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Abu Dhabi, UAEMonday 25 June 2018

We are on the verge of a post-antibiotic era

A world without antibiotics will be a world in which common infections will kill and routine surgeries will carry the risk of death

Pharmaceutical innovation has plummeted just at the time when it’s most needed. Only two new classes of antibiotics have appeared in the last three decades. Getty Images / Cultura RF
Pharmaceutical innovation has plummeted just at the time when it’s most needed. Only two new classes of antibiotics have appeared in the last three decades. Getty Images / Cultura RF

Three years ago, the World Health Organisation issued an urgent warning: “the world is headed for a post-antibiotic era, in which common infections and minor injuries, which have been treatable for decades, can once again kill”. On September 20, the WHO published a new report that showed that the world is now running out of antibiotics. We are on the verge of a post-antibiotic era.

Antibiotics are developed from molecules produced by bacteria and fungi that are toxic to other bacteria. Ever since the Scottish bacteriologist Alexander Fleming accidentally discovered penicillin in a mould that destroyed bacteria growing in a culture plate in his lab in 1928, millions of lives have been saved by antibiotics. But antibiotic therapy has always been vulnerable to resistance. A few bacteria that are genetically resistant to antibiotics survive in human bodies even after treatment has wiped out virtually all the disease-causing bacteria. The survivors then transfer their biological invulnerability to their own species and to others, spawning a bacteria capable of resisting, at its most tenacious, the whole gamut of antibiotic drugs in human hands.

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The multiplication of multiple-drug resistant bacteria is the product of overuse of antibiotics: the threat of extinction activates genetic countermeasures in the bacteria. Overexposure to drugs is turning our bodies into factories of drug-resistant killers. Consider a disturbing case study released by the US Centres for Disease Control and Prevention earlier this year of an elderly woman who checked into a hospital in Nevada with a bacterial infection. The bug she was carrying was resistant to 26 different antibiotics, virtually everything in the arsenal of the medical team treating her, and she died a few weeks later of septic shock. In India, the world’s second most populous nation, the over-prescription of antibiotics, coupled with poor sanitation, has caused a proliferation of multiple-drug resistant microorganisms.

Pharmaceutical innovation has plummeted just at the time when it’s most needed. Only two new classes of antibiotics have appeared in the past three decades. This is because drug companies do not want to invest in the production of medicines that will have commercial utility only after others in their class have become fully obsolete. Non-profit organisations are attempting to plug the void created by the gradual exit of Big Pharma.

The charitable health foundation Wellcome has been joined by the governments of Germany, Luxembourg, the Netherlands, South Africa, Switzerland and Britain in a pledge to contribute €56 million (Dh246.4 million) to the WHO’s efforts to develop new antibiotics. To say that this sum is not commensurate to the threat the world faces would be an understatement. A world without antibiotics will be a world in which tuberculosis will re-emerge as a mass killer, routine surgeries will carry the risk of potential death and urinary tract infections will become hard to treat. There are many causes that demand the world’s attention. But the pace at which we are entering a post-antibiotic era calls for urgent coordinated global action.

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