Director, Oxford University Clinical Research Unit, a Wellcome Trust Africa Asia Programme
Title of the talk: Bad bugs and bad drugs – antimicrobial resistance in Southeast Asia
Over the last 80 years drugs that kill bacteria, viruses, fungi and parasites – or ‘antimicrobials’ – have caused unparalleled improvements in human health. Around fifty years ago, it seemed as though antimicrobial drugs would lead to a world free from infectious diseases. In 1967 the Surgeon General of the United States of America famously quipped that, “The time has come to close the book on infectious diseases. We have basically wiped out infection in the United States.”
The reasons why this statement has been proven wrong are numerous and complex. The emergence of novel infectious diseases, like HIV, provides one explanation; but we have also squandered many of our key weapons in the battle against infections and antimicrobial drugs, in particular. Infectious diseases, from tuberculosis to malaria, and more recently HIV, have evolved genetically determined mechanisms that allow them to resist killing by antimicrobial drugs. This is called antimicrobial resistance, or ‘AMR’. In large measure, the creation and spread of AMR infectious diseases has been caused and accelerated by the misuse of antimicrobials. Controlling the spread and consequences of AMR infections is now one of greatest challenges to global health.
In this lecture, I will describe the work of the Oxford University Clinical Research Unit (OUCRU) in Ho Chi Minh City to tackle AMR infections in Southeast Asia. OUCRU has been working in the region for more than 25 years and has witnessed the steady rise of AMR across all its major infectious diseases. I will tell the story of these changes, how they have affected the health of those in the region, and how we, with many others, are trying to control AMR and the devastating effects it can have on individuals and communities.
Guy Thwaites is an academic infectious diseases physician and clinical microbiologist. He has been Director of the Oxford University Clinical Research Unit/Wellcome Programme in Vietnam since October 2013. He is responsible for the scientific strategy of the programme, with its major research themes of emerging viral infections, dengue, brain infections, tuberculosis, malaria, enteric infections, antimicrobial drug resistance and care of the critically ill. His personal research interests focus on severe bacterial infections, including meningitis and Staphylococcus aureus bloodstream infection, and tuberculosis. He has a longstanding research interest in the diagnosis, treatment and pathophysiology of tuberculous meningitis. Much of his research has been centred on large, pragmatic, randomized controlled trials which have addressed questions of key clinical importance, but have also provided the framework for providing unique insights into disease pathogenesis, antimicrobial pharmacology, and host and bacterial genetics.