RIYADH — The illustrious career of eminent Saudi epidemiologist Prof. Hanan Balkhy has gained wider acceptance and growing significance at a time when the world is struggling to contain the coronavirus pandemic. In honor of outstanding contributions, she was appointed as Assistant Director-General for Antimicrobial Resistance at the World Health Organization (WHO) last year. Though a specialist in pediatric infectious diseases, her contributions were mainly in infection control for more than 20 years in the Kingdom through holding the position of director of Infection Prevention and Control at the Ministry of National Guard as well as Professor of Pediatric Infectious Diseases, College of Medicine, King Saud University for Health Sciences, in addition to managing the Gulf Center for Infection Control and the Cooperative Center for Infection Control, in addition to WHO's antimicrobial resistance for ten years. After graduating from King Abdulaziz University, she became a physician. Then she pursued specialization in pediatrics at Massachusetts General Hospital, and then in infectious diseases at the Cleveland Clinic Foundation and Case Western Reserve University in the United States. Dr. Hanan rendered remarkable contributions with a leading role in containing epidemics, especially major pandemics, such as SARS, bird flu and coronavirus. She has achieved pioneering medical breakthroughs endorsed by all medical institutions around the world. In a media interview, Dr. Hanan spoke at length about her first scientific research: "I started research in 1997 while pursuing specialization at Case Western Reserve University in Ohio, one of the finest research centers known as a pioneer in hotspot research in the US. I joined a laboratory that specialized in the study of salmonella infection and its effect on the immune system and used the animal model for research." When I returned to Saudi Arabia in 1999, there was no room for laboratory scientific research in the Kingdom, and when it was decided to establish a research center at the Ministry of National Guard, I was honored to be part of the core team to establish the center in 2007. My role was to focus on creating a research assessment program, as well as to teach and develop researchers' ability to do their work, and to form the nucleus of research related to infectious diseases. Meanwhile, my future outlook was to enable the center to lead private research in infectious pathology not only at the national and regional levels but also at the global level." Research to contain contagious diseases Dr. Hanan published research papers on the spread of infectious diseases in hospitals, the burden of antibiotic-resistant bacteria on the patient first, and on the health system secondly. She elaborated saying: I had a great interest in epidemics and their propensity to spread, and the possibility and methods of controlling them. So I studied the MERS pandemic and how it spread in the hospital environment in 2015, in addition to researches that I conducted in cooperation with my colleagues at the Ministry of Agriculture, about MERS-CoV, Salmonella and Malta fever. In my opinion, the most important research was my participation in a preliminary study of the MERS-CoV serum, which was developed in Oxford laboratories by researcher Naif Al-Harbi. Studies were resumed on an animal model in Saudi Arabia in cooperation with the King Abdullah International Research Center, Ministry of Environment, Water and Agriculture, and the University of Oxford, in the hope that studies will continue in this field to reach an effective serum for the protection of camel and subsequently humans from MERS-CoV. Finally, with the participation of my colleagues and team leaders, we worked out basic steps for carrying out the first phase of the clinical study in the Kingdom in cooperation with the Saudi Food and Drug Authority. In fact, these research studies will be completed soon. Experience at WHO In April 2019, Saudi Minister of Health nominated Dr. Hanan to the prestigious position of Assistant Director-General for Antimicrobial Resistance at the WHO, as the first official to manage this new program in the organization. This was in response to the request of member states that the WHO should take over the lead in the global response to this file. This was to be undertaken in coordination between the organization and the member states, and also in coordination with the World Organization for Animal Health and the Food and Agriculture Organization. Work in this area is based on supporting member states in creating a national program to combat the outbreak of antibiotic resistance. The program should focus on creating a national infection control program, a national program for the optimal use of antibiotics, establishing the infrastructure for diagnostic laboratories, knowing the burden of antibiotic resistance on patients, spreading awareness of the problem, as well as supporting scientific research related to antibiotic resistance. Impact of measures taken by Saudi Arabia Dr. Hanan said that Saudi Arabia was dealing with the epidemic better than many other countries in the world because the dimensions of this catastrophe went from being a simple inflammation spreading among people to a greater challenge with social, economic, psychological, health and other repercussions. Saudi Arabia has taken strict decisions to protect society from a possible catastrophe, especially with regard to pilgrims, visitors and worshipers to the Two Holy Mosques. It is obvious that there were gradual phases in taking precautions, and then removing them based on a continuous evaluation of the potential danger of the virus, compared to the existence of a foolproof health care service for patients. Although this balance was found very difficult to achieve in many countries between excesses and negligence, Saudi Arabia succeeded in achieving such a balance with its wise decisions. Dr. Hanan also commented on the significance of enforcing curfews in containing the pandemic. "Certainly, the basis for controlling any epidemic is cutting or breaking the chain of spread. In the absence of a vaccine, the physical space between people and preventing them from exposure to respiratory fluid from a person carrying the virus are the most significant measures to be taken account of," she added.
