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Chief medical officer speaks out on antimicrobial resistance, drugs, and homeopathy

BMJ 2013; 346 doi: http://dx.doi.org/10.1136/bmj.f537 (Published 24 January 2013) Cite this as: BMJ 2013;346:f537
  1. Adrian O’Dowd
  1. 1London

A cross government strategy to tackle antimicrobial resistance will be launched in the spring, aimed at targeting the problem of the growing ineffectiveness of antibiotics in the United Kingdom and beyond, England’s chief medical officer, Sally Davies, has told MPs.

Davies was giving evidence to parliament’s Science and Technology Committee on 23 January as part of a one-off evidence session on the work of the chief medical officer. Her forthcoming annual report, due in the spring, would have a strong focus on the issue of increasing antimicrobial resistance, she said.

“The apocalyptic scenario is that when I need a new hip in 20 years I’ll die of a routine infection because we’ve run out of antibiotics,” Davies said. “For gonorrhoea, for example, there is only one useful antibiotic now, but cases of gonorrhoea in younger people and middle aged women are going up.1

“It is very serious and is so because we are not using our antibiotics effectively in countries. We need to get our act together in this country, and my annual report will be coming out at the beginning of March alongside a cross government antibiotics strategy that takes in DEFRA [Department for Environment, Food and Rural Affairs] and will promote antibiotic stewardship from the clinical professions.

“As a result of this work, we have already put antimicrobial resistance on the Department of Health’s risk register and DEFRA’s risk register. I will call for the government to place it on the government risk register as well, and we need to take international action.”

Davies recently met World Health Organization officials to discuss how countries could work together on the issue.

Asking Davies about the government’s planned review that will result in new guidance on alcohol and recommended safe levels of consumption, the MPs heard that it may not be ready until 2015.

Davies said, “We have a timetable [for the review], and it’s much slower than I would like. It took time to get agreement from the other CMOs [UK chief medical officers], and it took more time than it should have done to agree who would support the evidence gathering process.”

There would be two groups of evidence gathering, each lasting 12 months. One would look at the physiology and pathology of alcohol in the body and the other at behavioural and guideline aspects.

A group of experts would then work out how the evidence should affect official guidance and how best to communicate that to the general public.

MPs also asked Davies about the government’s tendency to focus on the criminal aspects of illicit drug use, rather than the health aspects and the legal status of cannabis use, to which she replied, “I believe we have a health problem, and we would do well as a nation to look at the health problem.

“But the lead for drugs and alcohol is the Home Office, and this government is choosing to continue to treat it in that way.”

MPs were also interested in whether voluntary regulation of sugar, salt, and fat content of foods through the “responsibility deal” networks (set up as partnerships between the government, the food and drinks industry, and health bodies and charities) were working or whether statutory regulation was needed.

Davies said, “There’s some evidence that it’s beginning to work. There is improvement. Would it work if there were no risk or threat of regulation behind it? Perhaps not.

“I think we are making decent progress. I was sceptical, but it’s making more progress than I had expected, and this is a good start, but the threat of regulation needs always to be there.”

After questions about whether homeopathy should have a place in the NHS, Davies said, “I am very concerned when homeopathic practitioners try and peddle this way of life to prevent malaria or other infectious diseases.

“I believe there’s a place for a holistic approach with patients, but I am perpetually surprised that homeopathy is available on the NHS. Why am I being wishy washy? It’s rubbish.”

Notes

Cite this as: BMJ 2013;346:f537

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