Friday, January 25, 2013

Profits not peoples' needs

Chief medical officer Dame Sally Davies tells MPs of an "apocalyptic scenario" where people going for simple operations in 20 years' time die of routine infections "because we have run out of antibiotics". She also told the Guardian: "There are few public health issues of potentially greater importance for society than antibiotic resistance." More people died of infections than cancer in 2010.

The issue of drug resistance arises when drugs knock out susceptible infections, leaving hardier, resilient strains behind. The survivors then multiply, and over time can become unstoppable with frontline medicines. Some of the best known are so-called hospital superbugs such as MRSA that are at the root of outbreaks among patients Antibiotics are one of the few drugs that actually cure people rather than just holding symptoms at bay.

"In the past, most people haven't worried because we've always had new antibiotics to turn to," said Alan Johnson, consultant clinical scientist at the Health Protection Agency. "What has changed is that the development pipeline is running dry. We don't have new antibiotics that we can rely on in the immediate future or in the longer term."

The supply of new antibiotics has dried up for several reasons, but a major one is that drugs companies see greater profits in medicines that treat chronic conditions, such as heart disease, which patients must take for years or even decades. No truly novel types of antibiotic have come onto the market for 40 years. It is difficult and expensive to develop such medicines and because they are taken for short courses, unlike cardiovascular or cancer drugs, they do not generally generate a high income for a pharmaceutical company. "There is a broken market model for making new antibiotics," Davies told the MPs.

Another cause of increased resistance is the routine administration to farm animals to reduce the spread of infection in over-crowded farm-factory conditions. You can keep livestock alive in dreadful conditions if you throw antibiotics at them.  80% of antibiotics sold in the United States are used in animals. Half of all antibiotics manufactured are used for animals as "growth promoters". The Advisory Committee on the Microbiological Safety of Food told the UK government in 1999 that "giving antibiotics to animals results in the emergence of some resistant bacteria which infects humans".

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