AN INTERVIEW WITH BILL MUDGE, DIRECTOR OF "BEATING SUPERBUGS, CAN WE WIN?"

Winner: Best Health Film - March 2021 Edition

BIO

BILL MUDGE

DIRECTOR & CO-PRODUCER

Bill Mudge spent over 16 years at Merrill Lynch as a financial analyst and software developer while earning an MBA at the Stern School of Business at NYU. After consulting

in the business world, in 2010 Bill explored his passion for documentary filmmaking.

He attended San Francisco Film School with a special focus on studying documentary films. In the past decade, Bill has produced and directed short films that cover everything from paratroopers to cancer, and sailboats to superbugs. “BEATING SUPERBUGS: CAN WE WIN?” is his first feature film.

FILMOGRAPHY

. 2017 Class R-69

. 2016 Airborne Demonstration Team

. 2012 Seeing Red: A Woman's Quest For Truth, Power and The Sacred

. 2011 Still Here: Living With Incurable Cancer

. 2011 War In My Body

. 2009 Home Afloat: Living On a Sailboat

Hi Bill, thank you for having us, and for bringing this hot topic of « SuperBugs » to our awareness with your film! First question, can you explain how and why you made that pretty drastic professional choice to leave the business world for the world of film?

I always had a long-standing interest in the arts. I majored in Art History as an undergraduate and also studied Computer Science, and not just because job prospects were so much better. Both subjects fascinated me. Long before I went to film school, I had a variety of cameras, including video, that I used for casual projects. I did some interviews of friends, inspired by Studs Terkel’s famous book, “Working,” which is as much about how people feel about what they do as anything else. Reading the book and interviewing people also made me question my own professional work.

Not surprisingly, I found that while I had a major commitment in the corporate world I did not have enough time to pursue an outside interest like “hands-on” filmmaking in any real depth. It was only after the death of my father in 2009 that I realized I should not wait much longer. A year later, after my last corporate consulting assignment, I enrolled in the one year certificate program at San Francisco Film School.

One recurrent and striking statement in the documentary, is about « Superbugs », or antibiotic resistant bacteria, as lethal accomplices to viruses. In fact, the film opens on that crucial information that bacteria infections are « linked with as many as half of Covid

deaths! »

Have you been able to stay in touch with the scientists you worked with, and updated on ongoing research in this area? What more can you share with your audiences on this topic?

We remain in touch with many of our interviewees who share their latest developments.

Dr. Fred Tenover, VP at Cepheid, has reminded us of the importance of rapid and accurate diagnosis to guide appropriate treatment for both viral and bacterial infections. Also, one of our expert panelists, Helen Boucher at Tufts University, said the threat of superbugs is growing during the COVID pandemic because patients are at risk of getting a secondary infection at the hospital that sometimes can’t be treated, which puts them at a greater risk of dying.

In the 1980s, Anthony Fauci’s research revealed that during the 1918-19 flu pandemic, opportunistic infections were often the actual cause of death. No one had discovered antibiotics yet and phage research was very new and mostly unknown. And in the future, superbugs stand to conspire with new viruses as they emerge, making our ability to contain them all the more urgent.

Our purpose is at least two-fold. We want to remind people of the superbug danger and its amazing diversity and reach: no one can escape it. Beyond that realization, we want to show that real solutions exist, from basic prevention to the most sophisticated genetic manipulation. What’s emerging now is a global effort to coordinate and pay for all these ways to contain superbugs. There’s no single person or even country that can achieve and share these strategies on their own: it’s a global threat that demands a global response.

Some of the contributors bring up the crucial role of institutions and big pharmaceutical groups, in how choices are made to prioritize this or that research — a very hot topic at the moment. What role and what power do you believe the public can have in demanding that global health come before financial profit?

Both profit and global health will need to coexist. Love or hate Big Pharma, these capitalistic organizations have some of the world’s best people, processes and high-quality mass production to test and manufacture new antibiotics. Unless we can find viable, first-rate replacements, we must create incentives for drug companies to participate in creating antibiotic solutions. These include universities, startup companies, and governments.

