Escaping Our Post-Antibiotics Future

May 28, 2020

By: Badra Abbas

There are many miracles modern medicine has afforded us, the ability to undergo organ transplantation, recovering from infected cuts and scrapes, and surviving some of the deadliest infectious diseases on the planet. A primary component of this remarkable success is antibiotics, medicines that hinder or kill bacteria (Society, (n.d.)).
Since the advent of antibiotics, human life expectancy jumped up, and many of the worst diseases faded from memory. Ironically it was the positive reputation antibiotics gained that led to their overprescription. The consequences appeared a mere 4 years after the discovery of penicillin, the first antibiotic. Certain bacteria began surviving and continued to infect humans. In time the golden age of antibiotic development ended, and a public health crisis ensued. The killers of the past such as the Black Death, typhus, pneumonia, tuberculosis are returning. Human misuse of antibiotics in healthcare, agriculture, and the worldwide contamination of rivers is aggravating this situation. Animals are treated with more antibiotics than humans, a costly action that was banned in the EU in 2006 but is still an international practice. A worldwide examination of hundreds of rivers revealed heavy contamination from antibiotics, so the question of why the bacteria evolved against these medicines is easily answered. 
As for the cost? The death toll would be in the millions since anybody can get infected with a disease. The loss of human life from bacteria exists worldwide, in the deaths of almost 5.7 million people (“Lack of access to antibiotics is a major global health challenge”, 2019), and the resistance crisis will only be adding to these deaths. Those with compromised immune systems face the greatest risk. For example, a cancer patient undergoing chemotherapy, or an individual with a severe case of COVID-19. Patients with severe cases can contract secondary bacterial infections, such as pneumonia (Gerberding, 2020). For these vulnerable members of our communities, their quality of life or chance at surviving an illness is entirely dependent on having antibiotics available.

The solutions to this complex and daunting issue are manifold and require global collaborations, massive investments, and private sector cooperation. Some moves have already begun, such as the work of the global nonprofit partnership, CARB-X, which is accelerating global innovation in antibiotics with an investment of around 220.8 million. Revitalizing the pharmaceutical industry to encourage the production of antibiotics also needs to be addressed. R&D for any new drug requires the commitment of billions of dollars, and possibly decades of time, but especially in the case of antibiotics, returns on investments are low. These aren’t drugs like heart medications that a consumer must take every day, these are stored for emergencies (Outterson, 2018). Funding small startups and aiding them in their research makes more possibilities for a larger company to buy their patents and invest in promising drugs. Changes in drug development, such as patent extensions and upfront payments are proposed solutions, but they require government involvement (Mckenna, 2015). A solution that takes a different route is clamping down on the usage of antibiotics globally, enforcing stringent measures to monitor usage across industries and in healthcare (Zhang, 2015). This is already a reality in many hospitals globally in the form of stewardship for antibiotics to help determine where these drugs can be used. 

In a more futuristic sense, new technologies such as nanotechnology (“Antibiotic nanoparticles fight drug-resistant bacteria”, 2017), virus phage therapies (Schmidt, (n.d.)), and bacterial vaccines (Sweeney, 2019) are being produced. Repurposing old drugs, and combining them with new ones is an alternative track being taken by researchers (Torres, 2019). These promising treatments and experiments are all heading in the right direction creating a promising future with continued advancements in medical care and a lower death toll. 

At the end of the day, the governments of the world along with citizens, need to decide what the cost of living a healthy life means to them. This issue may involve a lot of biology and chemistry, but it’s ultimate impact is heaviest on people. According to a report by the European Consumer Organization in 2017, antibiotic resistance is on its way to causing more deaths than cancer by 2050, and a routine infection could be deadly in about 20 years. If a terrifying future without antibiotics is going to be avoided, continued efforts must be doubled, because the lives of over 10 million predicted victims are at risk by 2050 (Hu, 2018). 


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