AMRチャレンジ。抗菌抵抗性の闘士たちを祝う夜（2019年9月23日収録 (The AMR Challenge: A Night Celebrating Antimicrobial Resistance Fighters (Recorded Sept. 23, 2019))

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THE AMR CHALLENGE SEPTEMBER 23, 2019 7:00 8:30 P.M.
[Music]
[VIDEO] MORE AND MORE BACTERIA WERE BECOMING RESISTANT SPREADING ACROSS THE GLOBE VERY SOON,
WE WILL NOT HAVE ENOUGH ANTIBIOTICS TO TREAT INFECTIONS.
THIS IS A MAJOR PUBLIC HEALTH PROBLEM THAT NEEDSTO BE SOLVED.
WE NEED TO ASSIST EACH OTHER.
WE REALLY NEED TO DO MORE.
[Music]
AT CDC WE WORK A LOT WITH OUR PARTNERS INTERNATIONALLY TO DETECT AND RESPOND TO THREATS
THAT ARE CURRENT HEALTHCARE, LIKE ANTIBIOTIC RESISTANCE.
ONE OF THE WAYS TO MAKE A DIFFERENCE IS THROUGH USING EXISTING TECHNOLOGY
TO HELP US THINK ABOUT PROBLEMS DIFFERENTLY.
ONE OF THE WAYS WE'RE DOING THIS IS THROUGH AN APP CALLED ACUMEN
THAT WE ARE PILOTING IN COLOMBIA.
WITH THE ACUMEN APPLICATION, YOU HAVE THE GUIDELINES OF ALL THE ANTIBIOTIC USE
IN THE HOSPITAL, AND THE GUIDELINES OF INFECTION PREVENTION AND CONTROL.
THE CONTACT PRECAUTIONS, AIRBORNE PRECAUTIONS, ALL THE ISOLATIONS AND THE HAND HYGIENE TOO.
FOR THE PATIENTS, THE BEST BENEFIT OF THIS APPLICATION IS
TO HAVE THE RIGHT ANTIBIOTIC.KNOWING THE RIGHT ANTIBIOTIC IN THE RIGHT TIME, IN THE RIGHT DOSE,
FOR THE RIGHT PATIENTS, I THINK IT MAKES A HUGE IMPACT.
THE ECHO MODEL IS ANOTHER WAY THAT WE'RE USING EXISTING TECHNOLOGY, SOMETHING THAT'S AS SIMPLE
AS A WEBCAM, AS A WAY TO TEACH LABORATORIANS HOW CAN WE BETTER USE THE MICROSCOPES
AND THE EQUIPMENT THAT THEY HAVE TO BOLSTER THEIR TRAINING
SO THAT WE CAN BETTER DETECT ANTIBIOTIC-RESISTANT BACTERIA.
BECAUSE WE WON'T BE ABLE TO DO ANYTHING ABOUT THE BACTERIA IF WE DON'T KNOW IT'S THERE.
BY USING VIRTUAL CONNECTIVITY, 100 IF NOT 150 PARTICIPANTS,
CAN CONNECT IN AT ANY ONE GIVEN TIME.
WE CAN CREATE A SAFE HAVEN FOR THE PARTICIPANTS WHERE THEY'RE ABLE
TO COME IN ON A PEER-TO-PEER LEVEL.
WHERE THEY FEEL FREE TO ASK QUESTIONS AMONGST THEMSELVES, TO KNOW HOW TO FIND
WHERE THE PROBLEM WAS AND CORRECT IT SO THAT THE NEXT TIME, IT DOESN'T HAPPEN AGAIN.
WHAT CDC HAS RECOGNIZED IS THAT TECHNOLOGY IS REALLY CRITICAL.
BUT WHAT'S ALSO REALLY IMPORTANT IS HAVING THAT HUMAN INTERACTION,
HAVING THAT MENTORSHIP AND THAT TRAINING.
WE WERE CALLED TO ASSIST THIS REALLY LARGE PUBLIC HOSPITAL
BECAUSE THEY WERE SEEING HIGH RATES OF RESISTANT BACTERIA.
WE WERE ABLE TO IDENTIFY WHAT ARE THE MAJOR GAPS THAT COULD BE ADDRESSED,
AND IMPORTANTLY HOW CAN WE MAKE THOSE CHANGES LAST OVER A LONG PERIOD OF TIME?
WE FOCUSED AT THREE AREAS.
ONE AREA WAS SAFE PREPARATION OF MEDICATION.
THE OTHER PART WE LOOKED AT WAS TO HAVE THE EXPERT
IN INFECTION CONTROL VISITING OUR UNIT REGULARLY TO ASSIST THAT IPC NURSE
IN TERMS OF TRAINING AND SUPERVISING.
BUT TO ME EVEN MUCH MORE IMPORTANT IS THE PHARMACIST IS MONITORING MEDICATION ERRORS,
CHECKING AS TO THE USAGE OF ANTIBIOTICS.
THE ROLE OF A CLINICAL PHARMACIST IS HIGHLY, HIGHLY, HIGHLY IMPORTANT.
TO LOOK AFTER OUR ANTIBIOTICS, TO PRESCRIBE CORRECTLY,
O CONTROL ANTIBIOTIC USAGE IN THE HOSPITAL.
AND OUR GOAL IS THAT NO MOTHER WOULD TAKE HER BABY HOME AS A CORPSE FROM THIS UNIT.
BECAUSE THESE ANTIBIOTIC- RESISTANT BACTERIA ARE ACTUALLY SPREADING FROM ONE PERSON
TO ANOTHER PERSON, TO COMMUNITIES AND EVEN ACROSS BORDERS, WE ALL HAVE A ROLE TO PLAY
BECAUSE WE ALL HAVE A STAKE IN THE OUTCOME.
WE REALLY NEED MORE COMMITMENTS AND WE REALLY NEED MORE ACTION.
WHETHER YOU'RE THE HEAD OF A COUNTRY, THE HEAD OF A HOSPITAL, OR EVEN JUST THE HEAD
OF A HOUSEHOLD, I THINK THERE ARE A LOT OF THINGS THAT YOU CAN DO TOGETHER
TO EFFECTIVELY IMPACT THIS EPIDEMIC.
[MUSIC]
[Applause]
>> MADLEN DAVIES: HELLO AND WELCOME.
THANK YOU FOR COMING HERE TONIGHT.
I KNOW A LOT OF YOU HAVE COME FROM FAR AND WIDE
AND EVEN BRAVED THE STICKY NEW YORK SUBWAY TO BE HERE.
SO THANK YOU VERY MUCH.
DR. REDFIELD, THE CDC DIRECTOR, WAS DUE TO BE HERE TONIGHT,
BUT HE HAS BEEN CALLED AWAY URGENTLY TO THE WHITE HOUSE SO HE SENDS HIS APOLOGIES.
MY NAME IS MADLEN DAVIES.
I LEAD THE GLOBAL HEALTH TEAM OF THE BUREAU OF INVESTIGATIVE JOURNALISM IN LONDON.
THE BUREAU IS BRITAIN'S BIGGEST NON PROFIT MAJOR ORGANIZATION.
AND WE WRITE STORIES AND MAKE FILMS THAT ARE IN THE PUBLIC INTEREST.
SO FOR THE PAST THREE YEARS, WE HAVE BEEN WORKING
ON AN INVESTIGATIVE JOURNALISM PROJECT ABOUT DRUG RESISTANCE.
MY TEAM TRAVELED ALL OVER THE WORLD MEETING PEOPLE AFFECTED BY DRUG RESISTANT INFECTIONS.
THIS TIME LAST YEAR, I WAS IN A HOSPITAL IN NORTHERN INDIA.
THERE, I MET PINKY, A YOUNG WOMAN IN A BEAUTIFUL GREEN SARI.
SHE WAS PAINTING HER NAILED A PURPLE GLITTERY POLISH WHEN I MET HER AND ONCE THE POLISH DRIED,
SHE TOOK ME THROUGH A CLOSED DOOR AND SAID THAT IS WHERE MY BABY IS BEING KEPT.
THERE WAS NO WINDOW INTO THE ROOM AND I COULDN'T SEE HIM.
HE HAD BEEN IN THE HOSPITAL FOR MORE THAN TWO WEEKS.
SHE HAD AN INFECTION THAT WAS RESISTANT TO NEARLY ANTIBIOTIC,
EXCEPT ONE WHICH WAS BEING GIVEN INTRAVENOUSLY.
THIS IS THE TIME WHEN I'M SUPPOSED TO BE HOLDING AND FEEDING MY DAUGHTER,
PINKY SAID, BUT I CAN'T EVEN TOUCH HER.
WHEN I LEFT INDIA, PINKY WAS PRAYING THAT HER DAUGHTER MIGHT LIVE.
IN ANOTHER PART OF INDIA, WE MET A FATHER WITH MULTI DRUG RESISTANT TB.
HE HAD TO TAKE A COCKTAIL OF DRUGS WHICH HAD SEVERE SIDE EFFECTS AND HE WAS VERY DEPRESSED.
THIS, COUPLED WITH THE FACT THAT NONE OF HIS FAMILY WOULD VISIT HIM FOR FEAR
OF CATCHING THE DISEASE, LEFT HIM SUICIDAL.
IN MALAWI, WE MET A YOUNG WOMAN WHO JUST LOST HER CHILD DURING CHILDBIRTH.
THE WOUND FROM HER C SECTION HAD BECOME INFECTED WITH RESISTANT BACTERIA.
DOCTORS COULDN'T CRUSH IT WITH ANTIBIOTICS SO THEY WERE FORCED TO SURGICALLY REMOVE HER WOMB.
IN THE U.K., WE MET EMILY, SHE SUFFERED A RESISTANT INFECTION WHILE PREGNANT
AND WAS FORCED TO MAKE A FRIGHTENING DECISION ABOUT WHETHER TO TAKE ANTIBIOTICS
THAT NEVER HAD BEEN CHILD ON PREGNANT WOMEN BEFORE.
THESE PEOPLE ARE JUST A FEW OF THE HUNDREDS OF THOUSANDS AFFECTED BY AMR
THAT NUMBER IS SET TO INCREASE IF WE DON'T ACT.
BUT WHILE THE PROBLEM IS VAST, LOTS OF ACTION IS HAPPENING TO STEM ITS RISE.
THE BUREAU RAN A SERIES OF STORIES LAST YEAR ABOUT ONE OF OUR MOST PRECIOUS ANTIBIOTICS,
WHICH IS USED AS A LAST HOPE TO SAVE PATIENT'S LIVES WHEN ALL OTHER DRUGS FAILED.
IN INDIA, AS IN MANY OTHER COUNTRIES, IT WAS BEING GIVEN EN MASS TO LIVESTOCK
TO MAKE THEM GROW FATTER, A PRACTICE WHICH BREEDS THE RESISTANT BACTERIA
WHICH CAN GO ON AND INFECT HUMANS.
EARLIER THIS YEAR, WE HAD SOME GREAT NEWS.
THE INDIAN GOVERNMENT ANNOUNCED IT WILL BAN THE USE OF THIS DRUG IN VETERINARY MEDICINE,
JOINING MANY OTHER COUNTRIES AROUND THE WORLD.
THIS WAS A FORMIDABLE STEP AND IT WAS MADE POSSIBLE BY A RANGE OF PEOPLE WORKING TOGETHER;
JOURNALISTS, CAMPAIGNERS, LAWYERS, GOVERNMENT OFFICIALS, POLITICIANS AND THE INDUSTRY ITSELF.
MORE AND MORE STEPS ARE BEING TAKEN.
THE CDC LAUNCHED ITS AMR CHALLENGE PROGRAM LAST YEAR ASKING COMPANIES AND ORGANIZATIONS
TO MAKE A PRACTICAL PLEDGE, WHICH WOULD HELP TACKLE AMR.
AND I WAS REALLY IMPRESSED WITH HOW SPECIFIC THESE PLEDGES WERE.
AND TONIGHT, I'M VERY EXCITED TO SHARE SOME OF THE EARLY SUCCESSES WITH YOU.
