[Applause]
why am i showing you a picture of a nice
lady here and her son this is spa brocco
Vasek I know her she will be coming to
Singapore in a couple of weeks for a big
meeting food safety meeting we have
she’s a risk analyst and she will give a
nice presentation I think I’m not
showing the picture because of her I’m
showing the picture because of this the
son Kevin here he’s two and a half years
old and why am i showing you a picture
of him I’m showing you his picture
because he’s dead he only got to be two
and a half years old because he ate
tainted burger and got a coli o157
that’s a very dangerous e.coli if it
gets to your kidney and it did that to
him your kidney will stop functioning
and the doctor can do nothing so you die
and it’s not a nice death it takes some
time here it took ten eleven days I’m
showing you that because sometimes when
we talk about figures numbers 252
million it’s like we forget that behind
each of these figures there is actually
lives and many times there are kids
especially when we talk about food
safety water safety microorganisms it’s
a lot of kids that are affected now the
problem that I’m going to talk about now
is a problem that would result in many
more kids and grown-ups dying in the
future that we cannot treat not only in
relation to food or food safety but in
relation to all the microorganisms that
we share between each other so I’m
talking about antibiotics antibiotics
clearly was a blessing they were
invented 75 years ago around 1940 the
first one everybody heard about this
that penicillin was invented by Fleming
or discovered yeah I would say and he
found out that the penicillin would kill
microorganisms bacteria so we’ve used
that since then and many many millions
of lives
have been saved before that in the pre
antibiotic area era
you would die if you had an infection
just from a scratch or you have a sore
throat or something like that
after that you could actually take
penicillin or other antibiotics we have
maybe 30 different antibiotics now and
you will be cured we can even have
fantastic interventions in our bodies
you can cut out your heart and put in
another one you can only do that because
we also give the patient antibiotic when
the antibiotic works problem is they
don’t always work and the way we are
using them will give us a problem in the
future in relation to how it works the
problem is that in the center of a
microorganism we have DNA just like in
any of our cells we have DNA we have
mutations in DNA if bacteria are being
put into an environment with antibiotics
some of them will mutate when they
mutate they will become resistant to the
antibiotic meaning suddenly they can
live when the antibiotic is there and
that means that resistant bacterium will
fight back towards the antibiotic and
suddenly the antibiotic doesn’t work now
this is a fantastic description of how
that actually works so this is a lab
Keshawn art from Howard Medical School
they put up a big table with medium
there where you have your way you can
grow bacteria and then they put
different concentrations of antibiotics
so you can see in the ends that had no
antibiotic and into the center they had
1,000 times the antibiotic that they
were using in this case what they did
was that they would put bacteria into
the zero path there and when the
bacteria starts growing there you will
see that the bacteria cannot go across
the first line where you have the first
concentration of antibiotics so you see
that the bacteria is coming here on each
side they stop when you have this limit
where you have the first concentration
of antibiotics so here you see the fur
mutation that can actually grow in
antibiotic then it grows on and you will
have other mutations coming on you can
see them on both sides and they’re
moving towards the sensor and then they
meet the next limit and then they have
to have new changes in their DNA new
mutations so that they can actually take
the 10 times antibiotic and move on from
there
again they stopped at the net next limit
and move on from there so you can see
here this actually took like 1012 days
to film this but you can see how all
these populations of bacteria they have
the ability to have mutations which
means that suddenly they can actually
live and thrive even if you have
antibiotic here you can see the
different mutations that happened and
how they spread into the center so this
is a fantastic illustration of how
mutations can actually make bacteria
resistant to antibiotic and that is
happening every time we use antibiotic
so I’m talking about a problem that is
real because we use antibiotic a lot and
it’s a problem that is happening just
now and it’s really actually a very big
problem I’ll get back to how big it
really is but one of the reasons I say
that it’s a big problem is that just
last month the UN General Assembly
actually discussed antibiotic resistance
this is not something that happens every
year UN General Assembly is talking
about big economical things they
normally do not talk about health they
leave that to small minor organizations
like the World Health Organization or
