Modern medicine is not just a miracle – with the breakthrough of a globally accessible, safe and effective COVID-19 vaccine, modern medicine is a reality. It gives the whole world hope for 2021 and the year ahead. But the sad, simultaneous reality is that our modern medicine is being undermined. As our antimicrobial treatments become less effective, the goal of healthcare for all and the strength of our healthcare systems become more difficult to achieve. But if we work globally, to advocate and most importantly, to act, we can preserve antimicrobials for the humans and animals that need them.

We need urgent action to prevent AMR from having devastating effects on lives, poverty and development. AMR is happening now, though you might not see it. So my vision is simple: to keep it that way. To mitigate the despair and damage that AMR could cause. To secure our global health, happiness and the sustainability of the planet.

My vision is to make 2021 the year that counts and the year when the world got on with the advocacy and action to ensure that antimicrobials are accessible to those who need them most.

In the UK, we have a 20 year vision for AMR. By 2040, we hope to be living in a world where AMR is contained, controlled and mitigated. In practice, this means collaboration with other countries to share knowledge and data on what works, or what doesn’t. Reducing levels of infections will mean giving our healthcare heroes the best possible tools to deliver healthcare for all. We must support them to prescribe antimicrobials effectively – whether rapid diagnostics to determine if antimicrobials are appropriate, or vaccines to avoid relying on antimicrobials. I also know that the public – as patients, animal keepers, food consumers and activists – will be key to acting to holding others to account.

The world is moving on AMR, and I invite you to join us in this.

Late last year, the heads of the World Health Organisation, Organisation for Animal Health and the Food and Agriculture Organisation came together to launch this new group of global leaders and experts from right across the world. I am honoured to join the Global Leaders Group- to serve the international community and act to preserve the future of modern medicine.

Some advocates say that AMR does not have a face; but my hope is that the Global Leaders Group will give AMR a voice. We will show that the big statistics on AMR-related deaths and illnesses are more than just numbers- they are friends, relatives and colleagues who matter. We will ensure that AMR is at the top of our national and global agendas, and working for you and for our future.

A recent study found that here in the UK, less than half of adults know what they can do to help tackle AMR. We need this to change. My message to you is that you too can be a leader to turn the tide on AMR.

AMR is a complex issue; even after a decade of advocating for action on AMR, I am still uncovering more challenges and more evidence! But new evidence- on antibiotic pollution in rivers in India, on the levels of resistance in koalas injured in Australian bushfires, on the number of children lacking antibiotic access across the world- give us even more reason to act. You can share these messages with your families or at work. We must spread the word that COVID-19 is not the only health challenge on our horizon.

The most important thing that each and every one of us can do is to wash our hands. We can use COVID-19 as an opportunity to make progress on tackling AMR, because so many more people are now practicing good hygiene measures that protect against infection. Tragically, over 3 billion people across the world lack access to soap and water at home- the most basic of measures to protect against COVID-19 and other infections. We must advocate for sanitation and flushing toilets so that everyone can wash their hands.

Chickens and pigs consume more antibiotics than all humans combined – mostly inappropriately, to grow them, not to treat them when they are sick. So  we should not underestimate the power of advocacy. Thanks to the collective voices of consumers, KFC have stopped supplying chicken reared with medically important antibiotics, and McDonalds have pledged to reduce the use of antibiotics in its global beef supply. You can drive these trends by buying and eating sustainable food.

Change won’t happen overnight; but with every person who hears our messages on AMR, and with every antibiotic that is used responsibly, we can together move the dial. Future generations depend on it, but this generation can be the ones to save modern medicine.

Dame Sally Davies was appointed as the UK Government’s Special Envoy on AMR in 2019. She is also the 40th Master of Trinity College, Cambridge University.

Dame Sally was the Chief Medical Officer for England and Senior Medical Advisor to the UK Government from 2011-2019. She has become a leading figure in global health including serving as a member of the World Health Organisation (WH O) Executive Board 2014-2016 and as co-convener of the United Nations Inter-Agency Co-ordination Group (IACG) on Antimicrobial Resistance (AMR) reporting in 2019.

In the 2020 New Year Honours, Dame Sally became the second woman (and the first outside the Royal family) to be appointed Dame Grand Cross of the Order of the Bath (GCB) for services to public health and research, having received her DBE in 2009.

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Initial response from BSAC

It’s hard to disagree with the main contention of Dame Sally’s article: that when it comes to advocacy, AMR might not have a face – but it could be finding a voice.

That’s because there are high hopes for the impact of the Global Leaders Group on Antimicrobial Resistance, which was launched by the World Health Organization (WHO), the Food and Agriculture Organization (FAO), and the World Organisation for Animal Health (OIE), in November.

Made-up of elected representatives, as well as senior figures from civil society and the private sector, the Group will work hard to ensure AMR returns to the top of our national and global agendas.

Dame Sally then goes on to echo a point made by Dr Osterholm (see article published on January 11): that we all have a responsibility to work with elected representatives, opinionmakers, policymakers, and lawmakers, on AMR.

As such, we are here repeating our commitment to create a web page that will pull together some of the best available resources for those who are keen to advocate – but don’t know where to start.

For this, we will draw on some of the guidance, advice, and tools, that were highlighted in ‘Informing & Influencing: Stewardship, Politicians, and the Media’, a chapter in our eBook on Antimicrobial Stewardship: From Principle to Practice.

But first, we want to hear your thoughts on Dame Sally’s article. What you say could inform the recommendations we make in the Vanguard Report itself, which will be published at the end of the year.

You can join the conversation by emailing mcorley@bsac.org.uk or tweeting our @BSACandJAC account.