Sally By Olivia Gordon

Oxford's Women of Achievement lecture series welcomed Chief Medical Officer for England, Dame Sally Davies as its inaugural speaker this week. Vice-Chancellor Professor Louise Richardson explained in her introduction that the lectures' purpose is ‘to motivate women to aim as high as they can – we’ve come a long way, but there’s still a lot of work to be done’. Introducing Dame Sally, the Vice-Chancellor reflected: ‘I can think of few women who have achieved so much.’

A haematologist, Professor Davies developed the National Institute for Health Research (NIHR), chairs the UK Clinical Research Collaboration, and is a member of the World Health Organization Global Advisory Committee on Health Researcg. She holds 24 honorary degrees and the BBC has named her the sixth most powerful woman in England.

Dame Sally’s speech was in itself a lesson in how to be a confident 'woman of achievement'. Dry and irreverent, brisk and breezy in a wonderfully English way, she recounted how she fought every step of the way to build her stellar career. Sally

In 1985 she was a district hospital consultant with a special interest in sickle cell disease. She worked to set up the first regional screening of neonates for the disease, and by 2004 she was Director General of Research and Development in the NHS. Convinced that the Government needed to commit to research in the NHS ‘to increase health and wealth’, she set up the NIHR health research system ten years ago, including professorships which allow young scientists to get out of ‘boring work’ and focus on their careers. In 2010 she became the first ever female Chief Medical Officer – a decision she aptly illustrated in her lecture by placing a colour photograph of herself over a slide montage of back and white photos of male previous incumbents.  

Throughout this journey, Davies has followed the motto ‘If you believe it, you can do it’. Moreover, she explained, she ‘had to be resilient, which is important for leadership, and stay true to my principles’. When, early in her career, she wanted time out to train in emotional intelligence and leadership in India, she told her boss that she would leave if it wasn’t funded, and that the expensive high-level training should be paid for ‘because I only do the best’. 

Later, she clashed with ‘the rules’ which dictated that she wasn’t allowed to talk to the treasury. Davies, no shrinking violet, stuck to her guns and knew she was right in replacing ‘tea and biccie sessions’ with clinical research networks.  ‘I’m trying to get the right answer for the nation,’ Davies recalled insisting at the time, despite much opposition from hospital chief executives. Soon, Gordon Brown was eating out of her hand. Today she laughs, ‘rules are there to be…noted’ - and the treasury reports to her. Sally

Dame Sally went on to discuss the next wave of healthcare which she believes will see us moving away from ‘individualism’ (the current culture which fosters ‘disbelievers’ who refuse to vaccinate their children) towards a culture of ‘public health as a shared responsibility’. ‘We’ve done it with seatbelts and smoking in public places,’ said Dame Sally, ‘now we need to make it a social norm for employers to provide a good health environment.’

Anti Microbial Resistance (AMR) – also known as drug-resistant infections - is one of the biggest current examples of the need for collective responsibility. While working on an annual report on infections a few years ago, she was told by scientists that AMR was a huge problem. She has put the issue on the government’s risk register, meaning it had to be taken seriously in all policy decisions. 

Germs, which Davies head-mistressishly described as ‘nasty little sausages’, are increasingly resistant to our overprescribed arsenal of antibiotics. Because ‘antibiotics underpin modern medicine,’ said Davies, ‘modern medicine will really be at an end’ soon. There are very few new antibiotics in the pipeline – no new class of antibiotics has been discovered since 1987 and we have stopped investing in new ones. ‘It’s pretty appalling and we should have seen this coming,’ said Davies. She gave an example: ‘There’s an outbreak of gonorrhea in Leeds that worries me stiff – it’s on the rise and we have some cases that are untreatable.’

Davies noticed that another major global problem, climate change, only started to be taken seriously when its economic impact was noticed – and said she thinks similar financial forecasts might help the world take action on antibiotic overuse – especially in fish and animal farming – before it’s too late. Possible solutions she has been encouraging include vaccinating farmed fish instead of flooding their water with antibiotics, vaccinating patients pre-operatively against possible post-operative infections, and the development of rapid diagnostic tests, and she plans to spend most of 2016 travelling the world trying to raise awareness. Sally

Professor Sally Mapstone, Pro-Vice-Chancellor for Education, who organises the Women of Achievement lectures, thanked Dame Sally for her ‘frank, exhilarating’ talk. In the questions afterwards, Dame Sally was asked how she would define achievement. ‘Whether I made a difference,’ she reflected. If anyone can make a difference, it will be the determined Dame Sally.

