Why the resistance to tackling antibiotic resistance?
By Will Goodbody, Science & Technology Correspondent
There are certain issues which people know are serious, but for whatever reason choose to bury their heads in the sand about.
Climate change is one obvious one.
Despite decades of warnings that our manmade carbon emissions are effectively overheating our planet, only in the last two or so years has the global community woken up to the reality of the danger and started to take action – possibly too late.
Antimicrobial drug resistance is another example.
Scientists and physicians have for very many years been shouting from the rooftops about the threat that resistance to antibiotics, antivirals, antimalarials and antifungals would pose.
Yet despite the warnings, collectively we’ve done little or nothing of meaning to address the issue and stop the rise of superbugs.
Ever since Fleming discovered penicillin in 1928, we’ve come to rely heavily on antibiotics and related treatments as a means of making us better when ill.
Together with vaccinations, they’ve contributed to the eradication of many illnesses all over the world.
Yet, by overuse, inappropriate prescribing, lack of investment and frankly downright stupidity, we’ve managed to completely surrender the edge we had over many life limiting or threatening bugs.
Plus, a combination of factors means there have been no new antibiotics discovered in over three decades.
SCALE OF THE PROBLEM
The World Health Organisation says antibiotic resistance is no longer a prediction for the future; it is happening right now, across the world, and is putting at risk the ability to treat common infections in the community and hospitals.
Without urgent, coordinated action, the world is heading towards a post-antibiotic era, it says, in which common infections and minor injuries that have been treatable for decades, can once again kill.
That reality came a giant leap closer last year with news that the antibiotic of last resort, the only one that bacteria were not already resistant to, had succumbed in patients and livestock in China.
And the potential fallout of that apocalyptic post antibiotic era is laid bare in the new UK government commissioned review published today.
It predicts that by 2050, 10 million people around the world will be needlessly dying every year because of the problem of drug resistant infections.
And in case you think 2050 is a long way off, the review points out that since 2014 when it began its work, one million people have died from antibiotic resistant infections.
It says the risk the problem poses is as big as terrorism, that tuberculosis, malaria and E.coli pose the biggest threats, and calls for a revolution in how we use antibiotics.
The cost isn’t just human, says the report’s author, Lord Jim O’Neill. It is also economic, with drug resistance set to cost the global economy up to $100 trillion between 2014 and 2050 he predicts.
That’s money which instead of being spent on dealing with a preventable health crisis, could have been used to prevent other unavoidable health crises.
In contrast, action now to mitigate the impending disaster, the review says, would cost $40 billion over ten years.
MEASURES AND ACTORS
Among the many measures it recommends are a massive global awareness campaign, a reduction in the unnecessary use of antibiotics in agriculture, a financial reward system for companies that discover new antibiotics and the establishment of a global innovation and research fund, worth $2bn.
Many measures mean many actors and we all have role to play.
Big pharma needs to realise that as the only entity realistically capable of bringing new antibiotics to market, it has a moral responsibility to do so.
Indeed, the O’Neill review suggests pharmaceutical companies must either “pay or play”.
The Irish Pharmaceutical Healthcare Association said the industry is already playing a role, that 34 antibiotics and infection preventing vaccines are currently in the global innovative pipeline and that taxing the industry would be “counter-productive” and “unjust”.
It also points out that developing antibiotics and vaccines is a risky and expensive business.
In other words it’s not very profitable. Nobody doubts this.
But perhaps shareholders in pharma companies might want to consider how much use their matured pension funds will be when they are lying in a hospital bed dying from an incurable infection.
Governments too must play a bigger role.
They have a moral responsibility to inform people through high impact mass education campaigns that they are sleep-walking their way into a catastrophe.
They also need to bring in tougher rules around prescribing and the use of antibiotics in agriculture, and food producers need to see the light and abide by them.
Public health authorities should promote vaccine take-up in the hope that it might reduce the need for infection killing drugs.
And there’s an urgent need to boost access to clean water, improve sanitation and cleaner hospitals in parts of the world where that’s not already on offer.
Doctors, of course, are as central to the solution as they are to the problem.
Despite all the warnings, too many doctors continue to unnecessarily hand out antibiotics “like sweets”, the review claims.
This could be because of ignorance, laziness, or an inability to send a patient home empty handed after coughing up for a consultation – but whatever the reason, it is no longer acceptable.
The dilemma faced by doctors could, of course, be alleviated if diagnostics were better.
Enter the scientists, who need to turn their intelligence and resources to the challenge.
Finally, we must step up to the mark too.
It is no longer ok for patients to go to their local doctor with a cough, cold or other obvious viral infection and expect to come away with an antibiotic.
Nor is it ok to start popping the left over antibiotics in the cupboard when your nose starts to run, or to stop taking a course of antibiotics when half way through a treatment, just because you are feeling better.
We also need to be more conscious of infection control and sanitation, and where possible we need to put pressure on all the other players to step up to the mark.
Because it is time for everyone – politicians, pharmaceutical companies, doctors, food producers and all of us – to stop paying lip service to this most grave of problems.
It’s time to stop resisting efforts to tackle antibiotic resistance.
Comments welcome via Twitter to @willgoodbody