Although hardly a flashy headline, a new public health crisis is on its way. Slowly but surely, we are rendering our own medications useless, creating superbugs which are resistant to our antibiotics.
According to Vox, “Without antimicrobials that work, common medical procedures like hip operations, C-sections, or chemotherapy will become more dangerous, and some medical interventions — organ transplants, chemotherapy — would be impossible to survive.”
And nobody would be spared from the effects of this crisis. This is because drug resistance could cause health care expenditures to skyrocket, prompting economic damage on par with the 2008-2009 financial crisis. Furthermore, these drug-resistant diseases could also affect our food supply as many of our modern agricultural practices depend on these drugs.
How did we get here?
Antibiotics function by killing or neutralizing bacteria, however, as doctors and farmers have begun using these drugs more and more, bacteria have adapted and evolved resistance to these antibiotics.
“Many people will go to a doctor and demand an antibiotic when they have a cold or a flu, for which these antibacterial compounds are useless,” said an article in the Scientific American. “In many countries it is possible to buy antibiotics over the counter. Often, if people are poor, they will not take the full dose — all of that leads to resistance.”
In low and middle-income countries, like India, the lack of clean water can drive people to take antibiotics prophylactically, causing yet more resistance. The lack of sanitation systems afflicts more than 2 billion of the world’s population, but the antibiotic resistance it can create can spread and affect all countries.
Although “medically important” drugs have not been allowed for growth promotion of livestock in the United States since 2017, these policies against indiscriminate and excessive usage of antibiotics are not widespread in the international community.
In fact, according to the World Health Organization, some countries use approximately 80% of their total consumption of medically important antibiotics in healthy animals to promote growth promotion.
It is easy to feel helpless in the face of such a widespread issue, but cannot afford to sit back and despair while this crisis progresses.
So what can we do?
The World Health Organization has laid out some recommendations for what you can do on a personal level. You shouldn’t use antibiotics unless prescribed, nor share them with others.
Furthermore, practices which prevent the spread of disease, from washing your hands to safely preparing food to getting vaccinated, could also serve to combat overuse of antibiotics as it decreases the incidence of bacterial diseases which antibiotics might be needed for.
But more importantly (and more daunting), we need to push governments to mobilize around this issue.
Part of the reason very little has been done so far is simply because pharmaceutical companies have no motive to do so. It would take a lot of research and development for them to develop new antibiotics, and since antibiotics still aren’t in as high demand as drugs which need to be taken frequently, they don’t turn as much of a profit as other drugs.
As a result, these companies have no real incentive to create new antibiotics, even amidst a crisis where they are growing more ineffective.
“There is not the appetite [among pharmaceutical companies] to develop new medicines,” Dame Sally Davies said in an interview with The Guardian. “There is a systemic failure. We need something similar to the IPCC.”
Indeed, the United Nations report recommended that governments step in, treating access to effective antibiotics as a public good akin to infrastructure or national security. This could involve grant funding and tax credits to support early-stage research as well as sponsoring their own government research and development.
It could also include limiting the amount of antibiotics which can be used in food-producing animals internationally, a practice that The Lancet Planetary Health found reduced antibiotic-resistant bacteria in these animals by up to 39%.
In addition, the UN recommends wealthy countries need to help poorer nations improve their health systems in order to reduce their use of antibiotics as well as the creation of a major new intergovernmental panel similar to the one for climate change.
But there is good news. If each person in high and middle-income countries invested $2 a year in this cause, we could research new drugs and implement effective measures to reduce the threat of resistance.
Solutions are not out of reach, but me must act swiftly if we are to maintain the same expectations of modern medicine we have in the past.