*As director general of the British Specialist Nutrition Association (BSNA), Declan O’Brien had a unique overview of one of the fastest-growing areas within medical therapy – intravenous foods and medicines for the treatment of complex diseases such as cancer.
O’Brien was at the helm of the organisation, which represents the UK’s producers of infant formula, baby foods, parenteral medicines and nutrition, for 11 years up to last month. Taking on this role was a return to his roots for O’Brien, who grew up on a dairy, beef and sheep farm in Co Meath, studied agriculture and crop husbandry at UCD, and always had an interest in nutrition and the science behind food production.
By the age of 25, O’Brien was a recognised expert on oilseed rape and worked as an agricultural adviser before joining the Irish arm of the German agrochemical giant, BASF.
It was a move that was to prove formative. It exposed him to a well-run company with a cutting-edge approach to management that shaped his own leadership style, stimulated his interest in international affairs and introduced him to regulation and the intricacies of licensing of new products.
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O’Brien’s first experience of trade associations came in the late 1980s when he became director of the Irish Animal & Plant Health Association, where he stayed for 16 years. “I really enjoyed the interface between science, policy and politics while also working with European trade associations, which opened up opportunities to engage with policy and regulatory developments at a European level,” says O’Brien. Thorny issues that came across the desk during his tenure included genetically modified organisms (GMOs), pesticide residues and the safety of antibiotics.
O’Brien had experienced his first taste of living abroad as a student, when he spent three months in France herding cattle and sampling Gallic gastronomic delights such as snails and frogs’ legs. In 2005, the opportunity arose to move country full time when he was appointed managing director of the International Federation for Animal Health Europe. The federation is based in Brussels and during their time in Belgium, the O’Brien family lived in Waterloo, just south of Brussels, where Wellington defeated Napoleon in the famous battle of 1815.
“This was a super challenge, as the role included being the interface between the industry and the European Medicines Agency,” O’Brien says. “This involved negotiations around European legislation and negotiating the safety, quality and efficacy data required to obtain a licence for new veterinary medicines.
“It was a long way from milking cows or walking the crops, but nonetheless a key part of providing high-quality food.”
The O’Briens spent 10 years in Brussels before the job with the BSNA came up in London, and the family moved to Wye in Kent. “I was fascinated to enter the world of tube feeding, intravenous nutrition and medicines,” says O’Brien, who sits on the board of both the European and global specialist nutrition associations.
Part of O’Brien’s work involved liaising with Britain’s health service, the NHS, to ensure that future needs for nutritional and medical therapies can be met.
“Production versus demand has to be continuously monitored, as these products are critical to life; you can’t run out,” he says. “Between them, our members look after over 47,000 people using medical foods at home as well as patients in hospitals. Recent advances in administration technology also makes it more feasible to move a lot of chemotherapy treatments into the home, which is obviously much better for patients, but brings a different set of challenges.
“The demand for intravenous medicines, such as chemotherapy, is rising by about 5 per cent per year due to the ageing UK population, and it’s not just a question of producing more product to deal with the growing demand,” O’Brien adds. “For example, if a patient is living at home and using a pump, multiple elements have to be put in place to support them, such as nursing care and technical backup.”
In his professional life, O’Brien had to deal with several big crises including the first outbreak of avian flu, when some experts predicted that the virus would be zoonotic or able to jump the animal-to-human barrier.
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“It was pretty much panic conditions initially, with talk about commandeering veterinary medicine vaccine-production facilities to produce vaccines for humans. Clearly this wasn’t a good idea, as the vaccines were needed for the chickens to curtail the outbreak in the first place, but not everyone got that,” O’Brien says.
“Bluetongue was also a big worry when it broke out for the first time in the Netherlands. The industry produced a vaccine pretty quickly. The really hard work was convincing the sector to order and use it fast. Millions of vaccines were produced, and the outbreak was pretty much controlled.”
In terms of human health, O’Brien says Covid posed a big challenge for the association’s members, as there was a huge demand for high-protein tube feeds for people on ventilators, as well as for the specialist pumps required to administer them.
A typical day at the office could see O’Brien dealing with competition, market or supply chain issues, and liaising closely with the NHS and other healthcare providers to make the timely delivery of intravenous food and medicines run smoothly.
“Sometimes people compare us to the pharmaceutical industry, but the pharmaceutical industry is dealing with patients on maybe one five milligram tablet per day,” he says. “With medical foods, you’re looking at litres of product per patient per day, and this makes supply and procurement a complicated process.”
*Declan O’Brien retired from his role as director general of the British Specialist Nutrition Association last month