IN JUST ONE YEAR, NEARLY 350 COMMITMENTS HAVE BEEN MADE
FROM ORGANIZATIONS ACROSS 32 COUNTRIES.
THIS INCLUDES PLEDGES FROM 50 U.S. STATES AND WASHINGTON, D.C. TO TAKE ACTION AGAINST AMR.
ALMOST HALF OF THE COMMITMENTS FOCUS ON IMPROVING INFECTION PREVENTION AND CONTROL.
THAT'S MORE THAN 10,000 HEALTH CARE FACILITIES WORKING
TO PREVENT RESISTANT INFECTIONS OCCURRING IN THE FIRST PLACE.
IF YOU'RE A PATIENT YOU WOULD JUST PREFER NOT
TO CATCH THE INFECTION RATHER THAN BEING TREATED FOR IT.
MORE THAN 45 ORGANIZATIONS HAVE COMMITTED TO IMPROVING SAFE DRINKING WATER, SANITATION
AND HYGIENE ACROSS THE WORLD, AND THAT INCLUDES 100 MILLION DOLLAR COMMITMENT FROM WORLD VISION
TO IMPROVE WATER AND SANITATION IN RURAL HEALTH CARE FACILITIES ACROSS AFRICA.
NEARLY HALF OF THE COMMITMENT MAKERS FOCUS ON IMPROVING ANTIBIOTIC USE,
WHICH HELPS SLOW THE DEVELOPMENT OF RESISTANCE AND PROTECTS PATIENTS
FROM THE UNNECESSARY SIDE EFFECTS OF THE DRUGS.
LASTLY, MORE THAN 55 PHARMACEUTICAL AND BIOTECH GROUPS HAVE COMMITTED TO DEVELOP
OR PROVIDE ACCESS TO PRODUCTS THAT WILL PREVENT AND TREAT RESISTANT INFECTIONS.
BUT WE STILL NEED MORE ACTION.
TO TACKLE THE PROBLEM, AND TO DRIVE POLICY CHANGE, WE NEED POLITICIANS AND THE PUBLIC
TO TRULY BELIEVE IT SHOULD BE A PRIORITY.
AND FOR THAT, WE NEED BETTER COMMUNICATION ABOUT AMR.
THE WORLD INTERESTS HAD CARRIED OUT SOME RESEARCH ON HOW TO COMMUNICATE THIS ISSUE
TO THE PUBLIC IN WAYS THAT IT REALLY CUTS THROUGH.
IT'S ABSOLUTELY FANTASTIC TO HAVE SOLID EVIDENCE TO INFORM THE WAY WE TALK ABOUT THIS TOPIC,
AND I'M PLEASED THAT LATER I'LL BE ABLE TO SHARE SOME OF THE PRACTICAL RECOMMENDATIONS WITH YOU;
BUT FIRST, HERE TO SHOWCASE MORE OF THE SUCCESSFUL PLEDGES
FROM THE PAST YEAR IS ALEX AZAR, SECRETARY OF HEALTH AND HUMAN SERVICES.
Mr. AZAR WAS SWORN IN LAST JANUARY.
HE SPENT THE MAJORITY OF HIS CAREER WORKING IN SENIOR HEALTH CARE LEADERSHIP ROLES
IN THE PUBLIC AND PRIVATE SECTORS.
NO STRANGER TO THE DEPARTMENT OF HEALTH AND HUMAN SERVICES,
HAVING SERVED AS ITS GENERAL COUNSEL AND THEN DEPUTY SECRETARY IN THE EARLY 90s.
DURING HIS TIME AS DEPUTY SECRETARY,
HE WAS INVOLVED IN IMPROVING THE DEPARTMENT'S OPERATIONS, ADVANCING ITS EMERGENCY PREPAREDNESS
AND RESPONSE CAPABILITIES, ADVANCING ITS GLOBAL HEALTH AFFAIRS ACTIVITIES
AND HELPING OVERSEE THE ROLL OUTS OF MEDICARE PART D PRESCRIPTION DRUG PROGRAM.
IN 2007, AZAR REJOINED THE PRIVATE SECTOR AT ELI LILLY
AND WAS PRESIDENT OF LILLY USA FROM 2012 2017.
I'D LIKE TO WELCOME HIM TO THE STAGE.
[ APPLAUSE ]
>> SECRETARY AZAR: MADLEN, THANK YOU VERY MUCH AND GOOD EVENING, EVERYONE.
ON BEHALF OF THE UNITED STATES GOVERNMENT, THANK YOU ALL FOR JOINING ME HERE TONIGHT TO REFLECT
ON AND HIGHLIGHT THE REAL PROGRESS THAT WE HAVE MADE IN THE FIGHT
AGAINST ANTIMICROBIAL RESISTANCE IN THE PAST YEAR.
THE YEAR LONG INITIATIVE WE LAUNCHED LAST YEAR AROUND THIS TIME,
THE AMR CHALLENGE, SETS A PROMISING PRECEDENT.
THE SUCCESS OF THE CHALLENGE OVER THE PAST YEAR, DEMONSTRATES WHAT IS POSSIBLE
IN THE RELATIVELY SHORT TERM WHEN WE HAVE A REAL COMMITMENT TO FIGHT
AGAINST THIS PRESSING PUBLIC HEALTH THREAT.
SINCE THE LAUNCH OF THE AMR CHALLENGE UNDER THE LEADERSHIP OF THE CDC LAST YEAR,
GOVERNMENTS FROM THE GLOBE, PRIVATE SECTOR BUSINESSES AND NGOs AROUND THE GLOBE,
MADE 350 COMMITMENTS TO FIGHT AMR.
I KNOW MANY ARE HERE TONIGHT.
SO I WANT TO PERSONALLY THANK YOU FOR STEPPING UP TO THE PLATE.
AS ALL OF YOU KNOW, THE UNITED STATES HAS EAGERLY ENGAGED ON ANTIMICROBIAL RESISTANCE BOTH
IN PUBLIC AND THE PRIVATE SECTOR.
THE TRUMP ADMINISTRATION HAS MADE AMR A TOP PRIORITY IN OUR GLOBAL AND DOMESTIC WORK
AND THE RESPONSE HAS BEEN ENCOURAGING.
WE SAW OVER 225 COMMITMENTS TO THE AMR CHALLENGE MADE
IN THE UNITED STATES ALONE SPANNING ORGANIZATIONS ACROSS ALL 50 STATES.
I WANT TO HIGHLIGHT A FEW NOTABLE EXAMPLES.
OF THE 10,000 HEALTH CARE FACILITIES REPRESENTED BY ORGANIZATIONS COMMITTED TO THE CHALLENGE,
I WANT TO MENTION ONE BY WAY OF EXAMPLE.
PREMIER, INC., A LARGE HEALTH CARE ALLIANCE OF 4000 U.S. HOSPITALS
AND 175,000 MEDICAL PROVIDERS, THEY HAVE REDUCED THE RATE
OF A PARTICULAR HEALTH CARE ASSOCIATED INFECTION BY 46% IN 500 HOSPITALS SINCE 2015
THROUGH COACHING CALLS, SITE VISITS, WEBINARS AND A NEW WEBSITE FOCUSED ON AMR.
THAT'S JUST ONE OF THE MANY HEALTH CARE PROVIDERS THAT HAVE TAKEN THESE KINDS OF STEPS.
WE HAVE ALSO SEEN COMMITMENTS FROM MAJOR FOOD AND ANIMAL ORGANIZATIONS.
McDONALD'S AND YUM!
BRANDS SPECIFICALLY ARE COMMITTING TO REDUCING ANTIBIOTIC USE IN THE POULTRY
AND BEEF THEY USE FOR THEIR PRODUCTS.
McDONALD'S COMMITTED TO USE ITS MARKET SHARE POWER TO REDUCE ANTIBIOTIC USE
IN THE LIVESTOCK IT USES FOR BEEF PRODUCTS AND YUM!
AIMS TO CUT ITS ANTIBIOTIC USE IN BEEF BY 25% BY 2025, HAVING ALREADY MADE HUGE STRIDES
IN THE POULTRY PRODUCTS INDUSTRY.
FOR THOSE OF YOU WHO HAVE NOT GOTTEN DEEPLY INTO WHAT IT TAKES TO CURB ANTIBIOTIC USE
IN LIVESTOCK, I KNOW SOME OF YOU HERE THIS EVENING HAVE.
EXTENDING THESE POLICIES TO BEEF IS A PARTICULAR CHALLENGE.
SO WE APPRECIATE THESE ELEVATED AND AMBITIOUS COMMITMENTS.
WE HAVE ALSO SEEN COMMITMENTS FROM NGOs LIKE WORLD VISION, COMMITTING 100 MILLION DOLLARS
BY 2021 AND 35 COUNTRIES IN AFRICA TO HELP TO CURB THE SPREAD
OF ANTIMICROBIAL RESISTANT BACTERIA AND FUNGI.
FINALLY WE SEEN WORK FROM GOVERNMENTS AND THE PRIVATE SECTOR TOGETHER.
THE FDA RECENTLY APPROVED A CRITICAL DRUG REGIMEN TO TREAT DRUG RESISTANT TB,
AN EFFORT THAT HAS BEEN SUPPORTED BY THE TB ALLIANCE, ADVANCED BY NIH WORK AND BENEFITED
FROM THE FDA'S LIMITED POPULATION PATHWAY PROCESS.
WHILE THESE ARE CERTAINLY STEPS IN THE RIGHT DIRECTION, OUR WORK IS ONLY BEGINNING.
THAT'S WHY LATER THIS YEAR, THE CDC WILL RELEASE THE AMR THREATS REPORT GIVING US A CLEAR PICTURE
OF THE SIGNIFICANT WORK THAT IS STILL NEEDED
TO PREVENT RESISTANT INFECTIONS AND STOP THE SPREAD OF GERMS.
CONTINUING OUR FIGHT AGAINST AMR WITH THE SAME VIGOR WE HAVE SEEN OVER THE LAST YEAR,
WILL LEAD TO LOWER RATES OF INFECTION, LOWER HEALTH CARE COSTS,
REDUCE HUMAN SUFFERING AND LIVES SAVED.
SO THIS YEAR, COMPONENTS OF HHS, THE DEPARTMENT I RUN, ROLLED OUT A NUMBER OF NEW INITIATIVES
TO HELP REVITALIZE THE ANTIBIOTIC MARKET, INCREASE STEWARDSHIP PRACTICES,
INNOCENT VICE RESEARCH AND DEVELOPMENT AND USE RISK BASED ASSESSMENT
TO INFORM ALL ANTIMICROBIAL USE IN HUMAN AND ANIMAL HEALTH.
THE CENTERS FOR MEDICARE AND MEDICAID SERVICES OR CMS, HAS DEVELOPED A BUNDLE OF REFORMS
TO SECURE MEDICARE BENEFICIARIES ACCESS TO ANTIMICROBIALS IN THE SHORT TERM WHILE SEEKING
TO REALIGN FINANCIAL INCENTIVES TO SUSTAIN INNOVATION IN THIS SPACE FOR THE LONG TERM.
CMS IS ALSO NOW EXPLORING IMPLEMENTING CDC RECOMMENDATIONS
FOR HOSPITAL BASED ANTIBIOTIC STORAGE PROGRAMS AND THE REGULATIONS
THAT GOVERN HOSPITAL'S PARTICIPATION IN THE MEDICARE PROGRAM.
I'M ENCOURAGED BY THE PROGRESS WE ARE MAKING BUT AS NOTED EARLIER, OUR WORK HAS ONLY JUST BEGUN.
THE REAL WORK BEGINS AGAIN WHEN WE DEPART AND RETURN BACK TO OUR HOME COUNTRIES,
WHETHER TO JOBS IN GOVERNMENT OR THE PRIVATE SECTOR.
I'M COMMITTED TO CONTINUING THIS WORK IN THE COMING YEARS AT HHS.
ONE OF THE KEY ELEMENTS OF THE VISION THAT PRESIDENT TRUMP HAS
FOR OUR HEALTH CARE SYSTEM INCLUDES TACKLING IMPACTABLE PUBLIC HEALTH CHALLENGES.
