Sunday, March 24, 2019

A looming health crisis

Antimicrobial resistance (AMR) – the process of bacteria (and yeasts and viruses) evolving defence mechanisms against the drugs we use to treat them – is progressing so quickly that the UN has called it a “global health emergency”. 

At least 2 million Americans contract drug-resistant infections every year. In India and Pakistan, Bangladesh, China, and countries in South America, the resistance problem is already endemic. Sepsis currently kills more people in the UK than lung cancer, and the number is growing, as more of us develop infections immune to antibiotics.

In May 2016, the UK government’s Review on Antimicrobial Resistance forecast that by 2050 antibiotic-resistant infections could kill 10 million people per year – more than all cancers combined.

“We have a good chance of getting to a point where for a lot of people there are no effective antibiotics,” Daniel Berman, leader of the Global Health team at Nesta foundation, explained. : “Those of us who are following this closely are actually quite scared.”

One in three of us is prescribed a course of antibiotics each year – a fifth of those needlessly, according to Public Health England. As explained by Cassandra Kelly-Cirino, director of emerging threats at the Geneva-based Foundation for Innovative New Diagnostics. “Most doctors will err on the side of caution and give antibiotics, even though the patient might actually have a virus.”

For decades, many farmers have routinely injected livestock with antibiotics, as much to help fatten them up as to prevent infection (this practice is now banned in the EU, US and Canada.)

 “Our generation is besotted by the powers of antibiotics,” says Jim O’Neill, the economist behind the government’s review. “The problem is we use them for things that we shouldn’t need to.”

Antibiotic compounds are common in nature, but ones that can kill bacteria without harming humans aren’t. Soon, big pharma companies began cutting funding to their antibiotic research departments before shutting them down altogether.

“The reality is that we do not have sufficient investment by the private sector to support new research and development,” says Tim Jinks, head of the Drug Resistant Infections programme at the Wellcome Trust.  A new antibiotic might only have an effective lifespan of 10-15 years – barely enough to pay off years in development. “The numbers just don’t add up,” he says.

The problem is simple economics: ideally, antibiotics would be cheap, but also used as little as possible. That’s not a great business proposition.

“I occasionally think that pharmaceutical company CEOs say to themselves, ‘We’ll just wait until it becomes a real crisis,’” says O’Neill.

No comments: