Jim O’Neill: The Commercial Secretary leading review into how the world can defuse the time bomb of drug resistance

The James Ashton interview: With forecasts that drug-resistant superbugs could kill an extra 10 million people a year, he has his work cut out

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Last month, Jim O’Neill returned to the Manchester United directors’ box for the first time in more than a decade.

“It was all a bit weird,” said the former Goldman Sachs economist, who led the Red Knights consortium of moneymen that failed to buy the club from the unpopular Glazers in 2010. He wasn’t a guest of the American family which has just marked a decade of ownership. Instead, it was a friend from arch-rivals Manchester City who invited him to see the derby fixture.

O’Neill, who used to go to United games with his postman father, gave up his season ticket a couple of years ago – partly because he couldn’t stand sitting with pals on the halfway line opposite a half-empty directors’ box, and partly because Old Trafford has become “a bit soulless”. Instead of a sold-out stadium, he can usually buy a ticket on match day if he wants one.

“If you look at it in a really narrow, financial sense: wow, these guys have executed ruthlessly,” O’Neill, 58, says in his North-west twang, chatting in the monied cool of Mayfair’s Arts Club. “It is a commercial entity. Maybe that is what modern sport is, but I don’t think it has to be.”

Could he ever see himself trying to buy the club again? His status, he says, is “dormantly active – or actively dormant”. But the passion is clear. “It is something that has been in my blood since I was seven years old. If there was a chance of having a better-owned Man United I’d love to contribute in any way.”

In the meantime, O’Neill – made a Conservative peer last week and given a cabinet role as Commercial Secretary – is fighting a bigger, more unlikely battle: how to tackle the global problem of failing drugs. His review into a growing resistance to antimicrobials – drugs which include antibiotics, antivirals and antifungals – comes as the number people dying in Europe from infections too powerful to be treated reaches 25,000 a year.

Part of the reason is that new drugs of this type are not being developed because there are fatter profits to be had elsewhere, but another part is that antibiotics are doled out like sweets by doctors and gobbled down by patients. When O’Neill visited one of his sisters in Florida this year, she told him of a Caribbean cruise that stopped off in Mexico so that holidaymakers could stock up on cheap tablets.

“My generation and the one slightly older think antibiotics solve anything – and I might have done a year ago,” he confesses. As bacteria develop resistance to treatment, experts warn of a “post-antibiotic age” where basic healthcare becomes far more dangerous due to the risk of infection during simple procedures.

The government review he has led since September, co-funded by the Wellcome Trust medical charity, has already dished up some shock-and-awe statistics, forecasting that drug-resistant superbugs could kill an extra 10 million people a year and cost up to $100trn by 2050. That warmed people up for last week’s controversial solution. To overhaul the pipeline of new antibiotics, O’Neill suggested that up to $37bn of incentives should be dangled in front of Big Pharma over a decade – a 30-fold increase on the current schemes.

Aren’t these the same giant firms that turn billions in profits and shovel large dividend payments out to shareholders? The report argues that it would be a small price to pay for a problem that is already costing the US health system $20bn a year. But the pharmaceutical industry stands accused of serving its shareholders before society.

O’Neill had first of all assumed the global taxpayer would pick up the tab for this extra research and development through easier tax treatment of new antimicrobials. But now he’s not so sure. “In a lot of industries, the dominant companies aren’t really taking a lot of initiative,” he says. There is also the issue of enlightened self-interest, he says, telling the industry players: “If we are half right with the figures in our first paper then all of these cancer drugs you are selling won’t be of any use. Open your minds.” The answer to the funding question has been deliberately left open ahead of O’Neill’s White House visit in June. The issue might even make it on to next year’s G20 agenda in China. O’Neill set out thinking his No 1 priority was how to get new drugs developed. “I don’t any more”. Rather than a supply problem, he has come to believe “that the demand problem is bigger”.

He may recommend forcing the medical profession to be more disciplined and educating patients on the dangers of overuse, similar to tobacco and alcohol public-health campaigns. Whatever is in his final report a year from now, O’Neill’s ambitious goal is to get the UN to agree to it. He knows at some point he will have to engage with the World Health Organisation and the UN, “but for now I want to be the outsider who is sticking my nose in with bold solutions to be shot down or adopted”.

It is the second big review he has undertaken since retiring from Goldman Sachs two years ago. The first was the City Growth Commission, set up to examine what UK cities needed to catch up with the economic clout of London.

O’Neill spent 18 years at Goldman, clubbable enough for the investment bank’s credit-crunch image problem never to rub off on him and with a plain-speaking style that made him very quotable. His best-known achievement was to coin the Bric acronym – Brazil, Russia, India, China – referring to the fast-growing economic powers.

When he left, he knew he wanted a change from the “very rarified but enjoyable world” he had inhabited, which had also made him very wealthy. He didn’t fancy setting up a hedge fund, and charity work has so far not fulfilled him. O’Neill was flooded with offers of non-executive directorships, including a number of banks. He ruffled feathers by responding: “Isn’t that the kind of thing you do when you can’t speak any more?”

With the Conservatives returned to power, the “Northern Powerhouse” idea should roll on, and George Osborne was keen to name O’Neill as his “brilliant new minister” to help oversee the project “right in the heart of government”. O’Neill’s commission called for money and political authority to be devolved to civic leaders and for regional rivals Manchester, Sheffield, Leeds and Liverpool to agglomerate themselves with better transport links and planning. Some regions were more cautious than Greater Manchester, likely to be the first to pick a “metro mayor” to lead it. That won’t last, he guesses. “My bet is that senior treasury officials are having their doors knocked down right now by some of these cities saying, hang on a minute, we didn’t really mean what we said.”

O’Neill doesn’t think London has to be reined in for the North to prosper. But he is unconvinced by the argument that the capital needs more autonomy. “From a national policy perspective, does London really need additional help? Maybe. But the case for doing something about other places is a lot bigger.”

He still dabbles in the markets, investing his own money. Last year, O’Neill advised people to sell the euro, which he did, but “I took my profit too soon”. Now, despite continuing eurozone turmoil, he can see an upside. “I think the story of the year is that the cyclical bounce in Europe is stronger than people thought and the periphery excluding Greece is showing more and more signs of improvement – Italy and Spain in particular.”

Like his antimicrobial resistance work, keeping an eye on the City keeps him occupied – for now. “As I sometimes joke to my mates, I’ve got to do something while I wait to get rid of the Glazers.”

The CV: Jim O’Neill

Education: Grew up in Gatley, Stockport. Attended Burnage Comprehensive, studied at Sheffield University (MA economics) and gained a PhD from Surrey University.

Career so far: Bank of America economist from 1982, joining Swiss Bank as a research head in 1988 and moving to Goldman Sachs in 1995. Made chief economist, then chairman of asset management arm in 2010, retiring in 2013. Chaired City Growth Commission, then Review on Antimicrobial Resistance.

Personal: Married to scientist wife with a twentysomething son and daughter. Lives in west London. Relaxes by following Manchester United and walking.