Antibiotics were discovered well over a century ago, and since then, they have made a significant contribution to the improvement of human life. According to the findings of recent research, they have even increased the average human life expectancy by more than 20 years. But if we don’t exercise extreme caution right now, mankind might take a step backward into a world where antibiotics are rendered ineffective, and the common illnesses that they were previously able to treat cause premature death.
The pandemic caused by the COVID-19 virus has rendered the threat far more severe. According to research recently published by the Centers for Disease Control and Prevention (CDC), the treatment resistance problem only worsened during the first year the pandemic was active.
Antibiotic resistance is a problem that arises when we use antibiotics inappropriately in the treatment of people, animals, or crops. When a new antibiotic is launched, it has the potential to have amazing benefits that can save lives — at least temporarily. However, the bacteria eventually adapted. The antibiotic loses some of its effectiveness over time, and as a result, we are left with diseases that are more difficult to cure.
Even before the discovery of Covid-19, medical professionals had been sounding the alarm that we are getting closer to a post-antibiotic era, which is a time when our antibiotics will become largely ineffective against a variety of health problems, including tuberculosis, sexually transmitted infections (STIs), and urinary tract infections (UTIs). They made the observation that common hospital treatments like cesarean sections and joint replacements could become more hazardous when the risk of infection, particularly illnesses acquired in hospitals, grows.
We’d seen some progress as a direct result of the fact that certain professionals, particularly those working in hospitals, had taken the warnings from the specialists to heart. Consider staph infections as an illustration in this regard. According to a report published by the CDC in 2019, the prevalence of methicillin-resistant Staphylococcus aureus (MRSA) infections has decreased. Since 2013, there has been an overall 18% decline in the number of deaths that can be attributed to medication resistance.
However, the Covid-19 outbreak has set back years of painstakingly achieved progress. From 2019 to 2020, there was a 15% increase in the number of drug-resistant hospital-related deaths and infections caused by seven different microorganisms. This included a 13% increase in the number of potentially lethal MRSA infections.
According to the CDC, one of the reasons for this is that hospitals overprescribed antibiotics to their patients. Antibiotic treatment was provided to roughly 80 percent of Covid-19 patients who required hospitalization between March and October 2020. Antibiotics may not work against viral illnesses like Covid-19; yet, doctors may have been eager to prescribe them to cure or guard against secondary infections. This is especially true when taking into account the fact that hospital admissions for Covid-19 can be lengthy and extensive.
Michael Craig, director of the Antibiotic Resistance Coordination and Strategy Unit at the CDC, stated in a statement that “this setback may and must be temporary.” “The best approach to avert a pandemic brought on by a pathogen that is resistant to antimicrobials is to identify gaps and engage in prevention to keep our country safe,”
It should come as no surprise that the very last thing we want is for the Covid-19 pandemic to pave the way for a new pandemic that is caused by some drug-resistant disease.
Drug resistance is a problem that can be solved. Why aren’t we working to solve the problem?
The encouraging news is that it is entirely within our power to solve the problem of medication resistance. The Centers for Disease Control and Prevention (CDC) has released a new report in which it recommends that more effort be put into strategies that have already been proven to be effective. These include taking measures to eliminate hospital-acquired infections from the start and educating medical professionals on when it is and is not appropriate to prescribe antibiotics.
However, there are more things that we could do, many of which would not cost very much. Most importantly, pharmaceutical corporations may do research and development on new antibiotics for us to employ if our current antibiotics become ineffective.
Kevin Outterson, a professor at Boston University who specializes in antibiotic resistance, told me that the entire cost for the United States to fix the failed medicines paradigm is between $1.5 and $2 billion per year. The amount is comparable to what we shell out for toilet paper once every few months.
Or, to put it another way, according to a report published by the United Nations in 2019, if every person living in high-income and middle-income countries contributed $2 per year to this cause, we could conduct research on new drugs and put into place effective measures to reduce the risk of drug resistance.
Regrettably, there is a little financial incentive for pharmaceutical corporations to develop new antibiotics. Since 1990, seventy-eight percent of the world’s largest pharmaceutical corporations have reduced their spending on antibiotic research or eliminated it. They are aware that it takes several years to do the research and development that is necessary to bring a new antibiotic to market. The majority of newly created chemicals are unsuccessful. And even if they are successful, the payout is not very large: A medicine that must be used regularly is more likely to be purchased than an antibiotic, which is considered to be a “drug of last resort” at least in theory. Therefore, there is no financial incentive for businesses to participate in the program.
Antibiotics should not be dealt with in the same manner as other products available on the open market, according to the consensus of several industry professionals, if we wish to find a solution to this problem. Instead, we ought to consider antibiotics as public goods just like infrastructure or national security, both of which are indispensable to the operation of a civilized society. In addition, the government ought to provide financial support for the company’s R&D efforts.
Outterson explained by saying, “This is a product where we want to sell as little as possible.” It would be perfect if there was a fantastic antibiotic that could be stored away for decades, ready to be used whenever it might be required. That is wonderful news for the general public’s health, but it is a nightmare scenario for a business.
According to the report published by the United Nations in 2019, this incongruity with the profit-making imperative of the pharmaceutical business is the reason why the government (and, ideally, also the private sector and civil society) needs to step in. This could include financial incentives in the form of grant funds and tax credits to assist research in its early stages. In addition, the report urged affluent nations to assist poorer nations in improving their health systems and advocated the development of a large new intergovernmental group to address the issue of drug resistance. This panel would be similar to the one that addresses climate change.
However, for governments to come together behind this issue, it may first be necessary for the public to press it as an urgent concern, and it is not evident that a sufficient number of Americans regard it as such.
Outterson shared with me his concern that the number of fatalities may need to reach an extremely high number before a critical mass of people begin to notice, care, and take action. He stated that “We will eventually react” to their question. The question that needs to be answered is how many people have to pass away before we begin that response.