection. There must be ongoing discussion in research groups that makes it possible to critically review each other’s ideas and work,” says Ole Petter Ottersen.

He also emphasises the importance of academic freedom.

“Research must be conducted without interference from politics or special interests. Evidence and facts, generated through unbridled curiosity, are fundamental to building our societies. Basing political decisions on unreliable data is tantamount to navigating with an incorrect map,” says Ole Petter Ottersen.

However, this is a mutual responsibility.

“Politicians must respect and safeguard academic freedom. Universities, on the other hand, must conduct their work in a transparent fashion with due attention to the importance of ethical and critical reflection,” he says.

Ole Petter Ottersen on…

...the idea of university

It must be more than just a research hotel; it must be a place where education, research and innovation are integrated, where research permeates the educational curriculum and benefits society.

...whether research must be useful

Ultimately, all high-quality research is useful. The question is rather how long it takes. However, we must also ensure that basic knowledge has value in itself.

…Edvard Munch

For periods of his life he suffered from mental illness and through his art, which depicts life’s many trials and tribulations, he speaks to everyone involved in medicine. That inspires me.

...Hans Rosling

I have incredible respect for him. He stood for a fact-based worldview – the opposite of something we unfortunately see a good deal of in today’s society, namely the basing of decisions on emotion and intuition.