AMR IS CERTAINLY A CHALLENGE WHERE WE CAN MAKE AN IMPACT
AND FURTHER DEVELOPMENT OF ANTIMICROBIALS.
BUT IT'S ALSO THE KIND OF ISSUE WHERE IF WE DON'T MAKE AN IMPACT,
A LOT OF OTHER HEALTH CHALLENGES GET EVEN HARDER.
WE NEED COMMITMENTS FROM ALL SECTORS TO CONTINUE FIGHTING THIS THREAT AND SO,
IN THE SPIRIT OF THE AMR CHALLENGE I WANT TO OFFER A FURTHER CHALLENGE.
I CHALLENGE EVERYONE HERE TO RENEW YOUR EFFORTS IN YOUR OWN WORLD
AND CONSIDER WHAT YOU CAN DO TO COMBAT AMR.
ON TOP OF THAT, CONSIDER HOW YOU CAN BETTER COLLABORATE WITH OTHER COUNTRIES IN THIS EFFORT.
WE NEED BOTH INDIVIDUAL AND COLLECTIVE ACTION TO COMBAT THE LOOMING THREAT OF AMR
AND MAKE A LASTING DIFFERENCE FOR THE CITIZENS WE REPRESENT AND SERVE.
TOGETHER, WE CAN PROTECT FUTURE GENERATIONS FROM SERIOUS
BUT AVOIDABLE LOSSES TO OUR HEALTH AND PROSPERITY.
THANK YOU AGAIN FOR HAVING ME HERE TONIGHT.
THANK YOU ALL FOR YOUR DEEP COMMITMENT TO ENDING THE SCOURGE OF AMR AND I LOOK FORWARD
TO CELEBRATING MORE SUCCESSES AND ACHIEVEMENTS WITH YOU IN THE YEARS TO COME.
THANK YOU.
[ APPLAUSE ]
[Missing Text]
YOU HAVE A 90% CHANCE OF SURVIVAL OR A 10% CHANCE OF DEATH.
IT'S A PROBABILITY YET NOT MANY CHOOSE THE LATTER.
SO THE QUESTION BECOMES, WHEN WE TALK ABOUT ANTIBIOTIC RESISTANCE,
HOW CAN WE ENSURE THE LANGUAGE WE USE IS EFFECTIVE AND DRIVES ACTION?
WE TESTED DIFFERENT WAYS OF COMMUNICATING ABOUT ANTIBIOTIC RESISTANCE
IN SEVEN COUNTRIES AND THREE THEMES EMERGED.
ONE, MAKE IT HUMAN AND RELEVANT.
WHEN WE TALK ABOUT WHO IS AFFECTED AND HOW IT EFFECTS THEM,
PEOPLE ARE MUCH MORE LIKELY TO ACT.
FOR EXAMPLE, SAY EVERYONE IS AFFECTED, INCLUDING YOU, AND EXPLAIN THE IMPACT
ON ROUTINE OPERATIONS OR CANCER CHEMOTHERAPY.
TWO, MAKE IT SERIOUS BUT SOLVABLE.
PEOPLE ARE MUCH MORE LIKELY TO TAKE ACTION
WHEN THEY FEEL THE ISSUE IS URGENT BUT THERE IS SOME HOPE.
FOR EXAMPLE, HIGHLIGHT HOW ANTIBIOTIC RESISTANCE WORKS IN RECENT PROGRESS AND HEALTH
BUT CAN BE COUNTERED BY DEVELOPING NEW TREATMENTS.
THREE, USE SIMPLE SCIENTIFIC EXPLANATIONS.
PEOPLE DON'T WANT TO BE TOLD WHAT TO THINK.
THEY WANT TO UNDERSTAND THE ISSUE.
FOR EXAMPLE, USE SIMPLE, CLEAR LANGUAGE TO EXPLAIN THE SCIENCE.
FOR TIPS ON HOW TO EFFECTIVELY COMMUNICATE ANTIBIOTIC RESISTANCE, VISIT:
[Missing Text]
[ APPLAUSE ]
>> MADLEN DAVIES: SO THE WELCOME TRUST CARRIED OUT THIS NEW RESEARCH
ON HOW WE CAN COMMUNICATE AMR SO THAT IT CUTS THROUGH, AND THE THAT RESEARCH WILL BE PUBLISHED
IN FULL IN OCTOBER AND IT WILL BE SENT TO YOU VIA E MAIL SHORTLY.
BUT I JUST LIKE TO GO INTO MORE DEPTH ON THE FIRST RECOMMENDATION.
IT'S TO MAKE THE PROBLEM SOUND SERIOUS BUT SOLVABLE.
THE RESEARCH SHOWS THAT TO PAY ATTENTION, PEOPLE DO NEED TO FEEL THAT AMR A SERIOUS PROBLEM
BUT TO BE MOST EFFECTIVE, DESCRIPTIONS OF THE PROBLEM MUST BE COMBINED WITH SOLUTIONS,
OTHERWISE PEOPLE JUST LOSE HOPE AND SWITCH OFF.
GIVING A CLEAR CALL TO ACTION TO YOUR AUDIENCE HELPS MAKE IT A PRIORITY FOR THEM.
YOU MIGHT WANT TO COMMUNICATE ACTIONS AND SOLUTIONS SUCH AS THAT WE CAN GET AHEAD
OF THE PROBLEM OF AMR TO INCREASE BEST PRACTICES AROUND APPROPRIATE ANTIBIOTIC USE.
THE CDC HAS SEEN A GREAT EXAMPLE OF WORK IN COLUMBIA TO BETTER CONTROL ANTIBIOTIC USE.
A PARTNERSHIP WITH THE TECHNOLOGY COMPANY SAW THE DEVELOPMENT OF THE APP.
THE APP PROVIDES THE GUIDELINES FOR COMPLEX INFECTION CONTROL LIKE THE STEPS NEEDED
TO STOP AIRBORNE SPREAD OF MICROBES.
ADDITIONALLY, HEALTH CARE WORKERS CAN USE THE APP
WHEN THEY MAKE DECISION BUSY PRESCRIBING ANTIBIOTICS AND MAKING SURE THE RIGHT ANTICIPATE
BY ON THETIC IS USED AT THE RIGHT TIME AND AT THE RIGHT DOSE.
NEXT WE HAVE THE COLUMBIA MINISTER OF HEALTH WHO CAN SPEAK TO OTHER SOLUTIONS IN THE COUNTRY.
HE IS AN ACCOMPLISHED SURGEON AND HAS A LONG HISTORY OF WORK BOTH
IN THE PUBLIC AND PRIVATE SECTOR.
PREVIOUSLY, HE SERVED AS HEALTH DIRECTOR FOR THE WORLD'S BANK AND A PRIVATE NGO DEDICATED
TO STRENGTHENING EQUITY AND SOCIAL DEVELOPMENT IN COLUMBIA.
HE ALSO LED THE HOSPITAL IN BOGOTA, ONE OF THE MOST PRESTIGIOUS HOSPITALS IN COLUMBIA.
SO WELCOME TO THE STAGE!
[ APPLAUSE ]
>> SO, GOOD NIGHT AND THE THANKS SO MUCH FOR INVITING ME HERE AND HOSTING ME HERE.
SECRETARY AZAR, VERY NICE SEEING YOU AGAIN.
LAST YEAR IT WAS BETWEEN COLUMBIA AND VENEZUELA AND I WANT
TO APPRECIATE ALL YOUR SUPPORT TO OUR COUNTRY.
SALLY, DAVID, EXTREMELY NICE TO MEET YOU.
MICHAEL, VERY NICE SEEING YOU AS WELL.
I WANT TO EXPRESS ALSO MY APPRECIATION TO ALL THE ARTISTS
WHICH DID SUCH A GREAT JOB AROUND US.
I HAD TIME TO LOOK AT THEIR PAINTINGS AND MESSAGES ARE EXTREMELY IMPORTANT.
PLEASE EXCUSE MY ENGLISH.
I'M THINKING IN SPANISH AND SPEAKING IN ENGLISH.
AS YOU WILL ALL SEE.
SO, ANTIMICROBIAL RESISTANCE IS WHAT I WOULD CALL A PUBLIC ANTI GOOD.
WE HAVE PUBLIC GOODS AS YOU KNOW BUT HERE WE HAVE A PUBLIC ANTI GOOD.
IT REALLY HURTS ALL OF US AND IT'S EXACTLY THE OPPOSITE OF VACCINE.
AND BECAUSE OF THAT, BECAUSE OF THAT VERY SIMPLE FACT, IT IS REALLY A GLOBAL CHALLENGE
AND IT SHOULD TAKE THE BEST OF US OUT THERE.
IT GOES BEYOND THE HEALTH SECRETARY, AS WE WERE TALKING ABOUT.
IT REMINDS US OF HOW RIGHT THAT ONE HEALTH CONCEPT IS AND HOW DIFFICULT
AT THE SAME TIME IT IS TO BE IMPLEMENTED.
IT GOES FAR BEYOND THE HEALTH SECTOR WHERE I SPENT ALL OF MY LIFE.
IN COLUMBIA, WHICH IS A MIDDLE INCOME COUNTRY, 50 MILLION PEOPLE, WE HAVE A NATIONAL PLAN
TO RESPOND TO ANTIMICROBIAL RESISTANCE.
IT FOLLOWED A LOT OF INTERNATIONAL GUIDELINES AND WE PUT IT OUT TWO YEARS AGO,
BUT WE HAD MANY YEARS OF PRIOR WORK WITH ANTIBIOTICS AND THEIR CORRECT USE.
THIS NATIONAL PLAN INVOLVES THE MINISTRY OF AGRICULTURE.
IT INVOLVES OUR NATIONAL INSTITUTE OF HEALTH.
IT INVOLVES OUR FDA LIKE INSTITUTIONS.
AND WE TRY TO PUT ALL OF THIS TO WORK TOGETHER IN THIS BIG CHALLENGE.
THE NATIONAL PLAN HAS FIVE LEVELS OF INTERVENTION.
THE FIRST ONE IS THE SAME GOVERNANCE OF THE PLAN.
IT'S NOT A MINOR ONE.
AGAIN, HAVING THE HEALTH MINISTRY SPEAKING WITH THE MINISTRY OF AGRICULTURE,
IT DOESN'T HAPPEN EVERY DAY TO BE VERY FRANK.
SO IT NEEDS GOVERNANCE FOR SURE.
WE NEED TO BE SERIOUS.
IF YOU DON'T HAVE THAT FIRST DIMENSION AND ALL THAT OTHER ONES, VERY STRAIGHTFORWARD
AND VERY TECHNICAL, IT WILL NOT WORK.
SO GOVERNANCE AND MANAGEMENT OF THE PLAN.
THE OTHER HAS TO DO WITH COMMUNICATION AND EDUCATION.
I WAS IMPRESSED WITH THE CLARITY AND THE IMPACT OF THIS MESSAGES.
THE THIRD ONE HAS TO DO WITH SURVEILLANCE AND RESEARCH AND I'M GOING
TO SPEAK QUICKLY ABOUT IT A LITTLE BIT MORE.
THE FOURTH ONE HAS TO DO WITH HYGIENE AND PREVENTION, AND FINALLY,
WE HAVE THE OPTIMAL UTILIZATION OF ANTIBIOTICS.
OUT OF THOSE FOUR, WE HAVE BEEN ABLE TO MAKE, I WOULD SAY, A FAIR PROGRESS IN SURVEILLANCE
AND RESEARCH AND IN THE UTILIZATION OF ANTIBIOTICS.
WE WORK CLOSELY WITH CDC, BY THE WAY, AND ALL OUR APPRECIATION AND RECOGNITION
TO THEIR CONTRIBUTION TO THIS PROGRESS.
SURVEILLANCE AND RESEARCH.
WE HAVE OUR REPORT SYSTEM.
