Imagine a world without antibiotics. A world where common surgeries like hip replacements and caesarean sections are too dangerous to even contemplate and where even minor infections can lead to death. Did your thoughts drift back in time, to the bleak days before the invention of penicillin in 1928?
Now, imagine this nightmare scenario is not in our past, but our future.
Two years ago the World Health Organisation (WHO) warned that antibiotic resistant superbugs posed a “major global threat”. Analysing data from 114 countries, their report found that antibiotic resistance was present in every single country, and that at least two antibiotics were no longer effective in half of the people they were administered to. These included carbapenum, a so-called “last resort” drug.
Unless “significant” action was urgently taken, warned the WHO, the consequences would be “devastating.”
Sadly, that action has not being taken and antibiotic resistance is still on the rise. Last month, scientists discovered the first US case of a strain of bacteria with genes conferring resistance to colistin, another drug of last resort. The mcr-1 gene, as it is known, has also been found in Europe and Canada.
What does this mean?
Across the world bacteria are mutating to become less vulnerable to all of our known antibiotic medications. The more that bacteria are exposed to the drugs, the greater resistance they develop to them and the less effective the drugs become.
Currently, two million people are infected with antibiotic resistant bacteria each year in the US, with 23,000 of them dying as a result.
While this happens naturally, our own habits have been greatly accelerating the process. These include the gross overuse of antibiotics in the medical profession and in intensive animal agriculture.
This is a serious crisis. And yet it is one that is not being taken nearly seriously enough.
Despite the warnings, doctors are still prescribing patients antibiotics they don’t need, often overriding their own better judgement to meet the demands of patients. According to the US Centers for Disease Control and Prevention, up to half of all antibiotics are prescribed inappropriately. Currently, two million people are infected with antibiotic resistant bacteria each year in the US, with 23,000 of them dying as a result. This is only going to get much worse if things don't change." Patients are also at fault when they don’t finish the full course of prescribed medicines.
Even more egregious is the overuse of antibiotics in animal agriculture. Farmed animals kept in densely populated and unsanitary “factory farms” are fed antibiotics both to keep them just healthy enough to survive to slaughter, and to accelerate their growth so that they yield more weight per unit of feed.
Seventy per cent of all antibiotic used in the United States, and more than 50 per cent in Australia, are given to livestock.
Unfortunately, as the Union of Concerned Scientists warns, not only does this expose bacteria to large doses of antibiotics, thus improving their resistance, but “they provide resistant bacteria with a direct route into people's kitchens.”
To make matters infinitely worse, there is a severe lack of research into developing new antibiotics because there is simply no money in it.
Why are we not more concerned about this? We are not talking about a vague and distant problem; the WHO says the effects will happen in the near future if we continue on our current course.
Let that information sink in. We are hurling into a disastrous post-antibiotic future where people die of diseases that have been easily treatable for decades because it won’t make anyone rich to come up with a vital new antibiotic drug. So much for necessity being the mother of invention.
I don’t get it. Why are we not more concerned about this? We are not talking about a vague and distant problem; the WHO says the effects will happen in the near future if we continue on our current course.
Surely this is symptomatic of one of humanity’s biggest failings - the bizarre tendency to forget what it is that has led us to a particular point in time and assume things are just meant to be this way. The post-antibiotic threat is imminent and yet, as we so often do, we continue living in a state of instant gratification.
Because antibiotics are so ubiquitous, because we have grown up with them, because they work, we take it for granted they will always be there even though the world’s peak medical body has been sounding the death knell for years.
We need to start thinking ahead, to put the future of the planet ahead of our own immediate interests. This requires action on multiple fronts.
Personal action. If you must take antibiotics take the full course. Resist asking your doctor for antibiotics to treat colds, and don’t pressure your doctor to give you medication they don’t think you need.
Medical action. Doctors must be more sparing when prescribing antibiotics. John Gums, Associate Dean for Clinical Affairs and Professor of Pharmacy and Medicine, University of Florida recommends “hospital staff and individual providers…think carefully about when to prescribe antibiotics, and to prescribe the right dose, the right frequency of dose and the right duration if and when they do.” It’s so simple you wonder why it isn’t already being done.
Action by animal agriculture. This could be toughest to implement, both because of the sheer scale of the problem and because of the defensive reactions that occur whenever the practices of animal agriculture are challenged. But in the WHO’s own words, the sector must act by, “ensuring that antibiotics given to animals…are only used to treat infectious diseases and under veterinary supervision.” They also urge that animals are kept in stress- free and sanitary conditions. This necessitates a rethink of intensive farming altogether.
And finally, there needs to be research into developing new antibiotics. It may not make anyone rich but it just may prevent global catastrophe.
Watch The Feed: What happens when antibiotics stop working and superbugs take over?