things like that and normally they
believe that they can take care of it
but maybe in this case they don’t think
that they’re doing well I don’t know if
that’s the case the UN General Assembly
actually discussed this just last last
month so it is a big problem is realized
by a lot of countries why is it big 700
thousand deaths every year from
resistant anti antibiotic resistant
bacteria that’s a lot of people
I can compare to maybe one of the
biggest killers that we have is cancer
cancer is around 7 billion so this is
ten percent of cancer that dies from
resistant bacteria now how would that
compare to what is happening in
Singapore if you compare there it’s 500
people every year dying in Singapore
from resistant bacteria compare that to
how many people die from traffic
accidents that’s around 150 so it’s
three times more than die from traffic
accidents so it’s a really big really
significant problem and what is even
worse if you try to extrapolate the
development here in relation to that if
we don’t do anything apart from what
we’re doing now which is very little
then it will grow from 700,000 in 2050
it will be 10 million every year dying
10 million so that’s more than die from
cancer every year cancer was 7 to 8
million this is 10 million from
resistant bacteria in the world so it’s
a huge problem now where do we actually
use the antibiotics because I said that
whenever we use antibiotic we also have
the risk that we create resistant
bacteria so I would like you to vote on
this and before you vote so that the
thing is where do we where do we use
most antibiotic is it for sick human
sick animals before you vote just to
tell you that I’m a veterinarian I think
I said that
I’m from Scandinavia not smart
Scandinavia that’s Sweden not not you
yeah you will after that in the end see
you with her with you with the big guy
there yeah ok not from the beautiful
Scandinavia that’s Norway but from happy
Scandinavia that’s Denmark Denmark is
the happiest because we pay the highest
taxes No
we are the happiest because we have the
most pics we have 30 million pigs in
Denmark 30 million 3-0 we only have five
million people like Singapore 30 million
pigs so we must be happy now you
shouldn’t let that affect your voting
now so how many would vote that we moose
use most for the store sick animals the
pigs in Denmark and so on how many would
vote for that that we move okay yeah I
have the figure 435 how many would vote
for sick humans that we use most for
sick humans oh I think actually that the
animals are winning here maybe because
we have so many pigs in Denmark I don’t
know but actually it’s the same it’s
around 15 to 25 percent of the total use
of antibiotic is in sick animals and the
same in sick humans so what’s wrong with
the figures here there’s something wrong
with the figures I’m sure you can see
that the your university students some
of you yeah there is something wrong we
are missing we’re missing a big part
which is 60 to 70 percent of what we are
using an antibiotic in general we
actually use just to make healthy
animals grow faster 60 to 70% of all the
antibiotics somebody would say that we
figured out here somebody figure out
somebody who’s good at that not of it’s
an urn that it’s more than 63 tons
globally which corresponds to 10,000
African elephants I don’t know why we
had to have African elephants here if it
if it was it could also have been pigs
but then it will many more of course you
know it’s like a million Danish pigs or
someone bad but it’s a huge amount of
antibiotics that we use just to make
healthy animals grow faster a little bit
faster actually so sometimes people then
say yeah but it’s okay we understand you
use them for animals and for humans but
isn’t it when you use it for humans that
is really bad in relation to creating
resistance actually it’s not so look at
this picture here you can see that when
floki Nolan which is one of these 30
different antibiotics when it was
approved in the
u.s. in 1986 for the next ten years
there was no resistance recorded no
resistance at all for ten years they
used it in many many many different
people then they started using it in
poetry and immediately we saw resistance
immediately after that we saw resistance
so actually for this antibiotic it was
worse to use it in animals than in
humans in relation to whether it
generated antibiotic resistance so it’s
not true that the worst is when we use
it in animals so what can we do about it
because I’m talking to man Klum and you
know this is a big problem and the world
is gonna go on – no it’s not we can do
something about it first thing is we
need to know how much we use and where
we use it and most countries don’t look
for that at all at the moment we need to
induce how much resistance we have and
most countries don’t really look for
that at all then we need to have
regulation about how we use the
antibiotics and again most countries
don’t have that regulation at the moment
and then we need to convince the medical
doctors and the veterinarians who are
distributing antibiotics that they
should use less and I say this also
about veterinarians because in most