WE HAVE AN INFORMATION SYSTEM THAT CAPTURES EVERYTHING HAPPENS IN PUBLIC HEALTH IN COLUMBIA
AND IT IS REALLY GOOD BY THE WAY.
AND ANTIMICROBIAL RESISTANCE IS ONE
OF THE FACTORS WE ARE CAPTURING IN OUR INFORMATION SYSTEM.
AND THAT MEANS A LOT FOR EPIDEMIOLOGICAL RESEARCH
AND FOR PROPER PUBLIC POLICY IN THE FUTURE.
SECOND, AND AS YOU SAW IN THE VIDEO, WE ARE WORKING IN RESISTANCE IN HOSPITAL SETTINGS.
SO WE GO TO THE INTENSIVE CARE UNITS, THE NICUs, THOSE SPACES IN HIGH COMPLEXITY HOSPITALS
WHERE THIS CAN BE ONE OF THE BIGGEST CHALLENGES NOT THE BIGGEST
AND WE DO RESEARCH IN WHAT IS HAPPENING TO US.
I'M NOT AN EXPERT ON MICROBIOLOGY OR ANTIBIOTICS.
BUT WE CAN CLEARLY IDENTIFY WHICH ARE THE ELEMENTS THAT ARE POSING THE BIGGEST THREAT
TO US, WHICH ARE THE ANTIBIOTICS WHICH ARE IN A WAY, SHOWING RESISTANCE OR SHOWING EFFECT.
AND WE CAN KNOW IN A PRETTY GOOD WAY IN THOSE HOSPITAL SETTINGS WHAT OUR CHALLENGING ARE.
WE ALSO HAVE SOFTWARE THAT HELPS US KEEP ALL THIS INFORMATION PUT TOGETHER AND WE INVESTED
IN IMPROVING OUR PUBLIC HEALTH LABS, WHICH IS EXTREMELY IMPORTANT.
WE HAVE A VERY SOLID PUBLIC HEALTH LAB.
WE NEED THE LAB'S CAPACITY AT THE NATIONAL LEVEL.
IN A BIG LEVEL WITH A LOT OF CITIES, A LOT OF THINGS GOING ON IN THE SAME TIME,
IT'S THE WHOLE SYSTEM THAT NEEDS TO BE STRENGTHENED.
MOVING FROM THE SURVEILLANCE AND RESEARCH TO THE OPTIMAL UTILIZATION OF ANTIBIOTICS,
WE FOLLOW THE BEST PRACTICES AND THE BEST EVIDENCE IN TERMS OF DIAGNOSIS AND TREATMENT
AND WHAT THE PROPER GUIDELINES ARE OF UTILIZATION OF ANTIBIOTICS ARE.
WE HAVE AN INDUSTRY THAT HAS AGREED ON A SELF REGULATION WHICH HELPS AND PUSHES US
IN THE RIGHT WAY AND MORE IMPORTANT, WE TRY TO ENFORCE CONTROLS ON THE SALES OF ANTIBIOTICS.
THEY ARE NOT OUT OF THE SHELF.
YOU NEED TO HAVE A FORMULA.
THE FORMULA NEEDS TO BE OFFICIAL.
THEY CAN TRACK BACK WHO IS SELLING WHAT ANTIBIOTICS TO WHOM.
THAT IS SOMETHING THAT HAPPENS AND THAT IS AGAIN, PROPER.
HOWEVER, AND THIS IS MY SECOND HALF OF THIS SHORT WORDS AND QUICKLY.
I WAS AGAIN TALKING TO DAVID AND HE WAS TELLING ME HOW DOES IT HAPPEN IN COLUMBIA?
I WAS TELLING HIM, WHEN YOU GO TO BOGOTA, OR WHEN LIMA OR BUENOS AIRES OR SAN PAULO
OR MEXICO CITY, AND YOU GO TO SOLID INSTITUTIONS TO BIG HOSPITALS,
I WOULD SAY A LOT OF SO FIRST INDICATION.
ANTIBIOTIC USE IS REALLY SOLID AND PROPER GOVERNANCE.
THERE IS CLINICAL GOVERNANCE.
THE PHYSICIANS HAVE SELF CONTROL.
THEY ARE ACCOUNTABLE.
THERE IS REVIEW.
THERE IS PEER REVIEW.
SO IT WORKS PRETTY WELL.
HOWEVER, WHEN YOU LOOK AT THIS CHALLENGE, YOU NEED TO CONSIDER THE MIDDLE INCOME COUNTRIES
AND LOW INCOME COUNTRIES ARE EXTREMELY DESPAIRED.
THEIR PERFORMS HAS A GREAT VARIABILITY.
YOU WILL FIND INSTITUTIONS AND THEN PLACES OF INEQUALITY AND POVERTY CONCENTRATIONS
WHERE THERE IS REALLY VERY LIMITED PRESENCE OF THE STATE
AND VERY LIMITED ORGANIZATIONAL CAPACITY.
SO FOR ME, WHEN WE ARE TALKING GLOBALLY, SALLY, WHEN WE ARE TALKING
ABOUT ANTIMICROBIAL RESISTANCE GLOBALLY, IT'S THOSE POCKETS WHERE WE NEED TO FOCUS A LOT
OF OUR EFFORT AND A LOT OF OUR COLLABORATION.
THESE ARE PLACES WHERE THE MOST BASIC INPUTS AND RESOURCES ARE NEEDED,
WHERE INFRASTRUCTURE IS NOT YET THERE.
WHERE HUMAN RESOURCES ARE STRUGGLING DOING THEIR BEST EFFORT WITH BEAR HANDS.
WHERE MANY TIMES KNOWLEDGE IS NOT AVAILABLE IN THE RIGHT TIME.
WHERE COMMITMENT MAY NOT BE IN PLACE FOR MANY RIGHT REASONS.
THERE IS MANY OTHER NEEDS.
WHERE POLICIES DO NOT EXIST AND WHERE LEADERSHIP IS STRUGGLING.
I DO BELIEVE THAT IT'S FOR THOSE PLACES, FOR THOSE POCKETS, AGAIN IN THIS ANTI PUBLIC GOOD,
THAT WE NEED TO PUT THE BEST OF OUR EFFORTS.
I WILL JUST CONCLUDE, RECOGNIZING AND APPRECIATING THE EFFORT OF ALL OF YOU FIGHTERS
AGAINST THE ANTIMICROBIAL RESISTANCE.
THANK YOU VERY MUCH.
[ APPLAUSE ]
[Silence]
[Music]
ANTIMICROBIAL RESISTANCE IS ONE OF THE MOST SERIOUS THREATS GLOBALLY FOR PUBLIC HEALTH.
EVERYBODY OUT THERE NEEDS TO BE CONCERNED ABOUT THIS ISSUE.
THIS IS A ONE HEALTH ISSUE.
ONE HEALTH IS THE IDEA THAT HUMANS, ANIMALS, AND THE ENVIRONMENT ARE ALL CONNECTED TO EACH OTHER.
WE'RE WITHIN THE ENVIRONMENT EVERY DAY.
WE ALL INTERACT WITH EACH OTHER.
WE GO HOME AND INTERACT WITH OTHER PETS.
WE'RE EATING FOOD FROM THE ANIMALS THAT ARE BEING PRODUCED ON THE FARM.
ANTIMICROBIAL-RESISTANT INFECTIONS CAN SPREAD BETWEEN PEOPLE AND ANIMALS.
THAT TO US EXACTLY WHY IT'S IMPORTANT THAT WE WORK WITH STAKEHOLDERS AND PARTNERS
ACROSS THE PET CARE COMMUNITY ON ANTIMICROBIAL RESISTANCE.
WE ALL NEED TO MOVE THE NEEDLE FORWARD TOGETHER THROUGH COLLABORATIONS.
THAT'S WHY OUR PARTNERSHIPS ARE SO IMPORTANT.
WE AT PIJAC ARE PROUD TO WORK WITH THE CENTERS FOR DISEASE CONTROL ON ALL ASPECTS
OF THE PET CARE COMMUNITY.FROM BREEDERS AND DISTRIBUTORS OF ANIMALS TO FOOD
AND PRODUCT MANUFACTURERS SERVICE PROVIDERS AND RETAILERS.
WE LOOK AT THE SANITATION THAT'S USED TO KEEP CLEAN ENVIRONMENTS.
WE LOOK AT TRANSPORTATION PROTOCOLS.
AND WE ALSO MAKE SURE THAT PEOPLE WORKING WITH ANIMALS TAKE STEPS TO PREVENT THE SPREAD
OF POTENTIALLY RESISTANT DISEASES BEFORE THEY EVEN ENTER INTO THE EQUATION
TO MINIMIZE THE RISK OF ANTIMICROBIAL RESISTANCE DEVELOPING.
PETCO WORKS HAND-IN-HAND WITH THE CDC BOTH TO MAKE SURE THAT WE HAVE STRONG POLICIES
TO PREVENT ANTIMICROBIAL RESISTANCE,
BUT ALSO TO ENSURE WE HAVE THE RIGHT EDUCATION
AROUND THAT RELATIONSHIP BETWEEN PETS AND PEOPLE.
NOT ONLY DO WE NOT SELL ANY ANTIBIOTICS OVER THE COUNTER,
WE ALSO DO NOT ALLOW ANY PROPHYLACTIC USE BOTH IN OUR STORES OR FROM ANIMALS THAT ARE COMING
FROM ANY SORT OF VENDOR.WE PUT THOSE INTO PLACE NOT ONLY BECAUSE OF CONCERNS
FOR OUR OWN ANIMAL HEALTH IN OUR STORES AND FROM THE SUPPLY CHAIN,
BUT MAKING SURE THAT AS A COMPANY WE ARE BEING AS PROACTIVE AS POSSIBLE
TO PROTECT HUMAN HEALTH AND PUBLIC HEALTH.
BECAUSE WE CAN NEVER FORGET THAT THESE ARE GOING TO BE FOLKS PETS LIVING IN THE HOUSE
WITH THEIR FAMILY, AND WE WANT EVERYBODY IN THAT ENTIRE FAMILY VERY HEALTHY.
WE ALL LIVE IN ONE WORLD TOGETHER.
WHAT WE DO IMPACTS THE ANIMALS AROUND US.
WHAT THE ANIMALS AROUND US DO IMPACT US.
IF YOU MAKE GREAT STRIDES FOR INSTANCE ON THE HUMAN SIDE IN HEALTHCARE
IF THOSE SAME STRIDES AREN'T MADE ON THE ANIMAL SIDE, THEN IT'S GOING TO SET US BACK.
THE BIGGEST STRIDES WE'RE GONNA MAKE IS THE ENTIRE INDUSTRY COMING TOGETHER
TO ADDRESS THESE ISSUES.SO THAT PETS CAN CONTINUE TO BE AN IMPORTANT PART OF OUR LIVES
AND ENRICH EVERYTHING THAT WE DO.
[Music]
[ APPLAUSE ]
>> MADLEN DAVIES: NOW I'D LIKE TO SHARE THE SECOND RECOMMENDATION
FOR EFFECTIVE COMMUNICATION AROUND AMR, WHICH IS TO USE SIMPLE, SCIENTIFIC EXPLANATIONS.
THE WELCOME TRUST RESEARCH SHOWED THAT PEOPLE DON'T WANT TO BE TOLD WHAT TO THINK
BUT THEY DO WANT THE FACTS AROUND AMR.
SO THEY ARE ABLE TO UNDERSTAND THE ISSUE FOR THEMSELVES AND COME TO THEIR OWN CONCLUSIONS.
SO PROVIDING A BASIC UNDERSTANDING OF AMR IS NECESSARY TO MAKE PEOPLE PRIORITIZE THE ISSUE,
WHILE ALSO PREVENTING MISCONCEPTIONS ABOUT HOW RESISTANCE OCCURS
AND THE NEED FOR A COLLECTIVE RESPONSE.
SO WE NEED TO MAKE SURE THAT OUR EXPLANATIONS ARE SUFFICIENTLY CLEAR
AND ACCESSIBLE FOR OUR AUDIENCE.
WE REALLY DON'T JUST WANT THESE PEOPLE TO BE ALREADY INTERESTED IN SCIENCE HERE.
