Presentation by Sir Mark Walport at the Rothamsted Research conference 'Resistance 2015' - 14 September 2015.

1. Resistance 15: The Grand Challenge
Sir Mark Walport
Government’s Chief Scientific Adviser
14th September 2015

2. Resistance 15: The Grand Challenge
• Health, wellbeing, resilience &
security
• Knowledge translated to economic
advantage
• The right science for emergencies
• Underpinning policy with evidence
• Advocacy and leadership for
science
Government Chief Scientific Adviser
Credit: iStockphoto

3. Resistance 15: The Grand Challenge
Risk is all-pervasive
Natural
events
Credit: iStockphoto Credit: US Agricultural Research Service
Credit: Maccheek/PD
Credit: US Agricultural Research Service
Credit:Jeff Pettis/CC BY 3.0

4. Resistance 15: The Grand Challenge
Human
Risk is all-pervasive
Credit: AP Credit: Robert Campbell/CC BY-SA 3.0

5. Resistance 15: The Grand Challenge
Innovation is needed to
mitigate these risks
The challenges we face include:
• Climate change
• Water security
• Food and agriculture
Credit: Lindsey Bengtson/PD
Credit: stockphoto Credit: ‫שרגיאן‬ ‫יגאל‬/CC BY 2.5

6. Resistance 15: The Grand Challenge
Innovation has got us where we are
• Widespread electrification
• Improvements in healthcare
• Mass production systems
• Better transport links Credit: A_Werdan/PD
Credit: Foodcollection RF

7. Resistance 15: The Grand Challenge
Forms of innovation and risks
1) High level of acceptance but who pays?
Credit: Sponge/CC BY-SA 3.0 Credit: Fluzone

8. Resistance 15: The Grand Challenge
Forms of innovation and risks
2) Science meets values
8
Credit: werktuigendagen/CC BY-SA 2.0
Credit: Peretzp/CC BY-SA 3.0

9. Resistance 15: The Grand Challenge
Forms of innovation and risks
3) My risk, your benefit
Credit: istockphoto
Credit: Sunil060902/CC-BY-SA-3.0 Credit: US Dept of Energy/PD

10. Resistance 15: The Grand Challenge
Forms of innovation and risks
4) Unintended consequences
Credit: Dalbera/CC BY 2.0 Credit: istockphoto

11. Resistance 15: The Grand Challenge
Forms of innovation and risks
5) New challenges
Credit: US Air Force/CC BY-NC 2.0 Credit: Walterdenkens/CC BY-SA 3.0

12. Resistance 15: The Grand Challenge
Resistance:
Borne out of innovation
Humans:
• Infections Diseases
→Vaccines, Antibiotics
Animals and Plants:
• Infectious diseases
• Pests
• Weeds
→Vaccines, Antibiotics,
Pesticides, Herbicides
Credit: Rasbak/CC BY-SA 3.0 Credit: Pl77/CC BY-SA 3.0
Credit: CDC/James Hicks Credit: CDC/James Gathany

13. Resistance 15: The Grand Challenge
Darwin in action:
• Viruses
• Microbes
• Pests and weeds
"Influenza geneticshift" by Influenza_geneticshift.jpg: Dhorspool at en.wikipediaderivative work: Jiver - This file was derived from: Influenza geneticshift.jpg:. Licensed under CC BY-SA 3.0 via
Commons -
Resistance:
A growing problem

14. Resistance 15: The Grand Challenge
Resistance:
Balance risk and benefits
We want to treat infections or infestations,
however, we must balance the risks and
benefits e.g.
• Antibiotics can damage gut flora,
leading to opportunistic infections such
as C difficile
• Herbicides and pesticides can kill
‘useful’ insects as collateral damage,
and significantly harm biodiversity
• Needless use of antibiotics hastens
the growth of resistance without
providing any benefit
Credit: Sage Ross/CC BY-SA 3.0
Credit: Samir/CC BY 3.0

15. Resistance 15: The Grand Challenge
The important of meta-analysis:
Resistance:
Need for clear evidence
NICE
• Independent of the customer
• International leader on quality
• Creates evidence standard -
"Technology Appraisal Process"
• Reviews evidence:
Science
Economics
• Provides clear recommendation
to the customer

16. Resistance 15: The Grand Challenge
Resistance:
Need clear communication
To healthcare
professionals
To the agricultural
sector
The public at
large

17. Resistance 15: The Grand Challenge
Resistance:
Market failures
Globally, we have not been
investing enough in research to
prepare for when our current
disease controls will be ineffective
The Market Place is not
working

18. Resistance 15: The Grand Challenge
Resistance:
The next steps?
Animals and plants
• Breed new resistant species
• Develop new vaccines and
antibiotics
• Develop new herbicides and
pesticides
Humans
• Develop new vaccines and
antibiotics - a constant race
against nature
Credit: CDC/James Gathany

19. Resistance 15: The Grand Challenge
Resistance:
Science meets values
Teosinte Zea mays
Credit: Daniel Goehring/CC-BY-2.0

20. Resistance 15: The Grand Challenge
Conclusion
• Resistance is a huge and
growing problem
• There are new tools, particularly
in the area of genetics
• We need to work across
disciplines, recognising
commonalities
• Communication is key
• The market place is a challenge
Methicillin-resistant Staphylococcus aureus
Credit: National Institutes of Health (NIH)

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apologise for any errors or omissions in the included attributions and would be grateful if notified of any corrections that
should be incorporated in future versions of this slide set. We can be contacted through contact@go-science.gsi.gov.uk.
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