countries veterinarians more than 50% of
what they earn they get by actually
antibiotic dealers 50% of the income how
easy is it going to be to convince the
veterinarians that they should use less
antibiotic when 50% of the antrum come
from there how could what can you do
about that you can actually ban that you
can say veteran ants are not allowed to
sell antibiotics they’re not allowed to
deal drugs and that has been done in
some countries especially in in
Scandinavia but it’s been done in a few
countries so it could be done anywhere
if you can do it in Denmark you can do
it everywhere
and then just everybody also have to
consider that antibiotics shouldn’t be
used when we have a virus so if we have
common cold
that’s a virus antibiotic doesn’t work
and actually we can get well many times
without antibiotics last thing I’m going
to tell you now is we also have new
scientific ways of investigating this
problem and something that could
actually be used so
we might not get to these 10 million
deaths every year this is a new system
that we’re working on also here at the
NTU in Singapore together with
scientists 300 Sciences from more than
50 countries so the idea is that when
you have a patient you can actually find
out what is causing the disease in the
patient by doing DNA sequencing so the
DNA we have in the middle of us we also
have in the middle of a bacterium so you
sequence that DNA if you do that you can
put that to a database in the cloud that
would have and that’s our idea would
have all the DNA of all the
microorganisms in the world bacteria
viruses everything if you do that you
would immediately get the answer back
what what does this DNA tell us what’s
the name of the microorganism and how
can you treat it because resistance is
also in the genes so you would be able
to treat the patient in the right way
and with the right antibiotic at the
same time you would have a global
surveillance system where you could
follow resistant microorganisms and how
they move because they move with people
and they move with animals and they move
with fruit and that would be a fantastic
solution a fantastic global machine that
we’re suggesting may be the most
fantastic global machines in school or
something like that so we suggest there
are global solutions but we need to work
globally on them we need to work between
the countries between scientists in the
countries to actually do something like
this because when we have a global
problem we need to also look at global
solutions thank you very much [Applause]
why am i showing you a picture of a nice
lady here and her son this is spa brocco
Vasek I know her she will be coming to
Singapore in a couple of weeks for a big
meeting food safety meeting we have
she’s a risk analyst and she will give a
nice presentation I think I’m not
showing the picture because of her I’m
showing the picture because of this the
son Kevin here he’s two and a half years
old and why am i showing you a picture
of him I’m showing you his picture
because he’s dead he only got to be two
and a half years old because he ate
tainted burger and got a coli o157
that’s a very dangerous e.coli if it
gets to your kidney and it did that to
him your kidney will stop functioning
and the doctor can do nothing so you die
and it’s not a nice death it takes some
time here it took ten eleven days I’m
showing you that because sometimes when
we talk about figures numbers 252
million it’s like we forget that behind
each of these figures there is actually
lives and many times there are kids
especially when we talk about food
safety water safety microorganisms it’s
a lot of kids that are affected now the
problem that I’m going to talk about now
is a problem that would result in many
more kids and grown-ups dying in the
future that we cannot treat not only in
relation to food or food safety but in
relation to all the microorganisms that
we share between each other so I’m
talking about antibiotics antibiotics
clearly was a blessing they were
invented 75 years ago around 1940 the
first one everybody heard about this
that penicillin was invented by Fleming
or discovered yeah I would say and he
found out that the penicillin would kill
microorganisms bacteria so we’ve used
that since then and many many millions
of lives
have been saved before that in the pre
antibiotic area era
you would die if you had an infection
just from a scratch or you have a sore
throat or something like that
after that you could actually take
penicillin or other antibiotics we have
maybe 30 different antibiotics now and
you will be cured we can even have
fantastic interventions in our bodies
you can cut out your heart and put in
another one you can only do that because
we also give the patient antibiotic when
the antibiotic works problem is they
don’t always work and the way we are
using them will give us a problem in the
future in relation to how it works the
problem is that in the center of a
microorganism we have DNA just like in
any of our cells we have DNA we have
mutations in DNA if bacteria are being
put into an environment with antibiotics
some of them will mutate when they
