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Engaging the Public and Policymakers on Antibiotic Use and Healthcare

Leshner Fellow Brad Spellberg during an interview with ESPN.

In his years as a practicing physician, researcher, and hospital administrator, Brad Spellberg has devoted extensive time to communicating about antibiotic resistance. He has several important messages to share, and he regularly does so through media appearances, documentaries and books, and meetings with key decision-makers and stakeholders. Spellberg brings his perspectives as Chief Medical Officer at the Los Angeles County + University of Southern California Medical Center (the largest public hospital west of the Mississippi) and associate dean at the University of Southern California Keck School of Medicine to the 2017-18 Leshner Leadership Institute Public Engagement Fellows, a cohort comprised of infectious disease experts.

Spellberg’s first message is that antibiotic resistance is an urgent and widespread problem, and needs to be addressed through national policies and regulatory reform. Infectious disease experts, he adds, must be empowered to control antibiotics use in both humans and animals. As part of his efforts to share these messages broadly, in 2009 he published a book for the public called Rising Plague. He was later interviewed extensively as part of the 2013 PBS Frontline documentary Hunting the Nightmare Bacteria, appeared in the 2015 documentary, Resistance, and frequently writes scientific and policy articles on this topic.

Spellberg believes public engagement and “documentaries like these have fundamentally changed the public discourse on antibiotic resistance. The public is orders of magnitude more engaged today on this topic than they were 15 years ago, when the first question I’d get asked during an interview was, ‘You mean people still die of infection?’” The public attention has helped direct funding, research, and government reforms toward combating the problem (see this transcript of one of his interviews with PBS Frontline delving into the realities – medical, economic and political - of antibiotic drug development). Despite the progress, this remains a serious problem. PBS recently re-aired their documentary, with an updated segment featuring Spellberg, and Spellberg highlighted some of the major misconceptions that persist in a recent article for The Conversation, “Why You May Not Need All Those Days of Antibiotics.”

Spellberg’s second central message is related to U.S. healthcare: he is advocating for a universal healthcare system that makes use of market forces and focuses on outcomes, to both improve care and lower costs. This message is oriented toward policymakers. His initial intention was to seek meetings with Republican lawmakers in the U.S. Congress, however he now feels he will have more traction creating dialogue about healthcare reform in California. He hopes to help create what could eventually become a model for the nation (he cites Robert Pollin and colleagues for their work on the economics of instituting a single payer system). He has changed the framing of his message as well – with Republicans in Congress, he planned to discuss how these reforms will be better for U.S. businesses, whereas in California he will likely focus on the expansion of services to provide universal coverage, while improving outcomes and lowering costs. 

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Spellberg conducting an interview in his lab at the University of Southern California Keck School of Medicine.

From his experience with these documentaries and other interviews, Spellberg emphasizes the need to hone talking points so they can be shared quickly and repeated often, in a way that’s interesting enough to compete with everything else in the media. He recommends against being cautious and conservative in tone, mannerisms or conclusions. Spellberg’s latest engagement and communication work can be found on Twitter @BradSpellberg and his website,  

The AAAS Leshner Leadership Institute was founded in 2015 and operates through philanthropic gifts in honor of CEO Emeritus Alan I. Leshner. Each year the Institute provides public engagement training and support to 15 mid-career scientists from an area of research at the nexus of science and society.