Images © John Cairns

Comments

By Ronald Brown
on

I am writing as an outsider to this field, but I have heard from a biologist of the work on treating bacterial diseases using bacteriophage,, which attack bacteria. As they are virus sized, they evolve very quickly, and there is quite a lot on the internet about their use in treating bacterial infections by growing phages to treat an individual strain of bacteria. It is surprising that this method of using nature for our ends is rarely mentioned.

By CHARLES WICKHAM...
on

I was born on 24th November 1927.

Very sadly, my Mother caught an infectiion and died ten dsys later.

Too early by less than 20 years for an antibiotic to save her.

Later I met Alexander Fleming at a Masonic Meeting.

Please work and work to find more antibiotics!

All strength to your arm!

All good wishes

Charles Wickham-Jones
35 Frenchay Road
Oxford
OX2 6TG

E&OE

By chris erwin
on

The French live five years on average more than us (I was a Principal at a consulting actuary when I learnt this), This is mainly due to: maximum exposure to unpasteurised foods, to build up an immunity; drinking wine with meals to reduce heart disease; (the Bordeaux paradox, also ignored elsewhere by Dame Sally); and taking two antibiotics when we take one or none If you work the matrix of multiple antibiotics, there is no problem with effectiveness, if you keep on varying the combination of two antibiotics..
For flu we are told antibiotics don't work. A colleague at a conference in France had flu and was really ill. His doctor had said no treatment would work. A French doctor prescribed two antibiotics and he was better the next day. I was really ill with flu whilst flying to Australia, via a stopover in Singapore. The hotel doctor was British qualified, but said Singapore was the crossroads of the world. He prescribed a British antibiotic, Japanese nasal drops, and a Chinese herbal medicine ("don't ask what's in it, it's as disgusting as it looks.") Lo and behold, I was completely better the next day.
If we adopted the French model of healthcare would we be healthier and live longer like the French?
A good field for research?

By Paul Booker
on

Chris, antibiotics aren't effective against viruses like influenza, the clue is in the name. Anecdotal stories do not constitute sound medical evidence for a given treatment. I was unable to find any supporting evidence that life expectancy in France is 5 years more than in the UK, so dispute this assertion. More relevant to the above article, I also noted if not a denial then a dismissal of the problem of antimicrobial resistance, which I would categorise alongside, for example, denying anthropogenic climate change.

By chris erwin
on

Paul, the French believe antibiotics work against viruses, and I believe them from my own experience and reading (I read & speak French.) I see, from denying life expectancy statistics, that you are not aware of the Actuarial profession. I worked as a non actuarial Principal in a big firm of consulting Actuaries. I asked my Actuarial colleagues about French life expectancy. There is a publically available, via Google, table of international life expectancy from the ONS, but the French long term data has mysteriously been removed- I suspect Sir Humphrey because it's embarrassing for the NHS.
I do not deny resistance to ONE antibiotic..I was a consultant to the pension fund of a large US drug company. Half the Trustees are research scientists. I was saying the French have the short term answer- use two antibiotics at the same time. Assume 10 classes of antibiotic, called A to J, If patient is resistant to A, try A+B, then A+C, A+D. This will solve the problem for a long time. A+B is not the same as A or B on their own.
The real reason new antibiotics are not being developed is that they are not profitable. They need the scale of big companies. For example even when Glaxo merged with Smith Kline Beecham, one of them had the computers to design a million new compounds a months, and the other the robotics to test them. Patents last for 17 or so years, before generics can be marketed on the back of not paying for the original research (which discourages further research). but nowadays a new compound will often take over a decade to be approved. The compound has to be seriously profitable to recoup R&D in five years, My client, on whose Mexican made products I am dependent for my life, decided to exit antibiotics for more niche products.
I am, from personal experience, a great supporter of the NHS- I paid nothing for a treatment and diagnosis after an accident for which I would pay £15,000 in the US. My heart specialist is reviewing a Brit's heat attack in the US for which the patient was charged £50,000.
The French spend around twice as much on their National Health Service than us, even after tackling the cost o well meaning but ineffective f administration and non attendance for appointments. If we are not willing to pay the cost of better medicine, we should be honest and not be economical with the truth, It is true treatment by one antibiotic is becoming less effective, but people should be told the reason there are no new antibiotics and the reason is that the NHS won't pay enough for development to be profitable. There should not be economy with the truth that two antibiotics given at the same time still work, and the time of patent protection should be lengthened to give a realistic time after approval to make a profit.

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