Appointed Chief Medical Officer in 2010, Professor Dame Sally Davies is the first woman to fill the post. For over a decade, she was Chief Scientific Adviser for the Department of Health with responsibility for Research and Development, during which time she established the National Institute for Health Research.
Professor Dame Sally Davies
Dame Sally acts as the UK Government's principal medical adviser and the professional head of all directors of public health in local government. She is a haematologist with specialist research interest in sickle cell disease but, as Chief Medical Officer, she guides Government decisions on diverse issues, such as superbugs, drug trials and obesity.
Dame Sally has been widely commended for her leadership of global efforts to address the 'ticking time bomb' of antibiotic resistance, arguing that the threat posed to human health could lead to catastrophic consequences.
Ahead of her forthcoming Public Lecture at the University on 'Antimicrobial resistance: the global problem', Inspire spoke to Dame Sally about her work and extraordinary career.
Why has antimicrobial resistance become such an important public health issue?
Antimicrobial resistance (AMR) is not a new concept; Alexander Fleming predicted it back in 1945 when he delivered his Nobel lecture, warning that "it is not difficult to make microbes resistant to penicillin in the laboratory, and the same has occasionally happened in the body".
The reason AMR is such an issue now is down to a complex mix of factors. Firstly, there is a distinct lack of new drugs: we have not seen any new classes of antibiotics to come into clinical use in the last 30 years. In addition, we do not look after the antimicrobials that we have and need to ensure they are only used when clinically relevant – particularly antibiotics. In terms of sanitation and hygiene, we need to remember the basic principles which prevent the spread of infection in the first place – including vaccination. Last but not least, in many parts of the world, antibiotics are often used for the purposes of growth promotion in meat production (but not in the UK/EU) and to compensate for poor animal husbandry and hygiene.
These factors all increase the likelihood that resistant or multi-drug resistant bacteria will develop. We are already seeing the development of extreme drug resistance: infections resistant to most or all antibiotics.
Why is collective global action on the issue so urgently needed?
Due to the modern world we live in, air travel means that we are just as close to people in places such New York, Mumbai and Beijing as we are to people in London, Birmingham, Edinburgh and Exeter. We, therefore, cannot just tackle AMR here in the UK; we need to work with everyone to develop global solutions. These are scary times, and, if we do not take global action, we could see a return to the pre-antibiotic era when around 40% of deaths were due to infection.
At a local level, what can the average person do to help fight against the threat of AMR?
There are three simple but key things that everyone can do. The first relates to the use of antimicrobials. This means that we must only use antimicrobials when they are clinically needed – and where they are needed, we must complete the course. This requires a conversation with your doctor to discuss the symptoms and possible causes of the infection. Only 10% of sore throats benefit from antibiotic treatment, but prescription rates are as high as 60%. Lots of antibiotics are still being prescribed unnecessarily, despite great efforts by clinicians in the NHS.
It's important to remember that we do not need antibiotics for every infection. In some cases, such as viral infections, the infection will not respond to antibiotics, or in other cases our bodies will naturally fight off bacterial infection without any medical intervention. We need to start recognising that taking antibiotics when they are not needed provides the perfect conditions for resistant bacteria to develop – there are risks to taking antibiotics 'just in case'.
Secondly, we must remember the importance of prevention. Basic hand hygiene and vaccination are vital. If we can prevent the infections in the first place, then we will reduce the need for antimicrobials.
Finally, buy meat from animals raised under standards which require principles of responsible antibiotic use and appropriate use of hygiene measures/disease prevention. These measures mean antibiotics should only be used when clinically appropriate. This is important as inappropriate use of antimicrobials in farming and agriculture can lead to the development of drug resistant infections, which can transfer across to humans.
You have built up a stellar career. Did you always have a career plan in mind?
No, I never had a career plan. Serendipity and grasping opportunities have given me a fascinating life. I like the opportunities that change offers.
You are the first woman to hold the position of Chief Medical Officer for England. Why do you think there are not more women in senior leadership positions and do you feel you have faced barriers in your own career because you are a woman?
Like many women my age, I have broken a lot of glass ceilings in my time. I think that we have progressed as a society over the past few decades and that we now live in a period where it is possible for women in this country to do anything. However, as a society, we need to remember that combining a career and family is hard work for anyone and we need to be mindful of this, particularly in the workplace.
Of the various roles you've held, which have you enjoyed the most? And which have you found the most challenging?
Each job I have had, as I have worked my way into it, seemed the best and most challenging for that time in my life. I have grown and developed with each and I have been grateful for the opportunities each has provided.
Whom do you admire and who do you think has influenced you most in your career?
Scientifically, I admire Sir David Weatherall, who is both a wonderful clinician and a great scientist. If I think about those who have looked at how to make the world a better place, I admire Bill Gates. He is showing real leadership in global health, including on crucial issues such as AMR.
What drives you?
A desire to make the world a better place and a belief that by working together we can achieve this.
How would you define success?
Being able to recognise when 'good enough' will allow you to move to the next stage. Sometimes people get caught up in perfection when in fact what they need is a journey, developing and improving at each stage. But, it's important to recognise the milestones and celebrate along the way.
What is your greatest accomplishment professionally?
In the UK, I am most proud of the National Institute for Health Research, which I created in 2006. This now distributes over £1billion of translational research funding each year, driving innovation from the lab bench to the bedside for the benefit of patients.
More recently, I have been working internationally to build a political consensus around the necessity of taking action to tackle AMR. In September, 193 heads of state signed a declaration for action on AMR at the United Nations General Assembly. This is only the start of the work we need to do around the world, but shows that the political will is there to make it happen.
Both were achievements that relied enormously on the work of others. I am so grateful to all those who gave their help, publicly and behind the scenes, over the course of many years.
What advice, if any, would you offer to your younger self?
Hold your nose and jump!
With such a demanding work schedule, how do you relax and unwind?
Jogging, cooking and holidays – all of these with the family.
Do you have any unfulfilled ambitions?
Yes – but I'm still working on them and I do not intend to give up!
Professor Dame Sally Davies will deliver her lecture, 'Antimicrobial resistance: the global problem', at the University on 8 May. All talks are free and open to the public. For details and to book a place, please visit the Public Lectures web page.