THE RESEARCH SHOWS YOU MIGHT WANT TO DESCRIBE IT LIKE THIS:
THE BACTERIA THAT CAUSE ILLNESSES ADAPT AND CHANGE OVER TIME,
MEANING THEY CAN DEVELOP THE ABILITY TO DEFEAT THE ANTIBIOTICS DESIGNED TO KILL THEM.
OUR OVERUSE OF ANTIBIOTICS IS SPEEDING UP THIS PROCESS.
THE RESULT IS THAT ANTIBIOTICS ARE BECOMING LESS EFFECTIVE IN TREATING ILLNESSES.
THE VIDEOS YOU WILL SEE TONIGHT
AND THE ART AROUND THE ROOM FROM CDC, WELCOME TRUST, AMERICAN SOCIETY FOR MICROBIOLOGY
AND THE AMR FIGHTER COALITION, ARE GREAT EXAMPLES
OF MAKING IMPORTANT TECHNICAL WORK MORE RELATABLE WITHOUT COMPLETELY LOSING THE SCIENCE.
SO TO HELP US SHOW THE HUMAN FACE OF AMR,
WE DESPERATELY NEED MORE PATIENTS TO TELL THEIR STORIES.
I HAVE INTERVIEWED OUR NEXT SPEAKER BEFORE AND I KNOW FIRSTHAND HIS STORY
AND BRAVERY AND DRIVE ARE QUITE REMARKABLE.
I'LL SOON BE WELCOMING TO THE STAGE Mr. DAVID RICCI.
Mr. DAVID RICCI AND A SURVIVOR OF A INFECTION THAT NEARLY TO GO HIS LIFE.
HE TRAVELED TO WASHINGTON, D.C. TO LOBBY FOR STRONGER REGULATIONS TO COMBAT THE PROBLEM.
HE NOW WORKS FOR THE INSTITUTE FOR SYSTEMS BIOLOGY
AND THE AMR 350 CAMPAIGN TO EDUCATE YOUTH ABOUT AMR.
WELCOME TO THE STAGE Mr. RICCI.
[ APPLAUSE ]
>> DAVID RICCI: HELLO.
EXCUSE ME.
MY THROAT IS A LITTLE STIFF TONIGHT.
SO, MY NAME IS DAVID RICCI.
MY UNCLE SAYS THE SAME THING.
NO WORRIES ABOUT IT.
IN 2011, I WAS WORKING AT AN HIV CLINIC IN CALL CUT, INDIA,
ONE OF THE BEST THINGS I EVER DONE IN MY LIFE.
I REALLY GOT TO SEE THE HUMAN IMPACT OF WHAT HEALTH IS LIKE FOR THE POOREST PEOPLE
IN THE WORLD AND ONE MORNING, I WAS WALKING TO THE ORPHANAGE I WAS WORKING AT
AND I WAS HIT BY A TRAIN AND RUN OVER.
SO THAT RESULTED IN THE BRUTAL AMPUTATION OF MY RIGHT LEG ABOVE THE KNEE
WITHOUT ANESTHETIC I WATCHED AS THEY CHOPPED IT OFF AND IT WAS VERY TRAUMATIC.
WOULD YOU LIKE TO SEE IT?
THAT'S THE HUMAN ASPECT OF THIS, RIGHT?
BECAUSE I'M HERE TO SHOW YOU WHAT HAPPENS WHEN AMR AFFECTS US PERSONALLY.
AND I WAS ON AND OFF ANTIBIOTICS FOR SIX MONTHS, WHICH IS THE LAST RESORT ANTIBIOTIC WE HAVE.
AND WITHOUT THAT, THERE IS REALLY NOTHING LEFT.
AND MICROBES ARE EVOLVING RESISTANCE EVEN TO THIS.
THE FIRST DOCUMENTED CASE WAS THE SAME YEAR I WAS HIT IN THE 2011.
BEING ON THIS ANTIBIOTIC IS THE WORST THING THAT EVER HAPPENED TO ME,
WORST THAN GETTING HIT BY A TRAIN.
WHEN YOU'RE ON IT, THEY HAVE TO GIVE IT TO YOU INTERMITTENTLY FOR TWO WEEKS AT A TIME
BECAUSE IT IS SO LETHAL AND TOXIC.
IT'S FROM THE 50s AND WE SHELVED IT BECAUSE IT WAS KILLING PATIENTS FASTER THAN THE INFECTION.
IT WIPES OUT YOUR IMMUNE SYSTEM.
IT KILLS YOUR KIDNEYS.
AND EVERY SINGLE DAY I WAS THROWING UP AND I LOST OVER 80 POUNDS.
IT FEELS LIKE YOUR ORGANS ARE DISINTEGRATING AND RUBBING AGAINST EACH OTHER.
I WAS IN CONSTANT PAIN.
AFTER I WAS SENT HOME FROM THE HOSPITAL AFTER A MONTH,
I CONTINUED USING THIS IV ANTIBIOTICS FOR SIX MONTHS.
AND IT IS A PRIVILEGE FOR ME TO BE HERE BECAUSE NOT ONLY BECAUSE OF THE COLOR OF MY SKIN
AND THE COUNTRY OF WHERE I'M FROM, BUT MOST PEOPLE WHO SUFFER
FROM THIS GO UNDIAGNOSED IN CHINA AND INDIA.
THEY ARE LEFT OUT OF THIS ENTIRE DISCUSSION.
THEY ARE NOT HERE ON THE STAGE AND MOST OF THEM, AS I SAID, THE HOSPITAL REPORTS THEY DIE
OF LIVER INFECTION OR SOMETHING ELSE.
AND I THINK THE GREATEST THING WE NEED TO DO IS SAY, HOW IS THIS HAPPENING?
WHY IS THIS HAPPENING?
IT ISN'T BECAUSE DOCTORS ARE IRRESPONSIBLE WITH ANTIBIOTICS, ALTHOUGH THAT IS PART OF IT.
SOME STATISTICS PUT IT AT OVER 30% OF ANTIBIOTICS ARE UNNECESSARILY PRESCRIBED.
OTHER COUNTRIES PUT THAT MUCH HIGHER.
BUT I THINK MOST IMPORTANTLY, IT'S IN AGRICULTURE.
AND THAT'S A HOT TOPIC FOR PEOPLE NOT TO MENTION.
OVER 70% OF THE ANTIBIOTICS THAT ARE DEVELOPED GO TO AGRICULTURE.
AND THE WAY THAT WE EAT MEAT IN THIS COUNTRY IS DISGUSTING.
IT REALLY IS.
IT'S UNNATURAL AND HASN'T BEEN DONE FOR 10,000 YEARS BUT JUST IN THIS CENTURY,
WE CONGREGATE ANIMALS INTO BILLIONS ABOUT THIS SIZE, THOUSANDS OF ANIMALS, NO SUNLIGHT,
AND WE GIVE THEM PROPHYLACTIC ANTIBIOTICS HOPING THAT BECAUSE OF THEIR RETCHED CONDITIONS,
LIVING IN THEIR OWN FECAL MATTER, BITING EACH OTHER AND OPEN WOUNDS,
AND WE HAVE TO GIVE THEM ANTIBIOTICS JUST TO SURVIVE.
AN AVERAGE COW'S LIFESPAN IS 20 YEARS BUT HERE IT IS FOUR.
AND THESE ARE MAMMALS JUST LIKE US.
THEY HAVE MEMORIES AND PAIN JUST LIKE US.
AND MANY COUNTRIES LIKE IN INDIA AND CHILE, THEY USE THE ANTIBIOTIC ON ANIMALS.
THAT'S THE LAST RESORT ANTIBIOTIC WE HAVE.
AND COLISTIN IS DISGUSTING.
IT KILLS YOU FROM THE INSIDE.
TO IMAGINE BECAUSE OF THE RETCHED CONDITIONS
OF THESE ANIMALS USING THIS ANTIBIOTIC BEFORE THERE IS ANY INFECTION.
THAT IS WHAT CAUSES AMR TO EVOLVE.
THAT'S WHAT CREATES IT.
WE ARE ACTIVELY CREATING IT WHILE WE PROFESS OURSELVES GRANDIOSE SCHEMES
FOR COMBATING RESISTANCE.
WE PROLIFERATE IT, RIGHT?
SO THAT'S HYPOCRISY.
ALL OF YOU HAVE MUCH MORE INFLUENCE AND KNOWLEDGE ABOUT THIS THAN I SO I URGE YOU
TO PLEASE, RE EVALUATE THE WAY THAT YOU CONSUME YOUR FOOD.
AND IF YOU'RE VEGAN, YOU'RE NOT SPARED FROM THIS AS WELL BECAUSE WHERE IS ALL THAT MANURE GOING
FROM ALL THESE ANIMALS THAT ARE PUMPED FULL OF ANTIBIOTICS?
WE PROPAGATE CROPS TO GROW CORN AND THE REST OF OUR FOOD.
ANTIBIOTICS ARE FOUND EVERY NOW.
IT'S IN OUR WATER AND EVERYWHERE.
AND I DON'T WANT TO SCARE EVERYONE AND JUST TALK
ABOUT NEGATIVE THINGS BECAUSE THERE IS A LOT OF HOPE.
THAT'S WHY I'M HERE.
I'M GRATEFUL.
AND THE SUBJECT IS SO INCLUSIVE TO SO MANY ISSUES, THAT'S WHY I DEDICATED THE REST
OF MY LIFE TO COMBATING THIS AND SPEEDING AWARENESS.
IT'S TRICKY.
THERE IS A LOT OF SUBJECTS THAT THE GENERAL PUBLIC CAN WRAP THEIR HEAD
AROUND BUT THIS ISN'T ONE OF THEM.
AS SOON AS YOU TALK ABOUT ENZYMES AND EVOLUTION AND MUTATIONS, YOU LOSE MOST OF THE PUBLIC.
AND FOR ME, I FIND JUST BEING HONEST IS THE BEST WAY TO START, NOT JUST TO GIVE ALL
OF THESE HAPPY CONNOTATIONS TO WHAT WE ARE DOING,
BUT TO REALLY ADDRESS WHAT IS WRONG WITH WHAT WE HAVE BEEN DOING.
AND YOU KNOW, DIVERSIFYING OUR USE OF ANTIBIOTICS AS WELL.
THERE HADN'T REALLY BEEN A NEW CLASS OF ANTIBIOTICS SINCE THE 80s.
THAT'S BECAUSE THERE IS NOT REALLY AN INCENTIVE.
THERE ARE ENORMOUSLY POWERFUL INTERESTS THAT ARE NOT WANTING TO INVEST 3 BILLION DOLLARS
INTO AN ANTIBIOTIC BECAUSE BY DEFINITION,
YOU'RE ONLY HOPEFULLY GOING TO USE IT ONCE FOR THREE WEEKS
AND WHEREAS THERE IS MUCH MORE PROFIT TO BE MADE IN CANCER AND IN CHRONIC ILLNESSES
THAT REQUIRE DRUG COMPANIES TO MAKE A REVENUE ON A MONTHLY BASIS OFF OF PATIENTS.
AND I'M BLESSED BECAUSE MY PARENTS WERE INSURED WHERE THERE ARE MANY PEOPLE
THAT THEY MIGHT NOT HAVE FOUND OUT THEY HAVE AN INFECTION.
I DON'T ALSO WANT THIS TO BE A DISCOURAGEMENT FROM PEOPLE TRAVELING THE WORLD.
PEOPLE ARE LIKE, YOU WENT TO INDIA.
WHAT DO YOU EXPECT?
OF COURSE THERE IS LOTS OF INFECTIONS THERE.
AND MASSIVE POVERTY.
BUT THIS ISN'T SOMETHING TO DISSUADE US FROM TRAVELING.
IF ANYTHING IT'S TO SHOW THAT IT HAPPENS HERE TOO.
IT HAPPENS ANYWHERE.
IT'S HAPPENED IN HOSPITALS HERE.
IF WE DON'T STOP THIS, IT WILL GET WORSE AND OUR FUTURES ARE AT RISK.
