Are we facing an antibiotic apocalypse? Lord Jim O’Neill speaks at International Business Festival

Yesterday Lord Jim O’Neill of Gatley, Chair of the review on Antimicrobial Resistance, delivered a speech at the 2018 International Business Festival’s Health and Life Sciences day about the challenges posed by antibiotic resistance.

He discussed the progress of the review over the last two years, which was followed by a panel discussion which explored the threat of an antibiotic apocalypse, from the perspectives of other leading figures in the sector. Panellists included Dr Janet Hemingway from the Liverpool School of Tropical Medicine, Dr Laura O’Brien, vice-president of operations for flu vaccine developer Seqirus, and Emmanuel Nsutebu, consultant in infectious diseases from the Royal Liverpool Hospital.

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Lord Jim O’Neill spoke about the progress of the review on Antimicrobial Resistance, of which he is the chair.

“Of the ten areas of focus [for the Review on Antimicrobial Resistance] there has been a ridiculous amount of talk, but in terms of action, nothing.”

“There are many, many parts of the world where people have no idea about this challenge.

“The British government, even before our review finished, announced that they were starting the so-called Fleming Fund, which supports surveillance initiatives and systems in the emerging world. The Chief Medical Officer of the UK, Sally Davis gets really annoyed with me when I say this, but it was great it was announced; it would be good if they got on and actually started delivering it.

“With respect to agriculture, where people in the agricultural industry are quite pleased to tell me the UK has formally hit the 50 milligrams per kilogram target we set for every developed country in the world to reduce. My thoughts on that is that maybe the targets we set weren’t tough enough for the UK, because it seems to me there are many areas where things could have been done better, in particular crucially in my opinion, the banning of so-called last in line antibiotics for any use in agriculture whatsoever.

“There’s nothing going on with vaccines. It’s astonished my review team that there wasn’t more done to incentivise vaccines at the expense of antibiotics. If you have genuine vaccines for disease prevention, that itself dramatically reduces the need for antibiotics, particularly in agriculture.

On the performance of the pharmaceutical industry on this matter, O’Neill pulled no punches.

“I have never heard a group of people talk about something as much as I have heard the pharmaceutical industry talk about antimicrobial resistance. What have any of them done since? Zip. It is time that they get off their distinguished backsides and put some skin in the game. Having come out of the financial crisis and seen what damage big multinationals can do, I say to them again here with people to listen – guess who’s going to get blamed if we don’t find a solution? And it’s the pharmaceutical world that needs to wake up more than others.”

“Of all the ten commandments we talk about, if there was only one you could emphasize as the most important, first of all I would say I cannot do that, because as I said earlier all ten are really necessary. But if the answer was only one, my answer is diagnostics.

“We need Google for doctors. We allow, encourage, force our doctors to guess if we need an antibiotic or not. It is ridiculous. We need to introduce state of the art technology right at the heart of our health system, here and all over the world to permanently reduce the excessive demand for antibiotics and to solve this problem, permanently, because even if we do get new drugs, it would only solve it for a generation until the antibodies become resistant to them as well.”

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