mutate they will become resistant to the
antibiotic meaning suddenly they can
live when the antibiotic is there and
that means that resistant bacterium will
fight back towards the antibiotic and
suddenly the antibiotic doesn’t work now
this is a fantastic description of how
that actually works so this is a lab
Keshawn art from Howard Medical School
they put up a big table with medium
there where you have your way you can
grow bacteria and then they put
different concentrations of antibiotics
so you can see in the ends that had no
antibiotic and into the center they had
1,000 times the antibiotic that they
were using in this case what they did
was that they would put bacteria into
the zero path there and when the
bacteria starts growing there you will
see that the bacteria cannot go across
the first line where you have the first
concentration of antibiotics so you see
that the bacteria is coming here on each
side they stop when you have this limit
where you have the first concentration
of antibiotics so here you see the fur
mutation that can actually grow in
antibiotic then it grows on and you will
have other mutations coming on you can
see them on both sides and they’re
moving towards the sensor and then they
meet the next limit and then they have
to have new changes in their DNA new
mutations so that they can actually take
the 10 times antibiotic and move on from
there
again they stopped at the net next limit
and move on from there so you can see
here this actually took like 1012 days
to film this but you can see how all
these populations of bacteria they have
the ability to have mutations which
means that suddenly they can actually
live and thrive even if you have
antibiotic here you can see the
different mutations that happened and
how they spread into the center so this
is a fantastic illustration of how
mutations can actually make bacteria
resistant to antibiotic and that is
happening every time we use antibiotic
so I’m talking about a problem that is
real because we use antibiotic a lot and
it’s a problem that is happening just
now and it’s really actually a very big
problem I’ll get back to how big it
really is but one of the reasons I say
that it’s a big problem is that just
last month the UN General Assembly
actually discussed antibiotic resistance
this is not something that happens every
year UN General Assembly is talking
about big economical things they
normally do not talk about health they
leave that to small minor organizations
like the World Health Organization or
things like that and normally they
believe that they can take care of it
but maybe in this case they don’t think
that they’re doing well I don’t know if
that’s the case the UN General Assembly
actually discussed this just last last
month so it is a big problem is realized
by a lot of countries why is it big 700
thousand deaths every year from
resistant anti antibiotic resistant
bacteria that’s a lot of people
I can compare to maybe one of the
biggest killers that we have is cancer
cancer is around 7 billion so this is
ten percent of cancer that dies from
resistant bacteria now how would that
compare to what is happening in
Singapore if you compare there it’s 500
people every year dying in Singapore
from resistant bacteria compare that to
how many people die from traffic
accidents that’s around 150 so it’s
three times more than die from traffic
accidents so it’s a really big really
significant problem and what is even
worse if you try to extrapolate the
development here in relation to that if
we don’t do anything apart from what
we’re doing now which is very little
then it will grow from 700,000 in 2050
it will be 10 million every year dying
10 million so that’s more than die from
cancer every year cancer was 7 to 8
million this is 10 million from
resistant bacteria in the world so it’s
a huge problem now where do we actually
use the antibiotics because I said that
whenever we use antibiotic we also have
the risk that we create resistant
bacteria so I would like you to vote on
this and before you vote so that the
thing is where do we where do we use
most antibiotic is it for sick human
sick animals before you vote just to
tell you that I’m a veterinarian I think
I said that
I’m from Scandinavia not smart
Scandinavia that’s Sweden not not you
yeah you will after that in the end see
you with her with you with the big guy
there yeah ok not from the beautiful
Scandinavia that’s Norway but from happy
Scandinavia that’s Denmark Denmark is
the happiest because we pay the highest
taxes No
we are the happiest because we have the
most pics we have 30 million pigs in
Denmark 30 million 3-0 we only have five
million people like Singapore 30 million
pigs so we must be happy now you
shouldn’t let that affect your voting
now so how many would vote that we moose
use most for the store sick animals the
pigs in Denmark and so on how many would
vote for that that we move okay yeah I
have the figure 435 how many would vote
for sick humans that we use most for
sick humans oh I think actually that the
animals are winning here maybe because
we have so many pigs in Denmark I don’t
