Among the multitude of health crises that face our world today, one that is not more widely regarded as an urgent threat is the rise of antimicrobial resistance.
Since Alexander Fleming’s 1928 discovery of penicillin, a naturally occurring substance with inherent antibacterial properties, the use of antimicrobial agents in the healthcare industry has grown exponentially. Bacterial diseases that were considered fatal a century ago are no longer in the public mind because of their widespread eradication through the use of antibiotics. Gone are the days when a simple case of strep throat could kill you.
Although antibiotic resistance is a natural evolutionary process in which bacteria select for traits that help them survive within hostile environments, this resistance can have devastating consequences on human health. According to the book, Guns, Germs, and Steel, World War II was the first major war in which the majority of casualties did not come from microbes, but instead from actual battle wounds. According to React, World War II occurred after the discovery of penicillin and during “the golden era of antibiotics.” Harvard estimates that antibiotics save up to 200,000 lives annually in the United States alone, and their widespread use has increased life expectancy by 5-10 years. Nature also states that deaths caused by infectious disease have fallen 70% since the advent of antibiotics. Given this information, it is clear that antibiotics have been one of the most important medical developments of all time.
However, in the face of growing antibiotic misuse and the discovery void, antibiotics are rapidly becoming useless as bacteria evolve and mutate in ways that confer immunity against antimicrobial agents. Bacteria have an extremely short life span and they reproduce quickly. They also have sophisticated, efficient ways of exchanging DNA material. Both of these characteristics ensure that when a trait for antibiotic resistance arises in bacteria, it spreads throughout a population, since it benefits bacteria to be resistant against a deadly agent.
Antibiotic misuse includes overprescription by medical professionals and the failure on the part of individuals in finishing their course of antibiotics when prescribed. Other sources include the spread of antibiotic-resistant bacteria through water and sanitation systems in areas with poor water quality. All of these issues have allowed for the rise of new bacteria, called “superbugs,” which are highly resistant to antimicrobial agents. Some of these bacteria, including MRSA and antibiotic-resistant tuberculosis, have had devastating effects on humans. In 2017 alone, the Centers for Disease Control and Prevention (CDC) estimated that 20,000 deaths occurred in the United States as a result of bloodstream infections with MRSA. Thus, it is of essence that this problem is stopped immediately.
Another issue contributing to the widespread problem of antibiotic resistance is the “discovery void.” There have been very few new antibiotics developed since 1967, and without the circulation of new classes of drugs, bacteria have grown resistant to the treatments already present in the medical field, building up immunity and creating the aforementioned “superbugs.”
However, this pause in novel drug manufacturing is not a result of a lack of innovation or an absence of knowledge on the part of the scientific community. It is instead a result of the decreased profitability of developing and manufacturing antibiotics. On the scale of medical innovations, antibiotics are not especially profitable in the present day, and this has caused pharmaceutical companies to withdraw from the endeavor. In a 2017 study, it was found that the average cost of developing a new antibiotic is $1.5 billion U.S. dollars, but the average yearly revenue is only around $46 million dollars. Other drugs, especially those which treat chronic conditions, guarantee repeated customers, which is a much more sound business model for pharmaceutical companies.
This paints a dire picture for the future. According to Nature, drug-resistant diseases currently cause around 700,000 deaths a year, and some models show that by 2050, it is expected that 10 million people a year will die as a result of antibiotic-resistant infections. These statistics are staggering, and it can be prevented if pharmaceutical companies were to use their time and resources to develop new drugs. If they are not self-motivated, pharmaceutical companies must be incentivized in some way to produce new antibiotics, most likely through government motivation and funding. Their present failure to do so is ethically wrong, and will prove to cost millions of lives if left unchecked.
However, another part of the issue is the lack of clear information available to inform people about the risks of antibiotic resistance. The public attitude towards antibiotics is entirely too relaxed. In addition, a study found that antibiotics are prescribed for a wide range of ailments that are not bacterial in nature such as the flu and the common cold. Using antibiotics when they are not needed is one of the biggest contributors to growing resistance, which must be stopped. Public health departments and organizations must prioritize better public education about the topic to push this agenda. Similarly, the easiest way to address the risks of discontinuing antibiotics is by spreading information about its risks through local public health departments. If people begin to treat antibiotics like the treasure that they are, it will help combat the spread of antibiotic resistance. This will then allow medical professionals to continue their use in treatment.
Pharmaceutical companies and public health organizations around the world must be called to action on the subject of antibiotic resistance. If new antibiotics are not developed and their misuse is not stopped immediately, then the world faces a dismal future in terms of available medical treatments. Bacteria are evolutionarily equipped to fight anything that attempts to kill them, but they do not have the capacity for rational thought. Only humans coming together will overcome any future negative effects of antibiotic resistance, and action must be taken immediately.