OUR CHILDREN'S FUTURES ARE AT RISK.
MY LIFE IS AT RISK BECAUSE OF THIS.
THIS ISN'T BECAUSE BACTERIA RANDOMLY MUTATED,
IT'S BECAUSE THERE IS A PRESSURE FOR SELECTION AGAINST THIS.
AND SO, I CHALLENGE ALL OF YOU TO, IN YOUR DAILY LIVES, BE MORE CONSCIOUS OF WHAT YOU EAT,
WHETHER IT IS PLANTS OR MEAT, JUST TO BE AWARE THAT IT'S NOT RAISED WITH ANTIBIOTICS.
AND SECRETARY AZAR MENTIONED THAT McDONALD'S HAS COMMITTED FOR THEIR CHICKEN NUGGETS
AND OTHER THINGS NOT TO BE USED WITH ANTIBIOTICS BUT THAT'S ONLY IN AMERICA.
RIGHT? McDONALD'S SERVES THE REST OF THE WORLD AS WELL AND THAT IS NOT THE CASE
IN MOST SOUTH AMERICAN COUNTRIES.
AND SO, EDUCATING OUR YOUTH IS REALLY IMPORTANT TO ME AND SO I HAVE BEEN WORKING
WITH THE INSTITUTE FOR SYSTEMS BIOLOGY TO EDUCATE PEOPLE BEFORE THEY GET TO THE GRADUATE
AND UNDERGRADUATE LEVELS SO THAT WAY HIGH SCHOOLERS AND YOUNGER CAN UNDERSTAND AMR
BECAUSE IT'S NOT A COMPLICATED SUBJECT.
IT'S THE WAY THAT A LOT OF TIMES PROFESSIONALS HAVE TALKED ABOUT IT, IT COMPLICATES THE ISSUE.
SO I ENCOURAGE ALL OF YOU TO READ UP ON THIS AND TO,
IF YOU KNOW ABOUT IT, EDUCATE YOUR FAMILY MEMBERS.
EVEN IF THEY ARE NOT INTERESTED.
TRY AND TAKE A MOMENT OF THEIR TIME BECAUSE ALL OF OUR LIVES ARE IN DANGER.
NOT JUST THE WESTERN WORLD THAT HAS TO TAKE PRECAUTIONS, IT'S ALL OF US.
JUST LIKE CLIMATE CHANGE.
THOSE THAT ARE WELL OFF WON'T SEE THE EFFECT IMMEDIATELY.
SO, BUT IT WILL HAPPEN.
IT WILL HAPPEN HERE TOO, IN ALL OF OUR HOSPITALS.
JIM O'NEIL, THE U.K. BRITISH COLUMNIST MENTIONED THAT POTENTIALLY BY 2050
OVER 10 MILLION PEOPLE A YEAR WILL DIE FROM AMR.
THAT'S MORE THAN CANCER AND THE COST WILL BE OVER 100 TRILLION DOLLARS.
SO THAT SHOULD BE AN ECONOMIC INCENTIVE ENOUGH FOR US TO MAKE A CHANGE.
SOME PEOPLE DISPUTED THAT FIGURE.
I WOULD SAY PROBABLY LIKELY A LOT HIGHER BECAUSE THE STATISTICS AREN'T THERE.
I MET WITH THE DEPUTY COMMISSIONER OF THE FDA
AND THEIR BIGGEST THING IS THEY DON'T HAVE ENOUGH DATA TO MAKE IMPLEMENTATION AND CHANGES.
THE FDA ASKS PERMISSION FOR THESE FACTORY FARMS BEFORE THEY CAN GO IN MONTHS IN ADVANCE.
SO THEY CHANGE THE PROCEDURES AND CHANGE THE QUALITY OF THEIR PROPHYLACTIC ANTIBIOTIC USE.
A LOT OF TIMES VETERINARIANS DON'T NEED PRESCRIPTIONS
TO GIVE THE ANIMALS MASS ANTIBIOTICS.
SO THAT'S WHY I'M MOST PASSIONATE ABOUT IT AND SO THANK YOU FOR YOUR TIME.
[ APPLAUSE ]
[Music]
[VIDEO] I HAD NEVER HEARD OF A YOUNG, HEALTHY PERSON GETTING C. DIFF.
I'VE BEEN A NURSE FOR 20 YEARS - I HAVE HEARD OF THAT.
SHE JUST GOT SICK SO FAST AND SHE WAS GONE.
I DID NOT KNOW I HAD XDR TB FOR THE FIRST SIX MONTHS.
I WAS POPPING OVER 20 PILLS A DAY FOR OVER TWO AND HALF YEARS, SIX MONTHS OF DAILY INJECTIONS.
I CAN'T EVEN COUNT WHAT HAPPENED TO ME.
THERE WAS JAUNDICE; I LOST MY EYESIGHT FOR A WHILE.
[Music]
I HAD JUST TURNED 26; AND THIS HAPPENED TWO WEEKS AFTER MY WEDDING AS WELL.
IT WAS INFECTIONS AFTER INFECTION, AFTER INFECTION.
I WAS DIAGNOSED WITH MRSA.
[Music]
WE ARE COLLECTIVELY, I THINK, FAILING THIS WORLD, IN TERMS OF RESISTANCE
TO ANTIBIOTICS AND IN TERMS OF DRUG RESISTANCE.
WE NEED TO GET INTO OUR COMMUNITIES.
WE NEED TO GO TO THE GRASSROOTS AND TALK TO THE COMMUNITY AND TELL THEM, LET THEM KNOW.
[Music]
WE HAVE TO MOVE PEOPLE INTO PREVENTING INFECTIONS, DIAGNOSING BETTER
AND ACTUALLY LOOKING AFTER OUR ANTIBIOTICS.
AND TO DO THAT, WE NEED A FACE.
[Music]
MY NAME IS B FLOW - SUPER-FANTASTIC-BIBBITY-BIBBITY-BIBBITY-B FLOW!
I AM A MUSIC ARTIST AND I USE MUSIC TO ADVOCATE FOR POSITIVE SOCIAL CHANGE.
SO I HAVE DECIDED TO TAKE ACTION AND TO SING ABOUT RESISTANCE,
BECAUSE IT HAS MADE MY FAMILY SMALLER THAN IT USED TO BE.
AND I DON'T WANT TO LOSE ANY MORE PEOPLE IN MY FAMILY, IN MY NEIGHBORHOOD, IN MY COUNTRY,
IN MY CONTINENT, OR ANYWHERE IN THE WORLD.
YEAH, MAN.
AND THAT'S EXACTLY WHAT WE DO.
[ APPLAUSE ]
>> MADLEN DAVIES: SO I JUST LIKE TO SHARE
WITH YOU THE THIRD RECOMMENDATION FOR EFFECTIVE AMR COMMUNICATION.
AS WE SAW WITH Mr. DAVID RICCI'S SPEECH, MAKE IT HUMAN AND MAKE IT RELEVANT.
THE WELCOME TRUST RESEARCH SHOWED FOR COMMUNICATIONS TO BE EFFECTIVE,
WE NEED TO SHOW THE HUMAN IMPACT OF AMR, EXPLAINING HOW PEOPLE ARE AFFECTED RATHER
THAN RELYING ON NUMBERS AND STATISTICS.
WE SHOULD LINK TO DISEASES AND PROCEDURES THAT WILL RESONATE WITH OUR AUDIENCE.
FOR EXAMPLE, THE RESEARCH SHOWED IN INDIA THIS MIGHT BE ABOUT HOW AMR WILL AFFECT TB.
IN KENYA, IT WAS UNDERSTOOD THROUGH THE IMPACT ON MALARIA ERADICATION.
AND IN THE U.K., PEOPLE RESPONDED BEST TO HOW IT COULD IMPACT CANCER TREATMENT.
TO STRENGTHEN OUR COMMUNICATION EVEN FURTHER,
WE SHOULD EXPLAIN HOW AMR COULD DIRECTLY AFFECT EVERYONE BUT THIS IS ENHANCED
IF WE COMBINE THE IDEA OF EVERYONE WITH A PERSONAL ANGLE.
AMR WILL AFFECT YOU, WE NEED TO SAY, YOU, YOUR FRIENDS, YOUR FAMILY.
THIS HAS THE POTENTIAL TO TRANSFORM PERCEPTIONS OF AMR FROM AN ISSUE THAT IS IMPORTANT
BUT FAR AWAY TO ONE THAT REQUIRES YOU TO MAKE IT A PRIORITY.
THE WORLD HEALTH ORGANIZATION HAS REALLY LED THE WAY ON RAISING THE PROFILE OF AMR.
MAKING THIS THE FIRST PILLAR OF EACH COUNTRY'S GLOBAL ACTION PLAN
AND HOSTING A WORLD ANTIBIOTIC AWARENESS WEEK EVERY YEAR.
WE HAVE A WORLD HEALTH ORGANIZATION SPEAKER NEXT WHO CAN TELL US MORE.
I'LL SOON BE WELCOMING TO THE STAGE DR. POONAM KHETRAPAL SINGH.
WORLD HEALTH ORGANIZATION REGIONAL DIRECTOR FOR SOUTHEAST ASIA.
DR. POONAM KHETRAPAL SINGH BECAME THE REGIONAL DIRECTOR IN 2014
AND SHE WAS THE FIRST EVER WOMAN TO HOLD THAT ROLE.
PREVIOUSLY, SHE WAS THE HEALTH SECRETARY FOR THE STATE OF PUN JAB, A POPULATION OF 27 MILLION.
SHE ALSO WORKED IN HEALTH CARE FOCUSED ROLES FOR THE WORLD'S BANK
AND INTERNATIONAL HEALTH ADVISOR TO THE INDIAN GOVERNMENT.
DURING HER TIME AT WORLD HEALTH ORGANIZATION, SHE HAS BEEN COMMITTED
TO COMBATING THE RESISTANCE SO THE PROGRESS MADE
ON PREVALENT DISEASES LIKE TB, IS NOT UNDERMINED.
WELCOME DR. POONAM KHETRAPAL SINGH.
[ APPLAUSE ]
>> POONAM KHETRAPAL SINGH: AS WE GATHERED HERE IN NEW YORK THIS TIME TO TALK
ABOUT UNIVERSAL HEALTH COVERAGE, AND I COME FROM A MEETING WHERE WE WERE DISCUSSING THAT,
I WONDERED REALLY WHY AMR WAS NOT ON THE AGENDA THERE?
BECAUSE IN VARIOUS PANELS THAT I HAVE BEEN IN, I HAVE NOT SEEN AMR BEING DISCUSSED.
SO I FIND THE ORGANIZERS OF THIS EVENT
FOR HAVING PROVIDED THIS PLATFORM FOR THE DISCUSSION ON AMR.
AS FAR AS AMR IS CONCERNED IN THE SOUTHEAST ASIA REGION OF W.H.O.,
WE HAVE BEEN GIVING IT A PRIORITY SINCE 2011,
FAR BACK BEFORE THE WORLD STARTED TALKING ABOUT IT.
MINISTERS OF OUR REGION MET IN INDIA TO DELIBERATE ON AMR
AND THERE WAS A MINISTERIAL DECLARATION.
THAT BECAME THE BASIS OF BIRTH ON AMR IN OUR REGION.
AFTER THAT, WE HAD A FOLLOW UP ACTION ON THE MINISTERIAL DECLARATION.
VERY OFTEN WE ARE CRITICIZED AND WE ARE TOLD THAT WE ARE EASY WITH DECLARATIONS,
WE ADOPT SOLUTIONS IN THE WORLD ASSEMBLY BUT THERE IS NO FOLLOW UP, REALLY.
DO WE REALLY SEE THERE IS PROGRESS ON WHAT WE HAVE DECIDED?
THERE IS ACTION TAKEN ON WHAT HAS REALLY BEEN ADOPTED
BY THE MEMBER STATES OF THE WORLD HEALTH ASSEMBLY?
IN 2014 WE AGAIN HAD A MEETING IN INDIA TO SEE WHERE WE WERE WITH AMR.
