As part of our series of exclusive interviews conducted at the World Vaccine Congress this month we are delighted to share our conversation with Dr Jomana Musmar. Dr Musmar serves as Designated Federal Officer for the Presidential Advisory Council on Combating Antibiotic Resistant Bacteria (PACCARB), which she has been managing since its conception in 2015. She is also the Senior Public Health Advisor in the Office of Infectious Disease and HIV/AIDS Policy (OIDP), Office of the Assistant Secretary for Health, HHS. She kindly made time during her Congress schedule to discuss AMR and One Health. We are grateful for her time and insights, and hope you enjoy this interview!
Introducing Dr Musmar
Dr Musmar’s roles are quite the mouthful, so we were impressed that she delivered such a concise introduction in one breath! She joined us at the Congress to explore how we can prepare for a future pandemic in the “era of AMR” and to participate in a panel that brought a governmental, agency, and regulatory perspective to vaccines for AMR.
Why One Health?
Many members of our community will be familiar with the term ‘One Health’, which WHO describes as an “integrated, unifying approach”. It draws on knowledge from animal, human, and environmental disciplines in pursuit of a sustainable and balanced result. Dr Musmar explains that is more than an approach, but a “holistic way of integrating” the “human, agricultural, and environmental domains of health”.
“The impacts of one affect the others as well.”
This is not only reflected in the proceedings of Dr Musmar’s Council, but the membership.
“We all sit at the same table.”
Since the establishment of the Council, “every single report” has had at least a human and animal health component, with an increasing focus on environmental health.
Communication is key
As Dr Musmar highlighted the importance of including all relevant experts at the table, we asked about how this works in her daily practice. She shared with us that at the time of establishing the council in 2015, involving everyone was “always a challenge”.
“The areas were very siloed until we finally broke those barriers.”
In spite of the apparent “biases” and “controversies” that might have been instinctual obstacles to progress, Dr Musmar and her team were able to demonstrate that “there is a common thread”. Thus, camaraderie developed, and is reflected in the makeup of the council and its questioning.
“There’s so much interaction and communication, and we always use up our discussion time because there’s so much information that can be shared and learnt on all sides.”
Going forward, Dr Musmar and her colleagues are hoping to “normalise the dialogue”, further extending to the environmental domain. For those of us who aren’t entirely sure what “environmental” covers, she explains that it involves more than just plant and crop health: “we’re talking climate change as well; we’re talking wastewater management”.
“Ultimately, the dialogue always circles back to ‘how does it impact human health’ but we want to make sure that the focus also is centred on ‘how does it impact animal health and environmental health as well?'”
Access and AMR
We know from other speakers that health efforts and interventions are worth nothing if they are only available to some. We therefore asked Dr Musmar how access and sustainability play into what she does. Helpfully, she referred us to a recent report, which you can access here, which discussed “four particular domains that need attention”.
These include, in her personal opinion, the most important: “ensuring that we have a robust workforce”. Incentivising, integrating, and supporting health workers is crucial to any health response, she argues. Finally, Dr Musmar explores the importance of “antibiotic stewardship”, which ensures that guidelines and practices are sustainable when we encounter fear or uncertainty during a pandemic.
In the report, the “foundation” is “establishing trust” in order to ensure equity. Dr Musmar uses the example of the COVID-19 pandemic, during which adults were a focus group. This excluded children and other “pockets” who may have been forgotten. In the future, they must be brought into the equation from the start, says Dr Musmar, if we are to achieve equity in future responses.
What are you looking forward to?
We concluded our interview with a question about what Dr Musmar was most looking forward to at the Congress. For her, the opportunity to share her recent report is exciting, and she was looking forward to emphasising the importance of One Health in tackling AMR.
“Seeing people’s perspectives and reactions to what the report says.”
We hope that this interview offers a unique perspective and that you find it as interesting as we did! Thank you once again to Dr Musmar for her time and enthusiasm. For more on what went on at the Congress, click here for a post-Congress report and make sure you subscribe for further Congress insights.