Groundbreaking medical research from Tasmania to the world

Professor Tim Walsh, a world-leader in the fight against antimicrobial resistance (AMR), says Tasmania helped to shape his career and world view.

Professor Walsh was the University of Tasmania’s Distinguished Alumni Award winner for 2023 and visited Tasmania last month to present the Arthur Cobbold Memorial Lecture at the College of Health and Medicine.

The topic of his guest lecture was antimicrobial resistance, a term which describes what happens when medicines such as antibiotics lose their effectiveness against disease-causing pathogens. Think antibiotic resistant bacteria in hospitals that can cause life-threatening conditions such as sepsis. It is no exaggeration to say that Professor Walsh’s work combatting antimicrobial resistance is having an impact across the globe.

A Professor of Medical Microbiology at the University of Oxford and the Co-Director and Biology Lead for the Ineos Institute of Antimicrobial Research, Professor Walsh has been studying antimicrobial resistance mechanisms for over 25 years. He has published over 340 papers and publishes regularly in the journals Nature and The Lancet. So how did his career evolve?

Tim moved from the UK to Tasmania in 1977, a move he says was fundamental to the career that unfolded.

In 1986 he graduated with a Bachelor of Applied Science from the Tasmanian State Institute of Technology, which became part of the University of Tasmania, and, while working at the Royal Hobart Hospital, completed a Graduate Diploma in Immunology and Microbiology, also from the University. He moved back to the UK in 1991 and completed a PhD.

Professor Walsh has conducted antimicrobial resistance studies in Karachi and Peshawar and has collaborative studies with Médecins Sans Frontières in Niger. Working with Médecins Sans Frontières, he has facilitated the design and construction of their Microbiology/AMR lab in Jordan and has provided support for antimicrobial resistance surveillance in Russia, Belarus and Kazakhstan.

He is also Director of BARNARDS, an international network examining the clinical burden of antimicrobial resistance in newborns in many countries including Pakistan, Bangladesh, Rwanda, Burundi, Egypt, Mozambique, Sierra Leone, Nigeria and Ethiopia.

Alongside this, he is director of BALANCE, comparing the burden of antimicrobial resistance in high- to low-middle income countries as well as understanding the role of insects in AMR’s global dissemination.

He is an advisor to the Foundation Merieux AMR teaching program and is a member of the World Health Organisation’s Strategic and Technical Advisory Group for Antimicrobial Resistance.

In 2020, he was awarded an Order of the British Empire for Microbiology and International Development.

It is a remarkable journey of importance for all of us. Here, Professor Walsh provides answers to some of our questions:

How did moving to Tasmania help your education?

Tasmania is an intrinsic, pertinent and fundamental part of my education. If I hadn’t come here, there is no way I’d be doing what I am today. I’m dyslexic. I failed the school system and coming here gave me a rest, a valuable re-set and a chance to be creative and find out where my boundaries were. That was very powerful.

In the UK, we were ranked at the beginning of high school. I was good at maths and creative writing but not at reading and other forms of writing, certainly not spelling. The UK schooling system put me into a middle ranking, and I was bored senseless. Going to Rosetta High in Hobart in the 70s gave me an opportunity to not feel that pressure and to think, how can I get education to work for me?

What would be your advice to new graduates?

My advice would be to not create boundaries for yourself. My Dad grew up in Persia and I have Spanish ancestry, my wife is Dutch and one of my daughters is Chinese, so I have a very multicultural family. Doing something international was where I wanted to go.

My sister and I came out to Australia in 1977 and went to school without a school uniform. I was beaten up for being different. But I was good at soccer and had a lot of friends who were Croats or Greek or Italian. There was a multicultural aspect to Hobart, especially in Rosetta. Being aware that you are different can be turned into a positive. You learn to show respect for others despite differences in creed, nationality and ethnicity.

My advice to young graduates, in addition to not setting boundaries for yourself, is to always look beyond problems – think of solutions, don’t focus on problems.

Were there other aspects of Tasmania that influenced you?

I became very involved in the wilderness – I went on wilderness walks at Mt Field, the Overland Track and the Western Arthurs; I joined the Wilderness Society and got involved in Green politics; I joined the TURDS (the Tasmanian University Rubber Ducky Society) and the No Dam movement. I became aware of the uniqueness of Tasmania, particularly the flora. My family moved to Tinderbox and I did a lot of diving. It all gave me a sense of freedom, of being at one with nature.

If you had to choose three career highlights, what would they be?

The first would be that my team found a gene which I called NDM in August 2010; that gene became very important to our understanding of antimicrobial resistance. Within two days of publishing this work there had been 4.7 million Google hits for NDM. That was before Twitter, before Instagram. We named the gene after the capital of India and published an article in The Lancet Infectious Diseases that associated the driving of antimicrobial resistance with people journeying to countries to have elective surgery. In the first week (of publishing that report), India lost $20M in bookings. I became aware of how politics is linked to money … and I was accused of working for MI5.

For the second highlight, fast forward five years to when we discovered a gene called MCR (a gene responsible for resistance to the antibiotic colistin) in China. After the experience in India, I spoke first to the government in China which helped make sure the geopolitical ramifications of this discovery were understood. In 2015, China banned the use of colistin in animals, in advance of Europe and the US.

In short, I learned from the mistakes in India and engaged at a political level to ensure a successful outcome (the second time around).

The third highlight was my move to the University of Oxford. In February 2020, a company called Ineos approached us regarding our work on antimicrobial resistance. By July 2020, in the middle of COVID, they gave a small group of us £100M to create an institute at Oxford, which became the Ineos Institute of Antimicrobial Research. It is the pinnacle of my career and quite a journey, from a school kid with learning difficulties in Hobart to an Oxford prof.

What are the main streams of your work at the Ineos Institute of Antimicrobial Research?

The first is around the issue of the continued use of human antibiotics in animals. For over 70 years we have been using human antibiotics in animals and, therefore, we are trying to design molecules that have the same effect but are not related to human antibiotics.

The second is finding new antibiotics for humans to combat the increasing issue of antimicrobial resistance.

The third focuses on the burden of AMR internationally. We are doing a lot of work in Africa, Pakistan and Bangladesh, building/refurbishing laboratories and supporting neonatal intensive care units, as well as empowering and training local colleagues to manage and improve data collection, and then share that data (on antimicrobial resistance) with us. It’s a unique model that generates a lot of engagement, trust and respect and which we hope will be sustainable.

Importantly, we need to address the fact that nearly all the issues with antimicrobial resistance in low-income countries are around access to diagnostics and to cost-effective and appropriate antibiotics.

It’s an important year this year as the UN General Assembly is meeting in New York and will discuss these issues. Access to diagnostics and cost effective and appropriate antibiotics are top of the agenda.