IN 2015, THE WORLD HEALTH ASSEMBLY ADOPTED A GLOBAL ACTION PLAN ON AMR AND MEMBER STATES
OF THE SOUTHEAST ASIA REGION WERE IN THE FOREFRONT TO HAVE NATIONAL ACTION PLANS ON AMR
AND NOT ONLY THAT, WE ARE REVIEWING THAT CONTINUOUSLY TO SEE WHAT IS THE PROGRESS ON AMR?
WE DO FIND THAT YES, THE ANIMAL SECTOR, THE AGRICULTURE SECTOR AND THE HUMAN SECTOR,
HAVE COME TOGETHER, BUT OF COURSE NOT THE WAY WE WOULD HAVE LIKED TO.
WE DO HAVE THE ONE HEALTH APPROACH.
MEMBER COUNTRIES OF OUR REGION ARE LOOKING AT IT.
WE IN THE SOUTHEAST ASIA REGION ARE ADVOCATING FOR IT.
CONSTANTLY MONITORING IT TO SEE WHERE THE DAMAGE IS THE MOST.
AS HAS BEEN SAID BY MANY SPEAKERS BEFORE ME, IT'S THE ANIMAL SECTOR,
THE ECOSYSTEM THAT WE REALLY NEED TO BE LOOKING AT.
A FEW DAYS AGO, A PATIENT WAS DETECTED IN INDIA WITH BACTERIA
WHICH WE ONLY FIND IN THE ICUs OF HOSPITALS.
AND THAT GOT US THINKING THAT HOW WAS IT THAT THIS ANTIBIOTIC WOULD BE FOUND IN A PATIENT,
IN A CITIZEN WHO NEVER REALLY BEEN TO A HOSPITAL?
WE DISCOVERED THAT THAT WAS BECAUSE OF WASTE DISPOSAL HAPPENING IN THE HOSPITALS.
WASTE DISPOSAL REALLY HASN'T BEEN ADDRESSED THE WAY IT OUGHT TO BE ADDRESSED.
SO TODAY LADIES AND GENTLEMEN, THE THREAT FOR AMR IS FAR MORE THAN WE WOULD LIKE TO BELIEVE.
TODAY, WHAT WAS IN THE ICUs OR HOSPITALS IS OUT IN THE OPEN
AND WE ARE HAVING VEGETABLES GROWN IN THAT SOIL.
WE ARE HAVING FRUITS GROWN IN THAT SOIL.
AND THAT IS HOW THE DANGER FROM AMR IS GETTING REALLY SPREAD ALL OVER.
WE'VE TRIED TO SEE HOW TO SUPPORT,
HOW W.H.O. COULD SUPPORT MEMBER STATES IN TRYING TO DEAL WITH THIS.
WE TRIED TO EXPAND OUR LABORATORY NETWORKS.
WE TRIED TO PASS THE MEMBER STATES TO BE ABLE TO DETECT AMR AND BE ABLE
TO SEE HOW THEY COULD CONTRIBUTE TO THE CONTROL OF THE AMR.
NOW WE DO REALIZE THAT THERE ARE MANY COUNTRIES OF OUR REGION
WHERE THEY HAVE DRUGS CAN BE OBTAINED OVER THE COUNTER.
AND THESE ARE NOT REALLY AGAINST A PRESCRIPTION.
SO THE DANGERS THAT ARE PLACED BY THE DEVELOPING WORLD ARE FAR MORE THAN WE FACE HERE
BECAUSE THERE, EVEN THOUGH THEY MAY BE LAWS THAT DO PRESCRIBE AND NOW IT IS HAPPENING
IN SEVERAL COUNTRIES IN MY REGION WHERE THEY ARE TALKING ABOUT PRESCRIPTION DRUGS
AND THERE IS NO REAL ENFORCEMENT OR REGULATION AND EVEN TODAY,
WE CAN GO AND GET THESE DRUGS ACROSS THE COUNTER.
I ALSO FEEL THAT THERE IS IT A LACK OF AWARENESS AMONG THOSE WHO PRESCRIBE DRUGS.
THEY DO PRESCRIBE DRUGS WITHOUT UNDERSTANDING THAT IT IS GOING
TO BUILD RESISTANCE IN A PATIENT.
WE FIND THAT YES, ANTIBIOTICS WHICH SHOULD BE TAKEN 5 7 DAYS ACTUALLY ARE TAKEN FOR 3 DAYS,
EVEN TODAY, AND THE DOCTORS ALSO NEED TO BE MADE AWARE OF THIS
WHEN THEY ARE PRESCRIBING THESE ANTIBIOTICS.
SO THE PROBLEM IS FAR MORE THAN WE WOULD LIKE TO BELIEVE.
IT IS SOMETHING THAT WE ARE AWARE OF, WHICH WE ARE TRYING TO DEAL WITH.
WE EVEN IN HOSPITALS, THE BEST OF HOSPITALS TODAY, I FIND THAT IT'S VERY CUSTOMARY
TO GIVE DRUGS WHICH REALLY SHOULD NOT BE GIVEN.
THE SPEAKER BEFORE ME WAS REFERRING TO COLISTIN AND I SEE THAT BEING PRESCRIBED IN SOME
OF THE BEST HOSPITALS IN OUR COUNTRY WHEN THEY SHOULD NOT REALLY BE GIVEN AT THAT STAGE.
AND THAT IS HOW WE ARE COMPOUNDING THE PROBLEM AND BUILDING THIS MORE AND MORE.
WE THEREFORE NEED TO DO A LOT OF THINGS TO BE ABLE TO HANDLE AMR.
WE NEED TO BUILD AWARENESS, NOT ONLY AMONG THE POPULATIONS, SO THAT THEY UNDERSTAND
THAT IF SOMETHING HAS WORKED FOR THEM, THEN THEY AT ONE STAGE OF TIME, IT'S NOT NECESSARY
THAT THEY SHOULD TAKE THE SAME ANTIBIOTIC WHEN THEY HAVE A PROBLEM THAT THEY HAD BEFORE.
AND I FIND THIS A VERY COMMON FEATURE.
WE ALSO NEED TO EDUCATE THOSE WHO HAVE TO PRESCRIBE DRUGS.
THEY HAVE TO BE VERY CAREFUL ABOUT WHAT THEY PRESCRIBE.
THEY HAVE TO BE VERY CAREFUL ABOUT THE LENGTH OF WHICH THEY PRESCRIBE THEM
BECAUSE THAT ALSO BECOMES A VERY MAJOR ISSUE.
WHEN THEY PRESCRIBE SOMETHING, PATIENTS FEEL THEY CAN TAKE THEM
FOR JUST THREE DAYS AND THAT'S ENOUGH.
THAT'S A VERY COMMON FEELING, NOT ONLY AMONG THE CITIES OR THE RURAL AREAS BUT ALL OVER.
AND WE ALSO NEED TO SEE THAT GOVERNMENTS GET INTO ACTION, THAT GOVERNMENTS SEE.
THEY BRING IN REGULATORY FORCES AND THAT THERE IS ENOUGH REGULATION TO SEE THAT THERE IS NOT
OVER THE COUNTER SALE OF DRUGS WITHOUT PRESCRIPTION,
THAT THERE IS SUFFICIENT AWARENESS AMONG THOSE WHO NEED TO BE AWARE OF AMR DEVELOPING
IF THEY TRADE DRUGS THAT ARE NOT NEEDED.
AND I DO BELIEVE THAT THE WORLD HEALTH ORGANIZATION IS TRYING
TO DO ITS VERY BEST FOR IT.
WE HAVE STARTED A LOT OF INITIATIVES WHERE WE THINK WE WOULD BE ABLE
TO HELP THE GOVERNMENTS IN HANDLING AMR.
THE ONE HEALTH APPROACH IS A SAMPLE WHERE THE ORGANIZATIONS, THE FAO AND THE W.H.O.,
HAVE COME TOGETHER TO BE ABLE TO ADVOCATE AGAINST AMR; YET A LOT REMAINS TO BE DONE.
AND AS WE CONTINUE TO HELP GOVERNMENTS AND AS WE HELP TO OR START HELPING THE COUNTRIES,
THE PEOPLE OF OUR COUNTRIES, WE STILL FIND THAT THERE ARE HUGE GAPS WHICH WE NEED
TO FILL BEFORE THE WORLD CAN BE SAFE AND BEFORE WE REALLY CAN SAY
THAT THE PROBLEM OF AMR IS HANDLED.
WE HAVE A LONG WAY TO GO.
AND THERE ARE ALL THE STAKEHOLDERS AND PARTNERS SHOULD BE PLAYING A VERY MAJOR ROLE
AND ARE DOING THAT, YET THE PROBLEM IS SO CHALLENGING THAT A LOT
OF EFFORT TO BE ABLE TO HANDLE THAT.
MY REQUEST REALLY, AND WHAT I REALLY URGE THOSE PRESENT HERE IS TO SEE
THAT AMR SHOULDN'T BE JUST IN THE PREAMBLE OF THE STGs.
TO THE SHOULD REALLY HAVE A PLACE IN THE STGs.
IT SHOULD FIGURE THERE.
BECAUSE THE PROBLEM IS SO ACUTE THAT UNLESS IT'S GIVEN THAT KIND OF VISIBILITY
AND UNLESS IT'S YEAR AFTER YEAR WHEN WE NEED TO SEE, WE WILL NOT BE ABLE TO HANDLE IT.
ONE OF THE MAIN WHEN WE ARE TALKING ABOUT LEAVING NO ONE BEHIND AND TALKING
OF REACHING ALL, WHAT IS IT THAT WE ARE REALLY TALKING ABOUT?
WE ARE TALKING ABOUT ACCESS TO MEDICINES.
WE ARE TALKING ABOUT REACHING ONE AND ALL WHEN THEY NEED HEALTH CARE
AND WHEN THEY NEED ASSISTANCE, THEY WILL LEAD TO A BIGGER PROBLEM.
THAT IS WHERE WE NEED TO BE CAUTIOUS.
WHEN ALEXANDER FLEMMING DISCOVERED PENICILLIN, THE WORLD WENT CRAZY.
WE ALL THOUGHT IT WAS A GREAT DISCOVERY.
JUST SEE HOW LONG IT HAS BEEN TO DISCUSS RESISTANCE FROM THOSE ANTIBIOTICS.
AND WE ARE GETTING TOGETHER AND THINKING, WHAT WAS CONSIDERED TO BE A BULL NOT VERY LONG AGO,
IS CONSIDERED TO BE A MAJOR THREAT TODAY.
AND THAT, LADIES AND GENTLEMEN, IS IMPORTANT FOR US.
FOR US TO GIVE MORE THOUGHT AND FOR US TO THINK,
WHAT ARE THE WAYS IN WHICH WE CAN DEAL WITH THIS PROBLEM?
THANK YOU.
[ APPLAUSE ]
[Music]
[VIDEO] ALL ALONG FROM THE VERY BEGINNING OF THE ANTIBIOTIC ERA THERE'S BEEN THIS PARALLEL STORY
OF MISUSING ANTIBIOTICS IN AGRICULTURE.
OF GIVING ANTIBIOTICS TO ANIMALS THAT ARE NOT SICK THAT DO NOT NEED THEM.
ANTIMICROBIAL RESISTANCE IS A GLOBAL CRISIS.
THE PROBLEM OF ANTIMICROBIAL RESISTANCE HAS REACHED ALARMING LEVELS.
THE EXTENSIVELY DRUG-RESISTANT TUBERCULOSIS HAS BEEN IDENTIFIED
IN 105 COUNTRIES.THIS IS ARMAGEDDON; THIS IS THE END OF OUR CURRENT REGIME OF ANTIBIOTICS.
IF WE DON'T DO SOMETHING ABOUT ANTIMICROBIAL RESISTANCE IN ANOTHER 35 YEARS,
THERE COULD BE 10 MILLION PEOPLE A YEAR DYING.
THE POLICY MAKERS ONLY MOVE WHEN THE TSUNAMI IS THERE.
