Reported by Kate McNeil, CSaP Communications Coordinator
The case of antimicrobial resistance
Giving the keynote address at the 2020 CSaP Annual Lecture, Dame Sally shared her behind-the-scenes account of her work on antimicrobial resistance (AMR) as the UK’s Chief Medical Officer, while reflecting on what it takes to get the right science to inform the right policy questions at the right time.
Dame Sally is a global advocate on AMR, and in addition to her current role as Master of Trinity College, she is presently the UK Special Envoy on Antimicrobial Resistance. This path towards global advocacy began with a report on infections during her time as Chief Medical Officer, when she discovered that AMR was getting worse, but that doctors feeding information into systems overwhelmed with data were having difficulty getting that message heard by policy makers. This leads to the question of how you filter evidence so that it is prioritised, and so that important things get through.
“Part of the secret of getting evidence into policy is that if you are in the room, you can make the point."
Dame Sally suggested that rather than evidence-based policy, academics and policy makers should aim for evidence-informed policy, where active debate takes into consideration urgency, evidence, and political timing to inform what is fed into policy processes. Here, she emphasised that experts need to be cognizant of the role of political will and public opinion – you can have evidence to support a policy, and a minister who wants to make the change, but as highlighted by the classical example of the incremental pace of change in tobacco policies, little traction in policymaking spaces can be made if the recommended policies are not ‘doable’ or will be politically unacceptable at the voting box.
In the case of AMR, new antibiotics, and new behavioral methods are needed, but awareness across the whole system, public buy-in and public understanding of the problem will form an important part of solutions. While AMR has been made apolitical through the development of a fact-based risk register, in their work on this issue, academics should still be cognizant of what is happening in the policy sphere, informing processes by asking “what are politicians trying to do, and how can I fill in the evidence gaps in a way that is helpful to them?”
Dame Sally has emphasised that international, cross-sectoral partnership will also be needed to make progress in tackling AMR. The involvement of consumers, investors and industries taking an “AMR lens” in their decisions will be vital to address the market failure has resulted in an empty R&D pipeline for antibiotics and lack of diversification and resilience in drug supply chains. Moreover, this AMR lens must be used to encourage investments in biosecurity and animal hygiene, while addressing the overuse and misuse of antibiotics in agriculture which has consequences for public health.
The costs of AMR moves people into poverty, and the consequences of its spread will affect the poorest countries the most. We have one global health system through which AMR can spread, and if we don’t make progress in tackling AMR, Dame Sally warned that by 2050, there will be one AMR-related death every 3 seconds.
You can listen to the full lecture here:
Photo Credit: Paul Mazumdar's "Antibiotics" - https://flic.kr/p/bwN6kR