"We are in an arms race against microbes"

Sally Davies is part of a group that this week has warned the president of the United Nations: if nothing is done to fight against antimicrobial resistance, 10 million people in the world could die each year. year from here 2050.

Davies, the outgoing chief medical officer of the United Kingdom, has raised awareness of antimicrobial resistance on the world stage. On April 29, the UN Interagency Coordinating Group on Antimicrobial Resistance, which she co-convened, issued a report stating that immediate, coordinated and ambitious action is needed to avert the crisis.

Countries must urgently eliminate the use of antimicrobials in agriculture, invest in new technologies to fight against resistance and strengthen regulation, the document adds.

Davies has also helped to create a GBP 265 million (US $ 344 million) UK government fund to develop laboratories around the world to tackle the problem of AMR.

A physician and hematologist, Davies was the first female chief medical officer in the UK. She will retire in September, after nine years, to become a Trinity College professor at the University of Cambridge.

Davies spoke to Nature on the research needed to help stem resistance, and his time as a scientist at the heart of the government.

How is the fight against AMR going?

RAM is a complex and increasingly complex problem. In the end, we are in an arms race against microbes, fast-changing experts in resistance. We must therefore react quickly and in a multifaceted way.

Considerable work is underway to tackle this threat, but some very obvious gaps are in the works. Some countries – such as Norway, Sweden and the Netherlands – are doing very well in the human health sector, while others have very high resistance rates and need to take a lot more action.

The UK has made impressive progress in recent years: the use of antibiotics in humans has decreased by 7.3% between 2014 and 2017, and the use in the livestock sector decreased by 40% over the same period.

We also desperately need new antibiotics, diagnoses and alternative treatments. There is a "market failure" and companies are divesting, the current payment model not being mingled with the complex nature of resistance. The G7 and G20 countries have made progress in this area, but this is an area where more action is needed.

Do you think that the recommendations of the inter-agency group will have an impact?

I'm optimistic.

Is there a need for further research on AMR?

Absolutely. There is a great need for more research on new antimicrobials, alternative treatments for infection and improved diagnoses that will help guide the appropriate prescription. In addition, more research on optimal infection prevention and control, as well as new vaccines, will help reduce resistance by preventing infections.

Research is needed to understand the role of the environment in the emergence and spread of AMR. We know that runoff from farms, hospitals and factories contributes to the spread of resistance, but our knowledge of this is currently limited.

We also need more work and research on the behavioral aspects of AMR. Improving public understanding is a crucial part of solving the problem because we all have a role to play.

How difficult is it to defend the scientific evidence in the UK government?

I have generally found that politicians were receptive to this discussion and supportive of the implementation of evidence-based policies. The key is how we communicate the evidence to them.

Quality scientific advice is appreciated. The problems are either when the mediocre quality of the research is presented, or when the media and academia are working. We all have a duty to be objective with evidence and to present our remarks without bias.

What were your biggest frustrations in this post?

Late recognition of the role of prevention and the importance of the environment in which we live for the promotion of health.