know but actually it’s the same it’s
around 15 to 25 percent of the total use
of antibiotic is in sick animals and the
same in sick humans so what’s wrong with
the figures here there’s something wrong
with the figures I’m sure you can see
that the your university students some
of you yeah there is something wrong we
are missing we’re missing a big part
which is 60 to 70 percent of what we are
using an antibiotic in general we
actually use just to make healthy
animals grow faster 60 to 70% of all the
antibiotics somebody would say that we
figured out here somebody figure out
somebody who’s good at that not of it’s
an urn that it’s more than 63 tons
globally which corresponds to 10,000
African elephants I don’t know why we
had to have African elephants here if it
if it was it could also have been pigs
but then it will many more of course you
know it’s like a million Danish pigs or
someone bad but it’s a huge amount of
antibiotics that we use just to make
healthy animals grow faster a little bit
faster actually so sometimes people then
say yeah but it’s okay we understand you
use them for animals and for humans but
isn’t it when you use it for humans that
is really bad in relation to creating
resistance actually it’s not so look at
this picture here you can see that when
floki Nolan which is one of these 30
different antibiotics when it was
approved in the
u.s. in 1986 for the next ten years
there was no resistance recorded no
resistance at all for ten years they
used it in many many many different
people then they started using it in
poetry and immediately we saw resistance
immediately after that we saw resistance
so actually for this antibiotic it was
worse to use it in animals than in
humans in relation to whether it
generated antibiotic resistance so it’s
not true that the worst is when we use
it in animals so what can we do about it
because I’m talking to man Klum and you
know this is a big problem and the world
is gonna go on – no it’s not we can do
something about it first thing is we
need to know how much we use and where
we use it and most countries don’t look
for that at all at the moment we need to
induce how much resistance we have and
most countries don’t really look for
that at all then we need to have
regulation about how we use the
antibiotics and again most countries
don’t have that regulation at the moment
and then we need to convince the medical
doctors and the veterinarians who are
distributing antibiotics that they
should use less and I say this also
about veterinarians because in most
countries veterinarians more than 50% of
what they earn they get by actually
antibiotic dealers 50% of the income how
easy is it going to be to convince the
veterinarians that they should use less
antibiotic when 50% of the antrum come
from there how could what can you do
about that you can actually ban that you
can say veteran ants are not allowed to
sell antibiotics they’re not allowed to
deal drugs and that has been done in
some countries especially in in
Scandinavia but it’s been done in a few
countries so it could be done anywhere
if you can do it in Denmark you can do
it everywhere
and then just everybody also have to
consider that antibiotics shouldn’t be
used when we have a virus so if we have
common cold
that’s a virus antibiotic doesn’t work
and actually we can get well many times
without antibiotics last thing I’m going
to tell you now is we also have new
scientific ways of investigating this
problem and something that could
actually be used so
we might not get to these 10 million
deaths every year this is a new system
that we’re working on also here at the
NTU in Singapore together with
scientists 300 Sciences from more than
50 countries so the idea is that when
you have a patient you can actually find
out what is causing the disease in the
patient by doing DNA sequencing so the
DNA we have in the middle of us we also
have in the middle of a bacterium so you
sequence that DNA if you do that you can
put that to a database in the cloud that
would have and that’s our idea would
have all the DNA of all the
microorganisms in the world bacteria
viruses everything if you do that you
would immediately get the answer back
what what does this DNA tell us what’s
the name of the microorganism and how
can you treat it because resistance is
also in the genes so you would be able
to treat the patient in the right way
and with the right antibiotic at the
same time you would have a global
surveillance system where you could
follow resistant microorganisms and how
they move because they move with people
and they move with animals and they move
with fruit and that would be a fantastic
solution a fantastic global machine that
we’re suggesting may be the most
fantastic global machines in school or
something like that so we suggest there
are global solutions but we need to work
globally on them we need to work between
the countries between scientists in the
countries to actually do something like
this because when we have a global
problem we need to also look at global
solutions thank you very much [Applause]
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