No single entity, or kind of organization, is likely to succeed on its own. The public needs to understand the essence of these relationships so they can vote for politicians who support the key science that underlies a wide range of solutions and their deployment and also backs up novel ways to finance them. In this way, the essential assets that Pharma brings to solving the superbug crisis may be appreciated and augmented rather than just criticized.

As viewers and « profanes », we have understood that bacteria have adapted to resist the excessive consumption of wide-scope antibiotics. Can you see a parallel with our current situation of the sudden apparition of wide-scope vaccines and the fast development of uncontrollable, seemingly vaccine resistant variants of the virus?

Have you had conversations with the scientists you worked with on these topics since you completed your film?

Experts tell us that drug resistance evolves faster than vaccine resistance, in part because drugs treat illnesses whereas vaccines prevent them. Prevention can limit replication and reduce the opportunities for mutations and for spread to new hosts.

Additionally, drugs (antibiotics) attack far fewer target sites than do vaccines. This means that drug resistance is more likely to arise in the first place from bacterial infections and then spread more rapidly once it has arisen.

By contrast, vaccines prevent infection and transmission and induce immunity (protective antibodies) against many pathogen target sites, making it harder for vaccine resistance to evolve.

To the best of my knowledge, most human vaccines have continued to provide protection since their introduction many decades ago. For example, smallpox was eradicated because no virus strains capable of transmitting between vaccinated individuals ever emerged. Also, to date, there is no evidence to suggest the SARS-CoV-2 or any other stains of the COVID-19 virus are resistant to our current vaccines.

However, resistance to vaccines or declines in vaccine efficacy in both animals and humans occur. For example, in Marek's disease, a commercially important disease of chickens caused by Marek's disease virus (Gallid herpesvirus II). In people, Streptococcus pneumoniae bacteria have evidence of evolution in response to a vaccine. The human hepatitis B virus (HBV) has shown similar adaptations.

At the same time, because vaccine resistance is so rare, vaccines are now considered a leading solution in the fight against superbugs e.g., antibiotic resistant bacteria.

To get back to documentary filmmaking, what did you learn through your experience in making your first full-feature film? Any tips you would like to share with up and coming filmmakers?

I have several observations to share:

- Choose a subject that really matters. Making a decent film takes far too much time, energy and money to settle for anything less.

- Your storytelling and dramatic structure may change significantly as you learn more about your topic, especially a “moving target” like ours.

- Resist the temptation to go into too much detail and focus on compelling characters, their challenges, and a few key concepts and statistics to give some credibility to their situation. You will likely end up discarding a lot of material that you originally thought was good.

- Use some key examples, as we have, but make sure you don’t lose track of the strategy behind your specific messaging. Your film will have a longer shelf-life that way. In our case, we’ve covered some representative examples of key discoveries, knowing that a continuous pipeline of new solutions is essential to contain antibiotic resistance. More broadly, effective solutions will also rely on public awareness and coordinating a range of organizations to make those breakthroughs widely available. Those trends continue even as science advances.

- During this editing process you’ll run into creative conflicts where compromise is vital to move forward.

- Don’t give up when a whole series of foundations turn down your grant proposals; keep going even if you need to take substantial work in house that you had hoped to outsource.

- Regardless, it will take much longer than you think before your film is ready for distribution.

- Always remember the PBS Nova mantra: you’re “telling the human story behind the science” in a film like “Beating Superbugs: Can We Win?”

Do you think that at some point, you might write a «fiction», a different type of story, be it inspired by a true story? Or do you believe you’ll stick to documentary film and if so, why?

That all depends on what kinds of opportunities present themselves and how practical pursuit of them becomes. It’s likely that we will stay with a documentary style since that’s where we’ve found our greatest success so far.

Post-covid cinema statement: do you think there will be notable changes?

. More streaming than ever, at the expense of movie theaters

. Streaming, while obviously convenient, will decrease the proportion of viewers who actually finish watching a given film. There’s little to lose from switching from one film to another compared to getting up and leaving a theater.

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