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Saturday 18 November 2017
Editorial

Antibiotic apocalypse

IT IS THE most silent of killers. It has no face. And it truly does not discriminate. It might be hard to fathom, but the greatest threat to mankind’s future existence is not necessarily nuclear annihilation. It is the dire problem of antibiotic resistance. Health experts across the planet this month raised the alarm. Sally Davies, England’s Chief Medical Officer, put it starkly: “The world is facing an antibiotic apocalypse.”

At least 700,000 people a year die from drug-resistant infections. This number is predicted to rise to 10 million a year by 2050. But in many cases, when a person dies due to a drug-resistant infection, their families just think they have succumbed to an uncontrolled side-effect of treatment. This lack of awareness is part of the problem. And the problem is getting worse.

Scientists report that bacteria containing the mcr-1 gene — which stimulates resistance to colistin, the antibiotic of last resort — has spread at an alarming rate around the world. In China, it was found that 25 per cent of hospital patients on one region carried the gene. Additionally, findings recently published by the American Society for Microbiology — the oldest and largest single life science membership organisation in the world — suggests drug-resistant contamination of grocery-store meat products is on the rise in the US as well as drug-resistant contamination among vegetables for sale in China. Globalisation means bacteria travel between countries, especially through food products.

At an important conference held in Berlin last week, national governments and multilateral institutions were warned they must come together with civil society to focus on critical gaps in tackling the development and spread of drug-resistant infection, and to commit to concerted and tangible actions. If no action is taken, the consequences will be dire.

A world without effective antibiotics will mean modern medicine will cease to exist. We will revert to life before Alexander Fleming discovered penicillin in 1928.

Routine surgery, joint replacements, caesarean sections, and chemotherapy, which depend on antibiotics, will be at risk. A simple procedure like the removal of an appendix will now pose a threat to life. Common infections could kill again. The effectiveness of antibiotics has always rested on a knife’s edge given bacteria’s remarkable ability to mimic and adapt at a fast rate. Yet, it is also the case that the world has not done enough to tackle the problem.

There has been the problem of antibiotic abuse and overuse, with a culture in which patients demand doctors prescribe a pill to solve their problems. Additionally, recent findings in the UK raised questions over the appropriateness of the standard advice that patients should complete their course of medicine even after the fading of symptoms. Some have also linked the use of antibiotics in meat products as well as poor disposal practices by drug companies to the problem. Meanwhile, drug companies have not been working fast enough.

In September, the World Health Organisation warned that antibiotics are “running out”— the world is simply not keeping pace with microorganisms. We in Trinidad and Tobago may not be able to develop new drugs.

However, we should build on our awareness of the problem. Already at local hospitals, it is now standard procedure for patients to be warned of the risk of infection for even the simplest of surgeries. Doctors’ prescriptions are also being more effectively tracked. And complaints have been addressed about the need for more sanitisation equipment at regional health authorities. But the private and public sectors must be encouraged to develop better systems to reduce the chances of contagion.

And patients have a right to know what is happening if they are to begin to develop better habits within their homes.

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