An outspoken epidemiologist becomes U.S. science envoy

If there’s an infectious disease that has threatened public health over the past 4 decades, epidemiologist Michael Osterholm of the University of Minnesota (UM) in Minneapolis likely has said something about it. Osterholm, who runs UM’s Center for Infectious Disease Research and Policy (CIDRAP), has a reputation for speaking bluntly—torpedoes, political correctness, friends, even funders be damned—and understands the power of a punchy metaphor. Yesterday, the U.S. Department of State announced he would be one of its five science envoys, a program that began in 2010 and taps prominent scientists for 1-year appointments to build global collaborations on pressing issues.

Joining Osterholm in this year’s class are chemical engineer Robert Langer of the Massachusetts Institute of Technology in Cambridge; bioengineer Rebecca Richards-Kortum of Rice University in Houston, Texas; environmental engineer James Schauer of the University of Wisconsin in Madison; and retired NASA Administrator Charles Bolden.

This interview has been edited for clarity and length.

Q: What does it mean to be a scientific envoy to the Department of State?

A: It’s a unique opportunity to be involved with countries around the world on specific topics through official government channels. Antibiotic resistance and antibiotic stewardship is something we’ve been involved with at CIDRAP for many years, and that will be my focus.

Q: What’s antibiotic stewardship?

A: One of the challenges we have is overuse of antibiotics and the ever-increasing risk of antibiotic resistance. For both humans and animals, the majority of antibiotics used are unnecessary from the standpoint of treatment—the diseases often aren’t even sensitive to antibiotics or aren’t even bacterial infections. There’s a lot of content on our website about how to reduce the unnecessary use of antibiotics.

Q: What exactly will you do?

A: I’m going to concentrate on low- and middle-income countries because it’s the area of the fastest growth of antibiotic resistance. Up to one-third of my time can be spent overseas working with countries on demonstration projects and sharing the tools. This is a tough topic to get people to see as a priority. We’re typically involved with outbreak crises. This has a pandemic potential, but it’s not just one disease. It’s a slow-moving tsunami. It’s a bigger challenge to get people involved.

Q: President Donald Trump’s administration has been heavily criticized for not seeking more advice from the scientific community. Are you concerned?

A: We always want the best science to inform public policy. That’s an important issue for every administration. We’re always concerned about how science is used by any government in any situation. I’m just another tire on the vehicle trying to make things better for antibiotic resistance.

Q: Are you a Trump supporter?

A: I have not been a supporter of any administration for the last six administrations. I’ve served Democrats and Republicans, and I’ve been agnostic. I was involved with the [Ronald] Reagan administration on AIDS, with presidents George H. W. and George W. Bush, and I was very involved with the [Barack] Obama administration. What’s important to me is the science. I’m just another private in the infectious disease army, and I do my best to serve.

Q: You’re well known for always speaking your mind.

A: I will do that here. This is not a Democratic or Republican issue. Conservative or liberal, we’re at risk, and it’s growing dramatically with time. The only real enemies with regard to antibiotic resistance are the bugs themselves. Antibiotic resistance is like gravity: It happens. Our grandparents and great-grandparents grew up in a preantibiotic era. And our grandkids and great-grandkids are going to live in a postantibiotic era. Our job is to slow that down.

Q: Did you have any hesitation when asked to serve?

A: I did not. This is not a political position and doesn’t require political sign off. I was told I’d have the freedom to promote antibiotic stewardship with the tools we have developed at CIDRAP. It’s no different than serving on any scientific advisory committee. It’s really important to promote the scientific agenda. In my latest book, Deadliest Enemy, I identified the two biggest issues coming down the pike as pandemic influenza and antibiotic resistance.

Q: Do you anticipate that you could be fired because of your views?

A: I don’t. I’ve been very impressed with the people I’ve worked with at [the Department of] State. When I went to work with the Bush administration after 9/11 there were complicated issues and I had an agreement with [Health and Human Services] Secretary Tommy Thompson that I’d say what was on my mind, and if I couldn’t, I’d leave. Let’s hope I can accomplish something.