Dame Sally Davies is the force elevating antimicrobial resistance into the stratosphere of global policy—straight to the G7, the G20 and the UN General Assembly. Without Dame Sally as England’s Chief Medical Officer (CMO), these developments would be just pie in the sky. This former practicing hematologist, in her keynote address to the 17th International Conference on Infectious Diseases, made it clear that she is using the powers of the CMO to move antibiotic resistance policy at home and across the world—and reveling in it.
England’s CMO doesn’t let anyone off the hook. She compels all parties to engage: medical and public health professionals, veterinarians, agriculturists and aquaculturists, environmental health specialists. When she calls, they must answer. She makes her points with evidence filed in memory: variations in antibiotic use in England and globally, trends in antibiotic resistance, the effects of interventions like hospital infection control, the projected increases in food animal antibiotic use in the next few decades. It’s all part of her narrative.
Take big pharma. She asks a CEO why his company, which makes cancer drugs, is uninterested in antibiotic development. He replies with something about the return on investment, yadda, yadda, yadda.
In response, she wonders out loud. “So if I get cancer and you want to treat me, the immunosuppressive effect of your drug might lead to a serious infection. And oh, by the way, I might die from that infection because you haven’t paid attention to developing new antibiotics. Should I go ahead with the cancer treatment or start on my bucket list?” she asks. “It makes big pharma look like the big banks before the crash.”
The BRICS countries have by far the biggest increases in antibiotic use in recent years. Recognizing that access in poor countries has historically been suboptimal, Dame Sally wonders: are these “good” increases? Let’s not assume we know without nailing down the evidence. And while we’re at it, she adds, why is it we conveniently “forget” about the importance of prevention—hospital hygiene, for instance.
Some questions are no longer open in her estimation. We cannot allow the continued massive use of antibiotics in animals, for instance. Using antibiotics for growth promotion has to go. Full stop.
The UN General Assembly is on tap for a session on antimicrobial resistance later this year, and Dame Sally is leading the charge. She knows from the evidence that we can and must make a difference. Her ideas coalesce into a coherent whole that could set the world on a healing course for antibiotics and antibiotic resistance.
Meet Dame Sally Davies: Chief Marketing Officer for taking AMR seriously at the highest global levels and doing something about it.
Hellen Gelband is CDDEP’s Associate Director for Policy.