I DO WORRY ABOUT THAT.
I LOSE SLEEP ABOUT IT.
IT'S IMPORTANT TO NOT WALK AWAY FROM THE BATTLEFIELD.
IF WE TRULY LOST ALL OUR ANTIBIOTICS, IT WOULD BE A BOMB BLOWING
UP OUR HEALTHCARE SYSTEMS AROUND THE WORLD.
[Music]
[ APPLAUSE ]
>> MADLEN DAVIES: SO AS I HAVE MENTIONED PREVIOUSLY,
THE FULL FINDINGS FROM THE AMR COMMUNICATIONS RESEARCH BITE THE WELCOME TRUST,
WILL BE PUBLISHED IN OCTOBER AND IT WILL BE SENT TO YOUR INBOXES.
BUT IN THE MEANTIME, I REALLY HOPE YOU TAKE THREE TOP TIPS AWAY WITH YOU TODAY AND START
TO ADOPT THEM DURING YOUR COMMUNICATIONS ABOUT SUPERBUGS.
ONE, MAKE IT SERIOUS BUT SOLVABLE.
TWO, USE SIMPLE, SCIENTIFIC EXPLANATIONS.
THREE, MAKE IT HUMAN AND MAKE IT RELEVANT.
THE CDC'S AMR CHALLENGE SHOWS US WHAT IS POSSIBLE WHEN WE ALL STEP UP,
WHEN WE ALL PARTNER, WHEN WE ALL COMMIT
TO TAKING MEANINGFUL ACTION AGAINST ANTIBIOTICS RESISTANCE.
WHILE WE CELEBRATE THE END OF A SUCCESSFUL YEAR AND THERE IS A LOT
TO CELEBRATE, THE WORK IS NOT DONE.
MOST OF YOU IN NEW YORK HERE TO TALK ABOUT UNIVERSAL HEALTH COVERAGE.
THE RISE OF EVERY PERSON TO HEALTH CARE WITHOUT FACING FINANCIAL HARDSHIP.
THE AMR IS A SHINING EXAMPLE OF HEALTH INEQUALITY.
MILLIONS OF PEOPLE EVERY YEAR DIE OF TREATABLE INFECTIONS BECAUSE THEY HAVE NO ACCESS
TO THE ANTIBIOTICS THEY NEED OR THEY CAN'T AFFORD THEM.
MEANWHILE, OVERUSE OF THE DRUGS HAS FUELED RISING RESISTANCE RATES.
SO COUNTRIES NOW FACE A TWO HEADED MONSTER.
LACK OF ACCESS TO ANTIBIOTICS AND ANTIBIOTIC RESISTANCE.
AMR CREATES A VICIOUS CYCLE BECAUSE AS RESISTANCE RISES, IT LIMITS THE POOL
OF EFFECTIVE ANTIBIOTICS AVAILABLE.
BY THE TIME WE IMPROVE UNIVERSAL HEALTH COVERAGE, BY THE TIME WE IMPROVE ACCESS
TO ANTIBIOTICS FOR THE POOR, THEY MAY NO LONGER WORK.
A NEW DRUG IS LIKELY TO BE EXPENSIVE AND OUT OF REACH FOR THE GLOBAL SOUTH UNLESS WE COME
UP WITH BETTER WAYS OF FINANCING DRUG DEVELOPMENT.
SO I HOPE IN ANY FURTHER MEETINGS YOU HAVE THIS WEEK AND BACK AT HOME, YOU WILL INCLUDE AMR
IN YOUR DISCUSSIONS ABOUT UNIVERSAL HEALTH COVERAGE.
AND I HOPE TONIGHT WILL INSPIRE YOU TO MAKE A PLEDGE OR CONTINUE
WITH A PLEDGE, AND TO CONTINUE FIGHTING.
I THINK YOU CAN SEE WHAT WE DO IN THIS ROOM MATTERS AND WE CAN MAKE A DIFFERENCE.
SO IT'S WITH GREAT PLEASURE NOW THAT I'M GOING TO INTRODUCE A FELLOW BRITT TO THE STAGE.
DAME SALLY DAVIS HAS BEEN ENGLAND'S CHIEF MEDICAL OFFICER FOR NINE YEARS.
DURING THAT TIME, SHE HAS BEEN A PASSIONATE AND OUTSPOKEN CAMPAIGNER ON AMR
AND MASSIVELY RAISED ITS PROFILE INTERNATIONALLY RESULTING IN A U.N. RESOLUTION
IN 2016 WHICH WAS A HUGE ACCOMPLISHMENT.
SHE SUBSEQUENTLY BECAME CO CONVENER OF THE UNITED NATIONS INTERAGENCY GROUP ON AMR
AND HELPED TO ESTABLISH THE 265 MILLION FLEMMING FUND TO DEVELOP THE LABORATORIES
AND SURVEILLANCE FOR AMR ACROSS THE WORLD.
THOUGH SHE IS STEPPING DOWN AS ENGLAND CHIEF'S MEDICAL OFFICER AND WILL START HER NEW ROLE
AS MASTER OF TRINITY COLLEGE CAMBRIDGE, I KNOW SHE WILL CARRY ON CAMPAIGNING
AS U.N. SPECIAL ENVOY ON SUPERBUGS AND I HOPE SHE IS JUST AS OUTSPOKEN.
WELCOME TO THE STAGE, DAME SALLY.
[Applause]
>> DAME SALLY: THANK YOU VERY MUCH, MADLEN.
THE STORIES AROUND THE WORLD MADE AMR REAL.
DAVID, YOU BROUGHT THE STORY ALIVE IN A WAY THAT ONLY A PERSON WHO SUFFERED HAS.
I CAME TO THIS ACTUALLY THROUGH MY MEDICINE AS A DOCTOR, A HEMATOLOGIST, LOOKING AFTER PATIENTS.
SICKLE CELL DISEASE CHILDREN, GETTING INFECTION THAT IS WE COULDN'T TREAT.
AND I HAVE SEEN PEOPLE SUFFER.
I HAVE SEEN PEOPLE DIE.
I DON'T LIKE IT.
STILL, LET'S TALK ABOUT THE GOOD BIT.
WE HAVE MADE LOTS OF PROGRESS AND I THINK THIS EVENING A CELEBRATION OF PROGRESS.
I ALSO HAVE A PERSONAL CELEBRATION.
WHEN I TALK ABOUT PETS IN ENGLAND, THEY TELL ME TO TALK ABOUT COMPANION ANIMALS.
IT WAS LOVELY TO HEAR YOU IN AMERICA TALK ABOUT PETS!
THAT, FOR ME, WAS ANOTHER HIGH POINT THIS EVENING.
THE FILM THAT YOU JUST SEEN A CLIP FROM, AND I HOPE YOU WILL STAY AND WATCH WITH US,
IS THE ANTIMICROBIAL RESISTANCE FIGHTERS FILM.
I WAS TALKING WITH GARY FROM THE ANTIMICROBIAL RESISTANT FIGHTERS COALITION
WHO DO THIS WONDERFUL PROGRAM YOU SAW SOME OF HIS PICTURES
AND SPEAKING ABOUT IT ALL AROUND THE WORLD.
IT IS FANTASTIC PROGRAM.
I SAID YOU KNOW WHAT?
WE NEED TO GET THIS FILM SEEN BY PEOPLE BECAUSE I KNOW A LOT ABOUT THIS SUBJECT.
I LEARN THINGS AND ACTUALLY IT REALLY GOT ME.
I FELT RENEWED IN MY DETERMINATION TO GO ON WORKING TO MAKE A CHANGE, MAKE IT BETTER.
SO HERE WE ARE, AND I WANT YOU TO WATCH IT.
BUT LET'S JUST FOR A MOMENT THINK ABOUT THE OTHER ART WORK THAT IS HERE.
AND WANDERING AROUND EARLIER I WAS IMPRESSED.
I LIKE THE 50 SHADES OF AMR OVER HERE, BECAUSE I THINK WE HAVE SPENT A LOT OF TIME TRYING
TO EXPLAIN NOT ONLY TO THE PUBLIC BUT TO DOCTORS, THAT FONDLY ENOUGH,
BUGS CAN GET THEIR RESISTANT GENES OVER TO ANOTHER ONE.
AND I HAVE DESCRIBED IT IN ALL SORT OF WAYS.
EVEN DESCRIBED IT AS PUTTING OUT A PRICK AND PASSING IT ALONG.
BUT THAT PICTURE SHOWS IT BEAUTIFULLY.
THERE ARE OTHER WONDERFUL ONES AND YOU HAVE ALL BEEN WANDERING AROUND THINKING ABOUT WHICH YOU
LIKE MOST, THE SURGEON'S COMIC SET AGAINST AN ANTIBIOTIC APOCALYPSE, OR THE AMR DANCE?
ALL OF THESE THINGS WHERE PEOPLE ARE BRINGING THE ISSUES TO LIFE AND IN DOING SO,
BRINGING OTHERS INTO THIS FIGHT FOR LIFE, FIGHT FOR WHAT WE NEED TO DO.
SO, WHAT WE REALLY WANT YOU TO DO IS SIGN
UP TO THE ANTIMICROBIAL RESISTANT FIGHTERS COALITION, AND WATCH THE FILM.
AND THEN OF COURSE, WE HAVE GOT TO THINK ABOUT WHAT WE ARE GOING TO DO IN THE NEXT YEAR.
WE HAVE GOT TO RENEW OUR PLEDGES.
WHEN I CAME LAST YEAR -- AND THANK YOU CDC, HEALTH AND HUMAN SERVICES AND THE REST OF YOU,
THE WELCOME TRUST WHO PUT THIS EVENT ON.
I PROMISED TO MYSELF I'M NOT VERY GOOD AT WRITING THESE THINGS
DOWN THAT I WOULD GO ON WITH RENEWED ENERGY.
I CAN SEE I'M GOING TO GO AWAY AGAIN AND REFLECT EVEN MORE STRONGLY
ON HOW I CAN USE MY NEW SPECIAL ENVOY ROLE TO HELP THIS FIGHT
AGAINST BUGS THAT DO SEEM TO WANT TO WIN.
AND REMEMBERING THAT ACTUALLY BUGS ARE OUR BEST FRIENDS AS WELL.
A WONDERFUL MICRO BIOLOGIST IN THE AUDIENCE, EXPLAINS IT MUCH BETTER THAN ME.
HOW MORE THAN HALF OF OUR CELLS ON OUR BODIES ARE MICROBES AND THEY ARE THERE
TO HELP US, TO GO ON LIFE'S JOURNEY WITH US.
WE NEED TO FIND A BALANCE TO CONTINUE ON THAT JOURNEY WITH OUR FRIENDS, AS I CALL MINE,
AND YET REDUCE THE RESISTANCE AND ILLNESSES AND SUFFERING THAT COMES WITH IT.
SO, I FELT INSPIRED BY ALL OF THAT I HAVE SEEN AND ALL I HAVE HEARD.
YOU MUST BE AWFULLY BORING IF YOU HAVEN'T BEEN INSPIRED AS WELL.
I THINK YOU PROBABLY HAVE.
AND I HOPE YOU'RE GOING TO STAY AND WATCH THE FILM, BECAUSE I THOUGHT IT WAS GRIPPING
WHEN I WENT AND SAW THE FULL FILM IN COPENHAGEN AND THEY SHORTENED IT ESPECIALLY FOR US.
WHAT I NEED TO ASK IS, ARE WE MOVING STRAIGHT ON TO THE FILM
OR ARE WE LETTING PEOPLE HAVE A COMFORT BREAK?
COMFORT BREAK.
A COMFORT BREAK MEANS YOU CAN LOOK AT THIS OR HAVE A PEE.
IT DOES NOT MEAN YOU CAN WALK OUT OF THE DOOR.
IF YOU DO WALK OUT OF THE DOOR, YOU'RE MISSING A GREAT FILM THAT YOU'LL WANT TO TALK ABOUT.
SO SEE YOU IN 10 MINUTES TO WATCH THE FILM.
THANK YOU, VERY MUCH.
[ APPLAUSE ]